[Senate Report 105-58]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 125
105th Congress                                                   Report
                                 SENATE

 1st Session                                                     105-58
_______________________________________________________________________


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

                                _______
                                

                 July 24, 1997.--Ordered to be printed

_______________________________________________________________________


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

                              R E P O R T

                         [To accompany S. 1061]

    The Committee on Appropriations reports the bill (S. 1061) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education and related agencies for the 
fiscal year ending September 30, 1998, and for other purposes, 
reports favorably thereon and recommends that the bill do pass.



                     Amount of budget authority

Total bill as reported to Senate........................$269,050,387,000
Amount of adjusted appropriations, 1997................. 279,398,355,000
Budget estimates, 1998.................................. 268,405,783,000
The bill as reported to the Senate:
    Under the adjusted appropriations for 1997..........  10,347,968,000
    Over the budget estimates for 1998..................     644,604,000


                            C O N T E N T S

                              ----------                              
                                                                   Page
Budget estimates.................................................     4
Title I--Department of Labor:
    Employment and Training Administration.......................     8
    Pension and Welfare Benefits Administration..................    19
    Pension Benefit Guaranty Corporation.........................    20
    Employment Standards Administration..........................    20
    Occupational Safety and Health Administration................    22
    Mine Safety and Health Administration........................    24
    Bureau of Labor Statistics...................................    24
    Departmental management......................................    25
    Assistant Secretary for Veterans' Employment and Training....    26
Title II--Department of Health and Human Services:
    Health Resources and Services Administration.................    28
    Centers for Disease Control and Prevention...................    49
    National Institutes of Health................................    67
    Substance Abuse and Mental Health Services Administration....   115
    Agency for Health Care Policy and Research...................   122
    Health Care Financing Administration.........................   125
    Administration for Children and Families.....................   132
    Administration on Aging......................................   145
    Office of the Secretary......................................   148
Title III--Department of Education:
    Education reform.............................................   159
    Education for the Disadvantaged..............................   162
    Impact aid...................................................   166
    School improvement programs..................................   168
    Bilingual and immigrant education............................   174
    Special education............................................   176
    Rehabilitation services and disability research..............   179
    Special institutions for persons with disabilities:
        American Printing House for the Blind....................   184
        National Technical Institute for the Deaf................   185
        Gallaudet University.....................................   185
    Vocational and adult education...............................   185
    Student financial assistance.................................   188
    Federal family education loan program........................   190
    Higher education.............................................   191
    Howard University............................................   200
    College housing and academic facilities loans................   201
    Historically black college and university capital financing 
      program....................................................   201
    Education research, statistics, and improvement..............   201
    Child literacy initiative....................................   208
    Institute of Museum and Library Services.....................   209
    Departmental management......................................   211
    Office for Civil Rights......................................   212
    Office of the Inspector General..............................   212
Title IV--Related agencies:
    Armed Forces Retirement Home.................................   213
    Corporation for National and Community Service...............   213
    Corporation for Public Broadcasting..........................   215
    Federal Mediation and Conciliation Service...................   215
    Federal Mine Safety and Health Review Commission.............   215
    National Commission on Libraries and Information Science.....   216
    National Council on Disability...............................   216
    National Education Goals Panel...............................   216
    National Labor Relations Board...............................   217
    National Mediation Board.....................................   217
    Occupational Safety and Health Review Commission.............   217
    Physician Payment Review Commission..........................   217
    Prospective Payment Assessment Commission....................   218
    Railroad Retirement Board....................................   218
    U.S. Institute of Peace......................................   219
    Social Security Administration...............................   219
Title V--General provisions......................................   225
Budgetary impact of bill.........................................   226
Compliance with paragraph 7, rule XVI of the standing rules of 
  the Senate.....................................................   226
Compliance with paragraph 7(C), rule XXVI of the standing rules 
  of the Senate..................................................   227
Compliance with paragraph 12, rule XXVI of the standing rules of 
  the Senate.....................................................   228
Comparative statement of new budget authority....................   232

       Summary of Budget Estimates and Committee Recommendations

    For fiscal year 1998, the Committee recommends total budget 
authority of $269,050,387,000 for the Department of Labor, 
Health and Human Services, and Education, and Related Agencies. 
Of this amount, which includes subsequent year advances, 
$79,702,000,000 is current year discretionary funding.

                           allocation ceiling

    Consistent with Congressional Budget Office scorekeeping, 
the recommendations result in full use of the $79,457,000 in 
general purpose discretionary budget authority pursuant to 
section 602(b) of the Congressional Budget Act of 1974, as 
amended. In addition, the recommendations include $245,000,000 
in budget authority for the Social Security Administration to 
conduct continuing disability reviews provided consistent with 
Public Law 104-124 and Public Law 104-193.

                         Highlights of the Bill

    Drug abuse.--A total of $2,698,786,000 is included for drug 
abuse prevention treatment, and research activities, including 
$555,978,000 for safe and drug free schools and communities.
    Crime activities.--The bill recommends $144,000,000 for 
violent crime reduction activities, more than double the 1997 
enacted level; included is $76,800,000 for battered women's 
shelters.
    Juvenile justice.--The Committee bill includes $50,000,000 
for new programs to assist communities in preventing juvenile 
crime. Funds include $25,000,000 for youth offender 
demonstration training grants, $15,000,000 for youth offender 
education grants, and $10,000,000 for at-risk youth substance 
abuse prevention grants.
    Pell grants.--The Committee bill includes $6,910,334,000 
for the Federal Pell Grant Program. The amount provided will 
allow the increase in the maximum Pell grant to be raised to 
$3,000, an increase of $300 over the 1997 amount.
    Education for individuals with disabilities.--The Committee 
bill provides $4,958,073,000 to ensure that all children have 
access to a free appropriate education and that all infants and 
toddlers with disabilities have access to early intervention 
services.
    Rehabilitation services.--The Committee bill provides 
$2,591,286,000 for rehabilitation programs, an increase of 
$81,858,000 above the amount provided in 1997. These funds are 
essential for individuals with disabilities seeking employment.
    Family planning.--The Committee bill recommends 
$208,452,000, for the family planning program, an increase of 
$10,000,000 over last years appropriation. These funds support 
primary health care services at over 4,000 clinics nationwide.
    National Institutes of Health.--The Committee bill includes 
$13,692,844,000 for the National Institutes of Health, an 
increase of $952,001,000 above the amount provided in 1997.
    Grants for disadvantaged children.--The Committee bill 
provides $7,295,732,000 for grants to disadvantaged children, 
$500,000 more than the 1997 level.
    Services for older Americans.--The Committee recommendation 
includes $1,466,314,000 for programs authorized under the Older 
Americans Act, including $478,780,000 for nutrition services 
and $453,000,000 for employment programs.
    Head Start.--The Committee recommendation of $4,305,000,000 
for the Head Start Program represents an increase of 
$324,454,000 over the 1997 enacted level.
    Womens health.--The Committee bill provides $18,500,000 for 
programs focused on prevention and education and the 
advancement of women's health initiatives.
    Breast cancer screening.--The Committee bill provides 
$141,897,000, an increase of $2,238,000 over the 1997 level.
    AIDS.--The Committee bill provides $3,264,000,000 for AIDS 
research prevention and services. The bill also includes 
$1,077,252,000 for Ryan White programs, an increase of $81,000, 
and $646,790,000 for AIDS prevention programs at the Centers 
for Disease Control and Prevention.
    Rape prevention.--The bill provides $45,000,000 for rape 
prevention programs at the Centers for Disease Control and 
Prevention, an increase of $10,000,000 over 1997.
    Low-income home energy assistance.--The Committee 
recommendation includes $1,000,000,000 for heating and cooling 
assistance for this coming year. The Committee has also 
recommended $1,200,000,000 for the fiscal year 1999 advance 
appropriation. Also included is bill language permitting up to 
$300,000,000 in additional funding to meet emergencies.
    Community services block grant.--The Committee bill 
includes $492,600,000 for the community services block grant 
program.
    Child care and development block grant.--The Committee 
recommendation provides $963,120,000 for child care services, 
compared to $953,762,000 in the 1997 appropriation. This is in 
addition to the $2,075,000,000 appropriated in recently enacted 
welfare reform legislation for child care.
    Infectious disease.--The Committee bill recommends 
$112,428,000 within the Centers for Disease Control and 
Prevention to combat the growing threat of infectious disease. 
The amount recommended is an increase of $24,708,000 over the 
fiscal year 1997 amount.
    Older Americans.--For programs serving older Americans, the 
Senate recommendation includes a 9-percent increase totaling 
$3,500,000,000, an increase of $250,000,000 over the 
President's request and $290,000,000 over the fiscal year 1997 
level. Within this amount, $1,500,000,000 is for programs 
authorized under the Older Americans Act, including 
$453,000,000 for Community Service Employment for Older 
Americans, $305,000,000 for supportive services and centers, 
and $479,000,000 for senior nutrition programs. Another 
$1,200,000,000 is for the 1998-99 winter advance appropriation 
for the Low Income Home Energy Assistance Program which assists 
a high proportion of the low-income elderly with winter heating 
bills. An additional $300,000,000 is set aside in an emergency 
fund, for use in weather emergencies. For the medical research 
activities of the National Institute on Aging, the 
recommendation includes $520,000,000, an increase of 7.1 
percent. In addition, funding also is included to continue 
geriatric education centers, the Medicare insurance counseling 
program, and the Alzheimer's demonstration grants program.
    Social Security Administration.--The Committee bill 
recommends $6,417,708,000, an increase of nearly $11,131,000 
over the 1997 level, which expands both the automation and 
disability initiatives at the Social Security Administration.
    Job Corps.--The Committee bill provides $1,246,217,000 for 
the Job Corps, an increase of $92,708,000 over the 1997 level.
    School-to-work.--The bill includes $400,000,000 for school-
to-work programs, an increase of $27,000 over the 1997 level; 
funding is equally divided between the Departments of Labor and 
Education for this jointly administered program.

              reprogramming and initiation of new programs

    Reprogramming is the utilization of funds for purposes 
other than those contemplated at the time of appropriation 
enactment. Reprogramming actions do not represent requests for 
additional funds from the Congress, rather, the reapplication 
of resources already available.
    The Committee has a particular interest in approving 
reprogrammings which, although they may not change either the 
total amount available in an account or, any of the purposes 
for which the appropriation is legally available, represent a 
significant departure from budget plans presented to the 
Committee in an agency's budget justification.
    Consequently, the Committee directs that the Departments 
and agencies funded through this bill make a written request to 
the chairman of the Committee prior to reprogramming of funds 
in excess of 10 percent, or $250,000, whichever is less, 
between programs, activities, or elements. The Committee 
desires to have the requests for reprogramming actions which 
involve less than the above-mentioned amounts if such actions 
would have the effect of changing an agency's funding 
requirements in future years, if programs or projects 
specifically cited in the Committee's reports are affected or 
if the action can be considered to be the initiation of a new 
program.
    The Committee directs that it be notified regarding 
reorganization of offices, programs, or activities prior to the 
planned implementation of such reorganizations.
    The Committee further directs that each agency under its 
jurisdiction submit to the Committee statements on the effect 
of this appropriation act within 60 days of final enactment of 
this act.

                           transfer authority

    The Committee has included bill language permitting 
transfers up to 1 percent between discretionary appropriations 
accounts, as long as no such appropriation is increased by more 
than 3 percent by such transfer; however, the Appropriations 
Committees of both Houses of Congress must be notified at least 
15 days in advance of any transfer. Similar bill language was 
carried in last year's bill for the Department of Labor, and 
has been included in both House and Senate versions of this 
year's Labor-HHS-Education bill for all three Departments.
    Prior Committee notification is also required for actions 
requiring the use of general transfer authority unless 
otherwise provided for in this act. Such transfers specifically 
include taps, or other assessments made between agencies, or 
between offices within agencies. Funds have been appropriated 
for each office funded by this Committee; it is not the 
intention of this Committee to augment those funding levels 
through the use of special assessments. This directive does not 
apply to working capital funds or other fee-for-service 
activities.

                 government performance and results act

    The Government Performance and Results Act of 1993, 
commonly called GPRA, was enacted to improve management of 
Federal agencies by requiring an emphasis on planning and 
results. According to the requirements of GPRA, draft strategic 
plans must be submitted to the Office of Management and Budget 
by August 15, 1997, and final strategic plans are to be 
presented to Congress by September 30, 1997. As the strategic 
plans are developed, agencies are required to consult with 
Congress and other stakeholders on their draft strategic plans 
and incorporate suggestions or concerns in the plan submitted 
to OMB.
    The Committee is encouraged that Federal agencies are 
making an effort to fulfill the requirements of GPRA. The 
agencies within the jurisdiction of the Subcommittee on Labor, 
Health and Human Services, and Education, and Related Agencies 
have been in consultation with the subcommittee on their draft 
plans, and we encourage that process to continue. The 
subcommittee is fully committed to support these agencies as 
they seek to implement the requirements of GPRA. The resulting 
strategic plans and the goals outlined therein, should serve as 
important tools in the review of future funding requests.

                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

Appropriations, 1997....................................  $4,715,903,000
Budget estimate, 1998...................................   5,295,318,000
Committee recommendation................................   5,260,053,000

    The Committee recommends $5,260,053,000 for this account 
which provides funding authorized primarily by the Job Training 
Partnership Act [JTPA]. This is $544,150,000 more than the 1997 
level.
    Training and employment services is comprised of programs 
designed to 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.
    Adult training--title II-A.--For the Adult Training Program 
under title II-A of the JTPA, the Committee recommends 
$955,000,000. This is $60,000 more than the 1997 comparable 
level. The Adult Training Program is designed to prepare 
economically disadvantaged 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 Governor. 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.
    To promote greater flexibility in local decisionmaking, the 
Committee has once again included bill language that allows 
service delivery areas to transfer funds provided between the 
title II-A Adult Training Program and title III Dislocated 
Worker Assistance Program, if such transfer is approved by the 
Governor. The Committee is aware of concerns that work 
participation requirements under welfare reform could foster 
such transfers to the detriment of services available to 
dislocated workers. The Committee is also aware of concerns 
that national reserve account funds may be used to provide 
services that could have been provided with funds that had been 
transferred from title III to II-A. Because of these concerns, 
the Committee has chosen to limit the transfer authority to 20 
percent and will closely monitor its implementation to 
determine whether further transfer authority is warranted in 
fiscal year 1999.
    Youth training--title II-C.--For the Youth Training Program 
under title II-C of the act, the Committee recommends 
$129,965,000. This is the same as the budget request and 
$3,293,000 over the 1997 comparable level. The title II-C Youth 
Training Program is designed for youth to improve their long-
term employability, enhance their educational, occupational, 
and citizenship skills, encourage their school completion, 
increase their employment and earnings, and reduce welfare 
dependency. Like adult training, the program is administered by 
local service delivery areas, as directed by private industry 
councils.
    Summer youth employment and training--title II-B.--For the 
Summer Youth Program under title II-B of the act, the Committee 
recommends $871,000,000. This is the same as the budget request 
and the 1997 comparable level. The Summer Youth Program offers 
work experience, supportive services, and academic enrichment 
to economically disadvantaged youth, aged 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.
    To promote greater flexibility in local decisionmaking, the 
Committee has included bill language that allows service 
delivery areas to transfer funds between the title II-C year-
round youth program and the title II-B summer program, if such 
transfer is approved by the Governor.
    Dislocated worker assistance.--The Committee recommends 
$1,350,510,000 for dislocated worker programs. This is the same 
as the budget request and $64,310,000 over the 1997 comparable 
level. The title III system provides for early identification 
of dislocated workers, the rapid provision of services to such 
workers, and quality 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 is aware of the severe dislocation brought on 
by the closure of one of the three sugarcane plantations on the 
Hawaiian island of Kauai, and the likely closure of a second 
plantation. To provide assistance to this rural community, the 
Committee encourages the Secretary to support from 
discretionary funds, a proposal from the Kauai Cooperative 
Extension Service to use community-based expertise to provide 
agricultural and business training to dislocated sugarcane 
workers.
    The Committee includes language in the bill which continues 
flexibility in three areas. First, the language removes the 
cost limitations that States utilize not more than 25 percent 
of funds on needs-related payments and supportive services. It 
does not remove the 15-percent administrative cost limit. 
Second, the language modifies the State waiver authority which 
permits the Governor to reduce to 30 percent the requirement 
that not less than 50 percent of the funds be used for 
retraining services. This language will enable local areas to 
determine the appropriate share of resources for upfront, cost-
effective readjustment services that can facilitate rapid 
reemployment. Third, the language allows funds awarded under 
the National Discretionary Grant Program to be used to provide 
needs-related payments to participants who, in lieu of meeting 
the general EDWAA requirement that they be enrolled in training 
by the 13th week after layoff, have enrolled in training by the 
6th week after the grant is awarded. This provision adds 
appropriate flexibility while preserving the principle that 
retraining is most effective if individuals are enrolled in 
training early in the adjustment process. These provisions are 
effective for 1 year only.
    The Dislocated Workers Program is invaluable in assisting 
civilian and military personnel dislocated by post-cold-war 
military downsizing. Amendments to the JTPA authorize the use 
of title III moneys to continue to provide assistance to 
Americans displaced as a result of the country's changing 
military needs. The Committee urges the Department to continue 
to work with the Department of Defense and with States to 
develop appropriate plans for assisting workers being 
dislocated as a result of base closures.
    The Committee has also included $1,000,000 to provide for a 
manufacturing technology training demonstration project in 
Mississippi which will educate technically competent new 
entrants into the work force and retrain the existing work 
force to adapt to technological innovation. The project is 
intended to improve the skills of the east Mississippi region's 
workers and build a technically competent work force better 
prepared to compete in the global economy.
    The Committee is concerned that the Department may not be 
taking advantage of cost-effective services for job search 
assistance offered by the private outplacement sector. 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 II program. The Committee continues 
to be concerned that public funding of outplacement and job 
search assistance is displacing traditional funding sources 
from the private sector and that the public work force system 
is 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 work force system and private outplacement firms in 
25 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.
    Native Americans.--For native American programs, the bill 
provides $55,127,000. This is $2,625,000 above the budget 
request and the same as the 1997 comparable 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.
    Migrant and seasonal farmworkers.--For migrant and seasonal 
farmworker programs, the bill provides $72,749,000. This is 
$3,464,000 above the budget request and the same as the 1997 
comparable level. This program is aimed at alleviating chronic 
unemployment and underemployment being experienced by 
farmworker families. Training and employability development 
services prepare farmworkers for stable, year-round employment, 
both in and outside the agricultural industry. Supportive 
services such as transportation, housing, health care, and day 
care are also provided.
    The Committee believes that the Association of Farmworker 
Opportunity Programs [AFOP] provides valuable assistance to 
section 402 grantees in the form of technical assistance and 
training, training resource materials for grantee staff, and 
the development of a national farmworker data base to track 
program services of migrants who travel throughout the United 
States. The Committee has provided sufficient funds to maintain 
AFOP's support in fiscal year 1998.
    The Committee again reminds the Department that applicants 
for funding under the JTPA section 402 program must demonstrate 
a prior existing capacity to specifically serve the employment 
and training needs of migrant and seasonal farmworkers, and 
further reminds the Department of applicable provisions of the 
current law that states that the Secretary shall provide 
services to farmworkers through public agencies and private 
nonprofit organizations with a previously demonstrated 
capability to administer effectively a diversified 
employability development program for migrant and seasonal 
farmworkers.
    The Committee recommends the continuation of the Department 
of Labor Farmworker Housing Program at no less than the rate in 
effect in fiscal year 1997.
    Job Corps.--For the Job Corps, the Committee recommends 
$1,246,217,000 for program year 1998. This is the same as the 
budget request and an increase of $92,708,000 above the 1997 
comparable level. The amount in the bill includes 
$1,127,726,000 for operations to support 118 centers, including 
4 new centers scheduled to open during fiscal year 1997. The 
amount in the bill also includes $118,491,000 for facility 
construction, rehabilitation, and maintenance at existing 
centers.
    The Committee is aware of interest in the establishment of 
centers in two States without Job Corps campuses, Rhode Island 
and Delaware. The Committee requests that the Secretary 
consider including funding in the Department's budget request 
for fiscal year 1999 to ensure that at-risk youth in these 
States are being adequately served. The Department is 
encouraged to explore both low-cost options such as satellite 
centers, as well as the establishment of new centers.
    In order to help single parents enroll and succeed in Job 
Corps, the Committee urges the Department to pursue linkages 
and collaborative interagency agreements with the appropriate 
agencies with the Department of Health and Human Services, 
including Head Start. Through colocated child care services for 
Job Corps students and their children on Job Corps campuses, 
Job Corps can better serve single parents and agencies, such as 
Head Start, can reach a greater number of needy children.
    The Committee encourages Job Corps to establish effective 
working relationships with work force development entities, 
including employers, that will enhance services to students and 
increase students' career opportunities. The Department is 
encouraged to intensify its efforts to meet industry standards 
in its occupational offerings by developing a multiyear 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 
also encourages the Department of Labor's Employment and 
Training Administration to encourage Job Corps centers to 
coordinate with community-based organizations, such as 
substance abuse treatment centers, in innovative ways.
    The Committee also directs the Department 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.
    Veterans employment.--The Committee recommends $7,300,000 
for special veterans employment programs. This is the same as 
the budget request and the 1997 comparable level. These funds 
provide special employment and training programs designed to 
meet the unique needs of disabled, Vietnam-era, and recently 
separated veterans.
    School-to-work.--The Committee recommends $200,000,000 for 
school-to-work. This is the same as the budget request and the 
same as the 1997 comparable level. The school-to-work program 
is intended 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.
    The Committee is aware of school-to-work initiatives that 
expose students to career opportunities in the retail 
industries, while strengthening the behaviors and academic 
accomplishments of participating students through the 
integration of business and educational needs. The Committee 
supports ongoing efforts of the School-to-Work Office to 
competitively fund proposals to enhance linkages with employer 
associations that have developed model school-to-work programs. 
The Committee has included funds so that consideration can be 
given to the multi-State implementation of models such as the 
New Mexico Retail Association's Program, youth opportunities in 
retailing.
    National activities.--For national activities $369,685,000 
is provided. This is $67,636,000 more than the budget request 
and $315,250,000 above the 1997 comparable level. The bill 
includes funding for research and evaluation, $8,196,000; 
pilots and demonstrations, $83,000,000; labor market 
information, $5,489,000; the National Occupational Information 
Coordinating Committee, $8,000,000; skill standards, 
$9,000,000; women in apprenticeship, $3,000,000; and homeless 
veterans, $2,500,000.
    For homeless veterans, $2,500,000, is provided for the 
homeless veterans reintegration project, to be administered by 
the Assistant Secretary for Veterans Employment and Training 
Services. The Stewart B. McKinney Homeless Assistance Act 
authorization for this program was extended by the Veterans 
Benefits Improvement Act of 1996. It is anticipated that these 
funds will be awarded through a competitive grant process.
    The amount of $8,000,000 is provided to cover basic NOICC 
and SOICC activities including the development and delivery of 
occupational and career information to students, job seekers, 
employers, education and employment, and training programs 
(especially one-stop centers), school-to-work transition 
systems, military transition and staffing initiatives, and 
welfare to work efforts. At least 75 percent of this amount 
will pass through to State SOICC's. Of the total, $2,000,000 
will support continuation of national and State career 
development and related capacity building programs which train 
personnel in assisting students and adults to understand 
themselves in the context of their career development and 
career transition, to be aware of the world of work, to 
understand the linkage between academic skills and work-related 
skills, to understand the linkages among related occupations 
and their skill requirements, and to make more informed, 
effective career decisions. In addition, the Committee included 
language which allows NOICC to charge fees for publications, 
training and technical assistance.
    Under pilots and demonstrations, the Committee has provided 
$3,000,000 for the Samoan/Asian Pacific Island job training 
program in the State of Hawaii.
    In light of rapid growth in the plastics manufacturing and 
special tooling industries, the Vermont Department of 
Employment and Training is developing a skills training center 
to ensure that job training programs are able to meet these 
industries' demand for highly skilled workers. Under pilots and 
demonstrations, the Committee has provided $200,000 to aid in 
the development of a high skills training consortia and a pilot 
project to begin training in the targeted areas.
    The Committee has included $250,000,000 in advance 
appropriations for fiscal year 1999 funds for youth opportunity 
area projects, which is contingent upon passage of job training 
reform legislation that includes authority for these or similar 
at-risk youth projects by April 1, 1998.
    However, recognizing the severe problems facing out-of-
school youth in communities with high poverty and unemployment 
and the interrelatedness of poverty, juvenile crime, child 
abuse and neglect, school failure, and teen pregnancy, the 
Committee has provided a $50,000,000 increase in pilots in 
demonstrations, which consists of two components: $25,000,000 
in fiscal year 1998 funds for the youth opportunity area pilot 
to expand the current six site pilot projects; and $25,000,000 
for concentrated programs serving youth who are or have been 
under criminal justice system supervision.
    Because of the concentration of youth offenders and youth 
gangs in high-poverty areas and the importance of linking youth 
crime prevention programs to community-wide youth development 
programs, current Labor Department grantees involved in 
community-wide demonstrations should be encouraged to compete 
for the youth offender grants being supported here. High-
poverty communities tend to have high rates of illegal drug use 
and trafficking, much youth gang activity, and high school 
dropouts have particularly high rates of incarceration. Under 
this competition, local communities will be encouraged to test 
approaches that strengthen the coordination of prevention and 
recovery services for juveniles and exhibit a high degree of 
resource integration and result in reduced youth gang and 
juvenile criminal activity. Among the programs that communities 
will be encouraged to link are Job Training Partnership Act 
year-round youth training and summer jobs for at-risk youth, 
youth fair chance, the new opportunity areas for out-of-school 
youth, School-to-Work Program, and other Federal programs that 
could contribute to juvenile crime prevention such as 
vocational-technical education, and YouthBuild.
    The youth opportunity areas pilot is critical to provide 
venture capital to high poverty urban neighborhoods and rural 
areas to help them increase employment among out-of-school 
young people to a level of 80 percent as an alternative to 
welfare and crime. It provides an important jobs and skill 
development component to the economic development activities of 
empowerment zone and enterprise communities, and administers 
funds through the same local work force development system that 
will be used to administer other Federal job training and 
employment resources. The current youth opportunity pilot sites 
were funded in both fiscal year 1996 and fiscal year 1997 and 
are testing key features of the approach. These projects 
leverage other resources within the community to eventually 
sustain these services directed to out-of-school youth.
    The Committee's recommended expansion of the pilot will 
provide additional communities with the opportunity to improve 
the employment prospects of out-of-school youth.
    The Committee is aware of efforts of Lehigh University's 
Iacocca Institute, in conjunction with the National Coalition 
for Advanced Technology Centers, to create work force 
development education curricula specifically focused on the 
Nation's manufacturing sector. The Committee believes that the 
Department needs to undertake more aggressive efforts to foster 
initiatives between centers of excellence and U.S. 
manufacturers to promote work force training so as to bolster 
worker productivity, and in turn, help improve U.S. global 
competitiveness and lower the Nation's manufactured goods trade 
deficit. Therefore, the Committee encourages the Department to 
expedite consideration of the Iacocca Institute's request for 
funds from the fiscal year 1997 appropriations. Further, the 
Committee encourages full and fair consideration of a proposal 
from this organization for use in continuing its work force 
development pilot project for a second year.
    The Committee is aware of the efforts of the Eisenhower 
Foundation in replicating the south Bronx Argus community 
education, job training, job placement, and job retention 
program. The Committee is aware that the Foundation proposes to 
expand the replications of Argus to employ welfare recipients 
in high-tech industries, such as installation and repair of 
telephones, computers, and television. The Committee urges full 
and fair consideration of a proposal from this organization.
    The Committee recommends continued funding for a special 
native Hawaiian vocational education demonstration initiative 
that provides basic education skills and preemployment tutoring 
for high-risk youth residing in rural communities, with an 
emphasis on vocations that benefit these communities, such as 
child care workers and teachers.
    The Committee has recognized in the past that, due to the 
geographical isolation associated with rural communities in the 
State of Alaska and on the Hawaiian Island of Lanai, 
disadvantaged populations residing in these areas generally 
lack access to skill training programs, education 
opportunities, and other self-development initiatives. The 
Committee also recognizes that limited access to human 
development services has contributed to the increase in 
negative health and social indicators, such as high rates of 
poverty, unemployment, school dropouts, teen pregnancy, 
substance abuse, and mental illness.
    Expanding on the direction proscribed in previous years, 
the Committee urges that $5,000,000 be provided in Job Training 
Partnership Act [JTPA] pilot and demonstration funds to support 
training, education, employment, and entrepreneurial 
opportunities to improve the economic and social health and 
welfare for adults on the neighbor islands of Hawaii, and in 
Alaska. The Committee urges that community colleges be the 
focal point of these programs. In the case of the neighbor 
islands of Hawaii, the Committee urges the development of one 
program per island.
    In many rural areas and low-income urban neighborhoods, 
there is a lack of employment opportunities. So, low-income 
people often must travel long distances to get to centers of 
employment and lack of transportation is often a major 
obstacle. For fiscal year 1998, the Committee urges continued 
funding for the JOBLINKS demonstration. This demonstration 
program assists local communities in coordinating training and 
employment, social services and transportation services to 
improve job opportunities for individuals moving from welfare 
to work.
    The Committee has again included language to authorize the 
Secretary of Labor to waive requirements (with limited 
exceptions) of the Job Training Partnership Act and the Wagner-
Peyser Act to facilitate the implementation of State plans for 
improving work force development systems. This language allows 
the Secretary to waive requirements of JTPA and Wagner-Peyser 
that are determined to impede these efforts. In exchange for 
the greater flexibility provided by such waivers, the language 
requires that the State execute a memorandum of understanding 
with the Secretary of Labor identifying the outcomes the State 
intends to achieve and other measures that will ensure 
appropriate accountability for the use of Federal funds.
    In addition, the Committee has retained language included 
in the fiscal year 1997 bill for the ``Training and employment 
services'' account which authorizes the Secretary to establish 
a work-flex partnership demonstration program with six States. 
This language does not authorize an additional six States, but 
merely continues the authorization for the six States 
authorized in the fiscal year 1997 bill.
    The Committee understands that the welfare-to-work jobs 
initiative--which is intended to provide $750,000,000 in 
mandatory spending in fiscal year 1998--is currently in 
conference on the reconciliation bill. If necessary, the 
Committee intends to provide the authorized funding for this 
program in the Senate/House conference, and address the issue 
of increased costs associated with the administration of this 
initiative, once the reconciliation bill has been enacted.

            community service employment for older americans

Appropriations, 1997....................................    $463,000,000
Budget estimate, 1998...................................     440,200,000
Committee recommendation................................     453,000,000

    The Committee recommends $453,000,000, an increase of 
$12,800,000 above the budget request for community service 
employment for older Americans. The Committee recommends 78 
percent of the funds for national sponsors and 22 percent is 
for State sponsors; this is the same percentage distribution as 
current law. This program, authorized by title V of the Older 
Americans Act, provides part-time employment in community 
service activities for unemployed, low-income persons aged 55 
and over. It is forward-funded from July to June, and the 1998 
appropriation will support the effort from July 1, 1998, 
through June 30, 1999. These funds are to be distributed in the 
same manner as currently authorized under the Older Americans 
Act, unless this law is subsequently altered. The Committee 
would expect the administration of this program would remain at 
the Department of Labor, unless subsequent authorizing 
legislation is enacted which transfers the program to the 
Department of Health and Human Services.
    The Committee is concerned about the impact of welfare 
reform on indigent elderly legal immigrants who face the loss 
of Supplemental Security Income [SSI]. Current law states that 
title V funds should be targeted to eligible individuals with 
the greatest economic need. The Committee believes that within 
the title V community service employment for older Americans, 
special attention should be paid to providing community service 
jobs for elderly legal immigrants where possible.

              federal unemployment benefits and allowances

Appropriations, 1997....................................    $324,500,000
Budget estimate, 1998...................................     349,000,000
Committee recommendation................................     349,000,000

    The Committee recommends $349,000,000, the same as the 
budget request and an increase of $24,500,000 above the 1997 
enacted level for Federal unemployment benefits and allowances. 
These are entitlement funds.
    The trade adjustment line item has two activities totaling 
$304,700,000 in fiscal year 1998.
    The first activity, trade adjustment assistance benefits, 
provides for special unemployment benefit payments to workers 
as authorized by the Trade Act of 1974, as amended. For this 
activity the Committee recommends $208,000,000. This is the 
same as the budget request and an increase of $17,000,000 above 
the 1997 comparable level. These funds will permit payment of 
benefits, averaging $217 per week, to 35,700 workers for 1998. 
Of these workers, 26,800 will participate in training programs, 
receiving benefits for an average of 30 weeks. The remaining 
8,900 workers receiving benefits will receive training waivers 
and collect benefits for an average of 18 weeks.
    The second activity, trade adjustment assistance training, 
provides 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. The Committee recommends $96,700,000 for this 
activity. This is the same as the budget request and an 
increase of $11,800,000 over the 1997 comparable level. These 
funds will provide services for an estimated 30,500 workers.
    For NAFTA activities, $44,300,000 is provided, in two 
components.
    The first component, NAFTA transitional adjustment 
assistance benefits, provides for weekly benefit payments to 
workers affected by imports from Mexico and Canada. These 
payments 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 Committee recommends $22,000,000 
for this activity. This is the same as the budget request and 
an increase of $2,000,000 over the 1997 comparable 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 second component, 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 Committee recommends $22,300,000 for 
this activity. This is the same as the budget request and a 
reduction of $6,100,000 below the 1997 comparable level. These 
funds will provide training for an estimated 5,100 workers.

     state unemployment insurance and employment service operations

Appropriations, 1997....................................  $3,315,928,000
Budget estimate, 1998...................................   3,604,928,000
Committee recommendation................................   3,465,928,000

    The Committee recommends $3,465,928,000 for this account. 
This is $139,000,000 below the budget request and an increase 
of $150,000,000 over the 1997 comparable level. Included in the 
total availability is $3,292,476,000 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.
    Of this amount, $150,000,000 is included solely for the 
purpose of assisting States to convert their automated State 
employment security agency systems to be year 2000 compliant. 
Failure to convert employment security computer programs, such 
as benefit and tax systems, will result in disorder and 
numerous errors causing overpayment of benefits and under-
collection of taxes. State agencies will finance the remaining 
costs of conversion with their own funds.
    For unemployment insurance [UI] services, the bill provides 
$2,491,458,000. This total includes a regular contingency 
amount of $216,333,000 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 unemployment insurance service recommendation provides 
an increase of $150,000,000 over the fiscal year 1997 level. 
The allowance includes $2,115,125,000 for State operations, a 
decrease of $89,000,000 and the same as the 1997 comparable 
level. In addition, the allowance includes $10,000,000 for the 
national activities, the same as the budget request and 1997 
comparable level.
    For the employment service, the Committee recommends 
$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 
budget request and the 1997 comparable level.
    Included in the recommendation 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 1997 comparable level. Also 
included is $62,735,000 for national activities, the same as 
the budget request and the 1997 comparable level. Further, the 
recommendation includes $150,000,000 for one-stop career 
centers, which is the same as the budget request and the 1997 
comparable level.
    The Committee did not provide the $89,000,000 increase 
requested for UI integrity activities.
    The Committee agrees that the work opportunity tax credit 
[WOTC], established by the Small Business Job Protection Act, 
provides important resources to create new jobs, particularly 
for those Americans who would otherwise be dependent on 
welfare. Therefore, the Committee recommendation includes 
$20,000,000 for this initiative, the same as the request and 
fiscal 1997 enacted level.
    The Committee recommendation for employment service 
national activities, excluding the work opportunity tax credit 
program, is $42,735,000, the same as the request and the fiscal 
1997 enacted level.

        advances to the unemployment trust fund and other funds

Appropriations, 1997....................................    $373,000,000
Budget estimate, 1998...................................     392,000,000
Committee recommendation................................     392,000,000

    The Committee recommends $392,000,000 the same as the 
budget request and an increase of $19,000,000 over the 1997 
comparable level, for this account. 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 now 
repayable with interest to the general fund of the Treasury.

                           program operations

Appropriations, 1997....................................    $124,350,000
Budget estimate, 1998...................................     129,643,000
Committee recommendation................................     125,593,000

    The Committee recommendation includes $84,308,000 in 
general funds for this account, as well as authority to expend 
$41,285,000 from the ``Employment Security Administration'' 
account of the unemployment trust fund, for a total of 
$125,593,000. This is $4,050,000 less than the budget request 
and $1,243,000 more than the 1997 comparable level.
    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, as amended. Federal staff 
costs related to the Wagner-Peyser Act in this account are 
split 97 percent to 3 percent between unemployment trust funds 
and general revenue, respectively.

              Pension and Welfare Benefits Administration

                         SALARIES AND EXPENSES

Appropriations, 1997....................................     $76,840,000
Budget estimate, 1998...................................      84,307,000
Committee recommendation................................      82,000,000

    The Committee recommendation provides $82,000,000 for this 
account, which is $2,307,000 less than the budget request, and 
an increase of $5,160,000 over the 1997 comparable 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. PWBA is also responsible for enforcement of 
sections 8477 and 8478 of the Federal Employees' Retirement 
Security Act of 1986 [FERSA]. PWBA provides funding for the 
enforcement and compliance; policy, regulation, and public 
services; and program oversight activities.
    The Committee recommendation includes second year costs in 
support of the administration's $9,000,000 2-year request for 
the development of a new system devoted to processing form 5500 
series financial data required under the Employee Retirement 
Income Security Act. When completed, this project will enable 
employees to submit annual benefit plan reports electronically, 
reducing the cost, paperwork burden, and enhancing protection 
of pension funds. This new system is expected to result in 
savings of $57,000,000. The new system will be developed and 
managed by the Department of Labor. The Committee intends for 
the Internal Revenue Service and the Department of Labor to 
continue to share the ongoing operating costs of the system in 
the same manner as under the current system.

                  Pension Benefit Guaranty Corporation

    The Corporation's estimate for fiscal year 1998 includes 
benefit payments of $982,140,000, multiemployer financial 
assistance of $5,960,000, administrative expenses limitation of 
$10,433,000, and services related to terminations expenses of 
$137,376,000.
    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 Chair 
of its Board of Directors. The Corporation receives its income 
primarily 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 $200,000,000 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.

                  Employment Standards Administration

                         SALARIES AND EXPENSES

Appropriations, 1997....................................    $290,384,000
Budget estimate, 1998...................................     314,203,000
Committee recommendation................................     300,653,000

    The Committee recommendation includes $300,653,000 for this 
account. This is $13,550,000 less than the budget request and 
an increase of $10,269,000 above the 1997 comparable level. The 
bill contains authority to expend $993,000 from the special 
fund established by the Longshore and Harbor Workers' 
Compensation Act; the remainder are general funds. 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 more than the 1997 comparable level.

                            SPECIAL BENEFITS

Appropriations, 1997....................................    $213,000,000
Budget estimate, 1998...................................     201,000,000
Committee recommendation................................     201,000,000

    The Committee recommends continuation of appropriation 
language to provide authority to require disclosure of Social 
Security account numbers by individuals filing claims under the 
Federal Employees' Compensation Act or the Longshore and Harbor 
Workers' Compensation Act and its extensions.
    The bill includes $201,000,000, the same as the budget 
request and a decrease of $12,000,000 below the 1997 comparable 
level. This appropriation primarily provides benefits under the 
Federal Employees' Compensation Act [FECA]. The payments are 
prescribed by law.
    The total amount to be available in fiscal year 1998, 
including anticipated reimbursements from Federal agencies of 
$1,857,000,000 is $1,991,000,000, a decrease of $4,000,000 
below the 1997 comparable level.
    The Committee recommends continuation of 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 3 years of 
employment not to exceed 75 percent of salary in the worker's 
first year, declining thereafter. Costs will be charged to the 
FECA fund.
    The Committee again includes appropriation language that 
retains the drawdown date of August 15. The drawdown authority 
enables the agency to meet any immediate shortage of funds 
without requesting supplemental appropriations. The August 15 
drawdown date allows maximum flexibility for continuation of 
benefit payments without interruption.
    The Committee recommends continuation of appropriation 
language to provide authority to deposit into the special 
benefits account of the employees' compensation fund 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 recommends 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 computer system's hardware and 
software.
    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).

                    black lung disability trust fUND

Appropriations, 1997....................................  $1,007,982,000
Budget estimate, 1998...................................   1,007,000,000
Committee recommendation................................   1,007,000,000

    The bill includes authority to obligate $1,007,000,000 from 
the black lung disability trust fund in fiscal year 1998. This 
is an decrease of $982,000 below the 1997 comparable level.
    The total amount available for fiscal year 1998 will 
provide $466,650,000 for benefit payments, and $45,698,000 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. 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 $45,674,000 and 
$356,000.
    The Committee reiterates its directive to prevent the 
closing of and to ensure the staffing of black lung field 
offices.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
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. 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

Appropriations, 1997....................................    $324,955,000
Budget estimate, 1998...................................     347,805,000
Committee recommendation................................     336,205,000

    The Committee recommendation includes $336,205,000 for this 
account. This is $11,600,000 less than the budget request and 
an increase of $11,250,000 above the 1997 comparable level. 
This agency is responsible for enforcing the Occupational 
Safety and Health Act of 1970 in the Nation's workplaces.
    In addition, the Committee has included language to allow 
OSHA to retain up to $750,000 per fiscal year of training 
institute course tuition fees to be utilized for occupational 
safety and health training and education grants in the private 
sector.
    The Committee retains language carried in last year's bill 
effectively exempting farms employing 10 or fewer people from 
the provisions of the act except those farms having a temporary 
labor camp. The Committee also retains language exempting small 
firms in industry classifications having a lost workday injury 
rate less than the national average from general schedule 
safety inspections. These provisions have been in the bill for 
many years.
    The Committee is very pleased with OSHA's efforts in 
placing high priority on the voluntary protection programs 
[VPP] and other voluntary cooperative programs. The agency's 
work in reducing the VPP application backlog and its commitment 
to eliminate this backlog is particularly noteworthy. The 
Committee expects OSHA to continue to place high priority on 
the VPP, assuring prompt review and processing of VPP 
applications from interested employers and employees. 
Cooperative voluntary programs, especially the VPP, are an 
important part of OSHA's ability to assure worker safety and 
health and should be administered in conjunction with an 
effective strong enforcement program.
    In addition, the Committee is aware of two serious problems 
which OSHA needs to address in the areas of lead abatement and 
asbestos abatement that can lead to worker and community 
contamination: (1) There is a lack of emphasis on the use of 
reusable work clothes as the best alternative for protecting 
workers engaged in this type of work, especially in abrasive 
blasting, and (2) where reusable work clothes are utilized, 
there is a lack of adequate safeguards to assure that such 
clothes are laundered only in facilities operated in 
conformance with standards for such laundering, potentially 
endangering workers engaged in such laundering.
    The Committee also intends that the Office of Regulatory 
Analysis continue to be funded as nearly as possible at its 
present level.
    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 assist the employers' 
ability to meet the standard's requirements with methods that 
are well suited to their particular workplaces and capable of 
affording employers 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 not to enforce the 
methylene chloride 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 onsite 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 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.
    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.

                 Mine Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 1997....................................    $197,187,000
Budget estimate, 1998...................................     205,804,000
Committee recommendation................................     205,804,000

    The Committee recommendation includes $205,804,000 for this 
account. This is the same as the budget request and $8,617,000 
more than the 1997 comparable level. This agency is responsible 
for enforcing the Federal Mine Safety and Health Act in our 
Nation's underground and surface mines.
    This agency insures the safety and health of the Nation's 
miners by conducting inspections and special investigations of 
mine operations, promulgating mandatory safety and health 
standards, cooperating with the States in developing effective 
State programs, and improving training in conjunction with 
States and the mining industry.
    The Committee is satisfied with MSHA's justification of the 
consolidation of its technical support functions, and the 
General Accounting Office's [GAO] review of that decision. 
Specifically, the GAO concluded that: ``The revision to MSHA's 
relocation plan that maintains gas analysis equipment and staff 
in Denver adequately addresses the concern about MSHA's ability 
to protect the safety and health of miners in the West by 
responding to time-critical events promptly.'' GAO's report 
also states that: ``* * * we have little or no basis to believe 
that the revised relocation plan will have a significant 
adverse effect on MSHA's ability to protect the health and 
safety of western miners.'' Consequently, the Committee sees no 
reason for any further study or delay, and expects the 
Department of Labor to adhere to its consolidation schedule, 
which anticipates that consolidation will be complete by 
September 30, 1997.
    The Committee retains bill language 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

Appropriations, 1997....................................    $360,822,000
Budget estimate, 1998...................................     379,457,000
Committee recommendation................................     372,671,000

    The Committee includes $372,671,000 for this account, which 
is $6,786,000 less than the budget request and $11,849,000 more 
than the 1997 comparable level. This includes $52,574,000 from 
the ``Employment Security Administration'' account of the 
unemployment trust fund, and $320,097,000 in Federal funds. The 
Bureau of Labor Statistics is the principal fact finding agency 
in the Federal Government in the broad field of labor 
economics.
    The Committee has included $15,430,000 for the Consumer 
Price Index revision; this effort should remain the highest 
priority for the Bureau.

                        Departmental Management

                         SALARIES AND EXPENSES

Appropriations, 1997....................................    $145,119,000
Budget estimate, 1998...................................     152,678,000
Committee recommendation................................     152,413,000

    The Committee recommendation includes $152,413,000 for this 
account, which is $265,000 less than the budget request and 
$7,294,000 above the 1997 comparable level. This consists of 
$152,131,000 in general funds and 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.
    The primary goal of the Department of Labor is to protect 
and promote the interests of American workers. The departmental 
management appropriation finances staff responsible for 
formulating and overseeing the implementation of departmental 
policy and management activities in support of that goal. 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 Committee intends that the Women's Bureau maintain 
support at the fiscal year 1997 level for technical assistance 
and training on displaced homemaker programming through 
effective programs such as the Women Work Program. This 
assistance is critical as State and local agencies develop and 
implement new models for work force development and welfare 
reform. The Committee has not agreed to the requested reduction 
in the Women's Bureau budget, instead recommending the fiscal 
year 1997 level of $7,743,000.
    The Committee has expressed its concern in recent years 
about the exploitation of child labor around the world. The 
Committee's concern has been mirrored in a number of other 
international initiatives, and as a result, the fight to reduce 
child exploitation has been placed onto the global agenda. In a 
report released in 1996, the International Labor Organization 
estimates the total number of child workers between the ages of 
5 and 14 to be 250 million worldwide--some 120 million working 
full time.
    The Committee notes the positive work being done by the 
ILO's International Programme for the Elimination of Child 
Labor [IPEC], including funds made available to the Secretary 
of Labor by this Committee. The Committee has provided an 
additional $1,500,000 from within funds for the Bureau of 
International Labor Affairs, to continue work on international 
child labor issues and funding for the IPEC program.
    In the Committee's view, it is now appropriate to ask the 
Bureau of International Labor Affairs to study how the growing 
international public concern about child exploitation has been 
translated into specific actions in the countries where child 
labor has been identified as a significant problem. This review 
should examine the policies and initiatives by the relevant 
foreign governments to reduce the exploitation of child labor, 
and the results of such efforts. The review should include 
domestic efforts to strengthen law enforcement against the 
exploitation of children, additional investments in child 
education, changes in domestic child labor laws, effective 
partnerships with nongovernmental actors, and the position of 
such governments on international initiatives to fight the 
exploitation of child labor. The report should be completed and 
submitted to the Committee by July 15, 1998.
    In addition, the Committee is concerned by the large and 
growing problem of abusive treatment of workers around the 
world who produce apparel for export to the United States and 
the impact of that treatment on companies and workers in the 
United States. In an effort to obtain more detailed and 
accurate information, the Committee urges the Department to 
establish a methodology and format for reporting regularly on 
the use of sweatshops in the production of apparel for import 
into the United States. Because the Department's reporting 
capabilities are currently limited to violations by domestic 
producers only, the misleading impression that violations of 
law and substandard conditions in the industry are far more 
extensive within the United States than elsewhere is given. 
Development of new reporting methods should help to correct the 
existing imbalance in the Department's current reporting on 
this subject.
    The Committee retains bill language intended to ensure that 
decisions on appeals of Longshore and Harborworker Compensation 
Act claims are reached in a timely manner.

        Assistant Secretary for Veterans Employment and Training

Appropriations, 1997....................................    $181,851,000
Budget estimate, 1998...................................     181,955,000
Committee recommendation................................     181,955,000

    The Committee recommendation 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 1997 comparable level.
    For State grants the bill provides $80,040,000 for the 
Disabled Veterans Outreach Program and $77,078,000 for the 
Local Veterans Employment Representative Program.
    For Federal administration, the Committee recommends 
$22,837,000, an increase of $104,000 over the fiscal year 1997 
level. The Committee supports the concept of the Transition 
Assistance Program administered jointly with the Department of 
Defense which assists soon-to-be-discharged service members in 
transitioning into the civilian work force and includes funding 
to maintain an effective program.
    In addition, the Committee recommends $2,000,000 for the 
National Veterans Training Institute [NVTI]. This Institute 
provides training to the Federal and State staff involved in 
the direct delivery of employment and training related services 
to veterans. The administration requested elimination of the 
Institute.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1997....................................     $46,981,000
Budget estimate, 1998...................................      46,750,000
Committee recommendation................................      46,750,000

    The bill includes $46,750,000 for this account, the same as 
the budget request and $231,000 below the 1997 comparable 
level. The bill includes $43,105,000 in general funds and 
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 [OIG] 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.

                           GENERAL PROVISIONS

    General provisions bill language is included to: Prohibit 
the payment of more than $125,000 to Job Corps contractor 
employees (sec. 101); permit transfers of up to 1 percent 
between appropriations (sec. 102); and permit contracting out 
of Job Corps civilian conservation centers that fail to meet 
performance standards (sec. 103); and prohibit OSHA from 
promulgating or issuing any proposed or final standard 
regarding ergonomics (sec. 104).

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     health resources and services

Appropriations, 1997....................................  $3,404,567,000
Budget estimate, 1998...................................   3,266,479,000
Committee recommendation................................   3,429,071,000

    The Committee recommends an appropriation of $3,429,071,000 
for health resources and services. This is $162,592,000 above 
the administration request and $24,504,000 more than the fiscal 
year 1997 allowance.
    Health Resources and Services Administration [HRSA] 
activities support programs to provide health care services for 
mothers and infants; the underserved, elderly, homeless; 
migrant farm workers; and disadvantaged minorities. This 
appropriation supports cooperative programs in community 
health, AIDS care, health provider training, and health care 
delivery systems and facilities.

                      CONSOLIDATED HEALTH CENTERS

    The Committee has again provided funds for community health 
centers, migrant health centers, health care for the homeless, 
and public housing health service grants in a consolidated line 
rather than through separate lines. The Committee provides 
$826,000,000 for the consolidated health centers [CHC's], which 
is $23,991,000 above the 1997 level and $16,132,000 above the 
administration request for this group of programs.

Community health centers

    The community health centers provide comprehensive, case-
managed primary health care services to medically indigent and 
underserved populations in rural and urban areas. Of the 
clients served by community health centers, about 44 percent 
are children and 66 percent have incomes below the poverty 
line.
    The Committee understands that half of new patients served 
by health centers over the past 3 years have no health 
insurance. This increase in uninsured patients has driven 
demand for expanded services. The Committee expects that 
funding increases will be reasonably allocated to increase 
grant levels for existing grantees (particularly those serving 
greater numbers of uninsured persons) and to initiate new sites 
in underserved areas, particularly in rural regions.
    Of the amount provided for consolidated health centers, the 
Committee has again included bill language making available a 
total of up to $6,000,000 for loan guarantees for loans made by 
non-Federal lenders for the construction, renovation, and 
modernization of facilities that are owned and operated by 
health centers and for loans made to health centers for the 
costs of developing and operating managed care networks or 
plan, both to be administered by the Bureau of Primary Health 
Care. The Committee directs that funds collected through loan 
origination fees shall be deposited in the appropriate credit 
program account for authorized costs of such loans. It is 
anticipated that with the full amount provided for this 
activity, up to $80,000,000 in loans could be made available 
for health-center renovations and managed care network 
formation, assuming a subsidy rate of approximately 7.5 percent 
for Federal funds appropriated.
    The Committee reiterates its concern that social, cultural, 
and language barriers make it difficult to effectively provide 
primary health care to Hispanic populations in some States. The 
Committee strongly encourages HRSA to establish new centers in 
communities with significant Hispanic-American populations. The 
Committee is aware of a proposal by the Cabot Westside Clinic 
and Samuel U. Rodgers Health Center in Kansas City, MO, and 
encourages full and fair consideration of the proposal from 
these organizations.
    Within the increase provided for community health centers, 
the bureau is encouraged to demonstrate and evaluate the 
outcomes of linking community health centers and substance 
abuse treatment centers.

Migrant health centers

    The program helps provide culturally sensitive 
comprehensive primary care services to migrant and seasonal 
farm workers and their families. Over 80 percent of the centers 
also receive funds from the community health centers program.

Health care for the homeless

    The program provides project grants for the delivery of 
primary health care services, substance abuse services, and 
mental health services to homeless adults and children. About 
one-half of the projects are administered by community health 
centers. The other one-half are administered by nonprofit 
coalitions, inner-city hospitals, and local public health 
departments.

Public housing health service grants

    The program awards grants to community-based organizations 
to provide case-managed ambulatory primary health and social 
services in clinics at or in proximity to public housing. More 
than 60 percent of the programs are operated by community 
health centers.

Native Hawaiian health care

    The Committee again includes the legal citation in the bill 
for the Native Hawaiian Health Care Program. The Committee has 
included funding for the consolidated health centers line so 
that health care activities funded under the Native Hawaiian 
Health Care Program can be supported under the broader 
community health centers line. The Committee expects that not 
less than $3,500,000 be provided for these activities in fiscal 
year 1998.
    The purpose of this activity is to improve the health 
status of native Hawaiians by making primary care, health 
promotion, and disease prevention services available through 
the support of native Hawaiian health systems. Services 
provided include health screening, nutrition programs, and 
contracting for basic primary care services. This activity also 
supports a health professions scholarship program for native 
Hawaiians.
    The Committee is encouraged by the efforts of section 330 
grantees and Native Hawaiian health systems in forming a hui, 
an association dedicated to addressing the health needs of 
Hawaii's underserved. The Committee encourages HRSA to maintain 
grantees participating in the hui at their current funding 
level.
    Regarding Pacific basin activities, the agency is urged to 
address the pressing health needs of rural Hawaii. The 
Committee encourages utilization of the expertise and resources 
of the universities in the Pacific region in providing 
training, technical assistance, and program evaluation in 
Hawaii and the current and former territories in the Pacific. 
The Committee urges that special consideration be given to 
these universities when procuring services for the Pacific 
jurisdictions. The Committee looks forward to the completed 
report by the Institute of Medicine concerning the unmet health 
care needs of this area.

National Health Service Corps: Field placements

    The Committee provides $37,244,000 for field placement 
activities, which is the same as the 1997 level and the 
administration request. The funds provided for this program are 
used to support the activities of National Health Service Corps 
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.
    The Committee is concerned about the lack of dental 
participation in the NHSC Scholarship Program and few dental 
recipients of NHSC loan repayment awards, despite a significant 
increase in the number of dentists needed to service designated 
dental health professions shortage areas. The Committee 
strongly urges the NHSC to address this problem through 
increased dental participation.

National Health Service Corps: Recruitment

    The Committee provides $78,166,000 for recruitment 
activities, which is the same as the 1997 level and the 
administration request. This program provides major benefits to 
students (full-cost scholarships or sizable loan repayment) in 
exchange for an agreement to serve as a primary care provider 
in a high priority federally designated health professional 
shortage area. The Committee reiterates its intention that 
funds provided be used to support multiyear, rather than 
single-year, commitments.
    The Committee again intends that $3,000,000 of funds 
appropriated for this activity be used for State offices of 
rural health. The Committee continues to be concerned about 
possible overlap and duplication between primary care offices 
[PCO's] supported in every State through the health centers 
appropriation and State offices of rural health [SORH's] 
supported in each State through the National Health Service 
Corps appropriation. While some required activities are 
exclusive to one program or another, the majority are similar. 
These include assessment of need for health services and 
available resources, targeting areas of unmet need, site and 
community development, technical assistance, and training. The 
Committee reiterates its recommendation that HRSA encourage 
States to create agreements between each State's PCO and SORH 
delineating joint and separate activities and promoting 
collaboration to the satisfaction of program officials.
    In view of the disproportionate shortage of mental health 
care providers in the programs supported by the National Health 
Service Corps, the Committee is encouraged by the NHSC's 
announcement to launch a special initiative to target mental 
health care providers in underserved areas. The Committee 
requests that it be kept informed of the progress of this 
initiative and what additional action steps are planned to meet 
the demonstrated need for mental health care providers and to 
increase the numbers of such providers supported by the NHSC.
    The Committee is aware that the NHSC has conducted a 
special pilot project over the last several years to place 
psychologists and other behavioral and mental health providers 
in community and migrant health centers. The Committee is 
further pleased that the NHSC publicly announced a special 
initiative to place psychologists and other behavioral/mental 
health professionals. However, the Committee is concerned with 
the slow progress made to date to actually increase the number 
of these providers.

                           HEALTH PROFESSIONS

    For all HRSA health professions programs, the bill includes 
$220,000,000, which is $72,818,000 less than the fiscal year 
1997 appropriation and $90,000,000 higher than the overall 
administration request for these programs. The administration 
requested funding in consolidated program clusters. The 
Committee recommends separate, consolidated funding for 
programs authorized under either title VII or VIII of the 
Public Health Service Act.

Consolidated funding for authorized title VII programs

    For programs authorized under title VII of the Public 
Health Service Act, as amended, the Committee recommends 
$165,000,000, which is $62,433,000 less than fiscal year 1997 
appropriations and $42,700,000 above the administration 
request. The administration requested funding of the title VII 
programs in the following consolidated program clusters: 
Workforce development; minority/disadvantaged; primary care and 
public health; and enhanced area health education. The 
Committee has provided funding for these programs in one 
consolidated account to provide enhanced flexibility in 
priority setting and to encourage administrative 
simplification. The Committee previously provided funding as 
separate line items.
    Within the amount provided for title VII programs funded 
within this account, the Committee urges the Secretary to give 
priority consideration for the family medicine, rural 
interdisciplinary traineeships, and expects the Secretary to 
maintain the highest possible funding of geriatric education 
centers, area health education centers, and the programs 
designated by the administration within the minority/
disadvantaged cluster.
    The Committee continues to encourage collaboration between 
the agency and the Substance Abuse and Mental Health 
Administration to conduct interdisciplinary health professions 
training projects, including training of mental health 
professionals, for practice in managed care settings and other 
primary care health settings. The Committee encourages the 
agency to assess and disseminate exemplary interdisciplinary 
models of practice that integrate health care, mental health 
and addictions services in primary care.
    The following programs are included in this consolidated 
account:

Grants to communities for scholarships

    This 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 
States and sponsoring community organizations. The 
administration requested funding in a consolidated program 
cluster. This program is authorized by section 338L of the 
Public Health Service Act.

Health professions data and analysis

    This program supports the collection and analysis of data 
on the labor supply in various health professions and on future 
work force configurations. The administration requested funding 
in a consolidated program cluster.

Research on certain health professions issues

    This program supports research on the extent to which debt 
has a detrimental effect on students entering primary care 
specialties; the effects of federally funded education programs 
for minorities attending and completing health professions 
schools; and the effectiveness of State investigations in 
protecting the health of the public. The Committee reiterates 
its support for the three centers for health professions 
research that are current grantees. The administration 
requested funding in a consolidated program cluster.

Centers of excellence

    This program was established to fund institutions that 
train a significant portion of the Nation's minority health 
professionals. Funds are used for the recruitment and retention 
of students, faculty training, and the development of plans to 
achieve institutional improvements. The institutions that are 
designated as centers of excellence are private institutions 
whose mission is to train disadvantaged minority students for 
service in underserved areas. Located in poor communities and 
usually with little State funding, they serve the health care 
needs of their patients often without remuneration. The 
administration requested funding in a consolidated program 
cluster.

Health careers opportunity program

    This program provides funds to medical and other health 
professions schools for recruitment of disadvantaged students 
and preprofessional school preparations. The administration 
requested funding in a consolidated program cluster. The 
Committee urges the agency to distribute a reasonable 
allocation of grants among both historical minority 
institutions as well as those with more recent commitments 
toward diversity efforts.

Exceptional financial need scholarships

    This program provides scholarship assistance to 
exceptionally needy students enrolled in schools of medicine, 
osteopathic medicine, or dentistry who agree to practice 
primary care for 5 years after completing training. The 
administration requested funding in a consolidated program 
cluster.

Faculty loan repayment

    This program provides for the repayment of education loans 
for individuals from disadvantaged backgrounds who are health 
professions students or graduates, and who have agreed to serve 
for not less than 2 years as a faculty member of a health 
professions school. The administration requested funding in a 
consolidated program cluster.

Financial assistance for disadvantaged health professions students

    This program provides financial assistance to disadvantaged 
students at medical, osteopathic, or dental schools who agree 
to practice primary health care for 5 years after completing 
training. The administration requested funding in a 
consolidated program cluster.

Scholarships for disadvantaged students

    This program provides grants to health professions schools 
for student scholarships to individuals who are from 
disadvantaged backgrounds and are enrolled as full-time 
students in such schools. The Committee continues to intend 
that all health professions disciplines made eligible by 
statute be able to participate in the scholarships program. The 
administration requested funding in a consolidated program 
cluster.

Family medicine training

    Family medicine activities support grants for graduate 
training in family medicine, grants for predoctoral training in 
family medicine, grants for faculty development in family 
medicine, and grants for the establishment of departments of 
family medicine. The Committee reiterates its support for this 
program and recognizes its importance in increasing the number 
of primary care physicians in underserved areas. The 
administration requested funding in a consolidated program 
cluster.

General internal medicine and pediatrics training

    This program provides funds to public and private nonprofit 
hospitals and schools of medicine and osteopathic medicine to 
support residencies in internal medicine and pediatrics. Grants 
may also include support for faculty. The administration 
requested funding in a consolidated program cluster.

Physician assistants

    This program supports planning, development, and operation 
of physician assistant training programs. The administration 
requested funding in a consolidated program cluster.

Public health and preventive medicine

    This program supports awards to schools of medicine, 
osteopathic medicine, public health, and dentistry for support 
of residency training programs in preventive medicine and 
dental public health; and for financial assistance to trainees 
enrolled in such programs. The administration requested funding 
in a consolidated program cluster.

Health administration traineeships and special projects

    This program provides grants to public or nonprofit private 
educational entities, including schools of social work but not 
schools of public health, to expand and improve graduate 
programs in health administration, hospital administration, and 
health policy analysis and planning; and assists educational 
institutions to prepare students for employment with public or 
nonprofit private agencies. The administration requested 
funding in a consolidated program cluster.

Area health education centers

    This 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 programs with 50 percent Federal funding. The 
administration requested funding in a consolidated program 
cluster. The Committee intends that adequate funding be 
provided to the area health education centers [AHEC] grant 
program since AHEC's are an important component of the Federal/
State partnership in addressing rural health issues.
    Within funds allocated to this program, the Committee 
encourages the agency to undertake new provider education 
programs to improve the detection, treatment, and management of 
patients with chronic fatigue and immune dysfunction syndrome. 
The Committee understands that the recommendations made in the 
joint report between the agency and the CFIDS Association of 
America may form the basis for implementation strategies.
    The Committee is aware of and supportive of the WAMI 
medical education consortium for eligible residents of the 
States of Washington, Alaska, Montana, and Idaho. The current 
program seeks to add a rural integrated training experience 
program [WRITE] to provide clinical experiences for medical 
students under the tutelage of a rural physician as well as 
telecommunications links among participating centers. The 
Committee encourages the agency and the AHEC program to grant 
full and fair consideration of the WAMI proposal.

Border health training centers

    These centers provide training to improve the supply, 
distribution, and quality of personnel providing health 
services in the State of Florida or 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

    This program assists dental schools and postgraduate dental 
training institutions to meet the costs of planning, 
developing, and operating residency training and advanced 
education programs in general practice of dentistry and funds 
innovative models for postdoctoral general dentistry. The 
administration requested funding in a consolidated program 
cluster.

Allied health advanced training and special projects

    This program provides funds to assist schools or programs 
with projects designed to plan, develop, or expand 
postbaccalaureate programs for the advanced training of allied 
health professions; and provide traineeships or fellowships to 
postbaccalaureate students who are participating in the program 
and who commit to teaching in the allied health profession 
involved. This program also provides funds to expand existing 
training programs or develop new ones, recruit individuals into 
allied professions with the most severe shortages or whose 
services are most needed by the elderly, and increase faculty 
recruitment and education, and research. The administration 
requested funding in a consolidated program cluster.
    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

    This program supports grants to health professions schools 
to establish geriatric education centers and to support 
geriatric training projects. The administration requested 
funding in a consolidated program cluster. These centers and 
geriatric training programs play a vital role in enhancing the 
skill-base of health care professionals to care for our 
Nation's growing elderly population. The Committee is concerned 
about the shortage of trained geriatricians and urges the 
agency to give priority to building the work force necessary to 
care for the Nation's elderly.

Rural health interdisciplinary training

    This program addresses shortages of health professionals in 
rural areas through interdisciplinary training projects that 
prepare students from various disciplines to practice together, 
and offers clinical training experiences in rural health and 
mental health care settings to expose students to rural 
practice. The administration requested funding in a 
consolidated program cluster. The Committee encourages this 
program to continue addressing the issue of how the delivery of 
chiropractic health care can be enhanced in rural areas, and 
how more women and minorities can be recruited as chiropractic 
health care practitioners in rural areas.

Podiatric primary care training

    The program provides grants to hospitals and schools of 
podiatric medicine for residency training in primary care. The 
administration requested funding in a consolidated program 
cluster.

Chiropractic demonstration grants

    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. The administration requested funding in a 
consolidated program cluster. The Committee recommends that the 
program be continued and funded at current levels.

Consolidated funding for authorized title VIII programs

    For programs authorized under title VIII of the Public 
Health Service Act, as amended, the Committee recommends 
$55,000,000, which is $10,385,000 less than the total fiscal 
year 1997 appropriations and $47,300,000 above the 
administration request. The administration requested funding of 
the title VIII programs in a consolidated nurse education/
practice cluster. The Committee previously provided funding as 
separate line items. The Committee has provided funding for 
these programs in one consolidated account to provide for a 
comprehensive, flexible, and effective authority for nursing 
work force development. The Committee urges the Secretary to 
give priority within the consolidated account to nurse 
disadvantaged assistance and nurse practitioner programs.
    The following programs are included in this consolidated 
account:

Advanced nurse education

    This program funds nursing schools to prepare nurses at the 
master's degree or higher level for teaching, administration, 
or service in other professional nursing specialties. The 
administration requested funding in a consolidated program 
cluster.

Nurse practitioner/nurse midwife education

    This program supports programs preparing nurse 
practitioners and nurse midwives to effectively provide primary 
health care in settings such as the home, ambulatory, and long-
term care facilities, and other health institutions. These 
professionals are in especially short supply in rural and 
underserved urban areas. The administration requested funding 
in a consolidated program cluster.

Nursing special projects

    This program supports projects to increase the supply of 
nurses meeting the health needs of underserved areas; 
demonstrate methods to improve access to nursing services in 
nontraditional settings; and demonstrate innovative nursing 
practices. The administration requested funding in a 
consolidated program cluster.

Nurse disadvantaged assistance

    This program provides grants and contracts to qualified 
schools and education programs to recruit individuals from 
minority and disadvantaged backgrounds, and to assist them with 
their nursing education by providing training, counseling, and 
stipends. The administration requested funding in a 
consolidated program cluster.

Professional nurse traineeships

    Traineeships fund registered nurses in programs of advanced 
nursing education, including preparation for teaching, 
administration, supervision, clinical specialization, research, 
and nurse practitioner and nurse midwife training. The 
administration requested funding in a consolidated program 
cluster.

Nurse anesthetist traineeships

    Grants are awarded to eligible institutions to provide 
traineeships for licensed registered nurses to become certified 
registered nurse anesthetists [CRNA]. The program also supports 
fellowships to enable CRNA faculty members to obtain advanced 
education. The administration requested funding in a 
consolidated program cluster.

Nurse loan repayment for shortage area service

    This program offers student loan repayment to nurses in 
exchange for an agreement to serve not less than 2 years in an 
Indian health service health center, native Hawaiian health 
center, public hospital, community or migrant health center, or 
rural health clinic. The administration requested funding in a 
consolidated program cluster.

                          other hrsa programs

Hansen's disease services

    The Committee has included $14,424,000 for the Hansen's 
Disease Program, which is the $2,670,000 lower than the 1997 
level and $2,045,000 lower than the administration request. The 
administration proposed to consolidate all Hansen's disease 
programs into a program cluster, consisting of the National 
Hansen's Disease Center, a $1,750,000 payment to Hawaii for 
medical care for Hansen's disease patients in the State, and 
funds for buildings and facilities repair and renovation at the 
Gillis W. Long Hansen's Disease Center in Carville, LA. The 
Committee has provided funding for the payment to Hawaii as a 
separate line item.

Maternal and child health block grant

    The Committee recommends $681,000,000 for the maternal and 
child health [MCH] block grant. This is the same as the fiscal 
year 1997 appropriation and the administration request.
    The MCH block grant funds are provided to States to support 
health care for mothers and children. According to statute, 15 
percent of funds are used for special projects of regional or 
national significance [SPRANS]; and 12.75 percent of funds over 
$600,000,000 are used for community-integrated service systems 
[CISS] programs. After taking the 12.75-percent set-aside, the 
remaining 87.25 percent is distributed on the same percentage 
split as the basic block grant formula.
    The Committee again includes bill language designating 
$103,609,000 of the maternal and child health block grant for 
special projects of regional and national significance 
[SPRANS]. This designation will again provide $2,857,000 more 
for SPRANS activities than would otherwise be the case under 
the statutory formula. The Committee intends that this amount 
be used for the traumatic brain injury State demonstration 
projects authorized under title XII of the Public Health 
Service Act.
    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 the agency to 
sustain funding support for this program.
    The Committee has been pleased with the Bureau's efforts in 
responding to the joint effort with the National Institute of 
Child Health and Human Development in the back to sleep 
campaign for sudden infant death syndrome [SIDS], and by the 
effort to understand the need for SIDS services through its 
nationwide survey of sudden infant death services. The 
Committee commends the Bureau for its work toward establishing 
a SIDS program support center as recommended by the nationwide 
survey.
    The Committee again commends the Office of Adolescent 
Health for working to develop an integrated, multidisciplinary 
approach, and urges its continued emphasis on using the 
expertise of a variety of health professions, including 
nursing. The Committee reiterates that special attention be 
devoted toward addressing adolescents' mental health problems, 
including depression, violence, and suicide. The Committee 
commends the close working relationship between the Office of 
Adolescent Health and the Carnegie Council on Adolescent 
Development, and urges the implementation of the Carnegie 
Council's recommendations.
    Millions of infants are not receiving screening for hearing 
loss. Such screening can be performed at minimal cost and can 
prevent significant health and education costs for children. 
Recent advancements have been made on screening and the 
National Institutes of Health is concluding a major study of 
the most effective forms of screening. The Committee believes 
that infant hearing screening would be a wise use of block 
grant funds and recommends that HRSA provide States with the 
results of this landmark NIH study.
    Dental caries (tooth decay) is one of the most common 
health problems among children, and fluoridation has proven to 
be the single most cost-effective preventive measure. It is 
estimated that Medicaid spends $30 or more per child to care 
for a child's teeth in nonfluoridated areas compared to 
districts whose water supply is fluoridated. The Committee 
reiterates its support for implementation of enhanced 
fluoridation efforts, particularly in underutilized areas of 
the country, and intends that an amount no less than that 
expended last year by the agency be used for those States with 
fluoridation levels below 25 percent to allow them to develop 
implementation plans for increased fluoridation.
    The Committee emphasizes the importance and value of the 
LEND programs on neurodevelopment currently operating under the 
SPRANS set-aside within the MCH block grant and encourages the 
agency to continue to award such grants.
    The Committee has been concerned about the impact of the 
rapidly changing health care system upon families with children 
who have special medical needs. The Committee is especially 
concerned with the challenges confronting many of these 
families in obtaining comprehensive care for their children and 
by what processes this care is provided to them. Within the 
amount provided to the SPRANS set-aside, sufficient funds are 
available to initiate a 1-year planning and development grant 
prior to a potential multiyear study that examines the complex 
issue of resource integration for children with special medical 
needs. The Committee is aware of a proposal being developed by 
the Connecticut Children's Medical Center that has many 
meritorious characteristics, and urges the Bureau to give a 
full and fair consideration of this proposal.
    The Committee recognizes that amblyopia is the most 
widespread clinically serious eye problem in children, and that 
undetected vision problems hamper children's ability to learn. 
In order to improve early detection services, the Committee 
notes that there are sufficient funds within the amount 
available for the SPRANS setaside for a multistate 
demonstration project to provide and evaluate the practicality 
and effectiveness of ocular screening services for young 
children, including photoscreening technology. If implemented, 
the project should deliver ocular screening services to the 
largest practical number of children in one age group in each 
State, collect and maintain the screening results for all 
tested children in a data base, and report results to each 
child screened, each screening site, and to the appropriate 
State agency within a reasonable period of time. The Committee 
urges the Bureau to consult with the National Eye Institute and 
with appropriate State agencies in determining useful screens 
to efficiently detect amblyopic risk factors and other 
significant ocular problems.
    The Committee encourages the agency to work with 
organizations, such as the Children's Health Fund, that seek to 
initiate a national network of innovative pediatric programs 
providing health services to medically underserved children. 
The Committee understands that there is a need to learn from 
successful program models and to propagate these lessons to a 
broader national network with the participation of private 
support.

Healthy start initiative

    The Committee recommends $95,982,000 for the healthy start 
infant mortality initiative. This amount is the same as the 
fiscal year 1997 amount and the same as the administration 
request.
    The healthy start initiative was developed to respond to 
persistently high rates of infant mortality in this Nation. The 
initiative was expanded in fiscal year 1994 by a special 
projects program, which supported an additional seven urban and 
rural communities to implement infant mortality reduction 
strategies and interventions.
    While these projects have made substantial progress in the 
reduction of infant mortality, there remain significant 
challenges to sustain the gains already attained. Abrupt 
termination of the program will likely result in increases in 
infant mortality in the targeted project areas. While the 
Committee is aware of the original timeframe of the program, it 
places its highest priority toward averting and reducing infant 
mortality through sustainable means in areas with continued 
critical needs.
    The funds provided by the Committee would provide the 
opportunity to replicate the best models from the demonstration 
phase of the initiative and propagate the lessons learned with 
more than 300 urban and rural communities with a high rate of 
infant mortality. Within this amount, funds would be available 
to existing projects for: The increased support of successful 
strategies and interventions; the utilization of these projects 
as resource centers for other health providers, including 
managed care organizations; and for the initiation of projects 
in new communities with high incidence of infant mortality. 
Existing sites include those initially approved in 1991 but not 
funded until 1994.

Organ procurement and transplantation

    The Committee provides $2,778,000 for organ transplant 
activities. This is $1,113,000 lower than the administration 
request and $500,000 more than the fiscal year 1997 
appropriation. These funds support a scientific registry of 
organ transplant recipients and kidney dialysis patients, and 
the National Organ Procurement and Transplantation Network to 
match donors and potential recipients of organs. A portion of 
the appropriated funds may be used for education of the public 
and health professionals about organ donations and transplants, 
and to support agency staff providing clearinghouse and 
technical assistance functions.
    The Committee strongly believes that a concerted effort 
should be made to increase the supply of organs available for 
transplantation, and encourages the consideration of options 
that would enhance donor awareness, such as enhanced 
cooperation among public and private organizations, and 
behavioral research. The administration requested $1,687,000 in 
increased funding for a public education campaign aimed at 
specific segments of the population.
    The Committee has provided $500,000 over last year's level 
to identify and implement targeted strategies for assisting 
hospital staff to become more knowledgeable about and more 
committed to donation, and to develop and implement public 
education programs that focus upon key professions that can 
potentially affect donation, such as clergymen. The goal would 
be to significantly increase the rate that potential donor 
families are contacted by hospital staff for the purpose of 
informing them of donation options. The Committee understands 
that nearly one-third of potential donor families are not asked 
to donate because of the lack of hospital staff training or 
apprehension about the request process. The Committee is aware 
of the other educational activities proposed by the agency, 
such as developing a grade K-12 curriculum and college campus 
activities, and notes that SPRANS funds within the MCH block 
grant could be made available for these activities.
    The Committee is aware of the chronic difficulties that has 
existed for a number of years regarding allocation formulas for 
livers and other organs, and notes that last year while 50,000 
people were on the UNOS waiting list for an organ, only 19,000 
solid organ transplants were performed. The Committee 
reiterates its expectation of prior notification and 
consultation regarding any change in the current liver 
allocation criteria. It also expects the Department to 
carefully weigh key factors such as severity of illness and 
geography in determining a new allocation policy.
    The Committee is also aware of problems concerning the 
sharing of data between the agency and the primary contractor, 
and expects that information acquired with the use of Federal 
funds be accessible by the contracting agency with appropriate 
consideration for issues surrounding privacy.

Health teaching facilities interest subsidies

    The Committee recommends $225,000 for interest subsidies 
for three health professions teaching facilities. This is the 
same as the administration request and $72,000 less than the 
fiscal year 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.

National bone marrow donor program

    The Committee has included $15,270,000 for the national 
bone marrow donor program. This is the same as the 
administration request and the fiscal year 1997 level. The 
National Bone Marrow Donor Registry is a network, operated 
under contract, that helps patients suffering from leukemia or 
other blood diseases find matching volunteer unrelated bone 
marrow donors for transplants. The program also conducts 
research on the effectiveness of unrelated marrow transplants 
and related treatments.
    The Committee is pleased that the National Bone Marrow 
Registry is increasingly meeting the needs of a significant 
proportion of those in need of allogenic bone marrow 
transplants. In addition, the bone marrow program is continuing 
to increase the size and diversity of the registry of potential 
donors. Continued progress is critical to improving the chances 
of finding a matched marrow donor for patients of all races and 
ethnic heritage.

Rural health outreach grants

    The Committee recommends $30,092,000 for health outreach 
grants. This amount is $2,296,000 higher than the fiscal year 
1997 level and $5,000,000 higher than the administration 
request. This program supports projects that demonstrate new 
and innovative models of outreach in rural areas such as 
integration and coordination of health services and rural 
telemedicine projects. The Health Care Consolidation Act of 
1996 authorized a new rural network development program 
intended to develop integrated organizational capabilities 
among three or more rural health provider entities.
    Sufficient funds are provided within this account to 
initiate a telemedicine project dedicated to serving rural, 
poor, and medically underserved communities through a high-
speed, community-access telecommunication network. The 
Committee is aware of the University of South Alabama's 
proposal to initiate the Southwest Alabama Network for 
Education and Telemedicine and urges the agency to grant full 
and fair consideration to this noteworthy project.
    Within the increase provided, sufficient funds are 
available to conduct a telemedicine project that will 
strengthen the knowledge base in developing graduate and 
undergraduate health professions education program curricula 
that meet the special needs of rural communities. The Committee 
is aware of the proposal by the State of Vermont to conduct a 
telemedicine demonstration project that would integrate health 
professions education with the delivery of health services in 
rural areas, and urge the agency grant full and fair 
consideration to this proposal.

Emergency medical care for children

    The Committee provides $13,000,000 for emergency medical 
services for children. This 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. 
The Committee urges HRSA to focus attention on the shortage of 
these programs in remote and rural areas of the country, such 
as those in Alaska and Hawaii.

Black lung clinics

    The Committee includes $5,000,000 for black lung clinics. 
This is $1,000,000 more than the fiscal year 1997 amount and 
$3,094,000 higher than the administration request. This program 
funds clinics which treat respiratory and pulmonary diseases of 
active and retired coal miners. These clinics reduce the 
incidence of high-cost inpatient treatment for these 
conditions. The Committee intends the increase to sustain 
patient services at all current operating centers.

Alzheimer's disease demonstration grants

    The Committee recommends $5,999,000 for Alzheimer's 
demonstration grants, which is the same as the 1997 level. The 
administration requested transfer of funding and program 
operations to the Administration on Aging.
    The Committee is pleased that this program continues to be 
an effective catalyst by stimulating over 140 State, local, 
public, and private agencies to coordinate and strengthen 
community services for Alzheimer's families. The program 
focuses on making existing services work better, with special 
emphasis on hard-to-reach and underserved populations. With 
relatively modest funding, projects have provided outreach and 
support to an estimated 4.5 million persons in over 20 ethnic 
groups. The Committee is pleased with the current success of 
this program and with the creativity and flexibility with which 
HRSA has administered it. The Committee sees no compelling 
reason to transfer this program, as proposed by the 
administration, and is strongly concerned that a transfer risks 
disruption of the strong public/private partnerships already in 
place. The Committee, therefore, rejects the proposed transfer 
and directs that the program remain at HRSA.

Payment to Hawaii, Hansen's disease treatment

    Within the amount provided for Hansen's disease services, 
the Committee has provided $2,045,000 for the 1998 payment to 
the State of Hawaii for the medical care and treatment in its 
hospital and clinic facilities of persons with Hansen's disease 
at a per diem rate not greater than the comparable per diem 
operating cost per patient at the Gillis W. Long National 
Hansen's Disease Center in Carville, LA. This amount is 
$295,000 above the administration request and the same as the 
1997 level. The administration requested funding in a 
consolidated program cluster for Hansen's disease.

                  acquired immune deficiency syndrome

                        Ryan White AIDS programs

    The Committee provides $1,077,252,000 for Ryan White AIDS 
programs. This is $41,000,000 above the administration request 
and $81,000,000 above the 1997 level.

Emergency assistance--title I

    The Committee recommends $457,943,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic. This 
amount is $8,000,000 above the fiscal year 1997 amount and 
$3,000,000 higher than the administration request. These funds 
are provided to metropolitan areas with a cumulative total of 
more than 2,000 cases of AIDS or a per capita incidence of 
0.0025. One-half of the funds are awarded by formula and one-
half are awarded through supplemental competitive grants.
    The Committee is concerned about the limited AIDS therapy 
options for children and pregnant women, and encourages the 
Secretary, when awarding supplemental title I funds, to give 
priority as appropriate to EMA's whose applications increase 
services to women and children with AIDS/HIV infection.

Comprehensive care programs--title II

    The Committee has provided $469,954,000 for HIV health care 
and support services. This amount is $38,000,000 above the 
administration request and $53,000,000 above the 1997 level. 
These funds are awarded to States to support HIV service 
delivery consortia, the provision of home and community-based 
care services for individuals with HIV disease, continuation of 
health insurance coverage for low-income persons with HIV 
disease and support for State AIDS drug assistance programs 
[ADAP].
    The Committee is heartened by the advent of protease 
inhibitor therapy in combination with other medications for 
patients with HIV, which has resulted in lower mortality rates 
for individuals with HIV/AIDS for the first time in the history 
of the epidemic. The Committee continues to be concerned by the 
high costs of new medications for AIDS, and, in anticipation of 
higher demand for these treatments, has approved bill language 
for $217,000,000 for AIDS medications, compared to $167,000,000 
provided for this purpose in fiscal year 1997. The Committee 
remains concerned about the lack of timely national data 
available to estimate future demand for AIDS medications funded 
by the ADAP program, and is further concerned about the wide 
variation in State Medicaid policies regarding eligibility, 
benefits, and formularies. The Committee urges the Secretary to 
establish useful benchmarks in measuring progress for ADAP 
activities and to increase data collection and information 
sharing efforts between the Department, the States, and 
nongovernmental organizations such as the ADAP Working Group, 
the AIDS Treatment Data Network, and the National Alliance of 
State and Territorial AIDS Directors. The Committee reiterates 
its directive that the program use all means necessary to 
reduce the purchase price of AIDS drugs.

Early intervention program--title III-B

    The Committee recommends $79,568,000 for early intervention 
grants. This is $10,000,000 above the 1997 level and $5,000,000 
less than the administration request. These funds are awarded 
competitively to primary health care providers to enhance 
health care services available to people at risk of HIV and 
AIDS. Funds are used for counseling, testing, diagnostic, and 
therapeutic services.
    To the extent practicable, the Committee encourages HRSA to 
fairly allocate the increase for title III-B between existing 
grantees and new providers. The Committee understands that 
existing grantees have been level-funded throughout the history 
of the CARE Act. By providing additional funds to current 
grantees, the Committee intends to undergird the HIV care 
infrastructure already established in title III-B clinics. The 
Committee also supports expansion of the number of communities 
receiving assistance from this title. The Committee understands 
that HRSA is conducting a grant-review process expected to 
identify qualified new grantees in underserved rural and urban 
areas.

Pediatric AIDS demonstrations--title IV

    The Committee recommends $45,000,000 for title IV pediatric 
AIDS, which is $5,000,000 higher than the administration 
request and $9,000,000 above the 1997 amount. This program 
supports demonstration grants to develop innovative models that 
foster collaboration between clinical research institutions and 
primary/community-based medical and social service providers 
for underserved children, youth, pregnant women, and their 
families.
    Some 5 percent of the funds appropriated under this section 
may be used to provide peer-based training and technical 
assistance through national organizations that collaborate with 
projects to ensure development of innovative models of family-
centered and youth-centered care; advanced provider training 
for pediatric, adolescent, and family HIV providers; health 
care financing, outcome measures, and policy analysis; and 
coordination with research programs.
    The Committee is aware that the Ryan White CARE Act 
Amendments of 1996 requires significant enrollment of title IV 
patients in NIH research programs. The Committee is further 
aware that funding for the pediatric AIDS clinical trial group 
has been reduced by the NIH Office of AIDS Research, and urges 
HRSA to consider this reduction in funding as well as research 
protocol requirements when evaluating the ability of title IV 
projects to enroll significant numbers of patients in research 
programs.

AIDS dental services

    The Committee provides $7,500,000 for AIDS dental services, 
which is the same as the administration request and the 1997 
level. This program provides grants to dental schools and 
postdoctoral dental education programs to assist with the cost 
of providing unreimbursed oral health care to patients with HIV 
disease.

AIDS education and training centers

    The Committee recommends $17,287,000 for the AIDS education 
and training centers [AETC's]. This amount is $1,000,000 above 
the 1997 level and the same as the administration request. AIDS 
education and training centers train health care practitioners, 
faculty, and students who care for AIDS patients outside of the 
traditional health professions education venues, and support 
curriculum development on diagnosis and treatment of HIV 
infection for health professions schools and training 
organizations. With the issuance of new protease inhibitor 
treatment guidelines for patients with HIV, the Committee 
provides a significant increase in this account and expects the 
participating centers to disseminate and educate health care 
providers on the proper use of these new medications.

Family planning

    The Committee recommends $208,452,000 for the title X 
family planning program. This is $5,000,000 higher than the 
administration request and $10,000,000 above the 1997 level. 
Title X grants support primary health care services at more 
than 4,000 clinics nationwide. About 85 percent of family 
planning clients are women at or below 150 percent of poverty 
level.
    Title X of the Public Health Service Act, which established 
the family planning program, authorizes the use of a broad 
range of acceptable and effective family planning methods and 
services. The Committee believes this includes oral, 
injectable, and other preventive modalities.
    The Committee is concerned that programs receiving title X 
funds ought to have access to these resources as quickly as 
possible. The Committee, therefore, instructs the Department to 
distribute to the regional offices all of the funds available 
for family planning services no later than 60 days following 
enactment of this bill.
    The Committee urges that the Office of Family Planning 
support national and community-based initiatives to involve 
males in family planning matters. The Committee is aware of the 
efforts of the National Organization of Concerned Black Men, 
Inc., of Philadelphia, PA, and its local affiliates to enhance 
the involvement of African-American males in all aspects of 
family planning, including teen pregnancy prevention, parenting 
skills, fatherhood responsibility, and male mentoring, and 
applauds such practical solutions and urges the Office to 
support such endeavors.

Rural health research

    The Committee recommends $11,713,000 for the Office of 
Rural Health Policy. This is $3,000,000 more than the fiscal 
year 1997 level and the administration request. The funds 
provide support for the Office as the focal point for the 
Department's efforts to improve the delivery of health services 
to rural communities and populations. Funds are used for rural 
health research centers, grants to telemedicine projects, the 
National Advisory Committee on Rural Health, and a reference 
and information service.
    Within the increased amount provided above last year's 
level, sufficient funds are available to support a project that 
integrates biomedical research activities with rural health 
training of physicians. The Committee understands that the 
McLaughlin Research Institute of Great Falls, MT, is especially 
well-suited to both undertaking biomedical research and 
providing research opportunities to rural-based health 
practitioners, and urges the full and fair consideration of its 
proposal.
    Within the increased amount provided above last year's 
level, sufficient funds are available to support a project that 
consolidates instructional facilities for allied health 
programs into one site in a rural area. The Committee notes 
that the North Dakota State College of Science in Wahpeton, ND, 
has many meritorious characteristics that would efficiently and 
effectively conduct such a consolidation and urges the full and 
fair consideration of its proposal.
    Within the increased amount provided above last year's 
level, sufficient funds are included to support a project that 
establishes an integrated system to improve the health status 
of specific medically underserved populations identified in 
rural, transitional, and urban areas designated as health 
professional shortage areas. The Committee is aware of the 
proposal by the Carolinas HealthCare System of North Carolina 
to establish the Carolinas Community Health Institute and urges 
the agency's expeditious consideration of its proposal.

Health care facilities

    The Committee provides $10,000,000 for health care 
facilities, which is $2,902,000 below the 1997 level and 
$10,000,000 above the administration request. Funds are made 
available to public and private nonprofit entities for 
construction or modernization of outpatient medical facilities.
    Sufficient funds are provided for the construction of a 
health care center dedicated to the delivery of primary and 
preventive health care services to a medically underserved 
area. The Committee understands that the Sacred Heart Hospital 
of Allentown, PA, has many meritorious characteristics that 
would optimize the delivery of health care services to the 
underserved of its region, and urges the full and fair 
consideration of its proposal.
    Also available are funds supporting the development of a 
center that provides geriatric care, adolescent health 
services, and general prevention services. The Committee is 
cognizant of Lehigh Valley (Pennsylvania) Hospital and Health 
Network's efforts to construct such a center, and urges the 
full and fair consideration of its proposal.
    Funds are also available for the construction of a facility 
that would house a model program for the delivery of state-of-
the-art medical care to economically deprived, inner-city 
neighborhoods. The Committee is aware that the Associates in 
Medicine Program at Columbia University in New York City has 
been developing such a model program and urges the full and 
fair consideration of its proposal.
    Sufficient funds are provided for the initiation of 
construction of outpatient facilities at a genetics counseling, 
patient care, and research center. The Committee urges strong 
consideration of the proposal developed by the University of 
Alabama at Birmingham, whose expertise and leadership in health 
care delivery in underprivileged areas is especially 
noteworthy.

Buildings and facilities

    The Committee recommends no funding for buildings and 
facilities, the same as the administration request and $828,000 
below the fiscal year 1997 amount.

National practitioner data bank

    The Committee has not provided Federal funding for the 
national practitioner data bank, which is the same as the 
administration request. The Committee and the administration 
assume that $8,000,000 will be provided entirely through the 
collection of user fees and will cover the full cost of 
operating the data bank, an amount that is $2,000,000 higher 
than what was authorized to be collected in fiscal year 1997. 
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 Committee recommends $114,429,000 for program 
management activities for fiscal year 1998. This is $3,480,000 
higher than the administration request and $1,500,000 above the 
1997 level. The Committee is concerned that the growing number, 
complexity, and fiscal impact of HRSA's programs have expanded 
over the last 5 years, and that the agency's program management 
budget has not kept pace, resulting in problems ranging from 
insufficient numbers of qualified staff to outdated technology. 
The amount provided above the request is intended to enhance 
the agency's administrative and management capabilities, 
particularly in AIDS programs.
    The Committee has not provided bill language requested by 
the administration enabling HRSA's Office of Drug Pricing to 
finance the Public Health Service Prime Vendor Program through 
a user fee. Additional funds to run this office, if necessary, 
are available from the increase provided to the program 
management account.

               medical facilities guarantee and loan fund

Appropriations, 1997....................................      $7,000,000
Budget estimate, 1998...................................       6,000,000
Committee recommendation................................       6,000,000

    The Committee recommends $6,000,000 for the medical 
facilities guarantee and loan fund. This is the same as the 
administration request and $1,000,000 less than the fiscal year 
1997 appropriation. These funds are used to comply with the 
obligation of the Federal Government to pay interest subsidies 
on federally guaranteed loans throughout the life of the loans. 
These loans were used for hospital modernization, construction, 
and conversion. 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

    The Committee recommends guarantee authority of $85,000,000 
for new HEAL loans in fiscal year 1998, which is the same as 
the President's request and $55,000,000 below the fiscal year 
1997 level.
    The Committee recommends $29,566,000 to liquidate 1998 
obligations from loans guaranteed before 1992, which is the 
same as the administration request and $8,042,000 below the 
1997 appropriation. In addition, the Committee provides 
$1,020,000 to pay default claims arising from loans guaranteed 
in 1998, which is the same as the administration request and 
$543,000 above the 1997 appropriation.
    For administration of the HEAL Program, the Committee 
recommends $2,688,000, which is the same as the 1997 
appropriation and the administration request.
    The HEAL Program insures loans to students in the health 
professions and helps to ensure graduate student access to 
health professions education, especially among minority, 
disadvantaged students, and those from behavioral and mental 
health fields. The Budget Enforcement Act of 1990, changed the 
accounting of the HEAL Program. One account is used to pay 
obligations arising from loans guaranteed prior to 1992. A 
second account was created to pay obligations and collect 
premiums on loans guaranteed in 1992 and after. Administration 
of the HEAL Program is separate from administration of other 
HRSA programs.
    The Committee has provided a loan limitation level 
sufficient only to support the continuation costs of those 
students currently receiving HEAL loans. The Committee 
anticipates that the need for the HEAL Program will decline as 
loan limits for guaranteed student loans have been raised by 
the Department of Education. The Committee has also included 
bill language enabling the Office of HEAL Loan Default 
Reduction to use up to $1,000,000 derived by transfer from 
insurance premiums collected from such guaranteed loans.

                 vaccine injury compensation trust fund

Appropriations, 1997....................................    $169,721,000
Budget estimate, 1998...................................      45,448,000
Committee recommendation................................      45,448,000

    The Committee recommends that $45,448,000 be released from 
the vaccine injury compensation trust fund in 1998, of which 
$3,000,000 is for administrative costs. This amount is the same 
as both the budget request and the fiscal year 1997 amount. In 
addition, no general funds are appropriated for compensation of 
vaccine-related injuries associated with vaccines administered 
before fiscal year 1989. This is the same as the administration 
request and $110,000,000 below the fiscal year 1997 amount.
    The National Vaccine Injury Compensation Program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and a death 
benefit.
    The vaccine injury compensation trust fund is funded by 
excise taxes on certain childhood vaccines. The administration 
proposes to exempt the vaccines for children program of 
Medicaid and the CDC discretionary vaccine purchase program 
from payment of the vaccine excise tax in fiscal year 1998, 
yielding an appropriations reduction of $91,000,000.

               Centers for Disease Control and Prevention

                disease control, research, and training

Appropriations, 1997....................................  $2,302,168,000
Budget estimate, 1998...................................   2,315,795,000
Committee recommendation................................   2,368,133,000

    For the Centers for Disease Control and Prevention [CDC], 
the Committee provides $2,368,133,000, which is $65,965,000 
above the 1997 level and $51,338,000 more than the budget 
request.
    The activities of the CDC focus on four major priorities: 
provide core public health functions; respond to urgent health 
threats; promote women's health; and provide leadership in the 
implementation of nationwide prevention strategies to encourage 
responsible behavior and adoption of lifestyles that are 
conducive to good health. While Americans today enjoy the 
longest life expectancy of any time in our Nation's history, 
preventable diseases and conditions still cause death, and 
disability, and still compromise the quality of life for 
millions of Americans. Public health experts estimate that 
about one-half of the deaths which occur in the United States 
every year are considered preventable, as are many of the 
illnesses.

Preventive health and health services block grant

    The Committee recommends $143,940,000 for the preventive 
health and health services block grant, the same as the budget 
request and $10,054,000 below the 1997 appropriation. The 
Committee recommendation includes an additional $45,000,000 
from the violent crime reduction trust fund for rape prevention 
and education activities authorized by the Violence Against 
Women Act to be carried out through the preventive health and 
health services block grant. This amount is $10,000,000 over 
the 1997 appropriation and the full amount authorized by the 
act for fiscal year 1998.
    The preventive health and health services block grant 
provides States with funds for services to reduce preventable 
morbidity and mortality and improve the quality of life. The 
grants give States flexibility in deciding how available 
funding can be used to meet State preventive health priorities. 
Programs eligible for funding include screening, laboratory 
services, health education, and outreach programs for such 
conditions as high blood pressure and cholesterol, and breast 
and uterine cancer.

Prevention centers

    The Committee recommends $8,099,000 for prevention centers. 
This is the same as the budget request and the fiscal year 1997 
appropriation.
    CDC's prevention centers program provides grants to 
academic programs to support applied research designed to yield 
tangible results in health promotion, disease prevention, and 
injury control. This network of collaborating prevention 
centers works to fill the knowledge gaps that block achievement 
of prevention goals. The centers work with State and local 
health departments and other organizations to increase the 
implementation of research findings.
    The Committee encourages the continued support of center 
activities aimed at improving knowledge about the usefulness 
and effectiveness of health promotion programs for persons with 
disabilities.

Sexually transmitted diseases

    The Committee recommends $111,171,000 for sexually 
transmitted disease prevention and control, the same as the 
budget request and $4,968,000 more than the fiscal year 1997 
appropriation.
    The mission of the STD program is to survey, prevent, and 
control the transmission of STD's by providing national 
leadership for: prevention and control programs; monitoring 
disease trends; behavioral and clinical research; education and 
training; building partnerships for STD prevention; the STD 
accelerated prevention campaign; and infertility. 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.
    The increase provided will support replication of the 
successful chlamydia prevention demonstration program. The 
impact of this model has already been proven in 20 States to 
work rapidly. In the Pacific Northwest, for example, chlamydia 
rates have dropped by almost 60 percent within the first 5 
years of the program. Additional funds will be used to expand 
the number of women participating in this collaborative 
services delivery model and to implement and evaluate 
demonstration projects to extend screening to young men in 
order to augment prevention of complications in women.
    The Committee understands that the Institute of Medicine 
recently released a report that outlined the connection between 
non-HIV STD's and an increased risk of transmission of HIV. The 
report estimated that successfully treating 100 cases of 
syphilis among high-risk groups for STD's would prevent up to 
1,200 HIV infections over a 10-year period. The Committee 
concurs with the view of the IOM report that collaboration 
between the STD and HIV divisions of the CDC is critical and 
encourages the Director to improve the collaborative 
interventions and initiatives between these two divisions.
    Earlier this year the President appropriately apologized on 
behalf of the Nation to survivors of the Tuskegee experiment. 
The Committee requests that the CDC report to the Committee by 
February 1, 1998, concerning the progress made to date in 
eliminating syphilis, and the additional effort and investment 
needed over the next 5 years to eradicate this disease in the 
United States.

Immunization

    The Committee recommends $445,545,000 for immunization 
activities in fiscal year 1998 authorized under section 317 of 
the Public Health Service Act, $18,233,000 more than the budget 
request and $22,038,000 below the fiscal year 1997 
appropriation.
    The Omnibus Reconciliation Act [OBRA] of 1993 established a 
new vaccine purchase and distribution system that provides, 
free of charge, all pediatric vaccines recommended for routine 
use by the Advisory Committee on Immunization Practices to all 
Medicaid-eligible children, uninsured children, underinsured, 
and native Americans through program-registered providers. 
Included in the Medicaid estimate for fiscal year 1998 is 
$437,104,000 for the purchase and distribution of vaccines for 
a total immunization recommendation of $882,649,000 in the 
bill.
    The administration of safe and effective vaccines remains 
the most cost-effective method of preventing human suffering 
and reducing economic costs associated with vaccine-preventable 
diseases. Through the immunization program, the CDC provides 
leadership and support for national and international efforts 
to prevent and/or control vaccine-preventable diseases.
    Within the amounts appropriated, sufficient funds are 
provided for the purchase of vaccine under the 317 program. The 
Committee has not agreed to the language proposed in the budget 
request to exempt from the payment of excise tax vaccines 
purchased with Federal funds under the authority of section 317 
of the Public Health Service Act. As in previous years, the 
Director has discretion to make transfers from among funds 
provided for 317 vaccine purchase and infrastructure grants 
based upon the program requirements. The Committee requests 
that the CDC provide notification of the amount of any 
transfer, the latest State carryover balance estimates, and the 
justification for the transfer.
    The Committee recommends the Director ensure that the 317 
program concentrates on improving the vaccine delivery 
infrastructure for children, adolescents, and adults. Barriers 
to immunization involving poor delivery systems, ineffective 
tracking systems, and limited access to providers continue in 
many of our Nation's communities. The Committee urges the 
Director to build greater accountability mechanisms into the 
317 program so that States and localities receiving support are 
utilizing funds in a timely and effective manner. The Committee 
continues to receive reports of significant unspent balances in 
the 317 accounts of many States. The Committee requests that 
the Director be prepared to report on the calender year 1997 
balances in the program and steps the CDC has taken to ensure 
State and local health departments implement systems to ensure 
that limited Federal funds are properly and timely spent.
    An important role of the CDC is to ensure that parents and 
providers have full information about the safety and efficacy 
of vaccines. The Committee encourages the CDC to develop an 
ongoing program to communicate the relationship of benefits 
versus risk of immunization, as well as the consequences that 
result from underimmunization to appropriate individuals and 
providers.
    The Committee recommends that the CDC continue to ensure 
that all grantees receiving IAP funds reserve 10 percent of 
those funds for the purpose of funding immunization assessment 
and referral services in WIC sites in 1997. CDC should ensure 
that all of these funds are used in each State for WIC 
immunization activities unless CDC can document that assessment 
and referral in a State's WIC sites are taking place without 
the need for specific funds. CDC should collaborate with the 
National Association of WIC Directors and with State 
immunization directors in setting the criteria for assessment, 
referral, and annual reporting of WIC coverage.
    As in previous years, the Committee also recommends that 
the CDC require that all States receiving IAP funds continue to 
conduct annual provider site assessments in all public clinics, 
using CDC-approved methodology. In the event that States lack 
sufficient resources to conduct such assessments, the Committee 
requests that the CDC provide technical assistance to the 
States for this purpose.
    The Committee recommendation assumes the continuation of 
the bonus program to improve immunization rates. Using State-
specific immunization coverage data, CDC provides payments to 
States for 2-year-olds who have been fully immunized. CDC will 
provide to the States: $50 per child in excess of 65 percent 
and less than 75 percent; $75 per child in excess of 75 percent 
and less than 85 percent; and $100 per child in excess of 85 
percent.
    The recommendation includes the funds requested for polio 
eradication in order to support CDC's capacity 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 the CDC for its active 
leadership in the effort. Achieving the goal of eradication 
will mean savings in human and financial costs. In the United 
States alone, savings of $230,000,000 will accrue on an annual 
basis once the disease is eradicated and the need for 
immunization is eliminated.
    The Committee is aware that while hepatitis B [HBV] 
vaccines have been available for years and are recommended by 
the CDC, only 20 percent of the 4 million 11- and 12-year-old 
children are currently vaccinated. Vaccinating these preteens 
will prevent up to 30,000 new teenage HBV infections each year. 
To address this public health threat, the CDC is urged to 
assist States in working with physicians, nurses, public health 
care providers, schools, and others to increase the rate of 
compliance with HBV vaccination programs.
    The recommendation includes sufficient funds for the CDC, 
as part of their global polio eradication efforts, to provide 
measles vaccine for supplemental measles immunization campaigns 
and to expand epidemiologic, laboratory, and programmatic/
operational support to the WHO and its member countries. Such 
support should build on the global disease control and 
surveillance infrastructure developed for polio eradication in 
a manner that does not compromise ongoing global polio 
eradication activities. The Committee also encourages the 
Director to provide sufficient staff support for this 
accelerated international measles control effort.
    The Committee has received information on the work being 
undertaken at Thomas Jefferson University Center for Biomedical 
Research in collaboration with the Delaware Valley College 
involving research on plant-delivered oral vaccines. Through 
the use of genetically engineered plants, this research shows 
promise as a means of oral vaccine production for both animals 
and humans. The Committee encourages the Director to give 
consideration to supporting this important area of research.
    The Committee is aware that CDC will finally begin 
construction on a new infectious disease laboratory. The 
laboratory is a long overdue replacement for work that is now 
being carried out in two 1960's-era facilities that are no 
longer adequate for handling a broad array of pathogenic 
microorganisms. Because of inflationary and budgetary 
constraints, the laboratory will be much smaller than the 
148,000 square feet originally projected to meet CDC's needs. 
Since a significant portion of the work that will be done in 
the new laboratory directly relates to immunization such as 
influenza, polio, measles, meningococcal meningitis, rotavirus, 
rabies, and others, the Committee would give careful 
consideration to a one-time reprogramming request from funds 
provided for immunization activities that would allow 
construction of the complete laboratory project.

Infectious diseases

    The Committee's recommendation includes $112,428,000 for 
infectious disease activities, the same as the budget request 
and $24,708,000 over the 1997 appropriation.
    These activities focus on: national surveillance of 
infectious diseases; applied research to develop new or 
improved diagnoses; prevention and control strategies; working 
with State and local departments and private health care 
providers, to transfer application of infectious diseases 
prevention technologies; and strengthening the capability to 
respond to outbreaks of new or reemerging disease.
    Over the past 50 years, significant progress has been made 
in the prevention and control of many infectious diseases. Due 
to a myriad of factors, today this progress has been partially 
reversed, resulting in the emergence of drug resistance and new 
and resurgent bacteria and viruses. Funds provided in fiscal 
year 1998 will continue the phased implementation of the CDC 
developed strategic plan to combat new and emerging infectious 
diseases.
    In fiscal year 1997, the Committee requested that the CDC 
initiate a trans-Department public education campaign to foster 
more effective communication between consumers and health care 
providers on helicobacter pylori and its link to ulcer disease. 
The Committee has provided funding in fiscal year 1998 to 
continue the helicobacter pylori public education campaign. The 
Committee believes that the potential for improving the quality 
of life for thousands of Americans and for producing 
substantial cost savings warrant additional funding for this 
campaign to ensure that it is comprehensive and effective.
    Last year, the Committee called upon CDC to provide 
increased support to implement a comprehensive blood safety 
surveillance and patient outreach effort in the hematologic 
diseases branch. The Committee understands that CDC, working 
collaboratively with the National Hemophilia Foundation, 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 the initial 
efforts, the Committee supports further implementation of this 
important initiative. The Committee also encourages the CDC to 
maintain the current hemophilia prevention complications and 
outreach activities.
    The Committee notes that patients differ in their use of 
blood products, depending on the disease. For example, 
thalassemia patients rely on blood, and not blood products. As 
the single, largest group of chronically transfused patients, 
it is not uncommon for a patient to receive 30 to 35 
transfusions per year. As such, they are in an excellent 
position to assist in improving the safety of the blood supply. 
The Committee encourages CDC to recognize these differences 
when implementing its improved blood safety plans.
    The Committee is aware that in the United States there is 
currently no surveillance system to determine trends in chronic 
liver disease. This information is needed to assist the CDC, 
NIH, and other public health agencies to better target their 
research and other public health efforts. The Committee urges 
the CDC to give priority to developing the necessary 
epidemiological information regarding trends in chronic liver 
disease. The Committee supports the CDC efforts to establish a 
hepatitis and liver disease information center in fiscal year 
1997 and urges its continuation and expansion in fiscal year 
1998 to a level that would meet the need for public information 
on hepatitis and liver disease.
    In May 1997 the Department of Agriculture, the Department 
of Health and Human Services, 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. The report noted further that the relevant 
agencies ``need to better coordinate their research efforts on 
the highest priority issues and work together more effectively 
to leverage each other's resources.'' Toward that end, the 
Committee encourages the CDC to work with the National 
Institutes of Health and the Agricultural Research Service to 
develop a research agenda on food safety to be collaboratively 
funded by the three agencies.
    In the fiscal 1997 supplemental appropriations committee 
report, the Committee noted its concern that hepatitis C [HCV] 
is increasing in prevalence and mortality. The Committee has 
asked the CDC to increase disease surveillance efforts in this 
regard. Since then, the Committee has received information from 
Department of Health and Human Services on the issue of HCV and 
is concerned that the Department states that death certificate 
data is the only means of monitoring this disease and that an 
accurate analysis of the magnitude of the disease has been 
difficult to ascertain. The Committee looks forward to hearing 
from the CDC at its fiscal 1999 budget hearings about its 
efforts to improve disease surveillance in HCV.

Tuberculosis elimination

    The Committee's recommendation provides $119,236,000 for 
CDC's activities to prevent or control tuberculosis. This is 
the same as the budget request and $58,000 below the fiscal 
year 1997 appropriation.
    CDC provides support for the control and elimination of TB. 
This is accomplished in large part through awarding cooperative 
agreements to State, territorial, and large city health 
departments to strengthen their control and elimination 
programs.
    The Committee is pleased that the focus on tuberculosis 
control has had a positive impact on tuberculosis rates in the 
United States and commends the CDC and its State and local 
partners for the fourth year of decline in reported cases of 
TB. Clearly, 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 the increasing number 
of foreign-born TB cases, the need for improved surveillance 
and new diagnostic and preventive tools, such as a vaccine, and 
multidrug resistant TB. The Committee encourages CDC's 
continued efforts outlined in the national plan for the 
elimination of multidrug resistant tuberculosis.
    The Committee notes the number of cases in the United 
States and globally among the foreign born. The Committee 
commends CDC for working with the U.S. Agency for International 
Development to develop a joint plan for collaboration among 
both agencies that outlines specific initiatives that could 
take place to combat TB globally, and further recommends that 
CDC work with the USAID to encourage the expansion of their 
effort beyond the three foreign countries that contribute most 
heavily to the cases of foreign born TB in the United States.

Chronic and environmental disease prevention

    The Committee's recommendation includes $203,454,000 for 
chronic and environmental disease prevention activities. This 
is $12,415,000 over the budget request and $36,580,000 above 
the 1997 appropriation.
    In many instances, premature death, avoidable illness, and 
disability are caused by personal behavior, exposure to toxic 
substances, and/or natural disasters. Prevention of the 
occurrence and progression of chronic diseases, therefore, is 
based on reducing or eliminating behavioral risk factors, 
increasing the prevalence of health promoting practices, 
detecting disease early to avoid complications, assessing human 
risks from environmental exposures, and reducing or eliminating 
exposures to environmental hazards. The focus of the programs 
in this activity includes diabetes, cardiovascular diseases, 
developmental disabilities, tobacco use, comprehensive school 
health, teen pregnancy, birth defects, fetal alcohol syndrome, 
spina bifida, chronic fatigue syndrome, prostate cancer, 
women's health, cancer registries, oral health, skin cancer, 
arthritis, and epilepsy.
    Diabetes.--The incidence of diabetes affects more than 16 
million persons in America. Research has demonstrated that 
controlling blood sugar levels prevents diabetes-related 
complications. While the CDC supports local diabetes prevention 
and control programs in all States, additional support could 
further reduce the number of diabetes complications. The 
Committee supports this work and has included sufficient funds 
to enable the CDC to expand its diabetes prevention effort. 
Funds are provided as proposed in the request to: establish 
comprehensive State diabetes prevention programs; implement the 
public health components of the National Diabetes Education 
Prevention Program; develop and implement public health 
surveillance systems; and conduct applied prevention research.
    The Committee is particularly concerned about the high 
incidence of diabetes within the native American, Native 
Alaskan, and native Hawaiian populations. The Committee urges 
the CDC to conduct research and develop a targeted prevention 
and treatment program for these culturally unique groups with 
shared similarities. Funds are included to award cooperative 
agreements to establish core-capacity diabetes prevention 
research and control programs targeted to the needs of native 
populations, and conduct a community-based intervention project 
in Gallup, NM. Additionally, the Committee urges the CDC to 
work with native groups and community health centers during 
program development.
    The Committee recommends that some of the included increase 
be used for an independent, comprehensive evaluation, in 
cooperation with a State health department, of the 
effectiveness of preventing the complications of diabetes 
through enhanced education services to achieve improved self-
monitoring, nutrition and appropriate physical activity for 
rural, elderly populations.
    Hanford thyroid disease study.--The Committee 
recommendation includes funds requested for the continuation of 
the Hanford thyroid morbidity study. The Committee notes that 
the U.S. Department of Energy [DOE] provided supplemental 
funding in fiscal years 1995-97 and recommends the CDC again 
work with the DOE to provide support for fiscal year 1998. 
These supplemental funds will enable this project to remain on 
schedule for completion in the fall of 1998.
    Cancer.--Prostate cancer, and its disproportionate impact 
on minority males, continues to be a major concern of the 
Committee. More than 334,000 new cases of prostate cancer will 
be diagnosed in 1997, making it the most commonly diagnosed 
cancer. The Committee encourages the CDC to enhance its 
prostate cancer awareness/outreach program targeted at high-
risk populations through collaborations with public and private 
nonprofit organizations with expertise in cancer education.
    The Committee is very pleased with CDC's leadership in 
initiating a colorectal cancer screening public awareness 
campaign. Included in the bill is funding for the continuation 
of CDC's program which is designed to educate health care 
providers and consumers about colorectal cancer screening 
guidelines, inform the public about the availability and 
advisability of screening, and assess and resolve barriers to 
screening.
    The Committee has provided sufficient funds to continue the 
Cancer Registries Program. The information gleaned from these 
registries are important for planning, implementation, and 
evaluation of public health practices in cancer prevention and 
control at the State and national levels. Funding also has been 
included to assist in the conversion of the Savannah River site 
cancer registry, formerly supported by the Department of 
Energy, and the South Carolina State cancer registry into a 
single statewide registry.
    Safe drinking water.--The Committee recommendation includes 
funds above the request to enhance CDC supported evaluations 
and interventions regarding the health effects from inadequate 
provision of safe drinking water in remote arctic communities. 
The Committee recommends the CDC consider building upon 
existing cooperative agreements with State departments of 
health in the region when undertaking this initiative.
    Sudden infant death syndrome.--The Committee notes the work 
of the CDC, the National Institute of Child Health and Human 
Development, and the Health Resources and Services 
Administration in developing a model guideline for death scene 
protocol for sudden infant death syndrome. The Committee 
encourages continued development and publication of these 
guidelines.
    Birth defects.--The Committee recognizes that birth defects 
are the leading cause of infant mortality in the United States 
and are also the leading cause of childhood disability. The 
Committee has provided funds for the CDC to expand its efforts 
to research, survey, and prevent birth defects. The Committee 
is especially interested in CDC's efforts to prevent spina 
bifida and anencephaly through the promotion of increased 
consumption of folic acid among women of reproductive age.
    The Committee applauds the efforts of the agency in guiding 
the efforts of the National Skin Cancer Prevention Education 
Program. Through aggressive public education, this program 
presents a real opportunity to modify behaviors that place 
Americans at increased risk for developing skin cancer. The 
Committee is encouraged by the collaborative efforts of the 
National Association of Physicians for the Environment and 
Federal departments and agencies to implement a melanoma 
education initiative for Federal employees. The Committee 
encourages the Director to convene a working group of Federal 
departments and agencies to develop a plan of action in this 
critical area.
    Disabilities prevention.--The Committee continues to 
strongly support the CDC disabilities prevention program which 
provides support to States and academic centers to reduce the 
incidence and severity of disabilities, especially 
developmental and secondary disabilities. The Committee 
recommendation includes sufficient funds to continue the 
expansion of research on mild mental retardation, including 
Project Begin.
    The Committee recommendation includes sufficient funds to 
support a national information dissemination center to actively 
promote fitness opportunities and accessible facilities for 
participation in disability fitness and rehabilitative sport 
activities if in the judgement of the Director there is 
sufficient need for the center. The center should direct 
educational initiatives toward: medical and rehabilitation 
professionals; community programs that have traditionally 
offered fitness opportunities for the nondisabled populations; 
and the population of people with disabilities. The Committee 
intends that priority consideration be given to a national 
organization experienced in fitness and sport activities for 
people with disabilities.
    Tobacco.--The Committee supports CDC's Office of Smoking 
and Health, and encourages continued public health prevention 
and cessation activities. The Committee continues to strongly 
support efforts to reduce youth tobacco use and is very 
concerned about reports of increasing use. For a number of 
years, the Committee has included funding within the Office for 
counteradvertising. The Committee believes that more must be 
done in this area. The budget included an extensive proposal to 
target youth tobacco use. The Committee supports these 
important efforts and has included funding above the 1997 
level.
    Traditional healing.--Native Hawaiians continue to 
experience major health care problems, including 
extraordinarily high incidences of diabetes and asthma. The 
Committee urges CDC to work collaboratively with the community 
health centers serving this population to explore whether 
systematically utilizing indigenous Hawaiian healing expertise 
might effectively impact their health status. The Committee 
appreciates the CDC designating this as a high priority.
    Volcanic emissions.--The Committee continues to be 
concerned about the public health hazard posed by volcanic 
emissions, in Hawaii, and, therefore, encourages CDC to work 
with NINR and NIEHS in determining the environmental, physical, 
and mental effects of volcanic emissions that might result in 
higher levels of cancer, asthma, and other serious illnesses. 
The Committee is pleased with initial efforts in this area.
    Malama.--The Committee continues to support the concept of 
Malama. This innovative, culturally sensitive community 
partnership program addresses the prenatal needs of minorities 
in rural Hawaii. The Committee encourages the CDC to support 
the replication of this project to include teen pregnancies. 
The ever increasing epidemic of teen pregnancy makes the 
maximum utilization of effective strategies a necessity.
    Oral health.--The Committee notes the contribution of oral 
health to overall health status, the significant health care 
expenditures directed to oral conditions that are largely 
preventable, and the importance of strong scientific leadership 
on oral health issues. The Committee recommendation includes 
funds to expand the Division of Oral Health in fiscal year 
1998.
    Cardiovascular diseases.--The Committee remains concerned 
that cardiovascular diseases, including heart disease and 
stroke, remain the No. 1 killer in the United States. The 
Committee has included funding to expand its heart disease and 
health promotion activities and assist States in the prevention 
of risk factors associated with cardiovascular diseases, such 
as, tobacco use, physical inactivity, and poor nutrition.
    Chronic fatigue and immune dysfunction syndrome [CFIDS].--
The Committee understands that the CDC has taken steps to 
identify adolescents and children with CFIDS and encourages the 
CDC to continue, and expand where appropriate, these 
investigations on populations not formerly recognized as being 
affected by CFIDS. The Committee has received reports that 
growth in CDC's CFIDS research program has stalled and 
promising research is not being published in a timely manner. 
The Committee requests that the CDC be prepared to report 
during the fiscal year 1999 budget hearings concerning its 
allocation of funds to CFIDS, specifically detailing all 
program and administrative expenses that are charged to these 
activities.
    Limb loss.--The Committee recommendation includes 
sufficient funds for the CDC to continue support for 
development of a National Limb Loss Information Center.
    Asthma.--The Committee recognizes that asthma is estimated 
to affect between 14 and 15 million people, and is the most 
common chronic disease of childhood--affecting 5 million 
children under the age of 18. In addition, the Committee is 
aware that there have been significant scientific advances in 
the management of asthma and that there are many promising 
environmental interventions that have been shown to reduce the 
frequency and severity of asthma exacerbations. In order to 
assure that these breakthroughs are translated into effective 
actions that improve the public's health, the Committee 
encourages the CDC to begin implementation of a program to 
prevent the morbidity and mortality associated with asthma.
    In this regard, the Committee further encourages the 
National Center for Chronic Disease Prevention and Health 
Promotion, and the National Center for Environmental Health, to 
consider undertaking a collaborative effort to foster more 
effective communication between physicians and consumers on 
asthma and an effective means of controlling and preventing the 
disease.
    Iron overload.--Hereditary hemochromatosis is one of the 
most common genetic disorders. By middle age, excess iron 
accumulation often causes inflammation and tissue damage, and 
may cause arthritis, cirrhosis, diabetes, impotence, and heart 
failure. The Committee has provided funds for the CDC to 
further study and implement strategies for the prevention of 
iron overload diseases.
    Fetal alcohol syndrome.--Researchers at the University of 
New Mexico have been engaged with the CDC for the past 4\1/2\ 
years in a project to establish the prevalence and 
characteristics of fetal alcohol syndrome in the population of 
New Mexico. This project will provide extensive information 
from interviews with mothers of these children to establish 
risk factors for FAS which then will be used to design 
prevention programs. The Committee encourages the CDC to 
support an extension of this important project for another 
year.
    The Committee is aware of the CDC's work in assisting 
communities in developing strategies to prevent out-of-wedlock 
teen pregnancies. The city of Newark ranks among the highest in 
the Nation in teen pregnancy, low birthweight babies, and 
infant mortality. The Committee is aware of the city's bright 
futures initiative to combat teen pregnancy and encourages the 
Director to give appropriate consideration to supporting this 
program.

Lead poisoning

    The Committee recommendation includes $38,200,000 for lead 
poisoning prevention activities, $19,000 above the 1997 
appropriation and $46,000 above the President's request.
    Since its inception in fiscal year 1990, the CDC program 
has expanded to about 40 project areas that encompass States, 
local areas, and numerous communities and screens an estimated 
1,750,000 children annually.
    CDC is to be commended for its support of the continued 
development of more effective and portable blood lead hand 
screening tools, and for supporting 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 considered by 
the FDA.

Breast and cervical cancer mortality prevention

    The Committee's recommendation includes $141,897,000 for 
breast and cervical cancer mortality prevention activities, the 
same as the request and $2,238,000 more than the 1997 
appropriation.
    While some progress has been made recently in reducing 
deaths from breast cancer, many women who develop these cancers 
and who are at highest risk for premature death from cancers of 
the breast and cervix are minorities and/or the economically 
disadvantaged. These populations of women still have not showed 
reductions in deaths from breast cancer, in large measure due 
to not having access to preventive services such as screening 
mammograms and pap smears.
    In fiscal year 1998, 65 States, territories, and American 
Indian tribal organizations will receive resources for 
comprehensive programs. Funds provided for fiscal year 1998 
will help improve access for all women to preventive services, 
and assist State programs in: informing women of the value of 
early detection; educating physicians about recommended 
screening guidelines; ensuring the quality of screening 
mammography and pap tests; and monitoring program effectiveness 
through appropriate surveillance and evaluation activities.
    The Committee commends the CDC for utilizing funding for 
the breast and cervical screening program to continue to build 
programs nationwide, and to develop programs consistently from 
State to State that include minimum standards for participating 
States. Continued priority for breast cancer screening should 
be given to postmenopausal, low-income, underinsured and 
uninsured women, and those at high risk of breast cancer. The 
Committee requests that the CDC give consideration to expanding 
the Wisewoman Program from the current three States to a total 
of eight States.

Injury control

    The recommendation by the Committee includes $45,063,000 
for injury control efforts. This is $3,970,000 less than the 
President's request and $1,881,000 more than the fiscal year 
1997 appropriation. The recommendation includes an additional 
$6,000,000 from the violent crime reduction trust fund for 
domestic violence activities authorized by the Violence Against 
Women Act. This is the same level as the 1997 appropriation. 
The President's budget had requested the full $6,000,000 under 
general purpose appropriations. These funds will continue to 
support community program demonstrations on domestic violence.
    The Center is the lead Federal agency for injury prevention 
and control. Programs are designed to prevent premature death 
and disability and reduce human suffering and medical costs 
caused by: fires and burns; poisoning; drowning; violence; lack 
of bicycle helmets, seatbelts, and baby seats; and other 
injuries. The national injury control program encompasses 
nonoccupational injury and applied research in acute care and 
rehabilitation of the injured. Funds are utilized both for 
intramural and extramural research as well as for assisting 
State and local health agencies in implementing injury 
prevention programs. The Committee recognizes the important 
role that CDC provides as a focal point for all Federal injury 
control activities.
    The Committee supports the extramural research program of 
the Center which supports research aimed at preventing and/or 
mitigating the effects of injuries. The program supports 
research centers, individual investigator-initiated research 
projects, and the training of new workers in the injury control 
field. The Committee remains supportive of acute care training 
demonstrations at existing university-based research centers 
and encourages CDC to make acute care training demonstrations a 
priority. In addition, the Committee is pleased with the ICRC's 
work, especially in regards to acute trauma care.
    Each year, approximately 300 bicyclists 17 years and 
younger are fatally injured, and over 150,000 are treated in 
hospital emergency rooms for bicycle-related head injuries. 
Research has shown that 85 percent of these head injuries can 
be prevented by the use of helmets. Despite this fact, and the 
successful effort in many communities to promote bicycle helmet 
usage, it is estimated that less than 15 percent of American 
children wear them. The Committee encourages the Center to 
organize a national campaign to promote bicycle helmet usage. 
Such efforts should involve private and public partners, and 
include organizations interested in child health, safety, brain 
injury prevention, and cycling.
    Sufficient funds have been provided to enable the Center to 
support effective prevention programs for traumatic brain 
injury consistent with the Traumatic Brain Injury Act.
    Suicide and suicidal behavior is a major public health 
risk, particularly for elderly Americans. The Committee 
recommendation includes funds above the request for the Center 
to conduct evaluations of interventions focused on the 
prevention of suicide among the elderly.
    The Committee recognizes CDC's contribution to national 
efforts to reduce violence and prevent domestic violence. With 
over 1 million children a year the victims of abuse and 
neglect, the Committee recommends the Center give consideration 
to extending its focus on violence by supporting an initiative 
directed to the prevention of physical and emotional injuries 
associated with child maltreatment and neglect. The Committee 
encourages the NCIPC to collaborate with relevant national 
organizations and with academic institutions, including schools 
of social work, in the development and implementation of this 
initiative.
    The Committee recommendation maintains the proviso included 
in the House bill prohibiting the use of funds to advocate or 
promote gun control.
    The recommendation includes funding to establish a 
developmental center for the prevention of accidental injury 
among older Americans. In addition, sufficient funding is 
provided to initiate a developmental injury center for the 
prevention of suicide. The Committee recommends that in 
locating this center, the Director give consideration to an 
area with high rates of suicide.
    The Committee is pleased with the attention CDC has given 
to the national program for playground safety. The heightened 
public interest and awareness that have resulted from the 
development and dissemination of the national action plan for 
the prevention of playground injuries is encouraging. The 
Committee recommends the CDC continue to provide sufficient 
support to implement the plan in order to reduce the more than 
200,000 injuries reported annually.
    Emerging research is telling us that child sexual abuse 
represents a critical point on the intergenerational continuum 
of intimate partner violence. This research suggests that child 
sexual abuse is a risk factor in males for committing sexual 
offenses in adolescence and adulthood. Women who are survivors 
of child sexual abuse are at greater risk of sexual assault 
victimization in adulthood. To address this important public 
health problem with the goal of breaking the cycle of violence, 
the Committee requests that the CDC evaluate the effectiveness 
of current public health prevention efforts directed at 
perpetrators and to educate people who may know a perpetrator 
to confront the abusive behavior.

Occupational safety and health

    The Committee's recommendation includes $148,463,000 for 
the National Institute for Occupational Safety and Health 
[NIOSH], the same as the budget request and $7,123,000 more 
than the 1997 appropriation.
    The National Institute for Occupational Safety and Health 
[NIOSH] in CDC is charged with conducting a national program of 
occupational safety and health research and information 
dissemination to ensure safe and healthful working conditions 
for American working men and women. Occupational injuries occur 
at twice the rate of injuries in the home or in public places. 
Severe occupational trauma is second only to motor vehicle 
incidents as a cause of unintentional death in the United 
States. The majority of all of these deaths and injuries are 
preventable.
    To prevent work-related hazards, NIOSH conducts applied 
research with a corps of occupational safety and health 
professionals operating in multidisciplinary teams comprised of 
engineers, epidemiologists, industrial hygienists, physicians, 
and toxicologists. Intramural efforts are complemented by 
grants, contracts, and cooperative agreements to form a 
comprehensive and integrated program consisting of four 
components: Identification of hazards; research on causes and 
prevention of occupational injuries and illnesses, 
dissemination of research findings and recommendations; and 
training of those involved in preventing disease and injury at 
work.
    Funds have been provided as requested for intramural 
research on work-related diseases at the new state-of-the-art 
laboratory in Morgantown, WV, and to fully staff the laboratory 
research program. In addition, funds have been provided as 
proposed in the request to conduct firefighter fatality 
assessment and control investigations.
    The Committee recommends that NIOSH give consideration to 
increasing funding for a Northwest fishing safety and health 
initiative. Such an initiative would permit cooperative efforts 
among government and academia and the fishing industry to 
reduce lives lost in this high hazard occupation.
    Sufficient funding is provided to continue the farm health 
and safety initiative. This important initiative, begun in 
1990, has a primary focus of reducing the incidence of fatal 
and nonfatal injuries and occupational diseases among the 
millions of agricultural workers and their families in the 
United States. The Committee is particularly pleased with the 
research being undertaken by the agricultural research centers 
and expects that this program will continue at no less than the 
level of funding provided in fiscal year 1997.
    After more than 20 years of increasing rates of injuries in 
the building and construction trades industry, the Committee 
was very pleased to note from the Bureau of Labor Statistics 
that the rate of injuries decreased by 28 percent in 1993. The 
Committee is impressed with the progress that has been made on 
construction safety and health during the last 5 years, and has 
encourages NIOSH to maintain its level of effort in this area.
    Concerns continue to be brought to the Committee regarding 
the design and review of a multiyear study, jointly funded by 
NIOSH and the National Cancer Institute, to investigate the 
health effects of diesel fumes on workers in underground 
noncarbon mines. The Committee requests that NIOSH submit a 
report by December 1, 1997, detailing the following: (1) the 
extent to which time has been given for public comment on the 
draft study protocols; (2) the extent to which the study 
protocols have undergone peer review; (3) the makeup of the 
review group and the extent to which labor and industry were 
represented; (4) the extent to which modifications have been 
made to the study protocols which resulted from recommendations 
from the review process and/or public comment; (5) whether any 
feasibility study has demonstrated the effectiveness of the 
study equipment, protocol, and design, particularly with regard 
to the accuracy of historical diesel exposure assessment; and 
(6) the extent to which data will be shared with participating 
organizations as it is collected.
    The Committee commends the work of the university based 
educational resource centers and the smaller single discipline 
training project grants. The Committee is supportive of 
expanding the research and research training activities of the 
ERC's and TPG's.

Mine safety and health

    The recommendation includes $40,000,000 for the former U.S. 
Bureau of Mines mine safety and health research activities. In 
fiscal year 1996 these activities were transferred from the 
U.S. Bureau of Mines to NIOSH. The recommendation is $8,000,000 
above the budget request and $8,087,000 above the 1997 
appropriation. The former Bureau of Mines research activities 
address a broad spectrum of issues which target worker safety, 
disaster prevention, and health in the mining industry.
    While NIOSH has had responsibility for occupational safety 
and health research aimed at industry in general, the Committee 
understands that many mine safety and health research needs are 
either unique to mining or require mining-specific emphasis. 
The Committee, therefore, expects the NIOSH to continue to 
preserve the integrity of the mine safety and health research 
unit of the Bureau so that the collective experience and 
expertise of that group can be maintained within NIOSH.
    The additional funds have been provided restore the mine 
safety and health program in fiscal year 1998 to a level 
comparable to levels prior to the transfer of the program. 
Historical tables show that comparable programs received 
approximately $40,000,000 in fiscal year 1995. With the 
transfer to NIOSH, both former Bureau of Mines staff and 
facilities need to be prepared for the new work that will be 
undertaken to better protect the health and safety of mine 
workers.

Epidemic services

    The Committee's recommendation includes $69,322,000 for 
epidemic services, the same as the request and $286,000 less 
than the 1997 appropriation.
    The objectives of the epidemic services activity are to: 
provide for the investigation, prevention, or control of 
epidemics, develop, operate, and maintain surveillance systems, 
analyze data, and respond to public health problems when 
indicated; train public health epidemiologists [EIS]; carryout 
quarantine regulations; reduce the importation of disease from 
developing countries; publish the morbidity and mortality 
weekly report; develop, coordinate, and provide efficacious, 
effective, and economic prevention strategies; and assist in 
the improvement of State infrastructure.

Health statistics

    Included in the recommendation of the Committee is 
$18,033,000 in Federal funds for health statistics. Also 
included is $70,063,000 to be provided from PHS 1 percent 
evaluation funds. This brings the total available to the CDC 
for health statistics to $88,096,000. This is $930,000 less 
than the request and $2,084,000 more than the fiscal year 1997 
level.
    CDC's National Center for Health Statistics [NCHS] is the 
Nation's principal health statistics agency, whose mission is 
to provide statistical information that will guide actions and 
policies to improve the health of the American people.
    The increase provided is for the national health and 
nutrition examination survey [NHANES]. This is the same as the 
request and will provide for full funding of this important 
component of the Nation's health information strategy. When 
fully implemented, NHANES provides unique information from 
direct physical examinations, biochemical measures, interviews, 
and nutritional analysis from a large, representative sample of 
persons. This survey is the only national source of objectively 
measured health status data, and is essential to interpreting 
information from other survey components.
    The Committee has become aware of the prevalence of 
sarcoidosis as a public health problem. Overall, sarcoidosis is 
estimated to occur in 35.5 per 100,000 U.S. blacks and 10.9 per 
100,000 U.S. whites. The Committee recommends that NCHS give 
consideration to making sarcoidosis a reportable disease, by 
establishing a national sarcoidosis patient registry, in 
collaboration with the National Heart, Lung and Blood 
Institute, the National Institute of Allergy and Infectious 
Disease, and the Sarcoidosis National Network.

Human immunodeficiency virus

    The Committee recommendation includes $646,790,000 for HIV/
AIDS activities, $30,000,000 more than the fiscal year 1997 
appropriation and $12,524,000 more than the request.
    The Committee continues to support CDC's strategy to 
develop community planning to direct resources to where the 
most critical needs are.
    The Committee understands that the Institute of Medicine 
recently released a report that outlined the connection between 
non-HIV STD's and an increased risk of transmission of HIV. The 
report estimated that successfully treating 100 cases of 
syphilis among high-risk groups for STD's would prevent up to 
1,200 HIV infections over a 10-year-period. The Committee 
concurs with the view of the IOM report that collaboration 
between the STD and HIV divisions of the CDC is critical and 
encourages the Director to improve the collaborative 
interventions and initiatives between these two divisions.
    The Committee is very supportive of the hemophilia 
consumer-based patient involvement programs that have been 
successful in HIV/AIDS risk reduction and in the prevention of 
the complications of hemophilia. The Committee has included 
funds to maintain and strengthen hemophilia and other 
hematologic program activities focused on preventing and 
reducing the crippling, debilitating complications, and death 
caused by such bleeding disorders.

Building and facilities

    The Committee recommendation includes $23,007,000 for 
repair and renovation of CDC facilities, the same as the 
request and $7,546,000 below the fiscal year 1997 
appropriation. Funds are provided for the most needed repair 
and improvement projects as facilities age and programs change.

Program management

    For program management, the Committee recommends 
$2,465,000, the same as the President's request and $98,000 
below the fiscal year 1997 appropriation.
    The ``Program management'' account primarily supports the 
activities of the Office of the Director of the CDC. The vast 
majority of administrative costs are captured throughout the 
program accounts within the CDC.
    The recommendation includes bill language providing the 
Director with authority to transfer funds available from the 
sale of surplus vaccine from the vaccine stockpile to other 
activities within the jurisdiction of the Centers for Disease 
Control and Prevention. In the event the Director exercises 
this transfer authority, the Committee is to be notified 
immediately.
    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 continuation 
of innovative programs, such as the coordination of preventive 
care with substance abuse treatment centers.
    The Committee understands that under the Clinical 
Laboratory Improvement Act [CLIA], the FDA was given the 
responsibility to categorize the complexity of new invitro 
diagnostic [IVD] devices. However, the FDA failed to undertake 
this task and the responsibility for regulating the complexity 
of these IVD products is being carried out by the CDC. At the 
same time, FDA continues to conduct extensive evaluations of 
these IVD devices before clearing them for market under the 
FDCA, including reviewing their instructions for use. The 
Committee concurs with the concern expressed by the authorizing 
committee that this dual responsibility has resulted in a 
process that causes confusion, unnecessary conflict, and 
duplication of effort. This Committee encourages the CDC to 
review with the FDA the prospect of returning to the FDA the 
role of categorizing the complexity evaluations under the CLIA 
and be prepared to report on the review during the fiscal year 
1999 hearings.
    Local health departments are the first line of defense in 
protecting the public health. The Committee is concerned that 
many local health departments may lack basic and necessary 
technologies to carry out their mission. The Committee requests 
the Director of the CDC to review the technology and training 
needs of local health departments and report to the Committee 
on the findings prior to the fiscal year 1999 budget hearings. 
This report should include recommendations on how to address 
existing unmet needs.
    The Committee has received concerns from States regarding 
its policy for tapping program lines for central administrative 
activities. The Committee requests that the Director provide to 
the Committee a report on the amount of administrative funding 
that will be tapped from each program line before the end of 
the first quarter. The Committee requests that any subsequent 
change to program administrative taps be treated as a 
reprogramming request.

Violent crime reduction trust fund

    The Committee recommendation includes $51,000,000 from the 
violent crime reduction trust fund for activities authorized by 
the Violence Against Women Act in the crime bill included is 
$45,000,000 to augment rape prevention services supported by 
the States through the preventive health and health services 
block grant, and $6,000,000 for grants to public and private 
nonprofit organizations to support community programs to 
prevent domestic violence.
    The funds for rape prevention and services total 
$10,000,000 above the 1997 appropriation and will be used by 
States to expand support for rape crisis centers and State 
coalitions, to support rape crisis hotlines, victim counseling, 
professional training of police officers and investigators, and 
education programs in colleges and secondary schools.
    The Committee is concerned with the distribution of funds 
for rape prevention and education that are provided with funds 
from the violent crime reduction trust fund and sent to the 
States through the preventative health and health services 
block grant. States should comply with the statutory language 
and congressional recommendations accompanying the use of these 
funds. Funds should be used to supplement rape crisis centers 
and State sexual assault coalition's rape prevention and 
education efforts and not to supplant funds from other sources.

                     National Institutes of Health

    The Federal investment in biomedical research at the 
National Institutes of Health [NIH] is regarded by the 
Committee as one of its highest priorities. Few activities of 
the Government have the potential to improve the quality of 
life for our Nation's citizenry and reduce the costs of health 
care than medical research. Earlier this year, the Senate 
endorsed 98 to 0, a substantial expansion of funding for the 
National Institutes of Health. The Committee recommendation 
reflects this commitment to medical research while also 
maintaining support for other high priority primary and 
preventive health programs. The fiscal year 1998 recommendation 
for the 24 Institutes, Centers, and Divisions which comprise 
the National Institutes of Health totals $13,692,844,000. The 
recommendation is $952,001,000 over the 1997 level and 
$614,641,000 over the budget request.

                       NATIONAL CANCER INSTITUTE

Appropriations, 1997....................................  $2,254,951,000
Budget estimate, 1998...................................   2,441,738,000
Committee recommendation................................   2,558,377,000

    The Committee recommends an appropriation of $2,558,377,000 
for the National Cancer Institute [NCI]. This is $116,639,000 
more than the budget request and $177,228,000 more than the 
fiscal year 1997 appropriation. The comparable numbers for the 
budget estimate include funds to be transferred from the Office 
of AIDS Research.
    Mission.--The NCI conducts and supports basic and applied 
cancer research in prevention, early detection, diagnosis, 
treatment, and rehabilitation. NCI provides training support 
for research scientists, clinicians, and educators, and 
maintains a national network of cancer centers, clinical 
cooperative groups, community clinical oncology programs, 
cancer prevention and control initiatives, and outreach 
programs to rapidly translate basic research findings into 
clinical practice.
    The Committee has held a number of hearings this year 
examining the hopes, dreams, and frustrations of patients and 
scientists on the frontlines in our war against cancer. Through 
these hearings, the Committee has developed a greater 
understanding of the programs, priorities and needs of our 
National Cancer Program. It is abundantly clear that the hope 
of ameliorating the societal burden of cancer lies in the 
diligent pursuit of a comprehensive cancer research program to 
improve cancer prevention, early detection, treatment, and 
survival. The Committee recognizes that one in two males, and 
one in three females will develop cancer over their lifetime. 
This disease poses a major and catastrophic health threat to 
the American public. The costs, both human and economic, of 
cancer in this country are catastrophic. The national 
investment in cancer research remains the key to bringing down 
spiraling health care costs, as treatment, cures, and 
prevention remain much cheaper than chronic and catastrophic 
diseases, like cancer. The Committee continues to strongly 
support cancer research as a national priority.
    Cancer coordination.--The Committee is pleased that NCI 
continues to recognize its leadership role as coordinator of 
the National Cancer Program. As facilitator of the Nation's 
fight against cancer, the Committee encourages NCI to continue 
to work in collaboration with private/voluntary sector 
organizations, the CDC, and other Federal agencies to address 
the coordination challenges outlined in the National Cancer 
Advisory Board's report entitled: ``Cancer at a Crossroads''.
    Breast cancer.--While recent data continues to show a drop 
in deaths from breast cancer, still this disease is expected to 
strike over 180,000 women in 1997. The Committee continues to 
believe that an intensive research program on breast cancer 
should be among the top priorities of the NCI and the NIH. More 
research is needed to better understand the underlying 
mechanisms of this disease, and to improve the ability to 
detect, diagnose, and treat breast cancer. Research also is 
needed to develop new prevention strategies with respect to 
this form of cancer. The Committee urges the NCI to strengthen 
its budgetary commitment to breast cancer research.
    The recommendations include sufficient funds to support the 
activities of the national action plan on breast cancer which 
the Committee understands will continue to be implemented by 
the PHS Office on Women's Health. This important public/private 
partnership, which catalyzes breast cancer activities across 
the Federal Government and the private sector, has accomplished 
a great deal in the fight against breast cancer.
    Digital mammography.--The Committee is aware of promising 
technology to improve the early detection of breast cancer 
involving digital mammography. The Committee understands 
further that a number of small-scale trials are underway and 
encourages the Institute to give strong consideration to 
supporting a large-scale trial on this technology should these 
early trials show improved efficacy.
    Ataxia telangiectasia.--Ataxia telangiectasia is an 
inherited disorder that causes progressive loss of muscle 
control, immune deficiency, a strikingly high rate of cancer, 
and eventually death in children. With support from NIH, 
research has recently shown that the ATM protein missing in A-T 
children interacts with the well-known tumor suppressor gene 
p53 and plays a roll in DNA repair, cell-cycle control, and 
cellular aging. The Committee considers A-T research a high 
priority, and it is an outstanding example of how research on a 
rare disorder may ultimately benefit the public at large. In 
particular, the Committee strongly encourages NCI to sponsor 
workshops and participate at conferences on A-T aimed at 
sharing unpublished data, generating new research strategies, 
minimizing duplication of research efforts, and encouraging new 
collaborations.
    Waldenstrom's macroglobulinemia.--The Committee is 
concerned about the lack of information and treatments 
available for this rare disease which is particularly 
debilitating and costly to adults under the age of 50. The 
Committee and urges the Institute to intensify its research 
efforts with regard to Waldenstrom's macroglobulinemia.
    Neurofibromatosis.--Advances continue to be made in 
research on neurofibromatosis [NF]. The Committee encourages 
the Institute to expand its NF research portfolio and support 
novel approaches in clinical development of NF research and 
therapies, including the use of: requests for applications, as 
appropriate; program announcements; the national cooperative 
drug discovery group program; and small business innovative 
research grants. The Committee recognizes that 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 the recommendations in this 
and last year's Committee reports, at its hearing on the fiscal 
1999 budget.
    Nutrition science.--The Committee is encouraged by the 
continued emphasis placed on nutrition research by the NCI. The 
Committee is especially interested in the clinical aspects of 
nutrition research and would urge the Institute to expand 
support for clinical nutrition units and similar programs which 
can serve to integrate the findings of basic science with 
improved patient care.
    Ovarian cancer.--The Committee understands that more than 
70 percent of women with ovarian cancer are diagnosed by their 
physicians for the first time when the disease is in its 
advanced stages. As survival rates for women with ovarian 
cancer increase dramatically if the cancer is found in its 
earliest stages, which appears to be due to an absence of 
reliable diagnostics to detect it, in part because there are 
only vague symptoms in the early stages of the disease. The 
Committee encourages the NCI to support expanded research into 
the early detection, diagnosis, and staging of ovarian cancer.
    Prostate cancer.--The Committee continues to be concerned 
about the increasing rates of prostate cancer, particularly 
among African-American males. The Committee is encouraged by 
NCI's investment in the prostate component within the prostate, 
lung, colon, and ovary screening trial and the formation of a 
prostate cancer progress review group. In addition, the 
Committee applauds NCI's research collaborations with the 
Department of Defense and Howard University aimed at 
determining why African-American males are at greater risk. The 
Committee urges NCI to continue to expand and strengthen its 
prostate cancer research program.
    Adolescent tobacco use.--The Committee is pleased that NCI 
is seeking to increase the number of applications for 
prevention and cessation of tobacco use by children and youth. 
While rates of tobacco use among adults have been reduced, 
controlling tobacco use among U.S. youth has not been 
successful. The Committee understands that the NCI is seeking 
innovative behavioral proposals to target interventions that 
prevent use of tobacco, as well as community-based or health 
services research aimed at young people. The Committee is 
particularly interested to learn how lessons can be learned 
from youth populations with low use of tobacco, that is, 
African-American youth, and applied to populations with higher 
use.
    Cancer in minorities.--Recent statistics continue to 
document the high incidence of cancer among the native Hawaiian 
population. When compared with other ethnic and racial groups, 
native Hawaiians have among the highest incidence of the most 
common types of cancer such as breast, colon, and lung cancer. 
The Committee encourages continued research emphasis in this 
priority area and expresses its gratitude for the work the NCI 
has done with the Hawaii Cancer Center.
    Diethylstilbestrol.--The Committee continues to strongly 
support increased efforts to study and educate the public and 
health professionals about the impact of exposure to the 
synthetic hormone diethylstilbestrol [DES]. The NCI and other 
Institutes, along with the Office of Women's Health have 
developed a plan for expanded research activities in this area. 
The Committee encourages the Institute to carry out this plan. 
In addition, educational materials for consumers and health 
professionals have been developed as a result of a 
demonstration project funded by the Committee in previous 
years. The Committee also encourages the NCI, in conjunction 
with HRSA, CDC, and the Office of Women's Health, to 
disseminate these materials nationally and to undertake other 
educational efforts targeting consumers and health 
professionals on a national basis. The Committee expects NCI 
and these other agencies to continue to consult with 
organizations representing individuals impacted by DES as they 
carry out DES research and education efforts.
    Brain tumors.---The Committee continues to place a high 
priority on brain tumor research. The Committee strongly 
supports the approach of using centers of excellence 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.
    Translational research.--Translational clinical research is 
the bridge between the laboratory and new methods of diagnosis, 
treatment, and prevention and is, thus, essential to progress 
against cancer. This research has been responsible for some of 
the most stunning clinical successes of this century, including 
determining the molecular mechanisms of colon cancer, the 
engineering of effective AIDS treatment, and the new treatments 
to reduce the side effects of chemotherapy. Translational 
research is critical to fully develop the major advances made 
by basic scientists in areas such as molecular genetics, 
regulatory proteins, and cellular signaling into new detection 
technologies, targeted treatments, and prevention strategies 
for cancer patients. The Committee urges the Institute to 
strengthen its efforts in this area in an effort to rapidly 
translate our research progress.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 1997....................................  $1,351,440,000
Budget estimate, 1998...................................   1,467,189,000
Committee recommendation................................   1,531,898,000

    The Committee recommendation includes $1,531,898,000 for 
the National Heart, Lung, and Blood Institute [NHLBI]. This is 
$64,709,000 more than the budget request and $99,369,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    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 innovative 
basic, clinical, population-based, and health education 
research.
    Asthma.--The NHLBI continues to provide leadership in 
asthma through a comprehensive program that spans from basic 
research to health education and prevention initiatives. 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. Important 
efforts are underway by the 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. For this reason, the 
Committee encourages the NHLBI to continue its support of the 
Childhood Asthma Management Program to follow over 1,000 
children with asthma (with over one-third of the participants 
Hispanics or African-American asthmatics) and the Asthma 
Clinical Research Network. The NHLBI is to be congratulated on 
its coordination of asthma research and education programs 
throughout the United States under its National Asthma 
Education and Prevention Program, as well as its international 
efforts through the global initiative for asthma project 
conducted in collaboration with the World Health Organization.
    The Committee urges that NHLBI 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 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 encourages the NIH Director to 
take an active role in facilitating future collaborations. The 
Committee also urges NHLBI to follow up on recent scientific 
publications calling into question the public health 
significance of sleep apnea and 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 the 
NHLBI to expand 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 the NHLBI has made significant 
contributions to clinical research through its pulmonary 
related specialized centers of research programs.
    Sarcoidosis.--Sarcoidosis is an inflammatory, noninfectious 
multisystem disease of unknown cause that can lead to fibrosis, 
or scarring. Although sarcoidosis 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, 
therefore, 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.
    Cooley's anemia.--A special emphasis panel convened by 
NHLBI in September 1996 strongly recommended the establishment 
of a network of collaborative clinical centers to study the 
effectiveness of new clinical interventions for Cooley's 
anemia. Because no single clinical center has enough patients 
to undertake a meaningful clinical study, the network would be 
the most cost-effective plan to undertake this translational 
research. Such a network could serve as a model for other 
diseases with relatively small populations. The Committee looks 
forward to learning from NHLBI what progress has been made on 
this network prior to next year's hearings.
    Outreach and public education.--The success of NIH and the 
impact of its research initiatives are dependent to a degree on 
the translation of that research into clinical practice. The 
Committee commends NHLBI for its outreach and public education 
activities. The Committee encourages NHLBI to expand upon its 
efforts in this area and to continue to provide exemplary 
outreach and public education services to its constituencies 
and the general public.
    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 No. 1 killer of men and women since 1919 and 
a major cause of disability. The Committee urges the Institute 
to place the highest priority on cardiovascular research and 
expand, within the funds provided, the extramural Heart Program 
to support existing programs and invest in promising research 
initiatives.
    Origins of atherosclerosis.--Atherosclerosis (hardening of 
the arteries), causing blockage of blood vessels, underlies 
much of heart disease and stroke. The Committee encourages the 
Institute to expand and initiate research that could lead to 
the identification and treatment of high risk individuals 
before heart attack and stroke strikes and supports expanded 
research on the role of inflammation of the walls of blood 
vessels in development of these killer diseases.
    Congestive heart failure.--The result of a damaged heart 
muscle from diseases such as heart attack, high blood pressure 
and congenital heart defects and congestive heart failure, 
affects about 5 million Americans. Current treatment only slows 
the course of the underlying diseases, so the Committee 
recommends that the Institute support an intensified research 
program to test promising treatments to restore heart function 
and to study heart muscle cells that may lead to muscle cell 
regeneration and transformation of heart scar tissue into 
functioning cells. The Institute is also encouraged to study 
the genetic causes of cardiomyopathy, a heart muscle disease 
afflicting 50,000 Americans who are also prone to congestive 
heart failure.
    Congenital heart defects.--Congenital 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. 
The Committee encourages expansion of research that uses 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.
    A healthful lifestyle.--Success in translating awareness of 
heart attack, stroke and other cardiovascular disease risk 
factors into behavior modification has been limited. The 
Committee encourages the Institute to expand and initiate 
research into behavior modification and long-term compliance. 
Learning how to ensure adherence to programs known to be 
effective if followed can greatly reduce the occurrence of 
heart disease and stroke.
    Hemophilia.--The Committee fully supports the need to 
maximize funding for the hemophilia research program at NHLBI, 
especially in seeking a cure for this severe bleeding disorder. 
Further, the Committee remains deeply concerned that little 
progress has been made in addressing the vulnerability of the 
hemophilia community to the blood contaminants including 
Creutzfeldt-Jakob disease [CJD] in the blood supply. The 
Committee urges the NHLBI to develop a research program, in 
collaboration with CDC, to ensure maximum safety and integrity 
of the U.S. blood supply by end of this year.
    Transfusion medicine.--The Committee is pleased that the 
NHLBI has created a network of umbilical cord blood banks and 
transplant centers and encourages the Institute to continue to 
pursue an aggressive research program to improve blood safety 
and further the field of transfusion medicine.
    Alternative research resources.--The Committee supports the 
expansion of existing alternative resources to the use of 
animals, particularly through ensuring increased access by 
researchers to human tissues and organs for research purposes. 
The Committee encourages the Director to give consideration to 
participating in a multi-Institute initiative geared to 
increase support in this area and respond to the research 
community's growing need for human tissues and organs.
    Acute respiratory distress syndrome [ARDS].--ARDS is a 
devastating form of respiratory failure, remains a significant 
health threat for many seriously ill people for which there is 
no effective treatment. The ARDS Network, consisting of 10 
critical care treatment groups, has been established by the 
NHLBI to identify effective therapies through prospective, 
randomized multicentered clinical trials. The Committee is 
pleased to learn that the ARDS network will be evaluating a 
promising investigational toxicity modifier in the ARDS 
network. This product shows promise in preclinical 
investigations and may offer the first real innovation in the 
management of this disease over the past decade. The Committee 
believes that these types of innovative collaborations, 
supported by the public and private sectors, will serve to 
rapidly translate research progress from discovery to patients. 
The Committee looks forward to hearing about this important 
initiative at next year's hearing.
    Minority health.--The Committee has been pleased with the 
commitment of the NHLBI with respect to initiatives to study 
health issues disproportionately impacting African-Americans 
and other minorities. The Committee commends NHLBI for its 
leadership in supporting research and training programs at 
minority health professions institutions.

                 NATIONAL INSTITUTE OF DENTAL RESEARCH

Appropriations, 1997....................................    $195,825,000
Budget estimate, 1998...................................     202,831,000
Committee recommendation................................     211,611,000

    The Committee recommendation includes $211,611,000 for the 
National Institute of Dental Research [NIDR]. This is 
$8,780,000 more than the budget request and $15,786,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The NIDR supports research and research training 
to improve the oral health of the American people. The 
Institute emphasizes ways to prevent disease in high-risk 
groups, including the elderly, minority populations, and people 
with medical conditions and medications that compromise oral 
health. The research agenda includes studies of craniofacial 
genes and birth defects; bone and joint diseases; AIDS, other 
infections, and immunity; oral cancer; chronic pain; 
epidemiology; biomaterials; and diagnostic systems.
    Bone diseases.--The Committee is pleased with the growth of 
research on osteoporosis, Paget's disease and osteogenesis 
imperfecta and encourages the Institute to consider using a 
portion of the increased funding for fiscal year 1998 to 
further expand and intensify its research programs on bone 
diseases.
    Temporomandibular joint disorders [TMJ].--The Committee 
remains strongly interested in research on temporomandibular 
joint disorders [TMJ]. Last year, NIDR convened a Technology 
Assessment Conference on the Management of TMJ. The Committee 
urges the Institute to expand its efforts to implement this 
agenda. The Committee also asks NIDR to form an inter-institute 
committee along with representatives of the Office of Women's 
Health, AHCPR, and CDC to develop a short- and long-term 
research agenda. Further, a study of TMJ patients who are 
suffering craniofacial and systemic problems as the results of 
implants is recommended.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 1997....................................    $815,607,000
Budget estimate, 1998...................................     833,802,000
Committee recommendation................................     883,321,000

    The Committee recommends an appropriation of $883,321,000 
for the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK]. This is $49,519,000 more than the 
administration's request and $67,714,000 more than the fiscal 
year 1997 appropriation. The comparable numbers for the budget 
estimate include funds to be transferred from the Office of 
AIDS Research.
    Mission.--The NIDDK provides leadership for a national 
program in three major disease categories: diabetes, 
endocrinology, and metabolic diseases; digestive diseases and 
nutrition; and kidney, urologic, and hematologic diseases. The 
NIDDK plans, conducts, fosters, and 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.
    Polycystic kidney disease.--Polycystic kidney disease [PKD] 
is the most common life-threatening genetic disease, affecting 
600,000 Americans. The Committee understands that scientists 
worldwide agree that PKD science is mature and that discoveries 
leading to a treatment and ultimately a cure are now 
foreseeable. The Committee, therefore, urges the NIDDK to 
increase its research efforts to find a treatment and cure for 
PKD.
    Digestive diseases.--Diseases of the digestive system 
continue to affect more than one-half of all Americans at some 
time in their lives. 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 recommends that the NIDDK 
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 continues to be concerned about the 
increasing frequency of irritable bowel syndrome [IBS], a 
chronic complex of disorders that malign the digestive system. 
The Committee recommends that NIDDK provide adequate funding 
for irritable bowel syndrome/functional bowel disorders 
research and give priority consideration to funding IBS 
education/scientific symposiums.
    Food safety.--In May l997, the DOA, the Department of 
Health and Human Services, 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. This clarifies the need for biomedical 
research 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 other's resources.'' Toward that end, the 
NIDDK is encouraged to work with the NIAID, the Centers for 
Disease Control and Prevention, and the Agricultural Research 
Service to develop a research agenda on food safety to be 
collaboratively funded by the three agencies.
    Hepatitis C [HCV].--The Committee is pleased with the 
leadership of the 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 
mechanism of liver cell injury by HCV; and to study the 
interaction between alcohol ingestion and HCV. The Committee 
urges priority consideration be given to initiating this 
research in a manner responsive to the professional judgment 
recommendations.
    The Committee also recommends that the Institute ensure 
that the findings of this conference is disseminated among 
health care providers to heighten awareness with regard to 
effective treatments that are available, and lifestyle changes 
necessary to modify the progression and transmission of 
disease.
    Liver disease.--The Committee encourages the NIDDK to 
maintain a high-priority consideration on research to prevent, 
cure and better treat liver disease with a special focus on the 
needs for pediatric liver disease. The Committee supports the 
NIDDK minisymposium that was scheduled for 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 proposal. 
Finally, the Committee encourages the NIDDK to strengthen its 
outreach to the liver disease research community and its 
coordination and information program regarding liver disease 
research.
    Cooley's anemia.--The Committee has long supported research 
in the area of Cooley's anemia. Due to the numerous red blood 
cell transfusions that patients must undergo, iron accumulates 
in the major organs. The effective removal of this iron by 
chelating drugs requires an accurate assessment of iron levels 
in the patient. Accuracy is impeded, however, by the lack of a 
quality, noninvasive test to measure iron overload. The 
Committee, therefore, encourages NIDDK to move forward in an 
effort to develop an accurate noninvasive test to measure iron 
overload in patients with Cooley's anemia as well as other 
conditions. Treatment could be further enhanced by the 
development of an iron chelator drug that can be taken orally.
    Bone diseases.--The Committee is pleased with the growth of 
research on osteoporosis, Paget's disease, and osteogenesis 
imperfecta and encourages the NIDDK to further expand and 
intensify its research programs on these bone diseases.
    Diabetes.--Diabetes affects 16 million Americans and is a 
leading cause of blindness, kidney disease, heart disease, and 
amputations. Given the enormous human and economic costs of 
diabetes, the Committee urges the Director of the Institute to 
work closely with the Director of the NIH in establishing a 
diabetes research working group to develop a comprehensive plan 
for all NIH-funded diabetes research efforts. The Director of 
the Institute and the Diabetes Mellitus Interagency 
Coordinating Committee is encouraged to work closely with the 
working group in the development and implementation of the 
diabetes research plan.
    The NIDDK and the CDC are to be commended for their joint 
establishment of a National Diabetes Education Program. Recent 
research has determined that the key pathology underlying type 
II diabetes is insulin resistance. Accordingly, the Committee 
encourages the NDEP to fully reflect the latest scientific data 
regarding the importance of strict management of blood glucose 
levels by measures that include the direct treatment of insulin 
resistance.
    The Committee is concerned about the high incidence of 
diabetes in native American, Native Alaskan, and native 
Hawaiian populations. The Committee encourages the NIDDK to 
develop a targeted diabetes prevention and treatment program 
for these culturally unique groups which share many 
similarities. Additionally, the Committee encourages the CDC to 
work with native American, Native Alaskan, and native Hawaiian 
groups and local community health centers in the development 
and implementation of this program.
    The Committee notes that the availability of human islets 
is an essential component for translational diabetes research. 
The Committee is aware of the partnership between the Miami VA 
Medical Center, Jackson Memorial Hospital, and the University 
of Miami Diabetes Research Institute for multidisciplinary 
diabetes research. The Committee encourages NIDDK to give 
consideration to establishing a dedicated Human Islet 
Processing and Distribution Center.
    Interstitial cystitis.--The Committee continues to support 
a strong interstitial cystitis [IC] research program. IC is a 
serious and debilitating bladder disorder which primarily 
affects women. The Committee is pleased that in fiscal year 
1997 the NIDDK continued to fund IC clinical research and is 
encouraged by the progress made by the national IC data base.
    Nutrition sciences.--Nutrition science is a major part of 
the NIH research agenda related to prevention. Diet and 
nutrients are factors in the prevention of diabetes, heart 
disease, certain cancers, hypertension, and birth defects. 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 recommends the 
Institute give consideration to expansion of the clinical 
nutrition research centers programs in order to expand clinical 
research and assure the translation of research results into 
practice through training of professionals. The Committee is 
particularly interested in a focus on nutrition, obesity, and 
diabetes.
    Prostatitis.--The Committee is pleased that the NIDDK has 
begun to address the public health issues of prostatitis. The 
Committee encourages the NIDDK to consider expanding the number 
of clinical centers to be funded from the current solicitation 
and soliciting individual applications from investigators with 
diverse backgrounds to address basic and clinical research 
approaches to the disease.
    Urologic diseases.--The Committee encourages the Institute 
to increase research in urology, including the basic and 
applied science of the prostate, and urological health issues 
affecting women, such as interstitial cystitis, urinary 
incontinence, and urinary tract infections. The Committee 
recommends that the NIDDK consider developing an appropriate 
data base for urologic diseases. This data base would, for the 
first time, give realistic estimates of the extent of these 
diseases, the health care expenditures for these diseases, the 
variations in treatment, and the effect that these diseases 
have on the minority populations.
    End stage renal [ESRD].--With over 60,000 Americans dying 
each year from kidney failure, the Committee encourages the 
NIDDK to develop and to implement an interinstitute action plan 
for adult and pediatric kidney disease research, including 
other NIH institutes, AHCPR, HCFA, and the CDC, that shares and 
leverages funding opportunities inside and outside of the 
NIDDK.
    Cystic fibrosis.--As a result of the partnering the NIH has 
undertaken, the future looks promising for patients with this 
disease. The Committee encourages the NIDDK, along with the 
NHLBI and the NCRR to expand its support of centers of 
excellence in cystic fibrosis [CF] and the CF gene therapy 
centers. Furthermore, NIH is encouraged to assure the 
development of an infrastructure for the rapid assessment of 
the new clinical therapies to treat this and other devastating 
diseases.
    Alternative research resources.--The Committee supports the 
expansion of existing alternative resources to the use of 
animals, particularly through ensuring increased access by 
researchers to human tissues and organs for research purposes. 
The Committee encourages the Director to give consideration to 
participating in a multi-Institute initiative geared to 
increase support in this area and respond to the research 
community's growing need for human tissues and organs.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 1997....................................    $726,407,000
Budget estimate, 1998...................................     747,828,000
Committee recommendation................................     781,351,000

    The Committee recommends an appropriation of $781,351,000 
for the National Institute of Neurological Disorders and Stroke 
[NINDS]. This is $33,523,000 more than the budget request and 
$54,944,000 more than the fiscal year 1997 appropriation. The 
comparable numbers for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--The NINDS conducts and supports a broad range of 
research and research training on the normal function of the 
brain, spinal cord, and peripheral nerves, and on neurological 
and neuromuscular disorders. Neurological research includes 
epidemiology studies to identify risk factors for disease; 
laboratory studies to examine the structure and function of 
nerve cells; and brain imaging studies to understand how the 
brain is affected by disease and how it operates to carry out 
tasks such as learning and memory. New approaches for the 
diagnosis, treatment, and prevention of brain disorders are 
evaluated in studies with patients and people at risk for brain 
disorders.
    Parkinson's disease.--The Committee continues to seek 
intensified and expanded efforts by the Institute to understand 
the pathophysiology of Parkinson's disease and develop 
effective therapies for this devastating disorder.
    The Committee was pleased to learn of important advances in 
the genetics of Parkinson's disease, resulting from 
collaborations developed after the international workshop 
sponsored by the NINDS in collaboration with the NIA, the 
NIEHS, and the NIMH. Other Institute initiatives, including two 
recent program announcements, have stimulated additional 
research that will provide important insights into this 
devastating disorder. However, much remains to be done to 
improve the outlook for patients and their families. The 
Committee recommendation includes sufficient funds for the 
Institute to expand funding for research in Parkinson's 
disease. This will allow a balanced program of basic and 
clinical research, including centers, clinical trials, and 
further work in the genetics and cell biology of 
neurodegenerative disease.
    The Committee notes that the Institute has made use of 
exploratory center grants and is developing a similar mechanism 
to encourage the design of high quality clinical trails. The 
Institute is encouraged to use these and other innovative 
mechanisms to stimulate the field, such as a consortium of 
investigators focusing on the genetics and epidemiology of 
Parkinson's disease and the center without walls approach that 
proved successful for Huntington's disease research. The 
Committee looks forward to hearing about the progress of these 
efforts at the fiscal year 1999 hearing.
    The Committee also encourages the Institute to consider the 
creation of a position for a senior program officer with 
specific responsibility for the coordination of the NIH-wide 
Parkinson's research program.
    Multiple sclerosis [MS].--The Committee continues its 
strong interest in an aggressive research program on MS. The 
Committee is aware of recent progress in treating MS patients 
with recurrent/remissive forms of the disease and urges the 
Institute to continue and expand its support for basic and 
applied research on MS.
    Dystonia.--The Committee continues to be pleased with the 
Institute's 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 this 
disease.
    Neurodegenerative disorders.--The Committee encourages the 
Institute to continue research to determine the role of 
neurotransmitters in neurodegenerative disorders.
    Stroke.--Stroke remains America's No. 3 killer, the leading 
cause of serious disability and a major contributor to late-
life dementia. Now, opportunities to improve prevention and 
acute treatment of stroke appear to have never been greater. 
The Committee urges the Institute to place high priority on 
stroke research and encourages expansion of the stroke 
education program and support of innovative approaches to 
improved stroke diagnosis, treatment, rehabilitation, and 
prevention to make more rapid progress toward the ``Decade of 
the Brain'' goal of ``prevention of 80 percent of strokes and 
protection of the brain during acute stroke.''
    Amyotrophic lateral sclerosis [ALS].--Amyotrophic lateral 
sclerosis, commonly referred to as Lou Gehrig's disease, is a 
progressive, fatal neurologic disease for which no cure exists. 
Recent clinical research resulted in the first compound to 
alter the course of the disease. The Committee encourages NINDS 
to enhance its support of brain research relevant to ALS.
    Neurofibromatosis.--Neurofibromatosis [NF] is associated 
with many forms of human cancer, brain tumors, and learning 
disabilities affecting more than 100 million Americans. The 
Committee encourages the Institute to expand its NF research 
portfolio and to support novel approaches in the development of 
NF clinical research and therapies, including the use of: 
requests for applications, as appropriate; program 
announcements; the national cooperative drug discovery group 
program; and small business innovative research grants. The 
Committee requests that the Institute be prepared to report the 
status of NF research program, including progress in 
implementing the recommendations in this and last year's 
Committee reports, at its hearings on the fiscal 1999 budget.
    Batten disease.--Batten disease is an irreversible and 
severe neurologic disorder affecting the brains of infants, 
children, and young adults. The most common type is 
characterized by motor and intellectual deterioration, vision 
loss, behavioral changes, and the onset of progressively severe 
seizures and terminates in death in a vegetative state. The 
Committee continues to be concerned with the pace of research 
in Batten disease. The Committee recommends that the Institute 
consider actively soliciting and encouraging quality grant 
applications for Batten disease and should continue to take 
steps necessary to assure that a vigorous research program is 
sustained and expanded.
    Brain tumors.--The Committee continues to place a high 
priority on brain tumor research. The Committee strongly 
supports the approach of using centers of excellence 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.
    Minority health.--The Committee has been pleased with the 
commitment of the NINDS with respect to initiatives to study 
health issues disproportionately impacting African-Americans 
and other minorities. The Committee commends Institute for its 
leadership in supporting research and training programs at 
minority health professions institutions.
    Autism.--Given that there is already significant research 
in epilepsy, the Committee urges the NINDS to explore the link 
between seizure activity and autism. Additionally, the 
Committee recommends the Institute, along with the NIMH, 
explore more effective neural imaging strategies for young 
children.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 1997....................................  $1,256,659,000
Budget estimate, 1998...................................   1,312,502,000
Committee recommendation................................   1,359,688,000

    The Committee recommends an appropriation of $1,359,688,000 
for the National Institute of Allergy and Infectious Diseases 
[NIAID]. This is $47,186,000 more than the budget request and 
$103,029,000 more than the fiscal year 1997 appropriation. The 
comparable numbers for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--The NIAID supports and conducts basic and 
clinical research and research training programs in infectious 
diseases, including AIDS, and diseases caused by, or associated 
with, disorders of the immune system. The NIAID is the lead NIH 
Institute charged with developing new and improved vaccines and 
supporting research on acquired immunodeficiency syndrome, 
tuberculosis, sexually transmitted diseases, and tropical 
diseases. The NIAID's research goal is to improve the health 
and quality of life of people by improving diagnosis, 
treatment, and prevention of diseases.
    Tuberculosis.--NIAID's support for tuberculosis research is 
critical in developing improved diagnostic tests, and 
treatments in response to the reemergence of TB in the United 
States. The Committee understands that NIAID-supported 
researchers have begun to understand multidrug resistant 
tuberculosis and hope to develop methods to quickly determine 
which drug therapy is appropriate for MDRTB strains, so a 
patient can begin an appropriate treatment therapy immediately, 
thus reducing the risk of transmitting the disease to others.
    Primary immune deficiency diseases.--The Committee 
recognizes that more than 70 primary immune deficiency diseases 
have been identified to date, with 500,000 cases diagnosed and 
estimates of another 500,000 undiagnosed. These diseases, in 
which the body is unable to fight off infections, strike most 
severely at children, many of whom do not survive beyond their 
teens or early twenties. The Committee encourages NIAID to 
maintain its research focus on these devastating disorders as 
well its support of primary immune deficiency disease 
registries. The Committee also encourages the Institute to 
continue the important collaborations with the Jeffrey Modell 
Foundation on both research and public education endeavors.
    Sarcoidosis.--The Committee supports the role NIAID has 
played in the establishment of the sarcoidosis national network 
[SNN], a national network of sarcoidosis patients, their family 
members, and the public health community. We encourage their 
continued support of this effort. The Committee also urges 
NIAID to continue its examination of the environmental and 
genetic agents associated with sarcoidosis, since approximately 
one-fourth of the chronic sarcoidosis cases are dying due to 
respiratory failure, or other pulmonary dysfunctions.
    Food safety.--In May 1997 the DOA, the Department of Health 
and Human Services, 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. This clarifies the need for biomedical 
research 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 other's resources.'' Toward that end, the 
NIAID is encouraged to work with the NIDDK, the Centers for 
Disease Control and Prevention, and the Agricultural Research 
Service to develop a research agenda on food safety to be 
collaboratively funded by the three agencies.
    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 a HCV vaccine and 
to conduct clinical trials to better determine optimum 
treatment regimens, including better treatment for those 
coinfected with HIV. The Committee urges that this research be 
initiated in fiscal year 1998 in a manner responsive to the 
conference recommendations.
    Blood safety/hemophilia.--The Committee is pleased with 
NIAID's continuing commitment to maximize clinical funding 
support, to assure access to newly available HIV/AIDS drugs for 
people with hemophilia. The Committee urges 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.
    Chronic fatigue and immune dysfunction syndrome.--The 
Committee encourages the Institute to provide additional 
support for extramural grants focused on promising areas of 
CFIDS biomedical research, particularly those investigations 
which will define the pathophysiology of the illness and 
identify diagnostic markers.
    Organ transplantation research.--The Committee urges the 
Director to support research efforts to increase organ 
donation, including projects: (1) aimed at increasing organ 
donations in underserved and rural areas and among minority 
populations, and (2) evaluating community-based initiatives.
    Postpolio syndrome.--The Committee is aware of the progress 
being made on the postpolio syndrome and encourages the 
Institute to support research in this area, including providing 
rehabilitation alternatives for postpolio patients.
    E. coli.--The Committee is aware that 10,000 to 20,000 
infections of Escherichia coli (E. coli) occur in the United 
States annually and that such infections can lead to serious 
complications, including death. The Committee encourages the 
NIAID to expand its work in E. coli infections.
    Alternative research resources.--The Committee supports the 
expansion of existing alternative resources to the use of 
animals, particularly through ensuring increased access by 
researchers to human tissues and organs for research purposes. 
The Committee encourages the Director to give consideration to 
participating in a multi-Institute initiative geared to 
increase support in this area and respond to the research 
community's growing need for human tissues and organs.
    Malaria.--The Committee is encouraged by NIH's interest and 
effort to bring renewed attention to research opportunities for 
malaria prevention and control. U.S. leadership at this time is 
critical. The Committee supports the National Institute of 
Allergy and Infectious Diseases [NIAID] intention to launch a 
new malaria research initiative to better understand human 
immunity to several forms of malaria, and to accelerate the 
development of a malaria vaccine. In addition, the Committee 
urges NIAID to coordinate its efforts with the CDC, the Agency 
for International Development, and the Department of Defense to 
maximize Federal research efforts.
    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. The Committee 
urges that additional research be supported in this area to 
help determine risk factors for developing allergic disorders 
and sinusitis, and to determine the role of infectious agents 
including viruses, bacteria, and fungi in the pathogenesis of 
such disorders.
    The Committee is concerned about the effects of untreated 
allergies, as well as the impact of sedating antihistamines on 
worker safety and children's learning. Further, the Committee 
is concerned about allergic rhinitis as a factor contributing 
to the morbidity and mortality related to asthma. The Committee 
looks to the Institute to develop guidelines with regard to the 
management of allergic rhinitis and related conditions. These 
guidelines should build support for the proper diagnosis and 
treatment of allergic rhinitis.
    Emerging infectious diseases.--The Committee supports the 
continued focus on research into the antibiotic resistance of 
life-threatening bacterial organisms and the development of a 
new generation of antibiotics, and the Committee recommends 
support for this continued area of research. The Committee is 
aware of the research into infectious diseases being conducted 
at the Public Health Research Institute and encourages the 
NIAID to give appropriate consideration to research proposals 
received from this institution.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 1997....................................    $998,387,000
Budget estimate, 1998...................................   1,020,192,000
Committee recommendation................................   1,058,969,000

    The Committee recommendation includes $1,058,969,000 for 
the National Institute of General Medical Sciences [NIGMS]. 
This is $38,777,000 more than the budget request and 
$60,582,000 more than the fiscal year 1997 appropriation. The 
comparable numbers for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--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 supplies 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 regularly find applications in the 
biotechnology and pharmaceutical industries. The Institute's 
training programs help provide the scientists needed by 
industry and academia to maintain U.S. leadership in biomedical 
science.
    Trauma.--The Committee recognizes that injury is a leading 
public health problem: the leading cause of death for Americans 
under age 45, and the fourth leading cause of death overall. In 
recognition of this fact and the chronic shortage of basic and 
clinical investigators of trauma research, the Committee 
encourages the Institute to preserve and augment existing 
trauma and burn research training grants.

        NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

Appropriations, 1997....................................    $631,365,000
Budget estimate, 1998...................................     647,279,000
Committee recommendation................................     676,870,000

    The Committee recommends an appropriation of $676,870,000 
for the National Institute of Child Health and Human 
Development [NICHD]. This is $29,591,000 more than the budget 
request and $45,505,000 more than the fiscal year 1997 
appropriation. The comparable numbers for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--NICHD is that component of the National 
Institutes of Health which is responsible for conducting and 
supporting research on maternal and child health, the 
population sciences, and medical rehabilitation. Research 
encompassed by these areas targets infant mortality; genetic 
diseases, including birth defects; mental retardation; 
contraceptive development and evaluation; pediatric, maternal, 
and adolescent AIDS; developmental biology; vaccine 
development; demographic and behavioral research; and 
restoration or enhancement of function in individuals 
experiencing physical disability due to injury, disease, or 
birth defect.
    Sudden infant death syndrome [SIDS].--NICHD is to be 
commended for its aggressive efforts to reduce SIDS deaths 
through the national collaborative 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 encourages 
the Institute to support the fourth year of the second SIDS 5-
year research plan. These plans, developed in collaboration 
with the SIDS scientific and advocacy community, have 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. The 
Committee strongly supports these efforts and encourages the 
Institute to pursue additional emphasis on them. In addition, 
because of the critical importance of early diagnosis and 
proper treatment, the Committee is pleased with the efforts to 
educate primary care physicians, school nurses, and other 
providers in early diagnosis and treatment. The Committee 
strongly encourages NICHD to continue and expand its 
educational efforts and be prepared to report to the Committee 
prior to next year's hearings concerning the success of these 
efforts and future plans for public awareness and education.
    Osteogenesis imperfecta [OI].--NICHD is to be commended for 
its research on the mapping of gene markers associated with 
several diseases, including osteogenesis imperfecta [OI]. OI is 
a genetic disorder characterized by bones that break easily 
from little or no apparent cause. The Committee encourages the 
NICHD to further expand and intensify its research efforts on 
OI.
    Autism.--Autism is a developmental disability that 
typically appears during the first 3 years of life. At the 
present time, there is no prevention, treatment or cure for 
autism. The Committee is encouraged by the NIH's recent 
research effort focused on the neurobiology and genetics of 
autism.
    The Committee recognizes some recent strides, particularly 
the NICHD/NIDCD RFA in the genetics and neurobiology of autism 
and the creation of an interagency autism coordinating 
committee. The Committee encourages the coordinating committee 
to meet regularly, to make those meetings open to the public, 
and to report to Congress on the goals set and progress made 
prior to the fiscal year 1999 hearings. In addition, the 
Committee urges the Institute to develop a standardized and 
universal diagnostic criteria in autism to aid in earlier 
diagnosis, and to promote clinical trials, an important part of 
medical progress often unavailable to the pediatric population. 
Finally, the Committee urges consideration of a center-based 
approach, similar to the one used in research on Alzheimer's 
disease to speed the pace of progress in autism.
    Demographic research.--The Committee continues to place 
high priority on demographic research and data collection that 
provide objective information for public policy related to the 
well-being of children and families. The Committee urges NICHD 
to continue a proactive role in supporting state-of-the-art 
data collection to meet these research needs.
    Childhood development.--The Committee commends the NICHD 
for support of 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 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.
    Child care.--The Committee wants to emphasize its strong 
support for the ongoing developmental studies examining the 
effects of nonmaternal care on a child's psychological and 
cognitive development and physical health. The Committee 
encourages the Institute to pursue further research in this 
area.
    The Committee urges the Institute to conduct a study which 
will examine the quality of child care funded by Federal 
resources. The purpose of the study is to examine to what 
extent recent research on the brain development of young 
children is being applied by recipients of Federal child care 
funds and to make recommendations to ensure the use of best 
practices by these recipients.
    Health and behavior.--The Committee emphasizes its strong 
support for health and behavioral research at NICHD. The 
Committee looks forward to learning the results of the first 
national, longitudinal study about behaviors that place teens 
at risk. The data will yield a wealth of information invaluable 
in helping to understand how best to protect the health of our 
young people.
    Diet and nutrition.--The Committee is concerned about the 
large number of girls who are engaged in restrictive dieting 
and the consequences of dieting on their health and 
development. The Committee encourages the NICHD to further 
investigate behavioral, social, and cultural factors that 
affect adolescent girls' eating habits.
    Reading development and disability.--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, policymakers, and parents. Noting the fact that 
the NICHD is already collaborating with the Department of 
Education, the Committee urges the Director of the NICHD in 
consultation with the Secretary of Education, to convene a 
national panel to assess the status of research-based 
knowledge, including the effectiveness of various approaches to 
teaching children to read. The Committee recommends that the 
panel be comprised of 15 individuals, who are not officers or 
employees of the Federal Government and include leading 
scientists in reading research, representatives of colleges of 
education, reading teachers, educational administrators, and 
parents. Based on its findings, the panel should present a 
report to the Secretary of Health and Human Services, the 
Secretary of Education, and the appropriate congressional 
committees. The report should present the panel's conclusions, 
an indication of 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 the schools. If 
found warranted, the panel should also recommend a plan for 
additional research regarding early reading development and 
instruction. The Committee looks forward to discussing the 
findings of the report during the hearing on the fiscal year 
1999 budget.
    The Committee commends the Institute for its outreach and 
public education efforts which have had a significant impact on 
the health and well-being of our Nation's children. The 
Committee encourages the NICHD to expand 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 to 
children through the media.
    High-frequency oscillatory ventilation [HFOV] research.--
The Committee understands that a relatively new form of 
ventilation called high-frequency oscillatory ventilation has 
been used to care for fragile, low birthweight infants with 
respiratory problems. Many investigators believe this will 
decrease the incidence of pulmonary complications; however, the 
research evidence to date is split on whether this form of 
therapy is superior to conventional respiratory therapy. The 
Committee understands that research is needed to assess how 
well HFOV works and whether or not there may be potential 
dangers. The Committee urges NICHD to give strong consideration 
to supporting this HFOV research.
    Fragile X.--Fragile X is the most common inherited cause of 
mental retardation. The Committee urges NICHD to expand basic 
and applied research and testing of Fragile X. The Committee 
recommends that NICHD give consideration to convening a 
colloquium of leading scientists in this field and in related 
fields with a view toward publishing a report on the most 
promising directions of future research aimed at treatment.
    Behavioral and social sciences.--The Committee recognizes 
the NICHD's mission to study issues related not only to 
individuals, but to families and distinct population groups 
within the United States. In support of this mission, the 
Committee encourages the NICHD give careful consideration to 
demonstration projects to create virtual community-based 
centers designed to strengthen families in multicultural 
environments, such as the one proposed by the University of 
Hawaii's Center on the Family.
    Infertility and contraceptive research.--The Committee 
continues to place high priority on research to combat 
infertility and speed the development of improved 
contraceptives. The Committee encourages NICHD to continue 
aggressive activities in this area, including individual 
research grants and those of the infertility and contraceptive 
research centers.
    Media and youth.--The Committee is concerned that a recent 
review of the scientific literature on the factors leading to 
early sexual activity and pregnancy concluded that little 
empirical research has been conducted on the effects of growing 
up in an environment saturated by models of nonmarital sexual 
behavior, especially as portrayed by the popular media. What is 
not known is whether frequent exposure to various forms of 
media that include high levels of sexual content and low levels 
of portrayal of responsible sexual conduct affect young 
people's attitudes and behavior. Careful, peer-reviewed 
research is needed to address this question and the Committee 
encourages the NICHD to stimulate research in this area. The 
Committee further encourages the Institute to consider the 
following three basic issues: (1) What sexual messages do youth 
pay attention to, and how do they interpret what they see and 
hear? (2) Does sexual media content affect youth's sexual 
beliefs and behavior? and (3) Can the mass media be used to 
promote responsible sexual behavior among youth? The Committee 
requests that the Director be prepared to report on its 
activities in this area during the hearings on the fiscal year 
1999 budget.
    National Center for Medical Rehabilitation Research.--
Medical rehabilitation is a relatively new, rapidly expanding 
field and many of its therapeutic practices have never been 
evaluated for their effectiveness and cost justification. 
Though outcomes research is an expressed emphasis of the 
Center, the Committee understands that it has not yet supported 
full-scale clinical trials intended to assess the outcomes of 
significant rehabilitation practices. The Committee encourages 
the Center to initiate such research, where appropriate.
    Down syndrome research.--The Committee commends the NICHD 
for embarking on an expanded Down syndrome research initiative, 
and encourages other Institutes to join in similar 
collaborations with a Down syndrome focus. In addition, the 
Committee is pleased that NICHD and the National Down Syndrome 
Society [NDSS] have also made plans to jointly sponsor a state-
of-the-art research conference in which renowned scientists 
from NDSS, NICHD, and other NIH Institutes will collaborate and 
set priorities for future research in Down syndrome and related 
areas of cognition, behavior, and therapeutics. This sharing of 
information, technology, and the collective knowledge of the 
world's foremost researchers is expected to produce an 
acceleration of scientific and medical advancements that will 
benefit all individuals affected by Down syndrome.

                         NATIONAL EYE INSTITUTE

Appropriations, 1997....................................    $332,597,000
Budget estimate, 1998...................................     340,431,000
Committee recommendation................................     357,695,000

    The Committee recommends an appropriation of $357,695,000 
for the National Eye Institute [NEI]. This is $17,264,000 more 
than the budget request and $25,098,000 more than the fiscal 
year 1997 appropriation. The comparable numbers for the budget 
estimate include funds to be transferred from the Office of 
AIDS Research.
    Mission.--The NEI is the Nation's Federal resource for the 
conduct and support of 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.
    The NEI has reported exciting progress in developing 
treatments for age-related macular degeneration [AMD] in the 
areas of cell transplantation, inhibition of abnormal growth of 
blood vessels, and, potentially, gene therapy. The Committee 
was pleased to hear that the NEI is completing its sixth 
strategic program planning effort. The Committee would be 
pleased to receive a summary of this plan during the hearings 
on the fiscal year 1999 budget.
    Age-related eye disease study.--The Committee is especially 
pleased to learn that this study, a multicenter natural history 
study and clinical trial of AMD and cataract, is proceeding 
with over 4,700 patients already recruited. The Committee 
encourages the NEI to broaden the assessment of the nutrients 
involved in the study and to give research on this disease an 
even higher priority in the future, including support of more 
clinical trials, natural history studies, and clinical research 
training.
    The impact of age-related eye diseases such as glaucoma, 
cataract, diabetic retinopathy, and AMD, will multiply several 
fold in the 21st century as our population ages. The Institute 
is urged to develop research programs that will evaluate these 
new eye care delivery challenges, assess current efforts at 
providing eye care, and fostering the development of innovative 
approaches to eye care for the future.
    Alternative research resources.--The Committee supports the 
expansion of existing alternative resources to the use of 
animals, particularly through ensuring increased access by 
researchers to human tissues and organs for research purposes. 
The Committee encourages the Director to give consideration to 
participating in a multi-Institute initiative geared to 
increase support in this area and respond to the research 
community's growing need for human tissues and organs.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 1997....................................    $308,487,000
Budget estimate, 1998...................................     319,907,000
Committee recommendation................................     331,969,000

    The Committee recommends an appropriation of $331,969,000 
for the National Institute of Environmental Health Sciences 
[NIEHS]. This is $12,062,000 more than the budget request and 
$23,482,000 more than the fiscal year 1997 appropriation. The 
comparable numbers for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--The mission of the NIEHS is to define how 
environmental exposures affect our health, how individuals 
differ in their susceptibility to these effects, and how these 
susceptibilities change with time. This knowledge, coupled with 
prevention and communication programs, can lead to a reduction 
in environmentally associated diseases and dysfunctions.
    Parkinson's disease.--The Committee notes the recent 
findings, such as the study linking metals exposure to 
increased Parkinson's incidence, which supplement the 
significant body of data linking environmental exposures and 
this devastating disorder. The Committee urges the Institute to 
continue to build on its past initiatives, such as its 1995 
workshop, by increasing its intramural and extramural program 
in this area. The Committee encourages the NIEHS to coordinate 
such efforts with other NIH initiatives into other factors 
contributing to Parkinson's incidence, including the efforts of 
the NHGRI and the NINDS on the genetic links to the disease.
    Volcanic emissions.--The Committee continues to be 
concerned about the public health aspects of volcanic emissions 
[VOG] in Hawaii and urges the Institute to continue to 
collaborate with NINR in the multidisciplinary approach to this 
problem. The Committee appreciates the initial efforts of NIEHS 
to work with the University of Hawaii.
    Marine and freshwater biomedical science centers.--The 
Committee commends the research that NIEHS has conducted on 
ocean environment-related diseases. The theme of World Expo 
1998 is the ``Oceans: A Heritage for the Future'' and the U.S. 
pavilion will have exhibit areas for visitors to walk on the 
ocean floor. The Committee supports the NIEHS partnership with 
the U.S. pavilion at World Expo 1998 to develop exhibits on 
ocean environment-related diseases. The Committee encourages 
NIEHS to lend its expertise in this area to the United States 
exhibit at World Expo 1998 in Lisbon, Portugal, which relates 
to the ocean environment. Given the increase provided to NIEH, 
the Committee encourages the Institute to allocate resources to 
this project.
    Children's health.--The Committee is pleased that the NIEHS 
in collaboration with the Centers for Disease Control and 
Prevention and the Environmental Protection Agency, intends to 
develop centers of achievement targeted in children's health, 
with a focus in the areas of asthma and respiratory diseases. 
These programs will be multidisciplinary, community-based 
research programs to better understand, intervene, and 
ultimately prevent childhood environmental exposures related to 
asthma, other respiratory diseases, and other environmentally 
induced diseases. The Committee encourages the Institute to 
continue these programs.
    Green links.--The Committee encourages the Institute to 
give consideration to supporting the green links environmental 
research and development network. This 5-year program is 
expected to demonstrate a cost-effective transfer methodology 
to assure that the results of millions of dollars expended by 
the U.S. Government on research, new technology development, 
and innovative programming reaches our communities and our 
small- and medium-sized businesses.
    Environmental health sciences centers.--The Committee 
continues to support the Institute's centers program and 
believes that a vibrant centers program is critical to carrying 
out the expanding mission of the NIEHS. The Committee 
encourages the Institute to consider increasing support for 
current center grantees to bring them up closer to peer 
reviewed levels.
    Marine toxins.--The Committee remains aware of the 
importance of the research on natural marine toxins and their 
effect on the human body, and notes the unique work being 
performed at a Miami, FL-based NIEHS center. The Committee 
continues to recommend that NIEHS advance the establishment of 
a comprehensive center of excellence focusing on natural marine 
toxins and their impact on the human body, to assist both HHS 
and FDA with their mandate to develop standards and conduct 
research on marine toxins and dietary risk and human disease.
    Superfund Basic Research Program.--The Committee supports 
the Superfund Basic Research Program which is administered by 
the National Institute of Environmental Health Sciences [NIEHS] 
and funded by a passthrough by the Environmental Protection 
Agency [EPA]. The Committee believes this research program 
plays an integral role in the Superfund hazardous waste cleanup 
program. The primary purpose of this research program is to 
provide the scientific basis needed to make accurate 
assessments of the human health risks at hazardous waste sites 
and to develop better methods for remediating hazardous waste 
sites. It is the only university-based scientific research 
program focused on health and cleanup issues for these sites. 
The Committee encourages EPA and NIEHS to work together to 
ensure the continuation of this important research program.
    National Toxicology Program.--The Committee continues to 
support the National Toxicology Program [NTP] which was 
established to provide information to health, regulatory, and 
research agencies, and the general public about potentially 
toxic chemicals, as well as to strengthen the science base of 
toxicology. NIEHS-supported research has shown the health 
effects of lead, leading to the reduction of many sources of 
environmental lead. The Committee is pleased that researchers 
are now expanding their efforts to better understand why some 
people are more susceptible to environmental exposures than 
others. In addition, the Committee supports NIEHS' efforts, 
under the auspices of the NTP, to develop new mouse models to 
more efficiently test the toxicity of chemicals.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 1997....................................    $485,806,000
Budget estimate, 1998...................................     497,076,000
Committee recommendation................................     520,705,000

    The Committee recommendation includes $520,705,000 for the 
National Institute on Aging [NIA]. This is $23,629,000 more 
than the budget request and $34,899,000 more than the fiscal 
year 1997 appropriation. The comparable numbers for the budget 
estimate include funds to be transferred from the Office of 
AIDS Research.
    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. Research in aging over the 
last two decades demonstrates that aging should not be equated 
with inevitable decline and disease.
    Alzheimer's disease.--Over the past several years, the 
Committee has called special attention to the fact that 
Alzheimer's disease and related disorders present one of the 
greatest threats to the health and economic security to 
generations of Americans. Left unchecked, this devastating 
illness will defeat all of our best efforts as a Nation to 
control the costs and assure the quality of health care in 
general, and of public programs such as Medicare and Medicaid. 
The Committee urges NIA to maintain the priority status of 
Alzheimer's disease. The Committee also expects that a portion 
of the increase provided be devoted to finding effective 
treatments to delay the onset and progress of the disease, and 
develop techniques for presymptomatic diagnosis.
    Cardiovascular aging research.--Heart attack, congestive 
heart failure, stroke, and other cardiovascular diseases remain 
America's No. 1 killer of older men and women and a main cause 
of disability. The Committee urges the Institute to make 
cardiovascular research a priority and to expand into 
innovative extramural and intramural cardiovascular research 
programs.
    Demographic research.--The Committee believes that NIA's 
demography programs play a vital role in understanding many of 
the Nation's important health, social and economic issues. The 
Committee encourages NIA's initiative to study disability 
trends, as well as its research on the impact of the aging baby 
boom generation. Coordinated efforts in providing data for 
present and future studies are encouraged, as are sufficient 
funds for training and recruiting the professionals necessary 
to undertake such studies.
    Roybal centers for research on applied gerontology.--The 
Committee encourages NIA to continue to place a high priority 
on funding for the Roybal centers. The Roybal centers are 
designed to improve the quality of life of older adults by 
translating the results from basic behavioral and social 
research on aging into practical outcomes that will benefit the 
lives of older people.
    Bone diseases.--The Committee notes the growth of research 
on osteoporosis, Paget's disease, and osteogenesis imperfecta 
and encourages the Institute to consider further expansion and 
intensification of its research programs on these bone 
diseases.
    Rural aging.--The Committee is aware that the West Virginia 
University's Center on Aging, in cooperation with the United 
Nations, is planning a Year 2000 International Conference on 
Rural Aging. The Committee supports this initiative and urges 
the NIA to give careful consideration to provide assistance to 
this important effort.
    Minority populations.--The Committee encourages the 
Institute to consider efforts targeted toward minority 
populations. These efforts are necessary to meet the challenges 
facing an increasingly diverse senior population. The Committee 
is aware of organizations, such as the National Asian Pacific 
Center on Aging, that are equipped to reach some of the fastest 
growing, yet underserved and isolated, senior groups and urges 
the NIA to work with these organizations in targeting research 
efforts toward these important minority populations.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 1997....................................    $257,003,000
Budget estimate, 1998...................................     263,242,000
Committee recommendation................................     272,631,000

    The Committee recommends an appropriation of $272,631,000 
for the National Institute of Arthritis and Musculoskeletal and 
Skin Diseases [NIAMS]. This is $9,389,000 more than the budget 
request and $15,628,000 more than the fiscal year 1997 
appropriation. The comparable numbers for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    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; orthopedic disorders, such as back pain and sports 
injuries; and numerous skin diseases. The research agenda of 
the NIAMS includes many devastating and debilitating diseases 
that afflict millions of Americans. These diseases of the 
joints, muscles, bones, connective tissues, and skin, in the 
aggregate, will affect nearly every American at some point in 
their lives, causing tremendous human suffering and costing the 
Nation billions of dollars in both health care and lost 
productivity. The research activities of this Institute serve 
the concerns of many different special populations; these 
include women, minorities, children, and the elderly.
    Growth plate injuries.--Fifteen percent of all children's 
fractures reportedly involve the growing part of the bone. 
Damage to the growth plate results in deformities and shortened 
limbs. The Institute is urged to support research directed 
toward controlling and understanding bone growth and the damage 
to the growing bone, and treatment modalities, such as leg 
lengthening. The Committee also recommends that the NIAMS and 
the NICHD ensure that information is available to practitioners 
and parents regarding the possibility of damage to the growth 
plate as a result of injury.
    Musculoskeletal growth and development conditions in 
children.--The Committee is very pleased with the progress 
being made by NIAMS to focus attention on conditions that 
prevent normal musculoskeletal growth and development in 
children. NIAMS is urged, in conjunction with NICHD, to 
continue to invest in research to discover cures and treatments 
for conditions that damage muscles, nerves, and bones in 
children.
    Bone diseases.--The Committee is pleased with the important 
strides that have been made with the establishment of an 
osteoporosis and related bone disease national resource center 
under the Musculoskeletal Disease Program. The Committee urges 
the NIAMS to build upon this initiative by expanding support 
for the resource center's activities in order to allow the 
center to continue to broaden its information services. The 
Committee also notes the growth of research on osteoporosis, 
Paget's disease, and osteogenesis imperfecta and encourages the 
Institute to further expand and intensify its research programs 
on these bone diseases.
    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 diseases than white women. The Committee is 
encouraged by recent NIAMS research success. Working at gaining 
understanding of the factors associated with the high 
prevalence of lupus in minorities and development of new and 
innovative treatments is of great importance to the Committee.
    Chronic fatigue and immune dysfunction syndrome [CFIDS].--
The Committee encourages the Institute to provide additional 
support for extramural grants focused on promising areas of 
CFIDS biomedical research, particularly those investigations 
which will define the pathophysiology of the illness and 
identify diagnostic markers.
    Fibromyalgia.--Fibromyalgia syndrome [FMS] is a clinically 
diagnosed disorder which is poorly understood and difficult to 
treat. It is a syndrome of debilitating, chronic, widespread 
pain, fatigue, sleep disturbance, and other associated 
disorders. The Committee encourages NIAMS, specifically, and 
NIH, generally, to give consideration to taking additional 
appropriate steps, including a new RFA on fibromyalgia, to 
increase the research that is carried out on this widespread 
and debilitating disease.
    Incontinence in women.--The Committee encourages the NICHD 
to collaborate with the NIDDK to enhance fundamental basic and 
clinical research that will find the causes as well as new 
solutions for the problem of incontinence in women.
    Osteoporosis.--The Committee notes that osteoporosis occurs 
in 37 percent of the population. Hip and vertebral fractures 
add significant costs to Medicare, and preventative measures 
identified in the study of osteoporosis could greatly reduce 
those costs and improve the well-being of millions of people 
afflicted with this disorder. The Committee encourages the 
Institute to support research, including the identification of 
risk factors for the disease and the development of public 
education strategies to decrease the prevalence of 
osteoporosis. The Committee further encourages the NIAMS to 
collaborate with the Agency for Health Care Policy and Research 
to initiate planning of definitive studies, including 
epidemiologic studies, that would better integrate patient 
outcomes with basic research, screening, and preventative 
measures.
    Vulvodynia.--Hundreds of thousands of women suffer from 
vulvodynia, a painful and often debilitating disorder of the 
female reproductive system. Despite its prevalence very little 
attention has been paid to the disorder by health professionals 
or researchers. However, in April NIH convened an international 
symposium to exchange information and develop a research 
agenda. The Committee is concerned about the lack of attention 
to this important women's health problem and has included 
sufficient funds to carry out research on the prevalence, 
causes and treatment of vulvodynia.
    Scleroderma.--Scleroderma is a chronic, degenerative 
disease which causes the overproduction of collagen in the 
body's connective tissue. The Committee was encouraged to learn 
that the NIAMS is planning a symposium on scleroderma progress 
and urges the Institute to encourage the participation of 
relevant institutes of the NIH in the symposium. The Committee 
also requests that the Institute aggressively pursue an active 
research program on this devestating disorder.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 1997....................................    $188,345,000
Budget estimate, 1998...................................     194,221,000
Committee recommendation................................     200,428,000

    The Committee recommends an appropriation of $200,428,000 
for the National Institute on Deafness and Other Communication 
Disorders [NIDCD]. This is $6,207,000 more than the budget 
request and $12,083,000 more than the fiscal year 1997 
appropriation. The comparable numbers for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The NIDCD funds and conducts research and 
research training in the normal and disordered processes of 
human communication, specifically in the areas of hearing, 
balance, smell, taste, voice, speech, and language. The 
Institute addresses the special biomedical and behavioral 
problems of people who have communication impairments or 
disorders, is actively involved in health promotion and disease 
prevention, 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 effort in this promising scientific area.
    Communication skills.--The Committee recognizes that, as 
the communications revolution intensifies into the 21st 
century, many Americans who lack communication and language 
skills will fall behind socially and economically. Underlying 
speech and language disorders often affect the development of 
good communication skills, placing those individuals at a 
disadvantage in the workplace. These underlying disorders are 
often not diagnosed or treated in children from disadvantaged 
backgrounds. The Committee recommends that the Institute hold a 
national factfinding workshop on this issue, including 
representatives of the Departments of Labor and Education and 
that the Director be prepared to report on their findings of 
that workshop during next year's appropriation hearings.
    Infant screening.--The Committee is concerned that millions 
of infants are not receiving appropriate screening for hearing 
loss. NIDCD is completing a large-scale multiyear study on the 
best methods of carrying out infant hearing screening. The 
Committee recommends that NIDCD develop an action plan as to 
steps it can take to increase consumer and health professional 
awareness of the importance of and most effective method of 
infant screening and asks that it reports its recommendations 
to the Committee by March 1, 1998.
    Environmental causes of hearing loss.--The Committee is 
concerned that many Americans lack information about the risk 
to their hearing of exposure to high decibel noises. Hearing 
loss associated with this type of exposure is clearly 
preventable. Therefore, the Committee urges NIDCD to consider 
holding a consensus conference along with NIEHS, NIOSH, and the 
private sector as to steps that can be taken to increase 
awareness and reduce the incidence of this preventable form of 
hearing loss.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 1997....................................     $59,721,000
Budget estimate, 1998...................................      61,052,000
Committee recommendation................................      64,016,000

    The Committee recommends an appropriation of $64,016,000 
for the National Institute of Nursing Research [NINR]. This is 
$2,964,000 more than the budget request and $4,295,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The NINR supports research and training in the 
biological and behavioral aspects of critical national health 
problems. Research seeks to reduce the burden of illness and 
disability by understanding and easing the effects of acute and 
chronic illness; to improve quality of life by preventing or 
delaying the onset of disease or slowing its progression; to 
establish better approaches to promoting health and preventing 
disease; and to improve clinical environments by testing 
interventions that influence patient health outcomes and reduce 
costs and demand for care.
    Managing pain.--Research into the causes and management of 
pain is a critical area of investigation, and the Committee 
commends the NINR for its strong focus on this area of 
research. The Committee further applauds the important 
contributions of NINR-supported work that explores the 
biological and behavioral parameters of pain. The Committee 
encourages the Institute to actively investigate the role that 
cultural differences play in various aspects of pain 
management.
    Community-based interventions for underserved 
populations.--Research is needed on the specific problems 
facing rural populations, as well as on how to ensure that the 
outcomes of research will benefit our Nation's diverse racial 
and ethnic populations. The Committee commends the NINR for its 
strong commitment to community-based information strategies. 
The Committee encourages the Institute to ensure that research 
efforts extend to the diverse health care needs of racial and 
ethnic populations, such as, native Hawaiians. The Committee 
also calls attention to Malma, an innovative, culturally 
sensitive community partnership program which addresses the 
prenatal care needs of minorities in Hawaii.
    Telehealth.--The Committee encourages the Institute to 
explore the relationship between telehealth, nursing, and 
increased access to care for prevention and treatment. The 
Committee is aware that there is limited data on the efficacy 
of telehealth nursing interventions and would be interested in 
the results of any research efforts in this area.
    Managing symptoms of chronic neurologic conditions.--The 
Committee urges the NINR to continue its collaborations with 
the NINDS to address symptoms of chronic neurological 
conditions, such as Parkinson's disease, multiple sclerosis, 
stroke, and spinal cord injury. This is especially important 
since two of three Americans seek treatment for a condition 
involving the brain or nervous system each year, at tremendous 
cost on the health care system.
    Traumatic brain injury.--The Committee agrees that there is 
a critical need for nursing research in the area of traumatic 
brain injury, which hospitalizes 500,000 patients each year. 
The Committee urges NINR to continue research on preventing the 
progressive deterioration of the brain and to expand its 
research on promising therapies to prevent the progressive 
deterioration of the brain resulting from the initial trauma. 
The Committee also encourages NINR to collaborate with NICHD on 
the treatment and rehabilitative needs of children with head 
trauma.
    Quality of life in organ transplantation.--The Committee 
understands that technological advances have permitted an 
estimated 12,000 Americans to benefit from an organ transplant 
each year. The Committee supports NINR in undertaking research 
to improve the quality of life for patients with organ 
transplantations in collaboration with NIAID, NIKKD, NIA, and 
NHLBI.
    Extending advances in cardiovascular risk management to 
high-risk populations.--The Committee recognizes that the basis 
of adult cardiovascular disease often is traced back to 
childhood, and that interventions early in life are key to 
achieving a healthy adulthood. The Committee supports the 
important work of nurse researchers aimed at reducing 
cardiovascular risk factors that can be tested in high-risk and 
underserved populations.
    Chronic illness and caregiving.--The Committee is well 
aware that chronic illnesses, such as Alzheimer's disease and 
related dementias, affect almost 100 million people in the 
United States. The Committee strongly endorses NINR's 
collaboration with the NIA to prevent or reduce disabilities 
associated with chronic diseases and, supports NINR's strong 
focus on developing effective caregiving strategies.
    End-of-life issues.--The Committee strongly supports NINR 
activities, in collaboration with other NIH Institutes, related 
to end-of-life issues by studying palliative care, end-stage 
symptoms, such as pain and depression, and measuring relief of 
symptoms.
    Ethical use of genetic knowledge.--Genetic tests are 
becoming a component of medical and public health practice. The 
Committee urges NINR to continue its close collaboration among 
NCI and NHGRI to strengthen the program in nursing research in 
the field of genetics.
    Career development in support of nursing research.--The 
Committee recognizes that the continued vitality in the field 
of nursing research depends upon the experienced researchers 
dedicated to active, long-term research programs. The Committee 
believes that because of the unique patient-oriented research 
emphasis of NINR, such increases in the number of experienced 
nurse researchers are essential to securing further benefits to 
human health.

           National Institute on Alcohol Abuse and Alcoholism

Appropriations, 1997....................................    $211,870,000
Budget estimate, 1998...................................     219,346,000
Committee recommendation................................     228,585,000

    The Committee recommends an appropriation of $228,585,000 
for the National Institute on Alcohol Abuse and Alcoholism 
[NIAAA]. This is $9,239,000 more than the budget request and 
$16,715,000 more than the fiscal year 1997 appropriation. The 
comparable numbers for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--The NIAAA conducts biomedical and behavioral 
research for improving prevention and treatment and reducing or 
eliminating the associated health, economic, and social 
consequences. NIAAA provides leadership in the country's effort 
to combat these problems by developing new knowledge that will 
decrease the incidence and prevalence of alcohol abuse and 
alcoholism and associated morbidity and mortality. NIAAA 
addresses these questions through an integrated program of 
biomedical, behavioral, and epidemiologic research on 
alcoholism, alcohol abuse, and related problems. This broad-
based program includes various areas of special emphasis such 
as medications development, fetal alcohol syndrome [FAS], 
genetics, and moderate drinking.
    Fetal alcohol syndrome.--Fetal alcohol syndrome is the 
leading known cause of mental retardation in the United States 
and the leading preventable cause of birth defects in the 
Western World. The Committee urges NIAAA to increase research 
support to better understand preventing and treating fetal 
alcohol syndrome. Equally important is the need to identify 
instructional conditions that must be in place in order to help 
FAS children develop competent academic and social skills. The 
Committee commends the Institute 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 was pleased to learn that the NIAAA has issued a 
program announcement on education, prevention, and intervention 
strategies to reduce alcohol consumption by women of 
childbearing age in high-risk populations. This initiative 
along with the appropriate funding is essential in view of the 
recent and alarming findings that alcohol consumption by 
pregnant women is increasing.
    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 has been 
investigating the potential contributions of research in such 
areas as behavioral genetics, responses to stress, 
developmental psychology, human learning and cognitive science, 
social psychology, organizational behavior, evaluation and 
methodology, and motivation and craving.
    Genetic vulnerability.--The Committee is pleased with 
NIAAA's leadership in the area of genes and alcoholism. The 
Committee understands that NIAAA held a successful 2-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. NIAAA should continue to take the initiative in 
pursuing collaborative discussions with NIMH 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 is aware that NIAAA 
investigators have been 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 the NIAAA to bring together neuroscientists from 
around the country to present their findings and map out new 
directions for research on alcohol and the brain. The 
development of a specific research plan in this area would be 
most useful in charting a course for future research.
    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 the 
Institute to expand support for developing new medications that 
prevent alcohol induced liver damage, cardiomyopathy, and 
damage to other tissues.
    Alcohol advertising study.--The Committee is concerned 
about the prevalence of underage use of alcohol and encourages 
the NIAAA to support studies to review the impact of alcohol 
advertising on our Nation's youth and to develop 
recommendations on potential options to combat the effect of 
alcohol advertising on young people.
    Moderate drinking.--The Committee supports funding by the 
NIAAA of studies of the benefits and risks of moderate alcohol 
consumption and the impact of alcohol consumption on human 
health. The Committee looks forward to learning more about the 
Institute's efforts in this area during the hearings on the 
fiscal year 1999 budget.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 1997....................................    $489,160,000
Budget estimate, 1998...................................     521,915,000
Committee recommendation................................     531,751,000

    The Committee recommends an appropriation of $531,751,000 
for the National Institute on Drug Abuse [NIDA]. This is 
$9,836,000 more than the budget request and $42,591,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--Created in 1974, NIDA supports about 85 percent 
of the world's biomedical research in the area of drug abuse 
and addiction. The Committee commends NIDA for demonstrating 
through research that drug use is a preventable behavior and 
addiction is a treatable disease of the brain. NIDA's basic 
research plays a fundamental role in furthering knowledge about 
the ways in which drugs act on the brain to produce drug 
dependence and contributes to understanding how the brain 
works. In addition, NIDA research identifies the most effective 
pharmacological and behavioral drug abuse treatments. NIDA 
conducts research on the nature and extent of drug abuse in the 
United States and monitors drug abuse trends nationwide to 
provide information for planning both prevention and treatment 
services. An important component of NIDA's mission is also to 
study the outcomes, effectiveness, and cost benefits of drug 
abuse services delivered in a variety of settings.
    Behavioral and cognitive science.--The Committee agrees 
that research should inform the Nation's policies on treating 
and preventing drug abuse and commends NIDA for its aggressive 
pursuit of an expanded behavioral science research portfolio to 
investigate such critical 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.
    Putting research to work for drug abuse prevention.--The 
Committee congratulates NIDA for its recently released research 
based guide. The Committee is pleased that the guide is being 
distributed to schools and community groups nationwide.
    Sobriety programs.--The Committee is very concerned by the 
high incidence of alcoholism and alcohol abuse among children 
and adolescents of Native Alaskan and native Hawaiian descent. 
The Committee encourages NIDA to work with existing native 
American organizations to assess and increase their 
effectiveness.
    Information dissemination and education.--The Committee is 
pleased that NIDA continues to reach out to communities across 
the country to provide research-based information to 
scientists, practitioners, policymakers, and the public. The 
Committee encourages NIDA to continue to develop culturally 
appropriate research-based materials, work with local 
community-based networks and hold town meetings at various 
locations to present the latest scientific information 
available to prevent and treat drug abuse and addiction.
    Methamphetamine initiative.--Recognizing that 
methamphetamine abuse is a growing problem of alarming 
proportions in the Western United States, the Committee is very 
pleased that NIDA sponsored a regional meeting in San Francisco 
to bring together scientists, practitioners, policymakers, and 
members of the community to discuss the most current research 
on methamphetamine effects and to identify those research areas 
that are the most promising.
    Treatment initiative.--Behavioral therapies are often the 
only available treatments for drug problems where no medication 
yet exists. The Committee applauds NIDA's treatment initiative 
which is directed toward transplanting the knowledge in 
behavioral science into new and useful therapies and for laying 
the groundwork for the integration of both behavioral and 
pharmacotherapies.
    Genetic research.--Great strides have been made in 
understanding of human genetics. The Committee encourages NIDA 
to continue working to identify genes that contribute to 
individual vulnerability to drug addiction. This research may 
ultimately lead to the development of new and more effective 
prevention and treatment strategies.
    Children and adolescents.--Addiction affects every segment 
of American society, but nowhere is it more devastating in its 
consequences than among our Nation's youth. The Committee 
recognizes that NIDA's research is providing critical insights 
into the factors that place young people at particular risk for 
drug abuse. NIDA is also identifying those characteristics that 
protect against drug abuse, and it is providing the foundation 
on which to build effective, research-based drug abuse 
prevention strategies. The Committee is pleased that NIDA has 
launched a special initiative on children and adolescent 
research to speed progress in this important area.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 1997....................................    $701,107,000
Budget estimate, 1998...................................     728,249,000
Committee recommendation................................     753,334,000

    The Committee recommends an appropriation of $753,334,000 
for the National Institute of Mental Health [NIMH]. This is 
$25,085,000 more than the budget request and $52,227,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The research programs of the Institute lead the 
Federal effort to identify the causes of--and the most 
effective treatments for--mental illnesses, which afflict more 
than one in five Americans. Severe mental illnesses affect 2.8 
percent of the U.S. adult population annually, approximately 5 
million people. These individuals suffer from disorders such as 
schizophrenia, manic-depressive illness, major depression, 
panic disorder, and obsessive-compulsive disorder. One result 
of the Federal research investment has been a growing awareness 
that undiagnosed and untreated mental illness, in all its forms 
and with all of its consequences, is as damaging as physical 
illness is to the Nation's well-being.
    Rural mental health.--The Committee notes that the stigma 
associated with seeking behavioral and mental health services 
is particularly strong in rural areas and believes that an 
effective way of providing those services may be through an 
established and accepted rural institution such as the 
Extension Service. The Committee is aware of the successful use 
of this model in Florida following Hurricane Andrew and in 
North Dakota following the recent floods. The Committee, 
therefore, encourages the Institute to initiate a workshop and 
give consideration to supporting an additional service delivery 
research center to further develop this approach.
    Elderly suicide.--The Committee is concerned that the rate 
of elderly suicide has increased by 9 percent between 1980 and 
1992. The Committee has also learned from information provided 
by CDC that many older Americans who commit suicide have 
contacted a physician in the month before the suicide. The 
Committee, therefore, requests the NIMH to study the extent of 
this problem and make recommendations on how to address the 
problem, including the need for primary care physicians to make 
appropriate referrals. The Committee recommends that the NIMH 
consider seeking input from the Substance Abuse and Mental 
Health Services Administration on this problem.
    Aging.--The Committee is supportive of increased attention 
to mental health research on our aging population. This group 
of individuals is the fastest growing segment of our population 
and proactive efforts are necessary to meet the challenges of 
the future.
    Reorganization.--The Committee is aware that NIMH is 
undergoing a reorganization to improve connections between 
basic and clinical research, connections between disciplines, 
and to reflect promising new directions in mental health 
research. The Committee applauds this approach. The Committee 
looks forward to the NIMH Director's update on these issues of 
interest to the Committee.
    Eating disorders.--The Committee encourages the Institute 
to provide additional funding for direction to the research for 
prevention of eating disorders (defined as anorexia nervosa, 
bulimia, and binge eating disorder), including research on the 
development of psychosocial and behavioral interventions and 
strategies aimed at reducing the incidence of eating disorders.
    Children and adolescents.--The 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 about preventive interventions. The 
Committee encourages NIMH to increase its research about all 
childhood mental disorders, including a full range of 
preventive interventions and treatment based on behavioral 
approaches as well as medications. The Committee would 
appreciate a progress report during next year's hearing.
    Prevention.--The Committee is pleased that a workgroup of 
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. In addition, the 
Committee encourages NIMH to magnify its efforts to address the 
critical shortage of researchers in the area of prevention.
    Social work research.--The Committee commends NIMH for 
funding its fifth social work research development center, and 
urges NIMH to support an expanded research program in this 
area.
    Fundamental neuroscience.--The Committee encourages the 
Institute to continue to support research to understand the 
brain, how it functions, and how those functions go wrong in 
mental illness. The Committee maintains its interest in the 
human brain project, which, in supporting research that 
combines neuroscience and advanced informatics research, and 
has spawned the new scientific area of inquiry called 
neuroinformatics.
    Bipolar disorder.--Bipolar disorder is a severe, chronic 
brain disorder which affects an estimated 4 million Americans. 
The Committee is concerned about funding for research on 
bipolar disorder and requests that the Director give 
consideration to developing a national research plan for 
bipolar disorder. The Committee also requests that the Director 
be prepared to report at next year's hearings on the level of 
funding for this research and on the Institute's plans to 
support and enhance this effort.
    Autism.--The Committee recognizes that research into the 
genetics of autism is being supported by several Institutes at 
the NIH. Given the difficulty of recruiting multiplex families, 
the Committee requests that researchers be strongly encouraged 
to collaborate and share this important resource. To that end, 
the Committee recommends the NIMH consider supporting a 
collaborative autism gene bank and notes that one is already in 
existence, the autism genetic resource exchange.
    Program reviews.--The Committee notes the active steps 
taken by the Director in his first year to review critical 
Institute activities. These have included independent reviews 
of the Institute's intramural research program, its program of 
psychiatric genetics research, its prevention portfolio, its 
overall communications activities, and of a major study of the 
prevalence of, and service systems for, child and adolescent 
mental disorders, UNOCCAP. The Committee believes that such 
periodic indepth assessments of the Institute's research 
programs and opportunities assures the most productive use of 
the Institute's resources.
    Mental health parity.--The Committee read with interest the 
interim report on ``Parity in Coverage of Mental Health 
Services in an Era of Managed Care,'' and looks forward to 
seeing additional reports on this topic as more data from 
throughout the country become available. The Committee further 
requests that the National Advisory Mental Health Council 
provide, as a fundamental part of its next report on this 
topic, what is known about the impact of managed care on access 
to mental health services, and on the quality of the care that 
is made available. The Committee requests that such a report be 
prepared under section 406(g) of the Public Health Service Act, 
and that it be submitted before next year's hearings.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 1997....................................    $415,095,000
Budget estimate, 1998...................................     410,921,000
Committee recommendation................................     455,805,000

    The Committee recommends an appropriation of $455,805,000 
for the National Center for Research Resources [NCRR]. This is 
$44,884,000 more than the budget request and $40,710,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The NCRR develops and supports critical research 
technologies and shared resources that underpin research to 
maintain and improve the health of our Nation's people. The 
NCRR programs develop a variety of research resources; provide 
biomaterial and resources for complex biotechnologies, clinical 
research, and specialized primate research; develop research 
capacity in minority institutions; and enhance the science 
education of precollege students and the general public.
    Extramural facilities.--The Committee has included 
$20,000,000 for extramural biomedical facility renovation and 
construction, $16,000,000 above the amount requested by the 
administration. These funds are to be awarded on a competitive 
basis consistent with sections 481(A) of the Public Health 
Service Act.
    The Committee notes that the University of Colorado Health 
Sciences Center has the only NCI-designated cancer center in 
the Rocky Mountain west region. It serves more than 6 million 
people in a seven-State region. The cancer center research and 
clinical facilities are being colocated in Aurora, CO, as part 
of the conversion and redevelopment of the Fitzsimons Army 
Medical Center. The Committee strongly urges the NIH to 
consider a proposal from the UCHSC for this project.
    The Committee encourages that every appropriate 
consideration be given to support the Florida-based Batchelor 
Children's Research Center to develop a comprehensive 
children's biomedical research, training, and treatment 
facility dedicated to at-risk children in Miami's urban core. 
The center will focus on oncology and unique blood 
transplantation and genetic epidemiological work critical to 
the needs of African-American and Hispanic populations, as well 
as pediatric critical care, including AIDS, cystic fibrosis, 
asthma, and other raspatory diseases and neonatology.
    The Committee also is aware of a proposal from the School 
of Pharmacy at the University of Montana. The Committee urges 
the Director to give full and fair consideration of a proposal 
from this institution.
    IDeA grants.--The Committee has provided $5,000,000 for the 
Institutional Development Award [IDeA] Program authorized by 
section 402(g) of the Public Health Service Act. This is 
$2,400,000 over both fiscal year 1997 and the budget request. 
The program is intended to broaden the geographic distribution 
of NIH funding of biomedical research through enhancing the 
competitiveness of institutions that conduct biomedical and 
behavioral research which historically have had low rates of 
success in obtaining funding. The Committee intends that the 
increase is to be used in eligible States to cofund high 
quality applications for shared instrumentation and RO-1 
proposals that would otherwise not receive support under the 
normal peer-review cycle. The Committee believes that the 
existing Shannon Awards Program can serve as the model for 
deciding which grants should be selected by NCRR for funding 
under the expanded IdeA Program.
    Clinical research.--In its 1994 report on clinical 
research, the Institute of Medicine of the National Academy of 
Sciences describes the GCRC's as a nationwide resource that 
could be used to increase the number of scientific advances 
that are translated to the bedside. As such, the GCRC's are 
critical to the NIH's ability to fulfill its mission and should 
be the highest priority within the budget for the NCRR. The 
Committee is concerned about dwindling private sector support 
for clinical research and reductions made in GCRC grants below 
the advisory council-approved budgets. The Committee requests a 
report from the NCRR Director by February 1, 1998, as to the 
funding that would be necessary to support the current number 
of GCRC's 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 GCRC's. In the interim, the Committee has provided 
funds sufficient for a $10,000,000 increase in the GCRC 
program.
    Research centers in minority institutions.--The Committee 
recognizes the continued importance of the minority 
institutions in addressing the health research and training 
needs of our minority populations. The Research Centers in 
Minority Institutions [RCMI] Program continues to impact 
significantly on these problems. The Committee encourages NIH 
to evaluate the budgetary requirements of this program and 
additional funding as required.
    The Committee recognizes the health research and training 
needs of Alaska Natives and Aleuts and requests that the 
National Center for Research Resources recognize the University 
of Alaska as a minority school for purposes of qualifying for 
support under its Research Centers in Minority Institutions 
Program.
    Biomedical research support grants.--The Committee 
recognizes the value of maintaining research facilities and 
equipment and providing initial support for young investigators 
and bridge support for established researchers. For years, the 
NIH utilized the biomedical research grants program to provide 
flexible funds to strengthen and stabilize NIH-supported 
researchers and research programs and academic health centers 
redirected portions of clinical revenues to make up for 
research shortfalls. Since 1992, however, no funds have been 
requested for the BRSG program. In addition, the Committee has 
received 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 research 
programs at academic medical centers where much of NIH-
supported research is performed. The Committee requests that 
the NIH study the feasibility of reestablishing a revised 
biomedical research support grants program or creating another 
mechanism which would assist with unmet needs in this area. The 
Committee would expect that funds would be provided for direct 
costs only, would be rigorously peer-reviewed at the 
institutional level, and would be administered with full 
accountability.
    Research equipment.--The Committee is aware of a request of 
the Children's Hospital and Medical Center of Seattle for 
Federal assistance for its large medical laboratory equipment 
needs to support NIH-funded research at eight research 
laboratories within the hospital and at the new pediatric 
clinical research center. The Committee requests that every 
appropriate consideration be given to a grant proposal 
submitted from this Institute within the normal competitive 
review process.
    The Committee recognizes the importance of the shared 
instrumentation grants program to providing academic research 
centers with opportunities to purchase equipment needed to 
better understand, diagnose, and treat disorders, such as 
severe mental illness. The Committee encourages the Director to 
give consideration to supporting grants for facilities and 
advanced instrumentation equipment, including magnetic 
resonance brain scanning devices, at sites performing research 
on the causes and treatment of severe mental illness.
    Alternative research resources.--The Committee supports the 
expansion of existing alternative resources to the use of 
animals, particularly through ensuring increased access by 
researchers to human tissues and organs for research purposes. 
The Committee is aware of the centers support for human tissue 
repositories. The Committee urges the Director to expand its 
support for these alternative resources, including giving 
strong consideration to a multi-Institute initiative geared to 
increase support in this area and respond to the research 
community's growing need for human tissues and organs.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 1997....................................    $189,529,000
Budget estimate, 1998...................................     205,187,000
Committee recommendation................................     218,851,000

    The Committee recommendation includes $218,851,000 for the 
National Human Genome Research Institute [NHGRI]. This is 
$13,664,000 more than the budget request and $29,322,000 more 
than the fiscal year 1997 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The NHGRI coordinates extramural research and 
research training for the NIH component of the human genome 
project, an international 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, data base management and analysis, and 
studies of the ethical, legal, and social implications of human 
genome research. The division of intramural research [DIR] 
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. Since 
its establishment in 1993, the intramural program has developed 
a strong research program and forged collaborative ties with 
several of the NIH research institutes to unravel the 
complexities of genetic diseases such as diabetes, breast and 
colon cancer, and melanoma.
    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 one as a means to further its mission of 
the identification of disease-related gene mutations.

 JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH 
                                SCIENCES

Appropriations, 1997....................................     $26,557,000
Budget estimate, 1998...................................      27,168,000
Committee recommendation................................      28,468,000

    The Committee recommends an appropriation of $28,468,000 
for the Fogarty International Center [FIC]. This is $1,300,000 
more than the budget request and $1,911,000 more than the 
fiscal year 1997 appropriation. The comparable numbers for the 
budget estimate include funds to be transferred from the Office 
of AIDS Research.
    Mission.--The primary function of the FIC is 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.
    Global tuberculosis [TB].--The Committee has become 
increasingly concerned with the growing global health threat 
posed by TB and understands that there exists a serious 
shortage of trained TB health professionals capable of setting 
up model in-country TB control programs. The Committee commends 
the FIC for its cooperation and collaboration with the 
International Union Against Tuberculosis and Lung Disease 
[IUATLD], and encourages the Center work with the IUATLD to 
further develop a training program for TB professionals.
    Emerging infectious diseases.--In recent years, epidemics 
have surfaced that threaten public health in the United States 
and abroad; examples are hantavirus, dengue, ebola virus, 
cholera, tuberculosis, malaria, and HIV/AIDS. The Committee 
recognizes the continuing need for international efforts to 
detect and contain diseases before they become global epidemics 
and commends the FIC's efforts in initiating a program that 
addresses global emerging and reemerging infectious diseases. 
The Committee encourages the Center to expand its efforts in 
the international training and research program in emerging 
infectious diseases.
    Global priorities.--The Committee notes the importance of 
efforts to address other global priorities, such as population 
and health, environmental and occupational health, and 
biodiversity. FIC programs that address these issues provide 
opportunities to improve maternal and perinatal health through 
biomedical research and increase demographic and behavioral 
research capabilities. The Committee has included additional 
funding above the President's request for the furtherance of 
these important efforts.
    Bioinformatics.--The Committee encourages the FIC, in 
cooperation with the National Library of Medicine, to establish 
a training program in bioinformatics and medical librarianship 
to link United States scientists and health professionals with 
counterparts in developing nations and the former Soviet Union.
    International Center for Health Research.--The Committee is 
concerned with the dramatic increase in the past two decades of 
emerging and reemerging infectious diseases, including the high 
rate of AIDS and tuberculosis among minority populations in 
densely populated areas. The Committee is especially concerned 
with the introduction of these and other diseases from air 
travelers and migration from Latin America and the Caribbean. 
The Committee is, therefore, encouraged by the research 
conducted at the University of Miami's International Center for 
Health Research to help control the emergence and migration of 
infectious diseases and encourages consideration be given to 
providing funding for this important work.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 1997....................................    $150,828,000
Budget estimate, 1998...................................     155,968,000
Committee recommendation................................     162,825,000

    The Committee recommends an appropriation of $162,825,000 
for the National Library of Medicine [NLM]. This is $6,857,000 
more than the budget request and $11,997,000 more than the 1997 
appropriation. The comparable numbers for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The National Library of Medicine is the Federal 
institution that for more than 150 years has collected, 
organized, preserved, and disseminated the world's output of 
biomedical literature in all forms. As a result of this 
activity the Library is the world's largest library of the 
health sciences, its holdings numbering more than 5,000,000 
items. The NLM, as part of the National Institutes of Health, 
has pioneered in creating innovative methods to disseminate 
bibliographic information. Basic to the mission of the NLM is a 
wide-ranging research program to improve how medical 
information is communicated. This responsibility is aided by a 
grants program and by specialized services in toxicology, 
environmental health, and biotechnology.
    High-performance computing and communications.--The 
Committee has been impressed with NLM's stewardship of health 
projects related to the High-Performance Computing and 
Communications Program. The recent series of awards to develop 
and evaluate telemedicine test-bed networks is well conceived 
and will provide much valuable data for future health care 
efforts. The Committee is pleased that NLM is now one of six 
Government agencies involved in the NGI initiative and has 
increased the NLM budget above the President's request to 
demonstrate new HPCC-related health applications. Specifically, 
to demonstrate new HPCC-related health applications the 
Committee has provided an additional $7,000,000.
    Outreach.--The Committee encourages NLM to continue its 
special outreach program to the Nation's health professionals 
and, to the extent possible, 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. Recently, members of the 
Committee were pleased to participate in the announcement of 
free MEDLINE access over the World Wide Web. This will be of 
inestimable value not only to the Nation's health 
professionals, but to the public at large. The resulting access 
to high-quality health information would be an important step 
to improving the public health and would build upon the 
national investment already made in telecommunications 
connectivity.

                         OFFICE OF THE DIRECTOR

Appropriations, 1997....................................    $286,810,000
Budget estimate, 1998...................................     270,159,000
Committee recommendation................................     292,196,000

    The Committee recommends an appropriation of $292,196,000 
for the Office of the Director [OD]. This is $22,037,000 more 
than the budget request and $5,386,000 more than the fiscal 
year 1997 appropriation. The comparable numbers for the budget 
estimate include funds to be transferred from the Office of 
AIDS Research. The recommendation also includes $40,266,000 
within the Office of the Director to support the activities of 
the OAR as proposed in the budget request.
    Mission.--The Office of the Director provides leadership 
and direction to the NIH research community, and coordinates 
and directs initiatives which crosscut the NIH. The Office of 
the Director 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 
operation of the NIH.
    The Office of Research on Women's Health.--The Office of 
Research on Women's Health [ORWH] works to coordinate, refine, 
and expand the programs and activities of the NIH to address 
the inclusion of women in clinical research and to promote 
biomedical careers for women. In addition, the ORWH is charged 
with developing new collaborative initiatives to address 
continuing gaps in knowledge about women's health which affect 
both mortality and morbidity.
    Women's health initiative.--This initiative is a large 
cross Institute study regarding the prevention of conditions 
afflicting a large number of women, such as, breast cancer, 
heart disease, and osteoporosis. There are three components of 
the study: a clinical trial, an observational study, and a 
community prevention study. In fiscal year 1998, funds will be 
used to support continued activities in the coordinating center 
and the participating clinical centers.
    Office of Research on Minority Health.--The Office of 
Research on Minority Health [ORMH] is the coordinating office 
for minority health research and research training efforts at 
the NIH. ORMH programs strive to improve the health status of 
all minorities across the lifespan and to increase the numbers 
of minorities pursuing careers in the biomedical sciences. 
Additional activities of the ORMH include providing 
supplemental support to ICD projects, developing programs to 
increase minority participation in clinical trials, initiating 
and supporting infrastructure development projects at minority 
institutions, and developing programs to increase the 
competitiveness of grant applications submitted by minority 
researchers.
    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 social work researchers.
    The Committee encourages the Director to give full and fair 
consideration to a proposal received from the Seattle Indian 
Health Board's American Indian Family Practice Residency 
Program. This collaborative effort involves a 3-year program 
that recruits and trains family practice physicians into 
service to American Indian and Native Alaska populations.
    Minority health initiative.--The minority health initiative 
[MHI] is tailored to improve the overall health of minorities 
through expanded research and to provide training to more 
minority biomedical researchers. The goals of the MHI include 
continuing initiatives in collaboration with several 
Institutes, addressing newly emerging areas of research such 
as: health and behavioral effects of lead exposure in childhood 
in inner-city neighborhoods and the health of minority women. 
In addition, MHI funds will support all minority research 
training efforts.
    Office of Behavioral and Social Sciences Research 
[OBSSR].--The Committee is pleased that OBSSR is fulfilling its 
mission to coordinate behavioral and social sciences research 
at NIH and leveraging its modest budget to ensure that cross-
directorate research and training initiatives are more easily 
funded. The Committee is particularly interested in two recent 
projects of the Office, the request for applications on 
innovative initiatives for behavior change, and the 
interdisciplinary training initiative. The Committee requests a 
brief report on each of these initiatives, including which 
Institutes are contributing, how many applications are 
received, and summaries of applications that are ultimately 
funded. In particular, the Committee encourages OBSSR to 
develop proposals for methodological research that would follow 
up on the successful conference, ``The Science of Self 
Report.'' The Committee also encourages NIH to evaluate the 
possibility of realigning OBSSR within an existing Institute 
such as the National Institute for Nursing Research.
    The Committee understands that the Office of Behavioral and 
Social Sciences Research is providing additional support to 
individual Institutes to supplement their National Research 
Awards [NRSA's] 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.
    Clinical research.--In 1995 and again last year, the 
Committee recommended that the NIH Director move forward with 
implementation of the recommendations of the Institute of 
Medicine report on careers in clinical research. Further the 
Committee urged the Director to improve the peer review of 
clinical research grant proposals. The Committee is extremely 
concerned about the state of clinical and translational 
research. NIH efforts to address issues related to large-scale 
clinical trials are commendable, but do not sufficiently 
respond to this Committee's repeated expressions of concern 
about investigator-initiated clinical/translational research. 
The NIH cannot fulfill its mission to improve human health if 
the Nation's clinical research capacity continues to 
deteriorate. Accordingly, the Committee recommends that the 
Director initiate new programs to train and provide stable 
funding for extramural clinical/translational researchers. The 
Committee requests a report from the Director by Jaunary 31 on 
specific initiatives undertaken to enhance extramural clinical 
research training and project support in the extramural 
program.
    Pediatric research.--The Committee recommendation provides 
sufficient funds to allow for the expansion of the pediatric 
research initiative to at least $20,000,000 in fiscal year 
1998. The Committee intends that the Office of the Director 
continue to work with the Institutes to coordinate this high 
priority research related to the illnesses and conditions 
affecting children.
    The Committee recognizes that a specific focus often has 
been needed to assure that biomedical research addresses 
illnesses and conditions affecting children. The Committee, 
therefore, encourages the NIH to strengthen its portfolio of 
basic, behavioral, and clinical research for children overall. 
It also encourages the NIH to continue its progress toward 
increasing the participation of children in NIH-supported 
clinical research trials, including the expeditious 
implementation of the policy revisions in fiscal year 1997.
    Diabetes.--In light of the enormous human and economic 
costs of diabetes and the cross-Institute nature of diabetes 
research at the NIH, the Committee urges the Director, in 
collaboration with the Director of the NIDDK, to consider the 
establishment of a diabetes research working group to develop a 
comprehensive plan for NIH-supported diabetes research. Members 
of the working group could include: high-level representatives 
from those Institutes that have diabetes research portfolios; 
leading diabetes researchers; representatives from industry; 
and leaders of organizations that represent people with 
diabetes. The Director of the 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.
    Chronic fatigue and immune dysfunction syndrome.--The 
Committee encourages the Director to consider identifying 
appropriate NIH advisory committees for CFIDS representation 
and ensuring appointment of appropriate persons thereon. The 
Committee is pleased that the CFS program announcement issued 
by NIH last year demonstrated a cross-Institute commitment to 
funding promising CFIDS research, but notes that it did not 
include participation by the National Institute on Child Health 
and Human Development. The commitment made by NIH at the May 
29, 1997, CFS Coordinating Committee meeting to hold a workshop 
on pediatric CFIDS is a positive step and the Committee 
strongly urges 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.
    Office of Dietary Supplements.--The Committee continues to 
strongly support the important work of this Office. Use of 
dietary supplements has increased significantly among Americans 
who want to improve their health and prevent disease. There is 
a great need for additional research to better inform consumers 
of the health benefits of supplements. The President's 
Commission on Dietary Supplements recently recommended that the 
Office be funded at its fully authorized level to meet this 
need. While overall funding limits prevent the Committee from 
fully meeting this request, the Committee has included 
sufficient funds to raise support for ODS in fiscal year 1998 
and encourages the Director to expand the staffing of the 
Office to a level sufficient to meet its statutory mission.
    Neurodegenerative and brain disorders initiative.--The 
Committee recommendation provides sufficient funds to allow for 
the expansion of the neurodegenerative initiative begun in 
fiscal year 1996 to $17,000,000 in fiscal year 1998. The 
Committee intends that the Office of the Director continue to 
work with the relevant institutes to coordinate this high-
priority research related to costly conditions, such as 
Parkinson's disease, Alzheimer's disease, and ALS.
    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.
    Hepatitis C.--The Committee notes that the March 1997 
Hepatitis C [HCV] Consensus Conference made significant new 
research recommendations that impact several NIH Institutes 
and, therefore, requests that the Office of the Director 
coordinate the necessary research in order to most effectively 
respond to the HCV epidemic.
    Young investigators.--The Committee is pleased that three 
Institutes, NIMH, NIDA, and NIA, have established small grant 
mechanisms for young investigators in behavioral science 
research. The Committee continues to encourage other National 
Institutes to develop mechanisms similar to these behavioral 
science track award for rapid transition [B/START] programs.
    Disadvantaged populations.--The Committee has provided 
adequate funding for the continuation and growth of a variety 
of competitive programs at NIH that emphasize improving the 
health status of disadvantaged populations, including racial 
and ethnic minorities. The Committee has placed a special 
emphasis on MARC, MBRS, RCMI, and ORMH programs, and expects 
these programs to continue to be supported at a level 
consistent with that of the overall increase for NIH.
    Autoimmune disease.--Autoimmunity is the root of a family 
of over 80 interrelated major diseases that cut across the 
Institutes at the NIH. The Committee is aware of a 
recommendation to establish a coordinating council on 
autoimmune disease research to improve the use of existing 
research funds and facilitate the application of important 
findings among the many research programs dealing with 
autoimmune diseases at the NIH. The Committee requests that the 
Director give careful consideration to the creation of such a 
committee.
    Nutrition science.--The Committee urges NIH to reaffirm its 
commitment to nutrition science as a major 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 
program project grants are an important method of advancing 
nutrition science through the integration of basic and clinical 
science and through training programs which permit nutritional 
scholars to develop training in molecular genetics and clinical 
science.
    Clinical depression and the elderly.--The Committee is 
concerned that the rate of elderly suicide has increased by 9 
percent between 1980 and 1992. It is recognized that elderly 
suicide is a preventable public health tragedy, as the majority 
of victims have major depression, and most have visited their 
primary care physician within 1 month prior to their suicide. 
The Committee encourages the expansion of research efforts, 
including the further study of the psychiatric, psychological, 
social, and medical risk factors associated with suicide, and 
understanding why so few depressed elderly, receive appropriate 
treatment. The Committee recommends that NIH study the extent 
of this problem, including the need for primary care physicians 
to make appropriate referrals and expects a report on this 
subject by February 15, 1998.
    Child abuse and neglect research.--The Committee recognizes 
the magnitude and significance of the problem of child abuse 
and neglect. The Committee applauds NIH, under the leadership 
of 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 to hold a conference on child 
abuse and neglect and to assess the state-of-the-art science 
and make recommendations for a research agenda in the 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.
    National Foundation for Biomedical Research.--Funds 
provided to the Office of the Director include $500,000 to 
support the National Foundation for Biomedical Research as 
authorized by section 499 of the Public Health Service Act. 
Funds were first provided for the NFBR in fiscal year 1997; 
these additional funds will allow 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.
    Research management and support review.--The Committee is 
aware that the NIH has undertaken a review of the agency's 
research management and support activities and costs with the 
view toward further streamlining the agency's administrative 
practices. Given the out-year budget constraints laid out in 
the balanced budget agreement, the Committee believes this is a 
timely and critical review. The identification of greater 
efficiencies will be essential to maintaining a vibrant 
extramural and intramural research program over the next 5 
years. The Committee looks forward to the examination of this 
review later this year and working with the Director in the 
implementation of the recommendations.
    Cancer in minorities study.--The Committee is concerned 
about the slow progress in moving forward with the Institute of 
Medicine Study of the status of research into cancer among 
minorities and the medically underserved. The Committee finds 
it difficult to understand why it has taken over 9 months to 
get this study underway. The Committee requests that the NIH 
move without delay to ensure that study arrangements are 
concluded within 30 days or provide notification to the 
Committee of the reasons for further delay.
    National High Magnetic Field Laboratory.--The Committee 
commends NIH for responding to its recommendation in fiscal 
year 1997 on NIH participation in the National High Magnetic 
Field Laboratory. The Committee intends that NIH more fully 
explore an interagency financial and research participation 
agreement with the laboratory so the research can be more fully 
shared with NIH and applied to NIH research initiatives. The 
Committee encourages the Director to participate in 
negotiations on an appropriate interagency participation 
agreement.
    Office of Alternative Medicine.--The Committee continues to 
strongly support the work of the Office of Alternative Medicine 
[OAM] and has included $13,000,000 to support the work of this 
office. This is $1,000,000 over the level provided for 1997 and 
$5,500,000 over the budget request. The Committee directed NIH 
to establish this Office in 1992 with the intent of assuring 
objective rigorous review of alternative therapies to provide 
consumers reliable information. However, it is now clear that 
without greater authority to initiate research projects and 
develop its own peer review panels, alternative therapies will 
not be adequately reviewed and inefficiencies will remain. 
Currently, much time and resources are wasted because the 
Office must work through an Institute in order to carry out 
research projects. The Committee encourages the authorizing 
committee to give consideration to enhancing the Office's 
authority during the reauthorization process for the National 
Institutes of Health.
    In addition, the Committee is very concerned that despite 
repeated instructions OAM has not completed even one field 
investigation of an alternative therapy. The Committee, 
therefore, directs OAM to undertake field investigations to 
investigate and validate promising alternative and 
complementary therapies and to implement an aggressive program 
for the collection and evaluation of outcome data on promising 
alternative therapies. The Committee also is concerned that 
despite the existence of unfunded and underfunded OAM initiated 
projects, OAM expended a significant portion of its 
appropriated funds to supplement existing projects already 
funded through other Institutes. The Committee urges OAM to use 
appropriated funds for OAM initiated projects. The existing 
centers and the field investigation/outcome data initiatives 
should receive high priority for these funds.
    Pain research.--The Committee remains interested in 
research on complementary methods such as chiropractic care to 
treat low back pain. A report released by the Agency for Health 
Care Policy and Research estimates that the total annual 
societal costs of back pain range from $20,000,000,000 to 
$50,000,000,000. Recent research also indicates that spinal 
manipulation is an effective form of initial treatment for 
acute low back problems. The Committee has included sufficient 
funds to increase support for the Center on Chiropractic Health 
Care and Manipulative Methods.
    The Committee commends the NIH for the creation of the pain 
consortium. While the consortium is a positive development, the 
Committee remains concerned about the overall commitment to 
pain research. The Committee also remains concerned about the 
extent to which the consortium is integrating its efforts with 
research initiatives outside the NIH. The Committee encourages 
the NIH to involve other relevant agencies in the work of the 
consortium, particularly those where a considerable amount of 
pain research is being conducted.

                        BUILDINGS AND FACILITIES

Appropriations, 1997....................................    $200,000,000
Budget estimate, 1998...................................     190,000,000
Committee recommendation................................     211,500,000

    The Committee recommends an appropriation of $211,500,000 
for buildings and facilities [B&F]. This is $21,500,000 more 
than the budget request and $11,500,000 more than the fiscal 
year 1997 appropriation.
    Mission.--The buildings and facilities appropriation 
provides for the NIH construction programs including design, 
construction, and repair and improvement of the clinical and 
laboratory buildings and supporting facilities necessary to the 
mission of the NIH. This program maintains physical plants at 
Bethesda, Poolesville, Baltimore, and Frederick, MD; Research 
Triangle Park, NC; Hamilton, MT; Perrine, FL; New Iberia, LA; 
and Sabana Seca, PR.
    Clinical research center.--The recommendation includes 
$90,000,000 in fiscal year 1998 for the third year of funding 
for the new Mark O. Hatfield Clinical Research Center. This is 
in addition to $113,000,000 appropriated in fiscal years 1996-
97. The recommendation does not include the advance 
appropriation requests totaling $130,000,000 as proposed in the 
budget request. This Center will replace the aging research 
hospital and related clinical laboratory facility and serve as 
the heart of the NIH intramural research program. The new 
clinical research center is currently being designed. To date, 
development of the detailed program requirements has been 
substantially completed; detailed design is being developed for 
the relocation of the existing clinical center entrance; and 
the verification of the project budget estimate based on the 
preliminary design concept and schematic drawings is being 
finalized. The Committee requests that the Director provide 
notification of any revised project cost estimate that exceeds 
the current projected cost of $310,000,000.
    AIDS vaccine lab building.--The recommendation includes 
funding to construct a laboratory to house the newly 
established Vaccine Research Center at the NIH. The Center, 
which will be a joint venture of the National Cancer Institute 
and the National Institute of Allergy and Infectious Diseases, 
will begin by incorporating a core of NIH scientists with 
interest and expertise in immunology, virology, and HIV vaccine 
research. The primary focus for the Center will be to stimulate 
multidisciplinary research from basic and clinical immunology 
and virology through to vaccine design. Construction of this 
state-of-the-art facility will help in both the recruitment of 
accomplished scientists from outside the NIH ranks and in 
accelerating progress in developing a safe and effective AIDS 
vaccine.

                        OFFICE OF AIDS RESEARCH

Appropriations, 1997....................................................
Budget estimate, 1998...................................  $1,540,765,000
Committee recommendation................................................

    The Committee recommendation does not include a direct 
appropriation of $1,540,765,000 for the Office of AIDS Research 
[OAR] as proposed in the budget request. Instead, funding for 
AIDS research is included within the appropriation for each 
Institute, Center, and Division of the NIH. The recommendation 
also includes a general provision which directs that the 
funding for AIDS research, as determined by the Directors of 
the National Institutes of Health and the OAR, be allocated 
directly to the OAR for distribution to the Institutes 
consistent with the AIDS research plan. The recommendation also 
includes a general provision permitting the Directors of the 
NIH and the OAR to shift up to 3 percent of AIDS research 
funding between Institutes and Centers throughout the year if 
needs change or unanticipated opportunities arise. These 
modifications to the budget recommendation are consistent with 
the manner in which funding for AIDS research was provided in 
fiscal year 1997. The Committee requests that the Director 
report on the fiscal year 1998 allocation plans for AIDS 
research within 60 days of enactment and provide notification 
to the Committee in the event the Directors exercise their 3 
percent transfer authority.
    The NIH Office of AIDS Research [OAR] coordinates the 
scientific, budgetary, legislative, and policy elements of the 
NIH AIDS research program. Congress provided new authorities to 
the OAR to fulfill these responsibilities in the NIH 
Revitalization Act Amendments of 1993. The law mandates the OAR 
to develop an annual comprehensive plan and budget for all NIH 
AIDS research and to prepare a Presidential bypass budget.

       Substance Abuse and Mental Health Services Administration

Appropriations, 1997....................................  $2,121,512,000
Budget estimate, 1998...................................   2,155,943,000
Committee recommendation................................   2,126,643,000

    The Committee recommends $2,126,643,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 1998. In addition, $50,000,000 was provided for 
substance abuse treatment in Public Law 104-121, and 
$10,000,000 in section 241, 1 percent evaluation set-aside 
funds was provided for State level data collection, which 
brings the program total for SAMHSA to $2,186,643,000. This is 
$15,131,000 more than the fiscal year 1997 level. SAMHSA is 
responsible for supporting mental health, alcohol abuse, and 
other drug abuse prevention and treatment services throughout 
the country, primarily through categorical grants and block 
grants to States. The Committee has provided funding for the 
Knowledge, Development, and Application Program to each of 
three authorities: mental health, substance abuse treatment, 
and substance abuse prevention. Separate funding is provided 
for the Children's Mental Health Program, the PATH formula 
grant, the Protection and Advocacy Formula Grant Program, and 
for the two block grant programs.
    The Committee has included bill language that retains the 
formula used in fiscal year 1997 for fiscal year 1998 
calculations of State allotments of the substance abuse 
performance partnership block grant and the mental health 
performance partnership block grant. States would receive the 
same allotment in fiscal year 1998 as they received in fiscal 
year 1997. This provision has been included to allow sufficient 
time for the authorizing committees of Congress to consider 
legislation to reauthorize the programs of the Substance Abuse 
and Mental Health Services Administration, including any 
revisions to the existing formula.
    The Committee recognizes the importance of the work of 
SAMHSA in reducing and treating substance abuse and providing 
mental health services, especially following the agency's 
reorganization. The Committee further recognizes the importance 
of linking an evaluation component with the improvement and 
dissemination of working strategies among the Nation's urban 
and rural communities. In establishing the funding levels and 
priorities for fiscal year 1998, the Committee has sought to 
accommodate the President's requests for agency activities 
while addressing congressional areas of concern. To better 
coordinate the agency's coordination of these priorities, the 
Committee directs the Secretary to issue, within 60 days of 
enactment of this bill, a report that details the agency's 
allocation and operational plans in fiscal year 1998 for 
administration proposals as well as priorities established by 
the Committee.
    The Committee remains concerned by the disproportionate 
presence of substance abuse in rural and native communities, 
particularly for American Indian and Alaska Native communities. 
The Committee reiterates its belief that funds for prevention 
and treatment programs should be targeted to those persons and 
communities most in need of service. Therefore, the Committee 
has provided sufficient funds to fund projects to increase 
knowledge about effective ways to deliver services to rural and 
native communities. Within the funds reserved for rural 
programs, the Committee intends that $6,000,000 be reserved for 
CSAT grants, and $4,000,000 be reserved for CSAP grants.
    Knowledge developed and implemented through the CSAP and 
CSAT KDA grant systems should be coordinated to the fullest 
practical extent with the public alcohol and drug prevention 
and treatment system administered by the State alcohol and drug 
agencies. The Committee urges the agency to establish stronger 
linkages between KDA programs and the State network through 
regular consultation and coordination of effort with the State 
agencies and through other appropriate steps.

                   CENTER FOR MENTAL HEALTH SERVICES

Mental health, knowledge, development, and application

    The Committee recommends $57,964,000 for the mental health, 
knowledge, development, and application program [KDA], the same 
as the comparable fiscal year 1997 amount and $68,000 less than 
the President's request. The following programs are included in 
the mental health center KDA: Community Support Program [CSP]; 
homeless and AIDS demonstrations; and training and AIDS 
training programs.
    Sufficient funds are available to establish a 24-hour 
crisis-response pilot program that provides expert assistance 
to local law enforcement officials in clinically identifying 
and assisting citizens with mental illness, victims of domestic 
violence, and victims of child abuse. The Committee notes that 
the Birmingham Alliance for the Mentally Ill Crisis 
Intervention Task Force of Jefferson County, AL, is especially 
well suited to operating such a program and urges the agency to 
grant full and fair consideration of its proposal.
    The Committee again restates its belief that mental health 
and substance abuse services are essential elements of primary 
care, and its concern about the impact of managed care on 
access to mental health services, and supports training of 
behavioral and mental health professionals for work in managed 
care settings, particularly in rural and underserved 
communities. The Committee urges the development of standards 
and guidelines for the delivery of such services in managed 
care entities, including curricula design and training models. 
The Committee further encourages CMHS to collaborate with the 
Health Resources and Services Administration on the development 
of training protocols for mental health professionals in 
primary care settings.
    The Committee is pleased that the Center for Mental Health 
Services funds state-of-the-art, peer-run programs that help 
people with mental illnesses live successfully in the 
community. These low-cost services have an impressive record of 
assisting people with mental disorders decrease their 
dependence on expensive social services and avoid psychiatric 
hospitalization. Having proved effective, they have been 
replicated in numerous communities with State and local 
funding. The Center has also funded two national technical 
assistance centers that provide training and information to 
help these groups grow. The Committee has included sufficient 
funds to continue to support these two clearinghouses.
    The Committee is pleased that SAMHSA continues its support 
of projects which provide outreach and counseling services in 
rural areas to displaced coal miners, farmworkers, and their 
families.
    The Committee is pleased with the successful collaboration 
between the Center for Mental Health Services and the Bureau of 
Health Professions in HRSA to fund interdisciplinary health 
professions training projects, including training of behavioral 
and mental health professionals, for practice in managed care/
primary care settings and urges that this joint effort be 
continued. The Committee encourages both agencies to develop 
technical assistance for use in health professions training 
programs for the purpose of enhancing primary care 
interdisciplinary models of practice. These efforts should be 
focused upon rural native populations that are at-risk for the 
problems most encountered by these health professionals.
    The Committee encourages the agency to encompass high 
priority system-change grants that show potential for enhancing 
community-based State and county public mental health programs. 
Some of these projects include the statewide family network 
grants, consumer self-help clearinghouses, and the service 
system improvement grants.

Clinical and AIDS training

    The Committee is aware of the need for more trained health 
providers, including allied health professionals and social 
workers, to work with people suffering from HIV/AIDS. To the 
extent that funds are available, the Committee encourages 
SAMHSA to continue funding existing grants and contracts 
approved by SAMHSA under the current AIDS Training Program.
    The Clinical Training Program trains mental health 
personnel to deliver services to designated underserved 
populations in exchange for a repayment through service to 
underserved or priority populations, including severely 
mentally ill adults, children, and adolescents with serious 
emotional disorders, and the elderly. The AIDS Training Program 
provides training for mental health providers to address the 
neuropsychiatric aspects of HIV spectrum infection.
    The Committee recognizes that clinical training programs 
such as the Minority Fellowship Program have proven valuable in 
developing and disseminating new knowledge regarding mental 
health service delivery to SAMHSA's priority populations. 
Additionally, it remains a Federal priority to lead knowledge 
development and dissemination in this area, both for providers 
in need of in-service training, as well as for pre-service 
trainees. The Committee urges the agency to fund training 
projects that foster cultural competencies, a diverse work 
force, collaboration among disciplines, and that promote the 
use of interdisciplinary service delivery models especially in 
rural areas such as Hawaii where the cultural and diversity 
factors predominate.

AIDS demonstrations

    This program provides 4 year grants to public and nonprofit 
private organizations to provide innovative mental health 
services to individuals who are experiencing severe 
psychological distress and other psychological sequelae as a 
result of infection with HIV. One coordinating center is 
supported to independently evaluate the quality and 
effectiveness of these services. The Committee again commends 
CMS for its leadership in working cooperatively in 
demonstrating the efficacy of delivering mental health services 
to individuals affected by and living with HIV/AIDS. The 
Committee encourages the Secretary to maintain these agencies' 
support for this program.

Mental health block grant

    The Committee recommends $275,420,000 for the mental health 
block grant, the same as the fiscal year 1997 amount and the 
President's request. States use these funds to support the 
development and implementation of innovative community-based 
services and maintain continuity of community programs. Funds 
are allocated to States by formula.

Children's mental health

    The Committee recommends $69,896,000 for the Children's 
Mental Health Program, the same as the fiscal year 1997 level 
and $31,000 less than the President's request. This program 
provides grants and technical assistance to support community-
based services for children and adolescents with serious 
emotional, behavioral or mental disorders. States must provide 
matching funds, and services must involve the educational, 
juvenile justice, and health systems.

Projects for assistance in transition from homelessness [PATH]

    The Committee recommends $20,000,000 for the PATH Program, 
the same as the fiscal year 1997 amount and the administration 
request.
    PATH is a critical program which provides outreach, mental 
health, and case management services and other assistance to 
persons who are homeless and have serious mental illnesses. The 
PATH Program makes a significant difference in the lives of 
homeless persons with mental illnesses. PATH services eliminate 
the revolving door of episodic inpatient and outpatient 
hospital care. Multidisciplinary teams address client needs 
within a continuum of services, providing needed stabilization 
so that mental illnesses and co-occurring substance abuse and 
medical issues can be addressed. Assistance is provided to 
enhance access to housing, rehabilitation and training, and 
other needed supports, assisting homeless people in returning 
to secure and stable lives.

Protection and advocacy

    The Committee recommends $21,957,000 for protection and 
advocacy, the same as the fiscal year 1997 amount and the 
President's request. This program helps ensure that the rights 
of mentally ill individuals are protected while they are 
patients in treatment facilities and for 90 days following 
their discharge. Funds are allocated to States according to a 
formula based on population and relative per capita income.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Substance abuse treatment knowledge, development, and application

    The Committee recommends $155,868,000 for the substance 
abuse treatment knowledge, development, and application program 
[KDA]. This amount is $132,000 less than the administration 
request and the same as the comparable fiscal year 1997 amount.
    The Committee has provided sufficient funds to continue all 
existing residential women and children grants. The Committee 
has provided funds to continue the supplemental demonstration 
and evaluation of enhanced children's services as part of the 
Center for Substance Abuse and Mental Health Centers' 
Residential Women and Children and Pregnant and Postpartum 
Women Programs.
    The Committee reiterates its concern about the 
disproportionate impact of substance abuse in rural and native 
communities, and has included $6,000,000 for rural CSAT 
programs, which is $3,000,000 higher than last year's level. 
The Committee again acknowledges the severe shortage of 
services in the State of Alaska, the pressing need to continue 
support of Alaska programs, and the need to develop knowledge 
about effective techniques for treating and preventing 
substance abuse in native populations. The Committee, 
therefore, expects that the increase provided will be 
reasonably allocated between expanding existing programs and 
initiating new programs, especially in Alaska.
    The Committee commends the efforts of independent self-run, 
self-supported organizations that are dedicated to helping 
overcome substance abuse and/or alcohol abuse. Entities, such 
as the Oxford House system, are innovators in developing the 
concept that recovering individuals can live together and share 
responsibilities in a living environment which supports the 
recovery of every resident. The Committee is aware of efforts 
by Oxford House to expand the self-help concept into unserved 
areas and urges the agency give full and fair consideration to 
its proposal.

Substance abuse block grant

    The Committee recommends $1,310,107,000 for the substance 
abuse block grant. In combination with the $50,000,000 provided 
for the block grant in Public Law 104-121, a total of 
$1,360,107,000 is provided for the block grant, the same as the 
comparable fiscal year 1997 level and $10,000,000 less than the 
administration's request.
    The substance abuse block grant provides funds to States to 
support alcohol and drug abuse prevention, treatment, and 
rehabilitation services. Funds are allocated to the States 
according to formula. State plans must be submitted and 
approved annually.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Substance abuse prevention, knowledge, development, and application

    The Committee has provided $151,000,000 for the substance 
abuse prevention, knowledge, development, and application 
program, $4,869,000 less than the comparable fiscal year 1997 
amount and the same as the administration's request.
    The Committee also provides $10,000,000 for the purpose of 
making grants to public and nonprofit private entities for 
projects to demonstrate effective models for the prevention, 
treatment, and rehabilitation of drug abuse and alcohol abuse 
among high risk youth, as authorized by section 517 of the 
Public Health Service Act as amended. This is a new activity 
for fiscal year 1998. The Committee is highly concerned about 
the extent of substance abuse among high risk youth. This 
population is vulnerable to initiating criminal activity 
against people and property, especially following the acute and 
chronic use of illicit substances and the abuse of alcohol. 
These grants are intended to strengthen local capabilities in 
confronting the complex interrelationships between substance 
and alcohol abuse and other activities that may predispose 
young individuals toward criminal, self-destructive, or 
antisocial behavior.
    In order for the State Incentive Grant Program to be 
effective it must include mechanisms for communities to develop 
strategic plans and needs assessments that identify their most 
pressing problems and the services and programs needs to 
address them. The Committee expects that States receiving 
funding under the State Incentive Grant Program will give 
priority in the use of the 20 percent prevention set-aside in 
the block grant to: (1) working with community coalitions to 
develop communitywide strategic plans and needs assessments; 
and (2) filling program and service gaps identified by these 
community plans.
    The Committee reiterates its concern about the 
disproportionate impact of substance abuse in rural and native 
communities, and has included $4,000,000 for CSAP programs 
which serve rural communities, which is $2,000,000 higher than 
last year's level. The Committee intends this increase to be 
reasonably allocated between expanding existing programs and 
initiating new programs, especially in Alaska.
    The Committee believes that prevention programs need to 
start when children are young, and need to continue to help 
children make successful transitions. The Committee has 
included sufficient funds for evaluations of established 
school-based early prevention and transition programs and 
continues to be supportive of the efforts of the Corporate 
Alliance for Drug Education [CADE] which has been operating a 
program providing education and prevention services to 120,000 
elementary school-aged children in Philadelphia.
    The Committee commends CSAP for recognizing problems 
created by past use of the phrase, ``Alcohol and Other Drugs'' 
[AOD]; however, many constituencies which rely on CSAP for 
leadership and funding are not aware of the agency's important 
policy change. The Committee urges CSAP to fully implement its 
move away from AOD terminology, through direct communications 
to other Government agencies including the Department of 
Education, nonprofit organizations, and other CSAP 
constituencies, without prescribing specific speech to 
grantees.
    Within the funds available, the Committee urges CSAP to 
continue the national effort to provide alcohol and substance 
abuse prevention and education to children of native Americans 
with alcoholism.

                           PROGRAM MANAGEMENT

    The Committee recommends $54,431,000 for program management 
activities of the agency, $1,069,000 less than the President's 
request and the same as the 1997 level.
    The program management activity includes resources for 
coordinating, directing, and managing the agency's programs. 
Program management funds support salaries, benefits, space, 
supplies, equipment, travel, and departmental overhead required 
to plan, supervise, and administer the programs.
    The Committee is aware of the administration's proposal to 
begin the process of sealing off and preservation of the 
buildings of St. Elizabeth's Hospital, to bring the complex 
closer toward the standard of care expected of its designation 
as a national historic landmark. The Committee further expects 
any additional funds for preservation to be derived from 
carryover balances from amounts previously appropriated for 
buildings and facilities.

                            DATA COLLECTION

    The administration requested $28,000,000 to expand the 
national household survey on substance abuse to facilitate the 
development of State-level estimates of substance abuse and the 
impact of youth prevention programs. The Committee has provided 
bill language authorizing up to $10,000,000 for this activity, 
to be derived from Public Health Service Act section 241, 1 
percent evaluation set-aside funds. This amount is sufficient 
to begin a reasonable expansion of the survey without undue 
disruption of other funded activities of the agency.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 1997....................................    $178,635,000
Budget estimate, 1998...................................     190,739,000
Committee recommendation................................     190,739,000

    The Committee provides an estimated $190,739,000 for 
retirement pay and medical benefits for commissioned officers 
of the U.S. Public Health Service. This is the same as the 
administration request and is $12,104,000 over the estimated 
payments for fiscal year 1997.
    This account provides for: retirement payments to U.S. 
Public Health Service officers who are retired for age, 
disability, or length of service; payments to survivors of 
deceased officers; medical care to active duty and retired 
members and dependents and beneficiaries; and for payments to 
the Social Security Administration for military service 
credits.

               Agency for Health Care Policy and Research

Appropriations, 1997....................................    $143,479,000
Budget estimate, 1998...................................     149,000,000
Committee recommendation................................     142,587,000

    The Committee recommends $77,587,000 in Federal funds for 
the Agency for Health Care Policy and Research [AHCPR]. In 
addition, the Committee provides transfers of $65,000,000 from 
funds available under section 241 of the Public Health Service 
Act. Total funding provided for the Agency is $142,587,000, 
which is $892,000 less than fiscal year 1997 funding and 
$6,413,000 less than the administration's request.
    The Agency for Health Care Policy and Research was 
established in 1990 to promote improvements in clinical 
practice and patient outcomes, promote improvements in the 
financing, organization, and delivery of health care services, 
and increase access to quality care. AHCPR is the Federal 
agency charged to produce and disseminate scientific and 
policy-relevant information about the cost, quality, access, 
and medical effectiveness of health care. AHCPR provides 
policymakers, health care professionals, and the public with 
the information necessary to improve cost effectiveness and 
appropriateness of health care and to reduce the costs of 
health care.
    The Committee is supportive of AHCPR's efforts to establish 
a children's health services research agenda. To the extent 
that resources permit, the Committee encourages AHCPR to 
consider sponsoring a national conference on developing a 
national research agenda on quality, effectiveness, and 
outcomes measures in children's health care. The Committee 
further encourages the Agency to work with the Emergency 
Medical Services for Children Program at HRSA to evaluate the 
potential impact of managed care on children's access to 
emergency services.

                  Health Care Systems Cost and Access

    The Committee provides $46,685,000 for research on health 
care systems cost and access, which is the same as the 
administration request and $1,677,000 below the 1997 level. Of 
the amount provided, $29,515,000 is derived from the section 
241, 1-percent evaluation set-aside, which is the same as the 
administration request.
    Research on health care systems cost and access programs 
examines ways to enhance efficiencies in the health care system 
by: identifying the most effective means in health care service 
delivery; determining how the structural and financial aspects 
of the health care system affects utilization, quality, and 
costs; and helps translate relevant research findings for the 
use of the major participants in the health care system.

Rural health services research

    The Committee reiterates its support of the Agency's work 
in the area of rural health services research, and expects that 
AHCPR continue to fund five specialized centers for rural 
health managed care services demonstrations. Many recent health 
care innovations such as managed care are available in 
metropolitan areas but are frequently unavailable to rural 
populations. The centers will conduct demonstrations of 
innovations in the delivery of health care services in rural 
areas. The Committee notes that sufficient funding has been 
provided to continue the rural managed care pilot projects.

Osteoporosis

    The Committee notes that osteoporosis occurs in 37 percent 
of the population. Hip and vertebral fractures add significant 
costs to Medicare, and preventative measures identified in this 
study could greatly reduce those costs and improve the well-
being of millions of Americans. Within the funds provided, the 
Committee encourages the Agency to conduct research, including 
competitive grants, to identify persons at risk for the disease 
and provide health education to decrease the prevalence of 
osteoporosis. The Committee further urges the agency to 
collaborate with the National Institute of Arthritis and 
Musculoskeletal and Skin Diseases to initiate planning of 
definitive studies, including epidemiologic studies, that would 
better integrate patient outcomes with research, screening and 
preventive measures.

                Health Insurance and Expenditure Surveys

    The Committee provides $36,300,000 for health insurance and 
expenditure surveys, which is the same as the administration 
request and $8,400,000 less than the 1997 level. Of the amount 
provided, $26,300,000 is derived from the section 241, 1-
percent evaluation set-aside, which is the same as the 
administration request.
    The health insurance and expenditure surveys obtain 
information necessary to develop timely national estimates of 
health care use and expenditures, private and public health 
insurance coverage, and the extent and costs of private health 
insurance benefits. The surveys also analyze changes in health 
care use, expenditures, and insurance coverage resulting from 
changes in market forces or government policy. To accomplish 
these functions, AHCPR employs medical expenditure panel 
surveys [MEPS], an interrelated series of surveys that replace 
the national medical expenditure survey. The Committee provides 
the full administration request for MEPS and urges continued 
efforts by the Agency to identify appropriate savings within 
MEPS that could be used for other agency research priorities, 
including health services research.

                    Health Care Outcomes and Quality

    The Committee provides $51,187,000 for research on health 
care outcomes and quality, which is $3,000,000 higher than the 
1997 level and $6,413,000 below the administration request. The 
Committee has included $9,185,000 from the section 241, 1-
percent evaluation set-aside for this activity, which is the 
same as the administration request.
    The health care outcomes and quality programs fund 
activities to ascertain what works best in medical care by 
enhancing cost effectiveness and appropriateness of clinical 
practice; developing tools to measure and evaluate health 
outcomes, quality of care, and consumer satisfaction; and 
facilitating translation of information into practical uses 
through data bases, information technology and provider-to-
patient education.
    The Committee is supportive of AHCPR's efforts to establish 
a children's health services agenda. The Committee encourages 
the Agency to work with schools of nursing to identify high 
risk areas requiring research to provide better direction in 
caring for this vulnerable group. The Committee further 
encourages the Agency to work with the Emergency Medical 
Services for Children Program at the Health Resources and 
Services Administration to evaluate the potential impact of 
managed care on children's access to emergency services.
    The Committee has held hearings on the subject of quality 
of care in the changing Medicare market. As a result, the 
Committee recommends the Agency should examine new and emerging 
health care delivery mechanisms, including: the potential 
effect on quality when a patient's first clinical evaluation is 
between either a specialist or primary care giver, and the 
quality assurance potential of a point-of-service product 
compared to a closed-panel health delivery system.
    The Committee continues to be supportive of the Agency 
working with Hawaii, its unique health insurance plan, and its 
culturally diverse population.
    In its 1997 report, the Physician Payment Review Commission 
emphasized the need for innovative strategies to improve health 
care access and quality for the vulnerable, frail elderly. The 
PPRC report recommended that an Agency such as the AHCPR should 
develop a research framework toward this objective. The 
Committee believes that the AHCPR should consider undertaking 
key elements of the PPRC recommendations.
    The Committee commends AHCPR for its work supporting 
projects focused on improving healthcare quality and outcomes. 
The Committee encourages AHCPR to provide conference support 
for a showcase sponsored by a network of nursing leaders in 
which professional practitioners can articulate their unique 
contribution to patient and community healthcare.

Program support

    The Committee recommends $2,230,000 for program support. 
This amount is the same as the 1997 level and the same as the 
administration request. This activity supports the overall 
management of the Agency for Health Care Policy and Research.

                  Health Care Financing Administration

                     GRANTS TO STATES FOR MEDICAID

Appropriations, 1997.................................... $75,056,618,000
Budget estimate, 1998...................................  71,530,429,000
Committee recommendation................................  71,602,429,000

    The Committee recommends $71,602,429,000 for grants to 
States for Medicaid. This amount is $3,454,189,000 less than 
the fiscal year 1997 appropriation and $72,000,000 more than 
the administration's request. This amount excludes 
$27,988,993,000 in fiscal year 1997 advance appropriations for 
fiscal year 1998. In addition, $27,800,689,000 is provided for 
the first quarter of fiscal year 1999, as requested by the 
administration.
    The Committee recommendation includes an additional 
$72,000,000 over the budget request for the Medicaid 
appropriation for fiscal year 1998. The current appropriation 
request reflects proposed savings of $72,000,000 for vaccine 
purchases for the Vaccines for Children Program. These savings 
were to result from a proposal for an exemption for the payment 
of excise tax for vaccines purchased with Federal funds, which 
has not been approved.
    The Medicaid Program provides medical care for eligible 
low-income individuals and families. It is administered by each 
of the 50 States, the District of Columbia, Puerto Rico, and 
the territories. Federal funds for medical assistance are made 
available to the States according to a formula which determines 
the appropriate Federal matching rate for State program costs. 
This matching rate, which may range from 50 to 90 percent, is 
based upon the State's average per capita income relative to 
the national average.

                  PAYMENTS TO HEALTH CARE TRUST FUNDS

Appropriations, 1997.................................... $60,079,000,000
Budget estimate, 1998...................................  63,581,000,000
Committee recommendation................................  63,581,000,000

    The Committee recommends $63,581,000,000 for Federal 
payments to the Medicare trust funds. This amount is the same 
as the administration's request and is an increase of 
$3,502,000,000 from the fiscal year 1997 appropriation.
    This entitlement account includes the general fund subsidy 
to the supplementary medical insurance trust fund (Medicare 
part B), plus other reimbursements to the hospital insurance 
trust fund (Medicare part A), for benefits and related 
administrative costs which have not been financed by payroll 
taxes or premium contributions.
    The Committee has provided $63,416,000,000 for the Federal 
payment to the supplementary medical insurance trust fund. This 
payment provides matching funds for premiums paid by Medicare 
part B enrollees. This amount is the same as the administration 
request, and is $3,960,000,000 more than the fiscal year 1997 
amount.
    The recommendation also includes -$52,000,000 for hospital 
insurance for the uninsured. This amount is the same as the 
administration's request and is $457,000,000 less than the 1997 
amount.
    The Committee also recommends $86,000,000 for the Federal 
uninsured benefit payment. This payment reimburses the hospital 
insurance trust fund for the cost of benefits provided to 
Federal annuitants who are eligible for Medicare. This amount 
is the same as the administration's request and is $10,000,000 
more than the fiscal year 1997 appropriation.
    The Committee recommendation includes $131,000,000 to be 
transferred to the hospital insurance trust fund as the general 
fund share of HCFA's program management administrative 
expenses. This amount is the same as the administration's 
request and is $11,000,000 less than the fiscal year 1997 
level.

                           PROGRAM MANAGEMENT

Appropriations, 1997....................................  $1,734,441,000
Budget estimate, 1998...................................   1,774,500,000
Committee recommendation................................   1,719,241,000

    The Committee recommends $1,719,241,000 for HCFA program 
management. This is $55,259,000 less than the budget request 
and $15,200,000 less than the fiscal year 1997 enacted level.

Research, demonstrations, and evaluation

    The Committee recommends $47,000,000 for research, 
demonstration, and evaluation activities. This amount is 
$2,000,000 more than the budget request, and $3,000,000 more 
than the amount provided in fiscal year 1997.
    HCFA research and demonstration activities facilitate 
informed, rational Medicare and Medicaid policy choices and 
decisionmaking. These studies and evaluations include projects 
to measure the impact of Medicare and Medicaid policy analysis 
and decisionmaking, to measure the impact of Medicare and 
Medicaid on health care costs, to measure patient outcomes in a 
variety of treatment settings, and to develop alternative 
strategies for reimbursement, coverage, and program management.
    The recommended funding level of $47,000,000 for the 
regular research and demonstration program will provide for 
continuation of current activities including telemedicine 
demonstration projects, which should remain a high priority. It 
will also fund new initiatives. Priority areas for HCFA 
research include access to high-quality health care, health 
service delivery systems, and provider payment systems.
    The Committee continues to strongly support efforts to test 
the use of telemedicine to expand access to health care in 
rural areas. Because HCFA did not develop a Medicare 
reimbursement policy for these pilot sites until 2 years into a 
3-year project, the Committee has included sufficient funds to 
cover the administrative and evaluation costs associated with 
these projects for an additional 24 months. This will ensure 
that these projects will continue to operate for a full 3 years 
under a pilot reimbursement program. While the Committee has 
been pleased with HCFA's work in this area, it is concerned 
about the limited amount of data that HCFA is collecting under 
the demonstration and the impact this will have on the 
timeliness and usefulness of the demonstrations. HCFA is not 
fully utilizing all of the sites affiliated with these 
projects. The Committee urges HCFA to include all sites and 
providers affiliated with the existing demonstration projects 
in the Medicare reimbursement policy demonstration regardless 
of whether these affiliated sites are funded by HCFA. The 
Committee also urges HCFA to evaluate, store, and forward 
applications as well as telemental health and emergency care 
services.
    The Committee recommends that the Secretary, in conducting 
the study of the costs and benefits of providing medical 
nutrition therapy services to Medicare beneficiaries, ensure 
that the study examine providing such services by registered 
dietitians in group as well as individual settings to determine 
the most cost-effective method to provide nutrition therapy. 
Further, the Committee recommends that the scope of the study 
include medical conditions ranging from malnutrition to 
obesity, recognizing that obesity is the second leading 
preventable cause of death in the United States.
    The Committee urges the Secretary of Health and Human 
Services to conduct a 2-year demonstration project on coverage 
of medical nutrition therapy by registered dietitians in the 
part B portion of Medicare. The demonstration should 
investigate the impact on program costs, savings, and 
beneficiary health and quality of life. In developing and 
implementing the demonstration, the Secretary should give 
strong consideration to the views of registered dietitians. The 
Secretary is expected to report to the Committee on the status 
of the demonstration 1 year after its initiation and again at 
its conclusion.
    The Committee strongly supports continued funding for the 
Temple University Hospital Ventilator Rehabilitation Unit. 
Demonstration authority for this highly successful project, 
rated outstanding in the Nation by an independent audit, 
expired June 30, 1997. The Committee expects, therefore, that 
the HCFA project, demonstration projects with respect to 
chronic ventilator-dependent units in hospitals, be extended 
for 3 years for the ventilator-dependent unit at Temple 
University Hospital.
    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 plans. The Committee 
recommendation includes sufficient funds to demonstrate and 
evaluate model programs developed and managed by nonprofit 
community and family services organizations, which help 
vulnerable populations in low-income settings to understand how 
to use managed care for themselves and their children.
    The Committee recommends that HCFA undertake a 
demonstration program with no fewer than four States to develop 
collaborative initiatives to provide insurance to uninsured 
individuals who are not eligible for Medicaid coverage. Under 
this demonstration program, States would be permitted to allow 
hospitals to utilize funds used to reimburse hospitals for the 
costs of medical care for the uninsured, to provide assistance 
to low-income individuals for the purchase of health coverage. 
States selected to participate in this demonstration project 
should coordinate with local private entities for planning and 
implementation, and initially may restrict the project to a 
limited geographic area. The Administrator should permit 
multiple States to jointly develop a program for metropolitan 
statistical areas that cross State boundaries. The Committee is 
aware of an initiative by St. Louis 2004, which is located in 
St. Louis, MO, to provide expanded coverage to uninsured 
individuals using existing resources in the community including 
State and Federal dollars already spent for medical care for 
the uninsured; the Committee urges full and fair consideration 
of this group's effort.
    The Committee believes that HCFA research efforts should 
focus on strategies for assuring health care access and quality 
for the vulnerable, frail elderly. For those with chronic 
conditions, the Physician Payment Review Commission has 
recommended the use of case management services. The Committee 
encourages HCFA to continue to pursue demonstration projects 
that would test the use of case management and aid in the 
development of appropriate fee-for-service payment 
methodologies for Medicare. The Committee encourages HCFA to 
support research to develop cost-effective models for end-of-
life care for Medicare beneficiaries suffering from chronic, 
fatal illnesses who do not qualify for the hospice benefit. The 
Committee also encourages research on appropriate ways to 
recognize, in Medicare payment methods, the extra time and 
complexity associated with care for the frail elderly.
    As in the past, the Committee encourages that research and 
demonstration activities include the concept of nurse-run 
clinics and the utilization of advanced practice nurses as 
primary care providers. As Medicare moves into the managed care 
arena it is important that the most effective health care 
delivery systems be identified and utilized. Health promotion 
and prevention initiatives which are integral functions of 
nursing will play a significant role in the future healthcare 
of our aging population.
    Within the amount provided, the Committee has included 
sufficient funds to continue an existing grant to the National 
Indian Council on Aging that increases Indian elder awareness 
and participation in the public policy issues that have direct 
impact on all of Indian country.
    The Committee urges the consideration of activities which 
would develop, test, and evaluate health education and outreach 
methodologies targeted toward isolated and difficult to reach 
minority populations. The Committee also encourages initiatives 
that address health insurance, managed care, and the impact of 
public policy changes upon legal immigrants. The Committee is 
further aware of a proposal by the National Asian Pacific 
Center on Aging and recommends that this proposal receive full 
and fair consideration.
    The Committee is aware of the numerous advances made in 
diagnostic imaging technology that have the potential to 
reducing overall expenditures in the Medicare population, 
especially for heart disease. The Committee encourages the 
agency to consider undertaking evaluations of promising new 
generation imaging technology, such as coronary artery scanning 
by ultrafast computerized tomography, and their potential 
impact on Medicare expenditures.
    The Committee is aware of the Mercy Hospital of 
Philadelphia proposal to HCFA for disease management for 
predual (Medicaid/Medicare) eligible and dual-eligible minority 
populations in west Philadelphia. This proposed intervention 
program focuses on disease prevention, early detection and 
disease management of common chronic diseases affecting middle-
aged and older adult minority men and women. Centered on 
primary care provider based screening and treatment protocols, 
the program promotes health, disease prevention, and disease 
management. The Committee recommends that HCFA provide 
additional funds for this demonstration project to address the 
access, delivery system, and financing issues related to 
predual eligible and dual-eligible minority adults.
    The Committee is aware of the interest of Wills Eye 
Hospital, serving the Philadelphia area, to establish a 
graduate medical education demonstration project in 
ophthalmology at the hospital's ambulatory surgery center 
network, and urges full and fair consideration of a proposal 
from this organization.
    The Committee recommends that up to $100,000, be utilized 
by the Bureau of Data Management of the Health Care Financing 
Administration to prepare and make available a statistical 
analysis of its patient data base, to determine the correlation 
between the occurrence of multiple sclerosis and the occurrence 
of gout. Important research is currently being performed to 
determine whether uric acid, which occurs at elevated levels in 
gout patients, may inhibit the development of multiple 
sclerosis, and the foregoing statistical analysis may lead 
research to develop means of providing important public health 
benefits.

Medicare contractors

    The Committee recommends a program level of $1,723,000,000 
for Medicare contractors, which is the same as the 
administration's request, and $75,800,000 more than comparable 
fiscal year 1997 appropriation. This includes funding of 
payment safeguards at $500,000,000 as part of recently enacted 
health insurance reform legislation, which converts funding to 
a mandatory basis. For claims processing activities, the 
Committee recommendation includes the budget request level of 
$824,200,000.
    The Committee recommendation for Medicare claims processing 
operations reflects the expectation of a continuing trend of 
cost reductions. In part, recent savings have come from the 
increased use of electronic filing. While the Committee 
encourages this trend, its recommendation also takes into 
account the fact that some small providers, particularly in 
rural areas, still will need to file hard copy claims, and the 
Committee urges the Administrator to avoid creating hardships 
for such providers as it expands the use of electronic filing.
    The Committee is concerned about adequately funding claims 
processing activities, which are the first line of defense 
against fraud and abuse in Medicare. The Committee strongly 
urges HCFA not to use the claims processing budget for 
unrelated functions such as the ``Medicare Handbook.''
    Furthermore, the Administrator is expected to report to the 
Committee in the event there is a reduction greater than 5 
percent in unit cost payments from the 1997 levels for Medicare 
contractors; this report should include information about unit 
cost claims processing for all the contractors.
    The Committee notes that the budget request provides an 
increase from $75,000,000 in fiscal year 1997 to $89,000,000 in 
fiscal year 1998 for the Medicare transaction system [MTS]. 
However, the Committee recommendation provides $55,000,000 for 
MTS funding, which the Committee understands is sufficient to 
fund necessary single system transitions. Bill language has 
been included permitting unexpended MTS funds to remain 
available for the subsequent fiscal year.
    The Committee is very concerned with the poor management of 
the development and implementation of the Medicare transaction 
system. This major undertaking has been subject to considerable 
cost overruns and implementation delays. The Committee expects 
to receive a comprehensive budget and justification for 
completion of the project and asks that it be consulted before 
any additional funds are allocated for this project.
    The Committee is very concerned that the Department of HHS 
has inadequate plans for assuring that by the end of 1999 
computer software used by its contractors and fiscal 
intermediaries has been adjusted to not misfunction because of 
the shift to the year 2000. Without appropriate corrective 
action, Medicare payments could be significantly delayed and 
could result in significant loss of confidence among 
beneficiaries and a reduction of providers willing to accept 
Medicare patients.
    The Committee agrees that contracts with States for health 
advisory services programs for Medicare beneficiaries is an 
allowable activity under the Medicare contractor beneficiary 
services budget, and recommends $10,000,000 for this activity 
in fiscal year 1998. These contracts would provide assistance, 
counseling, and information activities relating to Medicare 
matters as well as Medicare supplemental policies, long-term 
care insurance, and other health insurance benefit information.
    Medicare contractors, who are usually insurance companies, 
are responsible for reimbursing Medicare beneficiaries and 
providers in a timely fashion and a fiscally responsible 
manner. These contractors also provide information, guidance, 
and technical support to both providers and beneficiaries.
    The Committee recommends that, in the event that unexpended 
fiscal year 1997 funds are available in this account, the 
Secretary use these funds, prior to the end of the fiscal year, 
to address the need of expanding efforts to prevent and collect 
Medicare mispayments as identified in the recent CFO audit. The 
Committee recommends further that these additional funds be 
used to increase the number of prepayment reviews and 
postpayment audits as well as to pay for a statistical analysis 
contractor to provide national program and integrity data 
analysis for each program integrity contractor targeting 
patterns of abuse. The Committee also urges that a significant 
portion be used to cover the cost of additional appeals, 
overpayment recoveries, provider, and beneficiary inquiries. 
The Committee requests that it be consulted before final 
obligation of these funds occurs.

State survey and certification

    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety, and program 
standards. Onsite surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys.
    The Committee recommends $158,000,00 for Medicare State 
survey and certification activities. This is $10,000,000 more 
than the request and the same as the 1997 enacted level.
    The fiscal year 1996 appropriations bill included language 
which extended the intervals for surveying Medicare-certified 
home health agencies. According to the Congressional Budget 
Office, this amendment increases the funds available for 
Medicare survey and certification by $8,000,000 in fiscal year 
1998. Therefore, the total amount of funds available for these 
activities is $166,000,000.

Federal administration

    The Committee recommends a total of $325,241,000 for 
Federal administrative costs. This is $33,259,000 less than the 
administration's request and the same as the fiscal year 1997 
appropriation.
    The Committee has been informed that very young children 
often have vision problems which go undetected for a variety of 
reasons. The problems, when left untreated, lead to learning 
difficulties and other maladies which, if discovered at an 
early stage, can be treated. Accordingly, the Committee urges 
HCFA to review its Medicaid reimbursement policy for pediatric 
visual screening, including evaluation to assess conditions 
which can preclude normal visual development. The Committee 
requests that the evaluation include, but not be limited to, 
cycloplegic retinoscopy, photo screening, and visually evoked 
potentials. Further, the Committee recommends that the 
evaluation be carried out utilizing a method which employs a 
photo refractive technique.
    The Committee understands that the Health Care Financing 
Administration proposes to reduce Medicare reimbursement for 
radiosurgery, to begin October 1, 1997. Concerns have been 
expressed that severe reductions in Medicare gamma knife 
reimbursement could force many patients back to traditional 
surgical approaches at high cost to the Government and 
potentially resulting in harm to patients due to complications 
from needless surgical intervention. The Committee urges the 
Health Care Financing Administration to fully investigate these 
concerns prior to imposing reductions in reimbursement rates.
    The Committee is concerned that HCFA has not complied with 
last year's appropriations bill/law requiring it to reassess 
each variation of lung volume reduction surgery based upon all 
of the available data, and, therefore, expects HCFA to do so 
and issue its complete report with recommendations for coverage 
no later than September 30, 1997.
    The Committee remains extremely concerned with the amount 
of money lost every year to fraud, waste and abuse in the 
Medicare Program. The Committee has held many hearings and 
taken other corrective actions over a 9-year period to expose 
and reduce these losses. The Senate passed balanced budget act 
contains a number of important reforms derived from Committee 
hearings. The Committee urges HCFA to promptly utilize these 
new authorities for competitive bidding, inherent 
reasonableness, and improved beneficiary information so that 
savings to Medicare will accrue as quickly as possible.
    GAO found that billions of dollars could be saved if 
Medicare carriers utilized commercially available software to 
detect and stop billing abuse. HCFA has not complied with the 
Committee's directive last year to implement such cost saving 
technology. The Committee again directs HCFA to take this step 
to modernize technology.
    The Administrator is strongly urged to take a leadership 
role in resolving the outstanding difficulties facing States 
attempting to develop Medicaid capitated managed care or 
primary care case management [PCCM] arrangements that enroll 
beneficiaries with chronic conditions or special health care 
needs. The Administrator is asked to develop and document 
strategies that may be used by States seeking to design 
successful plans. The Committee urges the Administrator to 
convene representatives from States, managed care 
organizations, beneficiaries with special health care needs, 
experts in specialized health care, and others to be actively 
involved in developing these strategies.
    The Committee would like the strategies to address issues 
of particular interest to people with special health care needs 
and chronic conditions enrolled in Medicaid capitated managed 
care of PCCM plans. Some examples of such issues are: risk 
adjustment, medical necessity definitions, quality controls, 
and adequacy of provider networks. Participants in the 
development of the guidelines are urged to expand this list as 
necessary. By September 1, 1999, the Administrator should 
report the results of this project to the Committee and to 
Congress.
    The Committee expects that no funds be used for the 
implementation of or planning for future implementation of the 
Medicare/Medicaid data bank.

                Administration for Children and Families

                   FAMILY SUPPORT PAYMENTS TO STATES

Appropriations, 1997.................................... $11,758,000,000
Budget estimate, 1998...................................................
Committee recommendation................................................

    The Committee concurs with the budget request in not 
recommending further appropriations for family support payments 
to States, which has been replaced by a new block grant, 
temporary assistance to needy families [TANF]. Funding for this 
new block grant was provided in Public Law 104-193 (the 
Personal Responsibility and Work Opportunity Reconciliation Act 
of 1996).

                      PAYMENTS TO STATES FOR JOBS

Appropriations, 1997....................................    $300,000,000
Budget estimate, 1998...................................................
Committee recommendation................................................

    The Committee concurs with the budget request in not 
recommending further appropriations for payments to States for 
AFDC work programs. This program has been consolidated under 
the newly created temporary assistance to needy families block 
grant [TANF], previously funded under Public Law 104-193, the 
Personal Responsibility and Work Opportunity Act of 1996.

               low-income home energy assistance program

Appropriations, 1997....................................  $1,000,000,000
Budget estimate, 1998...................................   1,000,000,000
Committee recommendation................................   1,000,000,000

    The Committee recommends that $1,000,000,000 be made 
available in fiscal year 1998 for the Low-Income Home Energy 
Assistance Program [LIHEAP], the same as the regular 
appropriation for fiscal year 1997 as well as the budget 
request.
    The Committee recommendation also includes a $1,200,000,000 
advance appropriation for fiscal year 1999, $200,000,000 more 
than the budget request. The advance appropriation, as 
authorized by law, gives States greater opportunity for 
effective program planning, including sound allocation of 
resources among the various components of the program.
    LIHEAP grants are awarded to the States, territories, and 
Indian tribes to assist low-income households in meeting the 
costs of home energy. States receive great flexibility in how 
they provide assistance, including direct payments to 
individuals and vendors and direct provision of fuel. LIHEAP 
grants are distributed by a formula defined by statute, based 
in part on each State's share of home energy expenditures by 
low-income households nationwide.
    The Committee recommendation includes an emergency 
allocation of up to $300,000,000 to be made available, only 
upon submission of a formal request designating the need for 
the funds as an emergency as defined by the Budget Enforcement 
Act. This is the same level as the emergency allocation 
available in fiscal year 1997.
    The Committee intends that up to $25,000,000 of the amounts 
appropriated for LIHEAP for fiscal year 1998 be used for the 
leveraging incentive fund, which will provide a percentage 
match to States for private or non-Federal public resources 
allocated to low-income energy benefits. Of the fiscal year 
1999 advance appropriation, up to $30,000,000 is recommended 
for the leveraging fund.

                     refugee and entrant assistance

Appropriations, 1997....................................    $412,076,000
Budget estimate, 1998...................................     392,332,000
Committee recommendation................................     392,332,000

    The Committee recommends $392,332,000 for refugee and 
entrant assistance, a decrease of $19,744,000 below the level 
appropriated for fiscal year 1997 and the same as the budget 
request.
    Based on an estimated refugee admission ceiling of 90,000, 
compared to 110,000, 2 years earlier, this appropriation, 
together with bill language allowing prior-year funds to be 
available for 1998 costs, will enable States to continue to 
provide at least 8 months of cash and medical assistance to 
needy refugees.
    The Refugee Assistance Program is designed to assist States 
in their efforts to assimilate refugees into American society 
as quickly and effectively as possible. The program funds 
State-administered cash and medical assistance, the voluntary 
agency matching grant program, employment services, targeted 
assistance, and preventive health.
    In order to carry out the program, the Committee recommends 
$227,138,000 for transitional and medical assistance, including 
State administration and the voluntary agency program; 
$110,882,000 for social services; $4,835,000 for preventive 
health; and $49,477,000 for targeted assistance. The total 
available for transitional and medical assistance, with the 
inclusion of bill language making available an estimated 
$3,300,000 in carryover funds, is $230,438,000.
    The Committee agrees that $19,000,000 is available for 
assistance to serve communities affected by the Cuban and 
Haitian entrants and refugees, the same as the amount contained 
in last year's appropriation; these funds are included in the 
social services line item.
    The Committee is aware of the valuable work the Voluntary 
Agency Assistance Program is doing to resettle immigrants, 
especially Russian Jews, in the United States. The Committee 
expects $39,000,000 will be used to support grants for the 
Voluntary Agency Grant Program.
    The Committee is concerned that the current policy of the 
Office of Refugee Resettlement prohibiting the use of a portion 
of refugee social services and targeted assistance formula 
grant funds for refugees who have been in the United States for 
more than 5 years deprives some counties and States of the 
ability to give employment-related assistance to many of their 
refugee welfare recipients. The Committee urges the ORR to be 
flexible in considering waiver requests of the 5-year policy.
    Section 412(a)(7) of title IV of the Immigration and 
Nationality Act authorizes the use of funds appropriated under 
this account to be used to carry out monitoring, evaluation, 
and data collection activities to determine the effectiveness 
of funded programs and to monitor the performance of States and 
other grantees.

                 child care and development block grant

Appropriations, 1997....................................    $953,762,000
Budget estimate, 1998...................................   1,000,000,000
Committee recommendation................................     963,120,000

    The Committee recommends $963,120,000 for the child care 
and development block grant, an increase of $9,358,000 over the 
1997 program level. Of this amount, the Committee 
recommendation includes $2,000,000 for child development 
scholarships. In addition, $1,000,000,000 is recommended as an 
advance appropriation for fiscal year 1999, the same as the 
budget request.
    These funds provide grants to States to provide low-income 
families with financial assistance for child care; for 
improving the quality and availability of child care; and for 
establishing or expanding child development programs. The funds 
are used to both expand the services provided to individuals 
who need child care in order to work or attend job training or 
education and allow States to continue funding the activities 
previously provided under the consolidated programs. In 
addition, the Committee notes that child care entitlement 
funding under welfare reform legislation will provide 
$2,067,000,000 in fiscal year 1998, an increase of $100,000,000 
over the fiscal year 1997 enacted level.
    The bill provides that $19,120,000 of the amount 
appropriated shall become available for obligation on October 
1, 1998. Of this amount, $6,120,000 is derived by transfer, the 
same as in the fiscal year 1997 enacted legislation. The 
Department is instructed to obligate these funds immediately 
for the purposes of supporting resource and referral programs 
and before and afterschool services. This represents the 
Federal commitment to the activities previously funded under 
the dependent care block grant. The Committee further expects 
that these funds will not supplant current funding dedicated to 
resource and referral and school age activities provided by the 
child care and development block grant. The Committee strongly 
encourages States to address the matters of before and 
afterschool care and the establishment of resource and referral 
programs with the funds provided in this program.

                      social services block grant

Appropriations, 1997....................................  $2,500,000,000
Budget estimate, 1998...................................   2,380,000,000
Committee recommendation................................   2,245,000,000

    The Committee recommends an appropriation of $2,245,000,000 
for the social services block grant. The recommendation, due to 
budget constraints, is $135,000,000 less than the budget 
request and $255,000,000 below the 1997 enacted level.
    Social services block grant funds are distributed to and 
used by States and territories to fund a wide variety of social 
services for the purpose of preventing or reducing dependency, 
and assisting individuals to achieve self-sufficiency. 
Activities include child and adult day care, child and adult 
abuse and neglect prevention, home-based services, and 
independent living services. Many of these activities are 
funded by separate appropriations elsewhere in the bill.

                children and families services programs

Appropriations, 1997....................................  $5,336,061,000
Budget estimate, 1998...................................   5,498,900,000
Committee recommendation................................   5,585,094,000

    The Committee recommends an appropriation of $5,585,094,000 
for the ``Children and families services programs'' account, 
which is $86,194,000 more than the administration request and 
$249,033,000 more than the fiscal year 1997 appropriation.
    This appropriation consists of programs for children, 
youth, and families, the developmentally disabled, and native 
Americans, as well as Federal administrative costs.

Head Start

    Head Start provides comprehensive development services for 
low-income children and families, emphasizing cognitive and 
language development, socioemotional development, physical and 
mental health, and parent involvement to enable each child to 
develop and function at his or her highest potential. At least 
10 percent of enrollment opportunities in each State are made 
available to children with disabilities.
    The Committee recommends $4,305,000,000 for the Head Start 
Program, an increase of $324,454,000 above the 1997 level and 
the same as the budget request.
    Recent research findings at NIH have demonstrated the 
importance of the first 3 years of life. This research 
emphasizes the importance of high-quality day care and other 
supportive services for the growing numbers of working mothers 
of very young children. The Committee bill doubles the set-
aside of funds for the early Head Start 0-3 Program out the 
fiscal year 1998 funding increase provided. In addition, the 
Committee strongly encourages the Department to target the 
entire remaining increase to expanding Head Start services for 
3-year-olds. The recommendation also includes $326,000 to 
enable the Central Montana Head Start Program to secure 
donations of surplus property, and $1,000,000 for a Charlotte-
Mecklenburg schools prekindergarten initiative for startup 
costs and renovations.
    The Committee bill includes funding for expansion of the 
Head Start Program in an amount consistent with the bipartisan 
balanced budget agreement. These expansion funds shall be used 
in a manner which is responsive to the needs of each community 
as identified in individual needs assessments. In addressing 
the needs of families returning to work under welfare reform, 
the Committee expects the Department of Health and Human 
Services to focus expansion efforts on providing full-day, 
full-year services to children and families in need who are 
presently enrolled in the program. In allocating expansion 
funds, the Department shall not establish a priority system 
which favors any one type of collaborative effort on the part 
of individual programs over any or all others.
    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 
be grantees.

Runaway and homeless youth

    The Committee recommends $58,602,000 for this program, the 
same as the fiscal year 1997 level. The Committee has also 
provided an additional $15,000,000 from the crime prevention 
trust fund for runaway youth activities, an increase of 
$7,000,000 over the fiscal year 1997 level.
    This program addresses the crisis needs of runaway and 
homeless youth and their families through support to local and 
State governments and private agencies. The Runaway and 
Homeless Youth Act requires that 90 percent of the funds be 
allocated to States for the purpose of establishing and 
operating community-based runaway and homeless youth centers, 
on the basis of the State youth population under 18 years of 
age in proportion to the national total. The remaining 10 
percent funds networking and research and demonstration 
activities including the National Toll-Free Communications 
Center. Consolidated within this line item is the transitional 
living for homeless youth program, which awards grants to 
public and private nonprofit entities to address the shelter 
and service needs of homeless youth. Grants are used to develop 
or strengthen community-based programs which assist homeless 
youth in making a smooth transition to productive adulthood and 
social self-sufficiency; and to provide technical assistance to 
transitional living programs for the acquisition and 
maintenance of resources and services.
    The Committee notes that there are a few model projects 
that provide coordinated substance abuse treatment, job 
training, transitional housing, and independent living to 
homeless youth who are pregnant or have small children and are 
recovering from substance abuse problems. Priority should be 
placed on supporting these projects such as House of Mercy in 
Des Moines, IA, where they have substantial promise for 
promoting self-sufficient and independent living.

Child abuse prevention programs

    The Committee has included $35,180,000 for child abuse and 
neglect prevention and treatment activities, including 
$21,026,000 for State grants and $14,154,000 for discretionary 
activities, and the same as the fiscal year 1997 level. No 
funding is provided for the Advisory Board on Child Abuse and 
Neglect. These programs seek 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.

Abandoned infants assistance

    The Committee concurs with the budget request in 
recommending an appropriation of $12,251,000 for abandoned 
infants assistance, the same as the 1997 level. This program 
provides financial support to public and private entities to 
develop, implement, and operate demonstration projects that 
will prevent the abandonment of infants and young children. 
Grants provide additional services such as identifying and 
addressing the needs of abandoned infants, especially those who 
are drug exposed or HIV positive; providing respite care for 
families and care givers; and assisting abandoned infants and 
children to reside with their natural families or in foster 
care.
    The Committee is aware of studies that show that as many as 
80,000 children will be orphaned by the AIDS epidemic by the 
year 2000, and is concerned about the level of cooperation and 
coordination between the Abandoned Infants Assistance Program 
and pediatric/family AIDS programs supported under title IV of 
the Ryan White CARE Act. The Committee expects that ACF will 
collaborate through inter-agency agreements with the Health 
Resources and Services Administration to ensure that the child 
welfare and permanency planning needs of families affected by 
AIDS are expanded at title IV project sites.

Child welfare

    The Committee recommends an appropriation of $291,989,000 
for child welfare services, the same as the fiscal year 1997 
appropriation and the administration request. This program 
helps State public welfare agencies improve their child welfare 
services with the goal of keeping families together. State 
services include: preventive intervention, so that, if 
possible, children will not have to be removed from their 
homes; reunification so that children can return home if at all 
possible; and development of alternative placements like foster 
care or adoption if children cannot remain at home.
    For child welfare training, the Committee recommends 
$8,000,000, an increase of $4,000,000 over the fiscal year 1997 
level. Under section 426, title IV-B discretionary grants are 
awarded to public and private nonprofit institutions of higher 
learning to develop and improve education/training programs and 
resources for child welfare service providers. These grants 
upgrade the skills and qualifications of child welfare workers.
    This program also provides teaching and traineeship grants 
to school of social work to train social workers in the 
specialty of child welfare. The Committee recognizes the 
increasing need for trained, skilled, and qualified child 
welfare protection personnel. This becomes even more urgent as 
more children enter the child protective system as a result of 
welfare reform. The Committee continues its interest in the 
national applicability of the University of Hawaii Center on 
the Family's use of Hawaii's ethnically diverse population to 
develop policies and programs to strengthen the family and 
provides $500,000 for this purpose. The Committee supports the 
Center's work directed to family resiliency and the building 
and reinforcement of family strengths. It is especially 
interested in the development of educational materials that 
promote self-help programs that contribute to containment of 
social program cost; and, the development of culturally 
sensitive educational programs with existing community services 
agencies.
    The Committee recommends that of amounts appropriated, 
$130,000 should be made available to colleges and universities 
that have enrolled American Indian and/or Alaska Natives in 
masters degree programs in social work for purposes of 
providing 20 field practicum placements of masters degree 
candidates in Indian reservations and rural Indian community 
settings.
    Based on the long-term emotional harm of child sexual 
abuse, the Committee recognizes the need for treatment 
programming that effectively addresses the needs of both the 
abused child and family who struggle with 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 for the 
treatment of child-sexual abuse like the one operated by Family 
Place in Louisville, KY.
    The Committee is aware of the work of the Institute for 
Responsible Fatherhood and Family Revitalization, building 
bridges between the generations, and creating environments that 
are father friendly, children friendly, and family friendly. 
The Committee recommendation includes $300,000 to replicate the 
Institute's successful model program started in Cleveland, to 
other cities in the United States, and urges full and fair 
consideration of a proposal from this organization.
    Prior to the advent of welfare reform, millions of dollars 
in Federal funds have been provided to State governments for 
the development of the necessary infrastructure to administer 
federally-funded welfare programs. While welfare reform has now 
vested authority in Indian tribal governments to administer 
welfare programs for eligible Indian citizens, no funding has 
been authorized to assist tribal governments in developing the 
necessary administrative structure. Under new provisions of 
Federal law, tribal governments must submit a plan for the 
provision of temporary assistance to needy families [TANF] to 
the Secretary of the U.S. Department of Health and Human 
Services and receive approval of a plan in order to administer 
welfare programs.
    Through the field practicum placement of 20 American Indian 
and/or Alaska Native masters degree in social work candidates 
in Indian Reservation or rural Indian community settings, 
tribal governments will have the professional assistance of 
second year social work masters degree candidates in the 
development of TANF plans, while masters degree candidates 
acquire critical experience in the field in which they will 
ultimately be applying their professional skills. The field 
practicum placements will also hold the potential for assuring 
the recruitment of native people with masters degrees in social 
work to serve the community. Funds made available under this 
authority would be provided to universities and colleges that 
have American Indians and Alaska Natives enrolled in masters 
degree programs in social work. The college or university would 
enter into a contract with a tribal government specifying the 
nature of the field practicum experience with the tribal 
community, and upon submittal of the contract to the Secretary 
of the Department of Health and Human Services, funds to cover 
living and travel expenses and tuition costs for a 15-week 
period would be made available to the college or university.
    The Committee has previously recommended that the 
Department utilize CAPTA resources for community-based child 
abuse prevention through Parents Anonymous, Inc. The 
authorizing committee included in the reauthorization of the 
Child Abuse Prevention and Treatment Act both bill language 
(section 105(a)(2) of CAPTA) and report language urging the 
Secretary to award a grant to a nonprofit organization such as 
Parents Anonymous to assist in the maintenance of a national 
network of mutual support and self-help programs to strengthen 
families and their communities in the fight against child 
abuse. The Committee again strongly urges the Department to 
implement this recommendation. To clarify its intent, the 
Committee has included bill language specifically citing 
appropriations authority under section 105(a)(2) of CAPTA.

Adoption opportunities

    The Committee recommends $13,000,000 for adoption 
opportunities, the same as the fiscal year 1997 level and the 
administration request. This program eliminates barriers to 
adoption and helps find permanent homes for children who would 
benefit by adoption, particularly children with special needs. 
Since the Committee recommendation exceeds $5,000,000, grants 
for placement of minority children and postlegal adoption 
services, as well as grants for improving State efforts to 
increase placement of foster children legally free for 
adoption, should be made, as required by law. This program also 
funds the national adoption clearinghouse, a national adoption 
information exchange system. Funding is not recommended for a 
new adoption initiative recommended by the administration, as 
the Committee intends to concentrate scarce resources on 
existing activities.

Social services research

    The Committee recommends $21,000,000 for social services 
and income maintenance research, for which $44,000,000 were 
provided in fiscal year 1997. A number of the projects for 
which funds were provided in 1997 were one-time only, reducing 
the amount needed in 1998. The administration requested 
$18,043,000 for this activity. Remaining funds are for grants 
and contracts for a national random sample study of child 
welfare, and for research, evaluations, and national studies.
    The Committee recommendation also includes funding to carry 
out activities authorized by section 429A(e) and 413(h)(3) of 
the Social Security Act, relating to surveys and research 
activities.

Family violence prevention programs

    For programs authorized by the Family Violence Prevention 
and Treatment Act, the Committee concurs with the budget 
request to delete line item funding. Instead, increased 
resources are concentrated under violent crime reduction 
programs, as described later in this report.

Community-based resource centers

    The Committee recommends $32,835,000, the budget request, 
for community-based resource centers. This represents level 
funding at the fiscal year 1997 level for a consolidation of 
the community-based family resource program and the temporary 
child care and crisis nurseries program. This program is 
intended to assist States in implementing and enhancing a 
statewide system of community-based, family-centered, family 
resource programs, and child abuse and neglect prevention 
through innovative funding mechanisms and broad collaboration 
with educational, vocational, rehabilitation, health, mental 
health, employment and training, child welfare, and other 
social services within the State. The temporary child care and 
crisis nurseries serve thousands of families with children who 
have a disability or serious illness, and families that are 
under stress, including families affected by HIV/AIDS, 
homelessness, violence, family crisis, and drugs and alcohol.

Developmental disabilities

    The Committee recommends $115,529,000 for developmental 
disabilities programs, which is $1,297,000 more than the 
request, and the fiscal year 1997 appropriation. The 
Administration on Developmental Disabilities supports 
community-based delivery of services which promote the rights 
of persons of all ages with developmental disabilities. 
Developmental disability is defined as severe, chronic 
disability attributed to mental or physical impairments 
manifested before age 22, which causes substantial limitations 
in major life activities.

State councils

    For State councils, the Committee recommends $65,574,000, 
an increase of $771,000 over the 1997 level and the 
administration request. In 1987, the Developmental Disabilities 
Act changed the focus of State councils from services provision 
and demonstration to planning and services coordination 
directed to effecting systems change. Since that time, the 
States have been shifting away from their original role of 
services provision to their current mission to effect system 
change on behalf of persons with developmental disabilities.

Protection and advocacy grants

    For protection and advocacy grants, the Committee 
recommends $27,036,000, which is $318,000 more than the 
administration request and the fiscal year 1997 level. This 
formula grant program provides funds to States to establish 
protection and advocacy systems to protect the legal and human 
rights of persons with developmental disabilities who are 
receiving treatment, services, or rehabilitation within the 
State.

Special projects

    The Committee recommends $5,250,000, which is the same as 
the request and the fiscal year 1997 appropriation. This 
program funds grants and contracts providing nationwide impact 
by developing new technologies and applying and demonstrating 
innovative methods to support the independence, productivity, 
and integration into the community of persons with 
developmental disabilities.

University-affiliated programs

    For university-affiliated programs, the Committee 
recommends $17,669,000, which is $208,000 more than the 1997 
level and the administration request. This program provides 
operational and administrative support for a national network 
of university-affiliated programs and satellite centers. Grants 
are made annually to university-affiliated programs and 
satellite centers for interdisciplinary training, exemplary 
services, technical assistance, and information dissemination 
activities.

Native American programs

    The Committee concurs with the budget request in 
recommending $34,933,000 for native American programs, the same 
as the 1997 level. The Administration for Native Americans 
[ANA] assists Indian tribes and native American organizations 
in planning and implementing long-term strategies for social 
and economic development through the funding of direct grants 
for individual projects, training and technical assistance, and 
research and demonstration programs.
    The Committee notes the sharp increase in efforts to 
preserve native American languages through the native American 
languages program, which provides funds to tribes and native 
organizations. Accordingly, the Committee urges increased 
funding for the native American languages program. The 
Committee further recommends continued funding of the native 
Hawaiian revolving loan program.
    The Committee notes that the May 1994 final report of the 
Joint Federal-State Commission on Policies and Programs 
Affecting Alaska Natives found that many Alaska Native 
individuals, families, and communities were experiencing a 
social, cultural, and economic crisis marked by rampant 
unemployment, the lack of economic opportunity, alcohol abuse, 
depression, and morbidity and mortality rates that were 
described by health care professionals as approaching those of 
Third World countries. To address these problems the Alaska 
Natives Commission adopted recommendations that raise important 
policy questions which are unresolved in Alaska and which 
require further study and review before Congress considers 
legislation to implement these recommendations. The Committee 
encourages the Department to use $350,000 for the Alaska 
Federation of Natives to conduct a study and provide 
recommendations to Congress on further approaches to implement 
recommendations of the Alaska Natives Commission.

Community services block grant

    The Committee recommends an appropriation of $492,600,000 
for the community services programs. This is $3,000,000 more 
than the fiscal year 1997 level and $77,880,000 higher than the 
administration request.
    The community services block grant [CSBG] makes formula 
grants to States and Indian tribes to provide a wide range of 
services and activities to alleviate causes of poverty in 
communities and to assist low-income individuals in becoming 
self-sufficient. The Committee recommendation recognizes the 
increased demand by the low-income population for services 
provided by CSBG-funded community action agencies.
    The Committee bill again contains a provision requiring 
that carryover CSBG funds remain with the local grantee. This 
is the same language that was contained in the fiscal year 1997 
appropriations bill.
    The Committee again expects fiscal year 1998 CSBG funding 
to be allocated to the States in a timely manner. In addition, 
the Committee again expects the Office of Community Services to 
inform the State CSBG grantees of any policy changes affecting 
carryover CSBG funds within a reasonable time after the 
beginning of the Federal fiscal year.
    Several discretionary programs are funded from this 
account. Funding for these discretionary programs is 
recommended at the following levels for fiscal year 1998: 
community economic development, $27,332,000; rural community 
facilities, $3,500,000; national youth sports, $12,000,000; and 
community food and nutrition, $4,000,000. The Committee 
reiterates its expectation that national youth sports funds to 
be awarded competitively. The Committee has again included 
$5,500,000 from within this account for the job creation 
demonstration authorized under section 505 of the Family 
Support Act of 1988. This program has been very successful in 
moving people off welfare and into work. As in past years, the 
Committee expects that this program will be administered by the 
Office of Community Services and that a priority be given to 
community development corporations.

Program administration

    The Committee recommends $138,343,000 for program 
administration, a decrease of $4,718,000 below the fiscal year 
1997 appropriation and $4,772,000 below the administration 
request. This reduction reflects the increased availability of 
mandatory appropriations available for administrative 
activities, under terms of recently enacted welfare reform 
legislation.
    This ``Program administration'' account funds Federal 
administration costs for the Administration for Children and 
Families [ACF]. The Committee is mindful of the many changes 
taking place among the programs administered by the 
Administration for Children and Families. The Committee has 
included what it believes are sufficient funds to permit ACF to 
carry out its important mission of improving the lives of 
America's children and families. The Committee recognizes that 
ACF will have to reallocate administrative resources within its 
budget to accommodate its changing workload and program mix. In 
particular, the Committee encourages ACF to utilize resources 
no longer needed to administer programs which the Congress has 
reduced, eliminated, or reformed to carry out its increased 
responsibilities in other important programmatic areas, such as 
child support enforcement, and in expanded activities to ensure 
program accountability, promote effective practices, and 
measure the effectiveness of new approaches to assisting 
families in need.

Rescissions

    The Committee has included bill language rescinding a total 
of $21,000,000 made available in recently enacted welfare 
reform legislation for surveys and research activities. These 
are activities that have been historically funded in 
appropriations bills, not through authorizing legislation. 
Funds for social services research activities are included 
elsewhere in this account.

Crime reduction programs

    The Committee recommends $93,000,000 for violent crime 
reduction programs, $60,200,000 above the fiscal year 1997 
appropriation and $6,000,000 below the administration request. 
The Committee notes that an additional $48,220,000 for crime 
bill activities is provided under the Centers for Disease 
Control and Prevention, which is $7,220,000 above the 1997 
level and $3,220,000 over the budget request.
    For the community schools youth services and supervision 
program, the Committee recommends no funding.
    For the runaway youth prevention program, the Committee 
recommends $15,000,000, which is $7,000,000 above the fiscal 
year 1997 appropriation and the same as the administration 
request. This is a discretionary grant program open to private 
nonprofit agencies for the provision of services to runaway, 
homeless, and street youth. Funds may be used for street-based 
outreach and education, including treatment, counseling, 
provision of information, and referrals for runaway, homeless, 
and street youth who have been subjected to or are at risk of 
being subjected to sexual abuse.
    For the national domestic violence hotline, the Committee 
recommends $1,200,000, which is the same as the fiscal year 
1997 appropriation and the administration request. This is a 
cooperative agreement which funds the operation of a national, 
toll-free, 24-hours-a-day telephone hotline to provide 
information and assistance to victims of domestic violence.
    The Committee recommends $76,800,000 for the grants for 
battered women's shelters program, $4,000,000 above the fiscal 
year 1997 program level and $6,800,000 above the administration 
request. This is a formula grant program to support community-
based projects which operate shelters for victims of domestic 
violence. Emphasis is given to projects which provide 
counseling, advocacy, and self-help services to victims and 
their children.

                    family support and preservation

Appropriations, 1997....................................    $240,000,000
Budget estimate, 1998...................................     255,000,000
Committee recommendation................................     255,000,000

    The Committee recommends $255,000,000 for fiscal year 1998, 
the same as the amount requested by the administration and 
$15,000,000 above the fiscal year 1997 level. These funds will 
support: (1) community-based family support services to assist 
families before a crisis arises; and (2) innovative child 
welfare services such as family preservation, family 
reunification, and other services for families in crisis. These 
funds include resources to help with the operation of shelters 
for abused and neglected children, giving them a safe haven, 
and providing a centralized location for counseling.

       payments to states for foster care and adoption assistance

Appropriations, 1997....................................  $4,445,031,000
Budget estimate, 1998...................................   4,311,000,000
Committee recommendation................................   4,311,000,000

    The Committee recommends $4,311,000,000 for this account, 
which is the same as the budget request and $134,031,000 less 
than the 1997 comparable level. Also included is the 
administration's request of $1,111,000,000 for an advance 
appropriation for the first quarter of fiscal year 1999. The 
Foster Care Program provides Federal reimbursement to States 
for: maintenance payments to families and institutions caring 
for eligible foster children, matched at the Federal medical 
assistance percentage [FMAP] rate for each State; and 
administration and training costs to pay for the efficient 
administration of the Foster Care Program, and for training of 
foster care workers and parents.
    The Adoption Assistance Program provides funds to States 
for maintenance costs, and the nonrecurring costs of adoption, 
for children with special needs. The goal of this program is to 
facilitate the placement of hard-to-place children in permanent 
adoptive homes, and thus prevent long, inappropriate stays in 
foster care. As in the Foster Care Program, State 
administrative and training costs are reimbursed under this 
program.

                        Administration on Aging

Appropriations, 1997....................................    $830,131,000
Budget estimate, 1998...................................     838,168,000
Committee recommendation................................     854,074,000

    The Committee recommends an appropriation of $854,074,000 
for aging programs, $23,943,000 more than the 1997 
appropriation and $15,906,000 above the amount requested by the 
administration.
    The Committee recommends a legislative provision which 
would prevent any State from having its administrative costs 
under title III of the Older Americans Act reduced by more than 
5 percent below the fiscal year 1995 level. This provision was 
included in the fiscal year 1996 omnibus appropriations bill.

Supportive services and senior centers

    The Committee recommends an appropriation of $305,556,000 
for supportive services and senior centers, an increase of 
$14,181,000 above the amount requested by the administration 
and $5,000,000 more than the amount appropriated in fiscal year 
1997. This State formula grant program funds a wide range of 
social services for the elderly, including multipurpose senior 
centers and ombudsman activities. State agencies on aging, 
award funds to designated area agencies on aging who in turn 
make awards to local services providers. All individuals age 60 
and over are eligible for services, although, by law, priority 
is given to serving those who are in the greatest economic and 
social need, with particular attention to low-income minority 
older individuals. The basic law States have the option to 
transfer up to 20 percent of funds appropriated between the 
senior centers program and the nutrition programs which allows 
the State to determine where the resources are most needed.

Ombudsman/elder abuse

    The Committee has earmarked $4,449,000 for the ombudsman 
services program and $4,732,000 for the prevention of elder 
abuse program within the funds for ``Supportive services and 
senior centers'' account. The amounts recommended are the same 
amount provided for these programs in fiscal year 1997. Both 
programs provide formula grants to States to prevent the abuse, 
neglect, and exploitation of older individuals. The ombudsman 
program focuses on the needs of residents of nursing homes and 
board and care facilities, while elder abuse prevention targets 
its message to the elderly community at large.

Preventive health services

    The Committee recommends $15,623,000 for preventive health 
services, the same amount as the budget request and the amount 
appropriated in fiscal year 1997. Funds appropriated for this 
activity are part of the comprehensive and coordinated service 
systems targeted to those elderly most in need.

Congregate and home-delivered nutrition services

    For congregate nutrition services, the Committee recommends 
an appropriation of $368,716,000, an increase of $4,181,000 
over the amount appropriated in 1997 and an increase of 
$8,906,000 over the budget request. For home-delivered meals, 
the Committee recommends $110,064,000, the amount recommended 
by the administration and $4,725,000 more than the fiscal 1997 
appropriation. These programs address the nutritional need of 
older individuals. Projects funded must make home-delivered and 
congregate meals available at least once a day, 5 days a week, 
and each meal must meet one-third of the minimum daily dietary 
requirements. While States receive separate allotments of funds 
for congregate and home-delivered nutrition services and 
support services they are permitted to transfer up to 30 
percent of funds between these programs.
    The Committee has included a provision carried in last 
year's bill which requires the Assistant Secretary to provide 
the maximum flexibility to applicants who seek to take into 
account subsistence, local customs, and other characteristics 
that are appropriate to the unique cultural, regional, and 
geographic needs. The provision clarifies that applicants who 
serve American Indian, native Hawaiian, and Alaska Native 
recipients in highly rural and geographically isolated areas 
are permitted to continue to tailor nutrition services that are 
appropriate to the circumstances associated with the served 
population. In addition, in an effort to meet the needs of the 
native Hawaiian elderly population sufficiently, the Committee 
urges the native Hawaiian grantee to coordinate with the 
Lunalilo Home, the only care facility for aged native 
Hawaiians.

Title VII

    The Committee recommendation does not include $9,181,000 
for line-item funding of the elder abuse and ombudsman 
programs, authorized under title VII of the Older Americans 
Act; these activities are earmarked within the ``Supportive 
services'' account, the same as was done in the fiscal year 
1997 appropriation.

In-home services for frail older individuals

    The Committee recommends $9,263,000 for in-home services 
for the frail elderly, the same as the fiscal year 1997 enacted 
level and the budget request. In-home services include 
homemaker and home health aides, visiting and telephone 
reassurance, chore maintenance, in-home respite care for 
families, and minor home modifications.

Aging grants to Indian tribes and native Hawaiian organizations

    The Committee recommends $20,057,000 for grants to Indian 
tribes, an increase of $4,000,000 over the budget request and 
fiscal 1997 level. Under this program awards are made to tribal 
and Alaskan Native organizations and to public or nonprofit 
private organizations serving native Hawaiians which represent 
at least 50 percent Indians or Alaskan Natives 60 years of age 
or older to provide a broad range of services and assure that 
nutrition services and information and assistance services are 
available.

Aging research and training

    The Committee recommends $10,000,000 for aging research, 
training, and discretionary programs, $6,000,000 more than the 
fiscal year 1997 enacted level and the budget request. These 
funds support activities designed to expand public 
understanding of aging and the aging process, test innovative 
ideas and programs to serve older individuals, and provide 
technical assistance to agencies who administer the Older 
Americans Act. Of the funds provided, the Committee expects the 
Department to use at least $2,000,000 to fund a national 
program of statewide senior legal services hotlines and related 
elder rights projects and $800,000 to continue and expand the 
Family Friends Program. Additional funds for the Family Friends 
Program may be used to initiate two new sites and for the 
National Council on Aging to continue to provide training and 
technical assistance to existing and new sites. The 
recommendation includes $2,000,000 to continue the initiative 
begun last year, with funds transferred from the Health Care 
Financing Administration, to test different models designed to 
train retirees in local communities in detection and reporting 
of Medicare waste and abuse. Although this second year funding 
is provided directly to the Administration on Aging, the 
Commissioner is expected to continue consultation with other 
affected agencies, including the Office of Inspector General 
and the General Accounting Office.
    Within the funds provided, the Committee has included 
$260,000 for the National Asian Pacific Center on Aging to 
continue an existing grant directed to developing, 
strengthening, and expanding linkages of a rapidly growing 
Asian Pacific aging community with local, State, and national 
community service providers and organizations.
    Within the amount provided for the National Indian Council 
on Aging, the Committee has included sufficient funds to 
continue an existing grant to increase Indian elder awareness 
and participation in the public policy issues that directly 
impact all of Indian country.
    The Committee recommendation includes funding for the 
pension counseling demonstration projects authorized under 
title IV of the Older Americans Act to both continue existing 
projects and create additional projects in other regions of the 
country. Pension counseling projects provide information, 
advice, and assistance to workers and retirees about pension 
plans, benefits, and pursuing claims when pension problems 
occur. The Committee recommendation also includes sufficient 
funding for a program that focuses on educating spouses across 
America on the importance of savings and retirement security. 
The Committee urges that full and fair consideration be given 
to a proposal from the Women's Institute for a Secure 
Retirement in this regard.
    The Committee urges the Secretary to provide $1,000,000 for 
social research into Alzheimer's disease care options, best 
practices, and other Alzheimer's research priorities, including 
respite care, assisted living, the impact of intervention by 
social service agencies on victims, and related needs. The 
Committee recommends this research utilize and give discretion 
to municipalities with aged populations (over the age of 60) of 
over 1 million with preference given to the largest population. 
The Committee also recommends that unique partnerships to 
effect this research be considered. Alzheimer's disease 
afflicts 10 percent of Americans over the age of 65, and as 
many as 47 percent of Americans over the age of 85, and has no 
effective treatment or cure.

Program administration

    The Committee recommends $14,795,000 to support Federal 
staff that administer the programs in the Administration on 
Aging, the same amount as the budget request and $37,000 more 
than the 1997 appropriation. These funds provide administrative 
and management support for programs administered by the 
Department. No funds have been included for the requested 
Alzheimer's initiative; instead, the Committee has funded an 
Alzheimer's program within the Health Resources and Services 
Administration.

Native Americans

    The Committee is aware that the Administration on Aging has 
only provided support for the first 3 years of the 4-year 
cooperative agreements. Therefore, the Committee strongly urges 
the Assistant Secretary on Aging to provide $350,000 from 
existing funds for each of the national resource centers 
serving native American elders in fiscal year 1998.

                        Office of the Secretary

                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 1997....................................    $178,033,000
Budget estimate, 1998...................................     163,177,000
Committee recommendation................................     180,439,000

    The Committee recommends $180,439,000 for general 
departmental management [GDM]. This is $17,262,000 more than 
the administration request and $2,406,000 more than the fiscal 
year 1997 level. Within this amount, the Committee includes the 
transfer of $5,851,000 from Medicare trust funds, which is the 
same as the administration request and the fiscal year 1997 
level.
    This appropriation supports those activities that are 
associated with the Secretary's role as policy officer and 
general manager of the Department. It also supports certain 
health activities that were previously performed in the former 
Office of the Assistant Secretary of Health, including the 
Office of the Surgeon General. GDM funds support the 
Department's centralized services carried out by several Office 
of the Secretary staff divisions, including personnel 
management, administrative and management services, information 
resources management, intergovernmental relations, legal 
services, planning and evaluation, finance and accounting, and 
external affairs.
    The Office of the Surgeon General, in addition to its other 
responsibilities, provides leadership and management oversight 
for the PHS Commissioned Corps, including the involvement of 
the Corps in departmental emergency preparedness and response 
activities.
    As was done last year, the Committee provides funds to the 
Office of the Secretary to administer the Office of Emergency 
Preparedness, the Office of Disease Prevention and Health 
Promotion, and the Office of Research Integrity. These offices 
were consolidated within the Office of the Secretary in 
conjunction with the elimination of the Office of the Assistant 
Secretary for Health. Sufficient funds are provided so that, if 
the Secretary so chooses, each of the above offices may be 
supported at or near the previous fiscal year's level.
    The Committee has provided $1,000,000 to support the 
activities of the United States-Mexico Border Health Commission 
as authorized by Public Law 103-400. This is a new activity. 
The Commission is authorized to assess and resolve current and 
potential health problems that affect the general population of 
the United States-Mexico border area. The United States 
representatives of the Commission include the Secretary and the 
health commissioners of the States of Arizona, California, New 
Mexico, and Texas. The Committee expects the Commission to 
build upon ongoing binational activities and to pursue 
cooperative activities that improve the health of residents in 
the border area.
    The Committee has encouraged the CDC to support 
multidisciplinary, collaborative efforts in health sciences and 
other relevant disciplines to examine the various aspects of 
health risk assessment. These efforts would identify 
individuals and groups at risk for adverse conditions, 
including genetic risks, and would develop interventions to 
address such risks. In this regard, the Committee recognizes 
the demonstrated excellence and collaborative efforts of the 
University of Miami and Florida State University consortium, 
and encourages full and fair consideration of support by the 
Office of Public Health and Science for this partnership.
    The Committee is again aware of the Public Health Service's 
sensitivity to the health needs of Hawaii, including the 
assignment of senior programmatic personnel, and is 
appreciative of these efforts.
    The Committee is aware of differences in the honoraria paid 
to nongovernment employees participating in the Department's 
objective review of grants and contracts. The Committee 
requests that it be informed prior to next year's testimony by 
the Secretary as to steps taken to correct any major 
discrepancies in this area.
    For several years, the Committee has supported efforts to 
relocate and revitalize the National Museum of Health and 
Medicine. The Committee is pleased to learn that the museum and 
its foundation are working with representatives of the Centers 
for Disease Control and Prevention and the National Institutes 
of Health to explore the potential for the museum to 
communicate information about activities currently underway at 
CDC and NIH in the areas of health promotion, disease 
prevention, and medical research.
    The Committee has again provided $500,000 from this account 
for the continuation of the human services transportation 
technical assistance program. In many cases, particularly in 
rural areas, human services transportation providers are the 
only source of public transportation for the elderly, people 
with physical and developmental disabilities, and the 
economically disadvantaged. As in the past, this program is to 
be administered by a national membership organization with 
expertise in working with local transit organizations. The 
program provides assistance to these organizations on 
coordination and management, and on meeting requirements of the 
Americans with Disabilities Act. With the biggest obstacle to 
gaining employment in many rural areas is obtaining 
transportation to centers of employment, the Committee expects 
a continued emphasis on assisting communities with welfare 
reform-related transportation issues involving jobseekers. The 
Committee commends the technical assistance provided by the 
Community Transportation Association of America.
    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 maintain and interpret for 
the public important national archives associated with the 
history of medical ethics.
    Last year, the Committee urged all necessary steps be taken 
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, NIH, and FDA, to 
reduce the risk of 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 these efforts. 
The Committee urges the Secretary to develop an implementation 
plan to improve the safety of the U.S. blood supply and blood 
products and to address the vulnerability of persons with 
bleeding disorders and transfusion recipients to blood 
contaminants.
    The Committee requests the Secretary to issue a report by 
March 1, 1998, on the U.S. Public Health Service Commissioned 
Corps that includes historical trends on direct and indirect 
costs of maintaining the Corps as well as the current funding 
level, numbers of Corps personnel assigned to the individual 
agencies of the PHS and other Federal agencies and to 
international organizations, the expenditures by agency on 
Corps personnel and operations, current organizational 
structure, and other analytical information. The Committee 
expects that this report include an evaluation of the overall 
strategic direction and rationale of the Corps, and an 
assessment of the cost effectiveness of maintaining the Corps 
in its present form compared to conducting similar activities 
within the civil service personnel system.
    The Committee remains supportive of the Department's 
Chronic Fatigue Syndrome Coordinating Committee [CFSCC] and is 
aware of the CFSCC's recommendations to the Secretary, 
including formation of a subcommittee to consider renaming the 
illness and other workshops.
    The Committee is aware of the efforts of the Public Health 
Service to enhance the value to a broad audience of its 
professional journal, Public Health Reports, and encourages the 
pursuit of all necessary means to attain the journal's fiscal 
stability, including cosponsorship with outside associations.
    The health status of children living in the Bronx section 
of New York City is particularly worrisome with 
sociodemographic and health status indicators which underscore 
a need for improved health services. The Committee is aware of 
plans to establish a state-of-the-art children's hospital in 
the Bronx to address the critical needs of its pediatric 
population. To enhance current Federal child health care 
programs in the area, the Committee encourages the Department 
to assist in the planning of this new facility and its 
potential programs.

Medicare fraud, waste, and abuse

    The Committee is aware of the results of an extensive chief 
financial officer audit of claims paid by Medicare last year, 
and understands that the audit revealed that up to 
$23,000,000,000 or over 14 percent of processed fee-for-service 
payments last year may have been lost as a result of 
mispayments. The Committee is very concerned over the lack of 
an adequate plan for the recovery of these projected losses or 
for the prevention of future losses. The Committee requests 
that the Secretary submit a comprehensive action plan to the 
Committee within 60 days of enactment of this bill. The 
Committee further asks to be briefed regularly on progress made 
in implementing this plan. Finally, the Committee expects that 
the Secretary, working in cooperation with the Office of 
Inspector General, will conduct a similar audit this fiscal 
year.
    Only 3 out of every 1,000 certified providers is subject to 
a comprehensive audit for overpayments in 1 year. In an effort 
to assure increased capacity to audit for, project, and collect 
overpayments due to the Government within the budget provided, 
the Committee urges the Secretary to test the imposition of a 
fee in cases where providers, physicians, or suppliers reject 
statistically valid overpayment projections and request a 
second audit with a larger sample. The fee would cover the cost 
of the more extensive audit requested by the provider. Funds 
recovered from agencies to cover the costs of a more extensive 
audit should be available to the Secretary to defray the cost 
of the audit. The Committee expects that this test will last no 
longer than 2 years and expects to receive a report on its 
results promptly after its conclusion.

Medicare transaction system

    The Committee is very concerned with the poor management of 
the development and implementation of the Medicare transaction 
system. This major undertaking has been subject to considerable 
cost overruns and implementation delays. The Committee expects 
to receive a comprehensive budget and justification for 
completion of the project and asks that it be consulted before 
any additional funds are allocated for this project.

Adolescent family life

    The Committee has provided $19,209,000 for the Adolescent 
Family Life Program [AFL]. This is $5,000,000 more than the 
administration request and $5,003,000 higher than the fiscal 
year 1997 appropriation.
    AFL is the only Federal program focused directly on the 
issue of adolescent sexuality, pregnancy, and parenting. 
Through demonstration grants and contracts, AFL focuses on a 
comprehensive range of health, educational, and social services 
needed to improve the health of adolescents, including the 
complex issues of early adolescent sexuality, pregnancy, and 
parenting.
    Within the total provided, the Committee has included funds 
to continue the prevention projects begun in fiscal year 1997, 
as well as start new prevention projects. The Committee directs 
the Department to fund new prevention projects which enable 
smaller communities to begin the organization and 
implementation of coalitions to implement abstinence-based 
education programs. The Committee also directs the Department, 
when announcing grant competitions, to extend the length of 
time that applicants are given to complete application 
packages, provide extensive technical assistance to applicants, 
with special assistance given to new applicants, and revise the 
terminology and instructions in grant applications to assure 
that the information being requested is as clear as possible.

Physical fitness and sports

    The Committee recommends $998,000 for the Federal staff 
which supports the President's Council on Physical Fitness and 
Sports. This is $2,000 less than the administration request and 
the same as the fiscal year 1997 appropriation.
    The President's Council on Physical Fitness and Sports 
serves as a catalyst for promoting increased physical activity/
fitness and sports participation for Americans of all ages and 
abilities, in accordance with Executive Order 12345, as 
amended. The programs sponsored by PCPFS are supported largely 
through private sector partnerships.

Minority health

    The Committee recommends $23,600,000 for the Office of 
Minority Health. This is $10,984,000 below the fiscal year 1997 
appropriation and $500,000 above the administration request.
    The Office of Minority Health [OMH] focuses on strategies 
designed to decrease the disparities and to improve the health 
status of racial and ethnic minority populations in the United 
States. OMH establishes goals, and coordinates all departmental 
activity related to improving health outcomes for disadvantaged 
and minority individuals. OMH supports several demonstration 
projects, including the Minority Community Health Coalition, 
the Bilingual/Bicultural Service, the Center for Linguistic and 
Cultural Competency in Health Care, and the Family and 
Community Violence Prevention Program.
    The Committee remains concerned about the high rate of 
cancer incidence and prevalence among the Nation's minority 
populations, and is aware of the success of the OMH North 
Philadelphia Cancer Awareness and Prevention Program at the 
Albert Einstein Medical Center, which is providing 
comprehensive cancer education outreach and screening programs 
targeted to minorities in underserved urban areas. The 
Committee believes the methods used by this innovative program 
can be disseminated nationwide to address the critical problem 
of hypertension among minority communities. The Committee has 
provided an increase in funding above the administration 
request to sustain the OMH North Philadelphia Cancer Awareness 
and Prevention Program at the current level.
    The Committee recognizes the need to encourage minority 
development of family practice physicians and encourages the 
Office to assist programs designed for the purpose of direct 
and indirect support of family practice residency programs 
which focus on training, recruitment, and retention of 
minorities, including American Indian and Alaska Natives, as 
family practice physicians.
    The Committee encourages the Office of Minority Health to 
conduct a study on how managed care and the changing health 
care marketplace is challenging historically minority health 
professions schools' ability to fulfill their mission to 
provide adequate health care services and health care 
professionals for underserved areas.
    The Committee is aware of the ongoing demonstration project 
at Meharry Medical College of Nashville, TN, that focuses on 
integrating health delivery systems in an underserved 
community. The Committee encourages the Department to consider 
sustaining the project through the Office of Minority Health 
and other operating divisions.

Office on Women's Health

    The Committee recommends $18,500,000 for the Office on 
Women's Health. This is $6,000,000 more than the administration 
request and the fiscal year 1997 appropriation.
    The PHS Office on Women's Health [OWH] develops, 
stimulates, and coordinates women's health research, health 
care services, and public and health professional education and 
training across HHS agencies. It advances important 
crosscutting initiatives and develops public-private 
partnerships, providing leadership and policy direction, and 
initiating and synthesizing program activities to redress the 
disparities in women's health.
    Moreover, in view of the disparities in women's health 
research, services, and education and training, the Committee 
believes that one mechanism through which these inequities can 
be resolved is through providing support through various 
mechanisms to academic, consumer, health care professional, and 
community groups in this important area. To that end, the 
Committee urges that the PHS OWH develop and support programs 
to support crosscutting research, services, innovative 
partnerships, and demonstrations that will advance women's 
health. The Committee commends the PHS OWH for its leadership 
in developing new initiatives to improve women's health.
    Within the amount provided, the Committee has included 
$2,500,000 to support continued implementation of the National 
Women's Health Information Center. This Center in partnership 
with the Department of Defense, provides a single access point 
to Federal information on women's health through a toll-free 
telephone number and the Internet, and links to over 1,000 
private sector resources as well. Consumers, researchers, 
health professionals, women's health advocates and the media 
will have access to the wide variety of information and 
resources on women's health that has been created by the 
various agencies of the Department of Health and Human 
Services, in partnership with the Department of Defense and all 
other agencies in the Federal Government.
    The National Centers of Excellence in Women's Health 
Program, established in fiscal year 1996 by the PHS OWH, 
through contracts to six academic health centers around the 
Nation, is developing model health care services, 
multidisciplinary research, public and health care professional 
education on women's health, and fostering leadership 
opportunities for women's health care professionals. Six new 
centers are expected to be awarded in fiscal year 1997, along 
with up to four minority women's health centers of excellence. 
The Committee has provided $5,000,000 to continue funding the 
existing centers established in 1996 and to support additional 
new centers.
    The Committee has also included funds for women's health 
coordinators. Regional coordinators have been established in 
the 10 Public Health Service regions around the Nation and link 
together all of the resources available from the Department of 
Health and Human Services and coordinate and stimulate women's 
health activities. They also work with women's groups and 
health care professionals at the regional, State, and local 
levels. These additional funds will be used to develop regional 
women's health activities in each of the 50 States.
    The Committee is concerned that cardiovascular diseases, 
including heart disease and stroke, remain the No. 1 killer of 
women. Twice as many women die from heart disease as those who 
die from breast and ovarian cancers. Although cardiovascular 
disease is commonly assumed to be a disease primarily of men, 
over one-half of all deaths caused by cardiovascular disease 
occur among women. The Committee is also concerned that women, 
especially older women are not properly screened for heart 
disease and there is little focus on prevention. The Committee 
is also concerned that traditionally women have not been the 
focus in prevention and treatment research. As a result, the 
survival rate for women following the first heart attack is 
less than for men. The Committee urges the PHS OWH to undertake 
a comprehensive review of the impact of heart disease on women.
    Osteoporosis is today a major health problem that the World 
Health Organization has characterized as epidemic. Osteoporosis 
effects 28 million Americans who either have or are at risk of 
the disease. The direct medical costs amount to $13,800,000,000 
annually and are expected to increase dramatically as the 
population ages. A task force convened by the Office of Public 
Health and Science on Women's Health, in conjunction with the 
National Osteoporosis Foundation has determined that a public 
education campaign is needed. The campaign will target teenage 
women, ages 13 to 18, to help them develop positive health 
behaviors, (for example, diet, exercise, calcium intake) that 
can have a significant effect on bone strength that can last a 
lifetime. Within the amount recommended the Committee has 
included funds to contribute to the launch of this campaign.
    The Committee commends the national action plan on breast 
cancer for its many accomplishments. This important public/
private partnership, which catalyzes breast cancer activities 
across the Federal Government and the private sector, has 
accomplished a great deal in the war against breast cancer. The 
Committee has provided sufficient funds within the budget of 
the National Cancer Institute to support the ongoing activities 
of the NAPBC which shall continue to be implemented by the PHS 
OWH.

Public health emergencies/antiterrorism measures

    The Committee has provided $13,764,000, which is the same 
as last year's level and $3,764,000 more than the President's 
request, for activities to counter the adverse health and 
medical consequences from major terrorist events. Within this 
amount, sufficient funds are provided for the Office of 
Emergency Preparedness to staff and administer this program, as 
well as the other OEP activities specified in the 
administration's request. The amount provided by the Committee 
is intended to continue the formation of new metroplitan 
medical strike teams in key uncovered urban areas of the 
country.
    The Department has lead responsibility for health, medical, 
and health-related support under the Federal response plan to 
catastrophic disasters. On behalf of the Department, the Office 
of Emergency Preparedness assesses the potential health and 
medical consequences of a terrorist incident and to formulate 
necessary responses. The funds provided would support 
activities to build local, State, and Federal capacity to 
respond to terrorist acts with public health implications. Such 
activities would include assisting local emergency managers 
through the MMST system to build an enhanced capability to 
detect and identify biologic and chemical agents.
    The Committee is encouraged by the office's efforts to 
consult broadly with other Federal-supported agencies and 
institutions, such as the Institute of Medicine, on planning 
and program assessment, and further encourages the office to 
broaden its consultation and shared activities to include 
nongovernmental organizations, such as the Chemical and 
Biological Arms Control Institute, with specific expertise in 
chemical and biological threat reduction and assessment.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 1997....................................     $34,790,000
Budget estimate, 1998...................................      31,921,000
Committee recommendation................................      31,921,000

    The Committee recommends an appropriation of $31,921,000 
for the Office of Inspector General. This is the same as the 
administration request and $2,869,000 less than the fiscal year 
1997 level. The Health Insurance Portability and Accountability 
Act of 1996 provides no less than $80,000,000 and no more than 
$90,000,000 in funds for the Office of the Inspector General in 
fiscal year 1998; the total funds provided to the Office by 
this bill and the authorizing bill would be between 
$111,921,000 and $121,921,000 in fiscal year 1998.
    The Office of Inspector General conducts audits, 
investigations, inspections, and evaluations of the operating 
divisions within the Department of Health and Human Services. 
The OIG functions with the goal of reducing the incidence of 
waste, abuse, and fraud. It also pursues examples of 
mismanagement toward the goal of promoting economy and 
efficiency throughout the Department.
    The Committee commends the Office of Inspector General for 
their efforts to reduce waste, fraud, and abuse in Department 
programs. The OIG CFO audit of the Health Care Financing 
Administration revealed significant shortcomings in the 
Department's efforts to prevent Medicare mispayments. The 
Committee urges the OIG to do further analysis of the results 
of this audit so that it can provide the Committee with a 
specific set of recommendations for reform within the next 6 
months. In addition, the Committee further urges the OIG to 
examine the use by providers of computer programs that are 
intended to maximize their Medicare payments. The Committee is 
interested to learn of any correlation between use of these 
programs and Medicare mispayments.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 1997....................................     $19,490,000
Budget estimate, 1998...................................      20,530,000
Committee recommendation................................      19,659,000

    The Committee recommends an appropriation of $19,659,000 in 
Federal funds for the Office for Civil Rights. This is $871,000 
less than the administration request and $169,000 more than the 
fiscal year 1997 level.
    The Committee also recommends the transfer of $3,314,000 
from the Medicare trust funds, which is the same as the 
administration request and $7,000 above the fiscal year 1997 
level.
    The Office for Civil Rights is responsible for enforcing 
civil rights-related statutes in health care and human services 
programs. To enforce these statutes, OCR investigates 
complaints of discrimination, conducts program reviews to 
correct discriminatory practices, and implements programs to 
generate voluntary compliance among providers and constituency 
groups of health and human services.

                            POLICY RESEARCH

Appropriations, 1997....................................     $18,486,000
Budget estimate, 1998...................................       9,000,000
Committee recommendation................................       9,500,000

    The Committee recommends an appropriation of $9,500,000 for 
policy research. This is $500,000 higher than the 
administration request and $8,986,000 less than the fiscal year 
1997 amount.
    Funds appropriated under this title provide resources for 
research programs that examine broad issues which cut across 
agency and subject lines, as well as new policy approaches 
outside the context of existing programs. This research can be 
categorized into three major areas: health policy, human 
services policy, and disability, aging and long-term care 
policy.
    The Committee encourages the HELP DESK initiative sponsored 
by the Office of the Assistant Secretary for Planning and 
Evaluation intended to complement and extend technical 
assistance provided at the local level to all communities which 
competed for Federal empowerment zone/enterprise community 
designation in 1994. This initiative is to be carried out by a 
nonprofit organization with expertise in providing 
multisectoral technical assistance at the local level. 
Sufficient funds are provided within the increase to this 
account to carry out this initiative. The Committee recommends 
the program begin in a State with the following 
characteristics: a large rural population, exceptionally high 
poverty rates and income transfer rates, and significant 
redistribution and return migration of African-American and 
other minorities over the past decade.
    The Committee is aware of the Department's March 1995 
report entitled ``Strategic Elements for Environmental 
Justice,'' issued pursuant to the President's Executive Order 
12898, which identified a strategy for addressing the 
disproportionate environmental and human health burdens in low-
income and minority communities. Recent studies on lead 
poisoning and asthma further indicate the need for additional 
resources focused on these communities. Therefore, the 
Committee strongly encourages the Department to place 
increasing emphasis and resources to support the capacity of 
community health centers, whose primary mission is to serve 
low-income minority communities, in conducting research and 
developing more effective intervention and prevention 
strategies. The Secretary should be prepared to identify what 
steps have been taken to address this recommendation at next 
year's hearings.

                           General Provisions

    The Committee recommendation includes language placing a 
$37,000 ceiling on official representation expenses (sec. 201), 
the same as existing law.
    The Committee recommendation includes language from last 
year's bill limiting assignment of certain public health 
personnel (sec. 202).
    The Committee recommendation retains language carried last 
year regarding set-asides in the authorizing statute of the 
National Institutes of Health (sec. 203).
    The Committee recommendation retains a provision carried in 
last year's bill to limit use of grant funds to pay individuals 
more than an annual rate of $125,000 (sec. 204).
    The Committee recommendation retains language from last 
year's bill restricting the use of taps (sec. 205) for program 
evaluation activities by the Secretary prior to submitting a 
report on the proposed use of the funds to the Appropriations 
Committee. Section 241 of the Public Health Service Act 
authorizes the Secretary to redirect up to 1 percent of the 
appropriations provided for programs authorized under the act 
for evaluation activities.
    The Committee recommendation retains language prohibiting 
the use of funds for the Federal Council on Aging and the 
Advisory Board on Child Abuse and Neglect (sec. 206).
    The Committee recommendation retains language included in 
last year's restricting transfers of appropriated funds among 
accounts and requiring a 15-day notification of both 
Appropriations Committees prior to any transfer (sec. 207).
    The Committee recommendation includes language from last 
year's bill permitting the transfer of up to 3 percent of AIDS 
funds among Institutes and Centers (sec. 208) by the Director 
of NIH and the Director of the Office of AIDS Research of NIH. 
The recommendation also includes language included in fiscal 
year 1997 which directs that the funding for AIDS research as 
determined by the Directors of the National Institutes of 
Health and the Office of AIDS Research be allocated directly to 
the OAR for distribution to the Institutes and Centers 
consistent with the AIDS research plan (sec. 209).
    The Committee recommendation includes a new provision to 
permit funds to be used for the National Institutes of Health 
to provide transit subsidies in amounts consistent with the 
transportation subsidy programs authorized under section 629 of 
the Public Law 101-509 to non-FTE bearing positions, including 
trainees, visiting fellows, and volunteers (sec. 210).

                   TITLE III--DEPARTMENT OF EDUCATION

                            education reform

Appropriations, 1997....................................    $890,973,000
Budget estimate, 1998...................................   1,245,000,000
Committee recommendation................................   1,271,000,000

    The Committee has provided $1,271,000,000 in this account 
for education reform initiatives. The recommendation includes 
$530,000,000 for education reform activities authorized by the 
Goals 2000: Educate America Act, $200,000,000 to continue 
implementation of school-to-work transition systems authorized 
by the School-to-Work Opportunities Act, and $425,000,000 for 
the technology literacy challenge fund, authorized by the 
Elementary and Secondary Education Act and $116,000,000 for the 
technology innovative challenge grants.

Goals 2000 State grants

    The Committee recommends $500,000,000 for State and local 
systemic education improvement grants authorized by title III 
of the Goals 2000: Educate America Act. This amount is an 
increase of $24,000,000 over the fiscal year 1997 appropriation 
and $105,000,000 below the administration request.
    Goals 2000 funds provide incentives for States to devise 
their own strategies for comprehensive reform of elementary and 
secondary education. Grants are distributed to States through a 
formula based on relative shares each State received in the 
previous year under titles I and VI of the Elementary and 
Secondary Education Act. By law, 1 percent is reserved for the 
outlying areas, schools supported by the Bureau of Indian 
Affairs and the Alaska Federation of Natives.

Parental assistance

    The Committee recommends $30,000,000 for title IV of the 
Goals 2000: Educate America Act, which authorizes a variety of 
activities designed to improve parenting skills and strengthen 
the partnership between parents and professionals in meeting 
the education needs of their school-age children, including 
those aged birth through 5. The recommendation is $15,000,000 
more than the administration request and the fiscal year 1997 
amount. The increase provided will permit expansion of 
voluntary parent centers to 12 additional States bringing the 
total number of States and territories participating in the 
program to at least 52. Of the $30,000,000, $15,000,000 will 
allow for continuation grants and $15,000,000 will allow for 
new grants. The Committee further directs the Department to 
reopen competition to eligible entities for fiscal year 1998 
funds.
    It has been brought to the Committee's attention that many 
of the grantees currently receiving funding under this program 
are making only minimal efforts to implement Parents as 
Teachers [PAT] or Home Instruction for Preschool Youngsters 
[HIPPY] Programs. Therefore, the Committee urges the Department 
to provide at least 50 percent of each grant award for PAT or 
HIPPY Programs. The Committee also directs the Department to 
report to the Committee by April 1, 1998, on steps being taken 
to assure that the program dollars are being spent in 
accordance with program requirements.

School-to-work opportunities

    The Committee supports funds for the School-to-Work 
Opportunities Act, and has recommended $200,000,000 for the 
Department of Education's share of program funding. The amount 
recommended is $27,000 more than the 1997 appropriation and the 
same as the administration request. Together with $200,000,000 
recommended for the Labor Department, $400,000,000 in direct 
funding is provided to help States implement their plans for 
creating systems to improve the transition from school to work.
    Local school-to-work programs will include a combination of 
work-based learning involving job training and school-based 
learning tied to both occupational skill standards and the 
voluntary academic standards States establish under Goals 2000. 
Students who complete a school-to-work program will receive a 
high school diploma, a certificate recognizing 1 or 2 years of 
postsecondary education, if appropriate, and a portable, 
industry-recognized skill certificate.

Technology literacy challenge fund

    The Committee recommends $425,000,000 for the technology 
literacy challenge fund authorized by section 3132 of the 
Elementary and Secondary Education Act, an increase of 
$225,000,000 over the fiscal year 1997 appropriation and the 
same as the budget request.
    The fund helps States put into practice strategies to 
enable schools to integrate technology into school curricula. 
Funds are used to enhance students' critical thinking skills, 
support training for teachers, connect classrooms to the 
information superhighway, and purchase computers and software. 
Funds are distributed according to each State's share of title 
I, part A moneys. To be eligible for funds, States must submit 
a statewide technology plan describing long-term strategies for 
financing technology education in the State, including private-
sector participation and targeting funds to school districts 
with the greatest need.

Technology innovation challenge grants

    The Committee recommends $116,000,000 for two of the 
technology programs authorized as part A of title III of the 
ESEA, an increase of $31,000,000 above the budget request. In 
fiscal year 1997, $266,965,000 was appropriated for this 
purpose. This year, the administration has requested 
$425,000,000 for State-grant activities that were previously 
funded by this program.
    This activity supports 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 has also included $10,000,000 to continue the 
regional consortia, the same amount appropriated in fiscal year 
1997 and recommended by the administration. These consortia 
assist States and local educational agencies in the 
identification and procurement of resources necessary to 
implement technology plans, develop training resources for both 
elementary and secondary and adult education, provide referrals 
to sources of technical assistance and professional 
development, and assist institutions of higher education to 
establish preservice training programs in the appropriate use 
of educational technology.
    The Committee is aware of the growing use of online 
resources in education, and of the increasing importance of 
access to computer technology for all educational institutions. 
Not only are computer resources essential tools for students, 
but they significantly increase access to global resources 
available for instruction, provide high performance computing 
capabilities for research, and create more flexible 
opportunities for continuous learning. The Committee believes 
that increasing computer connectivity, joint storage, and data 
mining capabilities at the regional level has the potential to 
vastly improve the quality of primary and secondary schools as 
well as colleges, universities, and the private sector. The 
Committee, therefore, urges the Department of Education to 
provide $10,000,000 for a demonstration project to develop a 
supercomputing infrastructure with broad-based networking 
applications for elementary and secondary schools, colleges, 
and universities. The model should also include access to 
science and medical technology. The HUBS project (hospitals, 
universities, businesses, and schools) in the Delaware Valley 
region of Pennsylvania is currently providing an array of 
technological services to their students, through e-mail, 
Internet access, and automated library systems and would be 
especially suited to conduct a demonstration in this area.
    The Committee urges the Secretary, when awarding 
educational technology grants to give consideration to school 
districts around the country, such as the Houston Independent 
School District, that exemplify high concentrations of at-risk 
youth; empowerment zones and enhanced enterprise communities.

Technology training for educators

    The Committee has included $30,000,000 within the funds 
provided for the Technology Innovation Challenge Grant Program 
for a new competitive grants to consortia that have developed 
exemplary programs that train new and current teachers, 
administrators, and other educators, to use advanced 
technology, and to integrate education technology into teaching 
methods that improve instruction. The challenge grants program 
has been effective in developing model programs that can be 
scaled up through replication, and the program's competitive 
approach is now needed to expand and improve the investment in 
the training of educators to use education technology to 
improve education. Building on this successful approach, the 
Secretary shall solicit proposals from State departments of 
education on behalf of consortia dedicated to teacher training 
in education technology; such consortia to consist of at least 
one local education agency, at least one college of education, 
private sector education technology firms, and nonprofit 
education organizations. Each State should be allowed to submit 
no more than one proposal. In forming the consortium for 
inclusion in its application, each State department of 
education should select those programs of preservice teacher 
preparation and professional development for educators that has 
been proven most effective and innovative. The review of 
proposals should consider: explicit evidence of innovation and 
effectiveness; the extent to which the members of the applicant 
consortium have sought to establish high standards for training 
in education technology and its use in schools; and specific 
efforts by applicant State and local education agencies to be 
publicly accountable for improving education through the use of 
technology. Awardees should use grant funds to improve, expand, 
and disseminate these successful models throughout the State 
and Nation. Recipients of the awards shall be required to share 
in the cost of the supported activities, from non-Federal 
sources, in an amount equal to twice the amount of the Federal 
share awarded.

                    Education for the Disadvantaged

Appropriations, 1997....................................  $7,799,573,000
Budget estimate, 1998...................................   8,077,266,000
Committee recommendation................................   7,807,349,000

    The Committee recommends an appropriation of $7,807,349,000 
for education for the disadvantaged. This is $7,776,000 more 
than the fiscal year 1997 appropriation and $269,917,000 less 
than the administration request. In fiscal year 1997, 
$1,298,386,000 was made available for this account in the 
fiscal year 1998 funds. This year, the Committee forward funded 
this same amount for fiscal year 1999. The Committee took this 
action because of the severe budget constraints facing the 
Committee in fiscal year 1998.
    Programs financed under this account are authorized under 
title I (formerly chapter 1) of the Elementary and Secondary 
Education Act [ESEA] and section 418A of the Higher Education 
Act. ESEA title I programs provide financial assistance to 
State and local educational agencies [LEA's] to meet the 
special educational needs of educationally disadvantaged 
children, migrant children, neglected and delinquent children 
in State institutions, and juveniles in adult correctional 
institutions. In addition, the Even Start Program supports 
projects that integrate early childhood education with 
parenting and adult literacy training. Funds for each of these 
programs, except for Even Start, are allocated through formulas 
that include the number of eligible children and each State's 
average per-pupil expenditure. Even Start funds are allocated 
according to each State's proportion of title I grants to 
LEA's.

Grants to local educational agencies

    Title I grants to local educational agencies provide 
supplemental education funding to LEA's and schools, especially 
in high-poverty areas, to help low-income, low-achieving 
students learn to the same high standards as other children. 
The program currently provides services to more than 9 million 
children. The formula for basic grants is based on the number 
of children from low-income families in each county, weighted 
by per-pupil expenditures for education in the State. States in 
turn make suballocations from the county to the LEA level using 
the best data available on the number of poor children. States 
are also required to reserve funds generated by counts of 
children in correctional institutions to make awards to LEA's 
for dropout prevention programs involving youth from 
correctional facilities and other at-risk children. By law, 1 
percent of the total LEA grant appropriation is set aside for 
the Bureau of Indian Affairs and the outlying areas.
    For title I basic grants, including the amount transferred 
to the Census Bureau for poverty updates, the Committee 
recommends an appropriation of $6,273,712,000. This amount is 
$500,000 more than appropriated in fiscal year 1997 and 
$82,362,000 more than the budget request.
    The Committee has provided no funding for the targeted 
grants program. The administration requested $350,000,000 for 
this program which distributes funds in a manner that provides 
higher per-children amounts for counties with the highest 
percentage of poor children.
    The Committee recommends $1,022,020,000 for concentration 
grants, the same amount appropriated in fiscal year 1997 and 
$22,771,000 more than the budget request. Funds under this 
program are distributed according to the basic grants formula, 
except that they only go to counties and LEA's where the number 
of poor children equals at least 6,500, or 15 percent, of the 
total school-aged population. Approximately 66 percent of 
counties nationally receive funds.
    The Committee has included bill language which provides 
that in allocating the 1998 appropriations for basic and 
concentration grants under title I, part A of the Elementary 
and Secondary Education Act, the Secretary shall apply a 100-
percent hold harmless based on total 1997 grants under this 
part, including supplemental 1997 appropriations provided under 
Public Law 105-18. The Committee has taken this action because 
it is very concerned about the accuracy of updated estimates of 
school-age children in poor families that were released by the 
Census Bureau in March 1997. In accordance with recommendations 
in an interim report by an advisory panel of the National 
Academy of Sciences, these updated population estimates were 
combined with 1990 population estimates in the allocation of 
most 1997 appropriations for title I, part A. However, the 
Committee has been, and remains, concerned about the accuracy 
of these updated population estimates, in part because the 
National Academy of Sciences advisory panel has not yet 
completed its full analysis and report on the estimation 
process, and in part because of a consistent pattern whereby 
use of the updates reduces the share of title I, part A funds 
that is allocated to States with the highest school-age child 
poverty rates. The Committee understands that the full National 
Academy of Sciences advisory panel report on the population 
estimation methods will be made available during the next 
several months. The Committee directs that when this report is 
completed, the Secretary shall consult with the Committee on 
the panel's findings, and on possible ways to use more up-to-
date population estimates without reducing the share of title I 
funds that is allocated to States and local educational 
agencies with high rates of poverty among school-age children. 
The Committee's recommendation of a 100-percent hold harmless 
for 1998 grants will avoid further shifting of title I funds 
away from high poverty States while the Committee considers 
further steps to better target title I aid on States and local 
educational agencies in greatest need.

Capital expenses for private school students

    The Committee recommends $41,119,000 for the Capital 
Expenses Program, the same as the 1997 appropriation and the 
budget request.
    The Supreme Court's 1985 Aguilar v. Felton decision 
prohibited districts from sending public schoolteachers or 
other employees to private sectarian schools for the purpose of 
providing title I services. The Capital Expenses Program has 
helped districts comply with Felton by paying a portion of the 
additional capital costs associated with serving religious 
school students outside school premises. Funds are used by 
districts for noninstructional goods and services such as 
renting classroom space in neutral sites, renting or purchasing 
mobile vans for title I instruction, or transporting private 
schoolchildren to the place of title I instruction.
    On June 23, 1997, the Court reversed its earlier ruling, 
and districts may now provide title I instruction in private 
schools. However, many school districts will continue, over the 
short term, to incur costs as a result of the original 1985 
decision. For example, some may have entered into multiyear 
leases for vans, portable classrooms, or other neutral 
instructional sites. The Committee, therefore, has recommended 
continuation of this program until an assessment has been made 
as to what the final costs are for Felton compliance.
    Funds are allocated to States according to the proportion 
of nonpublic school students served under the title I LEA 
Grants Program in the most recent year for which satisfactory 
data are available.

Even Start

    For the Even Start Program, the Committee recommends 
$108,000,000, an increase of $6,008,000 more than the fiscal 
year 1997 appropriation and the same as the budget request.
    The Even Start Program provides grants for family literacy 
programs that serve disadvantaged families with children under 
8 years of age and adults eligible for services under the Adult 
Education Act. Programs combine early childhood education, 
adult literacy, and parenting education.
    States receive funds on the basis of their proportion of 
title I LEA grant allocations and make competitive 4-year 
grants to partnerships of local educational agencies and 
community-based organizations. Grant funds must be equitably 
distributed among urban and rural areas and the local share of 
program costs increases from 10 percent in the first year to 40 
percent in the fourth year.

Migrant

    For the State Agency Migrant Program, the Committee 
recommends $305,473,000, the same amount appropriated in fiscal 
year 1997. The administration requested $319,500,000 for this 
program.
    The title I migrant program authorizes grants to State 
educational agencies for programs to meet the special 
educational needs of the children of migrant agricultural 
workers and fishermen. Funds are allocated to the States 
through a statutory formula based on each State's average per-
pupil expenditure for education and counts of migratory 
children aged 3 through 21 residing within the States. Only 
migratory children who have moved within the last 3 years are 
generally eligible to be counted and served by the program. 
Currently, this program serves approximately 610,000 migrant 
students.
    This appropriation also supports activities to improve 
interstate and intrastate coordination of migrant education 
programs.

Neglected and delinquent

    The Committee recommends $40,333,000 for the title I 
Neglected and Delinquent Program, an increase of $1,022,000 
over the amount appropriated in 1997 and the same amount 
recommended by the administration.
    This program provides financial assistance to State 
educational agencies for education services to neglected and 
delinquent children and youth in State-run institutions and for 
juveniles in adult correctional institutions.
    Funds are allocated to individual States through a formula 
based on the number of children in State-operated institutions 
and per-pupil education expenditures for the State.
    States are authorized to set aside up to 10 percent of 
their neglected and delinquent funds to help students in State-
operated institutions to make the transition into locally 
operated programs. Transition activities are designed to 
address the high failure and dropout rate of institutionalized 
students and may include alternative classes, counseling and 
supervisory services, or educational activities in State-
supported group homes.

State school improvement grants

    The Committee recommends no funds for State school 
improvement grants. The administration requested $8,000,000 for 
this purpose. No funds were appropriated in fiscal year 1997 
for this program. Funds are used to help States stimulate 
school-based change and hold local educational agencies 
accountable for making significant progress in the education of 
disadvantaged children. Funds for this purpose can be sustained 
through administrative set-asides in the title I program and 
other State and local funding sources.

Evaluation

    The Committee bill includes $6,977,000 for title I 
evaluation activities, the same amount appropriated in fiscal 
year 1997. The amount recommended is a decrease of $3,023,000 
below the budget request.
    Evaluation funds are used to support large-scale national 
surveys that examine how the title I program is contributing to 
student performance. The recommended amount will provide 
sufficient funds to design, implement, and produce multiyear 
evaluations that will assess the effects of the changes made in 
the reauthorization of the title I program.

High School Equivalency Program

    The Committee bill includes $7,634,000 for the High School 
Equivalency Program [HEP]. This amount is $193,000 above the 
amount appropriated in fiscal year 1997 and is the same amount 
requested by the administration.
    This program provides 5-year grants to institutions of 
higher education and other nonprofit organizations to recruit 
migrant students aged 16 and over and provide the academic and 
support services needed to help them obtain a high school 
equivalency certificate and subsequently gain employment, win 
admission to a postsecondary institution or a job-training 
program, or join the military. Projects provide counseling, 
health services, stipends, and placement assistance. HEP will 
serve about 3,600 migrants in 1997.

College Assistance Migrant Program

    For the College Assistance Migrant Program [CAMP], the 
Committee agrees with the House and the administration and 
recommends $2,081,000. The amount recommended is $53,000 above 
the fiscal year 1997 appropriation.
    Funds provide 5-year grants to institutions of higher 
education and nonprofit organizations for projects that provide 
tutoring, counseling, and financial assistance to migrant 
students during their first year of postsecondary education. 
Projects also may use up to 10 percent of their grants for 
followup services after students have completed their first 
year of college, including assistance in obtaining student 
financial aid. CAMP will serve about 375 students in 1997.

                               impact aid

Appropriations, 1997....................................    $730,000,000
Budget estimate, 1998...................................     658,000,000
Committee recommendation................................     794,500,000

    The Committee recommends an appropriation of $794,500,000 
for impact aid for the Department of Education. This amount is 
$64,500,000 above the 1997 amount and $136,500,000 above the 
administration request.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities. 
Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education. During 
the current school year, approximately 2,000 school districts 
will receive payments on behalf of 1.2 million eligible 
children.
    The Committee has turned down the administration's language 
as follows: Language specifying that payments shall be made 
only for children living on Indian lands and children of 
members of the uniformed services living on Federal property; 
language overriding the eligibility requirements under section 
8003; language specifying the maximum basic support payment for 
which an LEA is eligible; language overriding the learning 
opportunity threshold and language overriding the hold-harmless 
provision of the statute so that all payments would be 
distributed by formula.
    It has come to the Committee's attention that two school 
districts in Texas and one in New Jersey which receive funding 
under this subsection have been adversely affected by 
definitions used by the Department of Education in determining 
the amount of revenue available for general fund expenditure. 
The result of this definition problem is that all three school 
districts will be required to pay back a portion of the funds 
they have received under this subsection or its predecessor 
section 3(d)(2)(B) of Public Law 81-874. These are three of the 
neediest school districts in the impact aid program and, if 
compelled to make repayment to the Department, would be placed 
under a tremendous hardship. The Committee requests that the 
Department review its actions with regard to supplemental 
payments made to the Killeen Independent School District, the 
Copperas Cove Independent School District (Texas), and the 
North Hanover Township public schools (New Jersey).
    The Committee is aware of the financial problems that the 
Centennial School District in Warminster, PA, is experiencing 
due to the closure of the Warminster Naval Air Warfare Center. 
In addition, the school district is now responsible for 
educating children whose parents reside in naval housing, but 
are assigned to the Naval Air Station Joint Reserves in Willow 
Grove, located in a neighboring school district. The Committee 
requests that the Department review its actions with regard to 
payments made to the Centennial School District and take steps 
to ensure that the school district is given adequate payments 
to provide a quality education for all of the district's 
children, including the 300 children from the Willow Grove 
Naval Air Station.
    It has been brought to the Committee's attention that the 
Portsmouth School District in Rhode Island has been 
unsuccessful in its recent application for impact aid payments 
due to a misinterpretation of changes in the law. The Committee 
urges the Department to work with the Portsmouth School 
District to rectify the problem.
    Basic support payments.--The Committee recommends 
$623,500,000 for basic support payments, the same amount 
appropriated in fiscal year 1996 and $39,500,000 above the 
amount recommended by the administration. Under statutory 
formula, payments are made on behalf of all categories of 
federally connected children.
    Payments for children with disabilities.--Under this 
program additional payments are made for certain federally 
connected children eligible for services under the Individuals 
with Disabilities Education Act. The Committee bill includes 
$80,000,000 for this purpose, an increase of $40,000,000 above 
the 1997 level. The Committee has included this increase due to 
the rising costs of providing educational services to special 
needs children.
    Payments for heavily impacted districts.--These payments 
provide additional assistance to certain local educational 
agencies that enroll large numbers or proportions of federally 
connected children. The Committee recommends $52,000,000, the 
same amount appropriated in fiscal year 1997 and an increase of 
$32,000,000 over the amount requested by the administration.
    Facilities maintenance.--This activity provides funding for 
maintaining certain school facilities owned by the Department 
of Education. The Committee recommends $10,000,000 for this 
purpose in fiscal year 1998, the same as the budget request. No 
funds were provided for this purpose in fiscal year 1997.
    Construction.--Payments are made to eligible LEA's to be 
used for construction and renovation of school facilities, or 
for debt service related to the construction of school 
facilities. The Committee recommends $5,000,000 for this 
program, the same amount appropriated in fiscal year 1997, and 
an increase of $1,000,000 over the budget request.
    It has been brought to the Committee's attention that the 
Lodge Pole Elementary School on the Fort Belknap Reservation in 
north central Montana was closed due to serious health threats 
brought about by raw sewage, asbestos, diesel fuel 
contamination, and bacteria in the drinking water. Students 
have been temporarily relocated to the another school, creating 
a serious overcrowding situation. The Committee urges the 
Department to initiate discussions with the school district 
concerning the feasibility, construction and design of a 
facility to accommodate the educational needs of the Lodge Pole 
students.
    Payments for Federal property.--These payments compensate 
local educational agencies in part for revenue lost due to the 
removal of Federal property from local tax rolls. Payments are 
made to LEA's that have a loss of tax base of at least 10 
percent of assessed value due to the acquisition since 1938 of 
real property by the U.S. Government. The Committee recommends 
$24,000,000 for this activity in 1998, an increase of 
$6,500,000 over the fiscal year 1997 amount. No funds were 
requested by the administration for this activity.

                      school improvement programs

Appropriations, 1997....................................  $1,425,618,000
Budget estimate, 1998...................................   1,299,222,000
Committee recommendation................................   1,482,293,000

    The Committee recommends an appropriation of $1,482,293,000 
for school improvement programs. This amount is $56,675,000 
more than the 1997 appropriation and $183,071,000 more than the 
administration's request.
    Eisenhower professional development State grants.--The 
Committee recommends $310,000,000 for Eisenhower professional 
development State grants, the same as the fiscal year 1997 
appropriation and a decrease of $50,000,000 from the amount 
requested by the administration. This program provides formula 
grants to States to support sustained and intensive high-
quality professional development activities in the core 
academic subjects at the State and local levels.
    Innovative education program strategies State grants.--The 
Committee recommends $310,000,000 for innovative education 
program strategies State grants, the same as the fiscal year 
1997 appropriation. The administration proposed to eliminate 
funding for this program. This program makes grants to State 
and local educational agencies for activities intended to help 
meet the national education goals and assist in their reform of 
elementary and secondary education. Funds are awarded to States 
by a formula based on school-aged population and then to local 
districts under a State-determined formula. State and local 
funds may be used for acquisition of instructional materials 
such as library books, curricular materials, and computer 
software and hardware; improving educational services to 
disadvantaged children and dropout prevention; combating 
illiteracy among children and adults; programs for gifted and 
talented children; and reform activities consistent with Goals 
2000. Teacher training and other related activities in support 
of any of these purposes is also authorized.

Safe and drug free schools and communities

    State grant program.--The Committee bill provides 
$555,978,000 for the safe and drug free schools and communities 
State grant program. The amount recommended is the same as the 
fiscal year 1997 amount and $64,022,000 less than the budget 
request.
    National programs.--The Committee has included no funding 
for the national programs portion of the safe and drug free 
schools program, a decrease of $30,000,000 below the amount 
requested by the administration. In fiscal year 1997, 
$25,000,000 was provided for national programs through a 
reprogramming of funds. These funds are used to promote safety 
and discipline for students at all educational levels and to 
prevent violence and illegal use of drugs. The Committee would 
entertain a reprogramming of funds for this purpose.

Inexpensive book distribution

    For the inexpensive book distribution program, the 
Committee provides $12,000,000, an increase of $1,735,000 over 
the 1997 appropriation and the same amount recommended by the 
administration. This program is operated by Reading Is 
Fundamental [RIF], a private nonprofit organization associated 
with the Smithsonian Institution. RIF supports over 4,500 
projects at over 15,000 sites to distribute books to children 
from low-income families to help motivate them to read. In 
1997, an estimated 7.2 million books will be distributed to 2.3 
million children. This program has been successful in 
motivating children to read, increasing the use of libraries, 
increasing parental involvement in schools, and contributing to 
improved reading achievement.

Arts in education

    For the arts in education program, the Committee recommends 
$10,500,000, an increase of $1,500,000 over the 1997 
appropriation. The administration requested $9,500,000 for this 
program. The amount recommended will support two awards: 
$5,246,000 for a grant to very special arts [VSA], which 
supports the development of programs to integrate the arts into 
the lives of children and adults with disabilities; and 
$4,254,000 for a grant to the John F. Kennedy Center for the 
Performing Arts, which supports a variety of activities through 
its education department that promote the arts throughout the 
Nation. In addition, $1,000,000 has been provided for very 
special arts to support the International Very Special Arts 
Festival to be held in Los Angeles, CA, in May 1999. This event 
will host over 3,000 artists with disabilities of all ages from 
around the globe. The festival will be held in conjunction with 
the Los Angeles Convention and Visitors Bureau and the Mayors 
Office of Cultural Affairs. The objectives of the festival are 
the creation of over 100 jobs in art-related fields for 
individuals with disabilities; the creation of lifelong 
learning programs through the arts; and the establishment of an 
international exposition focusing on technology applications 
particularly relevant to individuals with disabilities in the 
workplace.

Magnet schools assistance

    For the magnet schools assistance program, the Committee 
bill provides $95,000,000, the same amount recommended by the 
administration and the 1997 appropriation.
    This program supports grants to local educational agencies 
to establish and operate magnet schools that are part of an 
approved desegregation plan and are designed to attract 
substantial numbers of students of different social, economic, 
ethnic, and racial backgrounds. Grantees may use funds for 
teacher salaries, purchase of computers, and other educational 
materials and equipment.
    The Committee has also included language, carried in the 
fiscal years 1996 and 1997 bills, indicating that at least 
$3,000,000 of the magnet school appropriation shall be used for 
continuation costs for innovative programs as described in 
section 5111 of title V of the Elementary and Secondary 
Education Act.
    The Committee recognizes the positive impact the Magnet 
Schools Program has had on communities around the Nation. This 
program supports grants to local educational agencies to 
establish and operate magnet schools that are part of an 
approved desegregation plan and are designed to attract 
substantial numbers of students of different social, economic, 
ethnic, and racial backgrounds. The Seattle School District has 
a history of working hard to provide equal opportunities and 
access to a quality education to all children regardless of 
their social, economic, ethnic, and racial backgrounds. The 
Committee also recognizes that the Seattle School District will 
be submitting a grant application to the Department of 
Education for funding under the Magnet Schools Assistance 
Program and asks the Department to look favorably upon this 
request.

Education for homeless children and youth

    For carrying out education activities authorized by part B, 
subtitle B of the Stewart B. McKinney Homeless Assistance Act, 
the Committee recommends $28,800,000, an increase of $3,800,000 
over the fiscal year 1997 amount and $1,800,000 over the budget 
request.
    This program provides assistance to each State to support 
an office of the coordinator of education for homeless children 
and youth, to develop and implement State plans for educating 
homeless children, and to carry out other activities to ensure 
that all homeless children and youth in the State have access 
to the same free, appropriate public education, including a 
public preschool education, as provided to other children and 
youth. Grants are made to States based on the total that each 
State receives under the title I program.

Women's educational equity

    The Committee recommends $4,000,000 for the women's 
educational equity program, an increase of $2,000,000 over the 
fiscal year 1997 appropriation and the same as the amount 
requested by the administration. The program supports projects 
that assist in the local implementation of gender equity 
policies and practices.

Training and advisory services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $7,334,000, 
the same as the fiscal year 1997 appropriation and $7,000,000 
below the administration's request.
    The funds provided will continue the 10 regional 
desegregation assistance centers. Funds are used to provide 
technical assistance, training, and advisory services to school 
districts in addressing problems associated with desegregation 
on the basis of race, color, sex, or national origin. No funds 
are included for civil rights units in State education 
agencies.

Ellender fellowships

    For Ellender fellowships, the Committee bill includes 
$1,500,000, the same as the 1997 appropriation. The 
administration recommended no funding for this program. The 
Ellender fellowship program makes an award to the Close Up 
Foundation of Washington, DC, to provide fellowships to 
students from low-income families and their teachers to enable 
them to participate with other students and teachers for 1 week 
of seminars on Government and meetings with representatives of 
the three branches of the Federal Government.

Education for native Hawaiians

    For programs for the education of native Hawaiians, the 
Committee bill includes $20,000,000, which is $5,000,000 above 
the 1997 appropriation and the administration request.
    The Committee encourages the Department when allocating 
these funds to provide the following: $2,500,000 for the 
curricula development, teacher training, and recruitment 
program; $1,000,000 for the community-based education learning 
centers; $4,200,000 for the Hawaiian higher education program, 
including $500,000 for the support of native language 
revitalization curricula and the development of educational 
materials in native languages at the University of Hawaii at 
Hilo Native Languages College; $2,100,000 for the gifted and 
talented program; $2,100,000 for special education programs; 
$500,000 for the Native Hawaiian education council and island 
councils; and $7,100,000 for family-based education centers. 
The Committee notes the disproportionately high numbers of 
native Hawaiian students who have special educational needs, 
who fail to finish high school, who drop out, and who abuse 
drugs and alcohol. Continued funding must be provided to raise 
the educational status of native Hawaiians to the national 
average. The Committee urges the Department to provide $500,000 
for workshops in aquaculture/education for high school students 
and teachers at the Keahuolu training facilities on the Island 
of Hawaii.
    Native Hawaiians agriculture partnerships.--The Committee 
is aware of the dismal economic and social conditions in the 
rural areas of Hawaii resulting from the closure of several 
sugarcane plantations that formerly provided economic and 
social infrastructure for these communities. The Committee 
favors the proposed expansion of the successful partnerships 
between community-based agricultural businesses and cooperating 
high schools where agricultural and business practices are 
integrated into the curriculum, resulting in products that are 
ultimately purchased by the cooperating business. The Hawaii 
Institute of Tropical Agriculture and Human Resources would be 
especially suited to assist in the expansion of this program.

Prisoner education

    The native Hawaiians continue to represent the largest 
ethnic group in the State's prisons. Recent efforts to actively 
involve community elders with high-risk juveniles seem to have 
been notably successful. Accordingly, the Committee urges the 
Department to support a demonstration project to target this 
critical population.
    Waste management innovation.--Preservation of the 
environment is an important underpinning of Hawaiian culture. 
However, little is known of historical practices used by the 
Hawaiian people to deal with waste and over exploitation. It is 
the Committee's desire that sufficient funds be made available 
to study and document traditional Hawaiian practices of 
sustainable waste management and to prepare teaching materials 
for educational purposes and for demonstration of the use of 
native Hawaiian plants and animals for waste treatment and 
environmental remediation. This money should be made available 
for a partnership between Partners in Development (a Hawaii 
nonprofit corporation) and an appropriate nonprofit 
organization with expertise in sustainable waste treatment 
methods.
    Aquaculture.--The Committee is pleased with the aquaculture 
education program developed by the Oceanic Institute of Hawaii 
and recommends that sufficient funds be provided to continue 
funding for this program.

Alaska Native educational equity

    The Committee recommends $10,640,000 for the Alaska Native 
Educational Equity Assistance Program, authorized under title 
IX, part C, of the Elementary and Secondary Education Act. This 
amount is $2,640,000 over the 1997 appropriation and the budget 
request. These funds address the severe educational handicaps 
of Alaska Native schoolchildren. Funds are used for development 
of supplemental educational programs to benefit Alaska Natives. 
Of the amount provided, the Committee has included $6,500,000 
for Native educational planning, $2,500,000 for Native home-
based education for pre-school children and $1,640,000 for 
student enrichment.
    It has been brought to the Committee's attention that in 
urban areas 60 percent of Alaska Natives entering high school 
do not graduate, and the Alaska Natives test scores are on 
average 40 percent lower than those of other students. In some 
districts, none of the Alaska Native elementary students and 40 
percent of Native high school students are performing at their 
grade levels. The funds provided under the Alaska Native 
Educational Equity Assistance Program will help to address some 
of the barriers faced by Native Alaskan children and develop 
programs tailored to the unique needs of these children to 
improve performance levels.

Charter schools

    The Committee recommends $50,987,000 for support of charter 
schools, which is the same as the 1997 appropriation and 
$49,103,000 below the budget request.
    This program, authorized under title X, part C of the 
Elementary and Secondary Act of 1965, as amended, provides 
funds to the Secretary to make awards to State educational 
agencies, which, in turn, make subgrants to partnerships of 
developers and local education agencies or other public 
entities that can authorize or approve a charter school. Grants 
are limited to 3 years in duration, of which not more than 18 
months may be used for planning and program design, and not 
more than 2 years for the initial implementation of a charter 
school.
    Unlike traditional public schools, charter schools operate 
under charters or contracts with school districts, State 
education agencies, or other public institutions. They are 
designed by groups of parents, teachers, school administrators, 
other members of the community, and private corporations and 
are held accountable for student performance under the terms of 
their contracts. Also, charter schools can operate with 
considerable autonomy from external controls such as district, 
State, and union requirements.

Technical assistance for improving ESEA programs

    The Committee recommends $25,554,000 for the comprehensive 
regional technical assistance centers. This recommendation is 
the same as the fiscal year 1997 level. The administration 
recommended $34,388,000 for this program. This program supports 
15 regional centers that provide support, training, and 
technical assistance to Department of Education grantees. Of 
the amount recommended, $750,000 is for an evaluation to 
collect performance indicator data that would improve the 
delivery of technical assistance centers.

Education infrastructure

    The Committee recommends $40,000,000 for this new program 
authorized by title XII of the Elementary and Secondary 
Education Act, that would provide Federal grant funding for the 
repair, renovation, alteration, and construction of public 
elementary and secondary school libraries, media centers, and 
facilities used for academic or vocational instruction.
    Infrastructure grants would be made to urban and rural 
school districts that serve large numbers or percentages of 
disadvantaged students and that have urgent infrastructure 
needs. The statute requires the Secretary to give priority to 
applicants lacking the fiscal resources to undertake the 
project without Federal support and to projects needed to 
address conditions that compromise learning, health, or safety.
    Grants may be used for the inspection, repair, and upgrade 
of academic and library facilities; to meet the requirements of 
section 504 of the Rehabilitation Act of 1973 and the Americans 
With Disabilities Act of 1990; to remove or contain severely 
hazardous materials such as asbestos, lead and radon; and to 
comply with Federal, State, or local building codes.

                            indian education

Appropriations, 1997....................................     $60,993,000
Budget estimate, 1998...................................      62,600,000
Committee recommendation................................      62,600,000

    The Committee recommends $62,600,000 for Indian education 
programs, an increase of $1,607,000 above the fiscal year 1997 
appropriation and the same as the budget request.
    For grants to local education agencies, the Committee 
recommends $59,750,000, an increase of $1,700,000 above the 
1997 appropriation and the same as the budget request. These 
funds provide financial support to reform elementary and 
secondary school programs that serve Indian students, including 
pre-school children. Funds are awarded on a formula basis to 
local educational agencies, the Bureau of Indian Affairs [BIA]-
supported schools and BIA operated schools.
    The Committee recommends $2,850,000 for Federal 
administration, a decrease of $93,000 below the fiscal year 
1997 appropriation and the same as the budget request. These 
funds 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.

                   bilingual and immigrant education

Appropriations, 1997....................................    $261,700,000
Budget estimate, 1998...................................     354,000,000
Committee recommendation................................     354,000,000

    The Committee recommends an appropriation of $354,000,000 
for bilingual and immigrant education. This is $92,300,000 more 
than the 1997 appropriation and the same as the 
administration's request.
    The bilingual programs authorized by title VII of ESEA are 
designed to increase the capacity of States and school 
districts to provide special instruction to limited-English 
proficient students.

Instructional services

    The Committee bill includes $160,000,000 for bilingual 
instructional programs, an increase of $18,300,000 above the 
1997 level and the same as the President's request.
    This activity provides competitive grants, primarily to 
school districts, to improve the quality of instructional 
programs for limited-English proficient students. Schools are 
permitted to select the instructional approach best suited to 
their students, except that no more than 25 percent of program 
funds may be used to support instruction that does not make use 
of the students' native language. Funds may also be used to 
provide services for preschool children and parents to assist 
in the education of their children.

Support services

    The Committee has included $14,000,000 for support 
services, an increase of $4,000,000 above the fiscal year 1997 
appropriation and the same as the administration's request. 
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. The Committee 
strongly encourages school districts to use their overall 
funding for bilingual education for support services 
activities. The need for support services increases every year. 
School personnel, parents, and other organizations rely on 
these services to understand the needs of students, plan 
effective instructional services, meet State and Federal legal 
requirements, and train staff to work with limited-English 
proficient students.

Professional development

    The Committee recommends $25,000,000 for professional 
development, the same as the budget request and $20,000,000 
over the fiscal year 1997 appropriation.
    These funds support the training and retraining of 
bilingual education teachers and teacher 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 Committee recommends $150,000,000 for immigrant 
education, the same as the administration request and 
$50,000,000 over the fiscal year 1997 appropriation.
    The Immigrant Education Program provides financial support 
to offset the additional costs of educating recently arrived 
immigrant students who often lack proficiency in English and 
need special services to make the transition to the American 
education system. Federal dollars flow through State 
educational agencies to school districts enrolling a minimum of 
500 eligible immigrant students or where eligible immigrant 
children represent at least 3 percent of the enrollment. The 
Committee agrees with the administration and has included bill 
language to permit States to allocate all or any part of the 
funds to LEA's on a discretionary basis.

Foreign language assistance

    The Committee recommends $5,000,000 for competitive foreign 
language assistance grants, the same amount appropriated in 
fiscal year 1997 and requested by the administration.
    This activity provides grants to increase the quantity and 
quality of instruction in foreign languages deemed critical to 
the economic and security interests of the United States.

                           Special education

Appropriations, 1997....................................  $4,035,979,000
Budget estimate, 1998...................................   4,210,000,000
Committee recommendation................................   4,958,073,000

    The Committee recommends an appropriation of $4,958,073,000 
for special education. This is $922,094,000 more than the 1997 
appropriation and $748,073,000 above the administration 
request.
    These programs, which are authorized by the Individuals 
with Disabilities Education Act [IDEA], provide assistance to 
ensure that all children with disabilities have access to a 
free, appropriate public education, and that all infants and 
toddlers with disabilities have access to early intervention 
services. This assistance is provided through State grants that 
offset a portion of the costs incurred by States and local 
educational agencies in educating children with disabilities 
and in developing and implementing statewide systems of early 
intervention services, and through six new programs that will 
provide a streamlined structure to help States improve 
educational and early intervention results for children with 
disabilities.

Grants to States

    The Committee bill provides $3,941,837,000 for special 
education grants to States, an increase of $834,315,000 more 
than the fiscal year 1997 appropriation and $701,087,000 above 
the budget request. This program supports formula grants to 
States to finance a portion of the cost of providing special 
education and related services for children with disabilities.
    The Committee's recommended funding level represents 
approximately 11 percent of the estimated average per-pupil 
expenditure and 10 percent of excess costs, and would provide 
an estimated $622 per child for the 5.5 million children 
expected to receive special education.
    Also included in the recommendation is $8,000,000 for the 
national assessment carried out under the IDEA and related 
studies.

Preschool grants

    The Committee recommends $378,985,000 for preschool grants, 
an increase of $18,576,000 over the fiscal year 1997 
appropriation and $4,160,000 over the budget request. The 
preschool grant program provides formula grants to States based 
on the amount of funding received in fiscal year 1997, the 
number of preschool children, aged 3 through 5 years, and the 
number of preschool children living in poverty.
    The amount provided by the Committee is approximately $655 
per child for the 578,600 preschoolers expected to receive 
special education and related services in the next school year.
    States may retain an amount equal to 25 percent of their 
1997 allocation, adjusted for inflation, of which 20 percent 
may be used for administration. These funds may be used for 
direct and support services for 3- through 5-year-olds; and, at 
a State's discretion, to serve 2-year-olds with disabilities 
who will turn age 3 during the school year; and for other 
purposes. The remaining funds must be distributed to local 
educational agencies.

Grants for infants and families

    The Committee bill provides $350,790,000 for the part C 
grants for infants and families program, an increase of 
$35,036,000 above the fiscal year 1997 appropriation and 
$26,826,000 over the budget request. This program provides 
formula grants to States to implement statewide systems of 
coordinated, comprehensive, multidisciplinary interagency 
programs to make available early intervention services to all 
children with disabilities, ages birth through 2, and their 
families.

State improvement

    For State improvement, the bill provides $35,200,000, the 
same as the budget request. 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 systems. The funds provided include 
continuation costs for severe disabilities and secondary and 
transitional service programs, which have now expired.

Research and innovation

    The Committee has included $64,508,000 for research and 
innovation. This new program supports competitive awards to 
produce and advance the use of knowledge to improve services 
and results for children with disabilities.
    The Committee is concerned about high levels of unmet need 
among children with disabilities in rural areas, particularly, 
the Mississippi River delta, and the lack of adequate support 
in these areas for parents, schools, child care, and health 
providers to make effective use of local resources. The 
Committee urges the Department of Education to provide 
$1,800,000 for the purpose of initiating a 3-year, multistate 
demonstration project in the delta region to provide early 
intervention and early childhood services to children with 
disabilities ages birth through 12 years, to assist parents, 
and to build local capacity to provide and coordinate such 
services through use of mobile, multidisciplinary teams of 
professionals (including physical and occupational therapists, 
speech language therapists, and social workers). These teams 
should receive initial and periodic centralized training, and 
nationally coordinated program evaluation and information 
dissemination support. The Committee believes that this project 
is of national significance as a rural model for multiagency 
collaboration and should be implemented by a national nonprofit 
disability organization with demonstrated expertise in serving 
rural children with physical and mental disabilities and their 
families and with existing capacity in the delta region.
    The Committee is aware of the valuable service which the 
National Information Center for Children and Youth with 
Disabilities has been providing to parents, educators, and 
health care professionals in disseminating information 
concerning the options and services available to treat youth 
with disabilities. The Committee encourages the Department, as 
it moves forward to restructure and refine various disability 
programs, to include information, resources, and knowledgeable 
guidance regarding funding and delivery systems. The Department 
should also keep in mind that the families and organizations 
most directly affected by disabilities are not deprived of the 
critical information they need to address these concerns.

Technical assistance and dissemination

    The Committee bill provides $44,556,000. This new 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.
    Included in the amount provided is $10,000,000 to support 
the first year of a 5-year effort to provide training and 
disseminate information to State and local administrators, 
teachers, related services personnel, parents of children with 
disabilities, and other appropriate parties on the 
implementation of the Individuals with Disabilities Education 
Act Amendments of 1997. The purpose of this effort is to ensure 
a common understanding of what needs to be done under the act 
to improve educational services to and results for children 
with disabilities. The Committee urges the Department to use 
peer training and to encourage collaborative efforts among 
organizations representing different target audiences such as 
parents and school officials.

Personnel preparation

    The Committee recommends $82,139,000 for the new personnel 
preparation program. Funds support 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.
    The appropriation includes funds to provide personnel 
preparation grants to high incidence disabilities including 
grants for graduate support to ensure a proper balance among 
all authorized grant categories.

Parent information centers

    The Committee bill provides $18,535,000 for parent 
information centers, an increase of $3,000,000 above the budget 
request. This new 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.

Technology and media services

    The Committee recommends $32,023,000 for technology and 
media services, an increase of $2,000,000 over the budget 
request. 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. Included in this amount is $6,000,000 for 
recording for the blind and dyslexic which will help to meet 
the growing need for services to blind, severely dyslexic, and 
physically disabled students.
    The Committee is concerned that hundreds of hours of 
noncommercial educational instructional programming have been 
and are being produced for classroom use, but that this 
programming is not fully accessible through closed captions. 
The Committee therefore urges the Department to make funds 
available in the amount of $750,000 for the captioning of 
noncommercial educational instructional material.
    Also included in the amount provided is $500,000 for a 
project to develop, refine, and disseminate information on 
adaptive technologies. The project would include activities 
such as conducting research, developing state-of-the-art 
personnel preparation programs, and developing a pilot project 
using technology to link parents and their children with 
disabilities, public school districts, community service 
providers with the project. The Committee believes that the 
University of Northern Iowa would be well suited to administer 
such a project because of its long history of exemplary work in 
both personnel development and research.

Readline

    The Committee recommends $1,500,000 for the Readline 
Program, authorized by section 687 (b)(2)(G) of the Individuals 
With Disabilities Education Act, as amended, that would 
disseminate research conducted by the National Institutes of 
Health, as well as other research concerning effective teaching 
strategies, early diagnosis of, and intervention for, young 
children with reading disabilities. The Greater Washington 
Educational Telecommunications Association is well-suited to 
provide information to parents and teachers of young children 
through the publicly funded telecommunications systems and 
would be especially qualified to receive such a grant.

            rehabilitation services and disability research

Appropriations, 1997....................................  $2,509,428,000
Budget estimate, 1998...................................   2,583,376,000
Committee recommendation................................   2,591,286,000

    The Committee recommends $2,591,286,000 for rehabilitation 
services and disability research, $81,858,000 more than the 
1997 appropriation and $7,910,000 more than the administration 
request.

Vocational rehabilitation State grants

    The Committee provides $2,246,888,000 for vocational 
rehabilitation grants to States, which is $70,850,000 more than 
the fiscal year 1997 appropriation and the same as the budget 
request.
    Basic State grant funds assist States in providing a range 
of services to help persons with physical and mental 
disabilities prepare for and engage in meaningful employment. 
Authorizing legislation requires States to give priority to 
persons with the most severe disabilities. Funds are allotted 
to States based on a formula that takes into account population 
and per capita income, and States must provide a 21.3-percent 
match of Federal funds, except the States share is 50 percent 
for the cost of construction of a facility for community 
rehabilitation program purposes. Each State is also required to 
use 1.5 percent of its allotment for innovation and expansion 
activities.
    The Rehabilitation Act requires that no less than 0.5 
percent and not more than 1.5 percent of the appropriation in 
fiscal year 1998 for vocational rehabilitation State grants be 
set aside for grants for Indians. Service grants are awarded to 
Indian tribes on a competitive basis to help tribes develop the 
capacity to provide vocational rehabilitation services to 
American Indians with disabilities living on reservations.

Client assistance

    The Committee bill recommends $10,714,000 for the Client 
Assistance Program, an increase of $322,000 more than the 
fiscal year 1997 appropriation and the same amount recommended 
by the administration request.
    The Client Assistance Program funds State formula grants to 
assist vocational rehabilitation clients or client applicants 
in understanding benefits available to them and in their 
relationships with service providers. Funds are distributed to 
States according to a population-based formula, except each 
State is guaranteed a minimum grant of $100,000 if the 
appropriation exceeds $7,500,000. States must operate client 
assistance programs in order to receive vocational 
rehabilitation State grant funds.

Training

    The Committee provides $39,629,000 for training 
rehabilitation personnel, the same as the 1997 appropriation 
and the administration request.
    The purpose of this program is to ensure that skilled 
personnel are available to serve the rehabilitation needs of 
individuals with disabilities. It supports training, 
traineeships, and related activities designed to increase the 
numbers of qualified personnel providing rehabilitation 
services. The program awards grants and contracts to States and 
public or nonprofit agencies and organizations, including 
institutions of higher education, to pay all or part of the 
cost of conducting training programs. Long-term, in-service, 
short-term, experimental, and innovative and continuing 
education programs are funded, as well as special training 
programs and programs to train interpreters for persons who are 
deaf and deaf-blind.

Special demonstration programs

    The Committee bill includes $20,836,000 for special 
demonstration programs for persons with disabilities, an 
increase of $1,894,000 above the fiscal year 1997 appropriation 
and $3,894,000 more than the administration request.
    This program awards grants to States and nonprofit agencies 
and organizations to develop innovative methods and 
comprehensive services to help individuals with disabilities 
achieve satisfactory vocational outcomes. Special demonstration 
programs support projects for individuals with a wide array of 
disabilities.

Migratory workers

    The Committee recommends $2,350,000 for migratory workers, 
an increase of $500,000 above the 1997 appropriation and the 
same level as the budget request.
    This program provides a 90-percent Federal match for 
comprehensive rehabilitation services to migrant and seasonal 
farm workers with disabilities and their families. Projects 
also develop innovative methods for reaching and serving this 
population. The program emphasizes outreach, specialized 
bilingual rehabilitation counseling, and coordination of 
vocational rehabilitation services with services from other 
sources.

Recreational programs

    The Committee provides $2,596,000 for recreational 
programs, the same as the 1997 appropriation and the 
administration request.
    Recreational programs help finance activities such as 
sports, music, dancing, handicrafts, and art to aid in the 
employment mobility, and socialization of individuals with 
disabilities. Grants are awarded to States, public agencies, 
and nonprofit private organizations, including institutions of 
higher education. Grants are awarded for a 3-year period with 
the Federal share at 100 percent for the first year, 75 percent 
for the second year, and 50 percent for the third year. 
Programs must maintain the same level of services over the 3-
year period.

Protection and advocacy of individual rights

    The Committee recommends $7,894,000 for protection and 
advocacy of individual rights, an increase of $237,000 more 
than the 1997 appropriation and the same as the budget request.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities.

Projects with industry

    The Committee bill includes $22,071,000 for projects with 
industry, the same as the 1997 appropriation and the 
administration request.
    The Projects With Industry [PWI] Program is the primary 
Federal vehicle for promoting greater participation of business 
and industry in the rehabilitation process. PWI provides 
training and experience in realistic work settings to prepare 
individuals with disabilities for employment in the competitive 
job market. Postemployment support services are also provided. 
The program makes grants to a variety of agencies and 
organizations, including corporations, community rehabilitation 
programs, labor and trade associations, and foundations.

Supported employment State grants

    The Committee bill includes $38,152,000 for the Supported 
Employment State Grant Program, the same as the 1997 
appropriation and the budget request.
    This program assists persons who may have been considered 
too severely disabled to benefit from vocational rehabilitation 
services by providing the ongoing support needed to obtain 
competitive employment. Short-term vocational rehabilitation 
services are augmented with extended services provided by State 
and local organizations. Federal funds are distributed on the 
basis of population. In 1997 an estimated 39,000 individuals 
will receive services and it is estimated that approximately 
11,000 will achieve an employment outcome.

Independent living State grants

    The Committee recommends $21,859,000 for independent living 
State grants, which is the same as the amount appropriated in 
1997 and the budget request.
    The independent living State formula grants program 
provides funding to improve independent living services, 
support the operation of centers for independent living, 
conduct studies and analysis, and provide training and 
outreach.

Independent living centers

    For independent living centers, the Committee bill includes 
$46,205,000, which is $2,000,000 above the budget request and 
$3,329,000 over the 1997 appropriation.
    These funds support consumer-controlled, cross-disability, 
nonresidential, community-based centers that are designed and 
operated within local communities by individuals with 
disabilities. These centers provide an array of independent 
living services.

Independent living services for older blind individuals

    The Committee provides $11,947,000 for independent living 
services to older blind individuals, an increase of $1,995,000 
above the 1997 appropriation and the administration request.
    This program provides discretionary grants on a competitive 
basis to State vocational rehabilitation agencies to assist 
persons aged 55 or older to adjust to their blindness by 
increasing their ability to care for their individual needs. 
Services may include the provision of eyeglasses or other 
visual aids, mobility training, braille instruction, guide 
services, reader services, and transportation.

Program improvement

    For program improvement activities, the Committee provides 
$3,900,000, the same as the budget request and $1,509,000 more 
than the 1997 appropriation. In fiscal year 1998, funds for 
these activities will continue to support technical assistance 
efforts to improve the efficiency and effectiveness of the 
vocational rehabilitation program and improve accountability 
efforts and performance measures. The increase will support 
demonstration projects designed to increase the capacity of 
employment and employment training programs to serve 
individuals with disabilities who are not currently being 
served by State vocational rehabilitation agencies.

Evaluation

    The Committee recommends $1,587,000 for evaluation 
activities, the same as the 1997 appropriation and the 
administration request.
    These funds support evaluations of the impact and 
effectiveness of programs authorized by the Rehabilitation Act. 
The Department awards competitive contracts for studies to be 
conducted by persons not directly involved with the 
administration of Rehabilitation Act programs.

Helen Keller National Center

    The Committee bill includes $7,549,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, an increase of 
$212,000 over the 1997 appropriation and $21,000 over the 
budget request.
    The Helen Keller National Center consists of a national 
headquarters in Sands Point, NY, with a residential training 
and rehabilitation facility where deaf-blind persons receive 
intensive specialized services; a network of 10 regional field 
offices which provide referral and counseling assistance to 
deaf-blind persons; and an affiliate network of 45 agencies. At 
the recommended level, the center would serve approximately 90 
persons with deaf-blindness at its headquarters facility and 
provide field services to approximately 2,125 persons.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $71,000,000 for the National 
Institute on Disability and Rehabilitation Research [NIDRR], an 
increase of $1,010,000 over the amount appropriated in 1997 and 
the same as the budget request.
    NIDRR develops and implements a comprehensive and 
coordinated approach to the conduct of research, demonstration 
projects, and related activities enabling persons with 
disabilities to better function at work and in the community, 
including the training of persons who provide rehabilitation 
services or who conduct rehabilitation research. The Institute 
awards competitive grants to support research in federally 
designated priority areas, including rehabilitation research 
and training centers, rehabilitation engineering research 
centers, research and demonstration projects, and dissemination 
and utilization projects. NIDRR also supports field-initiated 
research projects, research training, and fellowships.
    It has been brought to the Committee's attention that 
traumatic brain injury with moderate to severe characteristics 
affects about 2 million people with lifetime costs estimated at 
$37,000,000 per case. It is the No. 1 cause of death and 
disability among children and young people. The Committee has 
included $2,500,000 for traumatic brain injury, an increase of 
$700,000 over the fiscal year 1997 amount to provide models of 
comprehensive services for traumatic brain injury. The increase 
provided will expand the number model system to permit more 
regions of the country to be served by a program. The increase 
is consistent with the goals of the Traumatic Brain Injury Act 
of 1996.
    It has been brought to the Committee's attention that a 
possible breakthrough in voice recognition technology has the 
potential to be of tremendous assistance to millions of 
Americans living with the effects of stroke, cerebral palsy, 
multiple sclerosis, or other diseases that severely impair 
speech. A new voice recognition system based upon frequency 
analysis research that recognizes each voice command as a 
unique sound has proven to correctly interpret even the softest 
of sounds which greatly enhances the applications for elderly 
and those finding vocal projection difficult. The Committee, 
therefore, requests the Department to provide funds to field 
test this new voice recognition technology.
    The Committee urges the Department to provide $850,000 to 
establish a rehabilitation engineering research center. This 
center could operate in cooperation with an institution of 
higher education that is a national leader in rehabilitation 
medicine and engineering research, training, and services to 
focus on the unique rehabilitation needs of landmine survivors, 
including 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 urges the Department to submit a 
detailed plan for the use of these funds and create a timetable 
to begin and implement such a program no more than 120 days 
following enactment of this bill. The Department's efforts 
should be coordinated with the Department to Defense.
    The Committee believes that techniques such as state-of-
the-art electronic technology can be used to develop new 
assisted living programs in neighborhood settings. Computers 
and other electronic features could provide the disabled 
consumer with the maximum amount of individual freedom, safety, 
and productive work stations for private sector employment. The 
Committee urges the Department to provide $1,000,000 to support 
new assisted living programs that develop and demonstrate 
state-of-the-art electronic technology. The Good Shepherd 
Rehabilitation Hospital in Lehigh County, PA, would be 
especially suited to conduct a model demonstration in this 
area.

Technology assistance

    The Committee bill provides $36,109,000 for technology 
assistance, the same as the budget request and fiscal year 1997 
appropriation and the same as the House allowance.
    The Technology Assistance Program is designed to improve 
occupational and educational opportunities and the quality of 
life for people of all ages with disabilities through increased 
access to assistive technology services and devices. It 
provides grants to States to develop comprehensive, consumer 
responsive statewide programs that increase access to, and the 
availability of, assistive technology devices and services. The 
National Institute on Disability and Rehabilitation Research 
administers the program.

           Special Institutions for Persons With Disabilities

                 American printing house for the blind

Appropriations, 1997....................................      $6,680,000
Budget estimate, 1998...................................       6,680,000
Committee recommendation................................       7,906,000

    The Committee recommends $7,906,000 for the American 
Printing House for the Blind [APH], an increase of $1,226,000 
above the budget request and the 1997 appropriation.
    This appropriation helps support the American Printing 
House for the Blind, which provides educational materials to 
students who are legally blind and enrolled in programs below 
the college level. The Federal subsidy provides about 40 
percent of APH's total sales income. Materials are distributed 
free of charge to schools and States through per capita 
allotments based on the total number of students who are blind. 
Materials provided include textbooks and other educational aids 
in braille, large type, and recorded form and microcomputer 
applications.

               national technical institute for the deaf

Appropriations, 1997....................................     $43,041,000
Budget estimate, 1998...................................      43,041,000
Committee recommendation................................      44,141,000

    The Committee recommends an appropriation of $44,141,000 
for the National Technical Institute for the Deaf [NTID], an 
increase of $1,100,000 over the budget request and 1997 
appropriation.
    The Institute, located on the campus of the Rochester 
Institute of Technology, was created by Congress in 1965 to 
provide a residential facility for postsecondary technical 
training and education for persons who are deaf. NTID also 
provides support services for students who are deaf, trains 
professionals in the field of deafness, and conducts applied 
research.

                          gallaudet university

Appropriations, 1997....................................     $79,182,000
Budget estimate, 1998...................................      79,182,000
Committee recommendation................................      81,000,000

    The Committee recommends $81,000,000 for Gallaudet 
University, an increase of $1,818,000 above the amount 
appropriated in 1997 and the administration request.
    Gallaudet University is a private, nonprofit institution 
offering college preparatory, undergraduate, and continuing 
education programs for students who are deaf, as well as 
graduate programs in fields related to deafness for students 
who are hearing-impaired. The university conducts basic and 
applied research related to hearing impairments and provides 
public service programs for the deaf community.
    The Model Secondary School for the Deaf serves as a 
laboratory for educational experimentation and development, 
disseminates models of instruction for students who are deaf, 
and prepares adolescents who are deaf for postsecondary 
academic or vocational education. The Kendall Demonstration 
Elementary School develops and provides instruction for 
children from infancy through age 15.

                     VOCATIONAL AND ADULT EDUCATION

Appropriations, 1997....................................  $1,486,517,000
Budget estimate, 1998...................................   1,565,966,000
Committee recommendation................................   1,486,698,000

    The Committee recommendation includes a total of 
$1,486,698,000 for vocational and adult education, consisting 
of $1,132,147,000 for vocational education, and $354,551,000 
for adult education.

                          Vocational education

    The Committee recommendation of $1,132,147,000 for 
vocational education is $39,819,000 less than the 
administration's request and $181,000 more than the fiscal year 
1997 amount.
    Basic grants.--The Committee has included $1,015,550,000 
for basic grants, the same as the 1997 appropriation and 
$28,000,000 less than the administration request.
    Funds provided under the State grant program assist States, 
localities, and outlying areas, in expanding and improving 
their programs of vocational education and providing equal 
access to vocational education for populations with special 
needs. Persons assisted range from secondary students in 
prevocational courses through adults who need retraining to 
adapt to changing technological and labor market conditions. 
Funds are distributed according to a formula based on State 
population and State per capita income.
    Under the Indian and Hawaiian natives programs, competitive 
grants are awarded to federally recognized Indian tribes or 
tribal organizations and to organizations primarily serving and 
representing Hawaiian natives for services that are in addition 
to services such groups are eligible to receive under other 
provisions of the Perkins Act.
    Tech-prep education.--The Committee recommends $100,000,000 
for tech-prep programs. This is the same as the 1997 
appropriation and $5,000,000 less than the administration 
request. This program is designed to link academic and 
vocational learning and to provide a structured link between 
secondary schools and postsecondary education institutions. 
Funds are distributed to the States through the same formula as 
the basic State grant program. States then make planning and 
demonstration grants to consortia of local educational agencies 
and postsecondary institutions to develop and operate model 4-
year programs that begin in high school and provide students 
with the mathematical, science, communication, and 
technological skills needed to earn a 2-year associate degree 
or 2-year certificate in a given occupational field.
    Tribally controlled postsecondary vocational 
institutions.--The Committee has provided $3,100,000 on a 
current-funded basis for tribally controlled postsecondary 
vocational institutions. This is an increase of $181,000 over 
the fiscal year 1997 appropriation and the administration 
request. This program provides grants for the operation and 
improvement of tribally controlled postsecondary vocational 
institutions to ensure continued and expanded educational 
opportunities for Indian students. Grantee institutions may use 
the funds for costs connected with training teachers, providing 
instructional services, purchasing equipment, administration, 
and operating and maintaining the institution.
    The Committee is concerned that, when awarding grants, the 
Department has not adhered to the statutory requirements 
concerning equitable distribution of funding and equal 
educational opportunity for all Indian students served. The 
Committee urges the Department to follow all statutory 
requirements under section 388 of the act, including the 
provision that the ``per capita payment for any fiscal year 
shall be determined by dividing the amount available for grants 
to tribally controlled postsecondary vocational institutions 
under this part for such program year by the sum of the Indian 
student counts for such institution for such program year.''
    The Committee requests the Department to submit to the 
Committee no later than September 1, 1997, the per capita 
enrollment data it uses to calculate grants made under this 
program.
    The Committee commends the Department for its intention to 
establish an office on tribal colleges and universities and has 
provided sufficient funds for this purpose within the program 
administration budget.
    National programs, research.--The Committee recommends 
$13,497,000 for national research programs, the same as the 
1997 appropriation and $7,000,000 less than the administration 
request.
    The National Center for Research in Vocational Education is 
the only federally funded center charged with the 
responsibility to conduct research and provide technical 
assistance to vocational educators. The results of the applied 
research done by the Center are converted into technical 
assistance to reform and improve vocational education 
instruction in our schools and colleges. The Committee believes 
that the work of the Center is critically important to provide 
state-of-the-art job-related instruction that, in turn, will 
strengthen our Nation's economy.
    Within the funds provided, the Committee urges the 
Department to use $1,500,000 for a demonstration program to 
design and implement a comprehensive project to develop work 
force skills for the Nation's rapidly expanding audio-visual 
communications industry. The program should identify 
appropriate work force career paths, skills for the audio-
visual industry; determine appropriate opportunities for 
applied educational experiences; and establish new vocational 
and academic programs at community colleges to help strengthen 
the level of industry certification. The Educational 
Communications Foundation, in partnership with seven nationwide 
community colleges, would be especially suited to carry out a 
demonstration such as the one described above.

                            Adult Education

    The Committee has included $354,551,000 for adult 
education, $39,449,000 less than the administration request and 
the same as the 1997 appropriation.
    Adult education State programs.--For adult education State 
programs, the Committee recommends $340,339,000, which is 
$41,661,000 less than the administration request and the same 
as the 1997 appropriation. These funds are used by States for 
programs to enable economically disadvantaged 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, evaluation, and technical assistance.--
The Committee has included $4,998,000, the same as the 1997 
appropriation and a decrease of $1,002,000 below the 
administration request.
    National Institute for Literacy.--The Committee recommends 
$4,491,000 for the National Institute for Literacy, authorized 
under section 384(c) of the Adult Education Act, the same 
amount appropriated in 1997 for this purpose and $1,509,000 
less than the budget request. The Institute provides leadership 
and coordination for the national literacy effort by conducting 
research and demonstrations on literacy, providing technical 
assistance through a State capacity building grant program, 
establishing and maintaining a national center for adult 
literacy and learning disabilities, and awarding fellowships to 
outstanding individuals in the field to conduct research 
activities under the auspices of the Institute.
    Literacy programs for prisoners.--The Committee provides 
$4,723,000 for literacy programs for prisoners, the same as the 
1997 appropriation. The administration recommended no funds for 
this purpose. This program provides funds to State and local 
correctional agencies to establish programs that, to the extent 
possible, use advanced technologies to assist persons 
incarcerated in prison, jail, or detention centers to achieve 
functional literacy and life skills. The Committee urges the 
Department to consult with correctional personnel to ensure 
that activities carried out under this authority address the 
most urgent needs of incarcerated individuals.

                      STUDENT FINANCIAL ASSISTANCE

Appropriations, 1997....................................  $7,560,407,000
Budget estimate, 1998...................................   9,263,407,000
Committee recommendation................................   8,557,741,000

    The Committee recommends an appropriation of $8,557,741,000 
for student financial assistance, an increase of $997,334,000 
over the fiscal year 1997 appropriation and $705,666,000 below 
the administration request.

Federal Pell Grant Program

    For Pell grant awards in the 1998-99 academic year, the 
Committee recommends $6,910,334,000.
    Pell grants provide need-based financial assistance that 
helps low- and middle-income students and their families pay 
the costs of postsecondary education and vocational training. 
Awards are determined according to a national need analysis 
formula that takes into account a student's family income and 
assets, household size, and the number of family members 
attending postsecondary institutions. Pell grants are 
considered the foundation of the Federal postsecondary student 
aid system and students must apply for a Pell grant before 
receiving a Federal family education loan.
    This funding amount, when coupled with carryover funding is 
sufficient to raise the maximum Pell grant to $3,000 the 
highest level in the program's history and an increase of $300 
over the maximum grant for 1997.

Federal supplemental educational opportunity grants

    The Committee recommends $634,407,000 for Federal 
supplemental educational opportunity grants [SEOG], an increase 
of $51,000,000 above the 1997 appropriation level and the 
budget request.
    This program provides funds to postsecondary institutions 
for need-based grants to undergraduate students. Institutions 
must contribute 25 percent of SEOG awards, which are subject to 
a maximum grant level of $4,000. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell grant recipients.

Federal work-study programs

    The Committee bill provides $830,000,000 for the Federal 
Work-Study Program, the same as the 1997 level, which is 
$27,000,000 less than the administration request. This program 
provides grants to approximately 3,700 institutions to help 
more than 945,000 undergraduate, graduate, and professional 
students meet the costs of postsecondary education through 
part-time employment. Work-study jobs must pay at least the 
Federal minimum wage and institutions must provide 25 percent 
of student earnings. Institutions also must use at least 5 
percent of their grants for community-service jobs.
    The Committee supports continuing funding for the work 
colleges authorized in section 448 of the Higher Education Act. 
The Department should continue to provide funding for work-
service-learning at the six eligible institutions as a 
percentage of the overall Federal work study appropriation. The 
Committee believes that the community service requirements, as 
part of the student's overall academic program, are especially 
compatible with the administration's America reads initiative.

Federal Perkins loans

    The Committee bill includes $158,000,000 for Federal 
Perkins loans capital contributions, which is the same as the 
1997 appropriation and the budget request.
    The Federal Perkins Loan Program supports student loan 
revolving funds built up with capital contributions to about 
2,700 participating institutions over the past 30 years. 
Institutions use these revolving funds, which also include a 
25-percent institutional match and student repayments, to 
provide low-interest (5 percent) loans that help financially 
needy students pay the costs of postsecondary education. The 
Committee has included the amount necessary to maintain the 
current loan volume level.
    The Committee bill also includes $25,000,000 for loan 
cancellations, an increase of $5,000,000 over the 1997 level 
and $5,000,000 below the amount requested by the 
administration. These funds reimburse institutional revolving 
funds on behalf of borrowers who perform statutorily specified 
types of public or military service, such as working in a Head 
Start Program, serving in the Peace Corps or VISTA, or teaching 
in a low-income school. The additional funds are necessary 
because of the growth in the outstanding loan volume and the 
expanded eligibility for cancellations as a result of the 1992 
amendments to the Higher Education Act.

State student incentive grants

    For the State Student Incentive Grant Program [SSIG], the 
Committee agrees with the budget request and includes no 
funding for this program. The 1997 appropriation was 
$50,000,000. The ``National Performance Review'' concluded that 
the SSIG program has achieved its purpose of providing 
incentive grants to States. Today, all 50 States and the 
District of Columbia have need-based State grant programs and 
almost all States overmatch their SSIG allotments. In award 
year 1996-97, SSIG funding accounted for only 2 percent of the 
total State grant aid. This recommendation is consistent with 
the multiyear phaseout of the program proposed in 1996.
    The Committee recognizes the importance of a student aid 
program that leverages money from the States into need-based 
financial assistance, but at the same time, sees the need to 
reevaluate the current structure of SSIG program. The Committee 
believes student assistance should include an ongoing source of 
Federal support which encourages and leverages State 
contributions. Thus, the Committee expects that the program be 
thoroughly evaluated and modified during reauthorization of the 
Higher Education Act.

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

Appropriations, 1997....................................     $46,482,000
Budget estimate, 1998...................................      47,688,000
Committee recommendation................................      46,482,000

    The Committee recommends $46,482,000 for discretionary 
Federal administrative expenses related to the Federal Family 
Education Loan [FFEL] Program, formerly known as the Guaranteed 
Student Loan Program. The amount recommended is $1,206,000 
below the budget request and the same appropriated in fiscal 
year 1997.
    Funds appropriated for Federal administrative expenses will 
partially cover the fiscal year 1998 salaries and benefits, 
travel, printing, contracts, and other expenses associated with 
the program, including payment and claims processing, reducing 
loan default costs, and program monitoring. This discretionary 
administrative funding is included in the ``Federal family 
education loans'' appropriation account rather than under the 
Department's ``Salaries and expenses'' account pursuant to a 
requirement of the Federal Credit Reform Act of 1990.
    The FFEL Program is administered through State and private 
nonprofit guarantee agencies that insure loans directly, 
collect defaulted loans, and provide various services to 
lenders. The Federal Government supports the guarantee agencies 
by providing loan advances and reinsurance payments for 
borrower default, death, disability, and bankruptcy. The 
Federal Government also pays administrative cost allowances to 
guaranty agencies under section 458 of the Higher Education 
Act.
    The Federal Government also pays an interest subsidy to 
lenders, based on the borrower's interest rate, on behalf of 
Stafford loan student borrowers while they are in school and 
during certain grace and deferment periods. To be eligible for 
this subsidy, students must demonstrate financial need. Federal 
Stafford loans may be borrowed by eligible students, regardless 
of their school year or dependency status. Borrowing limits are 
tied to the extent of need, for the cost of attendance minus an 
expected family contribution, and other aid as determined by an 
approved need analysis system.
    Under the HEA reauthorization of 1992, a new unsubsidized 
Stafford Loan Program for middle-income borrowers provides 
federally reinsured loans to borrowers who do not qualify for 
Federal interest subsidy payments under the need-based Stafford 
Loan Program. Except for the interest benefit and certain loan 
limits, all other terms and conditions of the Federal Stafford 
Loan Program apply to the unsubsidized Stafford loans.
    Federal PLUS loans are made to parents of dependent 
undergraduate students. Interest rates for PLUS loans are 
usually higher than those for Federal Stafford loans, and the 
Federal Government does not pay the interest during in-school, 
grace, and deferment periods. No need analysis is required, but 
borrowing cannot exceed cost of attendance minus other aid.
    The Committee has not included bill language, carried in 
previous years, regarding the payment of administrative cost 
allowances [ACA] to guaranty agencies, because language 
regarding this issue was included in both the House and Senate 
versions of the budget reconciliation bills. The Committee 
understands that the budget reconciliation conferees are 
currently working on language to be included in the final 
agreement. This language will require the payment of ACA on new 
loans guaranteed on or after the date of enactment of the 
reconciliation bill, at the rate of 0.85 percent. However, to 
the extent that there is a shortfall in the funding of ACA for 
fiscal year 1997, prior to the date the reconciliation bill is 
enacted, it is the Committee's intent to include sufficient 
funds to cover that shortfall in the final fiscal year 1998 
Labor, Health and Human Services and Education appropriations 
bill. Further however, if language regarding ACA is not 
included in the budget reconciliation conference agreement, it 
is the Committee's intention to instead include language that 
will specify the amount of ACA paid to guaranty agencies for 
fiscal year 1997; include a requirement that for fiscal year 
1998, the Department of Education shall pay ACA to guaranty 
agencies, calculated on the basis of 0.85 percent of the total 
principal amount of insured loans; and, require that such 
payments be made on a quarterly basis.

                            HIGHER EDUCATION

Appropriations, 1997....................................    $879,048,000
Budget estimate, 1998...................................   1,035,292,000
Committee recommendation................................     929,752,000

    The Committee recommends an appropriation of $929,752,000 
for higher education programs, $50,704,000 more than the 1997 
amount and $105,540,000 below the budget request. The Committee 
has included no funds for the new merit-based scholarship 
program proposed to be funded at $132,000,000.

Aid for institutional development

    The Committee recommends $196,046,000 for aid for 
institutional development authorized by title III of the Higher 
Education Act, an increase of $1,200,000 over the 1997 
appropriation and $6,025,000 below the budget request.
    Strengthening institutions.--The Committee bill includes 
$55,450,000 for the part A Strengthening Institutions Program, 
the same as the 1997 level and the budget request. The part A 
program supports competitive, 5-year development grants for 
institutions with a significant percentage of financially needy 
students and low educational and general expenditures per 
student in comparison with similar institutions. Applicants may 
use part A funds to develop faculty, strengthen academic 
programs, improve institutional management, and expand student 
services.
    Hispanic-serving institutions [HSI].--The Committee 
recommends $12,000,000 for the section 316 set-aside for 
institutions at which Hispanic students make up at least 25 
percent of enrollment, an increase of $1,200,000 over the 1997 
level and the same as the administration request. The Committee 
has included bill language which is, consistent with the budget 
request overriding 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. Institutions applying for section 316 funds must 
meet the regular part A requirements and show: (1) that at 
least one-half of their Hispanic students are low-income, 
first-generation college students, and (2) that another one-
quarter of their Hispanic enrollments are either low-income or 
first-generation college students. In addition to the regular 
part A purposes, funds may be used for acquisition of 
scientific or laboratory equipment, renovation of instructional 
facilities, and purchase of educational materials. Section 316 
recipients are not eligible for other awards provided under 
part A.
    Strengthening historically black colleges and 
universities.--The Committee provides $108,990,000 for part B 
grants, the same as the 1997 level, and $4,010,000 below the 
administration request. The part B Strengthening Historically 
Black Colleges and Universities [HBCU] Program makes formula 
grants to HBCU's that may be used to purchase equipment, 
construct and renovate facilities, develop faculty, support 
academic programs, strengthen institutional management, enhance 
fundraising activities, provide tutoring and counseling 
services to students, and conduct outreach to elementary and 
secondary school students. The minimum allotment is $500,000 
for each eligible institution. Part B recipients are not 
eligible for awards under part A.
    Strengthening historically black graduate institutions.--
The Committee bill includes $19,606,000 for the part B, section 
326 program, the same as the 1997 level, and the administration 
request. The section 326 program provides 5-year grants to 
strengthen historically black graduate institutions [HBGI's]. 
The Higher Education Amendments of 1992 increased the number of 
recipients to 16 named institutions, but reserved the first 
$12,000,000 appropriated each year to the first 5 institutions 
included in the original authorization. Grants may be used for 
any part B purpose and to establish an endowment.
    The Committee continues to support the strengthening and 
expansion of assistance to historically black colleges and 
university graduate and professional schools/programs. HBCU's 
continue to provide a disproportionate share of the African-
American doctors, dentists, lawyers, and doctorates in the 
physical and natural sciences and mathematics, as well as 
serving as undergraduate feeder institutions for traditionally 
white institutions that contribute to reversing the under 
representation of minority professionals and doctorates. 
Although the Committee is providing level funding in its bill, 
the Committee does not believe that funding to the existing 16 
graduate and professional schools and programs should be 
reduced. Assuming an institution continues to qualify and meet 
the matching requirements above the minimum award level--no 
institution or qualified graduate program should receive less 
funding in fiscal year 1998 than it did in fiscal year 1997.
    The Committee believes that the Department of Education has 
previously misconstrued the matching requirements in section 
326(a)(2) of the Higher Education Act. Each participating 
professional and graduate institution, or qualified graduate 
program is eligible to receive $500,000 minimum allocation that 
must be matched with an equal amount from non-Federal sources. 
The Department has previously required those participating 
institutions that elected to match, to also match the initial 
$500,000. This is inconsistent with congressional intent and 
discourages eligible institutions from matching funds.
    Endowment challenge grants.--The Committee bill does not 
provide funding for part C endowment challenge grants. No funds 
were provided for this purpose in fiscal year 1997. The 
administration requested $2,015,000 for this program. These 
funds enable eligible institutions to establish or increase 
institutional endowment funds.
    While the Committee has not seen fit to restore funding for 
this program, the Committee does believe that endowment 
building represents an important fiscal insurance for smaller, 
less financially stable colleges and universities. We have 
accepted an approach incorporated in the house bill--which 
allows institutions participating in part A and part B to use 
up 20 percent of their grant amount for endowment building 
purposes.

Fund for the improvement of postsecondary education

    The Committee recommends $30,000,000 for the fund for the 
improvement of postsecondary education [FIPSE], which is 
$12,000,000 more than the 1997 appropriation and the 
administration request. FIPSE stimulates improvements in 
education beyond high school by supporting exemplary, locally 
developed projects that have potential for addressing problems 
and recommending improvements in postsecondary education. The 
fund is administered by an independent board that provides 
small, competitive grants and contracts to a variety of 
postsecondary institutions and agencies, including 2- and 4-
year colleges and universities, State education agencies, 
community-based organizations, and other institutions and 
organizations concerned with education beyond high school.
    The Committee believes that an exemplary program is needed 
to encourage underrepresented groups, such as women and 
minorities, to enter careers in the fields of science, 
technology, engineering, and mathematics. Many business and 
industrial communities have established relationships with 
postsecondary institutions to provide the type of career-
oriented technical education programs described above. The 
Committee encourages the Department to provide $1,000,000 to 
conduct a competition to encourage postsecondary institutions 
to enhance their management, professional development, and 
academic programs, to meet the technical education needs of the 
business and industrial communities and to foster strong 
relationships with these communities. An institution such as 
the Pennsylvania Institute of Technology would be especially 
suited in providing career-oriented technical education in the 
areas described above.
    It has been brought to the Committee's attention that a 
program being implemented at Prairie View A&M University in 
Texas provides a unique and effective means for enhancing the 
academic skills and future success of incoming college freshmen 
who are at risk to not complete their education. This 
innovative program entitled academy for collegiate excellence 
and student success [ACCESS] envisions a training component for 
personnel at other universities to build upon the model now 
being developed at Prairie View A&M. The Committee urges the 
Secretary to provide $1,000,000 for a project such as the one 
discribed above.
    The Committee urges the Department to provide $1,000,000 
for the establishment of a center to provide in-state 
laboratory testing for businesses, and training for high school 
graduates in the use of scientific testing equipment and 
techniques. This Center would provide the hands-on training 
needed to pursue good-paying product testing or science 
oriented jobs. The Vermont Science and Education Center, 
located in St. Albans, VT, would be especially suited to carry 
out such a program.
    The Committee encourages the Department to use $2,000,000 
for a demonstration project that could serve as a model for 
cooperation between community colleges and State universities. 
A project which allows students at a community college to 
receive course credit toward a 4-year degree could serve as a 
model for making the limited resources of universities 
accessible and affordable to anyone who wants to pursue a 
higher education. The Community College in Onslow County, NC, 
and the University of North Carolina at Wilmington have been 
working on a project such as the one described above and would 
be especially suited to conduct such a demonstration.
    The Committee urges the Department to provide $2,000,000 
for demonstrations to establish a comprehensive voice-video 
data network, to allow students to link up with instructors in 
other classes from around the State and the world. The project 
should include statewide access to the faculty, research and 
library resources, and professional development programs. The 
Empire State College in New York and Rutgers University in New 
Jersey would be especially suited to carry out demonstration 
projects such as the ones described above.
    The Committee urges the Secretary to use $180,000 within 
the funds provided for a project to expand cooperative 
education beyond the traditional focus of placing students in 
business settings. The expanded program would focus on faculty 
development, student development and employer development. The 
faculty development program would place faculty in business 
settings and bring business, cooperative and manufacturing 
representatives into the academic environment. The student 
development initiative would focus on developing mentoring 
activities to improve interviewing and job search skills. The 
employer program would benefit by utilizing both student and 
faculty in the business setting, as well as by establishing a 
faculty/employer exchange program. The Committee urges the 
Department to give full consideration to an application from 
North Dakota State University for such a project.
    It has been brought to the Committee's attention that a 
group of Kansas universities has been processing and 
disseminating information generated through a model distance 
learning program for continuing education in rural areas. 
Augmenting production and distribution capabilities will make 
courseware more accessible, flexible and interactive than 
current distance learning systems. The Committee has included 
$1,000,000 for a project such as the one described above. The 
Committee encourages full and fair consideration to a proposal 
from this consortium of Kansas universities.
    The Committee urges the Department to provide $1,000,000 
for a program modeled after the Linking International Trade 
Program at Bryant College, located in Smithfield, RI. This 
program utilizes interactive video conferencing, as well as an 
international trade data base that enables students to learn 
about global economic statistics, international industries and 
trade, and business trends.
    The Committee urges the Department to provide $300,000 for 
a project such as the Hispanic education technology system, 
modeled after the distance education programs pioneered in 
engineering and agriculture. This system, a collaboration among 
nine institutions including the University of New Mexico, would 
support staff training and course development that would serve 
the needs of Hispanics for distance learning opportunities.
    It has come to the Committee's attention that the Southeast 
Missouri State University's planned technical education center 
is serving as a regional staging point for the coordinated 
delivery of technical education in cooperation with community 
colleges and vocational technical schools. Southeast Missouri 
State University serves a 24-county area that is included, as 
defined by Federal statute, in the Lower Mississippi Delta 
region. The Lower Mississippi Delta Development Commission has 
identified it as the poorest region in the United States, 
lagging in industrial development, having high dropout rates, 
and limited technical educational opportunities. The Committee 
urges the Department to provide $2,000,000 for a high-tech 
computer integrated manufacturing equipment center. Southeast 
Missouri State University would be especially suited to carry 
out a demonstration in this area.
    The Committee has provided $500,000 for a demonstration 
project that would serve as the staging point for the 
coordinated delivery of technical education in cooperation with 
community colleges and vocational technical schools. The 
Advanced Technical Center in Mexico, MO, would be particularly 
suited to carry out such a project.
    The Committee has included $2,000,000 for a demonstration 
project to implement a resource-sharing video conferencing 
network. The Pennsylvania Telecommunications Exchange Network 
is currently carrying out such a project and the Committee 
urges the Department to give full and fair consideration to the 
Network when funds are awarded for such a demonstration.

Minority teacher recruitment

    The Committee recommends $2,212,000 for the Minority 
Teacher Recruitment Program, which is the same as the 1997 
appropriation, and $1,515,000 below the budget request. This 
program, authorized by the Higher Education Amendments of 1992, 
is designed to increase the numbers of African-Americans, 
Hispanics, native Americans, and other minorities in the 
teaching profession. Partnership projects identify students 
with an interest in entering the teaching profession and 
provide support services such as scholarship funds, tutoring, 
and academic counseling. Teacher placement projects prepare 
minority students to become elementary and secondary 
schoolteachers and help place these students in schools with at 
least 50 percent minority enrollment.

Minority science improvement

    The Committee recommends $5,255,000 for the Minority 
Science Improvement Program [MSIP], the same as the 1997 level 
and the administration request. This program provides 
discretionary grants to institutions with minority enrollments 
greater than 50 percent to purchase equipment, develop 
curricula, and support advanced faculty training. Grants are 
intended to improve science education programs and increase the 
number of minority students in the fields of science, 
mathematics, and engineering.

International education and foreign language studies

    The bill includes a total of $60,351,000 for international 
education programs, $600,000 more than the 1997 level and 
$100,000 above the budget request.
    Domestic programs.--The Committee recommends $53,481,000 
for domestic program activities related to international 
education and foreign language studies, including international 
business education, under title VI of the HEA. This is the same 
as the 1997 appropriation and the administration request. 
Domestic programs include national resource centers, 
undergraduate international studies and foreign language 
programs, international studies and research projects, 
international business education projects and centers, American 
overseas research centers, language resource centers, and 
foreign language and area studies fellowships.
    Overseas programs.--The bill includes $5,870,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This is $600,000 above the 1997 level and 
$100,000 above the budget request. Under these overseas 
programs, grants are provided for group and faculty research 
projects abroad, doctoral dissertation research abroad, and 
special bilateral projects. Unlike other programs authorized by 
the Fulbright-Hays Act and administered by the U.S. Information 
Agency, these Department of Education programs focus on 
training American instructors in order to improve foreign 
language and area studies education in the United States.
    The Committee is aware of the success of the American 
Overseas Research Center Program, and commends the Department 
for its support of the Centers. However, the Committee is 
concerned that qualified applicants were denied awards due to 
the overall funding limits. To support more overseas centers, 
the Committee urges the Secretary to allocate the additional 
$100,000 for grants to additional centers to be awarded on a 
competitive basis.
    Institute for International Public Policy.--The Committee 
bill recommends $1,000,000 for the Institute for International 
Public Policy, the same as the 1997 appropriation and the 
budget request. This program is designed to increase the number 
of minority individuals in foreign service and related careers 
by providing a grant to a consortium of institutions for 
undergraduate and graduate level foreign language and 
international studies. An institutional match of 25 percent is 
required.

Urban community service

    The Committee recommends $4,900,000 for urban community 
service program, a decrease of $4,300,000 below the fiscal year 
1997 appropriation. The budget requested no funding for this 
purpose. This program provides grants to urban universities to 
encourage community involvement in solving the social and 
economic problems of the urban area which they serve. Other 
programs within the Department of Education, the Department of 
Health and Human Services and the Department of Housing and 
Urban Development carry out a variety of community development 
activities to help urban areas solve local community problems. 
The recommendation will be a 2-year phaseout of the program and 
is sufficient to continue funding of existing grantees.

Youth offender grants

    The Committee has included $15,000,000 for a program 
authorized by part E of title X of the Higher Education Act. No 
funds were included for this program in fiscal year 1997 or 
requested by the administration. This new program provides 
grants to State correctional education agencies to assist and 
encourage incarcerated youth to acquiring functional literacy, 
life and job skills, through the pursuit of a postsecondary 
education certificate, an associate of arts or bachelor's 
degree. Grants will also assist correction agencies in 
providing employment counseling and other related services that 
start during incarceration and continue through prerelease and 
while on parole. Each student is eligible for a grant of not 
more than $1,500 annually for tuition, books, and essential 
materials, and not more than $300 annually for related services 
such as career development, substance abuse counseling, 
parenting skills training, and health education. In order to 
participate in a program, a student must be no more than 25 
years of age and be eligible to be released from prison within 
5 years. Youth offender grants are for a period not to exceed 5 
years, 1 year of which may be devoted to study in remedial or 
graduate education.

Interest subsidy grants

    The Committee recommends $13,700,000 for interest subsidy 
grants, the same as the administration request and $1,973,000 
less than the 1997 level. This appropriation is required to 
meet the Federal commitment to pay interest subsidies on 
approximately 300 loans made in past years for constructing, 
renovating, and equipping postsecondary academic facilities. No 
new interest subsidy commitments have been entered into since 
1973 but subsidy payments on existing loans are expected to 
continue until the year 2013.

Bethune Memorial Fine Arts Center

    The Committee recommends $1,400,000 for the Bethune 
Memorial Fine Arts Center. This is the same as the 1997 
appropriation. The administration requested no funds for this 
purpose.

Federal TRIO programs

    The Committee bill includes $525,000,000 for Federal TRIO 
programs, the amount requested by the administration and 
$25,006,000 above the 1997 appropriation.
    TRIO programs provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students: upward bound 
offers disadvantaged high school students academic services to 
develop the skills and motivation needed to continue their 
education; student support services provides remedial 
instruction and counseling to disadvantaged college students to 
help them complete their postsecondary education; talent search 
identifies and counsels individuals between ages 12 and 27 
regarding opportunities for completing high school and 
enrolling in postsecondary education; educational opportunity 
centers provide information and counseling on available 
financial and academic assistance to adults who are low-income 
and first-generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in graduate 
programs.
    The additional funds provided will permit more intensive 
outreach services to low-income youth and to assist in 
preparing these students for postsecondary education. The 
Committee also urges the Department to expand the role of TRIO 
in providing out-of-school access to modern learning 
technologies for low-income youth. The Committee further urges 
the Department to use a portion of the increase provided to 
extend talent search and educational opportunity center 
services to additional youth and adults.

National early intervention scholarships and partnerships

    The Committee bill includes $3,600,000 for this program of 
grants to States for projects that provide mentoring, outreach, 
counseling, and academic support for at risk students. This is 
the same as the 1997 appropriation. The administration 
requested no funds for this purpose. This program is intended 
to provide incentives for States to combine TRIO-type outreach 
activities with a State guarantee of college tuition assistance 
that will encourage low-income elementary and secondary school 
students to stay in school, earn their high school diplomas, 
and pursue postsecondary education.

Advanced placement fees

    The Committee recommends $3,000,000 for the new advanced 
placement fees program. The administration requested $6,000,000 
for this purpose. This program awards grants to States to 
enable them to cover part or all of the cost of advanced 
placement test fees of low-income individuals who are enrolled 
in an advanced placement class and plan to take an advanced 
placement test.

Byrd honors scholarships

    The Committee recommends $39,288,000 for the Byrd Honors 
Scholarship Program, the amount recommended by the 
administration and an increase of $10,171,000 over the 1997 
appropriation.
    The Byrd Honors Scholarship Program is designed to promote 
student excellence and achievement and to recognize 
exceptionally able students who show promise of continued 
excellence. Funds are allocated to State education agencies 
based on each State's school-aged population. The State 
education agencies select the recipients of the scholarships in 
consultation with school administrators, teachers, counselors, 
and parents. The increase provided will fund a new cohort of 
first-year students in 1998, and continue support for the 1995, 
1996, and 1997 cohorts of students in their fourth, third and 
second years of study, respectively.

Presidential honors scholarships

    The Committee recommends no funding for the Presidential 
honors scholarships program. This new initiative would reward 
the excellence and achievement of the top 5 percent of 
graduating high school students in every high school in the 
Nation by providing a 1-year $1,000 scholarship to these 
students for use in postsecondary study. The Committee has 
deferred consideration of this request until the authorizing 
legislation has been signed into law.

George H.W. Bush fellowships

    The Committee has provided no funding for the George H.W. 
Bush Fellowship Program in fiscal year 1998, the same as the 
administration's request. In fiscal year 1997, the program 
received $3,000,000, the full amount allowed by the authorizing 
statute. A grant was awarded to assist in the establishment of 
the George Bush Fellowship Program, located at the George Bush 
School of Government and Public Service of the Texas A&M 
University. The Bush Fellowship Program would help the most 
qualified individuals from all parts of the country to obtain 
advanced degrees in public administration and international 
affairs.

Edmund S. Muskie Foundation

    The Committee recommends no funding in fiscal year 1998 for 
the Edmund S. Muskie Foundation, the same as the 
administration's request. A one-time appropriation of 
$3,000,000 was included in the fiscal year 1997 appropriation 
to establish an endowment fund.

Pell Institute for International Relations

    The Committee recommends no funding for the Pell Institute 
for International Relations in fiscal year 1998, the same as 
the administration's request. A one-time appropriation of 
$3,000,000 was provided for this purpose in fiscal year 1997.

Calvin Coolidge Memorial Foundation

    The Committee recommends no funding for the Calvin Coolidge 
Memorial Foundation in fiscal year 1998, the same as the 
administration's request. A one-time appropriation of 
$1,000,000 was provided in fiscal year 1997 to conduct 
education, archival, and preservation activities of the 
Foundation.

Javits fellowships

    The Committee concurs with the administration in not 
recommending separate funding for Javits fellowships but 
provides $5,931,000 under the graduate assistance in areas of 
national need [GAANN] program to fund the Javits fellowships at 
the same level as in fiscal year 1997. The funds will provide 
an estimated $2,556,000 for new awards and an estimated 
$3,375,000 for noncompeting continuation awards.
    This program provides fellowships to students of superior 
ability for doctoral study in the arts, humanities, and social 
sciences. The fellowships are awarded through a national 
competition and recipients pursue graduate study at the 
institutions of their choice.

Graduate assistance in areas of national need

    The Committee recommends $30,000,000 for graduate 
assistance in areas of national need, the same as the budget 
request and $5,931,000 above the 1997 level. This program 
awards competitive grants to graduate academic departments and 
programs for fellowship support in areas of national need as 
determined by the Secretary. The program is currently 
supporting study in mathematics, physics, biology, chemistry, 
engineering, and computer and information sciences. Recipients 
must demonstrate financial need and academic excellence, seek 
the highest degree in their fields, and plan teaching or 
research careers.
    The Committee provides $5,931,000 to fund the Javits 
fellowships at the same level as in fiscal year 1997 under the 
GAANN program. The Javits Program is of particular importance 
as a mechanism for supporting America's next generation of 
leaders in the arts, humanities, and social studies and 
although the Committee has consolidated funding within the 
Graduate Assistance Program, this action was taken to 
streamline programs. It is the Committee's intention that the 
merit-based Javits Fellowships Program remain an active and 
identifiable program.

                           howard university

Appropriations, 1997....................................    $196,000,000
Budget estimate, 1998...................................     196,000,000
Committee recommendation................................     198,000,000

    The Committee recommends an appropriation of $198,000,000 
for Howard University, which is $2,000,000 above the 1997 
appropriation, and the budget request. Howard University is 
located in the District of Columbia and offers undergraduate, 
graduate, and professional degrees through the 16 schools and 
colleges. The university also administers the Howard University 
Hospital, which provides both inpatient and outpatient care, as 
well as training in the health professions. Federal funds from 
this account support about 50 percent of the university's 
projected educational and general expenditures, excluding the 
hospital.
    Undistributed.--The Committee bill provides $168,511,000 in 
undistributed funds, which is $2,000,000 above the 1997 level 
and the administration request. Of the $168,511,000 in 
undistributed funds, Howard must allocate at least $3,530,000 
for the endowment program. 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 Committee notes that the 
authority under which funds are appropriated for Howard permits 
expenditures for, among other things, academic services, 
financial support of students, contribution to the university 
endowment, or construction.
    Howard University Hospital.--The Committee recommends 
$29,489,000 for the Howard University Hospital, the same as the 
1997 level and the budget request. The hospital serves as a 
major acute and ambulatory care center for the District of 
Columbia and functions as a major teaching facility attached to 
the university that trains physicians in 17 specialty areas. 
The Federal appropriation provides partial funding for the 
hospital's operations.

             college housing and academic facilities loans

Appropriations, 1997....................................        $698,000
Budget estimate, 1998...................................       1,069,000
Committee recommendation................................         698,000

    Federal administration.--The Committee bill includes 
$698,000 for Federal administration of the CHAFL program, the 
same as the 1997 level and $371,000 below the administration 
request.
    These funds will be used to reimburse the Department for 
expenses incurred in managing the existing CHAFL loan portfolio 
during fiscal year 1998. These expenses include salaries and 
benefits, travel, printing, contracts (including contracted 
loan servicing activities), and other expenses directly related 
to the administration of the CHAFL Program.

  historically black college and university capital financing program

Appropriations, 1997....................................        $104,000
Budget estimate, 1998...................................         104,000
Committee recommendation................................         104,000

    Federal administration.--The Committee recommends $104,000 
for Federal administration of the Historically Black College 
and University [HBCU] Capital Financing Program, the same as 
the administration request and the 1997 level.
    The HBCU Capital Financing Program makes capital available 
to HBCU's for construction, renovation, and repair of academic 
facilities by providing a Federal guarantee for private sector 
construction bonds. Construction loans will be made from the 
proceeds of the sale of the bonds.

            education research, statistics, and improvement

Appropriations, 1997....................................    $331,161,000
Budget estimate, 1998...................................     425,693,000
Committee recommendation................................     362,225,000

    The bill includes $362,225,000 for educational research, 
statistics, assessment, and improvement programs. This amount 
is $31,064,000 above the 1997 appropriation and $63,468,000 
below the administration request. This account supports 
education research, statistics, and assessment activities, as 
well as a variety of other discretionary programs for 
educational improvement.

Research

    The Committee recommends $72,567,000 for educational 
research, the same as the 1997 appropriation and $8,468,000 
below the budget request. Research activities are conducted by 
the Office of Educational Research and Improvement [OERI], 
which was reauthorized by the Educational Research, 
Development, Dissemination, and Improvement Act of 1994.
    These funds support research, development, dissemination, 
and technical assistance activities which are aimed at 
expanding fundamental knowledge of education and promoting the 
use of research and development findings in the design of 
efforts to improve education.
    The Committee has included $53,500,000 for regional 
educational laboratories, the same as the administration 
request and $2,500,000 above the 1997 appropriation.

Statistics

    The Committee recommends $52,000,000 for data gathering and 
statistical analysis activities of the National Center for 
Education Statistics [NCES], the same as the fiscal year 1997 
appropriation and a decrease of $14,250,000 below the 
administration request.
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
Technical assistance to State and local education agencies and 
postsecondary institutions is also provided by the Center.

Assessment

    The Committee recommends $29,752,000 for assessment, the 
same amount appropriated in fiscal year 1997 and $5,750,000 
below the administration request.
    The National Center for Education Statistics uses these 
funds to administer the national assessment of educational 
progress [NAEP], a 20-year-old congressionally mandated 
assessment created to measure the educational achievement of 
American students. The primary goal of NAEP is to determine and 
report the status and trends over time in educational 
achievement, subject by subject. NAEP has been expanded in 
recent years to include State representative assessments as 
well.
    Also included is $2,871,000 for the National Assessment 
Governing Board, the same amount requested by the 
administration and $6,000 more than the fiscal year 1997 
appropriation.

Fund for the improvement of education

    The Committee bill provides $50,000,000 for the fund for 
the improvement of education [FIE], which is $10,000,000 more 
than the 1997 appropriation and the administration request. 
This program provides the Secretary with broad authority to 
support nationally significant programs and projects to improve 
the quality of education, help all students meet high academic 
standards, and contribute to the achievement of the national 
education goals. The statute also authorizes support for 
specific activities, such as counseling and mentoring, 
comprehensive health education, and environmental education.
    The Committee encourages the Department to provide $750,000 
for a demonstration project to assist second grade students who 
need help with reading. This project should address the 
problems of reading fluency and comprehension before a pattern 
of continued long-term failure is established, and identify and 
eliminate the gap between students with reading problems and 
skilled readers. The reading together USA project has been 
training fifth grade tutors to assist second grade students to 
improve their reading skills and would be especially suited to 
carry out a demonstration in this area.
    The Committee recognizes that there continues to be a gap 
in the reading and writing scores of African American students 
and other student populations. According to research at the 
University of Pennsylvania, no matter what teaching methods are 
used and even when minority children from inner cities begin 
school at the same level as all others, they do progressively 
worse until graduation. For those who stay in school until 
graduation, the research has found that the majority are in the 
lowest 16th percentile. This performance differential is 
particularly pronounced for African American children. 
Preliminary findings suggest that this differential, in part, 
may be explained by the language usage patterns of African 
Americans. The Committee urges the Department to provide 
$1,000,000 to support a university-based research project with 
an emphasis on university consortium efforts which target 
inner-city, public schools, that would evaluate the 
relationship between the language usage patterns of African 
American students and their ability to read and write standard 
English. The University of Pennsylvania would be especially 
suited to carry out such a project.
    The Committee concurs with the administration request and 
has included within the total provided $6,520,000 for character 
education partnership grants. These funds will continue the 
existing 12 grants as well as provide for approximately 16 new 
grants. Funds are used for the design and implementation of 
programs that incorporate the six elements of character 
identified in the statute: caring, civic virtue and 
citizenship, justice and fairness, respect, responsibility, and 
trustworthiness.
    The Committee urges the Department to provide $1,000,000 
for a demonstration project designed for children in grades 
three through nine who are educationally and/or socially at 
risk for school failure. The program should focus on students 
whose educational success is impaired due to difficulties in 
peer and adult relationships, who lack self esteem or the 
ability to make decisions. The project should focus on a 
program which provides a challenging educational environment 
including social, emotional, and academic support which will 
enable students to take full advantage of educational 
opportunities. A joint venture between the Newport News Public 
Schools System, the city of Newport News, the local business 
community and the nonprofit Achievable Dream Foundation is 
currently operating a program and would serve as an excellent 
model to demonstrate such a program.
    The Committee is aware that the Women in Natural Sciences 
Program, developed and managed by the Academy of Natural 
Sciences, provides science enrichment for talented minority and 
underserved 9th and 10th grade female students. Participants 
must be financially needy, be enrolled in a Philadelphia public 
school and live in a household where one or both parents are 
absent. The Committee encourages the Department to provide 
$1,000,000 to support an expansion of the program, which will 
permit the dissemination of information and an evaluation 
component.
    The Committee urges the Secretary to provide $3,000,000 for 
activities to extend the time for learning within or beyond the 
school year or day. Funds will be used to provide grants to 
schools and local education agencies to conduct outreach to and 
consult with parents, teachers, community leaders, and other 
stakeholders including students, where appropriate, to 
determine the feasibility of extending time for learning. The 
Committee notes that several Iowa school districts, including 
the Sioux City Community School District, the Creston Community 
School District, and the Ankeny Community School District, are 
looking at ways to extend the time for learning and would be 
ideally suited to receive such grants.
    The Committee urges the Department to provide $5,000,000 
for a demonstration project designed to improve student 
achievement through curriculum improvement and the effective 
use of information technology. Funds would be used to meet high 
levels of standards and assessments, and create multimedia 
courses and course modules. The Committee understands that the 
State of Washington Office of the Superintendent of Public 
Instruction is currently operating a program in this area. The 
Committee urges the Secretary to give consideration to projects 
such as the one described above.
    It has been brought to the Committee's attention that a 
recent study offers documentation about the low level of 
average literacy within State and Federal prisons, relative to 
the population at large, and raises some questions about the 
effectiveness of prison education programs. The Committee notes 
that among the responsibilities of the Institute on 
Postsecondary Education, Libraries, and Lifelong Learning, is a 
study of instructional programs and practices which are 
effective in correctional settings. Such a study would be of 
great importance to State and Federal prison officials, as well 
as to educators and policymakers, when making decisions 
regarding prison education programs. The Committee urges the 
Department to use $500,000 to begin a national study of 
correction education programs.
    The Committee was highly dismayed to learn of the 
Department's use of fiscal year 1997 funds to begin a new 
testing initiative without securing prior approval through the 
regular appropriations process. This initiative was not 
included in the Department's justification material, nor was it 
brought to the Committee's attention during the fiscal year 
1997 hearings. The Committee directs the Department to contract 
with the National Academy of Sciences to do a study and report 
to the Committee on the voluntary national testing initiative. 
This study should include the technical quality of the work 
performed under the test development contracts, the frameworks 
and test content, the adequacy of field tests, the reliability 
of the data produced by the field tests, and the degree in 
which the tests can be expected to provide valid and useful 
information to the public. The Committee further directs that a 
preliminary report be completed by no later than August 31, 
1998, and a final report be issued by September 15, 1998. The 
Committee further prohibits the Department from administering 
national tests until the final report is completed.
    The Committee has included $2,000,000 for a program to 
develop a common infrastructure plan for multiple college 
campuses. The plan will include the installation of a fiber-
optic system which would support voice, data, and video 
applications, a library automation program to improve access 
and facilitate use by the campuses; implementation and 
improvement of intracampus networking and remote access, and 
expanding access to the Internet to members of the college 
community. The Pennsylvania Consortium for Higher Education is 
in the process of carrying out a project such as the one 
described above and could act as a model for other projects 
around the nation. The Committee urges the Secretary to give 
full and fair consideration to the Consortium when awarding 
this project.
    The Committee urges the Department to provide $1,000,000 to 
conduct a demonstration project using state-of-the-art 
technology to help students learn English. The National Science 
Center Foundation, in Augusta, GA, is developing a program such 
as the one described above, and would be especially suited to 
develop such a software program.

International education exchange

    The Committee has provided $5,000,000 for the International 
Education Exchange Program authorized by section 601(c) of 
Public Law 103-227. These funds are the same amount recommended 
by the administration and appropriated in fiscal year 1997. The 
program provides funds to support democracy and free market 
economies in Eastern Europe, the Commonwealth of Independent 
States, and other countries that formerly were part of the 
Soviet Union, by providing educators and other leaders from 
those countries curricula and teacher training programs in 
civic and economic education, as well as the opportunity to 
exchange ideas and experiences with teachers in the United 
States and other participating countries. The 1998 funds would 
support continuation of grants awarded to two independent 
nonprofit organizations with significant expertise in civics 
education and economic education.

Civic education

    The Committee recommends $4,500,000 for the Center for 
Civic Education, the same amount as appropriated in fiscal year 
1997 and the administration request. This program provides a 
course of instruction at the elementary and secondary level on 
the basic principles of our constitutional democracy and the 
history of the Constitution and the Bill of Rights. Funds also 
may be used to provide advanced training for teachers 
concerning the Constitution and the Bill of Rights.

Eisenhower professional development Federal activities

    The Committee recommends $25,000,000 for the Eisenhower 
Professional Development Federal Activities Program, $5,000,000 
below the budget request and $11,658,000 above the 1997 
appropriation.
    This program supports activities of national significance 
contributing to the development and implementation of high-
quality professional development in the core academic subjects. 
Projects may include development of teacher training programs, 
or dissemination of information about exemplary programs of 
professional development.
    The Committee has included $16,000,000 for the National 
Board for Professional Teaching Standards, an increase of 
$11,000,000 above the fiscal year 1997 appropriation and 
$5,000,000 below the administration request. The Committee has 
included this increase for assessment development, but has 
included no funding for teacher subsidies.
    Consistent with the budget requests, the Committee has 
included $4,621,000 for the National Clearinghouse for 
Mathematics and Science Education, the same amount appropriated 
for this purpose in 1997. The clearinghouse maintains a 
permanent repository of mathematics and science education 
instructional materials and programs for elementary and 
secondary schools; disseminates information, programs, and 
instructional materials to the public, information networks, 
and regional consortiums; and coordinates with existing data 
bases containing mathematics and science curriculum and 
instructional materials.

Eisenhower regional mathematics and science education consortia

    The Committee has included $15,000,000 for the Eisenhower 
regional mathematics and science education consortia, the same 
amount appropriated in fiscal year 1997 and the same amount 
recommended by the administration. This program supports grants 
to establish and operate regional consortia to disseminate 
exemplary mathematics and science instructional materials and 
provide technical assistance in the use of improved teaching 
methods and assessment tools to benefit elementary and 
secondary school students, teachers, and administrators.

21st century community learning centers

    The Committee has included $1,000,000 for the 21st century 
community learning centers, the same amount appropriated in 
fiscal year 1997. The administration requested no funding for 
this purpose. This program supports grants to rural and inner-
city public elementary or secondary schools, or consortia of 
such schools, to enable them to plan, implement, or expand 
projects that benefit the educational, health, social service, 
cultural, and recreational needs of a rural or inner-city 
community.
    Projects that place schools at the center of the community 
are contributing to rural renewal both culturally and 
economically. They also bring the community into the school in 
the areas of curriculum reform, school organization, planning, 
teacher and administrator education, and fiscal and tax policy. 
The Committee urges the Department to place a high priority on 
schools-at-the-center projects.

Javits gifted and talented students education

    The Committee has included $7,000,000 for the Javits Gifted 
and Talented Students Education Program, the same amount 
recommended by the administration and $2,000,000 above the 
fiscal year 1997 appropriation.
    This program authorizes awards to State and local education 
agencies, institutions of higher education, and public and 
private agencies for research, demonstration, and training 
activities designed to enhance the capability of elementary and 
secondary schools to meet the special educational needs of 
gifted and talented students. Priority is given to projects 
that identify and serve gifted and talented students who may 
not be identified and served through traditional assessment 
methods, including those who are economically disadvantaged or 
limited English proficient, or have disabilities. Some funds 
are set aside for a national center for research and 
development in the education of gifted and talented children 
and youth, which researches methods and techniques for 
identifying and teaching gifted and talented students.

Star schools

    For the Star Schools Program, the Committee recommends 
$30,000,000, an increase of $4,000,000 above the administration 
request and the same as the 1997 appropriation.
    The Committee has included sufficient funds to continue a 
statewide fiber optic demonstration project.
    This program is designed to improve instruction in math, 
science, foreign languages, and other subjects such as 
vocational education, primarily by means of telecommunications 
technologies and to serve underserved populations. The program 
supports eligible telecommunications partnerships to develop 
and acquire telecommunications facilities and equipment, 
instructional programming teacher training programs and 
technical assistance.
    The Committee is aware of the important work being carried 
out by the National Center on Adult Literacy at the University 
of Pennsylvania. The Center is currently operating a program 
entitled ``LiteracyLink'' which provides online services to 
assist adults in obtaining a high school diploma or a general 
education diploma. The Committee has included sufficient funds 
to continue this program.

National writing project

    The Committee bill provides $5,000,000 for the national 
writing project, an increase of $1,900,000 above the 1997 
appropriation. The administration requested no funds for this 
program.
    These funds are awarded to the national writing project in 
Berkeley, CA, which in turn funds projects in 45 States to 
train teachers of all subjects how to teach effective writing.
    The Committee remains strongly supportive of the efforts of 
the national writing project [NWP] to improve the skills of our 
Nation's teachers. The NWP trained more than 166,000 teachers 
across the country at a cost of less than $22 per teacher in 
Federal funds. The Committee believes that funds for the NWP 
represent an important investment in our Nation's teachers and 
students.

After school learning centers

    The Committee bill includes no funding for this new 
initiative. The administration requested $50,000,000 for this 
program. Funds would supports grants to rural and inner-city 
public elementary and secondary schools, or consortia of such 
schools, to enable them to plan, implement, or expand projects 
that benefit the educational, health, social service, cultural, 
and recreational needs of a rural or inner city community.

Ready to learn television

    The Committee recommends an appropriation of $7,000,000 for 
the Ready to Learn Television Program, the same amount 
appropriated in fiscal year 1997 and requested by the 
administration.
    This program supports the development and distribution of 
educational television programming designed to improve the 
readiness of preschool children to enter kindergarten and 
elementary school, consistent with the first national education 
goal that all children should start school ready to learn. The 
program also supports the development, production, and 
dissemination of educational materials designed to help 
parents, children, and care givers obtain the maximum advantage 
from educational programming.

Telecommunications demonstration project for mathematics

    The Committee recommends $2,035,000 for the 
telecommunications demonstration project for mathematics, the 
same amount recommended by the administration and an increase 
of $1,000,000 above the fiscal year 1997 appropriation. Funds 
are used to carry out a national telecommunication-based 
demonstration project designed to train elementary and 
secondary school teachers in preparing all students for 
achieving State content standards in mathematics.

                       child literacy initiative

Appropriations, 1997....................................................
Budget estimate, 1998...................................    $260,000,000
Committee recommendation................................     260,000,000

    The Committee recommends $260,000,000 for a child literacy 
initiative. The administration requested $260,000,000 to begin 
the new America reads challenge program which would train 
30,000 reading specialists and coordinators to mobilize 1 
million volunteer reading tutors over the next 5 years. The 
funds recommended have been provided only if authorized by 
subsequent legislation enacted by April 1, 1998. Funds have 
been provided on an advance funded basis and will not become 
available until October 1, 1998 and shall remain available 
through September 30, 1999.
    The Committee expects the Department to work with parents 
and educators to complement and support other programs with 
literacy components, such as Head Start, Even Start, and title 
I, so they can be even more effective in helping children 
increase their skills and achievement levels.
    The Committee recognizes that the national service 
programs, especially the Volunteers in Service to America, 
Foster Grandparent, and the Retired Senior Volunteer Programs 
could serve as a valuable resources in accomplishing the goal 
of having all children read well and independently by the third 
grade. The Committee urges the Department to establish a 
comprehensive approach to implement the child literacy 
initiative.
    The Committee urges the Department, when drafting 
legislation, to give special consideration to a professional 
development initiative designed to teach teachers and other 
education professionals methods in instructing children how to 
read. The Committee further encourages the Department to 
implement this initiative using the 10-regional educational 
laboratories, which have particular expertise in the area of 
professional development.

                Institute of Museum and Library Services

Appropriations, 1997....................................    $136,369,000
Budget estimate, 1998...................................     136,369,000
Committee recommendation................................     146,369,000

    The Committee recommends an appropriation of $146,369,000 
for the Institute of Museum and Library Services, an increase 
of $10,000,000 above the budget request.

Office of Library Services State Grants

    The Committee recommends $126,824,000 for State grants. 
Funds are provided to States by formula to carry out 5-year 
State plans. These plans must set goals and priorities for the 
State consistent with the purpose of the act, describe 
activities to meet the goals and priorities and describe the 
methods by which progress toward the goals and priorities and 
the success of activities will be evaluated. States may 
apportion their funds between two activities, technology and 
targeted services. For technology, States may use funds for 
electronic linkages among libraries, linkages to educational, 
social and information services, accessing information through 
electronic networks, or link different types of libraries or 
share resources among libraries. For targeted services, States 
may direct library and information services to persons having 
difficulty using a library, underserved urban and rural 
communities, and children from low income families. Within the 
total recommended, $2,045,000 has been provided for services to 
Indian tribes.

National leadership projects

    The Committee recommends $15,455,000 for national 
leadership projects, an increase of $10,000,000 above the 
administration request. These funds support activities of 
national significance to enhance the quality of library 
services nationwide and to provide coordination between 
libraries and museums. Activities are carried out through 
grants and contracts awarded on a competitive basis to 
libraries, agencies, institutions of higher education and 
museums. Priority is given to projects that focus on education 
and training of library personnel, research and development for 
the improvement of libraries, preservation, digitilization of 
library materials, partnerships between libraries and museums 
and other activities that enhance the quality of library 
services nationwide.
    The Committee urges the Director of the Institute of Museum 
and Library Services to provide $1,000,000 to conduct a 
demonstration to provide interactive connections via Internet 
to the information resources available between universities and 
their satellite campuses, community colleges and public, school 
and special libraries, and other entities. The project should 
also contain a training component so that staff will be able to 
access and use the new resources provided through these 
connections. This project would be especially beneficial in 
rural areas where resources sharing is particularly important. 
The Montana information consortium including the University of 
Montana and Montana State University is in the beginning stages 
of a project such as the one outlined above and would be 
especially suited to carry out a project in this area.
    Within the funds available, the Committee urges the 
Director to provide $1,000,000 for a project to digitalize a 
card catalog. The New York public library is currently 
undertaking a digitalization project and would be especially 
suited for this type of project.
    The Committee urges the Director to provide funds for a 
program which will use the resources of libraries and 
children's museums to provide innovative learning opportunities 
for at-risk children. Children's museums are a unique community 
resource which provides a safe learning environment for young 
children, their parents, teachers, and care givers. These 
projects provide multidisciplinary cultural programming that 
integrates the arts and humanities with mathematics and 
science. These programs are also available to all children, 
regardless of their ability to pay. The Children's Museums of 
Philadelphia, Baltimore, and Boston have been operating 
programs such as the ones described above and the Committee 
urges the Director to provide $4,000,000 for such programs.
    Within the amount recommend, the Committee has included 
$1,130,000 for a project to maintain and interpret a historic 
medical library collection which could enhance public health 
information and outreach. The College of Physicians of 
Philadelphia maintains one of the worlds' leading collections 
of historic medical reference materials and has developed an 
innovative public health information outreach program serving 
health providers and consumers throughout the greater 
Philadelphia area and would be especially suited to carry out a 
project such as the one described above.
    It has been brought to the Committee's attention that a 
one-of-a-kind historical library has been established in 
Pennsylvania's anthracite coal region. The library traces the 
history of Pennsylvania's northeastern anthracite coal region 
and contains detailed information regarding miners' 
compensation and occupational disease records, geological 
studies, maps, newspaper clips, and more than 8,000 
photographs. The Committee urges the Director to provide 
$800,000 to assist in the cataloging and preservation of this 
historic collection.

Administration

    The Committee recommends $4,090,000 for program 
administration, the same as the budget request. Funds will be 
used to continue the transition from two agencies into a single 
entity. Funds support personnel compensation and benefits, 
travel, rent, communications, utilities, printing, equipment 
and supplies, automated data processing, and other services.

                        Departmental Management

                         program administration

Appropriations, 1997....................................    $326,217,000
Budget estimate, 1998...................................     341,039,000
Committee recommendation................................     338,964,000

    The Committee recommends $338,964,000 for program 
administration, an increase of $12,747,000 above the 1997 
appropriation and $2,075,000 below the budget request.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing, and other services 
required to award, administer, and monitor some 200 Federal 
education programs. Support for program evaluation and studies 
and advisory councils is also provided under this activity.
    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, 
policymakers, and parents. Noting the fact that the Department 
of Education is already collaborating with NICHD, the Committee 
directs the Secretary of Education, or his designee, to consult 
with the Director of NICHD, or his designee, and participate in 
a national panel convened by NICHD to assess the current status 
of research-based knowledge, including the effectiveness of 
various approaches to teaching children to read.
    As part of participation in this panel, the Secretary shall 
assist in recommending a strategy for rapidly disseminating 
this information to facilitate effective reading instruction in 
the schools.
    The Committee is concerned that the proclamation 
designating 1.7 million acres in Utah as the Grand Staircase-
Escalante National Monument could have a negative impact on 
schoolchildren in the State. A recent report prepared by the 
Department of Education, stated that Utah must redirect funds 
for appraisals, resource studies, and other expenses that would 
otherwise be available for education expenses. The Department 
further recommended that the issue be resolved as expeditiously 
as possible and that the Department of the Interior should work 
to reduce transactional costs. In light of these 
recommendations, the Committee urges the Secretary to continue 
to work with the Department of the Interior to reduce the 
expense of this land exchange and assist in helping to identify 
revenue producing activities on State school trust lands within 
the monument, so that the educational opportunities of Utah's 
school students will not be negatively affected. The Committee 
further requests the Secretary to report by May 1, 1998, on the 
progress being made on this land exchange.

                        office for civil rights

Appropriations, 1997....................................     $54,900,000
Budget estimate, 1998...................................      61,500,000
Committee recommendation................................      57,522,000

    The Committee bill includes $57,522,000 for the Office for 
Civil Rights [OCR], $2,622,000 above the 1997 appropriation and 
$3,978,000 below the budget request.
    The Office for Civil Rights is responsible for the 
enforcement of laws that prohibit discrimination on the basis 
of race, color, national origin, sex, disability, and age in 
all programs and institutions funded by the Department of 
Education. To carry out this responsibility, OCR investigates 
and resolves discrimination complaints, monitors desegregation 
and equal educational opportunity plans, reviews possible 
discriminatory practices by recipients of Federal education 
funds, and provides technical assistance to recipients of funds 
to help them meet civil rights requirements.

                    office of the inspector general

Appropriations, 1997....................................     $29,943,000
Budget estimate, 1998...................................      32,000,000
Committee recommendation................................      32,000,000

    The Committee recommends $32,000,000 for the Office of the 
Inspector General, $2,057,000 above the 1997 appropriation and 
the same as the administration request.
    The Office of the Inspector General has the authority to 
investigate all departmental programs and administrative 
activities, including those under contract or grant, to prevent 
and detect fraud and abuse, and to ensure the quality and 
integrity of those programs. The Office investigates alleged 
misuse of Federal funds, and conducts audits to determine 
compliance with laws and regulations, efficiency of operations, 
and effectiveness in achieving program goals.

                           General Provisions

    The Committee bill contains language which has been 
included in the bill since 1974, prohibiting the use of funds 
for the transportation of students or teachers in order to 
overcome racial imbalance.
    The Committee bill contains language included in the bill 
since 1977, prohibiting the transportation of students other 
than to the school nearest to the student's home.
    The Committee bill contains language which has been 
included in the bill since 1980, prohibiting the use of funds 
to prevent the implementation of programs of voluntary prayer 
and meditation in public schools.
    The Committee bill includes a provision giving the 
Secretary of Education authority to transfer up to 1 percent of 
any discretionary funds between appropriations.

                       TITLE IV--RELATED AGENCIES

                      Armed Forces Retirement Home

Appropriations, 1997....................................     $56,095,000
Budget estimate, 1998...................................      79,977,000
Committee recommendation................................      65,452,000

    The Committee recommends authority to expend $65,452,000 
from the Armed Forces Retirement Home trust fund for operation 
and construction activities at the U.S. Soldiers' and Airmen's 
Home and the U.S. Naval Home, $9,357,000 more than the 1997 
appropriation and $14,525,000 less than the budget request.

Operation and maintenance

    The Committee recommends $55,452,000 for the operation and 
maintenance of the Soldiers' and Airmen's Home and the U.S. 
Naval Home, $211,000 less than the fiscal year 1997 
appropriation and the same as the budget request.

Capital outlay

    The Committee recommends $10,000,000 for capital activities 
at the Soldiers' and Airmen's Home and the U.S. Naval Home, 
$9,568,000 more than the 1997 appropriation and $14,525,000 
less than the budget request.

             Corporation for National and Community Service

                  domestic volunteer service programs

Appropriations, 1997....................................    $213,849,000
Budget estimate, 1998...................................     260,300,000
Committee recommendation................................     232,604,000

    The Committee recommends an appropriation of $232,604,000 
for the domestic volunteer service programs of the Corporation 
for National and Community Service, $18,755,000 more than the 
1997 appropriation and $27,696,000 less than the budget 
request.

VISTA

    The Committee bill provides $45,235,000 for the Volunteers 
in Service to America [VISTA] Program, $4,000,000 more than the 
fiscal year 1997 level and $8,765,000 less than the budget 
request.
    VISTA is a 30-year-old program which provides capacity 
building for small community-based organizations. VISTA 
volunteers raise resources for local projects, recruit and 
organize volunteers, and establish and expand local community-
based programs in housing, employment, health, and economic 
development activities.

National Senior Volunteer Corps

    The Committee bill provides $159,240,000 for the National 
Senior Volunteer Corps programs, $14,476,000 more than the 
fiscal year 1997 level and $17,224,000 less than the budget 
request.
    In allocating funds appropriated to the National Senior 
Service Corps under the Domestic Volunteer Service Act, the 
Committee proposes the following distribution. First, for the 
Foster Grandparent Program and Senior Companion Program, the 
stipend for volunteers should be increased from $2.45/hour to 
$2.55/hour. Funds should also be provided to pay for the 
stipend increase for non-CNS volunteers for at least 1 year. 
Second, existing FGP, SCP, and RSVP programs should receive an 
increase of 2.5 percent for support costs in order to maintain 
current service levels and enhance quality. Third, in 
accordance with the Domestic Volunteer Service Act [DVSA], one-
third of the increase over 1997 levels should be used to fund 
Programs of National Significance grants. Fourth, remaining 
funds up to the levels provided in the administration's request 
for each of the three programs should be used to begin new 
foster grandparent, senior companion or RSVP programs in 
geographic areas currently unserved. Finally, funds 
appropriated in excess of the President's request for the three 
programs (FGP, SCP, and RSVP) should be used for a Senior 
Demonstration Program as proposed in the President's budget and 
funded, for the most part, through existing programs.

Foster Grandparent Program

    The Committee recommends $85,593,000 for the Foster 
Grandparent Program, $7,781,000 more than the 1997 level and 
$379,000 less than the budget request.
    This program provides volunteer opportunities to seniors 
age 60 and over who serve at-risk youth. This program involves 
seniors in their communities and provides a host of services to 
children.

Senior Companion Program

    For the Senior Companion Program, the Committee bill 
includes $34,368,000, $3,124,000 more than the 1997 level and 
$1,081,000 less than the budget request.
    This program enables senior citizens to provide personal 
assistance and companionship to adults with physical, mental, 
or emotional difficulties. Senior companions provide vital in-
home services to elderly Americans who would otherwise have to 
enter nursing homes. The volunteers also provide respite care 
to relieve care givers.

Retired and Senior Volunteer Program

    The Committee bill provides $39,279,000 for the Retired and 
Senior Volunteer Program [RSVP], $3,571,000 more than the 1997 
level and $5,764,000 less than the budget request.
    This program involves persons age 55 and over in volunteer 
opportunities in their communities.

Program support

    The Committee bill includes $28,129,000 for program 
support, $279,000 more than the 1997 level and $1,707,000 less 
than the budget request.

                  Corporation for Public Broadcasting

Appropriations, 1998....................................    $250,000,000
Appropriations, 1999....................................     250,000,000
Budget estimate, 2000...................................     325,000,000
Committee recommendation................................     300,000,000

    The Committee recommends an appropriation of $300,000,000 
for the Corporation for Public Broadcasting [CPB], an advance 
appropriation for fiscal year 2000. This amount is $50,000,000 
more than the fiscal year 1998 appropriation and $25,000,000 
less than the budget request.
    The Committee intends that CPB foster services for unserved 
or underserved audiences focusing on entities whose primary 
services are directed at audiences in rural areas and native 
American audiences. The committee is concerned about the 
erosion of grants for radio stations serving these communities.
    The Committee recognizes that stations serving rural and 
underserved audiences have limited local potential for 
fundraising because of sparse populations serviced, limited 
number of local businesses, and low-income level. In rural 
areas, while many stations receive per capita local support far 
greater than that contributed in urban areas, they receive 
relatively few matching dollars because the populations served 
are small.
    The Committee directs CPB to explore new methodologies for 
distribution of Federal matching dollars which take into 
account measures such as per capita support and other factors 
that would serve to level the playing field between urban and 
rural stations in the distribution of matching funds.

               Federal Mediation and Conciliation Service

Appropriations, 1997....................................     $32,525,000
Budget estimate, 1998...................................      33,481,000
Committee recommendation................................      33,481,000

    The Committee recommends an appropriation of $33,481,000 
for the Federal Mediation and Conciliation Service [FMCS], 
$956,000 more than the 1997 appropriation and the same as the 
budget request.
    The FMCS was established by Congress in 1947 to provide 
mediation, conciliation, and arbitration services to labor and 
management. FMCS is authorized to provide dispute resolution 
consultation and training to all Federal agencies.

            Federal Mine Safety and Health Review Commission

Appropriations, 1997....................................      $6,049,000
Budget estimate, 1998...................................       6,060,000
Committee recommendation................................       6,060,000

    The Committee recommends an appropriation of $6,060,000 for 
the Federal Mine Safety and Health Review Commission, $11,000 
more than the fiscal year 1997 appropriation and the same as 
the budget request.
    The Federal Mine Safety and Health Review Commission 
provides administrative trial and appellate review of legal 
disputes under the Federal Mine Safety and Health Act of 1977. 
The five-member Commission provides administrative appellate 
review of the Commission's administrative law judge decisions.

        National Commission on Libraries and Information Science

Appropriations, 1997....................................        $897,000
Budget estimate, 1998...................................       1,123,000
Committee recommendation................................       1,000,000

    The Committee recommends an appropriation of $1,000,000 for 
the National Commission on Libraries and Information Science, 
$103,000 more than the fiscal year 1997 appropriation and 
$123,000 less than the budget request.
    The Commission determines the need for, and makes 
recommendations on, library and information services, and 
advises the President and Congress on the development and 
implementation of national policy in the library and 
information field.

                     National Council on Disability

Appropriations, 1997....................................      $1,791,000
Budget estimate, 1998...................................       1,793,000
Committee recommendation................................       1,793,000

    The Committee recommends an appropriation of $1,793,000 for 
the National Council on Disability, $2,000 more than the fiscal 
year 1997 appropriation and the same as the budget request.
    The Council is mandated to make recommendations to the 
President, the Congress, the Rehabilitation Services 
Administration, and the National Institute on Disability and 
Rehabilitation Research, on the public issues of concern to 
individuals with disabilities. The Council gathers information 
on the implementation, effectiveness, and impact of the 
Americans With Disabilities Act and looks at emerging policy 
issues as they affect persons with disabilities and their 
ability to enter or reenter the Nation's work force and to live 
independently.

                     National Education Goals Panel

Appropriations, 1997....................................      $1,495,000
Budget estimate, 1998...................................       2,000,000
Committee recommendation................................       2,000,000

    The Committee recommends $2,000,000 for the national 
education goals panel, $505,000 more than the 1997 
appropriation and the same as the budget request.
    Following the 1989 education summit in Charlottesville, the 
Governors and President Bush agreed on education goals for the 
Nation and created the National Education Goals Panel as an 
accountability mechanism to monitor and report on the Nation's 
progress toward reaching the goals. To date, the goals panel 
has issued four annual reports delineating National and State 
progress toward the national education goals.

                     National Labor Relations Board

Appropriations, 1997....................................    $174,661,000
Budget estimate, 1998...................................     186,434,000
Committee recommendation................................     174,661,000

    The Committee recommends an appropriation of $174,661,000 
for the National Labor Relations Board [NLRB], the same as the 
fiscal year 1997 appropriation and $11,773,000 less than the 
budget request.
    The NLRB is a law enforcement agency which adjudicates 
disputes under the National Labor Relations Act.
    The Committee remains concerned about the potential impact 
of the NLRB-proposed rule regarding the appropriateness of 
single bargaining units, and includes language which prohibits 
the NLRB from promulgating a final rule on the appropriateness 
of requested single location bargaining units in representation 
cases.

                        National Mediation Board

Appropriations, 1997....................................      $8,284,000
Budget estimate, 1998...................................       8,100,000
Committee recommendation................................       8,600,000

    The Committee recommends an appropriation of $8,600,000 for 
the National Mediation Board, $316,000 more than the fiscal 
year 1997 appropriation and $500,000 more than the budget 
request.
    The National Mediation Board protects interstate commerce 
as it mediates labor-management relations in the railroad and 
airline industries under the Railway Labor Act. The Board 
mediates collective bargaining disputes, determines the choice 
of employee bargaining representatives through elections, and 
administers arbitration of employee grievances.

            Occupational Safety and Health Review Commission

Appropriations, 1997....................................      $7,738,000
Budget estimate, 1998...................................       7,800,000
Committee recommendation................................       7,800,000

    The Committee recommends an appropriation of $7,800,000 for 
the Occupational Safety and Health Review Commission, $62,000 
more than the fiscal year 1997 appropriation and the same as 
the budget request.
    The Commission serves as a court to justly and 
expeditiously resolve disputes between the Occupational Safety 
and Health Administration [OSHA] and employers charged with 
violations of health and safety standards enforced by OSHA.

                  Physician Payment Review Commission

Appropriations, 1997....................................      $3,258,000
Budget estimate, 1998...................................       3,578,000
Committee recommendation................................       3,258,000

    The Committee recommends the transfer of $3,258,000 from 
the Medicare trust funds to support operations of the Physician 
Payment Review Commission, the same as the fiscal year 1997 
level and $320,000 less than the budget request.
    Established in 1986, the Physician Payment Review 
Commission is mandated to make recommendations to the Secretary 
of Health and Human Services and Congress, regarding Medicare 
payments for health services provided by physicians and other 
practitioners. The Commission is also mandated to consider 
policies related to controlling health costs.

               Prospective Payment Assessment Commission

Appropriations, 1997....................................      $3,257,000
Budget estimate, 1998...................................       3,579,000
Committee recommendation................................       3,257,000

    The Committee recommends the transfer of $3,257,000 from 
the Medicare trust funds for the operation of the Prospective 
Payment Assessment Commission [ProPAC], the same as the fiscal 
year 1997 level and $322,000 less than the budget request.
    ProPAC provides objective analysis of the Medicare hospital 
prospective payment system, Medicare inpatient and outpatient 
payments to hospitals and excluded facilities, skilled nursing 
facilities, renal disease services, home health services, 
inpatient Medicaid payments, and Medicare's managed-care 
programs.

                       Railroad Retirement Board

                     dual benefits payments account

Appropriations, 1997....................................    $223,000,000
Budget estimate, 1998...................................     206,000,000
Committee recommendation................................     206,000,000

    The Committee has provided a total of $206,000,000 for dual 
benefits, including $12,000,000 in income tax receipts on dual 
benefits as authorized by law. The Committee recommendation is 
the same as the budget request.
    This appropriation provides for vested dual benefit 
payments authorized by the Railroad Retirement Act of 1974, as 
amended by the Omnibus Reconciliation Act of 1981. This 
separate account, established for the payment of dual benefits, 
is funded by general fund appropriations and income tax 
receipts of vested dual benefits.

          Federal payments to the railroad retirement account

Appropriations, 1997....................................        $300,000
Budget estimate, 1998...................................          50,000
Committee recommendation................................          50,000

    The Committee recommends $50,000 for interest earned on 
unnegotiated checks. This is $250,000 less than the fiscal year 
1997 appropriation and the same as the budget request.

                      limitation on administration

Appropriations, 1997....................................     $87,728,000
Budget estimate, 1998...................................      88,800,000
Committee recommendation................................      87,728,000

    The Committee recommends an appropriation of $87,728,000 
for the administration of railroad retirement/survivor benefit 
programs. This amount is the same as the fiscal year 1997 
appropriation, and $1,072,000 below the budget request.
    The Board 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 Board for administrative expenses.

           limitation on the office of the inspector general

Appropriations, 1997....................................      $5,394,000
Budget estimate, 1998...................................       5,400,000
Committee recommendation................................       5,394,000

    The Committee recommends $5,394,000 for the Office of the 
Inspector General, the same as the 1997 appropriation and 
$6,000 less than the budget request.

                        U.S. Institute of Peace

Appropriations, 1997....................................     $11,149,000
Budget estimate, 1998...................................      11,160,000
Committee recommendation................................      11,160,000

    The Committee recommends an appropriation of $11,160,000 
for the U.S. Institute of Peace, $11,000 more than the fiscal 
year 1997 appropriation and the same as the budget request.
    The Institute was established by the U.S. Institute of 
Peace Act (Public Law 98-525) in 1984. The Institute is an 
independent, nonprofit, national organization whose primary 
mission is to promote, through scholarship and education, 
international peace, and the resolution of conflicts without 
recourse to violence.

                     Social Security Administration

                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 1997....................................     $30,923,000
Budget estimate, 1998...................................      20,308,000
Committee recommendation................................      20,308,000

    The Committee recommends $20,308,000 for payments to Social 
Security trust funds, the same as the administration request. 
This amount reimburses the old age and survivors insurance and 
disability insurance trust funds for special payments to 
certain uninsured persons, costs incurred administering pension 
reform activities, and the value of the interest for benefit 
checks issued but not negotiated. This appropriation restores 
the trust funds to the same financial position they would have 
been in had they not borne these costs, properly charged to the 
general funds. The fiscal year 1998 request for these mandatory 
payments decreases primarily because special payments for 
certain uninsured persons decline due to a declining 
beneficiary population.
    As requested by the administration, the Committee has not 
included additional funds to reimburse the trust funds for 
costs the Social Security Administration incurs in continuing 
mandatory administrative activities required by the Coal 
Industry Retiree Health Benefits Program, as provided for by 
section 19141 of the Energy Policy Act of 1992, The fiscal year 
1997 appropriations act codified the reimbursement for this 
activity and made $10,000,000 available until expended.

                    SPECIAL BENEFITS FOR COAL MINERS

Appropriations, 1997....................................    $460,070,000
Budget estimate, 1998...................................     426,090,000
Committee recommendation................................     426,090,000

    The Committee recommends an appropriation of $426,090,000 
for special benefits for disabled coal miners. This is in 
addition to the $160,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1997. The 
recommendation is the same as the administration request. These 
funds are used to provide monthly benefits to coal miners 
disabled by black lung disease and to their widows and certain 
other dependents, as well as to pay-related administrative 
costs.
    Social Security holds primary responsibility for claims 
filed before July 1973, with the Department of Labor 
responsible for claims filed after that date. By law, increases 
in black lung benefit levels are tied directly to Federal pay 
increases. The year-to-year decrease in this account reflects a 
declining beneficiary population.
    The Committee recommends an advance of $160,000,000 for the 
first quarter of fiscal year 1999, the same as the 
administration request. These funds will ensure uninterrupted 
benefit payments to coal miners, their widows, and dependents.

                      SUPPLEMENTAL SECURITY INCOME

Appropriations, 1997.................................... $19,547,010,000
Budget estimate, 1998...................................  16,345,000,000
Committee recommendation................................  16,335,300,000

    The Committee recommends an appropriation of 
$16,335,300,000 for supplemental security income. This is in 
addition to the $9,690,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1998 and includes 
funds for continuing disability reviews. The recommendation is 
$9,700,000 less than the administration request and 
$3,211,710,000 less than the fiscal year 1997 level. The 
Committee also recommends an advance of $8,680,000,000 for the 
first quarter of fiscal year 1998 to ensure uninterrupted 
benefit payments.
    These funds are used to pay benefits under the SSI Program, 
which was established to ensure a Federal minimum monthly 
benefit for aged, blind, and disabled individuals, enabling 
them to meet basic needs. It is estimated that approximately 
5.8 million persons will receive SSI benefits each month during 
fiscal year 1998. In many cases, SSI benefits supplement income 
from other sources, including Social Security benefits. The 
funds are also used to reimburse the trust funds for the 
administrative costs for the program with a final settlement by 
the end of the subsequent fiscal year required by law.

Beneficiary services

    The Committee recommendation includes $46,000,000 for 
beneficiary services, which is the same as the administration 
request and $54,000,000 below the 1997 level. This amount is 
available for reimbursement of State vocational rehabilitation 
services agencies for successful rehabilitation of disabled SSI 
recipients.
    Enactment of Public Law 104-121 halted SSI payments 
beginning January 1, 1997, to drug addicts and alcoholics who 
previously qualified for assistance primarily on the basis of 
their addictions. It is anticipated that significant numbers 
deemed ineligible for assistance will reapply to the program on 
the basis of other qualifying conditions. Last year, the 
Committee provided $59,000,000 for drug addict and alcoholic 
[DA&A] monitoring. This year referral and monitoring activities 
[RMA] ended with the statutory removal of DA&A as an 
eligibility category for benefits, and RMA contracts were 
terminated at the end of December 1996. The administration did 
not request funding for this activity in fiscal year 1998. 
Closeout costs for RMA contracts which ended will be paid out 
of funds currently available for this activity. Unobligated 
funds available at the end of fiscal year 1997 will be carried 
over to fiscal year 1998 and used for benefit payments in 
fiscal year 1998.

Research and demonstration projects

    The Committee recommendation includes $7,000,000 for 
research and demonstration projects conducted under sections 
1110 and 1115 of the Social Security Act. This is $9,700,000 
less than the administration request and the same as the 1997 
amount. This amount, along with an estimated $10,700,000 
unobligated carryover funds from previous fiscal years, will 
support research into underlying causes of the recent growth in 
the SSI and OASDI disability programs, research into return-to-
work activities, and activities strengthening program 
effectiveness and training.

Administration

    For administration services related to SSI activities, the 
Committee provides $2,037,000,000, which is $90,985,000 above 
the fiscal year 1997 level and the same as the administration 
request. This includes funds for the SSI disability initiative 
that was previously funded as a separate line item.

Investment proposals

    For the SSI portion of the automation investment, the 
Committee recommends $50,000,000, which is the same as the 
administration request and $30,105,000 higher than the fiscal 
year 1997 appropriation. Total funding of $200,000,000 for this 
initiative is explained in the limitation on administrative 
expenses portion of this report.

Continuing disability reviews

    The bill provides $175,000,000 to process continuing 
disability reviews [CDR's] related to the SSI caseload as 
authorized by Public Law 104-121 and supplemental security 
income administrative work as authorized by Public Law 104-193, 
the same as the comparable 1997 appropriation.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 1997....................................  $6,406,577,000
Budget estimate, 1998...................................   6,521,040,000
Committee recommendation................................   6,417,708,000

    The Committee recommends a program funding level of 
$6,417,708,000 for the limitation on administrative expenses, 
which is $103,332,000 less than the administration request and 
$11,131,000 higher than the fiscal year 1997 level.
    This account provides resources from the Social Security 
trust funds to administer the Social Security retirement and 
survivors and disability insurance programs, and certain Social 
Security health insurance functions. As authorized by law, it 
also provides resources from the trust funds for certain 
nontrust fund administrative costs, which are reimbursed from 
the general funds. These include administration of the 
supplemental security income program for the aged, blind, and 
disabled; work associated with the Pension Reform Act of 1984; 
and the portion of the annual wage reporting work done by the 
Social Security Administration for the benefit of the Internal 
Revenue Service. The dollars provided also support automated 
data processing activities and fund the State disability 
determination services which make disability determinations on 
behalf of the Social Security Administration. Additionally, the 
limitation provides funding for computer support, resources for 
State disability agencies which make initial and continuing 
disability determinations, and other administrative costs. In 
1998, about 50.6 million beneficiaries will receive a Social 
Security or supplemental security income check each month and 
cash payments are expected to exceed $402,000,000,000 during 
fiscal year 1998.
    The limitation includes $5,972,708,000 for routine 
operating expenses of the agency, which is $58,332,000 less 
than the amount requested by the President and $111,026,000 
over the 1997 comparable amount. These funds, including those 
derived from an increase in the user fee, cover the mandatory 
costs of maintaining equipment and facilities, as well as 
staffing.
    The Committee understands the Social Security 
Administration has under consideration the closing of the 
Social Security field office in Statesville, NC. The Committee 
is aware of the recommendation of the North Carolina Social 
Security Administration's State Director and encourages the 
agency to maintain a physical presence in the Statesville 
office for a minimum of 2 days a week for the purpose of online 
claims-taking ability.

User fees

    The administration proposed a law change to enable an 
increase in the current user fee for Federal administration of 
State supplementation SSI payments effective in fiscal year 
1998. The increase would be $1.20 above the current fee of $5 
per payment. The additional revenue generated by this fee, 
expected to be $35,000,000, is intended to increase work 
capacity in SSA's field offices. The Committee includes bill 
language that would enact this proposal. Any additional fees 
above this amount would be available in fiscal year 1999 only 
to the extent provided in appropriations acts.

Social Security Advisory Board

    The Committee has included $1,268,000 within the total 
limitation on administration for the Social Security 
Administration Advisory Board for fiscal year 1998, which is 
$332,000 below the President's request. Public Law 103-296, the 
Social Security Independence and Program Improvements Act of 
1994, as amended, established a seven-member Advisory Board, 
each of whom would serve without salary, that would make 
recommendations on policies and regulations regarding Social 
Security and supplemental security income programs.

Automation initiative

    An additional $200,000,000 has been included within the 
limitation amount to fund the fifth and last year of the 5-year 
automation initiative requested by the President. This is a 
decrease of $34,895,000 from fiscal year 1997 and is the same 
as the administration request. In addition to this amount, the 
Committee expects that unspent carryover funds will be made 
available for these activities in fiscal year 1998. Since 
funding of the automation investment fund began in fiscal year 
1994, $910,000,000 in budgetary resources will have been 
committed to this effort, compared to the $1,125,000,000 
originally requested.

Chronic fatigue and immune dysfunction syndrome

    The Committee is concerned about reports from people with 
chronic fatigue and immune dysfunction syndrome [CFIDS] who 
encounter at their local SSA offices a lack of knowledge about 
CFIDS, its diagnosis, and impact on the functional ability of 
sufferers. The Committee requests a summary to the CFSICC of 
SSA's CFIDS-related education activities conducted during the 
past fiscal year. The Committee further urges SSA to develop 
effective means to investigate obstacles to benefits for 
persons with CFIDS and to keep relevant medical information 
updated throughout the application process. The Committee 
reiterates its previous recommendation for the establishment of 
a CFIDS advisory committee, and expects SSA's cooperation in 
expediting the committee's formation.

Continuing disability reviews

    The Committee has provided an additional $245,000,000 to 
the ``Limitation on administration expenses'' account for 
continuing disability reviews [CDR's] and redeterminations. 
This amount is based on current authorized levels from Public 
Laws 104-121 and 104-193, is $45,000,000 below the 
administration request. The Committee is aware of pending 
legislation that may increase the authorized level, and 
anticipates that such an upward adjustment would be made in the 
conference with the House.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1997....................................     $37,354,000
Budget estimate, 1998...................................      44,424,000
Committee recommendation................................      37,354,000

    The Committee recommends $37,354,000 for activities of the 
Office of the Inspector General. This is $7,070,000 below the 
amount requested by the administration. This includes a general 
fund appropriation of $6,265,000 together with an obligation 
limitation of $31,089,000 from the Federal old age and 
survivors insurance trust fund and the Federal disability 
insurance trust fund.

                      TITLE V--GENERAL PROVISIONS

    The Committee recommendation retains provisions which: 
authorize transfers of unexpended balances (sec. 501); limit 
funding to 1 year availability unless otherwise specified (sec. 
502); limit lobbying and related activities, amended to cover 
State legislatures (sec. 503); limit official representation 
expenses (sec. 504); prohibit funding of any program to carry 
out distribution of sterile needles for the hypodermic 
injection of any illegal drug unless the Secretary of HHS 
determines such programs are effective in preventing the spread 
of HIV and do not encourage the use of illegal drugs (sec. 
505); state the sense of Congress about purchase of American-
made equipment and products (sec. 506); clarify Federal funding 
as a component of State and local grant funds, amended to cover 
only funds included in this act (sec. 507); and limit use of 
funds for abortion (sec. 508).
    The Committee recommendation also retains provisions 
carried in last year's bill relating to transfer authority, 
obligation and expenditure of appropriations, and detail of 
employees (sec. 509).
    The Committee recommendation retains a general provision 
which prohibits funds made available in this act to be used to 
enforce the requirements of the Higher Education Act of 1965 
with respect to any lender that has a loan portfolio that is 
equal to or less than $5,000,000 (sec. 510). It also retains 
modified language on human embryo research (sec. 511).
    The Committee recommendation retains the limitation on use 
of funds for promotion of legalization of controlled substances 
included last year (sec. 512).
    The Committee recommendation retains the bill language 
limitation on use of funds to enter into or review contracts 
with entities subject to the requirement in section 4212(d) of 
title 38, United States Code, if the report required by that 
section has not been submitted (sec. 513).
    The Committee recommendation includes a new provision to 
permit the Social Security Administration to collect a user fee 
for Federal administration of State supplementary payments 
under the Supplemental Security Income Program (sec. 514).
    The Committee recommendation also includes a new provision 
with regard to buy out authority for the Railroad Retirement 
Board (sec. 515).
    The Committee recommendation retains a proviso included 
last year which reduces agency administrative expenses by 
$30,500,000 (sec. 516).


                                            BUDGETARY IMPACT OF BILL                                            
  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS  
                                                     AMENDED                                                    
                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays        
                                                             ---------------------------------------------------
                                                               Committee    Amount  of   Committee    Amount  of
                                                               allocation      bill      allocation      bill   
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations                                                    
 to its subcommittees of amounts in the First Concurrent                                                        
 Resolution for 1998: Subcommittee on Labor, Health and                                                         
 Human Services, Education, and Related Agencies:                                                               
    Defense discretionary...................................  ...........  ...........  ...........  ...........
    Nondefense discretionary................................       79,197       79,558       75,779   \1\ 75,926
    Violent crime reduction fund............................          144          144           65           65
    Mandatory...............................................      206,611      206,611      209,167      209,167
Projections of outlays associated with the recommendation:                                                      
    1998....................................................  ...........  ...........  ...........  \2\ 188,641
    1999....................................................  ...........  ...........  ...........       40,547
    2000....................................................  ...........  ...........  ...........       10,206
    2001....................................................  ...........  ...........  ...........        1,249
    2002 and future year....................................  ...........  ...........  ...........           80
Financial assistance to State and local governments for 1998                                                    
 in bill....................................................           NA      115,640           NA       89,510
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.                                                          
\2\ Excludes outlays from prior-year budget authority.                                                          
                                                                                                                
NA: Not applicable.                                                                                             
                                                                                                                
Note.--Consistent with the funding recommended in the bill for continuing disability reviews and in accordance  
  with Public Laws 104-124 and 104-193, the Committee anticipates that the Budget Committee will file a revised 
  section 602(a) allocation for the Committee on Appropriations reflecting an upward adjustment of $245,000,000 
  in budget authority and associated outlays.                                                                   

  COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 7 of rule XVI requires that Committee report on 
general appropriations bills identify each Committee amendment 
to the House bill ``which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.''

    The following items are identified pursuant to this 
requirement:
          Community service employment for older Americans, 
        $453,000,000;
          Consolidated health centers, $826,000,000;
          Health professions, $220,000,000;
          Organ transplantation, $2,778,000;
          Health teaching facilities interest subsidies, 
        $225,000;
          Bone Marrow Donor Registry Program, $15,270,000;
          Alzheimer's demonstration grants, $5,999,000;
          Family planning, $208,452,000;
          Health education assistance loan [HEAL] loan 
        limitation, $85,000,000;
          Vaccine Injury Compensation Program HRSA 
        Administration (trust fund), $45,448,000;
          Centers for Disease Control and Prevention, 
        $2,368,113,000;
          Childhood immunization, $445,545,000;
          Sexually transmitted diseases, $111,171,000;
          Substance Abuse and Mental Health Services 
        Administration, $2,126,643,000;
          Agency for Health Care Policy and Research, 
        $142,587,000;
          Runaway and Homeless Youth Consolidated Program, 
        $58,602,000;
          Child abuse State grants, $21,026,000;
          Child abuse discretionary activities, $14,154,000;
          Abandoned infants assistance, $12,251,000;
          Adoption opportunities, $13,000,000;
          Native American programs, $34,933,000;
          Adolescent family life, $19,209,000;
          Office of Minority Health, $23,600,000;
          Armed Forces Retirement Home, $65,452,000;
          Corporation for National and Community Service, 
        $228,604,000;
          Corporation for Public Broadcasting, $300,000,000.

COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Pursuant to paragraph 7(c) of rule XXVI, the accompanying 
bill was ordered reported from the Committee, subject to 
amendment and subject to appropriate scorekeeping, by recorded 
vote of 28-0 a quorum being present.
    The vote was as follows:
        Yeas                          Nays
Chairman Stevens
Mr. Cochran
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. Gorton
Mr. McConnell
Mr. Burns
Mr. Shelby
Mr. Gregg
Mr. Bennett
Mr. Campbell
Mr. Craig
Mr. Faircloth
Mrs. Hutchison
Mr. Byrd
Mr. Inouye
Mr. Hollings
Mr. Leahy
Mr. Bumpers
Mr. Lautenberg
Mr. Harkin
Ms. Mikulski
Mr. Reid
Mr. Kohl
Mrs. Murray
Mr. Dorgan
Mrs. Boxer

 COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 12 of rule XXVI requires that Committee reports 
on a bill or a joint resolution repealing or amending any 
statute include ``(a) the text of the statute or part thereof 
which is proposed to be repealed; and (b) a comparative print 
of that part of the bill or joint resolution making the 
amendment and of the statute or part thereof proposed to be 
amended, showing by stricken through type and italics, parallel 
columns, or other appropriate typographical devices the 
omissions and insertions which would be made by the bill or 
joint resolution if enacted in the form recommended by the 
committee.''
    In compliance with this rule, the following changes in 
existing law proposed to be made by the bill are shown as 
follows: existing law to be omitted is enclosed in black 
brackets; new matter is printed in italic; and existing law in 
which no change is proposed is shown in roman.

                TITLE 42--THE PUBLIC HEALTH AND WELFARE

          * * * * * * *

                       CHAPTER 7--SOCIAL SECURITY

          * * * * * * *

   SUBCHAPTER XVI--SUPPLEMENTAL SECURITY INCOME FOR AGED, BLIND, AND 
                                DISABLED

          * * * * * * *

                   Part A--Determination of Benefits

          * * * * * * *

Sec. 1382. Eligibility for benefits

    (a) * * *
          * * * * * * *

Mandatory Minimum State Supplementation of Supplemental Security Income 
 Benefits Program; December 1973 Income; Title XVI Benefit Plus Other 
  Income; Reduction of Amount; Administration Agreement; Payments to 
              Secretary; State Constitutional Restriction

    Section 212 of Pub. L. 93-66, as amended by Pub. L. 93-233, 
Sec. 10, Dec. 31, 1973, 87 Stat. 957; Pub. L. 93-335, Sec. 
2(a), July 8, 1974, 88 Stat. 291; Pub. L. 96-265, title II, 
Sec. 201(b)(2), June 9, 1980, 94 Stat. 446; Pub. L. 103-66, 
title XIII, Sec. 13731(a)(2), Aug. 10, 1993, 107 Stat. 661, 
provided that:
    ``(a)(1) * * *
          * * * * * * *
    ``(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.
          * * * * * * *
    [``(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.''
          * * * * * * *

Sec. 1382e. Supplementary assistance by State or subdivision to needy 
                    individuals

(a) * * *

          * * * * * * *

(d) Payment to Commissioner by State of amount equal to expenditures by 
                    Commissioner as supplementary payments; time and 
                    manner of payment by State; fees for Federal 
                    administration of State supplementary payments

    (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.

              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. For the purposes of this bill, or funding under a 
continuing resolution in lieu of a regular bill, 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. In the event of funding under a 
formula-based continuing resolution, agencies should fund each 
project or activity according to the formula, and if this 
process results in a funding level above what the account total 
would be if the formula were applied to it alone, an across-
the-board reduction in each project or activity in the account 
would be required to bring the account total within the 
formula.

  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 1997 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL 
                                                                        YEAR 1998                                                                       
                                                                [In thousands of dollars]                                                               
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation 
                                                                                                                            compared with (+ or -)      
                             Item                                     1997         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         1997                        
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                        
                 TITLE I--DEPARTMENT OF LABOR                                                                                                           
                                                                                                                                                        
            EMPLOYMENT AND TRAINING ADMINISTRATION                                                                                                      
                                                                                                                                                        
             TRAINING AND EMPLOYMENT SERVICES \1\                                                                                                       
                                                                                                                                                        
Grants to States:                                                                                                                                       
    Adult training............................................          895,000         1,063,990           955,000           +60,000          -108,990 
    Youth training............................................          126,672           129,965           129,965            +3,293   ................
    Summer youth employment and training program \2\..........          871,000           871,000           871,000   ................  ................
    Dislocated worker assistance..............................        1,286,200         1,350,510         1,350,510           +64,310   ................
Federally administered programs:                                                                                                                        
    Native Americans..........................................           52,502            52,502            55,127            +2,625            +2,625 
    Migrants and seasonal farmworkers.........................           69,285            69,285            72,749            +3,464            +3,464 
    Job Corps:                                                                                                                                          
        Operations............................................        1,064,824         1,127,726         1,127,726           +62,902   ................
        Construction and renovation \3\.......................           88,685           118,491           118,491           +29,806   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Job Corps.................................        1,153,509         1,246,217         1,246,217           +92,708   ................
    Veterans' employment......................................            7,300             7,300             7,300   ................  ................
    National activities:                                                                                                                                
        Pilots and demonstrations.............................           27,140            23,717            83,000           +55,860           +59,283 
        Research, demonstration and evaluation................            6,196            10,196             8,196            +2,000            -2,000 
        Opportunity areas for youth...........................  ................          250,000   ................  ................         -250,000 
        Opportunity areas for youth advance...................  ................  ................          250,000          +250,000          +250,000 
        Other.................................................           13,489            10,489            16,489            +3,000            +6,000 
                                                               -----------------------------------------------------------------------------------------
          Subtotal, National activities.......................           46,825           294,402           357,685          +310,860           +63,283 
                                                               =========================================================================================
          Subtotal, Federal activities........................        1,329,421         1,669,706         1,739,078          +409,657           +69,372 
                                                               =========================================================================================
          Total, Job Training Partnership Act.................        4,508,293         5,085,171         5,045,553          +537,260           -39,618 
                                                               =========================================================================================
Women in apprenticeship \2\...................................              610               647             3,000            +2,390            +2,353 
Skills Standards..............................................            7,000             7,000             9,000            +2,000            +2,000 
                                                               -----------------------------------------------------------------------------------------
      Total, National activities, TES (non-add)...............          (54,435)         (302,049)         (369,685)        (+315,250)         (+67,636)
School-to-work \4\............................................          200,000           200,000           200,000   ................  ................
Homeless veterans \2\.........................................  ................            2,500             2,500            +2,500   ................
                                                               =========================================================================================
      Total, Training and Employment Services.................        4,715,903         5,295,318         5,260,053          +544,150           -35,265 
      Subtotal, forward funded................................       (3,844,293)       (4,421,171)       (4,133,553)        (+289,260)        (-287,618)
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS..............          463,000           440,200           453,000           -10,000           +12,800 
                                                                                                                                                        
         FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES                                                                                                   
                                                                                                                                                        
Trade adjustment..............................................          276,100           304,700           304,700           +28,600   ................
NAFTA activities..............................................           48,400            44,300            44,300            -4,100   ................
                                                               -----------------------------------------------------------------------------------------
      Total...................................................          324,500           349,000           349,000           +24,500   ................
                                                                                                                                                        
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS                                                                                          
                                                                                                                                                        
Unemployment Compensation (Trust Funds):                                                                                                                
    State Operations..........................................       (2,115,125)       (2,204,125)       (2,115,125)  ................         (-89,000)
    National Activities.......................................          (10,000)          (10,000)          (10,000)  ................  ................
    Year 2000 computer conversion.............................  ................         (200,000)         (150,000)        (+150,000)         (-50,000)
    Contingency...............................................         (216,333)         (216,333)         (216,333)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Unemployment Comp (trust funds)...............       (2,341,458)       (2,630,458)       (2,491,458)        (+150,000)        (-139,000)
Employment Service:                                                                                                                                     
    Allotments to States:                                                                                                                               
        Federal funds.........................................           23,452            23,452            23,452   ................  ................
        Trust funds...........................................         (738,283)         (738,283)         (738,283)  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          761,735           761,735           761,735   ................  ................
    National Activities: Trust funds \5\......................          (62,735)          (62,735)          (62,735)  ................  ................
                                                               =========================================================================================
          Subtotal, Employment Service........................          824,470           824,470           824,470   ................  ................
              Federal funds...................................           23,452            23,452            23,452   ................  ................
              Trust funds.....................................         (801,018)         (801,018)         (801,018)  ................  ................
One-stop Career Centers.......................................          150,000           150,000           150,000   ................  ................
                                                               =========================================================================================
      Total, State Unemployment...............................        3,315,928         3,604,928         3,465,928          +150,000          -139,000 
          Federal Funds.......................................          173,452           173,452           173,452   ................  ................
          Trust Funds.........................................       (3,142,476)       (3,431,476)       (3,292,476)        (+150,000)        (-139,000)
ADVANCES TO UNEMPLOYMENT TRUST FUND and OTHER FUNDS \6\.......          373,000           392,000           392,000           +19,000   ................
                                                                                                                                                        
                    PROGRAM ADMINISTRATION                                                                                                              
                                                                                                                                                        
Adult employment and training.................................           25,842            26,486            26,100              +258              -386 
    Trust funds...............................................           (2,237)           (2,331)           (2,259)             (+22)             (-72)
Youth employment and training.................................           29,607            31,871            29,903              +296            -1,968 
Employment security...........................................            6,081             4,601             6,142               +61            +1,541 
    Trust funds...............................................          (37,324)          (39,807)          (37,697)            (+373)          (-2,110)
Apprenticeship services.......................................           16,271            17,367            16,434              +163              -933 
Executive direction...........................................            5,672             5,889             5,729               +57              -160 
    Trust funds...............................................           (1,316)           (1,291)           (1,329)             (+13)             (+38)
                                                               -----------------------------------------------------------------------------------------
      Total, Program Administration...........................          124,350           129,643           125,593            +1,243            -4,050 
          Federal funds.......................................           83,473            86,214            84,308              +835            -1,906 
          Trust funds.........................................          (40,877)          (43,429)          (41,285)            (+408)          (-2,144)
                                                               =========================================================================================
            Total, Employment and Training Administration.....        9,316,681        10,211,089        10,045,574          +728,893          -165,515 
                Federal funds.................................        6,133,328         6,736,184         6,711,813          +578,485           -24,371 
                Trust funds...................................       (3,183,353)       (3,474,905)       (3,333,761)        (+150,408)        (-141,144)
                                                                                                                                                        
          PENSION AND WELFARE BENEFITS ADMINISTRATION                                                                                                   
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Enforcement and compliance....................................           61,476            67,463            66,100            +4,624            -1,363 
Policy, regulation and public service.........................           11,781            13,158            12,281              +500              -877 
Program oversight.............................................            3,583             3,686             3,619               +36               -67 
                                                               -----------------------------------------------------------------------------------------
      Total, PWBA.............................................           76,840            84,307            82,000            +5,160            -2,307 
                                                                                                                                                        
             PENSION BENEFIT GUARANTY CORPORATION                                                                                                       
                                                                                                                                                        
Program Administration subject to limitation (Trust Funds)....          (10,330)          (10,625)          (10,433)            (+103)            (-192)
Services related to terminations not subject to limitations                                                                                             
 (non-add)....................................................         (125,338)         (137,376)         (137,376)         (+12,038)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, PBGC.............................................         (135,668)         (148,001)         (147,809)         (+12,141)            (-192)
                                                                                                                                                        
              EMPLOYMENT STANDARDS ADMINISTRATION                                                                                                       
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Enforcement of wage and hour standards........................          117,904           124,505           121,213            +3,309            -3,292 
Office of Labor-Management Standards..........................           25,489            26,382            26,709            +1,220              +327 
Federal contractor EEO standards enforcement..................           58,972            68,728            62,271            +3,299            -6,457 
Federal programs for workers' compensation....................           75,670            81,199            77,783            +2,113            -3,416 
    Trust funds...............................................             (983)           (1,760)             (993)             (+10)            (-767)
Program direction and support.................................           11,366            11,629            11,684              +318               +55 
                                                               -----------------------------------------------------------------------------------------
      Total, salaries and expenses............................          290,384           314,203           300,653           +10,269           -13,550 
          Federal funds.......................................          289,401           312,443           299,660           +10,259           -12,783 
          Trust funds.........................................             (983)           (1,760)             (993)             (+10)            (-767)
                                                                                                                                                        
                       SPECIAL BENEFITS                                                                                                                 
                                                                                                                                                        
Federal employees compensation benefits.......................          209,000           197,000           197,000           -12,000   ................
Longshore and harbor workers' benefits........................            4,000             4,000             4,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits.................................          213,000           201,000           201,000           -12,000   ................
                                                                                                                                                        
               BLACK LUNG DISABILITY TRUST FUND                                                                                                         
                                                                                                                                                        
Benefit payments and interest on advances.....................          961,665           960,650           960,650            -1,015   ................
Employment Standards Administration, salaries and expenses....           26,053            26,147            26,147               +94   ................
Departmental Management, salaries and expenses................           19,621            19,551            19,551               -70   ................
Departmental Management, inspector general....................              287               296               296                +9   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, black lung disability trust fund..............        1,007,626         1,006,644         1,006,644              -982   ................
Treasury administrative costs (indefinite)....................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, black lung disability trust fund.................        1,007,982         1,007,000         1,007,000              -982   ................
                                                               =========================================================================================
      Total, Employment Standards Administration..............        1,511,366         1,522,203         1,508,653            -2,713           -13,550 
          Federal funds.......................................        1,510,383         1,520,443         1,507,660            -2,723           -12,783 
          Trust funds.........................................             (983)           (1,760)             (993)             (+10)            (-767)
                                                                                                                                                        
         OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION                                                                                                  
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Safety and health standards...................................           11,971            12,566            12,091              +120              -475 
Enforcement:                                                                                                                                            
    Federal enforcement.......................................          125,907           135,689           130,606            +4,699            -5,083 
    State programs............................................           77,169            79,175            77,941              +772            -1,234 
Technical support.............................................           17,417            17,617            17,591              +174               -26 
Compliance assistance:                                                                                                                                  
    Federal assistance........................................           37,351            46,285            41,734            +4,383            -4,551 
    State consultation grants.................................           34,477            35,373            35,373              +896   ................
Safety and health statistics..................................           14,142            14,460            14,283              +141              -177 
Executive direction and administration........................            6,521             6,640             6,586               +65               -54 
                                                               -----------------------------------------------------------------------------------------
      Total, OSHA.............................................          324,955           347,805           336,205           +11,250           -11,600 
                                                                                                                                                        
             MINE SAFETY AND HEALTH ADMINISTRATION                                                                                                      
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Enforcement:                                                                                                                                            
    Coal......................................................          106,993           107,419           107,419              +426   ................
    Metal/nonmetal............................................           41,994            44,315            44,315            +2,321   ................
    Standards development.....................................            1,008             1,426             1,426              +418   ................
Assessments...................................................            3,497             3,578             3,578               +81   ................
Educational policy and development............................           14,782            14,834            14,834               +52   ................
Technical support.............................................           21,268            24,870            24,870            +3,602   ................
Program administration........................................            7,645             9,362             9,362            +1,717   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Mine Safety and Health Administration............          197,187           205,804           205,804            +8,617   ................
                                                                                                                                                        
                  BUREAU OF LABOR STATISTICS                                                                                                            
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Employment and unemployment statistics........................          102,169           109,955           106,415            +4,246            -3,540 
Labor market information (trust funds)........................          (52,053)          (52,848)          (52,574)            (+521)            (-274)
Prices and cost of living.....................................          100,134           107,028           107,028            +6,894   ................
Compensation and working conditions...........................           56,834            58,909            57,402              +568            -1,507 
Productivity and technology...................................            7,263             7,248             7,336               +73               +88 
Economic growth and employment projections....................            4,640             4,728             4,686               +46               -42 
Executive direction and staff services........................           21,584            23,311            21,800              +216            -1,511 
Consumer Price Index revision \6\.............................           16,145            15,430            15,430              -715   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Bureau of Labor Statistics.......................          360,822           379,457           372,671           +11,849            -6,786 
          Federal funds.......................................          308,769           326,609           320,097           +11,328            -6,512 
          Trust funds.........................................          (52,053)          (52,848)          (52,574)            (+521)            (-274)
                                                                                                                                                        
                    DEPARTMENTAL MANAGEMENT                                                                                                             
                                                                                                                                                        
                     SALARIES AND EXPENSES                                                                                                              
                                                                                                                                                        
Executive direction...........................................           20,029            19,714            19,714              -315   ................
Legal services................................................           59,911            64,813            64,813            +4,902   ................
    Trust funds...............................................             (297)             (282)             (282)             (-15)  ................
International labor affairs...................................            9,465            11,095            11,095            +1,630   ................
Administration and management.................................           13,904            14,259            14,259              +355   ................
Adjudication..................................................           20,483            20,979            20,688              +205              -291 
Promoting employment of people with disabilities..............            4,358             4,439             4,439               +81   ................
Women's Bureau................................................            7,743             7,569             7,743   ................             +174 
Civil rights activities.......................................            4,535             4,598             4,580               +45               -18 
Chief financial officer.......................................            4,394             4,930             4,800              +406              -130 
                                                               -----------------------------------------------------------------------------------------
      Total, salaries and expenses............................          145,119           152,678           152,413            +7,294              -265 
          Federal funds.......................................          144,822           152,396           152,131            +7,309              -265 
          Trust funds.........................................             (297)             (282)             (282)             (-15)  ................
                                                                                                                                                        
               VETERANS EMPLOYMENT AND TRAINING                                                                                                         
                                                                                                                                                        
State administration:                                                                                                                                   
    Disabled Veterans Outreach Program........................          (81,993)          (80,040)          (80,040)          (-1,953)  ................
    Local Veterans Employment Program.........................          (75,125)          (77,078)          (77,078)          (+1,953)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State administration..........................         (157,118)         (157,118)         (157,118)  ................  ................
Federal administration........................................          (22,733)          (22,837)          (22,837)            (+104)  ................
National Veterans Training Institute..........................           (2,000)           (2,000)           (2,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, trust funds......................................         (181,851)         (181,955)         (181,955)            (+104)  ................
                                                                                                                                                        
                OFFICE OF THE INSPECTOR GENERAL                                                                                                         
                                                                                                                                                        
Program activities............................................           37,480            37,345            37,345              -135   ................
    Trust funds...............................................           (3,543)           (3,645)           (3,645)            (+102)  ................
Executive direction and management............................            5,958             5,760             5,760              -198   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office of the Inspector General..................           46,981            46,750            46,750              -231   ................
          Federal funds.......................................           43,438            43,105            43,105              -333   ................
          Trust funds.........................................           (3,543)           (3,645)           (3,645)            (+102)  ................
                                                               =========================================================================================
      Total, Departmental Management..........................          373,951           381,383           381,118            +7,167              -265 
          Federal funds.......................................          188,260           195,501           195,236            +6,976              -265 
          Trust funds.........................................         (185,691)         (185,882)         (185,882)            (+191)  ................
                                                               =========================================================================================
      Total, Labor Department.................................       12,172,132        13,142,673        12,942,458          +770,326          -200,215 
          Federal funds.......................................        8,739,722         9,416,653         9,358,815          +619,093           -57,838 
          Trust funds.........................................       (3,432,410)       (3,726,020)       (3,583,643)        (+151,233)        (-142,377)
                                                                                                                                                        
     TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES \7\                                                                                              
                                                                                                                                                        
         HEALTH RESOURCES AND SERVICES ADMINISTRATION                                                                                                   
                                                                                                                                                        
                 HEALTH RESOURCES AND SERVICES                                                                                                          
                                                                                                                                                        
Consolidated health centers...................................          802,009           809,868           826,000           +23,991           +16,132 
National Health Service Corps:                                                                                                                          
    Field placements..........................................           37,244            37,244            37,244   ................  ................
    Recruitment...............................................           78,166            78,166            78,166   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, National Health Service Corps.................          115,410           115,410           115,410   ................  ................
                                                                                                                                                        
                      Health Professions                                                                                                                
                                                                                                                                                        
Grants to communities for scholarships........................              532   ................  ................             -532   ................
Health professions data system................................              236   ................  ................             -236   ................
Research on certain Health Profession issues..................              450   ................  ................             -450   ................
Nurse loan repayment for shortage area service................            2,197   ................  ................           -2,197   ................
Workforce Development Cluster (proposed leg)..................  ................              623   ................  ................             -623 
Centers of excellence.........................................           24,714   ................  ................          -24,714   ................
Health careers opportunity program............................           26,779   ................  ................          -26,779   ................
Exceptional financial need scholarships.......................           11,332   ................  ................          -11,332   ................
Faculty loan repayment........................................            1,061   ................  ................           -1,061   ................
Fin assistance for disadvantaged HP students..................            6,718   ................  ................           -6,718   ................
Scholarships for disadvantaged students.......................           18,673   ................  ................          -18,673   ................
Minority/Disadvantaged Cluster (proposed leg).................  ................           89,277   ................  ................          -89,277 
Family medicine training/departments..........................           49,256   ................  ................          -49,256   ................
General internal medicine and pediatrics......................           17,618   ................  ................          -17,618   ................
Physician assistants..........................................            6,376   ................  ................           -6,376   ................
Public health and preventive medicine.........................            7,998   ................  ................           -7,998   ................
Health administration traineeships/projects...................            1,095   ................  ................           -1,095   ................
Primary Care Medicine and Public Health Cluster (proposed                                                                                               
 legislation).................................................  ................            7,700   ................  ................           -7,700 
Area health education centers.................................           28,490   ................  ................          -28,490   ................
Border health training centers................................            3,752   ................  ................           -3,752   ................
General dentistry residencies.................................            3,785   ................  ................           -3,785   ................
Allied health special projects................................            3,832   ................  ................           -3,832   ................
Geriatric education centers and training......................            8,881   ................  ................           -8,881   ................
Rural interdisciplinary traineeships..........................            4,153   ................  ................           -4,153   ................
Podiatric medicine............................................              677   ................  ................             -677   ................
Chiropractic demonstration grants.............................            1,025   ................  ................           -1,025   ................
Enhanced Area Health Education Cluster (proposed legislation).  ................           24,700   ................  ................          -24,700 
Consolidated Title VII........................................  ................  ................          165,000          +165,000          +165,000 
Advanced nurse education......................................           12,467   ................  ................          -12,467   ................
Nurse practitioners/nurse midwives............................           17,586   ................  ................          -17,586   ................
Special projects..............................................           10,564   ................  ................          -10,564   ................
Nurse disadvantaged assistance................................            3,865   ................  ................           -3,865   ................
Professional nurse traineeships...............................           15,941   ................  ................          -15,941   ................
Nurse anesthetists............................................            2,765   ................  ................           -2,765   ................
Nurse Education/Practice Initiatives Cluster (proposed                                                                                                  
 legislation).................................................  ................            7,700   ................  ................           -7,700 
Consolidated Title VIII.......................................  ................  ................           55,000           +55,000           +55,000 
Undistributed reduction.......................................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health professions............................          292,818           130,000           220,000           -72,818           +90,000 
Other HRSA Programs:                                                                                                                                    
    Hansen's disease services.................................           17,094            16,469            14,424            -2,670            -2,045 
    Maternal and child health block grant.....................          681,000           681,000           681,000   ................  ................
    Healthy start.............................................           95,982            95,982            95,982   ................  ................
    Organ transplantation.....................................            2,278             3,891             2,778              +500            -1,113 
    Health teaching facilities interest subsidies.............              297               225               225               -72   ................
    Bone marrow program.......................................           15,270            15,270            15,270   ................  ................
    Rural outreach grants.....................................           27,796            25,092            30,092            +2,296            +5,000 
    Emergency medical services for children...................           12,493            12,000            13,000              +507            +1,000 
    Black lung clinics........................................            4,000             1,906             5,000            +1,000            +3,094 
    Alzheimers demonstration grants...........................            5,999   ................            5,999   ................           +5,999 
    Payment to Hawaii, treatment of Hansen's Disease..........            2,045   ................            2,045   ................           +2,045 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Other HRSA programs...........................          864,254           851,835           865,815            +1,561           +13,980 
Ryan White AIDS Programs:                                                                                                                               
    Education and training centers............................           16,287            17,287            17,287            +1,000   ................
    AIDS dental services......................................            7,500             7,500             7,500   ................  ................
    Emergency assistance......................................          449,943           454,943           457,943            +8,000            +3,000 
    Comprehensive care programs...............................          416,954           431,954           469,954           +53,000           +38,000 
    Early intervention program................................           69,568            84,568            79,568           +10,000            -5,000 
    Pediatric demonstrations..................................           36,000            40,000            45,000            +9,000            +5,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDS programs......................          996,252         1,036,252         1,077,252           +81,000           +41,000 
Family planning...............................................          198,452           203,452           208,452           +10,000            +5,000 
Rural health research.........................................            8,713             8,713            11,713            +3,000            +3,000 
Health care facilities........................................           12,902   ................           10,000            -2,902           +10,000 
Buildings and facilities......................................              828   ................  ................             -828   ................
National practitioner data bank...............................            6,000             8,000             8,000            +2,000   ................
    User fees.................................................           -6,000            -8,000            -8,000            -2,000   ................
Program management............................................          112,929           110,949           114,429            +1,500            +3,480 
                                                               -----------------------------------------------------------------------------------------
      Total, Health resources and services....................        3,404,567         3,266,479         3,449,071           +44,504          +182,592 
MEDICAL FACILITIES GUARANTEE AND LOAN FUND: Interest subsidy                                                                                            
 program......................................................            7,000             6,000             6,000            -1,000   ................
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM (HEAL):                                                                                                       
    New loan subsidies........................................              477             1,020             1,020              +543   ................
    Liquidating account (non-add).............................          (37,608)          (29,566)          (29,566)          (-8,042)  ................
    HEAL loan limitation (non-add)............................         (140,000)          (85,000)          (85,000)         (-55,000)  ................
    Program management........................................            2,688             2,688             2,688   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, HEAL.............................................            3,165             3,708             3,708              +543   ................
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:                                                                                                         
    Post-fiscal year 1988 claims (trust fund).................           50,476            42,448            42,448            -8,028   ................
    HRSA administration (trust fund)..........................            3,000             3,000             3,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Vaccine injury compensation trust fund........           53,476            45,448            45,448            -8,028   ................
VACCINE INJURY COMPENSATION: Pre-fiscal year 1989 claims                                                                                                
 (appropriation)..............................................          110,000   ................  ................         -110,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Vaccine injury...................................          163,476            45,448            45,448          -118,028   ................
                                                               =========================================================================================
      Total, Health Resources and Services Admin..............        3,578,208         3,321,635         3,504,227           -73,981          +182,592 
                                                                                                                                                        
          CENTERS FOR DISEASE CONTROL AND PREVENTION                                                                                                    
                                                                                                                                                        
            DISEASE CONTROL, RESEARCH AND TRAINING                                                                                                      
                                                                                                                                                        
Preventive Health Services Block Grant........................          153,994           143,940           143,940           -10,054   ................
Rape Prevention and Education (non-add).......................           35,000            45,000            45,000           +10,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Preventive Health Services Block Grant (non-                                                                                            
       add)...................................................          188,994           188,940           188,940               -54   ................
                                                               =========================================================================================
Prevention centers............................................            8,099             8,099             8,099   ................  ................
Childhood immunization \8\....................................          467,583           427,312           445,545           -22,038           +18,233 
Acquired Immune Deficiency Syndrome (AIDS)....................          616,790           634,266           646,790           +30,000           +12,524 
Tuberculosis..................................................          119,294           119,236           119,236               -58   ................
Sexually transmitted diseases.................................          106,203           111,171           111,171            +4,968   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          225,497           230,407           230,407            +4,910   ................
Chronic diseases:                                                                                                                                       
    Chronic and environmental disease prevention..............          166,874           191,039           203,454           +36,580           +12,415 
    Breast and cervical cancer screening......................          139,659           141,897           141,897            +2,238   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Chronic diseases..............................          306,533           332,936           345,351           +38,818           +12,415 
Infectious disease............................................           87,720           112,428           112,428           +24,708   ................
Lead poisoning prevention.....................................           38,181            38,154            38,200               +19               +46 
Injury control................................................           43,182            49,033            45,063            +1,881            -3,970 
Occupational Safety and Health (NIOSH)........................          141,340           148,463           148,463            +7,123   ................
Mine safety and health........................................           31,913            32,000            40,000            +8,087            +8,000 
Epidemic services.............................................           69,608            69,322            69,322              -286   ................
National Center for Health Statistics:                                                                                                                  
    Program operations........................................           37,612            18,963            18,033           -19,579              -930 
    1 percent evaluation funds (non-add)......................          (48,400)          (70,063)          (70,063)         (+21,663)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, health statistics.............................          (86,012)          (89,026)          (88,096)          (+2,084)            (-930)
Buildings and facilities......................................           30,553            23,007            23,007            -7,546   ................
Program management............................................            2,563             2,465             2,465               -98   ................
                                                               =========================================================================================
      Subtotal, Centers for Disease Control...................        2,261,168         2,270,795         2,317,113           +55,945           +46,318 
Crime Bill Activities:                                                                                                                                  
    Rape prevention and education.............................           35,000            45,000            45,000           +10,000   ................
    Domestic violence community demonstrations................            6,000   ................            6,000   ................           +6,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Crime bill activities.........................           41,000            45,000            51,000           +10,000            +6,000 
                                                               =========================================================================================
      Total, Disease Control..................................        2,302,168         2,315,795         2,368,113           +65,945           +52,318 
                                                                                                                                                        
                 NATIONAL INSTITUTES OF HEALTH                                                                                                          
                                                                                                                                                        
National Cancer Institute.....................................        2,381,149         2,217,482         2,558,377          +177,228          +340,895 
    Transfer, Office of AIDS Research.........................  ................         (224,256)  ................  ................        (-224,256)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................       (2,381,149)       (2,441,738)       (2,558,377)        (+177,228)        (+116,639)
National Heart, Lung, and Blood Institute.....................        1,432,529         1,404,770         1,531,898           +99,369          +127,128 
    Transfer, Office of AIDS Research.........................  ................          (62,419)  ................  ................         (-62,419)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................       (1,432,529)       (1,467,189)       (1,531,898)         (+99,369)         (+64,709)
National Institute of Dental Research.........................          195,825           190,081           211,611           +15,786           +21,530 
    Transfer, Office of AIDS Research.........................  ................          (12,750)  ................  ................         (-12,750)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (195,825)         (202,831)         (211,611)         (+15,786)          (+8,780)
National Institute of Diabetes and Digestive and Kidney                                                                                                 
 Diseases.....................................................          815,607           821,164           883,321           +67,714           +62,157 
    Transfer, Office of AIDS Research.........................  ................          (12,638)  ................  ................         (-12,638)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (815,607)         (833,802)         (883,321)         (+67,714)         (+49,519)
National Institute of Neurological Disorders and Stroke.......          726,407           722,712           781,351           +54,944           +58,639 
    Transfer, Office of AIDS Research.........................  ................          (25,116)  ................  ................         (-25,116)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (726,407)         (747,828)         (781,351)         (+54,944)         (+33,523)
National Institute of Allergy and Infectious Diseases.........        1,256,659           634,272         1,359,688          +103,029          +725,416 
    Transfer, Office of AIDS Research.........................  ................         (678,230)  ................  ................        (-678,230)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................       (1,256,659)       (1,312,502)       (1,359,688)        (+103,029)         (+47,186)
National Institute of General Medical Sciences................          998,387           992,032         1,058,969           +60,582           +66,937 
    Transfer, Office of AIDS Research.........................  ................          (28,160)  ................  ................         (-28,160)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (998,387)       (1,020,192)       (1,058,969)         (+60,582)         (+38,777)
National Institute of Child Health and Human Development......          631,365           582,032           676,870           +45,505           +94,838 
    Transfer, Office of AIDS Research.........................  ................          (65,247)  ................  ................         (-65,247)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (631,365)         (647,279)         (676,870)         (+45,505)         (+29,591)
National Eye Institute........................................          332,597           330,955           357,695           +25,098           +26,740 
    Transfer, Office of AIDS Research.........................  ................           (9,476)  ................  ................          (-9,476)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (332,597)         (340,431)         (357,695)         (+25,098)         (+17,264)
National Institute of Environmental Health Sciences...........          308,487           313,583           331,969           +23,482           +18,386 
    Transfer, Office of AIDS Research.........................  ................           (6,324)  ................  ................          (-6,324)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (308,487)         (319,907)         (331,969)         (+23,482)         (+12,062)
National Institute on Aging...................................          485,806           495,202           520,705           +34,899           +25,503 
    Transfer, Office of AIDS Research.........................  ................           (1,874)  ................  ................          (-1,874)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (485,806)         (497,076)         (520,705)         (+34,899)         (+23,629)
National Institute of Arthritis and Musculoskeletal and Skin                                                                                            
 Diseases.....................................................          257,003           258,932           272,631           +15,628           +13,699 
    Transfer, Office of AIDS Research.........................  ................           (4,310)  ................  ................          (-4,310)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (257,003)         (263,242)         (272,631)         (+15,628)          (+9,389)
National Institute on Deafness and Other Communication                                                                                                  
 Disorders....................................................          188,345           192,447           200,428           +12,083            +7,981 
    Transfer, Office of AIDS Research.........................  ................           (1,774)  ................  ................          (-1,774)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (188,345)         (194,221)         (200,428)         (+12,083)          (+6,207)
National Institute of Nursing Research........................           59,721            55,692            64,016            +4,295            +8,324 
    Transfer, Office of AIDS Research.........................  ................           (5,360)  ................  ................          (-5,360)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (59,721)          (61,052)          (64,016)          (+4,295)          (+2,964)
National Institute on Alcohol Abuse and Alcoholism............          211,870           208,112           228,585           +16,715           +20,473 
    Transfer, Office of AIDS Research.........................  ................          (11,234)  ................  ................         (-11,234)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (211,870)         (219,346)         (228,585)         (+16,715)          (+9,239)
National Institute on Drug Abuse..............................          489,160           358,475           531,751           +42,591          +173,276 
    Transfer, Office of AIDS Research.........................  ................         (163,440)  ................  ................        (-163,440)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (489,160)         (521,915)         (531,751)         (+42,591)          (+9,836)
National Institute of Mental Health...........................          701,107           629,739           753,334           +52,227          +123,595 
    Transfer, Office of AIDS Research.........................  ................          (98,510)  ................  ................         (-98,510)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (701,107)         (728,249)         (753,334)         (+52,227)         (+25,085)
National Center for Research Resources........................          415,095           333,868           455,805           +40,710          +121,937 
    Transfer, Office of AIDS Research.........................  ................          (77,053)  ................  ................         (-77,053)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (415,095)         (410,921)         (455,805)         (+40,710)         (+44,884)
National Center for Human Genome Research.....................          189,529           202,197           218,851           +29,322           +16,654 
    Transfer, Office of AIDS Research.........................  ................           (2,990)  ................  ................          (-2,990)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (189,529)         (205,187)         (218,851)         (+29,322)         (+13,664)
John E. Fogarty International Center..........................           26,557            16,755            28,468            +1,911           +11,713 
    Transfer, Office of AIDS Research.........................  ................          (10,413)  ................  ................         (-10,413)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (26,557)          (27,168)          (28,468)          (+1,911)          (+1,300)
National Library of Medicine..................................          150,828           152,689           162,825           +11,997           +10,136 
    Transfer, Office of AIDS Research.........................  ................           (3,279)  ................  ................          (-3,279)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (150,828)         (155,968)         (162,825)         (+11,997)          (+6,857)
Office of the Director........................................          286,810           234,247           292,196            +5,386           +57,949 
    Office of AIDS research (non-add).........................          (35,589)          (35,912)  ................         (-35,589)         (-35,912)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (286,810)         (234,247)         (292,196)          (+5,386)         (+57,949)
Buildings and facilities......................................          200,000           190,000           211,500           +11,500           +21,500 
Office of AIDS Research.......................................  ................        1,540,765   ................  ................       -1,540,765 
                                                               =========================================================================================
      Total N.I.H.............................................       12,740,843        13,078,203        13,692,844          +952,001          +614,641 
                                                               =========================================================================================
   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION                                                                                            
                                                                                                                                                        
Mental health:                                                                                                                                          
    Knowledge development and application.....................           57,964            58,032            57,964   ................              -68 
    Mental health performance partnership.....................          275,420           275,420           275,420   ................  ................
    Children's mental health..................................           69,896            69,927            69,896   ................              -31 
    Grants to States for the homeless (PATH)..................           20,000            20,000            20,000   ................  ................
    Protection and advocacy...................................           21,957            21,957            21,957   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, mental health.................................          445,237           445,336           445,237   ................              -99 
Substance abuse treatment:                                                                                                                              
    Knowledge development and application.....................          155,868           156,000           155,868   ................             -132 
    Substance abuse performance partnership (BA)..............        1,310,107         1,320,107         1,310,107   ................          -10,000 
    Public Law 104-121 funding (non-add)......................          (50,000)          (50,000)          (50,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, substance abuse treatment (BA)................        1,465,975         1,476,107         1,465,975   ................          -10,132 
        Program level.........................................       (1,515,975)       (1,526,107)       (1,515,975)  ................         (-10,132)
Substance abuse prevention: Knowledge development and                                                                                                   
 application..................................................          155,869           151,000           151,000            -4,869   ................
High risk youth grants........................................  ................  ................           10,000           +10,000           +10,000 
Program management............................................           54,431            55,500            54,431   ................           -1,069 
Data collection...............................................  ................           28,000   ................  ................          -28,000 
1 percent evaluation funding (non-add)........................  ................  ................          (10,000)         (+10,000)         (+10,000)
                                                               =========================================================================================
      Total, Substance Abuse and Mental Health (BA)...........        2,121,512         2,155,943         2,126,643            +5,131           -29,300 
          Program level.......................................       (2,171,512)       (2,205,943)       (2,176,643)          (+5,131)         (-29,300)
                                                                                                                                                        
 RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS                                                                                          
                                                                                                                                                        
Retirement payments...........................................          139,299           149,217           149,217            +9,918   ................
Survivors benefits............................................           10,417            11,643            11,643            +1,226   ................
Dependent's medical care......................................           26,363            27,470            27,470            +1,107   ................
Military services credits.....................................            2,556             2,409             2,409              -147   ................
                                                               -----------------------------------------------------------------------------------------
      Total, retirement pay and medical benefits..............          178,635           190,739           190,739           +12,104   ................
                                                                                                                                                        
          AGENCY FOR HEALTH CARE POLICY AND RESEARCH                                                                                                    
                                                                                                                                                        
Research on health care systems cost and access:                                                                                                        
    Research..................................................           35,650            17,170            17,170           -18,480   ................
    1 percent evaluation funding (non-add)....................          (12,712)          (29,515)          (29,515)         (+16,803)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (48,362)          (46,685)          (46,685)          (-1,677)  ................
Health insurance and expenditure surveys:                                                                                                               
    Research..................................................           10,000            10,000            10,000   ................  ................
    1 percent evaluation funding (non-add)....................          (34,700)          (26,300)          (26,300)          (-8,400)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (44,700)          (36,300)          (36,300)          (-8,400)  ................
Research on health care outcomes and quality:                                                                                                           
    Federal funds.............................................           48,187            57,600            48,187   ................           -9,413 
    Trust funds...............................................  ................  ................  ................  ................  ................
    1 percent evaluation funding (non-add)....................  ................           (6,185)           (9,185)          (+9,185)          (+3,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (48,187)          (63,785)          (57,372)          (+9,185)          (-6,413)
Program support...............................................            2,230             2,230             2,230   ................  ................
                                                               =========================================================================================
      Total, health care policy and research:.................                                                                                          
          Federal funds.......................................           96,067            87,000            77,587           -18,480            -9,413 
          Trust funds.........................................  ................  ................  ................  ................  ................
          Total, 1 percent evaluation funding (non-add).......          (47,412)          (62,000)          (65,000)         (+17,588)          (+3,000)
                                                               -----------------------------------------------------------------------------------------
      Total, health care policy and research (non-add)........         (143,479)         (149,000)         (142,587)            (-892)          (-6,413)
      Total, Public Health Service............................       21,017,433        21,149,315        21,960,153          +942,720          +810,838 
                                                                                                                                                        
             HEALTH CARE FINANCING ADMINISTRATION                                                                                                       
                                                                                                                                                        
                 GRANTS TO STATES FOR MEDICAID                                                                                                          
                                                                                                                                                        
Medicaid current law benefits.................................       98,210,228        99,144,000        99,144,000          +933,772   ................
State and local administration................................        4,633,884         4,874,546         4,874,546          +240,662   ................
Vaccines for children.........................................          522,904           365,104           437,104           -85,800           +72,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medicaid program level, fiscal year 1997/1998.      103,367,016       104,383,650       104,455,650        +1,088,634           +72,000 
      Carryover balance.......................................       -2,155,048        -4,864,228        -4,864,228        -2,709,180   ................
      Less funds advanced in prior year.......................      -26,155,350       -27,988,993       -27,988,993        -1,833,643   ................
                                                               =========================================================================================
      Total, request, fiscal year 1997/1998...................       75,056,618        71,530,429        71,602,429        -3,454,189           +72,000 
          New advance, 1st quarter, fiscal year 1998/1999.....       27,988,993        27,800,689        27,800,689          -188,304   ................
                                                               =========================================================================================
              PAYMENTS TO HEALTH CARE TRUST FUNDS                                                                                                       
                                                                                                                                                        
Supplemental medical insurance................................       59,456,000        63,416,000        63,416,000        +3,960,000   ................
Hospital insurance for the uninsured..........................          405,000           -52,000           -52,000          -457,000   ................
Federal uninsured payment.....................................           76,000            86,000            86,000           +10,000   ................
Program management............................................          142,000           131,000           131,000           -11,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, payment to trust funds, current law..............       60,079,000        63,581,000         3,581,000        +3,502,000   ................
Net Medicare trust fund/general fund cash flow (NA)...........      (15,000,000)  ................  ................     (-15,000,000)  ................
                                                                                                                                                        
                      PROGRAM MANAGEMENT                                                                                                                
                                                                                                                                                        
Research, demonstration, and evaluation: Regular program,                                                                                               
 trust funds..................................................          (44,000)          (45,000)          (47,000)          (+3,000)          (+2,000)
Medicare contractors (trust funds)............................       (1,207,200)       (1,223,000)       (1,189,000)         (-18,200)         (-34,000)
    H.R. 3103 funding (non-add)...............................         (440,000)         (500,000)         (500,000)         (+60,000)  ................
    Medicare transaction system (non-add).....................          (75,000)          (89,000)          (55,000)         (-20,000)         (-34,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, contractors program level.....................       (1,722,200)       (1,812,000)       (1,744,000)         (+21,800)         (-68,000)
State survey and certification: Medicare certification, trust                                                                                           
 funds........................................................         (158,000)         (148,000)         (158,000)  ................         (+10,000)
Federal administration:                                                                                                                                 
    Trust funds...............................................         (327,173)         (360,434)         (327,173)  ................         (-33,261)
    Less current law user fees................................          (-1,932)          (-1,934)          (-1,932)  ................              (+2)
                                                               =========================================================================================
      Subtotal, Federal administration........................         (325,241)         (358,500)         (325,241)  ................         (-33,259)
                                                               =========================================================================================
      Total, program management...............................       (1,734,441)       (1,774,500)       (1,719,241)         (-15,200)         (-55,259)
                                                               =========================================================================================
      Total, Health Care Financing Administration:                                                                                                      
          Federal funds.......................................      163,124,611       162,912,118       162,984,118          -140,493           +72,000 
              Current year, fiscal year 1997/1998.............     (135,135,618)     (135,111,429)     (135,183,429)         (+47,811)         (+72,000)
              New advance, 1st quarter, fiscal year 1998/1999.      (27,988,993)      (27,800,689)      (27,800,689)        (-188,304)  ................
          Trust funds.........................................       (1,734,441)       (1,774,500)       (1,719,241)         (-15,200)         (-55,259)
                                                               =========================================================================================
           ADMINISTRATION FOR CHILDREN AND FAMILIES                                                                                                     
                                                                                                                                                        
             FAMILY SUPPORT PAYMENTS TO STATES \9\                                                                                                      
                                                                                                                                                        
Aid to Families with Dependent Children (AFDC)................  ................  ................  ................  ................  ................
Quality control liabilities...................................  ................  ................  ................  ................  ................
Payments to territories.......................................  ................  ................  ................  ................  ................
Emergency assistance..........................................  ................  ................  ................  ................  ................
Repatriation..................................................  ................  ................  ................  ................  ................
State and local welfare administration........................  ................  ................  ................  ................  ................
Work activities child care....................................  ................  ................  ................  ................  ................
Transitional child care.......................................  ................  ................  ................  ................  ................
At risk child care............................................  ................  ................  ................  ................  ................
Undistributed.................................................        9,600,000   ................  ................       -9,600,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, welfare payments..............................        9,600,000   ................  ................       -9,600,000   ................
Child support enforcement:                                                                                                                              
    State and local administration............................  ................  ................  ................  ................  ................
    Federal incentive payments................................  ................  ................  ................  ................  ................
    Less federal share collections............................  ................  ................  ................  ................  ................
    Net welfare reform child support appropriation............        2,158,000   ................  ................       -2,158,000   ................
                                                               -----------------------------------------------------------------------------------------
        Subtotal, child support...............................        2,158,000   ................  ................       -2,158,000   ................
                                                               -----------------------------------------------------------------------------------------
        Total, payments, fiscal year 1997/1998 program level..       11,758,000   ................  ................      -11,758,000   ................
            Less funds advanced in previous years.............       -4,800,000   ................  ................       +4,800,000   ................
                                                               -----------------------------------------------------------------------------------------
        Total, payments, current request, fiscal year 1997/                                                                                             
         1998.................................................        6,958,000   ................  ................       -6,958,000   ................
            New advance, 1st quarter, fiscal year 1998/1999...          607,000   ................  ................         -607,000   ................
                                                               =========================================================================================
JOB OPPORTUNITIES AND BASIC SKILLS (JOBS).....................        1,000,000   ................  ................       -1,000,000   ................
                                                                                                                                                        
               LOW INCOME HOME ENERGY ASSISTANCE                                                                                                        
                                                                                                                                                        
Advance from prior year (non-add).............................  ................       (1,000,000)       (1,000,000)      (+1,000,000)  ................
    Adjustment................................................        1,000,000   ................  ................       -1,000,000   ................
                                                               -----------------------------------------------------------------------------------------
    Fiscal year 1997/1998 program level.......................       (1,000,000)       (1,000,000)       (1,000,000)  ................  ................
Prior year emergency allocation...............................         (300,000)  ................  ................        (-300,000)  ................
New emergency allocation (non-add)............................  ................         (300,000)         (300,000)        (+300,000)  ................
Advance funding (fiscal year 1998/1999).......................        1,000,000         1,000,000         1,200,000          +200,000          +200,000 
                                                                                                                                                        
                REFUGEE AND ENTRANT ASSISTANCE                                                                                                          
                                                                                                                                                        
Transitional and medical services.............................          246,502           227,138           227,138           -19,364   ................
Social services...............................................          110,882           110,882           110,882   ................  ................
Preventive health.............................................            4,835             4,835             4,835   ................  ................
Targeted assistance...........................................           49,857            49,477            49,477              -380   ................
                                                               -----------------------------------------------------------------------------------------
      Total, refugee and entrant assistance (BA)..............          412,076           392,332           392,332           -19,744   ................
                                                               =========================================================================================
Child care and development block grant:                                                                                                                 
    Advance funded fiscal year 1998/1999......................          937,000         1,000,000         1,000,000           +63,000   ................
    Forward/advance funding from prior year (non-add).........         (934,642)         (937,000)         (937,000)          (+2,358)  ................
    Adjustment (current funding)..............................           19,120            63,000            26,120            +7,000           -36,880 
                                                               -----------------------------------------------------------------------------------------
      Total...................................................  ................  ................  ................  ................  ................
      Total, program level (non add)..........................          953,762         1,000,000           963,120            +9,358           -36,880 
                                                               =========================================================================================
Social services block grant (title XX)........................        2,500,000         2,380,000         2,245,000          -255,000          -135,000 
                                                                                                                                                        
            CHILDREN AND FAMILIES SERVICES PROGRAMS                                                                                                     
                                                                                                                                                        
Programs for Children, Youth, and Families:                                                                                                             
    Head start................................................        3,980,546         4,305,000         4,305,000          +324,454   ................
    Consolidated runaway, homeless youth program..............  ................           58,602            58,602           +58,602   ................
    Runaway and homeless youth................................           43,653   ................  ................          -43,653   ................
    Runaway youth--transitional living........................           14,949   ................  ................          -14,949   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, runaway.......................................           58,602            58,602            58,602   ................  ................
    Child abuse state grants..................................           21,026            21,026            21,026   ................  ................
    Child abuse discretionary activities......................           14,154            14,154            14,154   ................  ................
    Abandoned infants assistance..............................           12,251            12,251            12,251   ................  ................
    Child welfare services....................................          291,989           291,989           291,989   ................  ................
    Child welfare training....................................            4,000             4,000             8,000            +4,000            +4,000 
    Adoption opportunities....................................           13,000            13,000            13,000   ................  ................
Adoption initiative...........................................  ................           21,000   ................  ................          -21,000 
Family violence...............................................           62,000   ................  ................          -62,000   ................
Social services and income maintenance research...............           44,000            18,043            21,000           -23,000            +2,957 
Community Based Resource Centers..............................           32,835            32,835            32,835   ................  ................
Developmental disabilities program:                                                                                                                     
    State councils............................................           64,803            64,803            65,574              +771              +771 
    Protection and advocacy...................................           26,718            26,718            27,036              +318              +318 
    Developmental disabilities special projects...............            5,250             5,250             5,250   ................  ................
    Developmental disabilities university affiliated programs.           17,461            17,461            17,669              +208              +208 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Developmental disabilities....................          114,232           114,232           115,529            +1,297            +1,297 
Native American Programs......................................           34,933            34,933            34,933   ................  ................
Community services:                                                                                                                                     
    Community Services Block Grants...........................          489,600           414,720           492,600            +3,000           +77,880 
    Discretionary funds:                                                                                                                                
        Community initiative program:                                                                                                                   
            Economic development..............................           27,332   ................           27,332   ................          +27,332 
            Rural community facilities........................            3,500   ................            3,500   ................           +3,500 
                                                               -----------------------------------------------------------------------------------------
              Subtotal, discretionary funds...................           30,832   ................           30,832   ................          +30,832 
    National youth sports.....................................           12,000   ................           12,000   ................          +12,000 
    Community Food and Nutrition..............................            4,000   ................            4,000   ................           +4,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Community services............................          536,432           414,720           539,432            +3,000          +124,712 
Program direction.............................................          143,061           143,115           138,343            -4,718            -4,772 
Rescission....................................................          -27,000   ................          -21,000            +6,000           -21,000 
                                                               =========================================================================================
      Total, Children and Families Services Prog (BA).........        5,336,061         5,498,900         5,585,094          +249,033           +86,194 
VIOLENT CRIME REDUCTION PROGRAMS:                                                                                                                       
    Community schools.........................................           12,800            12,800   ................          -12,800           -12,800 
    Runaway Youth Prevention..................................            8,000            15,000            15,000            +7,000   ................
    Domestic violence hotline.................................            1,200             1,200             1,200   ................  ................
    Battered women's shelters.................................           10,800            70,000            76,800           +66,000            +6,800 
                                                               -----------------------------------------------------------------------------------------
      Total, Violent crime reduction programs.................           32,800            99,000            93,000           +60,200            -6,000 
FAMILY PRESERVATION AND SUPPORT...............................          240,000           255,000           255,000           +15,000   ................
                                                               =========================================================================================
  PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE                                                                                            
                                                                                                                                                        
Foster care...................................................        3,807,143         3,540,300         3,540,300          -266,843   ................
Adoption assistance...........................................          567,888           700,700           700,700          +132,812   ................
Independent living............................................           70,000            70,000            70,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Payment to States................................        4,445,031         4,311,000         4,311,000          -134,031   ................
      Less funds advanced in prior year.......................  ................       -1,111,000        -1,111,000        -1,111,000   ................
                                                               =========================================================================================
      Total, request, fiscal year 1997/1998...................        4,445,031         3,200,000         3,200,000        -1,245,031   ................
      New advance, 1st quarter, fiscal year 1998/1999.........        1,111,000         1,157,500         1,157,500           +46,500   ................
                                                               =========================================================================================
      Total, Administration for Children and Families.........       25,598,088        15,045,732        15,154,046       -10,444,042          +108,314 
          Current year, fiscal year 1997/1998.................      (21,943,088)      (11,888,232)      (11,796,546)     (-10,146,542)         (-91,686)
          Fiscal year 1998/1999...............................       (3,655,000)       (3,157,500)       (3,357,500)        (-297,500)        (+200,000)
                                                               =========================================================================================
                    ADMINISTRATION ON AGING                                                                                                             
                                                                                                                                                        
                    AGING SERVICES PROGRAMS                                                                                                             
                                                                                                                                                        
Grants to States:                                                                                                                                       
    Supportive services and centers...........................          300,556           291,375           305,556            +5,000           +14,181 
    Ombudsman services........................................  ................  ................  ................  ................  ................
    Prevention of elder abuse.................................  ................  ................  ................  ................  ................
    Preventive health.........................................           15,623            15,623            15,623   ................  ................
    Title VII.................................................  ................            9,181   ................  ................           -9,181 
    Nutrition:                                                                                                                                          
        Congregate meals......................................          364,535           359,810           368,716            +4,181            +8,906 
        Home-delivered meals..................................          105,339           110,064           110,064            +4,725   ................
Frail elderly in-home services................................            9,263             9,263             9,263   ................  ................
Grants to Indians.............................................           16,057            16,057            20,057            +4,000            +4,000 
Aging research, training and special projects.................            4,000             4,000            10,000            +6,000            +6,000 
Program administration........................................           14,758            14,795            14,795               +37   ................
Alzheimer's initiative........................................  ................            8,000   ................  ................           -8,000 
                                                               -----------------------------------------------------------------------------------------
      Total, Administration on Aging..........................          830,131           838,168           854,074           +23,943           +15,906 
                                                               =========================================================================================
                    OFFICE OF THE SECRETARY                                                                                                             
                                                                                                                                                        
GENERAL DEPARTMENTAL MANAGEMENT:                                                                                                                        
    Federal funds.............................................           96,135            96,517            98,517            +2,382            +2,000 
        Trust funds...........................................           (5,851)           (5,851)           (5,851)  ................  ................
    1 percent Evaluation Funds (ASPE) (non-add)...............          (20,552)          (20,552)          (20,552)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (122,538)         (122,920)         (124,920)          (+2,382)          (+2,000)
    Adolescent family life (Title XX).........................           14,206            14,209            19,209            +5,003            +5,000 
    Physical fitness and sports...............................              998             1,000               998   ................               -2 
    Minority health...........................................           34,584            23,100            23,600           -10,984              +500 
    Office of women's health..................................           12,495            12,500            18,500            +6,005            +6,000 
    Anti-Terrorism............................................           13,764            10,000            13,764   ................           +3,764 
                                                               -----------------------------------------------------------------------------------------
      Total, General Departmental Management:                                                                                                           
          Federal funds.......................................          172,182           157,326           174,588            +2,406           +17,262 
          Trust funds.........................................           (5,851)           (5,851)           (5,851)  ................  ................
                                                               -----------------------------------------------------------------------------------------
            Total.............................................         (178,033)         (163,177)         (180,439)          (+2,406)         (+17,262)
OFFICE OF THE INSPECTOR GENERAL:                                                                                                                        
    Federal funds.............................................           34,790            31,921            31,921            -2,869   ................
        Trust funds...........................................  ................  ................  ................  ................  ................
    H.R. 3103 funding (non-add)...............................          (70,000)          (80,500)          (80,500)         (+10,500)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office of the Inspector General:                                                                                                           
          Federal funds.......................................           34,790            31,921            31,921            -2,869   ................
          Trust funds.........................................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
            Total (BA)........................................          (34,790)          (31,921)          (31,921)          (-2,869)  ................
            Total program level...............................         (104,790)         (112,421)         (112,421)          (+7,631)  ................
OFFICE FOR CIVIL RIGHTS:                                                                                                                                
    Federal funds.............................................           16,183            17,216            16,345              +162              -871 
        Portion treated as budget authority...................           (3,307)           (3,314)           (3,314)              (+7)  ................
                                                               -----------------------------------------------------------------------------------------
          Total, Office for Civil Rights:                                                                                                               
              Federal funds...................................           16,183            17,216            16,345              +162              -871 
              Trust funds.....................................           (3,307)           (3,314)           (3,314)              (+7)  ................
                                                               -----------------------------------------------------------------------------------------
                Total.........................................          (19,490)          (20,530)          (19,659)            (+169)            (-871)
POLICY RESEARCH...............................................           18,486             9,000             9,500            -8,986              +500 
                                                               =========================================================================================
Public Health and Social Services Emergency Fund..............           15,000   ................  ................          -15,000   ................
                                                               =========================================================================================
      Total, Office of the Secretary:                                                                                                                   
          Federal funds.......................................          256,641           215,463           232,354           -24,287           +16,891 
          Trust funds.........................................           (9,158)           (9,165)           (9,165)              (+7)  ................
                                                               -----------------------------------------------------------------------------------------
            Total.............................................         (265,799)         (224,628)         (241,519)         (-24,280)         (+16,891)
                                                               =========================================================================================
      Total, Department of Health and Human Services:                                                                                                   
          Federal Funds.......................................      210,826,904       200,160,796       201,184,745        -9,642,159        +1,023,949 
              Current year, fiscal year 1997/1998.............     (179,182,911)     (169,202,607)     (170,026,556)      (-9,156,355)        (+823,949)
              Fiscal year 1998/1999...........................      (31,643,993)      (30,958,189)      (31,158,189)        (-485,804)        (+200,000)
          Trust funds.........................................       (1,743,599)       (1,783,665)       (1,728,406)         (-15,193)         (-55,259)
                                                               =========================================================================================
            TITLE III--DEPARTMENT OF EDUCATION \10\                                                                                                     
                                                                                                                                                        
                     EDUCATION REFORM \11\                                                                                                              
                                                                                                                                                        
Goals 2000: Educate America Act:                                                                                                                        
    State and local educ systemic improvement grants..........          476,000           605,000           500,000           +24,000          -105,000 
    Parental assistance.......................................           15,000            15,000            30,000           +15,000           +15,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Goals 2000....................................          491,000           620,000           530,000           +39,000           -90,000 
School-to-work opportunities: State grants and local                                                                                                    
 partnerships.................................................          199,973           200,000           200,000               +27   ................
Technology literacy challenge fund............................          200,000           425,000           425,000          +225,000   ................
Technology innovation challenge grants........................           66,965            85,000           116,000           +49,035           +31,000 
                                                               =========================================================================================
      Total...................................................          957,938         1,330,000         1,271,000          +313,062           -59,000 
                                                                                                                                                        
             EDUCATION FOR THE DISADVANTAGED \12\                                                                                                       
                                                                                                                                                        
Grants to Local Education Agencies (LEAs):                                                                                                              
    Basic grants, forward funded..............................        6,269,712         6,187,350         6,269,712   ................          +82,362 
    Basic grants, current funded..............................            3,500             4,000             4,000              +500   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants..................................        6,273,212         6,191,350         6,273,712              +500           +82,362 
    Concentration grants......................................        1,022,020           999,249         1,022,020   ................          +22,771 
    Targeted grants...........................................  ................          350,000   ................  ................         -350,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Grants to LEAs................................        7,295,232         7,540,599         7,295,732              +500          -244,867 
Capital expenses for private school children..................           41,119            41,119            41,119   ................  ................
Even start....................................................          101,992           108,000           108,000            +6,008   ................
State agency programs:                                                                                                                                  
    Migrant...................................................          305,473           319,500           305,473   ................          -14,027 
    Neglected and delinquent/high risk youth..................           39,311            40,333            40,333            +1,022   ................
State school improvement......................................  ................            8,000   ................  ................           -8,000 
Evaluation....................................................            6,977            10,000             6,977   ................           -3,023 
                                                               -----------------------------------------------------------------------------------------
      Total, ESEA.............................................        7,790,104         8,067,551         7,797,634            +7,530          -269,917 
Migrant education:                                                                                                                                      
    High school equivalency program...........................            7,441             7,634             7,634              +193   ................
    College assistance migrant program........................            2,028             2,081             2,081               +53   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, migrant education.............................            9,469             9,715             9,715              +246   ................
                                                               =========================================================================================
      Total, Compensatory education programs..................        7,799,573         8,077,266         7,807,349            +7,776          -269,917 
      Subtotal, forward funded................................       (7,779,627)       (8,053,551)       (7,786,657)          (+7,030)        (-266,894)
                                                               =========================================================================================
                          IMPACT AID                                                                                                                    
                                                                                                                                                        
Basic support payments........................................          615,500           584,000           623,500            +8,000           +39,500 
Payments for children with disabilities.......................           40,000            40,000            80,000           +40,000           +40,000 
Payments for heavily impacted districts (sec. f)..............           52,000            20,000            52,000   ................          +32,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          707,500           644,000           755,500           +48,000          +111,500 
Facilities maintenance (sec. 8008)............................  ................           10,000            10,000           +10,000   ................
Construction (sec. 8007)......................................            5,000             4,000             5,000   ................           +1,000 
Payments for Federal property (Sec. 8002).....................           17,500   ................           24,000            +6,500           +24,000 
                                                               =========================================================================================
      Total, Impact aid.......................................          730,000           658,000           794,500           +64,500          +136,500 
                                                                                                                                                        
                  SCHOOL IMPROVEMENT PROGRAMS                                                                                                           
                                                                                                                                                        
Professional development \13\.................................          310,000           360,000           310,000   ................          -50,000 
Program innovation \13\.......................................          310,000   ................          310,000   ................         +310,000 
Safe and drug-free schools:                                                                                                                             
    State grants \13\.........................................          530,978           590,000           555,978           +25,000           -34,022 
    National programs.........................................           25,000            30,000   ................          -25,000           -30,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Safe and drug-free schools....................          555,978           620,000           555,978   ................          -64,022 
Inexpensive book distribution (RIF)...........................           10,265            12,000            12,000            +1,735   ................
Arts in education.............................................            9,000             9,500            10,500            +1,500            +1,000 
Other school improvement programs:                                                                                                                      
    Magnet schools assistance.................................           95,000            95,000            95,000   ................  ................
    Educational support services for homeless children and                                                                                              
     youth \13\...............................................           25,000            27,000            28,800            +3,800            +1,800 
    Women's educational equity................................            2,000             4,000             4,000            +2,000   ................
    Training and advisory services (Civil Rights IV-A)........            7,334            14,334             7,334   ................           -7,000 
    Ellender fellowships/Close up \13\........................            1,500   ................            1,500   ................           +1,500 
    Education for Native Hawaiians............................           15,000            15,000            20,000            +5,000            +5,000 
    Alaska Native Education equity............................            8,000             8,000            10,640            +2,640            +2,640 
    Charter schools...........................................           50,987           100,000            50,987   ................          -49,013 
    Education infrastructure..................................  ................  ................           40,000           +40,000           +40,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, other school improvement programs.............          204,821           263,334           258,261           +53,440            -5,073 
Technical assistance for improving ESEA programs:                                                                                                       
 Comprehensive regional assistance centers....................           25,554            34,388            25,554   ................           -8,834 
                                                               =========================================================================================
      Total, School improvement programs......................        1,425,618         1,299,222         1,482,293           +56,675          +183,071 
      Subtotal, forward funded................................       (1,177,478)         (977,000)       (1,206,278)         (+28,800)        (+229,278)
                                                               =========================================================================================
                     INDIAN EDUCATION \14\                                                                                                              
                                                                                                                                                        
Grants to local education agencies............................           58,050            59,750            59,750            +1,700   ................
Federal Administration:                                                                                                                                 
    Office of Indian Education................................            2,943             2,800             2,800              -143   ................
    National Advisory Council.................................  ................               50                50               +50   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Federal administration...........................            2,943             2,850             2,850               -93   ................
                                                               =========================================================================================
      Total, Indian Education.................................           60,993            62,600            62,600            +1,607   ................
                                                                                                                                                        
               BILINGUAL AND IMMIGRANT EDUCATION                                                                                                        
                                                                                                                                                        
Bilingual education:                                                                                                                                    
    Instructional services....................................          141,700           160,000           160,000           +18,300   ................
    Support services..........................................           10,000            14,000            14,000            +4,000   ................
    Professional development..................................            5,000            25,000            25,000           +20,000   ................
Immigrant education...........................................          100,000           150,000           150,000           +50,000   ................
Foreign language assistance...................................            5,000             5,000             5,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total...................................................          261,700           354,000           354,000           +92,300   ................
                                                                                                                                                        
                       SPECIAL EDUCATION                                                                                                                
                                                                                                                                                        
State grants:                                                                                                                                           
    Grants to States part B...................................        3,107,522         3,240,750         3,941,837          +834,315          +701,087 
    Preschool grants..........................................          360,409           374,825           378,985           +18,576            +4,160 
    Grants for infants and families...........................          315,754           323,964           350,790           +35,036           +26,826 
    Evaluation, forward funded................................            1,873             6,300             6,300            +4,427   ................
    Evaluation, current funded................................  ................            1,700             1,700            +1,700   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State grants..................................        3,785,558         3,947,539         4,679,612          +894,054          +732,073 
National activities:                                                                                                                                    
    State improvement.........................................           26,988            35,200            35,200            +8,212   ................
    Research and innovation...................................           62,803            64,508            64,508            +1,705   ................
    Technical assistance and dissemination....................           34,337            35,056            44,556           +10,219            +9,500 
    Personnel preparation.....................................           80,735            82,139            82,139            +1,404   ................
    Parent information centers................................           15,535            15,535            18,535            +3,000            +3,000 
    Technology and media services.............................           30,023            30,023            32,023            +2,000            +2,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, IDEA National activities......................          250,421           262,461           276,961           +26,540           +14,500 
Readline......................................................  ................  ................            1,500            +1,500            +1,500 
      Total, Special education................................        4,035,979         4,210,000         4,958,073          +922,094          +748,073 
                                                                                                                                                        
        REHABILITATION SERVICES AND DISABILITY RESEARCH                                                                                                 
                                                                                                                                                        
Vocational rehabilitation State grants........................        2,176,038         2,246,888         2,246,888           +70,850   ................
Client assistance State grants................................           10,392            10,714            10,714              +322   ................
Training......................................................           39,629            39,629            39,629   ................  ................
Special demonstration programs................................           18,942            16,942            20,836            +1,894            +3,894 
Migratory workers.............................................            1,850             2,350             2,350              +500   ................
Recreational programs.........................................            2,596             2,596             2,596   ................  ................
Protection and advocacy of individual rights..................            7,657             7,894             7,894              +237   ................
Projects with industry........................................           22,071            22,071            22,071   ................  ................
Supported employment State grants.............................           38,152            38,152            38,152   ................  ................
Independent living:                                                                                                                                     
    State grants..............................................           21,859            21,859            21,859   ................  ................
    Centers...................................................           42,876            44,205            46,205            +3,329            +2,000 
    Services for older blind individuals......................            9,952             9,952            11,947            +1,995            +1,995 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Independent living............................           74,687            76,016            80,011            +5,324            +3,995 
Program improvement...........................................            2,391             3,900             3,900            +1,509   ................
Evaluation....................................................            1,587             1,587             1,587   ................  ................
Helen Keller National Center for Deaf-Blind Youths and Adults.            7,337             7,528             7,549              +212               +21 
National Institute on Disability and Rehabilitation Research..           69,990            71,000            71,000            +1,010   ................
                                                               =========================================================================================
      Subtotal, mandatory programs............................        2,473,319         2,547,267         2,555,177           +81,858            +7,910 
Assistive technology..........................................           36,109            36,109            36,109   ................  ................
                                                               =========================================================================================
      Total, Rehabilitation services..........................        2,509,428         2,583,376         2,591,286           +81,858            +7,910 
                                                                                                                                                        
      SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES                                                                                                
                                                                                                                                                        
AMERICAN PRINTING HOUSE FOR THE BLIND.........................            6,680             6,680             7,906            +1,226            +1,226 
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF.....................           43,041            43,041            44,141            +1,100            +1,100 
GALLAUDET UNIVERSITY..........................................           79,182            79,182            81,000            +1,818            +1,818 
                                                               -----------------------------------------------------------------------------------------
      Total...................................................          128,903           128,903           133,047            +4,144            +4,144 
                                                                                                                                                        
              VOCATIONAL AND ADULT EDUCATION \15\                                                                                                       
                                                                                                                                                        
Vocational education:                                                                                                                                   
    Basic State grants........................................        1,015,550         1,043,550         1,015,550   ................          -28,000 
    Tech-Prep education.......................................          100,000           105,000           100,000   ................           -5,000 
    Tribally controlled postsecondary vocational institutions.            2,919             2,919             3,100              +181              +181 
    National programs: Research...............................           13,497            20,497            13,497   ................           -7,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Vocational education..........................        1,131,966         1,171,966         1,132,147              +181           -39,819 
Adult education:                                                                                                                                        
    State programs............................................          340,339           382,000           340,339   ................          -41,661 
    National programs:                                                                                                                                  
        Evaluation and technical assistance...................            4,998             6,000             4,998   ................           -1,002 
        National Institute for Literacy.......................            4,491             6,000             4,491   ................           -1,509 
                                                               -----------------------------------------------------------------------------------------
          Subtotal, National programs.........................            9,489            12,000             9,489   ................           -2,511 
    Literacy programs for prisoners...........................            4,723   ................            4,723   ................           +4,723 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, adult education...............................          354,551           394,000           354,551   ................          -39,449 
                                                               =========================================================================================
      Total, Vocational and adult education...................        1,486,517         1,565,966         1,486,698              +181           -79,268 
                                                                                                                                                        
                 STUDENT FINANCIAL ASSISTANCE                                                                                                           
                                                                                                                                                        
Federal Pell Grants: Regular program..........................        5,919,000         7,635,000         6,910,334          +991,334          -724,666 
    Memo (non-add): Maximum grant.............................           (2,700)           (3,000)           (3,000)            (+300)  ................
    Memo (non-add): Outlay effect for fiscal year 1998........  ................  ................  ................  ................  ................
Federal supplemental educational opportunity grants...........          583,407           583,407           634,407           +51,000           +51,000 
Federal work-study............................................          830,000           857,000           830,000   ................          -27,000 
Federal Perkins loans:                                                                                                                                  
    Capital contributions.....................................          158,000           158,000           158,000   ................  ................
    Loan cancellations........................................           20,000            30,000            25,000            +5,000            -5,000 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Federal Perkins loans.........................          178,000           188,000           183,000            +5,000            -5,000 
State student incentive grants................................           50,000   ................  ................          -50,000   ................
                                                               =========================================================================================
      Total, Student financial assistance.....................        7,560,407         9,263,407         8,557,741          +997,334          -705,666 
                                                                                                                                                        
            FEDERAL FAMILY EDUCATION LOANS PROGRAM                                                                                                      
                                                                                                                                                        
          (EXISTING GUARANTEED STUDENT LOANS PROGRAM)                                                                                                   
                                                                                                                                                        
Federal education loans: Federal administration...............           46,482            47,688            46,482   ................           -1,206 
Total Outstanding Loan Volume as of 10/96 (non-add)...........     (104,919,951)  ................  ................    (-104,919,951)  ................
                                                                                                                                                        
              FEDERAL DIRECT STUDENT LOAN PROGRAM                                                                                                       
                                                                                                                                                        
Mandatory administrative costs (indefinite)...................         (491,000)         (532,000)         (532,000)         (+41,000)  ................
Total Outstanding Loan Volume as of 10/96 (non-add)...........      (11,571,529)  ................  ................     (-11,571,529)  ................
                                                                                                                                                        
                       HIGHER EDUCATION                                                                                                                 
                                                                                                                                                        
Aid for institutional development:                                                                                                                      
    Strengthening institutions................................           55,450            55,450            55,450   ................  ................
    Hispanic serving institutions.............................           10,800            12,000            12,000            +1,200   ................
    Hispanic serving institutions (Agriculture bill)..........           (2,000)  ................  ................          (-2,000)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Hispanic serving institutions.................          (12,800)          (12,000)          (12,000)            (-800)  ................
    Strengthening historically black colleges and univ........          108,990           113,000           108,990   ................           -4,010 
    Strengthening historically black grad institutions........           19,606            19,606            19,606   ................  ................
    Endowment challenge grants, HBCU set-aside................  ................            2,015   ................  ................           -2,015 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Institutional development.....................          194,846           202,071           196,046            +1,200            -6,025 
Program development:                                                                                                                                    
    Fund for the Improvement of Postsecondary Educ............           18,000            18,000            30,000           +12,000           +12,000 
    Minority teacher recruitment..............................            2,212             3,727             2,212   ................           -1,515 
    Minority science improvement..............................            5,255             5,255             5,255   ................  ................
    International educ and foreign language studies:                                                                                                    
        Domestic programs.....................................           53,481            53,481            53,481   ................  ................
        Overseas programs.....................................            5,270             5,770             5,870              +600              +100 
        Institute for International Public Policy.............            1,000             1,000             1,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, International education...................           59,751            60,251            60,351              +600              +100 
    Urban community service...................................            9,200   ................            4,900            -4,300            +4,900 
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program development...........................           94,418            87,233           102,718            +8,300           +15,485 
Construction: Interest subsidy grants, prior year construction           15,673            13,700            13,700            -1,973   ................
Special grants:                                                                                                                                         
    Mary McLeod Bethune Memeorial Fine Arts Center............            1,400   ................            1,400   ................           +1,400 
    Federal TRIO programs.....................................          499,994           525,000           525,000           +25,006   ................
    Early intervention scholarships and partnerships..........            3,600   ................            3,600   ................           +3,600 
    Advanced placement fees...................................  ................            6,000             3,000            +3,000            -3,000 
Scholarships:                                                                                                                                           
    Byrd honors scholarships..................................           29,117            39,288            39,288           +10,171   ................
    Presidential honors scholarships..........................  ................          132,000   ................  ................         -132,000 
    George H. W. Bush fellowships.............................            3,000   ................  ................           -3,000   ................
    Edmund S. Muskie foundation...............................            3,000   ................  ................           -3,000   ................
    Pell Institute International Relations....................            3,000   ................  ................           -3,000   ................
    Calvin Coolidge Memorial Foundation.......................            1,000   ................  ................           -1,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Scholarships..................................           39,117           171,288            39,288              +171          -132,000 
Graduate fellowships:                                                                                                                                   
    Javits fellowships........................................            5,931   ................  ................           -5,931   ................
    Graduate assistance in areas of national need.............           24,069            30,000            30,000            +5,931   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Graduate fellowships..........................           30,000            30,000            30,000   ................  ................
                                                               =========================================================================================
Youth offender grants.........................................  ................  ................           15,000           +15,000           +15,000 
                                                               =========================================================================================
      Total, Higher education.................................          879,048         1,035,292           929,752           +50,704          -105,540 
                                                                                                                                                        
                       HOWARD UNIVERSITY                                                                                                                
                                                                                                                                                        
Academic program..............................................          166,511   ................  ................         -166,511   ................
Endowment.....................................................  ................  ................  ................  ................  ................
Howard University Hospital....................................           29,489            29,489            29,489   ................  ................
Undistributed.................................................  ................          166,511           168,511          +168,511            +2,000 
                                                               -----------------------------------------------------------------------------------------
      Total, Howard University................................          196,000           196,000           198,000            +2,000            +2,000 
COLLEGE HOUSING and ACADEMIC FACILITIES LOANS PROGRAM: Federal                                                                                          
 administration...............................................              698             1,069               698   ................             -371 
                                                                                                                                                        
  HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING                                                                                           
                            PROGRAM                                                                                                                     
                                                                                                                                                        
Federal administration........................................              104               104               104   ................  ................
                                                                                                                                                        
        EDUCATION RESEARCH, STATISTICS, AND IMPROVEMENT                                                                                                 
                                                                                                                                                        
Research and statistics:                                                                                                                                
    Research..................................................           72,567            81,035            72,567   ................           -8,468 
    Regional education laboratories...........................           51,000            53,500            53,500            +2,500   ................
    Statistics................................................           50,000            66,250            52,000            +2,000           -14,250 
    Assessment:                                                                                                                                         
        National assessment...................................           29,752            35,502            29,752   ................           -5,750 
        National assessment governing board...................            2,865             2,871             2,871                +6   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Assessment................................           32,617            38,373            32,623                +6            -5,750 
                                                               =========================================================================================
          Subtotal, Research and statistics...................          206,184           239,158           210,690            +4,506           -28,468 
Fund for the Improvement of Education.........................           40,000            40,000            50,000           +10,000           +10,000 
International education exchange (title VI)...................            5,000             5,000             5,000   ................  ................
21st century community learning centers.......................            1,000   ................            1,000   ................           +1,000 
Civic Education...............................................            4,500             4,500             4,500   ................  ................
Eisenhower professional development national activities.......           13,342            30,000            25,000           +11,658            -5,000 
Eisenhower regional mathematics and science education                                                                                                   
 consortia....................................................           15,000            15,000            15,000   ................  ................
Javits gifted and talented education..........................            5,000             7,000             7,000            +2,000   ................
National writing project......................................            3,100   ................            5,000            +1,900            +5,000 
After school learning centers.................................  ................           50,000   ................  ................          -50,000 
Education technology:                                                                                                                                   
    Star schools..............................................           30,000            26,000            30,000   ................           +4,000 
    Ready to learn television.................................            7,000             7,000             7,000   ................  ................
    Telecommunications demo project for mathematics...........            1,035             2,035             2,035            +1,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Education technology..........................           38,035            35,035            39,035            +1,000            +4,000 
                                                               =========================================================================================
      Total, ERSI.............................................          331,161           425,693           362,225           +31,064           -63,468 
Child Literacy Initiative:                                                                                                                              
    Forward funding...........................................  ................          260,000   ................  ................         -260,000 
    Advance funded fiscal year 1998/99........................  ................  ................          260,000          +260,000          +260,000 
                                                                                                                                                        
                        LIBRARIES \16\                                                                                                                  
                                                                                                                                                        
Public libraries:                                                                                                                                       
    Services..................................................          100,636   ................  ................         -100,636   ................
    Construction..............................................           16,369   ................  ................          -16,369   ................
    Interlibrary cooperation..................................           11,864   ................  ................          -11,864   ................
Library education and training................................            2,500   ................  ................           -2,500   ................
Research and demonstrations...................................            5,000   ................  ................           -5,000   ................
Institute of Museum and Library Services......................  ................          136,369           146,369          +146,369           +10,000 
                                                               -----------------------------------------------------------------------------------------
      Total, Libraries........................................          136,369           136,369           146,369           +10,000           +10,000 
                                                                                                                                                        
                    DEPARTMENTAL MANAGEMENT                                                                                                             
                                                                                                                                                        
PROGRAM ADMINISTRATION........................................          326,217           341,039           338,964           +12,747            -2,075 
OFFICE FOR CIVIL RIGHTS.......................................           54,900            61,500            57,522            +2,622            -3,978 
OFFICE OF THE INSPECTOR GENERAL...............................           29,943            32,000            32,000            +2,057   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Departmental management..........................          411,060           434,539           428,486           +17,426            -6,053 
                                                               =========================================================================================
      Total, Department of Education..........................       28,957,978        32,069,494        31,870,703        +2,912,725          -198,791 
                                                                                                                                                        
                  TITLE IV--RELATED AGENCIES                                                                                                            
                                                                                                                                                        
                 ARMED FORCES RETIREMENT HOME                                                                                                           
                                                                                                                                                        
Operation and maintenance (trust fund limitation).............           55,663            55,452            55,452              -211   ................
Capital program (trust fund limitation).......................              432            24,525            10,000            +9,568           -14,525 
                                                               -----------------------------------------------------------------------------------------
      Total, AFRH.............................................           56,095            79,977            65,452            +9,357           -14,525 
                                                                                                                                                        
        CORPORATION FOR NATIONAL AND COMMUNITY SERVICE                                                                                                  
                                                                                                                                                        
Domestic Volunteer Service Programs:                                                                                                                    
    Volunteers in Service to America: VISTA operations........           41,235            54,000            45,235            +4,000            -8,765 
    National Senior Volunteer Corps:                                                                                                                    
        Foster Grandparents Program...........................           77,812            85,972            85,593            +7,781              -379 
        Senior Companion Program..............................           31,244            35,449            34,368            +3,124            -1,081 
        Retired Senior Volunteer Program......................           35,708            45,043            39,279            +3,571            -5,764 
        Senior demonstration program..........................  ................           10,000   ................  ................          -10,000 
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Senior Volunteers.........................          144,764           176,464           159,240           +14,476           -17,224 
    Program Administration....................................           27,850            29,836            28,129              +279            -1,707 
                                                               =========================================================================================
      Total, Domestic Volunteer Service Programs..............          213,849           260,300           232,604           +18,755           -27,696 
Corporation for Public Broadcasting:                                                                                                                    
    Fiscal year 2000 (current request) with fiscal year 1999                                                                                            
     comparable...............................................          250,000           325,000           300,000           +50,000           -25,000 
    1999 advance (non-add) with fiscal year 1998 comparable...         (250,000)         (250,000)         (250,000)  ................  ................
    1998 advance (non-add) with fiscal year 1997 comparable...         (260,000)         (250,000)         (250,000)         (-10,000)  ................
Federal Mediation and Conciliation Service....................           32,525            33,481            33,481              +956   ................
Federal Mine Safety and Health Review Commission..............            6,049             6,060             6,060               +11   ................
National Commission on Libraries and Information Science......              897             1,123             1,000              +103              -123 
National Council on Disability................................            1,791             1,793             1,793                +2   ................
National Education Goals Panel................................            1,495             2,000             2,000              +505   ................
National Commission on Cost of Higher Education...............              650   ................  ................             -650   ................
National Labor Relations Board................................          174,661           186,434           174,661   ................          -11,773 
National Mediation Board......................................            8,284             8,100             8,600              +316              +500 
Occupational Safety and Health Review Commission..............            7,738             7,800             7,800               +62   ................
Physician Payment Review Commission (trust funds).............           (3,258)           (3,578)           (3,258)  ................            (-320)
Prospective Payment Assessment Commission (trust funds).......           (3,257)           (3,579)           (3,257)  ................            (-322)
                                                                                                                                                        
                   RAILROAD RETIREMENT BOARD                                                                                                            
                                                                                                                                                        
Dual benefits payments account................................          223,000           206,000           206,000           -17,000   ................
    Less income tax receipts on dual benefits.................           -9,000           -12,000           -12,000            -3,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Dual Benefits.................................          214,000           194,000           194,000           -20,000   ................
Federal payment to the Railroad Retirement Account............              300                50                50              -250   ................
Limitation on administration:                                                                                                                           
    Consolidated account......................................          (87,728)          (88,800)          (87,728)  ................          (-1,072)
    Inspector General.........................................           (5,394)           (5,400)           (5,394)  ................              (-6)
                                                                                                                                                        
                SOCIAL SECURITY ADMINISTRATION                                                                                                          
                                                                                                                                                        
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS.......................           20,923            20,308            20,308              -615   ................
ADDITIONAL ADMINISTRATIVE EXPENSES \17\.......................           10,000   ................  ................          -10,000   ................
                                                                                                                                                        
           SPECIAL BENEFITS FOR DISABLED COAL MINERS                                                                                                    
                                                                                                                                                        
Benefit payments..............................................          625,450           581,470           581,470           -43,980   ................
Administration................................................            4,620             4,620             4,620   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Black Lung, fiscal year 1997/98 program level.          630,070           586,090           586,090           -43,980   ................
      Less funds advanced in prior year.......................         -170,000          -160,000          -160,000           +10,000   ................
                                                               =========================================================================================
      Total, Black Lung, current request, fiscal year 1997/98.          460,070           426,090           426,090           -33,980   ................
          New advances, 1st quarter fiscal year 1998/1999.....          160,000           160,000           160,000   ................  ................
                                                               =========================================================================================
                 SUPPLEMENTAL SECURITY INCOME                                                                                                           
                                                                                                                                                        
Federal benefit payments......................................       26,559,100        23,710,300        23,710,300        -2,848,800   ................
Beneficiary services..........................................          100,000            46,000            46,000           -54,000   ................
Research and demonstration....................................            7,000            16,700             7,000   ................           -9,700 
Administration \18\...........................................        1,946,015         2,037,000         2,037,000           +90,985   ................
Automation investment initiative..............................           19,895            50,000            50,000           +30,105   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, SSI fiscal year 1997/98 program level.........       28,632,010        25,860,000        25,850,300        -2,781,710            -9,700 
      Less funds advanced in prior year.......................       -9,260,000        -9,690,000        -9,690,000          -430,000   ................
                                                               =========================================================================================
      Subtotal, regular SSI current year, fiscal year 1997/                                                                                             
       1998...................................................       19,372,010        16,170,000        16,160,300        -3,211,710            -9,700 
          Additional CDR funding..............................           25,000            75,000            75,000           +50,000   ................
          SSI reforms (welfare)...............................          150,000           100,000           100,000           -50,000   ................
                                                               -----------------------------------------------------------------------------------------
            Total, SSI, current request, fiscal year 1997/1998       19,547,010        16,345,000        16,335,300        -3,211,710            -9,700 
                New advance, 1st quarter, fiscal year 1998/                                                                                             
                 1999.........................................        9,690,000         8,680,000         8,680,000        -1,010,000   ................
                                                               =========================================================================================
          LIMITATION ON ADMINISTRATIVE EXPENSES \19\                                                                                                    
                                                                                                                                                        
OASDI trust funds.............................................       (3,068,300)       (2,992,440)       (2,934,440)        (-133,860)         (-58,000)
HI/SMI trust funds............................................         (846,099)         (965,000)         (965,000)        (+118,901)  ................
Social Security Advisory Board................................           (1,268)           (1,600)           (1,268)  ................            (-332)
User Fee Appropriation........................................  ................          (35,000)          (35,000)         (+35,000)  ................
SSI...........................................................       (1,946,015)       (2,037,000)       (2,037,000)         (+90,985)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, regular LAE...................................       (5,861,682)       (6,031,040)       (5,972,708)        (+111,026)         (-58,332)
OASDI automation..............................................         (215,000)         (150,000)         (150,000)         (-65,000)  ................
SSI automation................................................          (19,895)          (50,000)          (50,000)         (+30,105)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, automation initative..........................         (234,895)         (200,000)         (200,000)         (-34,895)  ................
                                                               =========================================================================================
      Total, REGULAR LAE......................................       (6,096,577)       (6,231,040)       (6,172,708)         (+76,131)         (-58,332)
          Additional CDR funding..............................         (160,000)         (190,000)         (145,000)         (-15,000)         (-45,000)
          SSI reforms (welfare)...............................         (150,000)         (100,000)         (100,000)         (-50,000)  ................
                                                               =========================================================================================
            Total, LAE........................................       (6,406,577)       (6,521,040)       (6,417,708)         (+11,131)        (-103,332)
                                                                                                                                                        
                  OFFICE OF INSPECTOR GENERAL                                                                                                           
                                                                                                                                                        
Federal funds.................................................            6,265            10,164             6,265   ................           -3,899 
Trust funds...................................................          (31,089)  ................  ................         (-31,089)  ................
    Portion treated as budget authority.......................  ................          (34,260)          (31,089)         (+31,089)          (-3,171)
                                                               -----------------------------------------------------------------------------------------
      Total, Office of the Inspector General:                                                                                                           
          Federal funds.......................................            6,265            10,164             6,265   ................           -3,899 
          Trust funds.........................................          (31,089)          (34,260)          (31,089)  ................          (-3,171)
                                                               -----------------------------------------------------------------------------------------
            Total.............................................          (37,354)          (44,424)          (37,354)  ................          (-7,070)
                                                               =========================================================================================
      Total, Social Security Administration:                                                                                                            
          Federal funds.......................................       29,894,268        25,641,562        25,627,963        -4,266,305           -13,599 
              Current year fiscal year 1997/1998..............      (20,044,268)      (16,801,562)      (16,787,963)      (-3,256,305)         (-13,599)
              New advances, 1st quarter fiscal year 1998/1999.       (9,850,000)       (8,840,000)       (8,840,000)      (-1,010,000)  ................
          Trust funds.........................................       (4,321,756)       (4,333,300)       (4,226,797)         (-94,959)        (-106,503)
          Trust funds considered BA...........................       (6,437,666)       (6,555,300)       (6,448,797)         (+11,131)        (-106,503)
                                                               =========================================================================================
United States Institute of Peace..............................           11,149            11,160            11,160               +11   ................
                                                               =========================================================================================
      Total, Title IV, Related Agencies:                                                                                                                
          Federal Funds (all years)...........................       30,873,751        26,758,840        26,666,624        -4,207,127           -92,216 
              Current year, fiscal year 1997/1998.............      (20,773,751)      (17,593,840)      (17,526,624)      (-3,247,127)         (-67,216)
              Fiscal year 1998/1999...........................       (9,850,000)       (8,840,000)       (8,840,000)      (-1,010,000)  ................
              Fiscal year 1999/2000...........................         (250,000)         (325,000)         (300,000)         (+50,000)         (-25,000)
          Trust funds.........................................       (4,421,393)       (4,434,657)       (4,326,434)         (-94,959)        (-108,223)
          Trust funds considered BA...........................       (6,537,303)       (6,656,657)       (6,548,434)         (+11,131)        (-108,223)
                                                               =========================================================================================
                  TITLE V--GENERAL PROVISIONS                                                                                                           
                                                                                                                                                        
General administrative reduction..............................  ................  ................          -30,500           -30,500           -30,500 
                                                               =========================================================================================
                            SUMMARY                                                                                                                     
                                                                                                                                                        
Title I--Department of Labor:                                                                                                                           
    Federal Funds.............................................        8,739,722         9,416,653         9,358,815          +619,093           -57,838 
    Trust Funds...............................................       (3,432,410)       (3,726,020)       (3,583,643)        (+151,233)        (-142,377)
Title II--Department of Health and Human Services:                                                                                                      
    Federal Funds.............................................      210,826,904       200,160,796       201,184,745        -9,642,159        +1,023,949 
        Current year..........................................     (179,182,911)     (169,202,607)     (170,026,556)      (-9,156,355)        (+823,949)
        1999 advance..........................................      (31,643,993)      (30,958,189)      (31,158,189)        (-485,804)        (+200,000)
    Trust Funds...............................................       (1,743,599)       (1,783,665)       (1,728,406)         (-15,193)         (-55,259)
Title III--Department of Education: Federal Funds.............       28,957,978        32,069,494        31,870,703        +2,912,725          -198,791 
Title IV--Related Agencies:                                                                                                                             
    Federal Funds.............................................       30,873,751        26,758,840        26,666,624        -4,207,127           -92,216 
        Current year..........................................      (20,773,751)      (17,593,840)      (17,526,624)      (-3,247,127)         (-67,216)
        1999 advance..........................................       (9,850,000)       (8,840,000)       (8,840,000)      (-1,010,000)  ................
        2000 advance..........................................         (250,000)         (325,000)         (300,000)         (+50,000)         (-25,000)
    Trust Funds...............................................       (4,421,393)       (4,434,657)       (4,326,434)         (-94,959)        (-108,223)
Title V--General Provisions: Federal Funds....................  ................  ................          -30,500           -30,500           -30,500 
                                                               =========================================================================================
      Total, all titles:                                                                                                                                
          Federal Funds.......................................      279,398,355       268,405,783       269,050,387       -10,347,968          +644,604 
              Current year....................................     (237,654,362)     (228,282,594)     (228,242,198)      (-9,412,164)         (-40,396)
              1999 advance....................................      (41,493,993)      (39,798,189)      (39,998,189)      (-1,495,804)        (+200,000)
              2000 advance....................................         (250,000)         (325,000)         (300,000)         (+50,000)         (-25,000)
          Trust Funds.........................................       (9,597,402)       (9,944,342)       (9,638,483)         (+41,081)        (-305,859)
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Forward funded except where noted.                                                                                                                  
\2\ Current funded.                                                                                                                                     
\3\ 3 year availability.                                                                                                                                
\4\ 15-month availability.                                                                                                                              
\5\ Includes $20 million related to the Work Opportunity Tax Credit.                                                                                    
\6\ 2 year availability.                                                                                                                                
\7\ All HHS accounts are current funded unless otherwise noted.                                                                                         
\8\ Request includes bill language exempting from the excise tax vaccine purchased with appropriated funds; savings are estimated at $25 million.       
\9\ Funds for these activities for fiscal year 1998 are provided through permanent appropriations in the welfare bill.                                  
\10\ All Education accounts are current funded unless otherwise noted.                                                                                  
\11\ Forward funded with the exception of parental assistance and educational technology.                                                               
\12\ All programs in this account are forward funded with the exception of current funded basic grants, Title I evaluation, Demonstration of Innovative 
  Practices, High School Equivalency Program and the College Assistance Migrant Program.                                                                
\13\ Forward funded.                                                                                                                                    
\14\ Comparable appropriation of $60.993 million was provided in the Interior Appropriations Bill for fiscal year 1997. The comparable figure is        
  included as a scorekeeping adjustment.                                                                                                                
\15\ All programs are forward funded with the exception of Tribally Controlled Postsecondary Vocational Institutions.                                   
\16\ These programs will be funded in the Institute for Museum and Library Sciences in fiscal year 1998.                                                
\17\ No-year availability for these funds related to sections 9704 and 9706 of the Internal Revenue Code of 1986.                                       
\18\ Figures include amounts for the SSI disability initiative previously displayed as a separate line item.                                            
\19\ All trust fund limitations will be scored as BA in fiscal year 1998. Comparable adjustments for fiscal years 1997 and 1998 displayed as            
  scorekeeping adjustments.                                                                                                                             



