    [Senate Report 106-293]
    [From the U.S. Government Publishing Office]

                                                           Calendar No. 547
    106th Congress                                                   Report
                                     SENATE
     2d Session                                                     106-293
    _______________________________________________________________________

      DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION AND
                   RELATED AGENCIES APPROPRIATION BILL, 2001

                                   ----------

                                  R E P O R T

                                  to accompany

                                    S. 2553

                      May 12, 2000.--Ordered to be printed

      Filed under authority of the order of the Senate of January 6, 1999
                                                           Calendar No. 547
    106th Congress                                                   Report
                                     SENATE
     2d Session                                                     106-293

    ======================================================================

      DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION AND
                   RELATED AGENCIES APPROPRIATION BILL, 2001

                                    _______

                      May 12, 2000.--Ordered to be printed

      Filed, under authority of the order of the Senate of January 6, 1999

                                    _______

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

                                  R E P O R T

                             [To accompany S. 2553]

        The Committee on Appropriations reports the bill (S. 2553)
    making appropriations for Departments of Labor, Health and
    Human Services, and Education and related agencies for the
    fiscal year ending September 30, 2001, and for other purposes,
    reports favorably thereon and recommends that the bill do pass.

    Amount of budget authority

    Total bill as reported to Senate........................$352,185,874,000
    Amount of adjusted appropriations, 2000................. 329,763,462,000
    Budget estimates, 2001.................................. 356,183,602,000
    The bill as reported to the Senate:
        Over the adjusted appropriations for 2000........... +22,422,412,000
        Under the budget estimates for 2001.................  -3,997,728,000

                                C O N T E N T S

                                  ----------
                                                                       Page
    Budget estimates.................................................     4
    Highlights of the Bill...........................................     4
    Reducing Medical Errors..........................................     7
    Women's Health Initiative........................................     7
    Drug Demand Reduction Initiative.................................    10
    Youth Violence Prevention Initiative.............................    12
    Government Performance and Results Act...........................    21
    Title I--Department of Labor:
        Employment and Training Administration.......................    24
        Pension and Welfare Benefits Administration..................    38
        Pension Benefit Guaranty Corporation.........................    38
        Employment Standards Administration..........................    38
        Occupational Safety and Health Administration................    41
        Mine Safety and Health Administration........................    42
        Bureau of Labor Statistics...................................    43
        Departmental management......................................    43
        Veterans Employment and Training.............................    46
    Title II--Department of Health and Human Services:
        Health Resources and Services Administration.................    48
        Centers for Disease Control and Prevention...................    83
        National Institutes of Health................................   115
        Substance Abuse and Mental Health Services Administration....   184
        Agency for Healthcare Research and Quality...................   195
        Health Care Financing Administration.........................   199
        Administration for Children and Families.....................   209
        Administration on Aging......................................   225
        Office of the Secretary......................................   232
    Title III--Department of Education:
        Education reform.............................................   246
        Education for the Disadvantaged..............................   256
        Impact aid...................................................   260
        School improvement programs..................................   262
        Reading excellence...........................................   272
        Indian education.............................................   272
        Bilingual and immigrant education............................   273
        Special education............................................   275
        Rehabilitation services and disability research..............   278
        Special institutions for persons with disabilities:
            American Printing House for the Blind....................   285
            National Technical Institute for the Deaf................   285
            Gallaudet University.....................................   286
        Vocational and adult education...............................   286
        Vocational education.........................................   286
        Adult education..............................................   288
        Student financial assistance.................................   289
        Federal family education loan program........................   291
        Higher education.............................................   292
        Howard University............................................   305
        College housing and academic facilities loans................   306
        Historically black college and university capital financing
          program....................................................   306
        Education research, statistics, and improvement..............   306
    Departmental management:
        Program administration.......................................   322
        Office for Civil Rights......................................   322
        Office of the Inspector General..............................   323
    Title IV--Related agencies:
        Armed Forces Retirement Home.................................   324
        Corporation for National and Community Service...............   324
        Corporation for Public Broadcasting..........................   326
        Federal Mediation and Conciliation Service...................   326
        Federal Mine Safety and Health Review Commission.............   326
        Office of Library Services: Grants and Administration........   326
        Medicare Payment Advisory Commission.........................   329
        National Commission on Libraries and Information Science.....   330
        National Council on Disability...............................   330
        National Education Goals Panel...............................   330
        National Labor Relations Board...............................   331
        National Mediation Board.....................................   331
        Occupational Safety and Health Review Commission.............   331
        Railroad Retirement Board....................................   332
        Social Security Administration...............................   333
        U.S. Institute of Peace......................................   337
    Title V--General provisions......................................   338
    Budgetary impact of bill.........................................   339
    Compliance with paragraph 7, rule XVI of the standing rules of
      the Senate.....................................................   339
    Compliance with paragraph 7(C), rule XXVI of the standing rules
      of the Senate..................................................   340
    Compliance with paragraph 12, rule XXVI of the standing rules of
      the Senate.....................................................   341
    Comparative statement of new budget authority....................   351

           Summary of Budget Estimates and Committee Recommendations

        For fiscal year 2001, the Committee recommends total budget
    authority of $352,185,874,000 for the Departments of Labor,
    Health and Human Services, and Education, and Related Agencies.
    Of this amount, which includes subsequent year advances,
    $97,820,000,000 is current year discretionary funding.

                               allocation ceiling

        Consistent with Congressional Budget Office scorekeeping,
    the recommendations result in full use of the $97,350,000,000
    in discretionary budget authority pursuant to section 302(b) of
    the Congressional Budget Act of 1974, as amended. In addition,
    the recommendations include $450,000,000 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 and $20,000,000 for adoption incentive
    programs conducted by the Administration on Children and
    Families, provided consistent with Public Law 95-266.

                          Overview and Bill Highlights

        The Labor, HHS and Education and Related Agencies bill
    constitutes the largest of the 13 federal appropriations bills
    being considered by Congress this year. It is the product of
    extensive deliberations, driven by the realization that no task
    before Congress is more important than safeguarding and
    improving the health and well-being of all Americans. This bill
    is made up of over 300 programs, spanning three federal
    Departments and numerous related agencies. But the bill is more
    than its component parts. Virtually every element of this bill
    reflects the traditional ideal of democracy: That every citizen
    deserves protection from illness and want; the right to a basic
    education and job skills training; and an equal opportunity to
    reach one's highest potential.
        This bill at the same time provides a safety net of social
    protections for the needy while stimulating advances in human
    achievement and the life sciences. At its core, this bill
    embodies those defining principles by which any free society
    must be guided: compassion for the less fortunate; respect for
    family and loved ones; acceptance of personal responsibility
    for one's actions; character development; and the avoidance of
    destructive behavior.

                             Highlights of the Bill

        Drug demand reduction initiative.--A total of
    $3,715,000,000 is recommended for currently authorized programs
    throughout the bill that promote activities aimed at reducing
    the demand for drugs.
        Youth violence prevention initiative.--Building on last
    year's efforts, the Committee bill includes $1,173,700,000 for
    currently authorized programs within the Departments of Labor,
    HHS and Education. The initiative will focus resources on
    activities that identify, prevent and help cope with violence
    among youth.
        Women's health initiative.--The Committee is recommending
    $4,175,200,000 for programs specifically addressing women's
    health and well-being.
        Youth employment and training.--The Committee bill provides
    $1,280,965,000 for programs to provide training and work
    experience to youths. This amount includes $1,000,965,000 for
    youth activities, $30,000,000 for a new youthful offender
    program, and $250,000,000 for youth opportunity grants.
        Job Corps.--The Committee recommendation includes
    $1,363,783,000 for the Job Corps, an increase of $6,007,000
    over the 2000 level.
        Worker protection.--The Committee bill includes
    $1,343,274,000 to ensure the health and safety of workers,
    including $425,983,000 for the Occupational Safety and Health
    Administration and $244,747,000 for the Mine Safety and Health
    Administration. The recommendation is an increase of
    $90,176,000 over the 2000 level.
        National Institutes of Health.--A total of $20,512,735,000
    is recommended to fund biomedical research at the 25 Institutes
    and centers that comprise the NIH. This represents an increase
    of $2,700,000,000 over the fiscal year 2000 level.
        AIDS.--The Committee bill includes $2,472,036,000 for AIDS
    research, prevention, and services. This includes
    $1,650,000,000 for Ryan White programs, an increase of
    $55,450,000, $762,036,000 for AIDS prevention programs at the
    Centers for Disease Control and Prevention, and $60,000,000 for
    global and minority AIDS activities within the Public Health
    and Social Services Fund. The Committee recommendation includes
    $85,000,000 for benefit payments authorized by the Ricky Ray
    Hemophilia Trust Fund Act.
        Bioterrorism initiative.--The Committee bill includes
    $249,333,000 to fund efforts to address bioterrorism threats.
        Medical Error Reduction.--The Committee recommendation
    includes $50,000,000 for activities of the Agency for
    Healthcare Research and Quality to reduce medical errors, an
    increase of $30,000,000 over the administration's request.
        Health Centers.--The recommendation includes $1,118,700,000
    for health centers, an increase of $50,000,000 over the budget
    request, and $100,000,000 over the fiscal 2000 enacted level.
        Infectious diseases.--The Committee bill provides
    $186,000,000 within the Centers for Disease Control and
    Prevention to combat the growing threat of infectious disease.
    The amount recommended is an increase of $10,390,000 over the
    fiscal year 2000 amount.
        Family planning.--The Committee bill recommends
    $253,932,000 for the family planning program, an increase of
    $15,000,000 over last year's appropriation. These funds support
    primary health care services at over 4,000 clinics nationwide.
        Child care and development block grant.--The Committee
    recommendation provides an additional $817,328,000 for child
    care services, for a total fiscal year 2001 funding level of
    $2,000,000,000.
        Community services block grant.--The Committee bill
    includes $550,000,000, an increase of $22,300,000 over the 2000
    enacted level.
        Head Start.--The Committee recommendation includes
    $4,867,000,000 for the Head Start Program. This represents an
    increase of $1,000,000,000 over the 2000 enacted level.
        Low-income home energy assistance.--The Committee
    recommends $1,100,000,000 for heating and cooling assistance
    for low-income individuals and families as an advance
    appropriation for fiscal year 2001. Also included is bill
    language permitting up to $300,000,000 in funding to provide
    additional energy assistance during weather emergencies.
        Crime reduction.--The bill recommends $184,299,000 for
    violent crime reduction activities, including $116,918,000 for
    battered women's shelters.
        Grants for disadvantaged children.--The Committee bill
    provides $7,113,403,000 for grants to disadvantaged children,
    $330,403,000 more than the 2000 level.
        Student financial aid.--The Committee recommends
    $10,624,000,000 for student financial assistance, including
    $1,011,000,000 for the Federal Work Study Program. The amount
    provided for the Pell Grant Program will allow the maximum
    grant to be raised to $3,650, an increase of $350 over the 2000
    amount.
        Higher education initiatives.--The Committee bill provides
    $1,694,520,000 for initiatives to provide greater opportunities
    for higher education, including $225,000,000 for GEAR UP,
    $30,000,000 for Learning Anytime Anywhere partnership grants,
    $736,500,000 for Federal TRIO programs, and $98,000,000 to
    improve teacher quality training.
        Education for individuals with disabilities.--The Committee
    bill provides $7,352,341,000 to ensure that all children have
    access to a free and appropriate education, and that all
    infants and toddlers with disabilities have access to early
    intervention services. This represents an increase of
    $1,316,145,000 over the 2000 level.
        Rehabilitation services.--The bill recommends
    $2,799,519,000 for rehabilitation services, an increase of
    $92,530,000 above the amount provided in 2000. These funds are
    essential for families with disabilities seeking employment.
        Services for older Americans.--For programs serving older
    Americans, the Committee recommendation totals $2,281,086,000
    including $187,330,000 for senior volunteer programs,
    $440,200,000 for community service employment for older
    Americans, $325,082,000 for supportive services and centers,
    and $521,412,000 for senior nutrition programs. For the medical
    research activities of the National Institute on Aging, the
    Committee recommends $792,062,000. The Committee recommendation
    includes $15,000,000 for the Medicare insurance counseling
    program.
        Public broadcasting.--The Committee bill provides
    $365,000,000 to support public radio and television, an
    increase of $15,000,000 over the previous year's appropriation.
        Social Security Administration.--The Committee bill
    recommends $7,010,800,000, an increase of $438,764,000 over the
    2000 level.

                            reducing medical errors

        The Committee recently held hearings to explore the
    findings of the Institute of Medicine's (IOM) report ``To Err
    is Human: Building a Safer Health System,'' which describes how
    each year, millions of Americans are at risk of serious injury
    or death when they seek medical attention. IOM found that
    deaths due to medical errors are considered to be the 5th
    leading cause of death in this country. Aside from the enormous
    personal cost, medical errors are estimated to cost the nation
    between $17,000,000,000 and $29,000,000,000 annually in
    additional health care costs, lost income, lost household
    production, and disability expenses.
        The Committee believes that the IOM findings are startling
    and beg for national attention to determine ways to reduce the
    number of medical errors, as these preventable mistakes erode
    the trust Americans have in the nation's health care system.
    This problem is complex and must be addressed with
    comprehensive solutions and rigorous changes that will prevent
    medical errors from happening in the future.
        The Committee is taking some critical first steps to reduce
    the incidence of deaths and injuries related to medical errors.
    The Committee has provided $50,000,000 to explore opportunities
    for a better understanding of the systemic problems in health
    care, in the hope that we can dramatically reduce the incidence
    of medical errors. The research initiatives include a focus on
    developing guidance to assist in States' development of data
    collection systems so that national trends can be determined
    and analyzed. Also, the Committee encourages health care
    providers to explore the use of technologies and other methods
    in reducing medical errors. Research and education efforts will
    undoubtedly help healthcare providers, and patients themselves,
    improve safety. The Committee believes that there should be
    zero tolerance for preventable medical mistakes and that we
    should work together to prevent further unnecessary deaths and
    injuries.

                           women's health initiative

        As we enter the 21st century, the Committee is pleased to
    note the tremendous progress achieved by women over the past
    100 years. But there is yet more progress to be made.
        In the past century, women have seen a 30 year gain in life
    expectancy, from 48.3 years in 1900 to 79.4 years in 1997.
    Women currently represent 51 percent of the total United States
    population, 59 percent of the over-65 population and 71 percent
    of Americans older than 85. Within the next 30 years, we can
    expect that 1 in 4 women in the U.S. will be 65 or older.
        As women live longer, our nation has made tremendous
    advances to delay or avoid the onset of the chronic conditions
    once thought to be the inevitable consequence of aging. Yet too
    many of these conditions continue to reduce the quality of life
    for millions of women. These conditions include osteoporosis,
    arthritis, cancer, heart failure, hypertension, urinary
    incontinence and diabetes. Among women aged 65-85, at least 27
    percent suffer from two chronic diseases, and 24 percent suffer
    from three or more. These debilitating conditions often result
    in activity limitations, loss of work and productivity,
    economic consequences as a result of needing supportive
    services for daily tasks, and increased risks to personal
    safety.
        In past years, the Committee has placed a high priority on
    women's health, emphasizing the prevention, detection,
    treatment and cure of diseases and conditions prevalent in
    female populations. The Committee has has included
    $4,175,200,000 to better understand and treat conditions such
    as cardiovascular disease, stroke, cancers of the breast,
    cervix, ovary and uterus, osteoporosis, lupus and other
    autoimmune diseases, sexually transmitted diseases, chronic
    fatigue syndrome, depression, incontinence, irritable bowel
    syndrome, temporomandibular joint (TMJ) disorders, vulvadynia,
    and conditions related to reproduction and contraception and
    other issues specifically affecting women.
        Other areas addressed by this Committee relate to
    environmental, social, cultural, racial, ethnic and lifestyle
    issues important to women and their families. These include
    initiatives that combat violence against women, reduce health
    disparities, eliminate tobacco addiction and substance abuse,
    provide for child care needs and early childhood education, and
    address conditions related to diet, exercise and nutrition.
        In the 1980's, public health leaders and this Committee
    drew attention to inequities in the health research agenda and
    the fact that women and minorities were being excluded from
    research studies. Many of the major research studies the
    National Institutes of Health funded included only men, making
    it uncertain whether the studies' results applied also to
    women. In 1990, the U.S. General Accounting Office (GAO) found
    that the NIH had been slow and ineffective in implementing a
    policy to include women in research study populations. At the
    urging of this Committee, and in response to passage of the NIH
    Revitalization Act of 1993, the NIH began to take more
    comprehensive measures to increase research on health problems
    affecting women.
        The GAO has now published a report assessing the NIH's
    progress on conducting research on women's health in the past
    decade. The GAO's report found that NIH has made significant
    progress in implementing a strengthened policy on including
    women in clinical research. However, the Committee is deeply
    concerned to learn that NIH has made little progress in
    implementing the requirement that clinical trials be designed
    and carried out to permit valid analysis by sex, which could
    reveal whether interventions affect women and men differently.
    In addition, the report found that NIH's data tracking system
    for monitoring the inclusion policy is inaccurate and
    inconsistent.
        The Committee is pleased to note that the budget for the
    Office of Research on Women's Health has more than doubled
    since 1993. While the Committee recognizes the central role
    played by ORWH in the implementation of NIH's 1994 guidelines,
    it is concerned that ORWH has not provided regular training and
    education of NIH staff and researchers on the inclusion policy
    and the data tracking system.
        In light of the GAO report's disturbing findings, the
    Committee urges NIH to adopt GAO's recommendations to implement
    the requirement that phase III clinical trials be designed and
    carried out to allow for the valid analysis of differences
    between women and men. To improve the accuracy of NIH's
    tracking data system on the inclusion of women and minorities,
    the Committee urges NIH to ensure their staff receive ongoing
    training on the requirements and purpose of the system.
        Unfortunately, women often face a fragmentation of health
    care services to meet their reproductive and other health
    needs. Women are also highly interested and informed about
    health care issues, but reliable health information needed to
    make informed choices has not been widely available.
        A number of recent studies describe a health care system
    that treats women like second-class citizens. In many cases,
    health care providers treat women differently than men by
    giving women less thorough evaluations for similar complaints,
    minimizing their symptoms, providing fewer interventions for
    the same diagnoses, prescribing some types of medications more
    often, such as anti-anxiety drugs, or providing less
    explanation in response to questions.
        The Committee wishes to address inequities in our national
    research agenda and our health care delivery system. Progress
    has been made to improve women's health status because of
    public pressure and Congressional attention, but more must be
    done. The Committee has therefore provided level or increased
    funding for existing programs for a women's health initiative.
        1. National Institutes of Health.--The Committee has
    provided a $2,700,000,000 increase for the NIH, the largest
    increase in history. Funds are therefore available for
    implementation of the recommendations detailed in the GAO
    Report of May 2000 titled ``Women's Health: NIH Has Increased
    Its Efforts to Include Women in Research'' and to expand
    research into a range of women's health concerns, including
    cardiovascular disease, stroke, cancers of the breast, cervix,
    ovary and uterus, osteoporosis, lupus and other autoimmune
    diseases, sexually transmitted diseases, chronic fatigue
    syndrome, depression, incontinence, irritable bowel syndrome,
    temporomandibular joint (TMJ) disorders, vulvadynia, and
    conditions related to reproduction and contraception.
        2. Breast and cervical cancer.--The Committee has provided
    $164,016,000, an increase of $8,000,000, for CDC's National
    Breast and Cervical Cancer Early Detection Program, which
    guides public health programs in formulating an aggressive
    response to these cancers. CDC further supports the delivery of
    screening services to underserved women, quality assurance,
    referral and follow-up services, surveillance and partnership
    development.
        3. Wisewoman.--The Committee is pleased with the progress
    of CDC's Wisewoman Program. This demonstration program provides
    low-income women participating in the national breast and
    cervical cancer early detection program with additional
    preventive screenings and medical referrals. The Committee has
    provided sufficient funds for a continued expansion of the
    program to additional States.
        4. Osteoporosis.--The Committee recommends the commitment
    of the Office on Women's Health to the National Bone Health
    Campaign aimed at adolescent girls. The Committee also
    recognizes that eating disorders and autoimmune diseases impact
    bone health and encourages the Office of Women's Health to
    develop information and outreach activities on these
    conditions.
        5. Maternal and child health.--The Committee recommends
    $704,130,000 for the maternal and child health (MCH) block
    grant. The MCH block grant funds are provided to States to
    support health care for mothers and children.
        6. Ryan White--pediatric AIDS.--The Committee recommends
    $58,450,000 for title IV pediatric AIDS. 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.
        7. Family planning.--The Committee recommends $253,932,000
    for the title X family planning program. The title X grants
    support primary health 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.
        8. Substance abuse prevention and treatment for pregnant
    and post-partum women.--The Committee has provided funding to
    combat the tragic results of drug abuse among pregnant women.
    The Committee encourages continued funding for new and existing
    residential treatment facilities for pregnant and post-partum
    women and continues to be supportive of efforts to prevent and
    treat mothers with substance abuse problems.
        9. Child care.--The Committee recommends an increase of
    $817,328,000 for the Child Care and Development Block Grant in
    fiscal year 2001. This brings the total funding level to
    $2,000,000,000.
        10. Violence Against Women.--The Committee has provided
    $116,918,000 for Battered Women's Shelters, an increase of
    $15,800,000 over last year's appropriation. The Committee also
    recommends $2,157,000 for the Domestic Violence Hotline.

                        drug demand reduction initiative

        Substance abuse is a critical and persistent problem facing
    this country's major cities and smallest communities. The
    effects of drug use are devastating: it destroys families, robs
    promising individuals of potential, and leads to crime in our
    neighborhoods. It is estimated that the social costs of illicit
    drug abuse add up to $110,000,000,000 each year. Nevertheless,
    the demand for drugs in this country continues.
        After a dramatic decline in illicit drug use between 1985
    and 1992, usage levels have remained more or less steady over
    the past 8 years. According to information provided by the
    Office of National Drug Control Policy (ONDCP), children most
    often begin to use drugs at the age of 12 or 13, moving from
    illicit use of legal substances, such as tobacco and alcohol,
    to the use of illegal drugs. Marijuana is usually the first
    illicit drug used. Recent studies indicate that by the time
    children turn 17, more than half of them have seen drugs sold
    on their school grounds, nearly two-thirds report they can buy
    marijuana within a day, and three-fourths know someone who has
    used LSD, cocaine, or heroin. In one survey cited by the ONDCP,
    over 50 percent of high school seniors had tried an illicit
    drug, and more than one in four was a current user.
        The U.S. Government now spends about $18,000,000,000 a year
    on drug control. Two-thirds of that amount, or about
    $12,000,000,000, is directed to activities such as interdiction
    and to fighting street crime. While the Committee believes this
    effort is important and must continue, it still addresses only
    one side of the problem. Until we become more successful in
    decreasing the demand for drugs in our own country, our drug
    control policy will not succeed.
        The Committee believes we must make an all-out effort to
    reduce the demand for drugs in this country. We must increase
    funding for drug education in the United States, teaching
    children and adults not only the dangers of drug use, but how
    to deal with life's challenges without turning to substances
    that numb the mind and reduce self-control. This calls for
    continuing innovation and a unswerving commitment to the future
    of our youth. We have to do everything in our power to ensure
    they are equipped to avoid the lure of drugs and the temporary
    solutions drugs seem to offer.
        For those who have already begun the downward spiral and
    who believe that drug use is a solution to their problems, we
    must continue to present options for rehabilitation. We must
    finds ways to restore hope and equip them to become productive,
    healthy members of society. It is an economic and moral
    imperative. The costs to the individual and to our nation are
    too great to do otherwise. Therefore, the Committee has
    included $3,715,276,000 for a number of programs in this bill
    that can help reduce the demand for drugs in this country.
        Responsible Reintegration for Young Offenders.--The
    Committee provided $30,000,000 for this program, an increase of
    $16,093,000 over fiscal year 2000. This program will link
    youthful offenders under age 35 with essential services to help
    them reintegrate into the mainstream economy. One of the major
    problems these youth face is substance abuse. Until these young
    offenders can overcome their dependency on illegal drugs, they
    will inevitably land back in the criminal justice system. This
    program will provide young offenders with the necessary drug
    counseling and other services they need to move on with their
    lives and gain productive employment.
        Safe Schools/Healthy Students.--The Safe Schools/Healthy
    Students program is a collaboration between the Departments of
    Labor, Health and Human Services and Education. The purpose of
    the program is to promote healthy childhood development,
    prevent school violence, and reduce drug demand though a
    comprehensive, community-wide approach. This year, the
    Committee has initiated funding for the Department of Labor
    component of the program, which will allow the program to
    address out-of-school youth. The Committee has included
    $20,000,000 for the Department of Labor component of the
    program and $90,000,000 for the Department of Health and Human
    Service's component in fiscal year 2001.
        National Institute on Drug Abuse.--The Committee has
    provided $790,038,000 for the National Institute on Drug Abuse
    (NIDA), an increase of $102,662,000 over the fiscal year 2000
    level. Created in 1974, NIDA supports about 85 percent of the
    world's biomedical research in the area of drug abuse and
    addiction. NIDA research identifies the most effective
    pharmacological and behavioral drug abuse treatments. NIDA also
    identifies effective prevention strategies that replicated in
    other communities.
        National Institute on Alcohol Abuse and Alcoholism.--The
    Committee has provided $336,848,000, an increase of $43,614,000
    over last year's level. NIAAA provides leadership in the
    country's efforts to combat alcoholism and alcohol abuse and
    their associated morbidity and mortality.
        Substance Abuse Treatment Demonstration Programs and
    Targeted Capacity Grants.--The Committee has included
    $249,566,000, an increase of $35,000,000 over fiscal year 2000,
    for substance abuse treatment demonstrations and grants to
    increase the capacity of State and local grantees to address
    emerging substance abuse treatment demands.
        Substance Abuse Block Grant.--The Committee has provided
    $1,631,000,000 for the Substance Abuse Block Grant, an increase
    of $31,000,000 over fiscal year 2000. While substance abuse
    treatment has been shown effective in reducing drug use, there
    are waiting lists of individuals needing treatment. The block
    grant represents 40 percent of public funds expended for
    treatment and prevention.
        Substance Abuse Prevention Demonstrations (SAMHSA).--The
    Committee has included $120,824,000 for fiscal year 2001, for
    substance abuse prevention activities at SAMHSA. Over the past
    few years, we have learned that some prevention approaches
    work, others don't. SAMHSA's activities are critical to the
    dissemination of effective prevention programs developed by
    SAMHSA and NIDA.
        Safe and Drug-Free Schools.--The Committee has included
    $447,000,000 for Safe and Drug-Free Schools, an increase of
    $7,750,000 over the fiscal year 2000 level. Students cannot be
    expected to learn in an environment where they are threatened
    by drugs or violence. The Safe and Drug-Free Schools program is
    designed to maintain drug-free and safe environments for
    learning by supporting effective, research-based approaches to
    drug prevention.

                      youth violence prevention initiative

        An estimated 3 million crimes a year are committed in or
    near the nation's 85,000 public schools. During the 1996-97
    school year alone, one-fifth of public high schools and middle
    schools reported at least one violent crime incident, such as
    murder, rape or robbery; more than half reported less serious
    crimes. Homicide is now the third leading cause of death for
    children age 10 to 14. For more than a decade it has been the
    leading cause of death among minority youth between the ages of
    15 and 24. The trauma and anxiety that violence begets in our
    children most certainly interferes with their ability to learn
    and their teachers' ability to teach: an increasing number of
    school-aged children say they often fear for their own safety
    in and around their classroom.
        The Gun-Free Schools Act of 1994 requires states to pass
    laws mandating school districts to expel any student who brings
    a firearm to school. A recent study indicates that the number
    of students carrying weapons to school dropped from 26.1
    percent in 1991 to 18.3 percent in 1997. While this trend is
    encouraging, the prevalence of youth violence is still
    unacceptably high. Recent incidents clearly indicate that much
    more needs to be done. Some of the funds provided in this
    initiative will help state and local authorities to purchase
    metal detectors and hire security officers to reduce or
    eliminate the number of weapons brought into educational
    settings.
        Fault does not rest with one single factor. In another
    time, society might have turned to government for the answer.
    However, there is no easy solution, and total reliance on
    government would be a mistake. Youth violence has become a
    public health problem that requires a national effort.
    Certainly, our government at all levels--Federal, State and
    local--must play a role. But we must also enlist the energies
    and resources of private organizations, businesses, families
    and the children themselves.
        The Committee is aware of the controversy regarding the
    media's role in influencing youth violence. The Committee
    recognizes that some members of the entertainment industry have
    challenged the methodology of studies conducted over the past 3
    decades which have linked movies, television programs, song
    lyrics, and video games with violent behavior. The Committee
    believes that any studies that determine causative factors for
    youth violence should be based on sound methodology which
    yields statistically significant and replicable results.
    Despite disagreement over the media's role, the Committee is
    encouraged by historic efforts of various sectors of the
    entertainment industry to monitor and discipline themselves and
    to regulate content. The industry's self-imposed, voluntary
    ratings system is a step in the right direction.
        Many familial, psychological, biological and environmental
    factors contribute to youths' propensity toward violence. The
    youth violence prevention initiative contained in this bill is
    built around these factors and seeks to be comprehensive and to
    eliminate the conditions which cultivate violence.
        Based on those three meetings and staff follow up, the
    following action plan was developed.
        The Committee has reallocated from existing programs
    $1,173,700,000 for a youth violence prevention initiative.
    These funds together with increases included for the National
    Institute of Mental Health, National Institute of Drug Abuse,
    and the National Institute of Alcohol Abuse and Alcoholism will
    provide resources to address school violence issues in a
    comprehensive way. This coordinated approach will improve
    research, prevention, education and treatment strategies to
    address youth violence.
        White House Council on Youth Violence.--The Committee
    supports the efforts of the White House Council on Youth
    Violence in overseeing and coordinating Federal programs and
    interagency initiatives that reduce the incidence of youth
    violence and address the needs of youth who have engaged in
    violent behavior. The council works with all Federal agencies
    that deal with youth violence prevention, intervention and
    treatment and that foster positive youth development to ensure
    that: policies related to these youth are consistent; research
    and data collection efforts are not duplicated; and programs
    are coordinated. Additionally, the White House Council
    stimulates collaborative initiatives across Federal agencies
    and where possible ensures that resources are linked or joined
    together in the development of broad-based comprehensive
    prevention and intervention strategies. However, the Committee
    has been disappointed in the slow progress in which funds have
    been awarded so that innovative projects can begin addressing
    this critical problem. Therefore, the Committee directs the
    Council to provide bi-monthly reports explaining the progress
    of coordination efforts, the awarding of grants, and the status
    and results of demonstration projects that are aimed at
    preventing youth violence.
    1. Office of the United States Surgeon General
        The Committee has included $400,000 directly to the Office
    of the Surgeon General (OSG) for a Surgeon General's report on
    youth violence. This report, to be coordinated by the OSG
    should review the biological, psychosocial and environmental
    determinants of violence, including a comprehensive analysis of
    the effects of the media, the internet, and video games on
    violent behavior and the effectiveness of preventive
    interventions for violent behavior, homicide, and suicide. The
    OSG shall have lead responsibility for this report and its
    implementation activities.
        B. National Academic Centers of Excellence on Youth
    Violence Prevention.--The Committee has included $10,000,000 to
    continue the 10 National Centers of Excellence at academic
    health centers that will serve as national models for the
    prevention of youth violence. These Centers should: (1) develop
    and implement a multi-disciplinary research agenda on the risk
    and protective factors for youth violence, on the interaction
    of environmental and individual risk factors, and on preventive
    and therapeutic interventions; (2) develop and evaluate
    preventive interventions for youth violence, establishing
    strong linkages to the community, schools and with social
    service and health organizations; (3) develop a community
    response plan for youth violence, bringing together diverse
    perspectives including health and mental health professionals,
    educators, the media, parents, young people, police,
    legislators, public health specialists, and business leaders;
    and (4) develop a curriculum for the training of health care
    professionals on violent behavior identification, assessment
    and intervention with high risk youth, and integrate this
    curriculum into medical, nursing and other health professional
    training programs.
        C. National Youth Violence Prevention Resource Center.--The
    Committee has included $2,500,000 to continue the National
    Resource Center on Youth Violence Prevention. This center has
    established a toll free number (in English and Spanish) and an
    internet website, in coordination with existing Federal web
    site resources, to provide accurate youth violence prevention
    and intervention information produced by the government and
    linked to private resources. Hundreds of resources are now
    available on this issue including statistics, brochures,
    monographs, descriptions of practices that work, and manuals
    about how to implement effective interventions. The Resource
    Center provides a single, user-friendly point of access to
    important, potentially life-saving information about youth
    violence, and an explanation about preventing youth violence
    and how to intervene. Additionally, technical assistance on how
    to establish programs in communities across the country by
    providing local resources would also be made available through
    the National Resource Center.
        The Committee directs CDC to work with the White House
    Council on Youth Violence to design and implement the Center as
    a single point of access to Federal agency resources and
    information on youth violence prevention and intervention. The
    White House Council will provide oversight to ensure that the
    Center provides access to all Federal information.
        D. Health Care Professional Training.--The Committee has
    included sufficient funds for the training of primary health
    care providers, pediatricians and obstetricians/gynecologists
    in detecting child and youth violence stemming from child
    abuse.
    2. National Institute of Mental Health
        A. Zero to Five.--Many risk factors are established early
    in a child's life (0 to 5 years), including child abuse and
    neglect. However, less dramatic problems that delay cognitive
    and social and emotional development may also lead to later
    serious conduct problems that are resistant to change. The
    Committee encourages NIMH to address both of these types of
    problems by supporting research to understand and prevent abuse
    and neglect, by encouraging research on how to best instruct
    parents and child care workers in appropriate interventions,
    and by supporting research that develops and evaluates
    interventions for early disruptive behavior in diverse
    preschool and community settings. In addition, the Institute
    should work to ensure that the goals of all interventions
    include effectiveness and sustainability.
        B. Five to twelve.--Attention Deficit Hyperactivity
    Disorder (ADHD) and depression often emerge in the 5-12 year
    age range. Comprehensive research-based programs have been
    developed to provide such children with the mental health
    services and behavioral interactions they need. The Committee
    urges NIMH to continue its work toward the development and
    evaluation of programs aimed at prevention, early recognition,
    and intervention for depression and youth suicide in diverse
    school and community settings to determine their effectiveness
    and sustainability; to support the development and evaluation
    of behavioral interventions for home and classroom to manage
    ADHD; to identify through research the most cost-effective
    features of proven prevention programs for resource poor
    communities; and to support multi-site clinical trials to
    establish safe and effective treatment of acute and long-term
    depression and ADHD.
        C. 12 to 18.--Early adolescence is an important time to
    stop the progression of violent behavior and delinquency.
    Multisystemic therapy (MST), in which specially trained
    individuals work with the youth and family in their homes,
    schools and communities, have been found to reduce chronic
    violent or delinquent behavior. Research has shown sustained
    improvements for at least 4 years, and MST appears to be cost
    effective when compared to conventional community treatment
    programs in that it has proven to reduce hospitalization and
    incarceration.
        D. Behavioral and Psychosocial Therapies.--Therapeutic
    Foster Care is an effective home based intervention for
    chronically offending delinquents. Key elements of the program
    include providing supervision, structure, consistency,
    discipline, and positive reinforcement. This intervention
    results in fewer runaways and program failures than other
    placements and is less expensive. The Committee encourages NIMH
    to work in collaboration with CDC, SAMHSA, and the Department
    of Justice to implement effective model interventions for
    juvenile offenders with conduct disorders in diverse
    populations and settings. NIMH has initiated the nation's first
    large-scale multi-site clinical trial for treatment of
    adolescent depression, and the Committee supports additional
    research to improve recognition of adolescent depression.
        E. Public Health Research, Data Collection and Community-
    based Interventions.--There are four cross-cutting areas in
    need of further research action across all agencies: community
    interventions, media, health provider training, and information
    dissemination. The Committee directs NIMH to ensure that
    research focuses on: examining the feasibility of public health
    programs combining individual, family and community level
    interventions to address violence and identify best practices;
    developing curricula for health care providers and educators to
    identify pediatric depression and other risk factors for
    violent behavior; studying the impact of the media, computer
    games, internet, etc., on violent behavior; disseminating
    information to families, schools, and communities to recognize
    childhood depression, suicide risk, substance abuse, and ADHD
    and decreasing the stigma associated with seeking mental health
    care. The Committee also encourages NIMH to work in
    collaboration with CDC and SAMHSA to create a system to provide
    technical assistance to schools and communities to provide
    public health information and best practices to schools and
    communities to work with high risk youth. The Committee has
    included sufficient funds to collect data on the number and
    percentage of students engaged in violent behavior, incidents
    of serious violent crime in schools, suicide attempts, and
    students suspended and/or expelled from school.
        3. National Institute of Drug Abuse.--Drug abuse is a risk
    factor for violent behavior. The Committee encourages NIDA to
    support research on the contribution of drug abuse including
    methamphetamine use, its co-morbidity with mental illness, and
    treatment approaches to prevent violent behavior.
        4. National Institute of Alcohol Abuse and Alcoholism.--The
    Committee encourages NIAAA to examine the relationship of
    alcohol and youth violence with other mental disorders and to
    test interventions to prevent alcohol abuse and its
    consequences.
    5. Safe Schools, Healthy students
        Mental Health Counselors/Community Support/Technical
    Assistance and Education and training.--The Committee has
    included $90,000,000, an increase of $11,793,000 over the
    fiscal year 2000 appropriation, to support the delivery and
    improvement of mental health services, including school-based
    counselors, in our nation's schools. These funds allow State
    and local mental health counselors to work closely with schools
    and communities to provide services to children with emotional,
    behavioral, or social disorders. Some of these funds also help
    train teachers, school administrators, and community groups
    that work with youths to identify children with emotional or
    behavioral disorders. The program is being administered
    collaboratively by the Substance Abuse and Mental Health
    Services Administration within the Department of Health and
    Human Services and the Departments of Education and Justice,
    with the addition of the Department of Labor in fiscal year
    2001. This initiative is designed to help school districts
    implement a wide range of early childhood development
    techniques, early intervention and prevention strategies,
    suicide prevention, and increased and improved mental health
    treatment services, and is being expanded to include out-of-
    school youth and linkages to the local employment and training
    partnerships. Some of the early childhood development services
    include effective parenting programs and home visitations.
        6. Parental responsibility/Early Intervention.--
    Sociological and scientific studies show that the first 3 years
    of a child's cognitive development sets the foundation for
    life-long learning and can determine an individual's emotional
    capabilities. Parents, having the primary and strongest
    influence on their child, play a pivotal role at this stage of
    development. Scientists have found that parental relationships
    affect their child's brain in many ways. A secure, highly
    interactive, and warm bond can bolster the biological systems
    that help a child handle their emotions. Research further
    indicates that a secure connection with the parent will better
    equip a child to handle stressful events throughout life.
    Statistics show that the parental assistance program in
    particular has helped to lower the incidence of child abuse and
    neglect, reduces placement of children in special education
    programs, and involves parents more actively throughout their
    child's school years. The Committee recognizes that early
    intervention activities conducted through the Department of
    Education's parent information and resource centers program can
    make a critical difference in addressing the national epidemic
    of youth violence, and therefore includes an additional
    $7,000,000 to expand its services to educate parents to work
    with professionals in preventing and identifying violent
    behavioral tendencies.
    7. Safe and Drug-Free Schools
        A. National Programs.--The Committee remains extremely
    concerned about the frequent occurrence of violence in our
    Nation's schools. Last year, the Committee provided
    $110,750,000 within this account for a school violence
    prevention initiative. As part of an enhanced and more
    comprehensive effort, the Committee has provided $145,000,000
    within the safe and drug-free schools and communities program
    to support activities that promote safe learning environments
    for students. Such activities should include: targeted
    assistance, through competitive grants, to local educational
    agencies for community-wide approaches to creating safe and
    drug free schools; and training for teachers and school
    security officers to help them identify students who exhibit
    signs of violent behavior, and respond to disruptive and
    violent behavior by students. The Committee also encourages the
    Department to coordinate its efforts with children's mental
    health programs.
        B. Coordinator Initiative.--The Committee has included
    $50,000,000, the same amount provided in the fiscal year 2000.
    The Committee recommendation will enable the Department of
    Education to continue to provide assistance to local
    educational agencies to recruit, hire, and train drug
    prevention and school safety program coordinators in middle
    schools with significant drug and school safety problems. These
    coordinators will be responsible for developing, conducting and
    analyzing assessments of their school's drug and crime
    problems, and identifying promising research-based drug and
    violence prevention strategies and programs to address these
    problems.
        8. 21st Century Community Learning Centers.--The Committee
    has included $600,000,000 for the 21st Century Community
    Learning Centers, an increase of $146,623,000 over the fiscal
    year 2000 level. These funds are intended to be used to reduce
    idleness and offer an alternative to children when they
    conclude their school day, at a time when they are typically
    unsupervised. Nationally, each week, nearly 5 million children
    ages 5-14 are home alone after school, which is when juvenile
    crime rates double. According to the Department of Justice, 50
    percent of all juvenile crime occurs between the hours of 2
    p.m. and 8 p.m. during the week. Therefore, the Committee has
    included funds to allow the Department of Education to support
    after-school programs that emphasize safety, crime awareness,
    and drug prevention.
        9. Teacher Quality Enhancement Grants.--The Committee has
    included $98,000,000 for teacher quality enhancement grants, an
    increase of $18,000,000, for professional development of K-12
    teachers, which is a necessary component to addressing the
    epidemic of youth violence. The Committee encourages the
    Department, in making these grants, to give priority to
    partnerships that will prepare new and existing teachers to
    identify students who are having difficulty adapting to the
    school environment and may be at-risk of violent behavior.
    Funds should also be used to train teachers on how to detect,
    manage, and monitor the warning signs of potentially
    destructive behavior in their classrooms.
        10. Character Education.--The Committee recommends
    $12,300,000, an increase of $5,000,000 over the fiscal year
    2000 level, for character education partnership grants. These
    funds will be used to encourage states and school districts to
    develop pilot projects that promote strong character, which is
    fundamental to violence prevention. Character education
    programs should be designed to equip young individuals with a
    greater sense of responsibility, respect, trustworthiness,
    caring, civic virtue, citizenship, justice and fairness, and a
    better understanding of the consequences of their actions.
        11. Elementary School Counseling.--The Committee is
    concerned about the inaccessibility of school counselors for
    young children and therefore is providing $30,000,000, an
    increase of $10,000,000 over the fiscal year 2000 level, for
    the Elementary School Counseling Demonstration. Many students
    who are having a difficult time handling the pressures of
    social and academic demands could benefit from having mental
    health care readily available. The Committee believes that
    increasing the visibility of school counselors would legitimize
    their role as part of the school's administrative framework,
    thereby, encouraging students to seek assistance before
    resorting to violence.
        12. Civic education.--Within the amounts provided, the
    Committee has included $1,500,000 to continue the violence
    prevention initiative begun in fiscal year 1999. The Committee
    encourages that funds be used to conduct a five State violence
    prevention demonstration program on public and private
    elementary, middle, and secondary schools involving students,
    parents, community leaders, volunteers, and public and private
    sector agencies, such as law enforcement, courts, bar
    associations, and community based organizations.
    13. Literacy programs
        A. The Committee has included $5,000,000, an increase of
    $3,000,000 over last year's level for the Reading is
    Fundamental program to promote literacy skills. Studies show
    that literacy promotion is one tool to prevent youth violence.
    The Committee believes that this program, which motivates
    children to read and increases parental involvement is another
    way to prevent youth violence at an early age.
        B. The Committee has included $22,000,000, an increase of
    $3,000,000 over last year, for the State Grants for
    Incarcerated Youth Offenders/Prisoner Literacy Programs. This
    program, which assists states to encourage incarcerated youth
    to acquire functional literacy, life and job skills, can also
    play a role in reducing recidivism rates and violent behavior.
        C. The Committee has included $50,000,000 for the Title I
    Neglected and Delinquent/High Risk Youth program, an increase
    of $8,000,000 over the fiscal year 2000 appropriation. These
    funds will assist states to strengthen programs for neglected
    and delinquent children to enhance youth violence prevention
    programs in state-run institutions and for juveniles in adult
    correctional facilities
        These funds will be used to motivate youth to read and
    enhance their academic achievement. Literacy promotion
    encourages young individuals to pursue productive goals, such
    as continued education and gainful employment.
        14. Youth Service delivery systems.--The Committee is aware
    that the Workforce Investment Act (WIA) brings new emphasis to
    the development of coherent, comprehensive youth services that
    address the needs of low-income youth over time. It believes
    that youth service delivery systems under WIA integrate
    academic and work-based learning opportunities, offer effective
    connections to the job market and employers, and have intensive
    private-sector involvement. Such effective systems can provide
    low-income, disadvantaged youth with opportunities in our
    strong economy as alternatives to youth violence and crime. The
    Committee further recognizes the potential of Youth Councils
    for creating the necessary collaboration of private and public
    groups to create community strategies that improve
    opportunities for youth to successfully transition to
    adulthood, postsecondary education and training. Thus, the
    Committee has included funds to continue investments in WIA
    formula-funded youth activities, the Youth Opportunities grant
    program, the Job Corps, and provides $30,000,000 for
    Responsible Reintegration for Young Offenders, which builds on
    the Committee's prior year's youth offender pilot projects.

                  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 $500,000, whichever is less,
    between programs, activities, or elements unless an alternate
    amount for the agency in question is specified elsewhere in
    this report. 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 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.

                            Claims Processing Costs

        Under the budget process Social Security, Medicare and
    unemployment benefits are classified as mandatory spending
    while the administrative costs to run the programs and pay the
    benefits are considered discretionary spending. As a result of
    this structural anomaly, the operating funds for these systems
    must compete with other important discretionary programs in
    this bill. With insufficient funds to take care of the needs in
    the bill, the Committee has not been able to provide as high a
    level of support for these operations as it wished even though
    ample resources exist in the Social Security and Federal
    Unemployment Trust Funds to support higher funding levels. The
    committee would like to work with the relevant committees and
    the administration to seek a solution to this structural
    anomaly.

                     GOVERNMENT PERFORMANCE AND RESULTS ACT

    Department of Labor
        The Committee received the Labor Department's performance
    plans in a timely manner--at the same time as the fiscal year
    2001 budget justification. In general, the Department's work is
    organized around three strategic goals: (1) A prepared
    workforce--enhance the opportunities for America's work force;
    (2) a secure work force--promote the economic security of
    workers and families; (3) quality workplaces--foster quality
    workplaces that are safe, healthy, and fair.
        For each of the three strategic goals there are supporting
    outcome goals in the fiscal year 2001 performance plan that
    refine and further focus the strategic goals. For each outcome
    goal, there are supporting performance goals that set specific
    and measurable target levels of performance for the the
    Department's agency programs for the fiscal year. Linkage to
    the budget is provided in the Department's annual performance
    plan by cross-referencing the Department of Labor budget
    activities to the Department's three strategic goals. Specific
    linkages between individual agency performance measures and
    budget activities are provided in the individual agency
    performance plans.
        With regard to the means for measuring performance, the
    Committee recognizes the significant progress made by the
    Department. Further, the Committee is encouraged by the
    analysis which the Department is implementing with this data.
    The Department will need to continue its work at developing
    performance measures that represent measures of the core work,
    test the measures, and implement reporting systems that capture
    the data in a timely and accurate manner. The Committee is also
    encouraged to see the Department's use of current performance
    goals as compared with fiscal year 1999 performance results and
    the relevent indicators and measures.
    Department of Health and Human Services
        The fiscal year 2001 annual performance plan for the
    Department of Health and Human Services includes valuable
    information about how HHS intends to accomplish its mission.
    The information included in the fiscal year 2001 HHS
    Performance Plan and Performance Report Summary is much
    improved over previous years. Many parts of the plan do fulfill
    the Results Act's purpose of ensuring that Congress has the
    necessary information to assess whether HHS programs are
    achieving intended results. In particular, the HHS agencies
    have set measurable performance goals, provided information
    about how they will coordinate with each other and other
    performance partners to achieve related goals, identified the
    resources they need to accomplish their goals, and discussed
    how they intend to address problems with their performance
    data.
        HHS should be commended for their efforts to fully
    incorporate annual GPRA performance planning and reporting into
    the budget process within the Department and into the budget
    documents submitted to OMB and the Congress. The annual Budget
    Review Boards, where senior Department and Operating Division
    management meet to discuss funding requests, also have become
    venues for addressing the linkage of program performance to the
    new program initiatives and budget requests of HHS components.
        HHS is a large, decentralized Agency that administers
    approximately 300 program activities, with over 750 annual
    performance goals. In spite of the challenges this creates, HHS
    has done an excellent job satisfying the intent of the Results
    Act. The Committee hopes that HHS will work to build on these
    accomplishments and continue the strong commitment that was
    demonstrated in the fiscal year 2001 HHS Performance Plan.
    Department of Education
        The Committee is pleased to have received the Department's
    1999 Performance Plan Report prior to the deadline set for this
    activity. The Committee also recognizes the significant
    progress that the Department has made in the 2001 Performance
    Plan. The 2001 Plan provides a clear framework of four goals
    and 22 objectives within which the Department will support
    strategies aligned with its mission to ensure equal access to
    education and to promote educational excellence throughout the
    nation.
        The Committee remains interested in how the Department
    coordinates the administration of education programs with other
    related activities and Federal and non-Federal partners in
    order to improve program outcomes. While the Plan reflects
    improvements in identifying collaborative efforts with other
    Federal agencies, the specific activities cited for each
    objective vary greatly: some provide specific information about
    how the Department is cooperating with other Federal agencies,
    and others simply state that there is coordination. While the
    Committee acknowledges the efforts of the Department to
    identify challenges to achieving its objective, it also notes
    the lack of consistency in identifying activities or strategies
    planned or being undertaken to address these challenges.
        The Committee continues to be concerned about the
    incomplete discussion of the amount of resources being directed
    to goals and objectives. For example, the objective related to
    the use of advanced technology for all students and teachers to
    improve education does not identify a total amount of resources
    allocated for this purpose. The Plan should be able to identify
    the amount of resources dedicated to goals and objectives for
    the current and/or budget year.
        Finally, the Committee commends the Department for
    presenting fairly the limitations on the use of the performance
    data. The Department should continue to work on improving the
    reliability and validity of performance information and their
    relation to and affect on program outcomes.
    Social Security Administration
        The Social Security Administration's (SSA) annual
    performance plan for fiscal year 2001 was received at the same
    time as the fiscal year 2001 budget justification. SSA's
    performance plan is organized around five stategic goals: (1)
    To promote valued, strong and responsive social security
    programs and conduct effective policy development, research and
    program evaluation; (2) to deliver customer-responsive, world-
    class service; (3) to make SSA program management the best-in-
    business, with zero tolerance for fraud and abuse; (4) to be an
    employer that values and invests in each employee; and (5) to
    strengthen public understanding of the social security
    programs.
        SSA has aligned strategic goals and performance goals by
    major functional responsibilities rather than by program or
    budget account. SSA does link funding amounts within the
    Limitation on Administrative Expenses, research and Office of
    Inspector General budgets to the four functional strategic
    goals: (1) Responsive programs; (2) world-class service; (3)
    program management; and (4) public understanding. For each
    strategic goal, there are strategic objectives to support the
    strategic goals. For each strategic objective, there are
    performance indicators and goals which are used to focus on the
    strategic objectives. From this data, SSA reports sets of
    strategies, called programs for objective achievement (POA).
        The Committee recognizes the challenge facing SSA to
    comprehensively and effectively gather and analyze data, and is
    pleased with the progress which SSA has made in measuring and
    reporting strategic goals and performance. The Committee hopes
    that SSA will use past performance in achieving strategic
    objectives when evaluating current strategic performance.
    Furthermore, the Committee encourages SSA to continue to
    improve performance measures and use customer satisfaction
    surveys to formulate future goals.

                          TITLE I--DEPARTMENT OF LABOR

                     Employment and Training Administration

                        training and employment services

    Appropriations, 2000....................................  $5,436,424,000
    Budget estimate, 2001...................................   6,106,062,000
    Committee recommendation................................   5,453,141,000

        The Committee recommends $5,453,141,000 for this account in
    2001 which provides funding authorized primarily by the
    Workforce Investment Act [WIA]. This is $16,717,000 more than
    the 2000 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.
    This appropriation is generally forward-funded on a July-to-
    June cycle. Funds provided for fiscal year 2001 will support
    the program from July 1, 2001, through June 30, 2002.
        Beginning with last year's appropriation, budget
    constraints required that a portion of this account's funding
    be advance appropriated, with obligations for a portion of
    Adult and Dislocated Worker Employment and Training Activities
    and Job Corps delayed until the following fiscal year. This
    practice will continue in this year's appropriation.
        Fiscal year 2000 is the first full year of operations under
    the new Workforce Investment Act, beginning July 1, 2000. The
    new legislation is expected to significantly enhance employment
    and training services, consolidating, coordinating, and
    improving programs utilizing a local level one-stop delivery
    system.
        The Committee is aware of the VIII Paralympic Winter Games
    in March 2002 and encourages the Department to consider funding
    for this effort.
        Adult employment and training activities.--For Adult
    Employment and Training Activities, the Committee recommends
    $950,000,000. This is the same as the 2000 comparable level.
    This program is authorized by the Workforce Investment Act and
    is formula-funded to States and further distributed to local
    workforce investment boards. Services for adults will be
    provided through the One-Stop system and most customers
    receiving training will use their individual training accounts
    to determine which programs and providers fit their needs. The
    Act authorizes core services, which will be available to all
    adults with no eligibility requirements, and intensive
    services, for unemployed individuals who are not able to find
    jobs through core services alone.
        Fathers Work/Families Win.--The Administration requested
    $255,000,000 for a new initiative entitled Fathers Work/
    Families Win. Due to severe budgetary constraints, the
    Committee has not recommended funding that initiative at this
    time. Funding was intended to support competitive grants to
    help custodial parents, mainly fathers, obtain or retain
    employment and progress up career ladders, including upgrading
    their skills so they can support their children. Funding would
    also support competitive grants to finance case management and
    skill training for low income families to help parents stay in
    jobs, move up career ladders, and stay off cash assistance. To
    the extent possible, the Committee encourages the use of
    existing resources to further these activities.
        Dislocated worker employment and training activities.--For
    Dislocated Worker Employment and Training Activities, the
    Committee recommends $1,589,025,000. This is the same as the
    2000 comparable level. This increase is allowed as part of an
    overall initiative to begin providing reemployment services for
    all who need them. In this program, the effort is a major step
    toward providing all dislocated workers who want and need
    assistance the resources to train for or find new jobs. This
    program, authorized by WIA, is a State-operated effort which
    provides core services, intensive services, training, and
    supportive services to help permanently separated workers
    return to productive, unsubsidized employment. In addition,
    States use these funds for rapid response assistance to help
    workers affected by mass layoffs and plant closures. Eighty
    percent of funding is distributed by formula to the States. The
    remaining twenty percent is available to the Secretary for
    activities specified in WIA, primarily to respond to mass
    layoffs, plant and/or military base closings, and natural
    disasters across the country, which cannot be otherwise
    anticipated, as well as technical assistance and training and
    demonstration projects.
        The Committee bill continues language authorizing the use
    of funds under the dislocated workers program for projects that
    provide assistance to new entrants in the workforce and
    incumbent workers. It also continues language modified to waive
    a 10 percent limitation in the Workforce Investment Act with
    respect to the use of discretionary funds to carry out
    demonstration and pilot projects, multiservice projects and
    multistate projects with regard to dislocated workers, and to
    waive certain other provisions in that Act.
        The Committee recommendation includes funds to continue the
    following fiscal year 2000 projects and activities in the
    fiscal year 2000 conference agreement which will be awarded
    under the dislocated worker program:
      --Hawaii Department of Labor/Kauai Cooperative Extension
      --High Tech Training--Maui, Hawaii
      --JobLinks Program
      --PA Training Consortium
      --Clayton College & State University GA-Virtual Ed & Training
            Project
      --Bethel Native Corp.--Alaska
      --Dislocated Farmer Training at the University of Idaho
        These continuation grants are subject to project
    performance, demand for activities and services, and
    utilization of prior year funding.
        The Committee is aware of the following projects that it
    encourages the Department to consider supporting:
      --Workforce Training and Retraining for dislocated and
            incumbent workers in real manufacturing environment-
            University of Albany, NY
      --Workforce Development project to retrain older incumbent
            workers for Montana workforce-Montana State University,
            Billings
      --Multi-State (AL, CA, CT, NH, MI, OH, and VT) Pilot of
            National Institute for Metal Working Skills to retrain
            and certify dislocated workers and low wage workers as
            metalworkers
      --University of Alaska/Ketchikan Shipyards training program
            for shipyard workers
      --State of New Mexico-telecommunications job training for
            dislocated workers
      --Clemson University, retraining of tobacco farmers
        The Committee has been advised that in some remote areas of
    the country local personnel have received inadequate
    firefighting training and in some cases lack even basic skills
    such as operation of fire trucks and firefighting equipment.
    The Committee urges the agency to work with local communities
    to develop basic firefighting job training programs utilizing
    existing training facilities.
        The Committee is aware of the severe worker dislocation
    brought on by the closure of one of three sugarcane plantations
    on the Hawaiian island of Kauai, and the likely closure of
    another plantation. To provide assistance to affected workers
    and communities, the Committee encourages the Department to
    support from National Emergency Grant funds a proposal from the
    Hawaii Department of Labor, the Kauai Cooperative Extension
    Service, and the Hawaii Small Business Development Center to
    provide agricultural and business training to dislocated
    sugarcane workers.
        The Committee is aware of the severe worker dislocation
    brought on by the closure of open-pit mines and the trend
    toward underground mining. Three decades of decline in
    underground operations have caused the industry to lose much of
    the work force and skills of underground mining. Few, if any,
    underground mechanics are available that have adequate training
    in the technologies required by the industry. The Committee
    encourages the Department to support funding proposals in this
    area.
        Incumbent workers.--The Committee includes $20,000,000 for
    a new program of employment and training assistance to
    Incumbent Workers under WIA pilot and demonstration authority.
    The effort is intended to address the major job losses in the
    manufacturing industry where half a million jobs have been lost
    since March, 1998. The initiative will boost skills and wages
    of non-management U.S. workers through competitive grants to
    States to train and upgrade the skills of incumbent workers
    and, through local partnerships, help firms with training,
    thereby preventing displacements before they occur. Applicants
    would be required to provide non-Federal matching resources,
    and employers that receive grant assistance for skill upgrading
    would be expected to demonstrate that training increased
    participants' earnings, while those receiving such assistance
    for layoff prevention would be expected to show evidence of
    worker retention. During the initial year of funding of this
    program, an estimated 20 grants serving an estimated 13,300
    participants will be awarded.
        Youth activities.--For Youth Activities, the Committee
    recommends $1,000,965,000, the same as the 2000 comparable
    level. Youth Activities, authorized by WIA, consolidates the
    Summer Youth Employment and Training Program under JTPA Title
    IIB, and Youth Training Grants under JTPA Title IIC. In
    addition to consolidating programs, WIA also requires Youth
    Activities to be connected to the One-Stop system as one way to
    link youth to all available community resources. The purpose of
    Youth Activities is to provide eligible youth with assistance
    in achieving academic and employment success through improving
    educational and skill competencies and providing connections to
    employers. Other activities include providing mentoring
    opportunities, opportunities for training, supportive services,
    summer employment opportunities that are directly linked to
    academic and occupational learning, incentives for recognition
    and achievement, and activities related to leadership
    development, citizenship, and community service.
        Youth opportunity grants.--For Youth Opportunity Grants,
    the Committee recommends $250,000,000, the same as the 2000
    comparable level. Youth Opportunity Grants are newly-authorized
    in the Workforce Investment Act. These grants are aimed at
    increasing the long-term employment of youth who live in
    empowerment zones, enterprise communities, and other high-
    poverty areas. Recent surveys conducted by the Department of
    Labor have found employment rates for out-of-school youth as
    low as 24 percent in selected high-poverty neighborhoods. Youth
    Opportunity Grants will attempt to dramatically increase these
    employment rates, and thus improve all aspects of life for
    persons living in these communities.
        Job Corps.--For Job Corps, the Committee recommends
    $1,363,783,000. This is $6,007,000 more than the 2000
    comparable level, and includes funding for cost increases of
    operating Job Corps centers. The Committee applauds Job Corps
    for establishing partnerships with nine national employers, and
    encourages Job Corps to continue to work with both large
    employers and small businesses to ensure that student training
    meets current labor market needs. Job Corps should intensify
    its efforts to upgrade its vocational offerings and curricula
    to reflect industry standards and skill shortages. The
    Committee requests that the Department submit a report prior to
    the fiscal year 2002 hearing process on the progress of
    building or rehabilitating Head Start centers on Job Corps
    campuses, as mandated in the fiscal year 2000 report, and on
    the progress of bringing on line the four new Job Corps Centers
    initiated in 1998. Job Corps, authorized by WIA, is a
    nationwide network of residential facilities chartered by
    federal law to provide a comprehensive and intensive array of
    training, job placement and support services to at-risk young
    adults. The mission of Job Corps is to attract eligible young
    adults, teach them the skills they need to become employable
    and independent, and place them in meaningful jobs or further
    education. Participation in the program is voluntary and is
    open to economically disadvantaged young people in the 16-24
    age range who are unemployed and out of school. Most Job Corps
    students come from disruptive or debilitating environments, and
    it is important that they be relocated to residential
    facilities where they can benefit from the highly structured
    and carefully integrated services provided by the Job Corps
    program. A limited number of opportunities are also available
    for non-residential participation.
        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 supports the goal of the Workforce Investment
    Act of 1998 to integrate our nation's many diverse job training
    programs, and its approach of retraining the national character
    of the Job Corps program within the new framework. The
    Committee encourages the Department to continue its work to
    develop national partnerships with major regional and national
    employers to increase employment opportunities for Job Corps
    graduates. The Department should also continue to establish
    connections between Job Corps and State workforce development
    programs, and between Job Corps and other national and
    community partners, to provide the most efficient, cost-
    effective services possible.
        The Committee recognizes that compliance with the Workforce
    Investment Act of 1998 may require infrastructure and
    programmatic changes to the Job Corps program. The Committee is
    concerned, however, with changes that may threaten the
    existence of Joint Action in Community Services, which provides
    Job Corps students with counseling, referrals and information
    on transportation, education and training. The Committee urges
    the Department to support this program, which has been very
    beneficial to Job Corps students.
        The Committee recognizes the importance of providing
    appropriate education and professional development to ensure
    future management leadership of the Job Corps, and encourages
    the Department to conduct a demonstration program which would
    address this concern.
        Responsible Reintegration for Young Offenders.--The
    Committee provides $30,000,000 for Responsible Reintegration
    for Young Offenders to address youth offender issues. This is a
    new initiative and will build on work begun earlier by this
    Committee, including $13,907,000 provided in fiscal year 2000
    demonstration funds. Building on lessons learned through
    smaller pilot projects in 1998 and 2000, this large scale WIA
    Pilot and Demonstration initiative will link youthful offenders
    under age 35 with essential services that can help make the
    difference in their choices in the future, such as education,
    training, job placement, drug counseling, drug demand reduction
    activities, and mentoring, in order to reintegrating them into
    the mainstream economy. Through local competitive grants, this
    program would establish partnerships between the criminal
    justice system and local workforce investment systems,
    complementing a similar program in the Department of Justice
    (DOJ). To maximize the impact of these initiatives, the DOL and
    DOJ funds will be targeted to the same communities and
    populations. An estimated 7,500 youth will be served, and it is
    expected that 65 percent of program graduates will get jobs,
    reenroll in high school, or be enrolled in post-secondary
    education or training.
        Safe Schools/Healthy Students.--The Committee includes
    $20,000,000 for the Department of Labor to participate in the
    next competitive round of Safe Schools/Healthy Students grants.
    This is an effort begun in fiscal year 1999 as a collaboration
    among the Departments of Education, Health and Human Services,
    and Justice to promote healthy childhood development and to
    prevent school violence, reduce drug demand, and alcohol and
    other drug abuse through a comprehensive, community-wide
    approach. With DOL's participation, the activities for the next
    round of grants can be expanded to serve out-of-school youth as
    well as provide connections among high schools, post-secondary
    schools, alternative schools, and work-based learning programs,
    in order to reduce violent behaviors. They will also help build
    local partnerships among Youth Councils, businesses, and
    community organizations, and schools to improve opportunities
    for at-risk youth. An estimated 12 communities' Youth Councils
    will build local Safe Schools/Healthy Students partnerships
    with business, community organizations, and schools to improve
    opportunities for at-risk youth.
        Native Americans.--For Native Americans, the Committee
    recommends $55,000,000. This is $3,436,000 less than the 2000
    comparable level. This program, authorized by WIA, is designed
    to improve the economic well-being of Native Americans
    (Indians, Eskimos, Aleuts, and Native Hawaiians) through the
    provision of training, work experience, and other employment-
    related services and opportunities that are intended to aid the
    participants to secure permanent, unsubsidized jobs. The
    Department of Labor allocates formula grants to Indian tribes
    and other Native American groups whose eligibility for such
    grants is established in accordance with Department's
    regulations.
        Migrant and seasonal farmworkers.--For Migrant and Seasonal
    Farmworkers, the Committee recommends $76,770,000. This is
    $2,575,000 more than the 2000 comparable level. This program,
    authorized by WIA, is designed to serve members of economically
    disadvantaged families whose principal livelihood is derived
    from migratory and other forms of seasonal farmwork, or
    fishing, or logging activities. Through training and other
    employability development services, the program prepares
    eligible seasonal farmworkers and their family members for
    stable, year-round employment, both inside and outside of the
    agricultural industry. The program also provides health care,
    day care and other supportive services for farmworkers who
    choose to stay in agriculture. At least 94 percent of each
    year's appropriation is allocated to States according to a
    population-based formula. The remainder of each year's
    appropriation is set aside for technical assistance to grantees
    and for other special projects to benefit seasonal farmworkers
    such as the Migrant Farmworker Housing Program.
        For migrant and seasonal farmworker housing, the Committee
    recommendation includes $4,000,000, an increase of $1,000,000
    over the fiscal year 2000 level.
        In its fiscal year 2000 appropriations report, the
    Committee provided an additional $2,928,000 to the Department
    because of the change in the formula used to allocate migrant
    and seasonal farmworkers funds to grantees. This formula change
    resulted in a number of States receiving reduced allocations,
    and the additional funds were to be used to restore funding to
    the 1998 level for those grantees. For fiscal year 2001, the
    Committee is adding $1,325,000 to the 2001 request to ensure
    that States impacted by the formula change are held harmless to
    their 1998 funding level. The Committee directs the Department
    to use this additional funding, along with the fiscal year 2000
    additional funding, to fund grantees in those States impacted
    by the formula change at their 1998 levels.
        National programs.--For National Programs, the Committee
    recommends $159,368,000. This is $4,712,000 more than the 2000
    comparable level. This activity includes WIA-authorized
    programs in support of the workforce system including technical
    assistance and incentive grants, evaluations, pilots,
    demonstrations and research, as well as the National Skills
    Standards Advisory Board. The Women in Apprenticeship program,
    previously funded in this account is now included under Program
    Administration, Apprenticeship Services, as requested by the
    Administration.
        Technical Assistance/Incentive Grants.--The Committee
    recommends $15,000,000 for the provision of technical
    assistance, staff development, and replication of programs of
    demonstrated effectiveness; as well as incentive grants to each
    State that exceeds State adjusted levels of performance for WIA
    State programs.
        Pilots, Demonstrations, and Research.--The Committee
    recommends $70,000,000 for grants or contracts to conduct
    research, pilots or demonstrations that improve techniques or
    demonstrate the effectiveness of programs.
        The Committee acknowledges changes under the Workforce
    Investment Act to develop and implement techniques and
    approaches, and demonstrate the effectiveness of specialized
    methods, of addressing the employment and training needs of
    individuals. The Committee encourages the Department to ensure
    that these projects are coordinated with local boards.
    Appropriate time limits are established for projects. Grant
    applications for over $500,000 are subject to peer review. The
    Committee encourages the Department of Labor to ensure that
    project performance is adequately documented and evaluated.
        The Committee recommendation includes funds to continue the
    following fiscal year 2000 projects and activities referenced
    in the fiscal year 2000 conference agreement which will be
    awarded under the pilot and demonstration program:
      --Samoan/Asian Pacific Job Training--Hawaii
      --Koahnic Broadcasting
      --Yukon Kuskokwim Health Corporation
      --Training and Education Opportunities--University of Hawaii
            at Maui
      --Ilasagvik College--Barrow, Alaska
      --Kawerak, Inc. Vocational Training for Alaska Natives--Nome,
            Alaska
      --Alaska Federation of Natives Foundation
      --Alaska Works, Construction Job Training--Fairbanks, Alaska
      --Alaska Native Heritage Center, and Bishop Museum in Hawaii
      --U of Missouri-St. Louis Regional Center for Ed and Work
      --VT Tech College--Tech Training Initiative
      --Hutchinson Career Center
      --Des Moines Community College--SMART Partners, Iowa
      --American Indian Science & Eng. Society--Rural Computer
            Utilization Training
      --Maui Economic Development Board--Rural Computer Training
      --South Dakota Intertribal Skill Training Cooperative
      --University of Colorado Health Sciences Center--Telehealth
            Distance Learning
      --Focus HOPE/Detroit--Info Tech
      --Aviation Center of Excellence--Jacksonville, FL
        These continuation grants are subject to project
    performance, demand for activities and services, and
    utilization of prior year funding.
        The Committee is aware of the following projects that it
    encourages the Department to consider supporting:
      --Odyssey Maritime, school to work initiative in Washington
            State
      --Technology Tool Kit to train at-risk young people in
            occupations related to the use of automated
            identification technology--Mississippi Valley State
            University
      --Creation of Southern NJ Regional Hospitality Workforce
            Development Consortium to coordinate training and
            develop career ladder structure in hospitality and
            gaming industry--Gloucester County College, NJ
      --Dream Center to provide job and training skills for new
            labor market entrants or reentrants--LA, CA
      --North Country Career Center model education and training
            program--Newport, VT
      --Vermont Department of Employment and Training employer-led
            education and training partnerships initiative
      --Vermont Information Technology Center model information
            technology training initiative--Champlain College,
            Burlington, VT
      --Jobs for America's Graduates-School-to-work projects for
            at-risk young people
      --LeHigh University Job Training for hard to serve
            disadvantaged youth in manufacturing sector--PA
      --Workplace Acclimation Program for Ex-Offenders to provide
            pre-employment training and job placement assistance to
            former offenders--Safer Foundation, Chicago, Ill.
      --Remote Rural Hawaii Job Training Project for low income
            youth and adults--Island of Oahu
      --Remote Rural Alaska Job Training Project
      --Model Community Jobs Initiative to train homeless persons,
            San Francisco, CA
      --Collegiate Consortium for Workforce & Economic Development,
            Philadelphia Naval Business Center
      --Kirkwood Community College and ACT, Inc. for workforce
            skills development in Iowa
      --Community Self-Empowerment & Employment Program (CSEEP)
            (PA)--comprehensive employment readiness, job
            development, job place, and case management for area
            low-income residents
      --Western Alaska workforce training initiative
      --UNLV Center for Workforce Development and Occupational
            Research
      --University of South Carolina College of Social Work,
            computer training for low-income unemployed workers
      --South Sumter Resource Center, S.C.--comprehensive system of
            academic and skill training, leadership development,
            support services, case management, on-the-job training,
            and cultural enrichment for at-risk youth
      --Green Thumb, Inc.--conduct program for rural, low-income
            elders to develop entrepreneurial skills that utilize
            e-commerce and IT
      --Tlingit-Haida project--job training to unemployed natives
            in southeast Alaska
      --Mott Community College Workforce Development Institute for
            Manufacturing Simulation-Access to electronic library
            of technology, developed as part of DOL's America's
            Learning Exchange
      --Workforce training to support real time captioning
            initiatives for hearing disabled--Oxford, Miss.
      --Greater Columbus Ohio Chamber of Commerce Career Academies
            program--project to design and test programs in
            partnership with workforce development system
      --Public/Private Ventures workplace mentoring program
      --Urban League of Hudson County, New Jersey, Workforce
            Development Center
      --Allegheny County, Pennsylvania, training of information
            technology workers
      --Waukesha, Wisconsin, workforce training for economically
            disadvantaged youth and adults at La Casa de Esperanza
      --Skill training for low-income and disadvantaged workers at
            the Center for Employment Training in San Jose
        The Committee is aware that even the best employment and
    training programs cannot serve those who lack the basic skills
    to enter such programs. The Committee understands that programs
    that help unskilled workers achieve the level of literacy
    necessary to participate in Employment and Training Programs
    improves their chances of successfully transitioning into full-
    time employment. The Committee encourages the Department to
    fund demonstration grants under Workforce Investment Act Title
    I National Programs to increase the capacity of national
    networks of volunteer adult literacy programs, library literacy
    programs and urban literacy coalitions to prepare the hardest-
    to-reach/hardest-to-teach adults and out of school youth for
    the workforce.
        Evaluation.--The Committee recommends $9,098,000 to provide
    for the continuing evaluation of programs conducted under WIA,
    as well as of federally-funded employment-related activities
    under other provisions of law.
        National Skills Standards Advisory Board.--The Committee
    recommends $3,500,000 for the Board a decrease of $3,500,000
    below 2000 as the Board's work is completed.
        Funding previously provided in this appropriation account
    for Veterans workforce investment programs and the Homeless
    veterans reintegration project is appropriated directly to the
    Veterans Employment and Training account in fiscal year 2001,
    and comparative amounts for fiscal year 2000 are reflected
    therein.

                community service employment for older americans

    Appropriations, 2000....................................    $440,200,000
    Budget estimate, 2001...................................     440,200,000
    Committee recommendation................................     440,200,000

        The Committee recommends $440,200,000, the same as the
    budget request and the fiscal year 2000 appropriation for
    community service employment for older Americans. The Committee
    recommends 78 percent of the funds for national sponsors and 22
    percent for State sponsors; this is the same percentage
    distribution as has been required by apropriations law for the
    past several years. 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 2001
    appropriation will support the program from July 1, 2001,
    through June 30, 2002. These funds are to be distributed in the
    same manner as currently authorized under the Older Americans
    Act, unless this law is subsequently altered. 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 older Americans with poor
    employment prospects, including individuals with a long-term
    detachment from the labor force, older displaced homemakers,
    aged minorities, limited English-speaking persons, and legal
    immigrants.
        The Committee is concerned about alleged program
    irregularities reported by the Inspector General, attributed to
    a national sponsor, and notes a resolution is being pursued.
    Currently, grants are awarded annually to sponsoring
    organizations and agencies on a non-competitive basis. The
    Committee recommends that if satisfactory resolution of
    irregularities with a national sponsor is not accomplished,
    that consideration be given to awarding such grant funds,
    competitively or through other means, among the other national
    sponsors, taking into consideration performance and the
    difficulty in reaching target populations. Implementing such a
    modification must, however, be sensitive to the need to avoid
    disruption to program participants in the event of a change in
    grantee.

                  federal unemployment benefits and allowances

    Appropriations, 2000....................................    $415,150,000
    Budget estimate, 2001...................................     406,550,000
    Committee recommendation................................     406,550,000

        The Committee recommends $406,550,000, the same as the
    budget request and a decrease of $8,600,000 below the 2000
    enacted level for Federal unemployment benefits and allowances.
    These are entitlement funds.
        The trade adjustment line item has two activities totaling
    $342,400,000 in fiscal year 2000.
        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 $248,000,000. This is the
    same as the budget request and a decrease of $7,000,000 below
    the 2000 comparable level. These funds will permit payment of
    benefits, averaging $224 per week, to 36,400 workers for 2000.
    Of these workers, 21,200 will participate in training programs,
    receiving benefits for an average of 30.5 weeks. The remaining
    15,200 workers receiving benefits will receive training waivers
    and collect benefits.
        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 $94,400,000 for this
    activity, the same as the budget request and an increase of
    $400,000 above the 2000 comparable level. These funds will
    provide services for an estimated 22,700 workers.
        For NAFTA activities, $64,150,000 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 $27,000,000
    for this activity. This is the same as the budget request and a
    decrease of $2,000,000 below the 2000 comparable level and
    represents the current services funding level.
        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 fiscal year 2000 current services
    recommendation is $37,150,000, the same as the fiscal year 2000
    enacted level and the budget request.
        Resources related to the Administration's legislative
    proposals will be considered upon enactment of the requested
    legislation.

         state unemployment insurance and employment service operations

    Appropriations, 2000....................................  $3,213,780,000
    Budget estimate, 2001...................................   3,389,198,000
    Committee recommendation................................   3,249,430,000

        The Committee recommends $3,249,430,000 for this account.
    This is $139,768,000 below the budget request and $35,650,000
    above the 2000 comparable level. Included in the total
    availability is $3,095,978,000 authorized to be drawn from the
    ``Employment Security Administration'' account of the
    unemployment trust fund, and $153,452,000 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.
        For unemployment insurance (UI) services, the bill provides
    $2,283,515,000. This includes $2,273,515,000 for State
    Operations, which is $75,768,000 below the President's request
    and $17,140,000 above the fiscal year 2000 level. The Committee
    expects the Department to manage these resources to ensure
    equitable funding to States to handle total workload, which is
    estimated to be 2,396,000 average weekly insured unemployment
    (AWIU) claims. The Committee recommendation includes the
    Administration's proposal to restructure the UI budget
    activities. This amount also includes $10,000,000 for UI
    national activities, the same as the fiscal year 2000 level and
    the President's request, which is directed to activities that
    benefit the State/Federal unemployment insurance program. The
    bill continues to provide for a contingency reserve amount
    should the unemployment workload exceed an average weekly
    insured claims volume of 2,396,000. This contingency amount
    would fund the administrative costs of unemployment insurance
    workload over the level of 2,396,000 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.
        For the employment service, the Committee recommends
    $835,915,000 which includes $23,452,000 in general funds
    together with an authorization to spend $812,463,000 from the
    ``Employment security administration'' account of the
    unemployment trust fund.
        Included in the recommendation for the employment service
    [ES] is $786,735,000 for Grants to States, available for the
    program year of July 1, 2001, through June 30, 2002. This is
    $25,000,000 less than the budget request and $25,000,000 above
    the 2000 comparable level. Included in the Grants to States
    activity is $761,735,000 for Wagner-Peyser formula grants to
    States, and $25,000,000 for Reemployment Services Grants as
    part of the Universal Reemployment Initiative to insure that
    all unemployed workers get the services they need to become
    reemployed. The latter will provide staff-assisted services to
    UI claimants, targeted on those identified as likely to exhaust
    their eligibility for benefits, insuring that those who need
    help in finding new jobs receive it so they can return more
    quickly to employment. Also included is $49,180,000 for
    national activities, an increase of $5,000,000 above the budget
    request. Funding previously provided in this activity for alien
    labor certification occupational employment statistics is
    appropriated directly to the Bureau of Labor Statistics in
    fiscal year 2001, and comparative amounts for fiscal year 2000
    are reflected therein.
        The recommendation includes $110,000,000 for one-stop
    career centers, which is the same as the 2000 comparable level.
    This Committee recommendation includes funding for America's
    Labor Market Information System, including core employment
    statistics, universal access for customers, improving
    efficiency in labor market transactions, and measuring and
    displaying WIA performance information. Funding previously
    provided in this activity for occupational employment
    statistics is appropriated directly to the Bureau of Labor
    Statistics in fiscal year 2001, and comparative amounts for
    fiscal year 2000 are reflected therein.
        The recommendation includes $20,000,000 for part of the
    proposed new Work Incentives Grants program, the same as last
    year's level and the President's request to help persons with
    disabilities find and retain jobs through the One-Stop Career
    Center system mandated by the Workforce Investment Act. Funding
    will support systems building grants intended to ensure that
    one-stop systems integrate and coordinate mainstream employment
    and training programs with essential employment-related
    services for persons with disabilities.
        The Committee continues to be concerned about the current
    state of the permanent labor certification program. This
    program, which provides access to needed workers in those cases
    where a shortage of American workers can be shown, is suffering
    from a lack of a streamlined process for handling both the
    backlog and significant increase in applications received,
    which has led to problems in administering the program.
    Although the Department has indicated that a complete new
    streamlined system will be implemented in 2001 and has reduced
    its budget to reflect this new process, the Committee wants to
    ensure that no further delays are encountered in processing
    applications. Therefore, the Committee is providing an increase
    of $5,000,000 over the request for State grants and directs the
    Employment and Training Administration and the States to work
    diligently to improve the administration of this important
    program, with the intent of eliminating backlogs by the end of
    2001 and implementing a new streamlined system during 2001. In
    addition, the Committee is restoring the $1,772,000 and 21 FTE
    in the Program Administration account to ensure that there are
    sufficient Federal staff to handle both the old system and
    certification system. The Committee wants a report by March 1,
    2001 of the progress made in reducing backlogs and the
    implementation of the new system.
        The Committee agrees that the work opportunity tax credit
    [WOTC], and the welfare-to-work tax credit provide 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 the
    administration of these initiatives, the same as the 2000
    level.

            advances to the unemployment trust fund and other funds

    Appropriations, 2000....................................    $356,000,000
    Budget estimate, 2001...................................     435,000,000
    Committee recommendation................................     435,000,000

        The Committee recommends $435,000,000 an increase of
    $79,000,000 above the 2000 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 2000 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 administration

    Appropriations, 2000....................................    $146,000,000
    Budget estimate, 2001...................................     159,311,000
    Committee recommendation................................     156,158,000

        The Committee recommendation includes $107,651,000 in
    general funds for this account, as well as authority to expend
    $48,507,000 from the ``Employment Security Administration''
    account of the unemployment trust fund, for a total of
    $156,158,000. This is $10,158,000 greater than the 2000
    comparable level.
        The Committee recommendation also includes restoration of
    $1,772,000 and 21 FTE for the foreign labor certification
    activity to ensure that there are sufficient Federal staff to
    handle both the old system and certification system.
        The Committee recommendation includes $1,300,000 for the
    management and oversight of the various pilot and demonstration
    projects funded as part of this year's appropriation and to
    support those projects that continue to be implemented from
    past years' administered by the Employment and Training
    Administration. These funds will be used exclusively for
    financial, technical, program and general administration
    provided by staff responsible for grant management, oversight,
    monitoring, guidance/operation and reporting and evaluation for
    the earmark activities.
        General funds in this account provide the Federal staff to
    administer employment and training programs under the Workforce
    Investment 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.
        The Committee recognizes the Home Builders Institute's
    Project CRAFT (Community Restitution and Apprenticeship-Focused
    Training) program as a successful model and proven intervention
    technique in the rehabilitation and reduced recidivism of
    accused and adjudicated juvenile offenders. The Committee
    encourages the Department of Labor to work in cooperation with
    the Department of Justice to replicate Project CRAFT in order
    to offer at-risk and adjudicated youth preapprenticeship
    training and job placement in the residential construction
    trades.

                  Pension and Welfare Benefits Administration

                             SALARIES AND EXPENSES

    Appropriations, 2000....................................     $98,934,000
    Budget estimate, 2001...................................     107,832,000
    Committee recommendation................................     103,342,000

        The Committee recommendation provides $103,342,000 for this
    account, which is $4,408,000 above the 2000 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.
        Implementation of the new EFAST (ERISA Filing and
    Acceptance System) devoted to processing form 5500 series
    financial data required under the Employee Retirement Income
    Security Act will enable employees to submit annual benefit
    plan reports electronically, reducing the cost, paperwork
    burden, and enhancing protection of pension funds. 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 old system.

                      Pension Benefit Guaranty Corporation

        The Corporation's estimate for fiscal year 2000 includes
    benefit payments of $987,609,000, multiemployer financial
    assistance of $6,266,000, administrative expenses limitation of
    $11,871,000, and services related to terminations expenses of
    $164,834,000.
        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 $100,000,000 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, 2000....................................    $338,770,000
    Budget estimate, 2001...................................     363,476,000
    Committee recommendation................................     352,764,000

        The Committee recommendation includes $352,764,000 for this
    account. This is $12,994,000 above the 2000 comparable level.
    The bill contains authority to expend $1,985,000 from the
    special fund established by the Longshore and Harbor Workers'
    Compensation Act; the remainder are general funds. In addition,
    an amount of $30,393,000 is available by transfer from the
    black lung disability trust fund. This is the same as the
    request and $1,717,000 above the 2000 comparable level.
        The Employment Standards Administration is involved in the
    administration of numerous laws, including the Fair Labor
    Standards Act, the Immigration and Nationality Act, the Migrant
    and Seasonal Agricultural Workers' Protection Act, the Davis-
    Bacon Act, the Family and Medical Leave Act, the Federal
    Employees' Compensation Act [FECA], the Longshore and Harbor
    Workers' Compensation Act, and the Federal Mine Safety and
    Health Act (black lung).
        The Committee is deeply concerned about the rising
    instances of child labor in the United States. Although no
    official estimate exists, studies place the number of illegally
    employed children in the United States between 300,000 and
    800,000. Therefore, the Committee has included funding for the
    President's initiative on domestic child labor. Furthermore,
    the Committee strongly believes that effective enforcement must
    be a part of any comprehensive strategy to eliminate illegal
    child labor.

                                SPECIAL BENEFITS

    Appropriations, 2000....................................     $79,000,000
    Budget estimate, 2001...................................      56,000,000
    Committee recommendation................................      56,000,000

        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 recommendation includes $56,000,000, the same as the
    budget request and a decrease of $23,000,000 below the 2000
    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 2001,
    including anticipated reimbursements from Federal agencies of
    $1,955,000,000 is $2,011,000,000, an increase of $9,000,000
    above the 2000 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 concurs with requested bill
    language to allow the Secretary to use fair share collections
    to fund capital investment projects and specific initiatives to
    strengthen compensation fund control and oversight.

                        black lung disability trust fund

    Appropriations, 2000....................................  $1,013,633,000
    Budget estimate, 2001...................................   1,028,000,000
    Committee recommendation................................   1,028,000,000

        The bill includes authority to obligate $1,028,000,000 from
    the black lung disability trust fund in fiscal year 2001. This
    is an increase of $14,367,000 over the 2000 comparable level
    and the same as the administration request.
        The total amount available for fiscal year 2000 will
    provide $409,343,000 for benefit payments, and $52,657,000 for
    administrative expenses for the Department of Labor. Also
    included is $566,000,000 for interest payments on advances. In
    fiscal year 2000, comparable obligations for benefit payments
    are estimated to be $430,506,000 while administrative expenses
    for the Departments of Labor and Treasury, respectively, are
    $49,771,000 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 59,500 people will be receiving black
    lung benefits financed from the trust fund by the end of fiscal
    year 2001. This compares with an estimated 63,200 receiving
    benefits in fiscal year 2000.
        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.
        The Committee notes favorably the administration's response
    to last year's conference report direction to provide a
    recommended solution to the structural deficit in the Black
    Lung Disability Trust Fund. The Committee is pleased that the
    administration has submitted a comprehensive legislative
    proposal to this end. The Committee urges the administration to
    work closely with Congress in pursuing a legislative solution
    to this problem.

                 Occupational Safety and Health Administration

                             SALARIES AND EXPENSES

    Appropriations, 2000....................................    $381,620,000
    Budget estimate, 2001...................................     425,983,000
    Committee recommendation................................     425,983,000

        The Committee recommendation includes $425,983,000 for this
    account. This is the same as the budget request and an increase
    of $44,363,000 above the 2000 comparable level. This agency is
    responsible for enforcing the Occupational Safety and Health
    Act of 1970 in the Nation's workplaces.
        Among the increases provided by the Committee are funds for
    a variety of compliance assistance activities, including the
    State consultation grants providing free consultation visits to
    small businesses, the Susan Harwood education and training
    grants, and completion of the effort to place a compliance
    assistance specialist in each Federal area office. Funding
    included for increased inspections are targeted to specific
    sites with the highest injury and illness rates. The
    recommendation also includes funds to support the State of New
    Jersey's proposed Public Employee Occupational Safety and
    Health Program. The recommendation continues the important
    balance between compliance assistance and enforcement
    activities, which has proven essential to improving
    occupational safety and health.
        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 expanding participation in the programs, and promoting
    prompt review and processing of applications is particularly
    noteworthy. In fiscal year 2001 the Committee expects OSHA to
    continue to place high priority on the VPP, making every effort
    to ensure 25 percent growth in participation by sites covered
    under federal OSHA jurisdiction. 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.
        The Committee also intends that the Office of Regulatory
    Analysis continued to be funded as close as possible to its
    present level.

                     Mine Safety and Health Administration

                             SALARIES AND EXPENSES

    Appropriations, 2000....................................    $228,057,000
    Budget estimate, 2001...................................     242,247,000
    Committee recommendation................................     244,747,000

        The Committee recommendation includes $244,747,000 for this
    account. This is $16,690,000 more than the 2000 comparable
    level.
        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.
        Among the increases provided by the Committee are funds for
    metal and nonmetal safety, educational policy and development
    for enhancement of the State grants program, and mine fire and
    explosion response.
        The Committee is aware that the Federal Mine Health and
    Safety Academy is the only federally funded service academy
    dedicated solely to promoting miners' safety and health.
    Although it remains a thoroughly modern facility, the Academy
    was constructed more than twenty years ago and currently
    requires physical improvements to bring it up to code and into
    compliance with the Americans with Disabilities Act.
    Furthermore, in order for the Mine Safety and Health
    Administration to continue to provide effective safety and
    health to a younger generation of miners, the Academy needs to
    incorporate the most modern technologies, such as electronic
    learning media, into its education programs. The Committee,
    recommendation therefore includes increased funding of
    $2,500,000 over the budget request for needed physical
    improvements.
        The Committee commends MSHA for its proactive approach in
    seeking the root causes of and solutions to persistent problems
    affecting miners' safety and health. In particular, the
    Committee is pleased with the agency's work to eliminate black
    lung disease and silicosis. Miners continue to be diagnosed
    with these diseases and black lung alone costs the Federal
    Government more than $1,000,000,000 annually. Understanding
    that changes and improvements to the program to protect miners'
    health are necessary, the Committee strongly urges the agency
    to continue to implement the recommendations of the Advisory
    Committee on the Elimination of Pneumoconiosis Among Coal Mine
    Workers. To that end, the Committee fully funds the
    administration's request for expansion of the coal dust
    sampling program, a unanimous recommendation of the Advisory
    Committee.
        The Committee finds that the Department of Labor's programs
    promote and protect workers' safety and health throughout the
    world and make American industry more competitive. Every year,
    the American mining industry, through cooperative efforts of
    labor, industry, and the MSHA, becomes safer and more
    productive. The Committee is pleased that MSHA has an
    established program to share its expertise and to actively
    promote mine safety and health globally, as we recommended in
    last year's report. The Committee continues to encourage the
    Department's and MSHA's work in this area.

                           Bureau of Labor Statistics

                             SALARIES AND EXPENSES

    Appropriations, 2000....................................    $433,877,000
    Budget estimate, 2001...................................     453,632,000
    Committee recommendation................................     446,584,000

        The Committee includes $446,584,000 for this account, which
    is $7,048,000 less than the budget request and $12,707,000 more
    than the 2000 comparable level. This includes $67,257,000 from
    the ``Employment Security Administration'' account of the
    unemployment trust fund, and $379,327,000 in Federal funds.
    This funding level will cover the agency's built in increases.
        The Bureau of Labor Statistics is the principal fact
    finding agency in the Federal Government in the broad field of
    labor economics.
        Funding previously appropriated to the State Unemployment
    Insurance and Employment Service Operations account for
    occupational employment statistics is appropriated directly to
    the Bureau of Labor Statistics in fiscal year 2001, and
    comparative amounts for fiscal year 2000 are reflected herein.
        The Committee has included bill language making $10,000,000
    of the BLS allowance for Occupational Employment Statistics
    available on a program year basis. This action is taken in
    order to maintain the funding stream established in the ETA
    State Unemployment Insurance and Employment Service Operations
    account, through which the program was previously funded,
    thereby avoiding a programmatic disruption at the State level.

                            Departmental Management

                             SALARIES AND EXPENSES

    Appropriations, 2000....................................    $244,889,000
    Budget estimate, 2001...................................     437,554,000
    Committee recommendation................................     337,964,000

        The Committee recommendation includes $337,964,000 for this
    account, which is $99,590,000 less than the budget request and
    $93,075,000 above the 2000 comparable level. In addition, an
    amount of $21,590,000 is available by transfer from the black
    lung disability trust fund, which 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 recommendation reflects major Committee
    priorities, including international labor affairs, and
    employment of adults with disabilities.
        The Committee recommendation also includes an increase of
    $905,000 for program direction and support which provides
    leadership and direction for all Department-wide initiatives,
    programs, and functions assigned to the Department.
        The Committee recommends $9,201,000 for the Women's Bureau,
    an increase of $377,000 over the fiscal year 2000 level.
        The Committee urges the Women's Bureau to continue support
    at the fiscal year 2000 level for effective organizations such
    as Women Work! to provide technical assistance and training on
    displaced homemaker programming.
        In fiscal year 2001, the Committee recommendation approves
    the request to establish the new Office of Disability Policy,
    subsuming the responsibilities of the President's Committee on
    Employment of People with Disabilities. The Committee
    recommendation includes $23,002,000 to support this new office.
    These resources will allow the new office to provide training
    and technical assistance at One Stop Career Centers and to test
    alternative ways of integrating youth with disabilities into
    mainstream employment and training programs.
        The Committee includes bill language establishing within
    the Department of Labor an Office of Disability Policy to bring
    a heightened and permanent disability focus within the
    Department. The provision provides that the office is to be
    headed by an Assistant Secretary, and the Committee intends
    that this position is to be in addition to the other Assistant
    Secretary of Labor positions authorized under any other
    provisions of law.
        The Committee recommendation includes $115,000,000 for the
    Bureau of International Labor Affairs, an increase of
    $45,000,000 over the fiscal year 2000 level. In total, the
    recommendation includes $60,000,000 to assist developing
    countries with the elimination of child labor. Of this amount,
    $45,000,000, the level requested by the President, is for
    expansion of ILO's International Programme for the Elimination
    of Child Labor (IPEC).
        Accessible and appropriate education is critical not only
    in preventing abusive and exploitative child labor. Therefore,
    the Committee recommends $15,000,000 for bilateral assistance
    to improve access to basic education in areas with a high rate
    of abusive and exploitative child labor. The Committee expects
    the Department of Labor to be the primary agency in programming
    funding, drawing upon its expertise in international child
    labor, developed through its collaboration with the
    International Programme for the Elimination of Child Labor
    (IPEC). Furthermore, the Labor Department should consult with
    USAID in developing programmatic initiatives. The Committee
    expects these resources to be leveraged to provide children
    without access to basic education the most benefits and to
    complement international efforts.
        The Committee believes that academic research is beneficial
    to understanding the long-term effects of abusive and
    exploitative child labor on global trade and the economy.
    Therefore, the Committee believes that at least $1,000,000
    should be used for university-based research on the issue of
    abusive and exploitative child labor. Additionally, the
    Committee notes that an increased number of U.S. college
    students have worked to ensure that university licensed
    products are not made with abusive and exploitative child labor
    or in sweatshops. Consequently, the Committee encourages the
    Department to use at least $1,000,000 with a non-governmental
    organization to establish a student apprenticeship training and
    field program to enable interested American college students to
    learn first-hand about abusive and exploitative child labor and
    continue to raise awareness about this important issue. The
    Committee requests the Department of Labor to report to the
    Committee by June 1, 2001, on the programs initiated, results
    to date and future plans in this effort.
        The Committee includes bill language intended to clarify
    the forms of assistance that may be used to provide foreign
    technical assistance, and to provide an extended period of
    obligational authority for the bilateral international child
    labor initiative.
        The Committee recommendation includes $45,000,000, the same
    as the President's request, to augment the capacity of
    Ministries of Labor to enforce labor standards, to develop
    social safety net programs, and to develop information on
    enforcement of labor laws around the world. This amount
    includes funds for increased ILAB staffing related to this
    initiative. The total includes an increase of $10,000,000 over
    last year's level for the core labor standards initiative, and
    $5,000,000 to establish a system for monitoring labor
    standards.
        The $10,000,000 requested for the Global HIV/AIDS Workplace
    Initiative is included in the HHS Public Health Emergency Fund,
    to be available by transfer to the Bureau of International
    Labor Affairs.
        It is the Committee's intent that the Department of Labor
    continue its work 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. The Department is
    encouraged to continue its pilot study applying its methodology
    to working conditions in the apparel industry in a limited
    number of apparel-exporting countries.
        The Committee notes that in June 1999, 174 nations of the
    world came together at the International Labor Organization's
    (ILO) Labor Conference and unanimously passed ILO Convention
    No. 182, on the Elimination of the Worst Forms of Child Labor.
    The United States was one of the first countries to ratify this
    important convention. The Committee recognizes that conventions
    alone will not eradicate abusive and exploitative child labor
    and that international and national strategies need to be
    developed in order to reduce the scourge of child labor.
    Consequently, the Committee requests that the Bureau undertake
    a study on the cost and benefits associated with the
    implementation of ILO Convention 182. As part of this study,
    the Bureau should develop and assess the feasibility of
    targeted strategies to reduce by 50 percent the number of
    children engaged in the worst forms of child labor. The study
    should be completed by November 2001.
        Acknowledging the need to upgrade the information
    technology capability in the Department of Labor, the Committee
    provides an increase of $30,000,000 to establish a permanent,
    centralized information technology investment fund. The total
    provided will support three cross-cutting investments including
    common office automation suite implementation, architecture
    requirements and web services, and security for critical
    infrastructure protection.
        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.

                        Veterans Employment and Training

    Appropriations, 2000....................................    $201,277,000
    Budget estimate, 2001...................................     210,213,000
    Committee recommendation................................     206,713,000

        The Committee recommendation includes $206,713,000 for this
    account, including $19,800,000 in general revenue funding and
    $186,913,000 to be expended from the ``Employment Security
    Administration'' account of the unemployment trust fund. This
    is $3,500,000 less than the budget request and $5,436,000 above
    the 2000 comparable level.
        For State grants the bill provides $81,615,000 for the
    Disabled Veterans Outreach Program and $77,253,000 for the
    Local Veterans Employment Representative Program. Included in
    the Committee recommendation is funding to establish an
    Internet-based national data base of credentials, licenses, and
    certifications for the Disabled Veterans Outreach Program.
        For Federal administration, the Committee recommends
    $28,045,000, an increase of $1,172,000 over the fiscal year
    2000 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. The
    Committee notes the budget request includes $2,000,000, the
    same as the fiscal 2000 level, 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
    Committee urged that funding for the Institute be maintained,
    to the extent possible, at the 2000 level.
        Funding previously provided in Training and Employment
    Services appropriation account for Veterans workforce
    investment programs and the Homeless veterans reintegration
    project is appropriated directly to the Veterans Employment and
    Training account in fiscal year 2001, and comparative amounts
    for fiscal year 2000 are reflected herein. The Committee
    recommendation includes $12,500,000 for the Homeless veterans
    reintegration project , the request and full authorization
    level.
        The recommendation also authorizes the Department of Labor
    to permit the Veterans' Employment and Training Service [VETS]
    to also fund activities in support of the VETS' Federal
    Contractor Program [FTP] from funds currently made available to
    States for veterans' employment activities.

                        OFFICE OF THE INSPECTOR GENERAL

    Appropriations, 2000....................................     $51,925,000
    Budget estimate, 2001...................................      56,147,000
    Committee recommendation................................      54,785,000

        The bill includes $54,785,000 for this account, a decrease
    of $1,362,000 below the budget request and $2,860,000 above the
    2000 comparable level. This funding will cover the agency's
    built in increases. The bill includes $50,015,000 in general
    funds and authority to transfer $4,770,000 from the
    ``Employment Security Administration'' account of the
    unemployment trust fund. In addition, an amount of $318,000 is
    available by transfer from the black lung disability trust
    fund. The reduction from the request was necessary due to
    severe budget constraints facing the Committee in fiscal year
    2001.
        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.

                               General Provisions

        General provision bill language is included to:
        Prohibit the use of Job Corps funding for compensation of
    an individual at a rate in excess of Executive Level II (sec.
    101).
        Permit transfers of up to 1 percent between appropriations
    (sec. 102).
        Extend the availability of the Welfare-to-Work grant funds
    for an additional 2 years until 2003; this will allow formula
    and competitive grantees to take advantage of the program
    eligibility improvements enacted in the fiscal year 2000
    appropriations act. (sec. 103.)
        Eliminate the authority of the Secretary of Labor to award
    grants to States for successful performance of welfare-to-work
    programs under section 403(a)(5) of the Social Security Act.
    The Welfare-to-Work Amendments enacted in the appropriations
    Act for fiscal year 2000 reduced the amount of the set-aside
    for such grants from $100 million to $50 million, and provided
    that no such grants could be awarded earlier than October 1,
    2000. However, the Labor Department's operating plan indicates
    these funds will not be spent. The amendments made by this
    section would repeal the set-aside and the authority to award
    such grants, and make necessary conforming amendments changing
    cross-references. (sec. 104).

               TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

                  Health Resources and Services Administration

                         health resources and services

    Appropriations, 2000....................................  $4,563,365,000
    Budget estimate, 2001...................................   4,681,337,000
    Committee recommendation................................   4,522,424,000

        The Committee recommends an appropriation of $4,522,424,000
    for health resources and services. This is $117,972,000 below
    the administration request and $40,941,000 less than than the
    fiscal year 2000 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.

                                 HEALTH CENTERS

        The Committee provides $1,118,700,000 for the health
    centers, which is $100,000,000 above the 2000 level and
    $50,000,000 above the administration request for this group of
    programs, which includes community health centers, migrant
    health centers, health care for the homeless, and public
    housing health service grants.
        The Committee recognizes health centers as the premier
    primary health care providers serving nearly 11,000,000 low-
    income patients, 4.5 million of whom are uninsured. The
    Committee is concerned that the number of uninsured Americans
    continues to grow at a rate of 100,000 per month and is
    expected to exceed 57 million by 2008. Health centers are the
    most direct and cost-effective response to this growing
    national concern. The Committee recognizes that in the last
    three years alone, the number of uninsured cared for at health
    centers increased by over one million. Over the past several
    years, the Committee has increased funding for health centers
    to work toward meeting the health care needs of low-income
    Americans.
        The Committee notes that HRSA should distribute additional
    resources provided in this measure as expeditiously as possible
    to ensure that financially-pressed health centers remain viable
    in underserved communities. The Committee believes that HRSA
    should place a priority on distributing new funds made
    available in fiscal year 2001 to stabilizing the existing
    health center safety net and expanding existing health centers
    to serve the needs of communities without adequate access to
    primary and preventive care.

    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 nearly forty percent of
    patients served by health centers have no health insurance. 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.
        The Committee notes the expeditious manner in which HRSA
    has distributed a substantial portion of the additional
    resources provided to the health center program in fiscal year
    2000 and with the use of a funding methodology that targets
    these funds to centers with the highest burden of uninsured
    patients. The Committee encourages that new funding made
    available in fiscal year 2001 be given to stabilizing existing
    health centers and to enlarging existing health centers to
    serve the needs of communities without access to primary and
    preventive care.
        The Committee does not set aside any additional
    appropriations for loan guarantee authority under Section
    330(d) of the Public Health Service Act. The Committee intends
    that loan guarantee authority made available from the
    $160,000,000 allocation both fiscal year 1997 and fiscal year
    1998 which continues to be available for guarantees of both
    loan principal and interest.
        The Committee is concerned about the low number of centers
    in rural areas where shortages of health professionals are the
    greatest. The Committee encourages the agency to place
    appropriate priority on applications for new centers on rural
    areas which fall within the service area of an existing center
    but where no satellite clinic has been established.
        The Committee repeats bill language from previous years
    limiting the amount of funds available for the payment of
    claims under the Federal Tort Claims Act to $5,000,000.
        Within the consolidated health center line, sufficient
    funds have been provided to support the activities intended to
    reduce health disparities among ethnic/racial groups with high
    rates of adverse health outcomes.
        The Committee understands that Spelman College in Atlanta
    is seeking to expand its African American Women's Health and
    Wellness Project. This project is an effort to close the health
    disparity gaps that exist between African Americans and other
    communities.
        The Committee believes that HRSA could undertake a
    demonstration project in Alaska to bring community health
    center services to small and isolated communities in Alaska
    using core providers with satellite operations. The Committee
    notes that the State of Alaska, the Southeast Alaska Regional
    Health Corporation, and Ketchikan General Hospital have
    proposals to serve the needs of many of these isolated
    medically underserved communities.
        The Committee recognizes the efforts of the University of
    Texas, Houston Health Science Center, M.D. Anderson Cancer
    Center, Rice University, Baylor College of Medicine, and the
    University of Houston in establishing a unique pilot program
    which uses a community-based approach to assess healthcare
    needs and deliver services through the use of community health
    workers. The consortium plans to examine what factors
    contribute to good health and will channel resources
    accordingly.
        The Committee believes the agency could establish a
    demonstration project in Hawaii to develop an integrated health
    and social services model, to include traditional healing,
    prevention, and disease management, that addresses the
    disparities in health status and barriers to accessing health
    and social services among native Hawaiians and other minority
    populations at the Waimanalo Health Center.
        The Committee understands that a coalition of the Nebraska
    chapter of the American Academy of Pediatrics, the U.S. Bureau
    of Primary Health Care, and the Creighton University Medical
    School are working to promote patient access to healthcare.
        The Committee acknowledges that the New York University's
    Program in Women's Cancer (PWC) plans to create a new program
    to treat women's cancer, including etiology and biology, risk
    identification and prevention, screening, diagnosis and
    staging, treatment, palliation and rehabilitation, and
    psychosocial support.
        The Committee is supportive of the efforts of the Brain
    Trauma Foundation in developing an innovative program to
    significantly decrease mortality and morbidity due to severe
    traumatic brain injury and reduce the economic costs of caring
    for individuals with head injury.
        The Committee is aware that the McLaughlin Research
    Institute's Office of Rural Health Policy has developed a
    cancer genetic education program in north-central Montana to
    assess the need for genetic counseling to support the education
    of physicians, staff, patients, and families while exploring
    the ethical, social, and legal impacts of genetics discoveries
    on rural healthcare.
        The Committee understands that the University of Montana
    aspires to assist health care professionals statewide so that a
    significant improvement can be made in the effective use of
    medications and dietary supplements.
        The Committee recognizes that the frontier environment of
    rural Montana presents significant challenges to emergency
    responders. The Committee understands that Montana State
    University in Billings plans to research the current emergency
    system software and hardware systems, adapt current software to
    meet the information needs of emergency responders in rural
    Montana, and provide training to emergency responders.
        The Committee recognizes the high prevalence of chronic
    diseases such as diabetes, asthma, hyperlipidemia, and
    cardiovascular disease in rural areas. Furthermore, the
    management and control of these chronic diseases through
    medication and lifestyle alteration is essential to controlling
    overall health expenditures. Because of a shortage of primary
    care in rural areas, many patients do not have consistent
    access to practitioners to guide them in the provision of
    complicated medications and the accompanying lifestyle
    necessary to achieve a high quality of life through the
    management of these diseases. The Committee believes that HRSA
    should undertake a demonstration project in the rural
    Mississippi Delta area applying the Mississippi Medicaid
    disease State management program to the area's Medicare
    population.
        The Committee continues to be supportive of the
    demonstration programs of the Center for Sustainable Health
    Outreach in developing model health access programs, health-
    related jobs and sustainability of community-based providers of
    health services in rural and urban communities.
        The Committee recognizes the increasing demand for
    comprehensive primary health care by individuals and families
    in Utah who lack access to affordable services. The Committee
    suggests that HRSA continue support for a primary care
    residencies program at remote and frontier sites. The Committee
    believes that HRSA could give special attention and
    consideration to allocating resources to the implementation of
    projects that have demonstrated cooperative State and medical
    education efforts to support primary care residences in
    underserved urban and rural/frontier areas in Utah.
        The Committee is aware of a proposal by the Community
    Health Centers of Fresno, California to develop an enhanced
    model ambulatory care facility to meet the growing demands of
    the economically distressed, culturally diverse Central Valley
    of California.
        The Committee also recognizes that the Los Angeles Eye
    Institute, the nation's first minority-founded eye institute,
    will focus on providing increased access to high quality eye
    care for underserved minority and socio-economically
    disadvantaged children and adults.
        The Committee understands that Santa Marta Hospital in Los
    Angeles is providing outreach and offering health education to
    underserved populations suffering from diabetes. This
    innovative program is culturally and linguistically sensitive
    and primarily serves the Latino community.
        The Committee acknowledges that the Henry Ford Health
    Services' African American Initiative for Male Health
    Improvement (AIM-HI), a program designed to address the level
    and consequences of undiagnosed and untreated chronic diseases
    affecting the African American community through a network of
    community-based health resource centers that would represent a
    partnership between the program and grass roots organizations
    within the African American community. The program would
    initially focus on Detroit.
        The Committee understands that the University of Kentucky's
    Appalachian Health Promotion Disease Prevention Project is
    helping local Appalachian communities identify health problems,
    develop plans, and implement solutions through community-
    initiated decision-making.
        The Committee recognizes that asthma is a growing problem
    nationwide, particularly among minorities and the underserved.
    The Committee encourages HRSA, through its Community Health
    Centers program, to enhance its efforts aimed at reducing the
    incidence of asthma among ethnic and racial minorities.
        The Committee understands that the agency has funded the
    Hui and encourages continued and increased support to address
    the unique health care needs of Hawaii's underserved
    population. Native Hawaiian indigenous populations continue to
    experience significant health problems, including asthma and
    diabetes. The Committee urges HRSA to implement a program under
    which the systematic utilization of native Hawaiian health
    expertise may effectively impact the health status in these
    populations. The Committee recommends that community health
    centers serve as a safety net for this program, utilizing nurse
    practitioners and psychologists as care providers for these
    underserved populations.
        The Committee notes the high prevalence of hepatitis C
    (HCV) in the low income communities served by Community Health
    Centers (CHC). The Committee urges adequate funding to permit
    CHCs to train their medical personnel on the risks and
    treatment protocols for HCV as well as resources for culturally
    appropriate educational materials for CHC clientele.
        The Committee is also concerned that regulations and
    application procedures currently governing distribution of
    community health center funds are preventing remote rural areas
    in states like Alaska and Hawaii from applying for and
    receiving funding for health centers despite severe shortages
    of health professionals and great need. The Committee urges the
    agency to give appropriate priority to locating new health
    centers in such remote communities and to developing a flexible
    approach to working with Native health providers and other
    similar groups to help meet the health needs of low income
    persons living in extremely remote locations.
        The Committee is aware of an effort by Health Choice
    Network, based in South Florida, to integrate an innovative
    system of clinical data management. The use of an automated
    medical record system is critical to improving outcomes and
    reducing ethnic disparities in the health in our patient
    population. Use of this system can improve the health care
    delivery system by improving the ability to track and manage
    key health factors of our vulnerable patients. Included in the
    project will be a document imaging system, automated medical
    records, and computer hardware and software. The Committee
    encourages full and fair consideration of this request.
        The Committee is aware of the proposal by the Madison,
    Wisconsin Community Health Center to establish an effective
    model for culturally sensitive, fiscally viably primary health
    care which would include health promotion and prevention of
    high risk behaviors in at-risk and hard-to-reach populations.
    The proposal would focus on preventive care, follow-up medical
    services, patient education and case management. This project,
    which could be replicated in other communities across the
    Nation, would involve extensive collaboration between public
    and private health care organizations, public health
    departments and schools, university medical and nursing schools
    and the public. The agency is encouraged to identify steps that
    would assist this entity in attaining its operational goals.

    School-based health centers

        This program provides grants for comprehensive primary and
    preventive health care services and health education to at-risk
    and medically underserved children and youth. Grants are
    awarded to public or private, nonprofit, community-based health
    care providers. Through agreements with a local school or
    school system, the health care entity provides the services in
    the school building or on school grounds.
        The Committee understands that Blackstone Valley Community
    Health Care provides a school-based clinic that provides needed
    services to under-served predominately new immigrant children.
    The Committee notes that, without a school clinic, these
    children would have greater difficulty obtaining health
    services.

    Migrant health program

        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.
        It has been brought to the Committee's attention that the
    Department may be developing a regulation to revise the process
    for designating health professions shortage areas and medically
    underserved populations. Recognizing the adverse impact of
    residential instability and poverty on access to health care,
    the Committee urges the department to consider designating
    homeless persons, migrant and seasonal farm workers, as
    medically underserved populations. The Committee further urges
    the Department to take steps to make health services provided
    by the department as fully accessible as possible to persons
    experiencing homelessness.

    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 sufficient funding 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 $7,000,000 be provided for
    these activities in fiscal year 2001.
        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 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 HRSA 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.
        The Committee believes the agency could establish a
    demonstration project in Hawaii to develop an integrated health
    and social services model, to include traditional healing,
    prevention, and disease management, that addresses the
    disparities in health status and barriers to accessing health
    and social services among native Hawaiians and other minority
    populations at the Waimanalo Health Center.
        The Committee encourages the development of a Center of
    Excellence for Indigenous Health and Healing at the University
    of Hawaii School of Public Health and on other schools serving
    a large population of native peoples including American
    Indians, Alaska Natives, native Hawaiians and Pacific Islanders
    to incorporate traditional medicine and healing practices into
    their training for medical, nursing, social work, psychology,
    and public health students. The Committee encourages HRSA, CDC,
    and SAMSHA to support this effort in their grants by including
    traditional practitioners as providers of care where there are
    native and indigenous people residing in the service area of
    the grantee.

    Native and rural Alaskan health care

        The Committee includes the legal citation in the bill for
    the Denali Commission, which authorizes the provision of
    services, including healthcare facilities, for Native and rural
    Alaskans living in the Denali region. The Committee has
    included sufficient funds under the broader community health
    centers line to support these activities. The Committee intends
    that not less than $10,000,000 be provided for these activities
    in fiscal year 2001.

    National Health Service Corps: Field placements

        The Committee provides $38,116,000 for field placement
    activities, which is $66,000 below the 2000 level and the same
    as 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.

    National Health Service Corps: Recruitment

        The Committee provides $78,625,000 for recruitment
    activities, which is the same as the 2000 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 support multiyear, rather than single-year, commitments.
        The Committee is concerned by the declining percentage of
    placements of NHSC assignees at Community, Migrant, Homeless,
    and Public Housing Health Centers. The program is intended to
    supplement efforts of other Federal programs, such as health
    centers, that are targeted to underserved communities and
    vulnerable populations, and the Committee remains supportive of
    efforts to place practitioners in close coordination with this
    program.
        The Committee urges the program to increase the level of
    services to medically underserved rural communities and areas.
    These areas are consistently in need of the kinds of services
    and care that NHSC professionals provide.
        The Committee intends that $4,000,000 of the funds
    appropriated for this activity be used for State offices of
    rural health.
        The Committee is interested in learning how successful
    National Health Service Corps has been in increasing the number
    of mental and behavioral health professionals in underserved
    areas. The Committee continues to be concerned about the slow
    progress of the Corps in addressing the need for mental and
    behavioral health providers in underserved areas and believes
    the Corps should take all necessary steps to increase the
    number of psychologists and other mental and behavioral health
    professionals.
        The Committee encourages the National Health Service Corps
    to support a demonstration project aimed at expanding and
    integrating the services of behavioral and mental health
    professionals, including psychologists, with other health
    services. The Committee intends that this program be targeted
    at underserved urban and rural areas through community health
    centers, with particular attention focused on the mental health
    problems created by the current farm crisis.

                               HEALTH PROFESSIONS

        For all HRSA health professions programs, the bill includes
    $230,714,000, which is $111,193,000 less than the fiscal year
    2000 appropriation and $67,245,000 less than the overall
    administration request for these programs.
        The Committee recommends consolidated funding for programs
    authorized under titles VII and VIII programs.
        The following clusters and their associated programs are
    included in this consolidated account:

    A. Workforce information and analysis

    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.

    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.

    B. Training for diversity

    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
    Committee is pleased that the agency has refocused the minority
    centers of excellence program on providing support to
    historically minority health professions institutions.
        The Committee believes HRSA should consider applications
    for the Centers of Excellence program that are responsive to
    allied health professions. These allied health professions are
    experiencing shortages and high vacancy rates, such as
    laboratory personnel.
        The Committee urges the agency to consider establishing at
    least one center for excellence focused on training Alaska
    Natives as community health aides to serve as sole community
    health providers in remote Alaska Native villages across
    Alaska.
        The Committee continues to be supportive of the work of the
    American Foundation for Negro Affairs in providing early
    intervention training.
        The Committee supports the existing INPSYCH programs at the
    University of North Dakota, the University of Montana and
    Oklahoma State University, which have established outreach and
    training programs to provide social, financial and academic
    support for American Indian high school students and mental
    health paraprofessionals who wish to continue their education
    at the bachelors or graduate degree level in psychology.
    Currently, Alaska and other states with large Native
    populations are experiencing a critical shortage of mental
    health and substance abuse providers with advanced training and
    degree credentials to serve Native populations in a culturally
    relevant way. The Committee urges the Department to consider
    establishing additional INPSYCH centers at the University of
    Alaska Anchorage, the University of Alaska Fairbanks, the
    University of South Dakota, and Utah State University.

    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 Committee is
    pleased that HRSA has given priority consideration for grants
    to minority health professions institutions, and recommends
    that grant review committees have proportionate representation
    from these institutions. The Committee believes that HRSA
    should consider applications that are responsive to allied
    health professions which are experiencing shortages and high
    vacancy rates, such as laboratory personnel.
        The Committee has been supportive of this program's
    critical role in improving the health status of minority and
    disadvantaged citizens by increasing available opportunities
    for those individuals seeking a health professions career. The
    Committee understands that minority providers are more likely
    to serve in underserved areas. The program has recognized the
    contribution of historically minority health professions
    schools, and have supported those institutions which have made
    the greatest contribution to increasing the number of
    minorities in health professions careers.

    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.

    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 Committee continues to recognize the importance of
    training greater numbers of psychologists and other health
    professionals from disadvantaged backgrounds to participate on
    interdisciplinary primary care teams addressing a range of
    behavioral and mental health needs.

    C. Training in primary care medicine and dentistry

        The administration proposes to terminate the programs
    within this cluster, however, the Committee intends that the
    programs receive funding from the consolidated appropriations
    allocated for fiscal year 2001 in proportion to the amount
    provided in fiscal year 2000, relative to the other health
    professions accounts. With the continued need for primary care
    throughout the country, the Committee believes these programs
    serve an important role in maintaining the country's public
    health infrastructure.

    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.

    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.

    Physician assistants

        This program supports planning, development, and operation
    of physician assistant training programs.

    General dentistry and pediatric dental 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 and
    pediatric dentistry.
        The Committee recognizes the need to increase the number of
    dentists in rural and underserved areas, and particularly
    increase the number of pediatric dentists in those areas. Rural
    States are disproportionately underserved by pediatric
    dentists.

    D. Public health workforce development

        The administration proposes to terminate the programs
    within this cluster, however, the Committee intends that the
    programs receive funding from the consolidated appropriations
    allocated for fiscal year 2001 in proportion to the amount
    provided in fiscal year 2000, relative to the other health
    professions accounts. With the continued need for public health
    training throughout the country, the Committee believes these
    programs serve an important role in maintaining the country's
    public health infrastructure.

    Public health, preventive medicine and dental public health

        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 Committee encourages the increase of residency training
    opportunities in dental public health so that Federal, State,
    and community-based programs have the leadership capabilities
    to prevent dental disease, promote oral health, and improve
    treatment outcomes.

    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.

    E. Interdisciplinary, community-based linkages

    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 Area Health Education Centers (AHEC)
    grants; and model programs to extend AHEC programs with 50
    percent Federal funding. The Committee intends that adequate
    funding be provided to the area health education centers grant
    program since AHEC's are an important component of the Federal/
    State partnership in addressing rural health issues.
        The Committee is pleased that HRSA is participating with
    the Surgeon General to implement the National Suicide
    Prevention Strategy. The Committee believes HRSA could develop
    structured programs for the education and continuing education
    of primary care providers in depression and anxiety assessment
    and intervention and to develop training materials and
    resources relating to depression available for use with HRSA
    grantees such as State Primary Care Associations, Geriatric
    Education Centers, and Area Health Education Centers.
        The Committee recognizes the nationwide shortage of
    psychologists and other mental and behavioral health
    professionals, particularly among minorities and in underserved
    areas. Therefore, the Committee urges the Bureau of Health
    Professions to increase its efforts to meet the behavioral and
    mental health needs of underserved populations.
        The Committee believes that HRSA could improve the
    detection, diagnosis, treatment and management of CFIDS
    patients through its training program for health care providers
    in practice and providers in-training. HRSA encourages the
    agency to support thorough evaluation of its CFIDS training
    program to assess its effectiveness. The Committee believes
    that HRSA could expand its CFIDS educational opportunities
    beyond the Area Health Education Centers (AHEC) program to
    other relevant areas of the agency. Effective programs could
    yield healthcare spending savings equal to many times this
    small investment.
        It has been brought to the attention of the Committee that
    the program has been emphasizing physical health needs, while
    more could be done in addressing behavioral and mental health
    needs. The Committee encourages the Bureau to train more
    behavioral and mental health professionals in the AHEC program.
        Funds are available to continue the demonstration project
    by the Utah area health education centers. The project seeks to
    show if these centers' support to primary care residencies in
    states with one regional health science center and medical
    school will improve access of health services to rural and
    underserved populations. The project also seeks to establish
    cooperation between a state council of medical education and a
    Utah AHEC program to support primary care residencies and
    participation by residents in those programs at remote and
    frontier sites.

    Health education and 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.

    Allied health and other disciplines

        The Committee expects this program to continue to support
    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. The administration requested termination
    of funding. 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 Committee intends that the program receive funding from
    the consolidated appropriations allocated for fiscal year 2001
    in proportion to the amount provided in fiscal year 2000,
    relative to the other health professions accounts. It has been
    brought to the Committee's attention that shortages of allied
    health personnel exist in medically underserved and rural
    communities, especially those who assist the elderly. The
    Committee understands that a workforce database is being
    developed that could detail the extent of these shortages. The
    Committee continues to recommend that the agency continue to
    play a role in partnership with state governments and private
    institutions in raising the number of allied health
    professionals.
        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.
        The Committee understands that the Northeastern
    University's Bouve College of Health Sciences plans to develop
    models for training physicians to serve low-income communities.
    Northeastern has been recognized as a leader in low-income
    health delivery models by providing services to communities
    with high rates of uninsured people.
        It has been brought to the Committee's attention that there
    is a lack of trained health professionals in Nevada. Given the
    large increase in Nevada's population, especially the elderly,
    the Committee encourages the agency to contribute technical
    assistance to the University of Nevada at Reno and Las Vegas
    toward the establishment of educational channels for a school
    of pharmacy.

    Geriatric education centers and training

        The Committee expects this program to continue to support
    grants to health professions schools to establish geriatric
    education centers and to support geriatric training projects.
    The administration requested termination of funding. 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.
        The Committee recognizes the Des Moines University
    Osteopathic Medical Center for its development of a model
    program for training and education in the field of geriatrics.

    Quentin N. Burdick program for 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 Committee notes its continuing support for the rural
    interdisciplinary training program designed to improve access
    to health care and health professionals in rural areas and has
    included sufficient funds to maintain this program at current
    levels. The Committee expects that this program will continue
    its current levels of support for 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.
        The Committee also urges the bureau to consider
    implementation of telecommunications and telehealth initiatives
    for providing distance education and training for nurses,
    community health aides, and other health professionals serving
    rural areas.
        The Committee is aware of the Global Health Corps at the
    University of Northern Iowa in training students in health
    promotion, health education, nursing, pre-medicine, and related
    areas to conduct culturally appropriate health programs with
    underserved populations.
        The Committee understands that Texas A&M/Texas Agricultural
    Extension Service is operating an innovative Health Education
    and Outreach (HERO) Program. The program is enabling health
    professionals to conduct public health research in areas
    traditionally under served and under represented in such
    studies.

    Podiatric primary care training

        The program provides grants to hospitals and schools of
    podiatric medicine for residency training in primary care. In
    addition to providing grants to hospitals and schools of
    podiatric medicine for residency training in primary care, the
    program also permits HRSA to study and explore ways to more
    effectively administer postdoctoral training in an ever
    changing health care environment.

    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 Committee recommends that the program be
    continued and funded at current levels.

    Children's hospital graduate medical education program

        The program provides support for health professions
    training in children's teaching hospitals that have a separate
    Medicare provider number (''free-standing'' children's
    hospitals). Children's hospitals are statutorily defined under
    Medicare as those whose inpatients are predominantly under the
    age of 18. The funds in this program are intended to make the
    level of Federal Graduate Medical Education support more
    consistent with other teaching hospitals, including children's
    hospitals which share provider numbers with other teaching
    hospitals. Payments are determined by formula, based on a
    national per-resident amount. Payments support training of
    resident physicians as defined by Medicare in both ambulatory
    and inpatient settings.

    F. Nursing workforce development

    Advanced education nursing

        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.

    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.

    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.

    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.

    Basic nurse education and practice

        Authorized by Public Law 105-392, the goal of this program
    is to improve the quality of nursing practice. Activities under
    this program will initiate new projects that will change the
    educational mix of the basic nursing workforce and empower the
    workforce to meet the demands of the current health care
    system.
        The Committee is aware of a recent meeting of the Council
    on Graduate Medican Education (COGME) and the National Advisory
    Council on Nursing Education Program(NACNEP) where they
    determined to work together to develop educational programs to
    address concerns raised in the Institute of Medicine Report,
    ``To Err is Human.'' Specifically, they have agreed to focus
    jointly on a new initiative,'' Training Physicians and Nurses
    Together to Improve Patient Safety.'' This promises to be a
    constructive and productive effort and the Committee encourages
    HRSA to fund this initiative.
        The Committee is aware of the University of Alaska
    Anchorage's program to recruit and retain Alaska Natives for
    basic and advanced training as nurses to serve in Native
    communities in Alaska, and notes that only 2 percent of the RN
    workforce in Alaska is composed of Alaska Natives. The
    Committee urges the Department to consider continuing and
    expanding the University of Alaska's current program to recruit
    and retain Alaska Natives as nurses, including supportive
    services, stipends for needy students, and distance delivery of
    educational components.

    Nursing workforce diversity

        The goal of this program is to improve the diversity of the
    nursing workforce through increased educational opportunities
    for individuals from disadvantaged backgrounds. Such diversity
    in the nursing workforce enables the health care system to
    deliver more culturally appropriate and sensitive care in
    disadvantaged neighborhoods.

                              other hrsa programs

    Hansen's disease services

        The Committee has included $17,016,000 for the Hansen's
    Disease Program which is the same as the administration
    request. This program offers Hansen's Disease treatment in
    Baton Rouge at the Center, at other contract supported
    locations in Baton Rouge, and in grant supported outpatient
    regional clinics. These programs provide treatment to about
    3,000 of the 6,000 Hansen's disease sufferers in the United
    States.
        With the exception of about 40 long term residents who
    continue to reside at Carville, the program has completed the
    move to leased space in Baton Rouge. Other former long term
    residents have been offered and elected to receive a living
    allowance from the program and now live independently. The
    former Federal property at Carville has been transferred to the
    State of Louisiana.
        Over the next few years a long term facility will be
    developed in the Baton Rouge area and offered to the current
    long term residents remaining at the Carville location as an
    alternative to remaining at the historic facility.
        The program also conducts research focusing on the global
    elimination of Hansen's Disease in laboratory facilities at
    Louisiana State University in Baton Rouge. Research activities
    are directed toward the development of new anti-leprosy drugs
    and short-term more effective regimens; manufacture and
    distribution of lepromin skin tests reagents through the World
    Health Organization; identification of host resistant
    mechanisms for potential use in vaccines development; and
    application of state-of-the-art biotechnology to develop simple
    lab techniques for case detection and diagnosis of preclinical
    disease.

    Maternal and child health block grant

        The Committee recommends $704,130,000 for the maternal and
    child health [MCH] block grant. This is the same as the fiscal
    year 2000 level and the administration request.
        The MCH block grant funds are provided to States to support
    health care for mothers and children. According to statute,
    12.75 percent of funds over $600,000,000 are used for
    community-integrated service systems [CISS] programs. Of the
    remaining funds, 15 percent is used for special projects of
    regional or national significance [SPRANS] while 85 percent is
    distributed on the same percentage split as the basic block
    grant formula.
        The Committee has transferred funding previously included
    within SPRANS for the traumatic brain injury State
    demonstration projects to the critical care cluster.
        The Committee is concerned that recent changes in factors
    that determine funding under SPRANS may have disadvantaged a
    number of programs that provide comprehensive care services to
    chronic patients, such as those with thalassemia or sickle cell
    disease. The Committee strongly encourages the bureau to
    continue current funding of programs for individuals with
    thalassemia and sickle cell disorder. These programs should
    include trait screening, as well as prenatal and postnatal
    services.
        The Committee commends HRSA's Maternal and Child Health
    Bureau for its support of the Sudden Infant Death Syndrome
    program support center, and encourages the Maternal and Child
    Health Bureau to continue its efforts in this important area of
    service.
        Since 1992, the Maternal and Child Health Bureau has worked
    in a cooperative agreement with the American College of
    Obstetricians and Gynecologists (ACOG) to run the Maternal and
    Child Health Providers' Partnership Project. The Committee
    commends the MCHB for establishing the Partnership program,
    which seeks to promote cooperative efforts and enhance
    communication between public and private organizations that
    serve pregnant women and children. The goal is to improve the
    health systems in place, remove barriers to care, and to ensure
    quality health services for pregnant women and infants. The
    Partnership brings together representatives from the Federal,
    State, and local level who want to work toward improving health
    services for women and their infants. Such efforts by the
    Partnership have recently resulted in work to address perinatal
    HIV transmission and develop strategies to increase access to
    psychosocial services for pregnant women. The Committee notes
    that the bureau could continue to use SPRANS funds to support
    the Partnership Project.
        Partners in Program Planning for Adolescent Health (PIPPAH)
    is a public-private initiative that promotes an adolescent
    health care agenda among professional disciplines through
    funding from the Office of Adolescent Health within the MCHB.
    The program aims to improve access to health services for
    adolescents, including access to mental health services. The
    Committee encourages the bureau to continue using SPRANS funds
    for the PIPPAH program. With sufficient funding, this program
    could be expanded to involve additional disciplines, including
    health care organizations such as the American College of
    Obstetricians and Gynecologists.
        The Committee recognizes the efforts of the Providence
    Smiles program in providing dental care to uninsured school-
    aged children and notes that additional funds would allow more
    children to receive these critical services.
        The Committee commends the efforts of Prince George's
    County, Maryland in reducing infant mortality rates, which are
    currently the highest in the State. With additional funds, the
    number of infant mortality prevention and treatment programs
    could be increased, particularly among African-American and
    low-income women. These programs would include perinatal
    diagnostic treatment for women with high-risk pregnancies,
    screening for chronic illnesses for women of child bearing age,
    and education services for expectant mothers.
        The Committee recognizes HRSA's Oral Health Initiative that
    uses a multi-faceted approach to eliminate disparities in oral
    health status and assures access to oral health services for
    low-income children. A recently released study by the General
    Accounting Office substantiates that dental disease is a
    chronic problem among many low-income and vulnerable
    populations and that children in these populations have five
    times more untreated dental caries than children in higher-
    income families. In an effort to better coordinate oral health
    activities such as community water fluoridation, sealant
    programs, education and training programs to improve pediatric
    oral health and grants to States to improve access to oral
    health care for Medicaid and CHIP eligible children, the
    Committee requests HRSA to present a report by February 1, 2001
    explaining how these programs can be consolidated and what
    additional investment would be required to sufficiently address
    improving access to oral health care for vulnerable
    populations.
        The Committee is pleased with the role that HRSA's Office
    of Adolescent Health is playing regarding promotion of mental
    health and substance abuse treatment services for adolescents
    in the primary health care setting. In particular, the
    Committee is interested in the collaborative activity between
    the Office of Adolescent Health and the three Centers of
    Substance Abuse and Mental Health Services Administration that
    explores and examines health services delivery models which
    will enhance access to and effective utilization of mental
    health and substance abuse treatment services by children,
    adolescents, and their families. The Committee encourages that
    this activity be expanded to include a set of evaluated
    demonstration projects.
        The Committee is aware of the history of collaboration
    between MCHB and regional health administrators in regions VII
    and X in youth suicide prevention programs. The Committee
    believes that this collaboration could be expanded to include
    the development of a comprehensive demonstration of youth
    suicide prevention programs in these regions. SPRANS funding of
    such a demonstration would be appropriate.
        The Committee also values the initiative, Mental Health in
    Schools, and encourages that the state level partnerships be
    expanded and the technical assistance, training and resource
    centers continue their work with educators and health care
    professionals.
        The Committee encourages HRSA's Office of Adolescent Health
    to take action on the recommendations made at the 1998 Health
    Futures of Youth II Conference, and is pleased that an
    initiative is planned that promotes healthy developmental
    transitions from childhood to adolescence. The Committee
    further encourages collaboration with the Administration on
    Children, Youth and Families.

    Healthy start initiative

        The Committee recommends $90,000,000 for the healthy start
    infant mortality initiative. This amount is the same as the
    fiscal year 2000 amount and the comparable 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.
        The Committee is pleased with the achievements of the
    healthy schools, healthy communities initiative which has been
    particularly effective in providing comprehensive school-based,
    school-linked, family centered, community based primary care to
    approximately 24,000 children.
        Since 1990, the Maternal and Child Health Bureau has worked
    in collaboration with the American College of Obstetricians and
    Gynecologists (ACOG) to run the National Fetal and Infant
    Mortality Program. NFIMR is a national activity where
    professionals review community fetal and infant mortality rates
    and work to address identified problems leading to mortality
    and establish systems of support for women and children. The
    public-private initiative also works to address problems with
    health disparities in minority health, as related to fetal and
    infant mortality rates. The Committee believes NFIMR should
    continue to be supported through the MCHB and notes that
    additional funds would allow more communities to be served.
    Adequate funding has been provided for NFIMR through the
    Healthy Start initiative. The Committee is aware that in order
    to meet the demand of serving an expanded number of
    communities, NFIMR must be able to continue its activities at
    an adequate funding level.

    Universal newborn hearing screening and early intervention

        The Committee provides $4,000,000 for universal newborn
    hearing screening and early intervention activities, which is
    $625,000 above both the fiscal year 2000 level and the
    administration request. The Committee understands that
    screening technology has enabled health providers to conduct
    accurate, cost-efficient newborn hearing screenings prior to
    hospital discharge. By detecting newborn hearing deficiencies,
    health providers can implement necessary treatment to the
    infant and advice to affected family members. This new program
    was begun last year and the response from States has been
    substantial. The Committee is aware that HRSA received many
    more high quality applications for this program than it was
    able to fund. Funds provided will support grants to states to:
    develop and expand statewide screening programs; link screening
    programs with community-based intervention efforts; monitor the
    impact of early detection and intervention activities; and
    provide technical assistance.

    Organ procurement and transplantation

        The Committee provides $15,000,000 for organ transplant
    activities. This is the same as the administration request and
    $5,000,000 more than the fiscal year 2000 appropriation.
        The Committee considers increasing the supply of organs,
    particularly livers, available for voluntary donation to be a
    top public health priority. Last year the Committee doubled the
    administration request to catalyze an aggressive, nationwide
    effort to improve public awareness and educate health care
    providers.
        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 encourages the agency to
    establish linkages with state and federal transportation
    officials to improve coordination of donation following
    vehicular accidents.
        To increase the rate of organ donation, the Committee urges
    increased behavioral research to better target and increase the
    effectiveness of public awareness campaigns.
        The Committee is aware of the proposal by the University of
    Alabama at Birmingham to conduct research on measures that
    could increase the number and quality of organs obtained from
    donors.
        The Committee considers increasing the supply of organs,
    particularly livers, available from voluntary donations to be a
    top public health priority and expects that funds be committed
    to those activities having the greatest demonstrable impact on
    donation rates.

    Health teaching facilities interest subsidies

        The Committee has not included funding for the health
    teaching facilities interest subsidies which has provided
    interest support on loan guarantees for construction of a
    health professions teaching facility under a now discontinued
    Public Health Act authority. The remaining Federal commitment
    on these loans will expire in year 2004. The interest subsidy
    payment for the remaining loan guarantee will be paid from
    existing carryover funds from prior years' appropriations;
    therefore, no appropriation is required to cover these
    payments.

    National bone marrow donor program

        The Committee has included $17,959,000 for the national
    bone marrow donor program. This is the same as the
    administration request and $41,000 below the fiscal year 2000
    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.

    Rural health outreach grants

        The Committee recommends $38,892,000 for health outreach
    grants. This amount is $3,012,000 higher than the fiscal year
    2000 level and the same as 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. 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.
        The Committee understands that the University of Colorado
    School of Dentistry plans to conduct an oral health prevention
    and treatment program in several counties in South Dakota that
    would test innovative ways to provide services to low-income
    children.
        The Committee continues to be supportive of the diabetes
    lower extremity amputation prevention program run by the
    University of South Alabama, the Louisiana State University
    medical school, the Roosevelt Institute for Rehabilitation and
    Jackson Medical Mall.
        The Committee is supportive of the La Crosse Health Science
    Consortium proposal to address severe shortages in dental
    access. The Committee is aware that only 30 percent of
    Medicaid-eligible persons in La Crosse County received dental
    services in 1997. The project will utilize the La Crosse Allied
    Health Sciences facility, the services of the Western Wisconsin
    Technical College Dental Hygiene and Dental Assistant Program
    and volunteer dentists, to increase access to dental care for
    individuals living in La Crosse County.

    Telehealth

        The Committee recommends $25,000,000 for telehealth
    activities. This amount is $19,388,000 higher than the
    administration request and $4,478,000 more than last year's
    comparable appropriation.
        The telehealth program promotes the use of technologies to
    improve access to health services and distance education for
    health professionals. The Committee recognizes the tremendous
    potential that telehealth has for improving the delivery of
    quality health care to rural underserved areas and for
    providing distance education to health care professionals. The
    Committee supports HRSA's numerous rural telehealth initiatives
    and encourages the agency to work in partnership with medical
    librarians and other health information specialists in the
    development and implementation of its telehealth projects.
        The Committee believes that HRSA could establish a number
    of regional centers for the advancement of telehealth. Such
    centers could advance the cost-effective deployment of
    telehealth technologies and provide technical assistance to
    health care providers. The centers could conduct research,
    evaluations, and assessments to determine the appropriate
    application of telehealth technologies that span healthcare
    disciplines, applications, and settings.
        The Committee is supportive of HRSA's efforts to include
    EMS issues in its Telemedicine/Telehealth initiative and
    encourages the Office of Rural Health Policy, the Office for
    the Advancement of Telehealth and EMSC program to collaborate
    on projects to improve emergency medical service for children.
        The Committee is supportive of the Magee-Womens Hospital's
    efforts to develop a model to support coordinated and
    integrated care to women with breast cancer. Associated with
    this model is the use of new information technologies that will
    allow collaboration of cancer specialists for case management
    decisions, research cooperation, and continuing professional
    development. In addition, the Committee understands that the
    model will include the use of new technologies for mammography
    imaging, ultrasound imaging, and pathology slides.
        The Committee is aware of HRSA's increased commitment to
    telehealth demonstration projects to serve as models for the
    efficient delivery of health care services to rural,
    underserved, and hard to reach populations. The Committee urges
    an increased focus on demonstration grants for providing
    behavioral and mental health services and advanced training for
    providers in prisons and other public institutions.
        The Committee understands that Montana State University
    plans to initiate a Tele-home Healthcare Intervention Project
    that will integrate and expands existing programs and maximize
    partnerships between State and local organizations. Through
    telecommunications technology, computer access, and Internet
    connectivity, self-care and supportive care for rural isolated
    elderly will be enhanced.
        The Committee acknowledges that Saint Vincent Hospital and
    Health Center is developing a State-and region-wide
    telecommunications model that increases telemedicine usage and
    incorporates health and business applications. The focus of
    this plan is the development of a Telehealth Education and
    Learning Center which includes deployment of video
    telecommunications in rural or extended community areas.
        The Committee understands that the North Philadelphia
    Health System plans to employ cutting-edge to provide better
    and more timely patient care.
        The Committee is also aware of the Susquehanna Health
    System's innovative electronic medical information and patient
    access project.
        The Committee recognizes that HRSA is beginning phase II of
    the Telehealth Deployment Research Testbed (TDRT) program,
    which will significantly expand the effective use of telehealth
    in underserved rural and urban areas. The program will
    incorporate wide participation, including the West Virginia
    University Concurrent Engineering Research Center and other
    centers of excellence.
        The Committee is supportive of the Children's Health Fund,
    a non-profit organization to offer comprehensive medical care
    to uninsured and medically underserved children. The fund is
    currently working in 5 States to implement state-of-the-art
    electronic patient record systems at its project sites.
        The Committee recognizes that providing health care in
    rural areas is difficult, and the difficulties increase
    exponentially when the location is a small island in the
    Pacific, however, Molokai General Hospital has been providing
    health care on this rural island and has found that its
    environment provides opportunities to research outcomes of new
    interventions, evaluate culturally-relevant health education,
    train health providers on care of ethnic populations, and
    facilitate the integration of non-Western health treatments.
    Molokai's rural setting also encourages the collaboration among
    diverse health professionals and necessitates the use of
    technology advances, including telehealth, telemedicine,
    electronic communication, and video consultation. Given
    Molokai's General Hospital's ability to thrive in its isolated
    location, the Committee believes that the Hospital could be
    designated a Center of Excellence that will focus on the
    provision of health care in rural areas.
        The Committee understands that Montana State University
    (MSU) campuses in Bozeman and Billings are developing a center
    to enhance health-related research programs, assisting with
    health care policy development, and clinical trial research
    efforts to health care institutions, providers, and consumers.
    The large health care enterprise in the Billings area and the
    biomedical, biotechnology, engineering, and economics research
    activities of MSU-Bozeman plan to form a research partnership
    through this center.
        The Committee recognizes that Rocky Mountain College and
    Deaconess Billings Clinic plan to provide medical imagery and
    education and create communications links to residents of rural
    Montana. The system features distance learning centers that
    offer both education and telemedicine services.
        The Committee recognizes that the Community Hospital
    Telehealth Consortium in Louisiana is developing a regional
    telehealth network.
        The Committee is aware that Santa Rosa Memorial Hospital is
    proposing the creation and implementation of a Northern
    California Telemedicine Network to provide health care access
    to the California north coast's remote and underserved
    populations.
        The Committee is also recognizes that Arrowhead Regional
    Medical Center is proposing to use technology to enable both
    indigent residents and incarcerated and juvenile offenders to
    have access to specialty medical care and not forego attention
    because of transportation problems.
        The Committee understands that the University of Michigan
    Health System's Emergency Telemedicine Network plans to develop
    an emergency telemedicine model of care, making significant
    improvements in the emergency medical services delivery system.
        The Committee is also aware of a proposal by the Rural
    Telehealth & Community Education Network through Central
    Michigan University to establish an interactive two-way audio
    video community education and rural telehealth network to
    improve access, efficiency and quality of healthcare services
    to migrants and underserved rural populations that could then
    be replicated as a model for rural communities nationwide. The
    goal would be to increase health promotion and disease
    prevention while reducing the cost of medical care associated
    with emergency room and unnecessary visits.
        The Committee is supportive of the Utah Telehealth
    Network's plans to expand service to 20 sites throughout the
    State. This project will link rural and frontier communities
    with health care services. The Committee is also supportive of
    the Montezuma Creek Health Center's efforts to provide
    telehealth services to the rural Navaho population.
        The Committee is aware of the New Mexico/Hawaii telehealth
    outreach for unified community health (TOUCH) which is provided
    much-needed health services to rural patients.
        The Committee understands that the Ohio Poison Control
    Center Collaborative needs to upgrade its computer technology
    so that they can have a compatible information link. Such a
    link is important since it will allow more patients to be
    served.
        The Committee is aware that the Community Partners
    HealthNet, Inc. in North Carolina is providing health services
    to poor, uninsured patients in rural locations.
        The Committee recognizes that the University of Nebraska
    Medical Center in Omaha is developing a telemedicine and
    distance learning outreach program to serve patients in remote
    and rural locations.
        The Committee understands that the Community Hospital
    Telehealth Consortium's Regional Telehealth Network is
    providing services to patients in rural Louisiana, Mississippi,
    and Arkansas.
        The Committee is supportive of efforts to develop a
    statewide Telemedicine Network to allow Vermont hospitals to
    provide trauma care.
        The Committee is supportive of the efforts of Union
    Hospital in Terre Haute, Indiana in establishing a rural
    telehealth initiative to provide medical services to patients
    in remote and rural areas.
        The Committee is supportive of a Mobile Health Screening
    Program at Western Kentucky University which would provide
    primary care, dental, and mental health examiniations in rural,
    medically underserved areas.
        The Committee understands that Dominican College, located
    in Orangeburg, New York is completing a state-of-the-art center
    and developing a telehealth network for educating teachers of
    the multi-handicapped.
        The Committee is also aware that Daemen College is
    continuing its distance learning/medical linkages to rural
    counties in Western New York.
        The Committee recognizes that the Children's Hospital and
    Regional Medical Center in Seattle, Washington plans to
    initiate a telemedicine project to provide services to patients
    in remote areas that would otherwise be unserved.
        The Committee is supportive of the University of Florida's
    efforts to use cutting-edge technology to provide functional
    imaging of the brain and enhance guided imagery for
    neurosurgery. Through it's Center for Human Brain Functional
    Imaging Technology, the University will accelerate the pace of
    invention and improvement of imaging technologies and enhance
    their applications to the diagnosis and treatment of brain
    diseases.
        The Committee understands that the Children's Hospital and
    Regional Medical Center in Seattle, Washington is establishing
    an interactive telemedicine system to improve the access to and
    quality of cost effective pediatric health care for patients in
    medically underserved rural and Native American areas
    throughout the region.
        The Committee is also aware that the Inland Health
    Northwest rural telemedicine cooperative is beginning a
    demonstration project in telepharmacy to improve outcomes for
    people living in rural areas in Eastern Washington.
        The Committee supports continued funding of the Alaska
    Federal Health Care Access Network, which is bringing
    telehealth services to remote villages and communities
    throughout Alaska, providing linkages between remote and
    inaccessible locations with tertiary care facilities in
    Anchorage and Fairbanks. Continued funding will allow expanded
    installation of telehealth sations and will support bringing
    non-federal partners into the project.
        The Committee recognizes that the Nevada Telemedicine
    Network plans to provide clinical, consultative and medical
    education services to patients in rural NV and to develop a
    full service, high performance computing facility at the Las
    Vegas Technology Center to support biomedical, bioengineering
    and biotechnological programs.
        The Committee continues to be supportive of the Southwest
    Alabama Network for Education and Telemedicine at the
    University of South Alabama in Mobile.
        The Committee continues to be supportive of the University
    of South Alabama telemedicine project which is extending
    medical services to remote rural areas which are traditionally
    underserved.
        The Committee understands that the Idaho Telehealth
    Integrated Care Center (ITICC) at Idaho State University is
    establishing a comprehensive telehealth clinic to provide
    consultation and technical assistance in a variety of fields in
    order to provide health care in rural and frontier areas.

    Critical care programs

        The Committee has grouped the following ongoing and
    proposed activities into a new cluster proposed by the
    administration: emergency medical services for children, the
    traumatic brain injury program, trauma care/emergency medical
    services, and poison control centers.
        The Committee provides $15,000,000 for emergency medical
    services for children. This is $2,000,000 below the 2000 level
    and the same as 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 consider EMSC a high priority,
    focusing on the development of prevention and treatment
    programs and education of emergency personnel in remote and
    rural areas such as Alaska and Hawaii, using telemedicine
    technology. For example, a collaborative effort with Tripler
    Army Medical Center, using the telemedicine technology already
    available would enhance the development of the EMSC
    initiatives.
        The Committee provides $6,000,000 for poison control center
    activities, which is $4,500,000 above the administration
    request. The Committee is pleased with the actions by HRSA and
    CDC to initiate planning for a national toll-free telephone
    number for poison control services. The funds provided will
    support the development and assessment of uniform patient
    management guidelines and will support HRSA's participation
    with CDC and the joint CDC/HRSA advisory committee on planning
    efforts.
        The Committee has included partial funding for the national
    poison control centers, as authorized pursuant to Public Law
    106-174, the Poison Control Center Enhancement and Awareness
    Act, and expects that these funds shall be administered and
    distributed according to the Act.
        The Committee commends the Emergency Medical Services for
    Children program for the delivery of emergency medical services
    to acutely ill and seriously injured children. The Committee
    also commends the Partnership for Children initiative which has
    provided useful training and information to pediatric emergency
    care personnel. The Committee urges HRSA to consider EMSC a
    high priority, focusing on the development of prevention and
    treatment programs and education of emergency personnel in
    remote and rural areas such as Alaska and Hawaii. Hana, on the
    island of Maui, provides an excellent example of EMSC design
    and implementation efforts targeted toward rural communities.
    Hana is extraordinarily isolated with pressing health care
    needs and has a population that is nearly one-third children
    and adolescents.
        The Committee supports the effective collaboration between
    NHTSA and HRSA in the administration of the EMSC program. The
    Committee urges the EMSC program to develop practice guidelines
    and other quality of care assessment and enhancement
    initiatives. The Committee encourages the EMSC program to
    continue a research focus and to develop a means of collecting
    data to ensure accountability and to better track
    accomplishments and needs.
        The Committee believes that HRSA could encourage those
    States receiving trauma systems support and development funds
    to incorporate issues of traffic congestion into their overall
    trauma systems response plans.
        The Committee provides $5,000,000 for the traumatic brain
    injury program, which is the same as the 2000 level and the
    comparable administration request. This item was previously
    funded through the SPRANS component of the maternal and child
    health block grant. The program supports implementation and
    planning grants to States for coordination and improvement of
    services to individuals and families with traumatic brain
    injuries. Such services can include: prehospital care,
    emergency department care, hospital care, rehabilitation,
    transitional services, education, employment, and long-term
    support.
        In rural Alaska, emergency medical service workers are
    often the only health providers for rural Alaskans and for the
    many tourists from all over the world who visit Alaska. The
    Committee is aware that lack of proper training for EMS workers
    in these conditions may result in needless injury or death and
    supports the request of the State of Alaska to establish a
    training program for rural Alaskan EMS workers.
        The Committee provides $3,000,000 for trauma/emergency
    medical services. This is a new activity for fiscal year 2001.
    This program is intended to improve the Nation's overall
    emergency medical system, including the joint efforts between
    HRSA and the National Highway Traffic Safety Administration to
    assess state systems and recommend improvements to the current
    system.
        The Committee is supportive of the American Trauma
    Society's plans to train trauma center and emergency room
    personnel to help families and individuals cope with the sudden
    news that someone close to them has suffered a traumatic injury
    or death.
        The Committee acknowledges the work of the Center for
    Injury Sciences in conducting an innovative program that
    integrates clinical care with clinical and basic research to
    reduce the risk of death and injury from trauma.
        The Committee is supportive of the work of the Brain Trauma
    Foundation in improving the prehospital care of persons with
    traumatic brain injury.

    Black lung clinics

        The Committee includes $6,000,000 for black lung clinics.
    This is $57,000 above both the fiscal year 2000 amount and 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.

    Nurse loan repayment for shortage area service

        The Committee includes $2,279,000 for nurse loan payment
    for shortage area services. This is the same level as last year
    and the administration request.
        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.

    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 fiscal year 2001
    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 the same as the administration request and the 2000
    level.
        The Committee appreciates the Institute of Medicine study
    of the Pacific Basin health care delivery system, conducted in
    1998. It is the Committee's understanding that the IOM cited
    findings for all health indicators for the people residing in
    the freely associated states, as being significantly worse than
    those for mainland Americans. The Committee, therefore, expects
    the Department to review the IOM findings and initiate
    implementation of its recommendations which include:
    jurisdictional coordination by the Pacific Islanders Health
    Officers Association; use of Tripler Army Medical Center and
    Guam Naval Hospital for care coordination, with emphasis on
    telehealth assessment and management; development of and
    participation in a regional health information system for
    information tracking and storage; continuing education for all
    health providers; and increased involvement in health care,
    particularly womens' health issues.

                      acquired immune deficiency syndrome

                            Ryan White AIDS programs

        The Committee provides $1,650,000,000 for Ryan White AIDS
    programs. This is $69,550,000 below the administration request
    and $55,450,000 above the 2000 level.
        Recent advances in diagnosis, treatment, and medical
    management of HIV disease has resulted in dramatic improvements
    in individual health, lower death rates and transmission of HIV
    from mother to infant. The Committee recognizes, however, that
    not all HIV infected persons have benefited from these medical
    advances and expects that the Ryan White CARE Act programs
    provide social and other support services with the specific
    intent of obtaining and maintaining HIV-infected individuals in
    comprehensive clinical care.
        The department is encouraged to identify obstacles
    confronting people with HIV/AIDS in receiving medical care
    funded through the Ryan White programs and to re-examine the
    design of both Ryan White programs and Medicaid in light of the
    changing medical needs of a patient population that is living
    longer with current therapies.
        The Committee is aware of the proposal by the National
    Training Institute to enhance volunteer training, support and
    retention model developed over the past twenty-five years to
    assist people with cancer and HIV/AIDS to help other
    populations needing supportive services.
        The Committee recognizes the recent advances in the
    treatment and medical care of persons with HIV disease and the
    need for early access to these interventions and services.
    Furthermore, the Committee understands that disparities exist
    in accessing and maintaining the benefits of these recent
    advances among communities highly impacted by HIV and AIDS. The
    Committee requests that the Secretary fund an independent study
    through the Institute of Medicine to evaluate the effectiveness
    of the current role and structure of the Ryan White CARE Act
    programs on improving access to effective HIV treatments among
    underserved communities. The report should include a review of
    the current structure of the types of services funded through
    the CARE Act and their relation to medical care, mechanisms to
    assure access to quality medical services to underserved and
    uninsured populations, and the effectiveness of the funding
    allocation formulas in targeting communities of the greatest
    need. The report should include recommendations to ensure that
    all persons with HIV-infection have reasonable access to new
    treatments and quality medical care and providers. The study
    should be made available by the end of the fiscal year.
        The Committee urges HRSA to assume a leadership role in
    ensuring that the prevention, treatment, and management of HIV/
    AIDS in correctional facilities is a high priority and that the
    care rendered meets current medical standards for AIDS care.
    The Committee encourages HRSA to collaborate with the Federal
    Bureau of Prisons, CDC, the White House Office on AIDS Policy,
    and other entities of jurisdiction.

    Emergency assistance--title I

        The Committee recommends $556,500,000 for emergency
    assistance grants to eligible metropolitan areas
    disproportionately affected by the HIV/AIDS epidemic. This
    amount is $10,000,000 above the fiscal year 2000 amount and
    $30,000,000 below the administration request. These funds are
    provided to metropolitan areas meeting certain criteria. 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.
        The Committee notes the work by the Department with Alameda
    County, California, which is the only county and health
    jurisdiction thus far which has declared a public health
    emergency on AIDS in the African-American community. Recent
    data clearly indicates that new HIV infections and AIDS
    diagnoses among African-Americans are growing. The county has
    requested emergency assistance to provide prevention and
    treatment services, as well as research in communities where
    HIV/AIDS prevalence is at crisis levels. The declared public
    health emergency has moved HHS to give a high priority to the
    city of Oakland and Alameda County. HHS plans to deploy a
    crisis response team to further evaluate the disease's
    devastating impact in Alameda County's health jurisdiction.

    Comprehensive care programs--title II

        The Committee has provided $834,000,000 for HIV health care
    and support services. This amount is $30,000,000 below the
    administration request and $10,000,000 above the 2000 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 continues to be encouraged by the progress of
    protease inhibitor therapy in reducing the mortality rates
    associated with HIV infection and in enhancing the quality of
    life of patients on medication. The Committee has approved bill
    language for $538,000,000 for AIDS medications, compared to
    $528,000,000 provided for this purpose in fiscal year 2000. The
    Committee further urges HRSA to encourage States to utilize
    Federal ADAP funding in the most cost-effective manner to
    maximize access to HIV drug therapies and to eliminate cost-
    shifting from Medicaid to the State ADAP programs. States with
    ADAP funding should be allowed the flexibility to purchase and
    maintain insurance policies for eligible clients including
    covering any costs associated with these policies, or continue
    to pay premiums on existing insurance policies that provide a
    full range of HIV treatments and access to comprehensive
    primary care services, as determined by a State. Funds should
    not be committed to purchase insurance deemed inadequate by a
    State in its provision of primary care or in its ability to
    secure adequate access to HIV treatments.
        It has been brought to the Committee's attention that many
    state HIV/AIDS programs seek increased flexibility to use some
    ADAP resources to fund medical care, laboratory tests, and
    services to enhance patient adherence to pharmaceuticals. The
    agency should consider allowing states to redirect a reasonable
    portion of ADAP funds, as determined in collaboration with the
    states, to such services that enhance the ability of eligible
    people with HIV/AIDS to gain access to, adhere to, and monitor
    their progress in taking HIV-related medications. The agency
    should submit a report to the Committee with details on the
    implications of such a change prior to implementation.
        The Committee is concerned that American Indians and Alaska
    Natives are not participating in ADAP to the extent that these
    services are needed. The burden of covering costs for AIDS-
    related drugs is often falling on local Indian Health Service,
    tribal or urban program providers, or on the families of
    American Indians or Alaska Natives with AIDS. The Committee
    requests that HRSA and IHS work together to ensure American
    Indians and Alaska Natives are participating proportionately in
    each State, and there are not barriers to American Indians
    accessing the ADAP drugs due solely to their status as American
    Indians.

    Early intervention program--title III-B

        The Committee recommends $166,400,000 for early
    intervention grants. This is $28,000,000 above the 2000 level
    and $5,000,000 below 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 comprehensive primary care,
    including 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 strengthen 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.
        Priority should be placed on funding new projects in rural,
    medically underserved areas, and secondary cities outside of
    major metropolitan areas in order to build clinical capacity
    for the delivery of HIV care among clinicians serving high-risk
    populations, minorities, and those who are unable to access
    clinical HIV care for economic reasons. In building capacity,
    the goal is to develop regional centers of knowledgeable
    clinicians to improve access to quality HIV treatment based
    upon the evolving HIV treatment guidelines of DHHS.
        As noted for the last 2 years, the Committee is aware that
    the FDA has approved at-home telemedicine diagnostic testing
    methods which seem to offer important fiscal, privacy and
    public health advantages. A study published by CDC indicates
    that a significant percentage of individuals using public
    clinics for on-site HIV testing do not return for their
    results. HRSA data indicates that the average cost for on-site
    testing, counseling and referral services is about $160 per
    person, compared with the $40 cost for at-home telemedicine
    testing. The Committee is concerned by the lack of an adequate
    effort in this area and again asks HRSA to evaluate and report
    on the benefits and costs of varying testing methods, including
    at-home telemedicine and to make program changes that are
    warranted. The Committee would like to be briefed by HRSA on
    their progress by November 1, 2000.

    Pediatric AIDS demonstrations--title IV

        The Committee recommends $58,450,000 for title IV pediatric
    AIDS, which is $1,550,000 below the administration request and
    $7,450,000 above the 2000 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.
        With additional funding, the Committee urges HRSA to expand
    comprehensive services for youth, including case finding,
    mental health and early intervention services. The Committee
    also urges the agency to expand services for HIV-positive women
    and men who are primary care givers of infected or affected
    children or youth. In allocating new funds, the Committee
    further urges the agency to create a consolidated grant
    application process and to ameliorate administrative burdens to
    grantees to the fullest extent that is practical. The Committee
    is aware of the efforts of the AIDS Policy Center for Children,
    Youth and Families to expand necessary services to those in
    need.
        Some 5 percent of the funds appropriated under this section
    may be used to provide peer-based technical assistance. Within
    this amount, sufficient funds are available to maintain and
    expand work being done to create a national consumer and
    provider education center on the use of various strategies and
    planning in the care of children, youth, women and families
    infected with or affected by HIV and AIDS.
        Transmission of HIV to newborns can be reduced by over 90
    percent if pregnant women are aware they are HIV-positive and
    are effectively treated with drugs prior to birth. To improve
    testing of pregnant women and reduce the incidence of HIV
    births, last year the Committee encouraged consideration of
    demonstration projects involving at-home diagnostic testing
    with telemedicine support, yet no action was taken. The
    Committee continues to strongly believe the use of at-home
    telemedicine services for HIV testing would be an effective
    outreach tool for pregnant women in high HIV prevalence states
    and urges HRSA to proceed with demonstrating this approach.

    AIDS dental services

        The Committee provides $8,000,000 for AIDS dental services,
    which is $500,000 less than the administration request and the
    same as the 2000 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.
        The Committee recognizes the importance of oral health care
    providers in the diagnosis of HIV and in treating the painful
    and debilitating oral manifestations of this disease. The
    Committee supports this program as it improves access to oral
    health services for low-income and uninsured people living with
    HIV and AIDS by providing partial reimbursement to dental
    education institutions for delivering care. The Committee
    recognizes that these dental services are vital because they
    are often the only services available to AIDS patients since
    many State Medicaid programs do not cover adult dental
    services.
        The Committee recognizes the effectiveness of this program
    in training dentists and in assisting with the cost of
    providing unreimbursed oral healthcare to HIV patients. The
    Committee noted last year the importance of providing adequate
    time and technical assistance for grantees to comply with the
    new uniform reporting requirements to better access outcomes
    and performance measures. With that in mind, the Committee
    recommends that HRSA provide a 1-year extension to its current
    deadline so that grantees can put into place reporting
    mechanisms that meet the new requirements in a manner
    consistent with State and institutional confidentiality
    protections.

    AIDS education and training centers

        The Committee recommends $26,650,000 for the AIDS education
    and training centers [AETC's]. This amount is the same as the
    2000 level and $2,500,000 below 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. The targeted education efforts by AETC's are
    needed to ensure the cost-effective use of the significant
    expenditures in Ryan White programs and the AIDS drugs
    assistance program. The agency is urged to fully utilize the
    AETC's to ensure the quality of medical care and to ensure, as
    much as possible, that no individual with HIV receives
    suboptimal therapy due to the lack of health care provider
    information.
        Emphasis should be placed on building clinical treatment
    capacity by reaching health professionals providing care to
    persons within medically underserved areas, minorities, the
    economically underprivileged, and rural populations. The goal
    is to provide clinical education and consultation to increase
    knowledge and skills of the targeted clinician group providing
    care to low or medium volume of HIV patients thereby improving
    the early and ongoing access to quality HIV treatment by
    clinicians within urban and rural medically underserved areas
    and secondary cities outside of major metropolitan areas.

    Family planning

        The Committee recommends $253,932,000 for the title X
    family planning program. This is $20,000,000 below the
    administration request and $15,000,000 above the 2000 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 remains concerned that programs receiving
    title X funds ought to have access to these resources as
    quickly as possible. The Committee, therefore, again 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 intends that at least 90 percent of funds
    appropriated for Title X activities be for clinical services
    authorized under section 1001 of the Act. All such funds for
    section 1001 activities are to be provided to the regional
    offices to be awarded to grantees to provide family planning
    methods and services as specified by the Title X statute. The
    Committee further expects the Office of Family Planning to
    spend all available year-end funds in section 1001 activities.
        Over the past 2 years, the Committee has provided
    significant funding increases for Title X. The Committee has
    also provided instruction for the distribution of these funds.
    Therefore, the Committee requests the Secretary to submit a
    report detailing how the funds were allocated for section 1001
    (by Federal region), 1003, and 1004 for fiscal years 1999 and
    2000. The report should also contain the total Federal expenses
    for program administration, including the number of FTEs being
    supported by Title X. This report shall also include a list of
    all grantees, their funding, and the main activities to be
    undertaken with Title X funds.

    Rural health research

        The Committee recommends $5,000,000 for the Office of Rural
    Health Policy. This is $28,201,000 below the fiscal year 2000
    level and $6,713,000 less than the comparable 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.
        The Committee is supportive of efforts to expand and
    integrate the services of behavioral and mental health
    professionals, including psychologists, in underserved rural
    areas, particularly in areas affected by the current farm
    crisis.
        The Committee is supportive of continuing funds to the
    Children's Health Fund to implement a rural health initiative
    that would expand availability and accessibility of pediatric
    care to underserved rural communities.
        The Committee is supportive of efforts by the Iowa
    Department of Public Health to demonstrate the use of portable
    technology to improve the delivery of health care in rural
    areas by public health nurses.

    Health care facilities

        The Committee provides $10,000,000 for health care
    facilities, which is $102,408,000 below the 2000 level and
    $10,000,000 above the administration request. Funds are made
    available to public and private entities for construction and
    renovation of health care and other facilities.

    National Hansen's Disease Program buildings and facilities

        The Committee recommends $250,000 for buildings and
    facilities, the same as the administration request and the same
    as the fiscal year 2000 amount.

    Rural hospital flexibility grants

        The Committee includes $25,000,000 for rural hospital
    flexibility grants, which is the same as the administration
    request and last year's appropriation.
        This program administers the Rural Health Flexibility
    Program previously administered by the Health Care Finance
    Administration. Under this program, eligible rural hospitals
    may convert themselves into limited service facilities termed
    Critical Care Hospitals. Such entities are then eligible to
    receive cost-based payments from Medicare. The grant component
    of the program assists states with the development and
    implementation of state rural health plans, conversion
    assistance, and associated activities.

    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 $17,200,000 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 $1,200,000 higher
    than what was authorized to be collected in fiscal year 2000.
    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.

    Health care integrity and protection data bank

        The administration has proposed to create a new data bank
    intended to collect, maintain, and report on certain actions
    taken against health care providers, suppliers, and
    practitioners. This information would be collected from and
    made available to government agencies, health plans, and to
    self-queries made by individuals and entities. The
    administration further proposes to fund the data bank through
    user fees. The Committee assumes that this amount will be
    provided entirely though the collection of user fees and will
    cover the full cost of operating the data bank.

    Healthcare access for the uninsured

        This program is designed to increase the capacity and
    effectiveness of community health care institutions and
    providers who serve patients, regardless of their ability to
    pay. These funds will enable public, private, and non-profit
    health entities to assist safety-net providers in developing
    and expanding integrated systems of care and address service
    gaps within such integrated systems. The Committee provides
    $25,000,000 for this activity, which is $15,000,000 less than
    fiscal year 2000 and $100,000,000 less than the
    Administration's request. This appropriation will fund all
    continuing grants.

    Program management

        The Committee recommends $135,766,000 for program
    management activities for fiscal year 2000. This is $11,413,000
    higher than the administration request and $11,000,000 more
    than the fiscal year 2000 level.
        The Committee continues to support the efforts of the
    American Foundation for Negro Affairs of Philadelphia and
    expects continued support at the level appropriated in fiscal
    year 2000.

                   medical facilities guarantee and loan fund

    Appropriations, 2000....................................      $1,000,000
    Budget estimate, 2001...................................................
    Committee recommendation................................................

        The Committee has not included funding for the Medical
    Facilities and Guarantee and Loan Fund. This fund was
    established in 1972 under the Medical Facilities Construction
    Program in order to make funds available for construction of
    medical facilities. The fund is established in the Treasury
    without fiscal year limitation to pay interest subsidies, make
    payments of principal and interest in the event of default on a
    guaranteed loan, and repurchase, if necessary loans sold and
    guaranteed. There are sufficient carryover funds from prior
    years' appropriations to pay defaults and interest subsidy
    payments; therefore, no appropriation is required to cover
    these payments.

                       health education assistance loans

        The Committee recommends no additional guarantee authority
    for new HEAL loans in fiscal year 2001, which is the same as
    the President's request.
        The Committee recommends $10,000,000 to liquidate 1999
    obligations from loans guaranteed before 1992, which is the
    same as the administration request and $5,000,000 below the
    2000 appropriation.
        For administration of the HEAL Program including the Office
    of Default Reduction, the Committee recommends $3,679,000,
    which is $8,000 below the 2000 appropriation and the same as
    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.

                     vaccine injury compensation trust fund

    Appropriations, 2000....................................     $65,300,000
    Budget estimate, 2001...................................     117,347,000
    Committee recommendation................................     117,347,000

        The Committee recommends that $117,347,000 be released from
    the vaccine injury compensation trust fund in fiscal year 2001,
    of which $2,992,000 is for administrative costs. This amount is
    the same as the budget request and $7,000 less than the fiscal
    year 2000 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.

                  RICKY RAY HEMOPHILIA RELIEF ACT FUND PROGRAM

    Appropriations, 2000....................................     $75,000,000
    Budget estimate, 2001...................................     100,000,000
    Committee recommendation................................      85,000,000

        The Committee makes available $85,000,000 from the Ricky
    Ray Hemophilia Relief Act Fund in fiscal year 2001, of which
    $10,000,000 is for program management. This amount is
    $15,000,000 below the budget request and $10,000,000 above the
    fiscal year 2000 level. The Ricky Ray Hemophilia Relief Act of
    1998 established in the Department of the Treasury a trust fund
    known as the Ricky Ray Hemophilia Relief Fund to provide
    compassionate payments to certain individuals with blood-
    clotting disorders, such as hemophilia, who contracted HIV
    through the use of antihemophilic factor administered between
    July 1, 1982 and December 31, 1987. Spouses who contracted HIV
    from these individuals and children who acquired HIV
    perinatally from their mothers and specified survivors of these
    categories of individuals may also be eligible for payments.

                   Centers for Disease Control and Prevention

                    disease control, research, and training

    Appropriations, 2000....................................  $3,036,991,000
    Budget estimate, 2001...................................   3,239,487,000
    Committee recommendation................................   3,204,496,000

        Financial Management Review.--The Committee was extremely
    concerned to learn of inconsistencies in funding of the
    Hantavirus Program, as well as the funding for the Chronic
    Fatigue Syndrome (CFS) during fiscal years 1995-1998. The
    amounts obligated in specific disease areas varied from
    congressional expectations and understandings. The GAO at the
    Committee's request is conducting an extensive review to
    develop procedures and practices that could mitigate or prevent
    future occurrences. In addition to the GAO review, the
    Committee was pleased to learn that CDC has also obtained the
    services of a professional management consultant to conduct a
    full-scope management review of CDC's general fiscal management
    practices, to document practices throughout the budget
    allocation and execution process and to suggest improvements,
    based on industry and other Federal agency best practices. The
    Committee recommends that this professional management firm and
    GAO closely collaborate to assure a thorough and efficient
    review. In conducting this independent management review, the
    Committee directs CDC to review the entire continuum of fiscal
    management activities, beginning from line item Congressional
    appropriations, CDC's budget allocation process, and budget
    executive activities of CDC's organizational components,
    centers, Institutes and offices.
        For the Centers for Disease Control and Prevention [CDC],
    the Committee provides $3,204,496,000, which is $167,505,000
    above the 2000 level and $34,991,000 below 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.
        The Committee has provided additional funds for
    bioterrorism and related public health infrastructure
    activities within the public health and social services fund.

    Preventive health and health services block grant

        The Committee recommends $134,279,000 for the preventive
    health and health services block grant. Of the amount provided,
    $130,899,000 is for program activities, which is $925,000 below
    the 2000 level and the same as the administration request. For
    salaries and expenses within this category of activities,
    $3,380,000 has been provided, which is the same as the 2000
    level and $866,000 below the request. The Committee
    recommendation includes an additional $7,000,000 for rape
    prevention activities to be carried out through the preventive
    health and health services block grant. This amount is the same
    as the 2000 appropriation.
        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 $14,713,000 for prevention
    centers. Of the amount provided, $14,080,000 is for program
    activities, which is $3,039,000 below the 2000 level and the
    same as the administration request. For salaries and expenses
    within this category of activities, $633,000 has been provided,
    which is the same as the 2000 level and $32,000 below the
    administration request.
        CDC's prevention centers program provides grants to
    academic programs to support applied research designed to yield
    tangible results in health promotion, disease prevention,
    tobacco use 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.
        Cardiovascular disease prevention.--The Committee is
    encouraged by CDC's work with State and national health
    organizations to develop an integrated and comprehensive
    national cardiovascular disease health program. The Committee
    encourages the CDC to increase funding for the Cardiovascular
    Disease Health Program, to expand prevention efforts with a
    focus on reducing heart disease and stroke risk factors through
    the promotion of physical activity and good nutrition and to
    prevent or control high blood pressure, elevated cholesterol
    and obesity.
        Disability health promotion.--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.
        Suicide prevention centers.--The Committee recently heard
    testimony about the Suicide Prevention Research Center at the
    University of Nevada School of Medicine Trauma Institute. The
    Committee is aware of the important work the Suicide Prevention
    Research Center is conducting in order to address the gaps in
    our knowledge of suicide. Nevada has had the highest suicide
    rate per capita in the United States for the past 10 years. The
    suicide rate in Nevada is twice the national rate making Nevada
    the most appropriate place to study this important health
    problem. The Committee urges the CDC to give full and fair
    consideration for support of the Suicide Prevention Research
    Center at the University of Nevada School of Medicine Trauma
    Institute.
        Tobacco.--The Committee continues to support within the
    prevention center program a Tobacco Prevention Research Network
    to increase the knowledge base on the most effective strategies
    for preventing and reducing youth tobacco use, as well as on
    the social, physiological and cultural reasons for tobacco use
    among children.

    Sexually transmitted diseases

        The Committee recommends $149,903,000 for sexually
    transmitted disease prevention and control. Of the amount
    provided, $135,978,000 is for program activities, which is
    $14,169,000 above the 2000 level and is $4,000,000 above the
    administration request. For salaries and expenses within this
    category of activities, $13,925,000 has been provided, which is
    the same as the 2000 level and $4,765,000 below the
    administration request.
        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.
        Syphilis and chlamydia elimination.--The agency has
    requested $33,750,168 to fully implement a comprehensive
    strategy to eliminate the prevalence of the disease. The
    Committee recognizes the opportunity to eliminate syphilis but
    also directs the agency to also address chlamydia as a disease
    with widespread prevalence among teens and young adults.
        Both of these activities require additional resources to be
    successful. Therefore, the Committee directs that 50 percent of
    the fiscal year 2001 increase requested be used to implement
    the National Plan to Eliminate Syphilis. The Committee further
    directs that the chlamydia funds be distributed to expand
    services to women and support pilot programs to initiate
    screening and treatment services for men. The Committee urges
    that the remainder of the increased provided in this account be
    directed for infertility prevention programs.
        Tuskegee activities.--The administration proposes
    $2,000,000 in support of bioethics activities at Tuskegee
    University.

    Immunization

        The Committee recommends $993,468,000 for immunization
    activities in fiscal year 2001 authorized under section 317 of
    the Public Health Service Act. Of the amount provided,
    $467,505,000 is for program activities, which is $34,539,000
    above the 2000 level and is the same as the administration
    request. For salaries and expenses within this category of
    activities, $56,909,000 has been provided, which is the same as
    the 2000 level and $5,229,000 below the administration request.
        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 2001 is
    $469,054,000 for the purchase and distribution of vaccines for
    a total immunization program level of $993,468,000 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.
        Many States are experiencing significant instability in
    immunization efforts and had have to cutback on vaccine
    delivery activities as a result of budgetary constraints.
    States continue to struggle to maintain immunization rates and
    in some areas of the country immunization rates of declined.
    These pockets of need create pools of susceptible children and
    increase the risk of dangerous disease outbreaks.
        Alaska's statewide immunization program.--The Committee
    urges CDC to increase section 317 grant support for
    infrastructure development and purchase of vaccines for the
    State of Alaska's universal immunization program. It has been
    brought to the Committee's attention that infrastructure costs
    of delivering vaccines to children in Alaska are substantially
    higher than in other areas of the country because of the many
    small, remote communities which must be served. The Committee
    encourages CDC to support Alaska's request for sufficient
    funding for the purchase of vaccines needed for 90 percent of
    Alaskan children and to provide infrastructure support needed
    to support delivery of these vaccines at the community level.
        Within the amounts appropriated, sufficient funds are
    provided for the purchase of vaccine under the 317 program. 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.
    This will ensure that States receive up to their maximum
    estimates for vaccine purchases and provide CDC with sufficient
    flexibility to reallocate vaccine purchase dollars if States'
    needs prove lower than the amount provided. The Committee
    continues to expect 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 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.
        Measles.--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.
        Polio.--The Committee recommendation includes the
    President's budget request for polio eradication to assist with
    the accelerated effort and continued need for National
    Immunization Days. The Committee is encouraged by the progress
    which has made the Americas, the Western Pacific including
    China, and virtually all of Europe polio-free, but recognizes
    that South Asia and Sub-Saharan Africa remain major reservoirs
    for the polio virus. The Committee believes the recommended
    increase is needed to ensure that African countries meet the
    goal of polio eradication as soon as possible.

    Infectious diseases

        The Committee's recommendation includes $186,000,000 for
    infectious disease activities. Of the amount provided,
    $106,000,000 is for program activities, which is $19,390,000
    above the 2000 level and $6,068,000 below the administration
    request. For salaries and expenses within this category of
    activities, $80,000,000 has been provided, which is the same as
    the 2000 level and $9,454,000 below the administration request.
        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.
        Activity centers.--The Committee is pleased with the work
    of CDC's centers of excellence in infection control, focusing
    upon the problem of antibiotic resistance, and encourages CDC
    to continue to support these applied research efforts and to
    expand the scope of the program.
        The Committee notes CDC's efforts to coordinate public
    health surveillance and communication on infectious and
    emerging infectious diseases including tuberculosis, and
    commends CDC's proposal to include emerging infectious diseases
    in its National Electronic Disease Surveillance Network
    Initiative (NEDSNI).
        Antimicrobial Resistance Initiative.--The Committee is
    concerned over the development of resistance in microbes to
    current antimicrobial therapies. Bacterial resistance to common
    antimicrobial agents has become one of the most serious
    emerging infectious disease threats facing the communities and
    the health care system in the United States. Resistance to drug
    therapies leaves entire populations vulnerable to both simple
    infections and complex bioterrorism, as almost all microbes
    have become resistant to any commercially available product. To
    combat this national health threat, the Committee recognizes a
    need to discover and develop new pharmaceutical products to
    combat these drug resistant microbes. In recognition of the
    growing problem, the CDC's goal is ``to develop and evaluate
    new antimicrobial drugs.'' With the CDC's mission and expertise
    in world-wide surveillance, it is uniquely positioned to
    facilitate the global bio-prospecting and development of new
    pharmacologically active compounds in untapped ocean and land
    environments to combat the growing threat posed by drug
    resistant microbes.
        Recognizing that a greater effort is needed to confront
    this problem, the Committee encourages CDC to provide
    sufficient funds to begin to address several critical areas.
    These include (1) development and evaluation of compounds with
    antimicrobial activity against multidrug resistant strains of
    Staphylococcus aureus, enterococcus, gram-negative hospital
    acquired pathogens, and vancomycin-tolerant pneumococcus; (2)
    development of demonstration projects to combat antimicrobial
    resistance in the hospital and community, particularly in rural
    settings; (3) development of Centers of Excellence in Health
    Care Epidemiology, and (4) enhancement of capacity at the CDC
    to support these and other activities related to control of
    antimicrobial resistance.
        The Committee notes that the University of Mississippi is
    working on such a project and full and fair consideration
    should be given to this project.
        Bioactive compounds.--Furthermore, the Committee, in order
    to accomplish this goal, recognizes the need for the CDC to
    discover and develop life saving and epidemic preventing
    medicines through collaborations with other government agencies
    and public institutions that possess the expertise in the
    development of products from natural sources to identify and
    safely extract prospective bioactive compounds from a variety
    of marine environments as well as the facilities and expertise
    to screen, evaluate and develop candidates for commercial
    pharmacological use. The Committee encourages the agency to
    provide sufficient funds for global bio-prospecting and
    development of new chemical entities for the purpose of
    combating drug resistant infectious diseases.
        Cooley's anemia.--The Committee is pleased to note that the
    agency has begun to work with the Cooley's Anemia Foundation in
    its implementation of improved monitoring of the safety of the
    nation's blood supply, as was recommended last year. With the
    establishment of the Thalassemia Clinical Research Network with
    funding from the National Heart, Lung, and Blood Institute, yet
    another opportunity is now available for coordination to assure
    the best possible monitoring system. The Committee urges the
    agency to integrate its existing monitoring and related
    research efforts with the Network, and other research and
    treatment facilities, to assure that the department achieves
    its goal of a no-risk blood supply. Further, the Committee
    requests that the Hematological Diseases Branch create a
    program of surveillance of blood safety and other transfusion-
    related complications and report back to the Committee by
    December 1, 2000 with an outline of the program.
        Emerging diseases.--The Committee notes that Tulane and the
    University of Mississippi has been working collaboratively to
    address research in the area of malaria, TB and HIV/AIDS. The
    Committee encourages CDC to give full and fair consideration to
    these projects.
        Emerging infections.--The agency has proposed $123,017,143,
    an increase of $24,937,143 to accelerate its efforts to combat
    emerging and re-emerging pathogens that may arise domestically
    or internationally. Of this increase, $17,930,000 is for the
    hepatitis C virus.
        Foodborne diseases.--The agency has proposed $39,450,857 an
    increase of $9,974,857 to implement a national food safety
    initiative that would include the expansion of the interagency
    foodborne disease surveillance program, analysis, training, and
    technology/standards development.
        The Committee requests that CDC prepare and disseminate
    annual summaries of information on foodborne illness, including
    outbreak summaries, surveillance findings, and study results.
    Such summaries would better inform the public on the current
    state of knowledge on the burden of illness, the nature of such
    outbreaks, and thus raise consumer awareness concerning the
    handling and preparation of foods.
        Hantavirus.--The Committee encourages the CDC to provide
    $3,500,000 for hantavirus research and to use a portion of
    these funds to educate the public and medical personnel on the
    prevention of the deadly hantavirus. In the past year, the
    State of New Mexico has experienced several cases of
    hantavirus, and this disease remains a deadly threat to the
    public health. The Committee strongly urges the CDC to
    implement a Hantavirus Education project and to give the New
    Mexico Department of Health full and fair consideration when
    awarding this project.
        Hepatitis.--Hepatitis chronically infects an estimated 4
    million Americans--8,000 to 10,000 people die in the United
    States of hepatitis C related cirrhosis and cancer each year.
    The Committee urges the CDC to provide increased funds for
    hepatitis research.
        Hepatitis C.--The Committee is aware of the research
    recommendations made by the March 1997 Hepatitis C (HCV)
    Consensus Development Conference and the impact on the program
    responsibilities of the CDC. These recommendations included
    continued monitoring of the epidemiology of acute and chronic
    HCV and the development of strategies to educate at-risk groups
    concerning transmission of the disease. The Committee urges the
    Hepatitis Council of the American Liver Foundation and the CDC
    to work together in developing these research initiatives.
        Hepatitis C lookback.--The Committee continues to be highly
    interested in supporting the Secretary's lookback initiatives
    regarding screening and counseling for people who may have been
    infected with hepatitis C through blood transfusions before
    1992. The Committee is aware that CDC is supporting an
    evaluation of the adequacy of ongoing efforts to screen and
    counsel these individuals and believes it is critical that such
    an assessment be made at least quarterly and made public. The
    Committee again calls upon CDC to assure that those potentially
    infected receive appropriate counseling and screening, and
    encourages CDC to develop a centralized national screening
    program supported by a toll-free telephone number-based
    operation, involving risk assessment, convenient screening and
    counseling. Under this program, persons receiving lookback
    notification letters would be advised of the hotline service
    that provides education and telephone counseling and
    coordinates convenient testing.
        The Committee is aware of the critical importance of
    prevention and detection of individuals at high-risk for
    Hepatitis C (HCV) and HIV/AIDS, and strongly urges the
    Department to evaluate and support new more efficient testing
    technologies such as at-home tests and rapid tests.
        Infectious Disease Surveillance.--The Committee is aware of
    an effort now underway, involving the University of Texas
    Medical Branch at Galveston and the University of Texas Health
    Center at Tyler, to establish a permanent, physician-based
    emerging infectious disease surveillance network in the lower
    Rio Grande Valley. The network will provide free-of-charge
    diagnostic services to physicians involved in the project to
    monitor and report on dengue fever, tuberculosis, St. Louis
    encephalitis, hepatitis C, and flea-borne typhus, all of which
    occur in higher rates along the United States/Mexico border.
        Lyme disease.--The Committee is concerned regarding reports
    regarding the current Lyme disease surveillance case
    definition. The definition states that ``this surveillance case
    definition was developed for national reporting of Lyme
    disease, however there is concern that it is not appropriate
    for clinical diagnosis.'' The definition is reportedly misused
    as a standard of care for healthcare reimbursement, product
    (test) development, medical licensing hearings, and other legal
    cases. The CDC is encouraged to look into this situation and
    correct the definition if inaccurate and issue an alert to the
    public and physicians to correct the definition.
        The Committee recommends that the CDC strongly support the
    re-examination and broadening of the Lyme disease surveillance
    case definition by the CSTE, with public input into this
    process. By developing other case definition categories while
    leaving the current ``confirmed case'' category intact, the
    true number of Lyme cases being diagnosed and treated will be
    counted more accurately, lending to improved public health
    planning. The CDC is encouraged to include a broad range of
    scientific viewpoints in the process of planning and executing
    its efforts. This includes the incorporation of input from
    community-based clinicians with extensive experience in
    treating these patients, voluntary agencies who have advocacy
    in their mission, and patient advocates in planning committees,
    meetings, and outreach efforts.
        West Nile virus.--The Committee is concerned regarding the
    outbreak of West Nile-like virus that occurred last summer in
    New York, Connecticut and New Jersey. The Committee urges the
    CDC to increase funding and research activities in this area to
    detect and combat mosquito-borne infectious disease outbreaks
    such as the West Nile Virus.

    Tuberculosis elimination

        The Committee's recommendation provides $120,721,000 for
    CDC's activities to prevent or control tuberculosis. Of the
    amount provided, $113,413,000 is for program activities, which
    is $7,007,000 below the 2000 level and the same as the
    administration request. For salaries and expenses within this
    category of activities, $7,308,000 has been provided, which is
    the same as the 2000 level and $6,951,000 below the
    administration request.
        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.
        Tuberculosis.--The Committee commends CDC for its continued
    efforts to control tuberculosis (TB) in the United States, as
    demonstrated by the 7th year of declining TB trends reported
    for 1999. However, the Committee remains concerned about the
    threat of multi-drug resistant tuberculosis. The Committee is
    also concerned that, until global control efforts are more
    effective and new treatments and effective vaccines are
    developed, the global crisis on TB will continue to directly
    impact the United States. Therefore, the Committee urges CDC to
    continue to work with domestic partners to maintain strong
    prevention and control programs. In addition, the Committee
    encourages CDC to work with international partners to assure
    the success of international control programs, and to encourage
    and support, when possible, the development of new TB
    treatments and the development of an effective TB vaccine.

    Chronic and environmental disease prevention

        The Committee's recommendation includes $382,733,000 for
    chronic disease prevention activities. Of the amount provided,
    $304,553,000 is for program activities, which is $18,008,000
    above the 2000 level and $11,439,000 above the administration
    request. For salaries and expenses within this category of
    activities, $78,180,000 has been provided, which is the same as
    the 1999 level and $13,260,000 below the administration
    request.
        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.
        Alaska's study of environmental health contaminants.--The
    Committee encourages 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 and
    expanding existing cooperative agreements with State
    departments of health in the region when undertaking this
    initiative to expand it to include field studies of the effects
    of environmental chemical contaminants and naturally occurring
    metals in subsistence foods in remote arctic communities,
    measurement of PCB levels in such communities, document mercury
    levels in ancient humans, documentation of incidence of
    childhood asthma and development of public health
    recommendations on food consumption in arctic subsistence
    users.
        Animal modeling.--The Committee encourages the CDC to
    provide increased dollars for research on animal modeling of
    chronic human diseases such as cancer, cystic fibrosis,
    hypertension and other diseases. The University of North
    Carolina at Chapel Hill has been operating animal modeling
    programs and the Committee urges that the CDC give this project
    full and fair consideration.
        Arthritis Action Plan.--This National Arthritis Action
    Plan, developed jointly between the Arthritis Foundation and
    the CDC, is just beginning to translate the recently gained
    knowledge about early diagnosis and treatment of arthritis into
    tangible clinical results in the treatment of the 43 million
    Americans with arthritis. The Committee supports these efforts
    and encourages the CDC to increase funds for States to expand
    their Arthritis Action Plan activities and help educate more
    Americans about the options in treating arthritis.
        Asthma.--The Committee is pleased with the work that the
    CDC has done to address the increasing prevalence of asthma.
    However, the increase in asthma among children, particularly
    among inner-city minorities, remains alarming. The Committee
    urges CDC to expand its outreach aimed at increasing public
    awareness of asthma control and prevention strategies,
    particularly among at risk minorities populations in undeserved
    communities. The Committee also encourages CDC to work with
    other Public Health Service (PHS) agencies at NIH, HRSA, and
    the Office of the Surgeon General to develop a PHS-wide plan to
    control asthma. The Committee urges the CDC to provide
    additional monies for asthma activities.
        The Committee is aware of an effort by the Cook County
    Bureau of Health Services, the Asthma Champion Initiative, to
    reduce morbidity and morality from asthma in the community
    areas in Cook County, Illinois with the highest prevalence and
    inadequate service.
        Asthma research centers.--It has been brought to the
    Committee's attention that the Meridian Health System's
    Pediatric Asthma Research Center (PARC) was developed to
    provide family community outreach and education via a mobile
    asthma learning center, as well as providing on-site education
    at all system hospitals and health centers. The Committee also
    notes that Forum Health is currently operating a pediatric
    asthma disease management program to better diagnose children.
    The Committee encourages CDC to give both of these projects
    full and fair consideration.
        Autism.--The Committee is pleased with the work being done
    by Marshall University's Autism Training Center. The Committee
    encourages the CDC to give full and fair consideration to the
    Center to expand and implement similar programs focused on
    infants, toddlers, and preschoolers.
        Biomonitoring program.--The Committee supports the CDC
    Biomonitoring Program and the study of environmental toxins and
    their relationship to chronic diseases, such as asthma, many
    birth defects, and cancer to increase our understanding of the
    cause of many chronic diseases and conditions and to facilitate
    the development of effective prevention strategies. The
    Committee is interested in pursuing the development of a
    coordinated system among all of the States to identify and
    track disease and conditions caused by exposure to
    environmental toxins and asks that the Director prepare a plan
    to implement such a system, coordinated with existing efforts,
    for presentation at the fiscal year 2002 appropriations
    hearings.
        Birth defects.--The Committee recognizes that human and
    economic toll of birth defects is significant and tragic. Birth
    defects are the leading cause of infant mortality and also a
    leading cause of childhood disability. The Committee encourages
    the agency to increase funding to continue its current programs
    and to expand its efforts in birth defects surveillance,
    research and prevention. The Committee is especially interested
    in efforts to prevent neural tube defects (NTDs). These birth
    defects, such as spina bifida, are among the most serious,
    costly and preventable birth defects. The Committee commends
    the CDC for initiating a folic acid education campaign and
    encourages CDC to expand its efforts to enhance State and local
    activities to educate women about this effective prevention
    strategy.
        Cancer.--Many of the cancer trials conducted to date are
    skewed toward younger persons even though older persons
    comprise the majority of cancer patients. Recent studies have
    shown that older persons could benefit and should be included
    in more aggressive cancer treatment research and prevention, so
    the number and range of eligible older persons is expected to
    dramatically increase over the next few years. Research is also
    needed to assess changes in patient quality of life as a result
    of nutrition intervention. More prospective, randomized
    clinical trials of older cancer patients are necessary to
    determine whether a relationship exists between nutrition
    support and clinical outcomes for cancer patients.
        The Committee is encouraged by the progress made by the
    Medical University of South Carolina toward establishing a
    cancer prevention and control program to develop various high-
    risk registries for patients with family histories of cervical,
    oral, esophageal, pancreatic, or lung cancer, and screen for
    genes that may be conveying this increased risk.
        Cancer epidemiology research.--The Committee encourages the
    CDC to establish a cancer epidemiology research training
    program. Funds could be used to provide training in designing
    and conducting multidisciplinary population-based basic and
    applied cancer epidemiology research for graduate and
    undergraduate students.
        Cancer in ethnic minorities and the medically
    underserved.--The Committee encourages the CDC to increase the
    funding for cancer control programs, including increases for
    the prostate, colorectal, and other cancer screening programs.
    The Committee also directs CDC to evaluate and document: (1)
    the barriers to access and implementation of effective
    screening and prevention programs it coordinates with the
    programs of States, tribes, and community health organizations;
    and (2) the subsequent linkages between detection, treatment
    and follow up to screening. The Committee also urges
    improvements in cancer surveillance efforts and directs
    substantial increases for the National Program of Cancer
    Registries, the Behavioral Risk Factors Surveillance Survey,
    and expansion of the National Health Nutritional and
    Examination Survey (HANES) to all ethnic minority and medically
    underserved populations.
        Cardiovascular disease.--The Committee is aware that
    despite improved detection and treatment of cardiovascular
    disease over the past two decades, severe hypertension is
    prevalent throughout the Southeastern United States, with
    recent data showing that the death rates from cardiovascular
    disease in this region remain significantly above the national
    average. The disparity in treatment control rates in the South
    as compared to the nation indicates a compelling need for an
    aggressive approach to reduce the excess risk of cardiovascular
    death. The Committee is aware of the work of the Southeastern
    Centers of Cardiovascular Excellence Program headquartered at
    the Wake Forest University School of Medicine and encourages
    CDC to provide funding to expand this program.
        Cardiovascular and other chronic diseases in African-
    American populations.--The Committee recognizes the high
    prevalence of cardiovascular and other chronic diseases in the
    Mississippi Delta's minority populations. The Committee also
    recognizes the work of the Jackson Heart Study in allowing the
    examination of cardiovascular disease in the African-American
    population. A needed component of this research is the
    examination of epidemiological risk factors contributing to the
    extremely high prevalence and incidence of cardiovascular and
    other chronic diseases in these minority populations. The
    prevention center would allow collaboration with the Jackson
    Heart Study as well as independent research activities to
    combat these chronic diseases through the epidemiological
    identification of risk factors and disease predictors. The
    Committee encourages the CDC to establish a cardiovascular and
    chronic disease research prevention center for the purpose of
    fostering epidemiological research among minorities with
    chronic diseases.
        Chronic fatigue syndrome.--The Committee is pleased that
    CDC intends to restore $12,900,000 to the CFS research program,
    in addition to CDC's base CFS funding in fiscal years 2000,
    2001, 2002, and 2003. The Committee will continue to monitor
    CDC's CFS research program to ensure that the funds are used in
    priority areas in CFS research and education.
        The Committee strongly encourages CDC to provide the funds
    and the infrastructure to support its ``reinvigorated'' CFS
    research plan, which includes the estimation of sex-, age-,
    race/ethnic-, and socioeconomic-specific prevalence of CFS
    through a national CFS survey; surveillance projects on
    children and adolescents and minorities with CFS; a national
    CFS patient registry; development and testing of an empirically
    derived case definition; studies of etiologic agents,
    diagnostic markers, natural history, and risk factors using
    specialized molecular epidemiology techniques and advanced
    surveillance methodologies; and CFS public education programs
    with special emphasis on general public service announcements
    and specialized efforts to educate primary care providers about
    the detection, diagnosis and treatment of CFS.
        Cardiovascular physical activity promotion program.--The
    Committee is aware that current funding and regulatory
    restrictions have prevented the State of Alaska from applying
    for a statewide cardiovascular disease prevention program, but
    notes that mortality is only one means of assessing the public
    health burden of diseases, and other factors, such as
    prevalence of risk factors for CVD should be considered in
    making State grants. The Committee encourages the agency to
    work with the State of Alaska to implement the Take Heart
    Alaska Cardiovascular Disease Prevention Plan to address
    critical risk factors in Alaska including teen smoking, obesity
    and lack of physical activity.
        Comprehensive health promotion.--The Committee is aware of
    the ``Healthlink'', a program that works to develop and
    implement a comprehensive health promotion initiative for
    senior retirees in Rhode Island. The Committee encourages the
    CDC to give full and fair consideration to this program.
        Craniofacial birth defects research center.--The Committee
    is aware of the University of Louisville Health Sciences
    Center's work to improve the diagnosis, treatment, and
    prevention of congenital craniofacial birth defects. The
    Committee encourages the CDC to give full and fair
    consideration to designating the Craniofacial Birth Defects
    Research Center as one of its National Centers on Birth Defects
    Research.
        Colorectal cancer.--Colorectal cancer is the third most
    commonly diagnosed cancer for both men and women in the United
    States, and the second leading cause of cancer related deaths.
    In 2000, 133,600 new cases will be diagnosed and 56,800 people
    will die from the disease. When colorectal cancer is detected
    and treated early, survival is greatly enhanced. However,
    despite the availability of proven screening tests, only 37
    percent of colorectal cancers are diagnosed while the disease
    is still in a localized stage. The Committee is very pleased
    with the leadership of CDC's National Colorectal Cancer
    Roundtable in promoting the availability and advisability of
    screening to both health care providers and the general public.
    The Committee encourages CDC to expand its partnerships with
    State health departments, professional and patient
    organizations, and private industry to combat this devastating
    disease.
        Complementary and alternative medicine.--As more and more
    Americans use alternative and complementary therapies to
    maintain and improve their health, there is a growing need for
    better consumer information about these therapies. The
    Committee is encouraged by CDC's plans to initiate an expansion
    of their effort in this area. Practice-based assessments and
    the identification and study of promising and heavily used
    complementary and alternative therapies and practices should be
    undertaken and results published. The Committee expects CDC to
    collaborate with the National Center for Complementary and
    Alternative Medicine to assure that its efforts complements
    efforts by this Center. The Committee is also pleased with the
    CDC's efforts to use quantitative policy methods to improve
    public health decision-making to ensure that public health and
    health care programs and policies deliver the greatest possible
    improvement in human health and quality of life and encourages
    CDC to expand these efforts. The Committee further encourages
    the CDC to include national surveillance of CAM utilization and
    health outcomes, mind body medicine, support for academic
    research centers, such as the prevention research centers,
    assess the determinants and outcomes of CAM prevention
    practices.
        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 remains acutely concerned over the high
    incidence of diabetes within the native American, Native
    Alaskan and native Hawaiian populations. The Committee urges
    the CDC to continue to develop a targeted prevention and
    treatment program for these culturally unique yet similar
    groups. The Committee encourages the CDC to continue to work
    with native Americans and native Hawaiians to incorporate
    traditional healing and develop partnerships with community
    centers as a safety net during program development. The
    Committee is pleased with CDC's efforts to work with the
    leadership of native Hawaiian and Pacific Basin Islander
    communities in these efforts.
        Diabetes and weight management.--The Committee is aware of
    efforts at the University of South Carolina School of Public
    Health to develop strategies for weight management in Type II
    diabetes.
        Diabetes Prevention Center.--The Committee urges the CDC to
    provide additional funds for the National Diabetes Prevention
    Center in Gallup, New Mexico, for implementation, design and
    dissemination of successful diabetes prevention models to
    Native American tribes and pueblos.
        The Committee is aware of the efforts of the Texas Tech
    University Health Sciences Center to establish its Center for
    Diabetes Prevention and Control--a national model for the
    prevention and control of diabetes in Hispanic and elderly
    populations. The model Center will use the Health Sciences
    Center's expertise and resources to: create access to
    comprehensive diabetes care; conduct in-depth surveys of the
    incidence, prevalence, and treatment of diabetes in the
    Hispanic population; clinical investigations; and the use of
    telemedicine as a means of delivering diabetes education to
    patients in remote communities and rural areas.
        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.
        Epilepsy.--Although the CDC has developed public health
    strategies to address epilepsy, additional investment is
    required to effectively implement these initiatives. The
    Committee calls on CDC to enhance its epilepsy efforts, with a
    focus on expanding disease surveillance; increasing public
    awareness activities; public and provider education; prevention
    research; and, importantly, to more aggressively address the
    stigma often associated with the disorder. Further, the
    Committee recognizes the recent commitment by CDC to partner
    with a national voluntary health organization dedicated to
    improving the lives of persons with epilepsy and expects CDC to
    work with this.
        Fetal alcohol.--The Committee commends CDC for its efforts
    to research fetal alcohol syndrome prevention and for its
    overall commitment to studying and addressing FAS and the range
    of alcohol-related birth defects. The Committee is pleased that
    CDC is convening a National FAS Task Force and urges them to
    allocate sufficient funds for the project.
        Fetal alcohol syndrome.--The Committee continues to
    encourage the agency to work with the State of Alaska to
    develop a comprehensive statewide strategy to prevent, detect
    and treat fetal alcohol syndrome and notes that Alaska has the
    highest rate of fetal alcohol syndrome in the nation.
        Folic acid education campaign.--The Committee is especially
    interested in efforts to prevent birth defects. Neural tube
    defects (NTD), such as spina bifida, are among the most
    serious, costly and preventable birth defects. Up to 70 percent
    of NTDs could be prevented if all women of childbearing age
    consumed 400 micrograms of folic acid daily before pregnancy.
    The Committee commends the CDC for initiating a folic acid
    education campaign and encourages CDC to expand its efforts to
    enhance State and local activities to educate women and health
    professionals about this effective prevention strategy.
        Glaucoma.--It has come to the Committee's that glaucoma
    testing by the Congressional Glaucoma Caucus has shown that
    high-risk populations, particularly African-Americans, have a
    higher number of individuals affected by glaucoma. Many of
    these individuals are going untested and untreated. The
    Committee urges the agency to provide resources for education,
    prevention and research for these high-risk populations.
        Global micronutrient malnutrition initiative.--The
    Committee is concerned that an international public health
    emergency exists in many regions of the world because of acute
    and chronic illnesses arising from preventable causes such as
    malnutrition. In particular, there are certain crucial
    micronutrients with high impact on a developing child or a
    pregnant women. Micronutrient malnutrition resulting from war
    or poverty, for example, can permanently damage a population's
    physical and mental development. Small amounts of essential
    vitamins and minerals, when delivered through dietary
    diversification, food fortification, and supplementation can
    prevent or reverse many illnesses. The Committee understand
    that no other technology offers as large an opportunity to
    improve lives at such low per-person cost and in such a short a
    period of time. The committee has encouraged NIH and CDC to use
    additional funds to establish international research,
    prevention and intervention strategies for micronutrient
    malnutrition. The Committee encourages the CDC to work with NIH
    and AID to work toward elimination of nutrition-dependent
    diseases such as goiter, cretinism, iron and vitamin A
    deficiencies. The Committee further encourages these agencies
    to coordinate efforts in innercity areas of the United States
    and certain minority populations.
        Health promotion partnerships.--The Committee recognizes
    the successful efforts of the University of Rhode Island's
    Health Promotion Partnership to encourage and promote positive
    behavioral change in college age students as well as in other
    populations. The Committee notes that in 1997 the University
    was one of only 9 colleges out of 116 nationally that showed a
    statistically significant decline in binge drinking. The
    Committee therefore urges the CDC in consultation with the
    National Institute for Alcoholism and Alcohol Abuse at the
    National Institutes of Health to favorably consider proposals
    by the Health Promotion Partnership to build upon these
    successful efforts to develop models that promote positive
    behavior change that can be applied at other institutions.
        Hemophilia.--The Committee urges the CDC to work with the
    National Hemophilia Foundation, to provide additional support
    to meet the disease management, prevention, and outreach needs
    of persons with hemophilia and other bleeding and clotting
    disorders, and in particular, to enhance efforts to address the
    needs of women with bleeding disorders. The Committee requests
    a progress report from CDC on the expanded activities to be
    implemented in fiscal year 2001 to reduce the complications of
    hemophilia.
        Hereditary hemochromatosis.--The Committee recognizes
    hereditary hemochromatosis is one of the most common genetic
    disorders. We appreciate CDC's effort and encourage their
    continued efforts to address hemochromatosis and other iron
    related disorders.
        Heart attack, stroke and other cardiovascular diseases.--
    Cardiovascular diseases remain the leading cause of death of
    men and women and across all racial and ethnic groups in the
    United States, killing more than 950,000 Americans each year.
    Heart disease, alone, is America's No.1 killer and stroke is
    the No. 3 killer. In fiscal year 2000, 18 States will have
    received Federal funding to design and/or deliver
    cardiovascular disease prevention and control programs to meet
    local needs. The Committee is encouraged by CDC's work with
    State and national health organizations to develop an
    integrated and comprehensive national cardiovascular health
    program. The Committee encourages CDC to support prevention
    activities in more than half of the States. State programs
    could target reduction of heart disease and stroke risk factors
    through efforts to promote physical activity and good nutrition
    and to prevent or control high blood pressure, elevated
    cholesterol and obesity.
        Inflammatory bowel disease.--It is estimated that up to 1
    million people in the United States suffer from Crohn's disease
    or ulcerative colitis, collectively know as inflammatory bowel
    disease. The Committee recognizes the need for enhanced
    epidemiological research in this area, especially in light of
    recent advancements in treatment for these diseases and the
    increased risk that IBD patients have for developing colorectal
    cancer. The Committee continues to encourage CDC to work to
    further our understanding of the prevalence of these diseases
    through appropriate epidemiological and surveillance
    activities.
        Limb loss prevention.--The Committee recognizes the
    importance of rehabilitation information in improving outcomes
    among persons with limb loss and the role of the National Limb
    Loss Information Center in addressing this need. To date, the
    Center has received thousands of requests for information.
        Lymphoma.--The Committee encourages CDC to expand its
    support into investigating the potential of environmental,
    bacterial, and viral factors that are associated with the
    development of lymphoma and encourages continued and expanded
    collaborative research efforts including active involvement in
    the National Cancer Institutes' progress review group (PRG) on
    lymphoma and with other Institutes at the National Institutes
    of Health. The Committee also includes the President's request
    for programs related to environmental factors relating to
    cancer at the CDC's Environmental Health Lab and the Committee
    is particularly supportive of research on the environmental
    causes of lymphoma.
        Newborn Screening.--Recent advances in genetic screening
    for newborns allow identification at birth of underlying
    conditions which can cause or contribute to disease,
    disabilities, and death. The Committee supports further
    intramural and extramural research and development projects to
    facilitate the translation of new scientific knowledge into
    applied newborn public health screening programs, particularly
    in the areas of fragile X syndrome and cystic fibrosis. The
    Committee urges the CDC to coordinate with HRSA in translating
    the results of these efforts into guidance for public health
    programs, including State newborn screening programs.
        Nutrition Therapy.--The Committee encourages the agency to
    expand research on the impact of nutrition therapy in the
    prevention and management of cancer, HIV/AIDS and osteoporosis.
    The Institute of Medicine has recommended that medical
    nutrition therapy with physician referral be a covered benefit
    under the Medicare program. IOM indicated that nutrition
    therapy has been effective in the management and treatment of
    many chronic conditions which affect Medicare beneficiaries,
    including dyslipidemia, hypertension, heart failure, diabetes
    and chronic renal insufficiency. However, IOM cited
    insufficient or inconclusive data with regards to the role of
    nutrition in the prevention or treatment of cancer, HIV/AIDS
    and osteoporosis and called for additional research in these
    areas.
        Obesity.--The Committee encourages the CDC to provide funds
    for promoting healthy eating and physical activity and
    preventing obesity. The Committee is concerned that the
    National Center for Chronic Disease Prevention and Health
    Promotion at CDC is not providing adequate resources to address
    the nation's obesity problem. The Committee is aware of the
    University of Iowa's efforts to improve youth health through
    the establishment of a National Youth Fitness Obesity
    Institute.
        Omega-3 fatty acids.--The Committee is aware of the health
    benefits of Omega-3 fatty acids and recognizes that fish and
    seafood produces are the primary source of Omega-3 fatty acids
    in the diet. The Committee encourages the CDC to support public
    education campaigns to promote the consumption of fish and
    seafood products.
        Oral Health.--Americans will make approximately 500 million
    dental visits this year. In the year 2000, an estimated
    $60,000,000,000 will be spent on dental services. Much of the
    health and economic burden associated with oral diseases and
    conditions could be prevented. The Committee urges the CDC to
    enhance oral health activities at CDC. Increases would enable
    CDC to implement proven strategies to help eliminate dental
    decay and reduce tooth loss at a substantial cost savings. CDC
    should also expand surveillance activities to help States
    target their prevention efforts at schools, in the community
    and in clinical settings. CDC should enhance efforts to reduce
    disparities and the health burden from oral cancers, gum
    disease and oral health conditions that are closely linked to
    chronic diseases such as diabetes and heart disease.
    Fluoridation is one of the most efficient and cost effective
    ways to promote oral health. Tragically, California and six
    other States have extremely low fluoridation rates. The
    Committee also urges CDC to work with States to assist them in
    implementing fluoridation plans.
        The Committee encourages the CDC to establish a preventive
    dentistry effort to improve the oral health of low income
    children. A preventive dentistry program could offer a
    screening assessment of dental needs, the placement of either
    dental sealants or varnishes on permanent teeth, and referral
    for care as indicated.
        Osteoporosis.--Current data is lacking on whether
    counseling by a nutrition professional improves the probability
    of meeting adequate calcium, vitamin D, protein and other
    micronutrient intake either through the use of supplements or
    without supplements. With the elderly in particular, who take
    multiple medications and supplements, many of these
    medications/supplements interact and work against each other.
    In addition, many older women have a strong intolerance for
    milk. Research should be conducted to determine the
    effectiveness of nutrition counseling in insuring against the
    intake of excess levels of calcium (>2500mg/day) and on the
    interactions of supplements and hormone replacement therapies.
    The role of calcium, vitamin D, protein and other
    micronutrients in preventing osteoporosis and associated
    problems, such as hip fractures, should also be considered.
        Prevention Research.--The Committee supports CDC's efforts
    to expand prevention research. There are many areas of research
    that can pay dividends in both improved health and reduced
    health care costs. The Committee expects some of these funds to
    be used to support research on ways to prevent disease and
    disability in rural areas and to better utilize nurses and
    allied health professionals in prevention and health promotion
    efforts.
        Primary Immunodeficiency Diseases.--The Committee continues
    to be concerned that up to 500,000 cases of primary
    immunodeficiency diseases remain undiagnosed or misdiagnosed.
    The Committee has reviewed the national education and awareness
    campaign created by the Jeffrey Modell Foundation in
    collaboration with a variety of government agencies and
    believes that the deeper the CDC commitment to the project, the
    more successful it will be in identifying those patients. The
    Committee strongly recommends that CDC adopt this program as a
    model education and awareness program and collaborate with its
    other partners to assure the maximum benefit is obtained from
    it. The agency should provide the Committee with a report
    updating its efforts by December 1, 2000.
        Primary Immune Deficiency Diseases national surveillance
    program.--The Committee is pleased that CDC is working to
    establish a primary immune deficiency diseases national
    surveillance program. These diseases, which impair the body's
    immune system, strike most severely at children, many of whom
    do not survive beyond their teens or early twenties. Primary
    immune deficient patients require regular infusions of immune
    globulin intravenous (IGIV) to bolster their immune systems and
    maintain their health. Given the serious public health problems
    caused by the longstanding shortage of IGIV in the United
    States, the Committee encourages the National Center for
    Infectious Diseases to continue its partnership with the
    primary immune deficiency community and the National Center for
    Health Statistics with respect to surveillance and
    epidemiological activities designed to further our
    understanding of the prevalence of these diseases and the
    difficulties that patients have encountered in receiving
    treatment.
        Promoting Healthy Eating and Physical Activity and
    Preventing Obesity.--The Committee encourages the agency to
    provide funding for promoting healthy eating and physical
    activity and preventing obesity. Unhealthy eating habits and
    physical inactivity are major causes of heart disease, cancer,
    stroke, and diabetes, four out of the seven leading causes of
    death and disability in the United States. According to the
    U.S. Department of Agriculture, healthier eating habits could
    reduce the costs of heart disease, cancer, and diabetes by at
    least $71,000,000,000 each year.
        Sleep disorders.--The Committee encourages the agency to
    provide increased funding for research on the effects and
    prevalence of sleep deprivation and other sleep chronic
    disorders. Sleep deprivation and other disorders have been
    identified as a causal factors in a growing number of vehicular
    and on-the-job injuries. The Committee further encourages the
    agency to validate existing data on sleep deprivation and
    disorders, develop injury prevention programs, and disseminate
    information to States.
        Smoking and Health.--Tobacco use is the single most
    preventable cause of death and disease in our society. It
    causes more than 400,000 deaths in the United States each year,
    and costs the nation $50,000,000,000 in medical expenses alone.
    Children are especially hard hit by tobacco. Ninety percent of
    adult smokers begin their habit as children. The Committee
    believes that a significantly increased effort to curtail youth
    tobacco use is needed. Therefore, the Committee has included
    the President's requested level of funding for tobacco control.
    These funds are intended to expand the capacity of all State
    and local health departments, education agencies, and national
    organizations to build comprehensive tobacco control programs
    and to develop and begin implementation of a national public
    education campaign to reduce access to and the appeal of
    tobacco products among young people. The Committee has included
    $103,347,636, the same amount requested by the administration
    and an increase of $5,000,000 above the fiscal year 2000
    appropriation for tobacco prevention.
        Sudden Infant Death Syndrome.--The Committee notes the work
    of CDC, the National Institute of Child Health and Human
    Development and the Health Resources and Services
    Administration in developing a model guidelines for death scene
    protocol for Sudden Infant Death Syndrome. The Committee
    encourages CDC to implement projects to demonstrate the
    effectiveness of the death scene protocol in a variety of
    locales (urban, suburban, and rural) throughout the nation.
    Funding is available through the CDC infant mortality program
    and through the health disparities initiative, which focuses on
    infant mortality. The Committee expects CDC to be prepared to
    report on progress on this initiative during the fiscal year
    2002 hearings.
        Thyroid cancer.--The Committee has included sufficient
    funds to continue the next phase of a study on radioactive
    Iodine-131 and thyroid cancer. This study will look at
    individuals exposed to fallout from the Nevada Nuclear Weapons
    Test Site. The Committee further expects the administrative
    costs charged to this project to be further minimized.
        Underage drinking.--The Committee notes with substantial
    concern the continuing problem of underage drinking. Evidence
    indicates that if a young American child begins using alcohol
    at the age of 13, that individual is at far greater risk of
    becoming dependent on alcohol and other illegal drugs in their
    adult years. Those who postpone the use of alcohol until they
    reach the national legal drinking age of 21 are at
    substantially less risk. Last year, the Congress rejected
    attempts to incorporate anti-underage drinking messages into
    the Office of National Drug Control Policy (ONDCP) media
    campaign against illegal drug use. In doing so, many Members of
    Congress made clear that a parallel effort to combat underage
    alcohol use was needed. The Committee encourages CDC to fund a
    campaign to be developed by Mothers Against Drunk Driving in
    conjunction with other appropriate organizations to lay the
    groundwork for a successful media campaign aimed at underage
    drinking. It is the Committee's intention that this be the
    first step in creating a media campaign at least on a par with
    the current ONDCP effort as regards illegal drugs.
        Vision screening.--The Committee encourages the CDC to
    continue the child vision screening program to provide vision
    screening to economically distressed students in public
    schools. The Committee is aware of the Chicago Public Schools'
    Expanded Vision Program that is designed to help provide
    students with quality vision care.
        The Committee is also aware of the ChildSight vision
    screening program created by Helen Keller Worldwide to improve
    the educational performance of low-income junior high school
    students by providing them with eyeglasses.

    Lead poisoning

        The Committee recommendation includes $38,226,000 for lead
    poisoning prevention activities. Of the amount provided,
    $30,978,000 is for program activities, which is $17,000 below
    the 2000 level and is the same as the administration request.
    For salaries and expenses within this category of activities,
    $7,248,000 has been provided, which is the same as the 2000
    level and the administration'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.
        Lead Poisoning Screening.--The General Accounting Office
    has estimated that more than 400,000 children eligible for
    Federal health care programs have undetected harmful levels of
    lead in their blood, despite a Federal law requiring that they
    be screened for lead poisoning. During appropriations hearings,
    the Committee learned about the benefits of a portable, easy to
    use lead screening device developed with the support and
    participation of CDC. The Committee continues to believe that
    this device holds great promise for increasing childhood
    screening rates in underserved communities in the United States
    and throughout the world and encourages CDC to support its
    further development for application in community public health
    settings.

    Breast and cervical cancer mortality prevention

        The Committee's recommendation includes $177,495,000 for
    breast and cervical cancer mortality prevention activities. Of
    the amount provided, $167,016,000 is for program activities,
    which is $11,000,000 above the 2000 level and $6,781,000 above
    the administration request. For salaries and expenses within
    this category of activities, $10,479,000 has been provided,
    which is the same as the 2000 level and the administration's
    request.
        Activities supported within this account include the
    National Breast and Cervical Cancer Early Detection Program,
    which guides public health programs in formulating an
    aggressive response to these cancers. CDC further supports the
    delivery of screening services to underserved women, quality
    assurance, referral and follow-up services, surveillance, and
    partnership development.
        Allied Health Personnel.--Given the shortages and high
    vacancy rates of qualified health personnel who work in
    laboratories to prepare and interpret tissue and cell samples,
    the Committee urges CDC's Breast and Cervical Cancer Screening
    program to develop a partnership with HRSA's Allied Health
    Special Projects Program to support programs at schools which
    contribute to solving the shortages.
        Breast cancer in minority women.--The Committee is aware of
    a CDC project at Swope Parkway Health Center in Kansas City
    that is successfully targeting African American women who are
    at high risk for breast and cervical cancer. The project is a
    collaborative effort between the Health Center and community
    groups in reaching out to this at-risk population through
    information dissemination, access to free testing, and the
    implementation of a screening follow-up program. The Committee
    urges the CDC to continue its support for this program.
        Breast cancer prevention.--The Committee is aware of the
    efforts of the Silent Spring Institute to study links between
    breast cancer and pollutants released into the environment. The
    need to understand the cause of breast cancer is urgent. In the
    1940's, the lifetime risk of breast cancer was 1 in 22, and
    today it is 1 in 8. Massachusetts has the highest incidence of
    breast cancer in the nation, it is vitally important to
    understand the factors that cause this deadly disease. The
    Committee encourages CDC to give full and fair consideration to
    conducting a study on Cape Cod in Massachusetts to understand
    the causes of breast cancer may help reduce the incidence of
    this disease nationwide.
        Wisewomen (Well-Integrated Screening and Evaluation for
    Women).--The amount recommended includes an increase for the
    Wisewomen screening demonstration program, allowing CDC to
    support this program in up to 20 States, including Washington
    State. The Wisewomen program uses the CDC's National Breast and
    Cervical Cancer Early Detection Program to also screen women
    for heart attack, stroke and other cardiovascular disease risk
    factors such as high blood pressure, elevated cholesterol, lack
    of physical activity and obesity. Cardiovascular diseases
    remain the leading cause of death of American women. Heart
    disease, alone, is the No. 1 killer of American women and
    stroke is the No. 3 killer. Currently in three States, the
    program has screened more than 8,500 low-income and uninsured
    women age 50 and older for heart disease and stroke risk
    factors. From 50 percent to 75 percent of these women were
    found to have either high blood pressure or elevated
    cholesterol. The program is well received by participants with
    more than two-thirds of the women returning for follow-up
    services.

    Injury control

        The recommendation by the Committee includes $86,840,000
    for injury control efforts. Of the amount provided, $63,000,000
    is for program activities, which is $2,568,000 above the 2000
    level and $2,197,000 below the administration request. For
    salaries and expenses within this category of activities,
    $23,840,000 has been provided, which is the same as the 2000
    level and $195,000 below the administration request.
        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 serves as a focal point for all Federal injury
    control activities.
        Childhood injury prevention program.--The Committee is
    aware that accidental injury is the leading cause of death (50
    percent) for Alaska children and teens. The injury fatality
    rate for Alaskan children exceeds the national average by 60
    percent. The Committee recommends that the agency give careful
    consideration to a proposal by the State of Alaska to collect
    and analyze data on injury occurrence, scientifically examine
    childhood death, and, working with the Alaska Injury Prevention
    Center, provide targeted community-based interventions to
    reduce the incidence of childhood injury and death.
        Decibels study.--The Committee encourages the CDC to
    establish a 3-phase program to create a national model for
    reducing the incidence of hearing loss in school age children.
    The Committee encourages the agency to give full and fair
    consideration to the Oregon Health Sciences University.
        Health center-based domestic violence prevention.--Victims
    of family and community violence often bring serious medical
    issues to health care providers. Battered women account for
    over 22 percent of women presenting with trauma to emergency
    departments, and about 17 percent of pregnant women experience
    abuse. The Committee is aware of efforts of the Partners
    Healthcare System in Greater Boston and their efforts to
    prevent and intervene early with children and adolescents at
    high risk for violence and to treat victims of domestic
    violence and child witnesses to violence. The Committee
    encourages that full and fair consideration be given to enable
    Partners to expand and integrate its violence prevention
    programs into a comprehensive health-center based model for
    addressing family and community violence in partnership with
    other community stakeholders.
        Injury control prevention centers.--The Committee notes the
    need for injury control prevention centers and encourages the
    CDC to increase funding for these centers. The Committee notes
    the University of Washington should be given full consideration
    for increased funding.
        Injury control research centers.--The Committee recognizes
    the outstanding work of the existing ICRCs in multiple research
    areas such as rural injuries, trauma, traffic injuries and
    falls among the elderly. Based at universities in many regions
    across the Nation, the ICRCs have excelled in discovering what
    prevention and treatment measures work and in disseminating
    these measures to State and community injury prevention
    programs in many regions of the country. The Committee
    recognizes the need for coordination of regionally focused
    research efforts in the Midwest Region, and encourages CDC to
    give full and fair consideration for establishing such a
    center. The ICRC could address preventable injuries in urban
    and rural areas and all phases of injury control and injury
    control science.
        Injury reporting.--The Committee recognizes the need for
    more timely, complete, objective and accurate information about
    injury and deaths to inform and evaluate policy and program
    efforts. The Committee is aware of the efforts of the Medical
    College of Wisconsin and the Harvard School of Public Health to
    develop population based injury reporting systems and applauds
    their development of a model reporting system that links
    information from law enforcement agencies, medical examiners
    and coroners, health providers, crime laboratories and other
    agencies. The Committee urges the CDC to contract with private
    health and educational agencies as well as State agencies which
    have demonstrated capacity or expertise.
        Injury control training.--Sufficient funds have been
    included to continue West Virginia University's Injury Control
    Training and Demonstration Center at the same level as last
    year.
        SAFE U.S.A. initiative.--The agency budget request includes
    $2,000,000 to support an array of activities intended to foster
    collaboration and cooperation between CDC and organizations
    working in injury control.
        Youth violence initiative.--Recent incidents of school
    violence highlights the need for a long-term response that
    incorporates prevention of problem issues for youth before they
    become manifested in violent behavior. The Committee has
    included funds to continue the initiative began last year to
    provide a national strategy to address school violence. The
    Committee has included $10,000,000 to continue the ten national
    centers of excellence at academic health centers that will
    serve as national models for the prevention of youth violence.
    These centers should: (1) develop and implement a
    multidisciplinary research agenda on the risk and protective
    factors for youth violence, on the interaction of environmental
    and individual risk factors, and on preventive and therapeutic
    interventions; (2) develop and evaluate preventive
    interventions for youth violence, establishing strong linkages
    to the community, schools, and social service and health
    organizations; (3) develop a community response plan for youth
    violence, bringing together diverse perspectives, including
    health and mental health professionals, educators, the media,
    parents, young individuals, police, legislators, public health
    specialists, and business leaders; and (4) develop a curriculum
    for the training of health care professionals on violent
    behavior identification, assessment, and intervention with high
    risk youth, and integrate this curriculum into medical,
    nursing, and other health professional training programs.
        Furthermore, the Committee has included funds to continue
    the national resource center on youth violence prevention. This
    center established a toll free number, bilingual in English and
    Spanish, and an internet website, in coordination with existing
    Federal website resources, to provide accurate youth violence
    prevention and intervention information produced by the
    government and linked to private resources. This resource
    center will provide a single, user-friendly point of access to
    important, potentially life-saving information about youth
    violence, an explanation about preventing youth violence, and
    intervention strategies. The center would also be responsible
    for lending technical assistance on how to establish programs
    in communities around the country using local resources.
        Youth violence prevention.--The Committee is pleased with
    the progress made by the agencies in coordinating youth
    violence efforts and requests that the CDC coordinate their
    efforts with the Domestic Policy Council and continue to work
    with the National Institute of Child Health and Human
    Development, the Substance Abuse and Mental Health Services
    Administration, and the Health Resources and Services
    Administration to develop a collaborative program in this
    regard. Issues relative to school violence, school failure,
    drug and tobacco use and other behavioral issues have become
    public health priorities. The Committee is pleased that the
    CDC's has focused a portion of their research efforts to
    discover approaches to intervene and prevent complex behavior
    problems in children and youth which utilize molecular
    neuroscience, brain mapping, behavioral analysis and behavioral
    analysis.
        Violence against women initiative.--The agency budget
    request includes $27,997,000 for services, research, public
    education geared toward the reduction of violence against women
    nationwide.
        Sufficient funds have been provided to enable the Center to
    support and expand effective prevention programs for traumatic
    brain injury consistent with the Traumatic Brain Injury Act.
    The Committee is supportive of a science-based process that
    identifies the most practical and effective steps communities
    can undertake to prevent suicide in high-risk populations.
        Suicide prevention.--Suicide and suicidal behavior is a
    major public health risk, particularly for the elderly,
    adolescents, and young adults. The Committee recommendation
    includes funds for the Center to sustain suicide prevention
    research and intervention.
        The Committee encourages CDC to establish a national
    suicide prevention resource center. This center would provide
    technical assistance to states and communities to identify and
    implement effective programs for those at significant risk for
    suicide, including African American males, American Indians/
    Alaska Natives, young adolescents, and 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 again 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 is supportive of National Violence Against
    Women Prevention Research Centers located at the Medical
    University of South Carolina, the University of Missouri at St.
    Louis and Wellesley College and encourages CDC to give full and
    fair consideration to this project.
        Playground safety.--The Committee continues to be pleased
    with the efforts of the National Program for Playground Safety
    and the level of public interest that has been generated by
    this program. Sufficient funds are available to continue to
    implement the action steps described in the National Action
    Plan for the Prevention of Playground Injuries, which includes
    activities aimed at enhancing playground safety, gathering of
    relevant statistics, research, and training. The Committee
    urges the agency to consider establishing a model playground
    for children ages 0 to 3 to advance research on early
    developmental experiences for children in this age group.

    Occupational safety and health

        The Committee's recommendation includes $222,833,000 for
    the National Institute for Occupational Safety and Health
    [NIOSH]. Of the amount provided, $95,000,000 is for program
    activities, which is $8,181,000 above the 2000 level and
    $3,466,000 above the administration request. For salaries and
    expenses within this category of activities, $127,833,000 has
    been provided, which is the same as the 2000 level and $189,000
    less than the administration request.
        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.
        The Committee encourages NIOSH to provide full and fair
    consideration to the National Children's Center on Rural
    Agricultural Health and Safety (NCCRAHS) in Marshfield,
    Wisconsin for a National Summit on Child and Adolescent Rural
    Injury Control in September 2001.
        Aviation safety.--The Committee continues to be pleased
    that the National Transportation Safety Board has taken an
    aggressive approach to address the recent rash of injuries and
    deaths from aircraft accidents in Alaska. The Committee
    supports continuation of the joint interagency initiative which
    involves the Federal Aviation Administration, the NTSB, and the
    National Institute of Occupational Safety and Health. The
    Committee encourages NIOSH to continue to implement the Board's
    recommendations to improve aviation safety in Alaska.
        Construction safety and health initiative.--The Committee
    notes that since the inception of the NIOSH, construction
    safety and health initiative, the rate of serious injury and
    illness in construction dropped 38 percent from 1992 to 1998,
    according to the Bureau of Labor Statistics. This drop is one
    of the highest compared to all other industries. Moreover,
    among the goods-producing industries, construction is the only
    industry where the rate has dropped consistently over the 7-
    year period. The Committee is pleased with NIOSH's focus on
    active implementation and evaluation of safety and health
    interventions designed to prevent accidents, adverse health
    effects and fatalities and for NORA for establishing research
    priorities and encourages CDC to continue the targeted
    construction program at its current level. However, the
    Committee is concerned with the continued high fatality rate in
    the industry, and has included funds to continue the program at
    no less than current levels.
        Education and Research Centers.--The Committee commends the
    work of the 15 university-based Education and Research Centers
    (ERC's) and the smaller single discipline Training Project
    Grants (TPG's). These regional centers are integral to the
    nation's efforts to improve the health and safety of working
    men and women, and important to the future efforts of NIOSH to
    implement the National Occupational Research Agenda (NORA).
        Farm Health and Safety.--The Committee has included funding
    to continue the farm health and safety initiative at its
    current level. This important initiative, begun in fiscal year
    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.
        Mine safety.--The Committee encourages the CDC to provide
    sufficient funds to improve safety and health for American
    miners. The Spokane Research Laboratory is working to improve
    miners safety and the Committee encourages CDC to provide full
    and fair consideration for this project.
        Mine safety research.--The Committee is concerned that
    funds and research for mine safety and health are no longer
    separately identified in the Department of Health and Human
    Services, Centers for Disease Control and Prevention fiscal
    year 2001 congressional justification. The Committee continues
    to recognize that many mine safety and health research needs
    are either unique to mining or require mining-specific
    emphasis. The Committee expects that the fiscal year 2002
    congressional justification will separately identify the funds
    and research activities dedicated to mine safety and health, as
    well as report to the Committee on the funding and research
    activities devoted to mine safety and health in fiscal year
    2001.
        National Occupational Research Agenda.--The Committee
    recognizes that the National Occupational Research Agenda
    (NORA) is the largest stakeholder-based research agenda in the
    United States, targeting 21 priorities considered by the
    nation's occupational safety and health community as the most
    critical for improving the safety and health of the American
    workforce. Representatives of over 200 organizations from the
    public and private sectors are working with NIOSH to implement
    NORA. Therefore, the Committee urges the CDC to provide NIOSH
    with the necessary resources to sustain the momentum of NORA
    and continue to expand the overall scientific effort to address
    occupational safety and health research, collaborate with NIH
    and other agencies, target important new initiatives to prevent
    and reduce work-related hazards and conduct evaluations of the
    impact of prevention strategies.
        National Laboratory for Personal Protective Equipment.--It
    has been brought to the Committee's attention the need for
    design, testing and state-of-the-art equipment for this
    nation's 50 million miners, firefighters, healthcare,
    agricultural and industrial workers. The Institute of Medicine
    identifies personal protective equipment as a critical need and
    had called for increased research to test commercial products,
    develop more protective respirators, develop better protective
    suites and uniform testing standards and guidelines for
    personal protective equipment use in hospitals. The Committee
    encourages NIOSH to carry out research, testing and related
    activities aimed at protecting workers, who respond to public
    health needs in the event of a terrorist incident. The
    Committee encourages CDC to organize and implement a national
    personal protective equipment laboratory. The city of
    Pittsburgh would be especially suited to carry out this
    initiative.
        Worker health and safety research.--The Committee
    recognizes the need for worker health and safety research at
    the Federal level, and to continue funding the laboratory in
    Morgantown, West Virginia.
        University of Hawaii at Hilo.--The Committee encourages
    NIOSH to give full and consideration to the work being done on
    environmental toxins at the University of Hawaii at Hilo.

    Epidemic services

        The Committee's recommendation includes $85,738,000 for
    epidemic services. Of the amount provided, $30,254,000 is for
    program activities, which is $18,160,000 below the 2000 level
    and is the same as the administration request. For salaries and
    expenses within this category of activities, $55,484,000 has
    been provided, which is the same as the 2000 level and the
    administration request.
        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

        The recommendation of the Committee includes $103,912,000
    for the National Center for Health Statistics. This is
    $6,073,000 below the administration request and $1,088,000
    below the fiscal year 2000 program 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 amount provided includes an increase 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.
        Primary immune deficiency national surveillance.--The
    Committee is pleased that NCHS is working to establish a
    primary immune deficiency national surveillance program, in
    collaboration with the National Center for Infectious Diseases.

    Human immunodeficiency virus

        The Committee recommendation includes $762,036,000 for HIV/
    AIDS activities. Of the amount provided, $640,000,000 is for
    program activities, which is $67,285,000 above the 2000 level
    and $29,791,000 below the administration request. For salaries
    and expenses within this category of activities, $122,036,000
    has been provided, which is the same as the 2000 level and
    $3,576,000 below the administration request.
        The mission of the agency's HIV prevention program is to
    avert HIV infection and to reduce the incidence of HIV-related
    illness and death, in collaboration with community, State,
    national, and international entities.
        Minorities.--The Committee urges that racial minorities be
    more fully targeted and included in HIV prevention efforts. The
    Committee directs the CDC to consider allocating increased
    resources to address the HIV-related health disparities in
    ethnic and racial minority populations. In particular, the CDC
    should consider increased support of minority community-based
    organizations and minority regional and national organizations
    including education, technical assistance, infrastructure,
    capacity building, community development, and public health
    initiatives.
        The Committee is aware of the agency's efforts related to
    correctional health care, particularly for surveillance, needs
    assessment, continuity of care, and efforts targeting minority
    communities disproportionally affected by HIV/AIDS and sexually
    transmitted diseases. The Committee urges the agency to expand
    such efforts within the budget provided.
        Native populations.--The Committee is concerned regarding
    the lack of adequate surveillance of HIV-STD among American
    Indian, Alaska Native, and native Hawaiian populations, and
    encourages CDC to work in consultation with tribes, urban
    programs, and the Indian Health Service to develop a more
    effective surveillance strategy.
        Prevention activities.--The additional funds provided by
    the Committee will provide for priority HIV prevention
    interventions identified through the HIV community planning
    process. These activities will focus on those at highest risk
    for infection, particularly communities of color. The Committee
    is pleased that the CDC plans to give priority funding to those
    States and populations that are disproportionately affected by
    HIV and AIDS, with a special emphasis on programs targeted
    towards African American and Hispanic communities.
        Rural centers.--The Committee notes the agency's efforts to
    address HIV/STD transmission in rural areas of the country. The
    Committee encourages CDC to sustain the Rural Center for AIDS
    and STD Prevention in order that it may continue its efforts in
    rural communities through prevention specialists.

    Building and facilities

        The Committee recommendation includes $175,000,000 for
    repair and renovation of CDC facilities, $47,926,000 above the
    administration request and $117,869,000 above the fiscal year
    2000 appropriation.
        The Committee is concerned that many CDC employees work in
    very inadequate facilities. These buildings are not only
    insufficient in terms of cramped working conditions, but they
    also pose an increasing threat to workers safety. The Committee
    urges the CDC to accelerate at the rate possible the current
    building and facilities 10-year master plan for construction
    and renovation. Priority projects for fiscal year 2001 should
    include the new Infectious Disease Laboratory Number 18, the
    Scientific Communication Center so CDC can continue as the
    public health communication link to all State and local health
    departments and other domestic and international partners, two
    critical laboratories on the Chamblee campus, the lease
    consolidation of CDC's buildings located throughout the Atlanta
    area, security infrastructure, repairs, improvements and
    scientific equipment.

    Prevention research

        For this activity, the Committee has provided $14,993,000
    for prevention research activities. Of the amount provided,
    $13,386,000 is for program activities, which is $1,386,000
    above the 2000 level and is the same as the administration
    request. For salaries and expenses within this category of
    activities, $1,607,000 has been provided, which is the same as
    the 2000 level and the administration request.
        This function seeks to discern the causative factors of key
    illnesses and diseases that may be addressable through
    intervention or education. Activities supported include
    community-based research, training of health professionals,
    research conducted by individual investigators, and guideline
    development.

    Office of the Director

        For the Office of the Director, the Committee recommends
    $35,564,000, which is the same as the President's request and
    $2,056,000 below the fiscal year 2000 appropriation. This line
    item includes amounts previously attributed to program
    management activities.
        This level includes $19,439,000 to be provided from PHS
    evaluation funds.
        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.

    Health disparities demonstration

        The Committee has included $30,000,000 for health
    disparities demonstration projects to address racial health
    disparities. Of the amount provided, $27,000,000 is for program
    activities, which is the same as the 2000 level and $4,468,000
    below the administration request. For salaries and expenses
    within this category of activities, $3,000,000 has been
    provided, which is the same as the 2000 level and $517,000
    below the administration request. These funds will support
    research demonstration projects which address six identified
    areas of health disparities--infant mortality, cancer, heart
    disease, diabetes, HIV infections, and child and adult
    immunizations.
        Drug and alcohol services to high risk families.--It has
    been brought to the Committee's attention that Center Point,
    Inc. provides low-cost, comprehensive drug and alcohol services
    to high risk families and individuals in the San Francisco Bay
    area. Included in their model is a licensed, fee-for-service
    medical clinic that provides on-site physical examinations,
    primary, and preventative health services. The Committee
    recognizes the important work that Center Point, Inc. has
    accomplished in San Rafael, California and encourages the
    Centers of Disease Control and Prevention to give full and fair
    consideration for this project to continue to develop and
    expand its programs.
        Health status of minorities and the disadvantaged.--The
    Committee is pleased with the CDC's commitment to improving the
    health status of minority and disadvantaged individuals and
    urges expansion of these efforts including the coordination of
    preventative health care, substance abuse treatment, and HIV.
        Minority health disparities.--The Committee recognizes the
    important work of the Albert Einstein Healthcare Network (AEHN)
    in addressing minority health disparities. The Committee urges
    the CDC to give full and fair consideration to a proposal from
    AEHN to develop an Urban Health Institute to address the
    special health needs of diverse, vulnerable, urban communities
    in a comprehensive and coordinated fashion and reduce the
    historic disparity between the health status of minorities and
    the general population.
        Stroke in the African-American population.--The prevalence
    of stroke is significantly higher in the African-American
    community than in other populations and young African-Americans
    are 2.5 times more likely to die of a stroke than whites. The
    Committee is aware of efforts by St. Luke's-Roosevelt Hospital
    Center in New York to create a Comprehensive Stroke Center to
    provide more direct intervention in the African-American
    community. The Committee urges CDC to work with the Hospital in
    addressing issues of racial disparities in health outcomes.

    Violent crime reduction programs

        The Committee recommendation includes $50,225,000 for
    violent crime reduction programs, which is $234,000 above the
    fiscal year 2000 level and $257,000 above the budget request
    for activities authorized by the Violence Against Women Act.
    Funds are used to augment rape prevention services supported by
    the States through the preventive health and health services
    block grant and for grants to public and private nonprofit
    organizations to support community programs to prevent domestic
    violence.
        The Committee has also included $6,000,000 for Domestic
    Violence Community Demonstrations, an increase of $134,000
    above the fiscal year 2000 appropriation, and $137,000 above
    the amount requested by the Administration.
        The funds for rape prevention and services 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.
        Distribution of funds.--The Committee is concerned with the
    distribution of funds for rape prevention and education that
    are provided with funds from violent crime reduction programs
    and sent to the States through the preventive 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.
        Domestic violence crisis intervention.--The Committee is
    aware that Portal to Hope, operates an innovative system of
    services, including counseling by licensed social workers,
    therapists, a 24-hour crisis intervention service that includes
    a hotline, a community outreach project, job placement
    assistance, legal services, and shelter and housing placement
    services. The Committee encourages CDC to give full and fair
    consideration to this project.
        Domestic violence hotline.--The Committee applauds the work
    of the DV Hotline and encourages their efforts to expand
    services to victims of sexual assault
        Psychosocial factors of violence.--It is the Committee's
    expectation that the Centers for Disease Control and Prevention
    take the lead in a collaborative effort between CDC and the
    Department of Justice in researching the behavioral and
    psychosocial factors relating to violence against women.
        Teen smoking.--The Committee is aware of the approach by
    the University of Pennsylvania School of Social Work to develop
    models for curtailing teenage smoking as a mechanism for
    reducing the number of teens in the juvenile justice system.
        Violent crime grants.--The Committee urges CDC to ensure
    that States receiving funds from the grants for assistance to
    victims of sexual assault, support State sexual assault
    coalitions and community-based rape crisis centers whose work
    is focused on ending sexual violence, operating hotlines for
    victims of sexual violence and their families, and those who
    provide crisis intervention, advocacy, and self-help services
    to victims. The Committee also urges that similar
    nongovernmental nonprofit agencies show a demonstrated
    effectiveness in carrying out the work achieving these goals in
    order to receive funds. The Committee further encourages CDC
    work to have States devote adequate resources from their
    allocation for rape prevention and education for middle,
    junior, and high school youth in both school and nonschool
    settings.

                         National Institutes of Health

        Our Nation's investment in medical research has at once
    fostered improved health, longer life expectancy, a better
    quality of life and lower health care costs. Horrible scourges
    like smallpox, cholera and diphtheria which devastated
    populations as late as the nineteenth century are now rare or
    non-existent in most parts of the world; visualization of once
    hidden parts of the body has become a common diagnostic method;
    many infections formerly regarded as hopeless are susceptible
    to antimicrobial medications; and irreversibly diseased organs
    can now be replaced by grafts and transplants. While each of
    these extraordinary breakthroughs may be viewed in isolation,
    they are actually extensions and elaborations of past advances.
    Our national investment in research is flexible enough to
    respond to society's changing health care needs and dynamic
    enough to open even more promising frontiers. For example,
    within a short time scientists will complete the sequencing of
    the human genome, enabling researchers to examine the
    relationship between genetic coding and health. And just ahead
    lies the unbounded promise of stem cell research to open the
    way to new treatments, cures and prevention strategies.
        It is no accident that many of society's greatest
    scientific achievements are the product of research supported
    in the United States. Science for the sake of improving the
    health and well-being of its citizens is an idea that has grown
    up with America. It is predicated upon the goal of creating an
    environment that fosters creativity on the part of individual
    researchers and institutions, creativity in pursuit of
    opportunities that are aligned with the needs of individuals.
    As a result, this country can claim the world's greatest
    biomedical research establishment, built and nurtured in large
    part by the National Institutes of Health. Through what some
    have described as a republic of science, NIH supports nearly
    39,000 researchers grants at approximately 2,400 institutions
    across the country. Beyond that, research supported by NIH has
    helped to foster today's burgeoning economy by also acting as a
    catalyst in the growth and development of the biotechnology,
    bio-engineering and pharmaceutical industries.
        Neither is it happenstance that as society shoulders its
    way into the 21st century there are more opportunities in basic
    and clinical research than ever before. Advances that have
    produced an explosion of new knowledge in molecular and cell
    biology, neuroscience and DNA research, for example, will
    enhance our ability to understand disease and find new
    treatments, cures and prevention strategies. The spectacular
    achievements of the past as well as the hope for the future can
    be traced in large part to the support and funding Congress has
    traditionally afforded NIH. Woven into this longstanding
    commitment to research is this Committee's firm recognition of
    the importance of sustaining a robust base of support and its
    adherence to the central principle that funding should be
    guided by competitive merit review.
        The Committee is once again disappointed over the
    administration's failure to recognize that medical and
    behavioral research demand a steady and sustained commitment of
    resources. In 1998, the Committee set out a vision that would
    double NIH funding within 5 years. That endeavor has already
    spawned efforts to advance the clinical development of
    treatments for a broad range of conditions including diabetes,
    rheumatoid arthritis, Alzheimer's disease, and multiple
    sclerosis. But much remains to be done. Serious and persistent
    perils still plague society. And investing in NIH is the single
    most important action our nation can take to overcome the
    challenges of cancer, heart disease, HIV/AIDS and other
    diseases and disorders. The Committee therefore recommends
    $20,512,735,000 for NIH, an increase of $2,700,000,000, which
    maintains the goal of doubling NIH funding by 2003.

                           NATIONAL CANCER INSTITUTE

    Appropriations, 2000....................................  $3,311,687,000
    Budget estimate, 2001...................................   3,505,072,000
    Committee recommendation................................   3,804,084,000

        The Committee recommends an appropriation of $3,804,084,000
    for the National Cancer Institute [NCI]. This is $299,012,000
    more than the budget request and $492,397,000 more than the
    fiscal year 2000 appropriation. The comparable amounts 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 continues to regard scientific investigation
    into the cause, cure, prevention, and treatment of cancer as
    one of the Nation's top priorities. Research offers the only
    hope for putting a stop to a disease that wastes precious human
    resources and contributes to spiraling health care costs.
        Behavioral science research.--The Committee commends NCI
    for expanding its infrastructure to fund behavioral and
    population research in cancer prevention, treatment, and
    control. NCI is encouraged to expand its investigation of the
    effective provision of mental health services to improve the
    course of cancer treatment and to aid in the adjustment to
    cancer survivorship. NCI is also encouraged to build upon its
    collaborations with the National Institute on Drug Abuse to
    more thoroughly investigate issues of youth tobacco use. In
    particular, the Committee is interested in expanding health
    promotion research focused on children and youth, and
    interdisciplinary research on tobacco addiction and cessation.
    The Committee also encourages NCI to expand its research on
    adherence to treatment regimens and to health-promoting
    behaviors such as physical activity and healthy diet.
        Bone disease.--The Committee encourages the National Cancer
    Institute to study the role of angiogenesis, i.e., the growth
    of new blood vessels, in metastasis of breast and prostate
    cancer to the bone. In addition, the Institute is encouraged to
    develop experimental genetic animal models that replicate the
    process of human cancer metastasis to the bone in humans, and
    to explore why bone is a preferential site for metastases.
        Breast cancer.--Breast cancer continues to have a
    devastating impact on our country. In the United States, there
    are approximately 2.6 million Americans living with breast
    cancer. Each year, nearly 180,000 women are diagnosed with and
    nearly 44,000 women die of breast cancer. The Committee
    strongly urges the Institute to continue to expand breast
    cancer research and to devote the highest possible funding
    level to finding the causes and cures for this disease.
        Cancer and minorities.--The Committee remains concerned
    over recent statistics citing higher incidences of cancer among
    the native Hawaiian population. In comparison to other ethnic
    and racial groups, native Hawaiians have the highest incidence
    of the most common forms of cancer such as breast, colon, and
    lung cancer. The Committee encourages continued research in the
    areas of prevention and detection, utilizing nurse
    practitioners in community-based centers for screening and
    education for the underserved populations.
        Complementary and alternative cancer therapies.--The
    Committee expects NCI to work collaboratively with the National
    Center for Complementary and Alternative Medicine to support
    expanded research on promising complementary and alternative
    cancer therapies as well as on their integration with
    traditional therapies. Thousands of Americans are turning to
    these therapies and consumers will benefit from the rigorous
    scientific review of these therapies. The Committee would like
    to be briefed on the progress of the Institute's efforts prior
    to the next appropriations cycle.
        DES.--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 Committee expects NCI to
    continue its support of research in this area. In addition, the
    Committee has included sufficient funds for NCI, through a
    contract it has developed with CDC, to implement a national
    education program for consumers and health professionals. 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.
        Esophageal and stomach cancer.--This year, approximately
    33,800 Americans will be diagnosed with esophageal or stomach
    cancer and 25,100 will die from these diseases. Both cancers
    disproportionately affect minority populations, especially
    African-Americans and Hispanics. The Committee urges the
    National Cancer Institute in conjunction with the National
    Institute of Diabetes, Digestive and Kidney Disorders to
    augment its efforts in these areas, and to focus resources on
    the genetic aspects of these cancers; diagnostic tests for
    genetic abnormalities and prevention efforts; the modulation
    and understanding of epithelial injury and repair;
    environmental factors; and the development and treatment of
    Barrett's syndrome in patients with gastroesophageal reflex
    disease.
        Head and neck cancer.--It has been brought to the
    Committee's attention that there is a need to develop molecular
    markers that are predictive of the presence or likelihood of
    regional metastasis in patients with head and neck cancer. Such
    molecular markers would not only provide useful prognostic
    information but would identify patients at risk who could
    benefit from early elective treatment of the regional lymph
    nodes. The Institute is urged to expand its research support in
    this important area.
        Health communication and basic biobehavioral Research.--The
    Committee is pleased with NCI's long range planning and
    commitment to train new cancer control scientists, as well as
    to provide opportunities for senior investigators to contribute
    their expertise to a new area of research. The Committee is
    also pleased to recognize the addition of two new programmatic
    research elements: health communication and basic biobehavioral
    research. The Committee further commends NCI for continuing to
    expand the pool of behavioral scientists on NCI program staff
    to ensure an optimal balance in the administration of this
    progressive research portfolio.
        Hepatocellular carcinoma.--It has been brought to the
    Committee's attention that there is a need to determine the
    mechanism and the natural history of the development of
    hepatocellular carcinoma in patients with hepatitis C. The
    Committee encourages the Institute to develop a comprehensive
    research portfolio in this area and looks forward to learning
    of the progress made in this area prior to next year's hearing.
        Imaging systems technologies.--The Committee is encouraged
    by progress made by NCI following its August 1999 conference on
    biomedical imaging and urges NCI to continue to take a
    leadership role with the Health Care Financing Administration
    and the Food and Drug Administration to avoid duplicative
    reviews of new imaging technologies which may prevent their
    benefits from reaching patients on a timely basis. The
    Committee is aware of the great potential for improved patient
    care and disease management represented by molecular imaging
    technologies, especially positron emission tomography (PET)
    through its ability to image the biology of many kinds of
    cancer and other diseases. The Committee continues to support
    NCI's increased emphasis on examining the molecular basis of
    disease through imaging technologies such as PET and MicroPET.
    The Committee continues to encourage the large scale testing of
    women for breast cancer and of men for prostate cancer to
    demonstrate and quantity the increased diagnostic and staging
    capabilities of PET relative to conventional diagnostic and
    staging technologies including mammography.
        Lymphoma.--The Committee is pleased that the NCI is
    committed to conducting a progress review group (PRG) on
    lymphoma. The PRG on lymphoma will afford NCI and other Federal
    agencies the opportunity to evaluate current research and
    determine future needs in lymphoma research. The Committee
    requests that NCI be prepared to report to the Committee at the
    fiscal 2002 hearings on the progress of the PRG on lymphoma and
    the development of a prioritized national research agenda for
    lymphoma.
        Multiple myeloma.--The Committee is pleased that MM was
    included in an NCI Progress Review Group and looks forward to
    hearing about the Institute's plans for the PRG findings at
    next year's hearing. The Committee continues to strongly urge
    support to address epidemiological and other data gathering
    activities relevant to MM and coordinate efforts with the
    Centers for Disease Control and Prevention, the Office of Rare
    Diseases, the Office of Research and Minority Health, and
    NIEHS. The Committee encourages the Institute to disseminate
    information and educate the public and health professionals
    about the symptoms of and treatment for MM.
        Neurofibromatosis (NF).--The Committee encourages NCI to
    strengthen its NF research portfolio in such areas as further
    development of animal models, natural history studies,
    therapeutic experimentation and clinical trials. The Committee
    also urges NCI to continue to coordinate its efforts with other
    Institutes engaged in NF research and be prepared to report on
    the status of the NF research portfolio at its fiscal year 2002
    appropriations hearing.
        Nutrition Therapy.--It has been brought to the Committee's
    attention that a recent Institute of Medicine report found that
    Medicare beneficiaries undergoing cancer treatment may also
    benefit from nutrition therapy aimed at controlling side
    effects or improving food intake. However, many of the cancer
    trials conducted to date are skewed toward younger persons even
    though older persons comprise the majority of cancer patients.
    Recent studies have shown that older persons could benefit and
    should be included in more aggressive cancer treatment, given
    that the number of older persons is expected to dramatically
    increase over the next few years. The Committee encourages the
    Institute to conduct research to assess changes in patient
    quality of life as a result of nutrition intervention. The
    committee further encourages the Institute to conduct
    randomized clinical trials of older cancer patients are
    necessary to determine whether a relationship exists between
    nutrition support and clinical outcomes for cancer patients.
        Ovarian and cervical cancer.--Ovarian cancer remains one of
    the deadliest cancers for women, in part due to the lack of
    effective early screening methods. According to 1998 estimates,
    25,400 new cases of ovarian cancer and 14,500 deaths from
    ovarian cancer are expected each year. The Committee strongly
    urges NCI to expedite current research on screening methods to
    detect, diagnose, and identify staging of ovarian cancer. The
    Committee encourages the Director of the NCI to fully fund the
    four ovarian cancer SPOREs in fiscal year 2001 and potentially
    issue a new request for applications for additional ovarian
    cancer SPOREs. The Committee also believes that identification
    of a cost-effective screening strategy could result in earlier
    diagnosis for women and higher cure rates. Similarly, 15,000
    cases of cervical cancer are diagnosed annually, and 5,000
    women die from the disease. NCI is strongly urged to accelerate
    research in this area.
        Pancreatic cancer.--The Committee is concerned that
    pancreatic cancer, the fourth leading cause of cancer deaths
    for men and women in the United States, is projected to claim
    the lives of nearly 30,000 Americans this year alone. The 5-
    year survival rate for pancreatic cancer, 4 percent, is the
    lowest of all cancers. The Committee is concerned that
    pancreatic cancer is not diagnosed until advanced stages when
    treatment options are limited and largely ineffective. The
    Committee expects the NCI to be prepared to report at next
    year's hearing on the Institute's commitment to support the
    development of early detection methods, improved surgical
    techniques, effective chemotherapy, and new drugs for
    pancreatic cancer and to support public education efforts
    concerning pancreatic cancer.
        Primary Immunodeficiency Diseases.--The relationship
    between primary immune disease and cancer is an area that is
    ripe for scientific investigation. The Committee notes that NCI
    co-sponsored a symposium in March 2000 bringing together some
    of the top experts in this field. It is hoped that this
    symposium will lead to the development of a strong research
    agenda in this field. In addition, the Committee is aware of
    the commitment of NIH to the national education and awareness
    campaign. The Committee commends the Institute for it's
    commitment to this campaign and the role the these efforts will
    play in assuring the earliest possible diagnosis of primary
    immunodeficiency and of any cancers that may stem from it.
        Prostate Cancer.--Prostate cancer is the single most common
    form of cancer in men in the United States. An estimated
    179,000 men will be diagnosed with prostate cancer and 37,000
    men will die from prostate cancer in 1999. The Committee urges
    the NCI and other institutes to aggressively increase efforts
    that will lead to the development of new treatments, new
    preventives, and new interventions with the potential to
    improve or extend the lives of men touched by prostate cancer.
        Increased use of serum analysis for prostate-specific
    antigen (PSA), the primary method of screening for prostate
    cancer, has led to an increased detection rate. However, only
    30 percent of early stage disease will progress to clinically
    relevant disease within the lifetime of the patient. The
    Committee encourages NCI to develop methods to identify those
    patients at risk of progression who would benefit most from
    aggressive therapy, while sparing low-risk patients the
    morbidity resulting from aggressive treatment of slow-growing
    disease. The Committee also encourages NCI to carry out
    clinical trials that will determine whether yearly screening
    for prostate cancer using the PSA blood test will decrease
    mortality from prostate cancer.
        NCI has identified the need to restructure the clinical
    trials program to make it faster, more flexible, more easily
    accessible to patients, and more responsive to key therapeutic
    questions. The Committee encourages NCI to test new systems
    that will identify the best trials, improve trial planning,
    speed trial activation, and improve availability of trials to
    patients. The Committee encourages NCI to implement programs to
    assist investigators in academia and in small businesses in
    getting compounds with promise for treatment and prevention of
    prostate cancer into clinical testing using NCI's existing
    development resources. Several key treatment questions must be
    addressed. The Committee urges NCI to initiate clinical trials
    that will optimize hormonal and chemotherapeutic approaches for
    the most common clinical presentations of prostate cancer.
        The incidence and severity of prostate cancer varies in
    different ethnic populations. African-American men are more
    than twice as likely to die of prostate cancer than Caucasian
    men. In African-American men, prostate cancer is also generally
    more advanced at the time of diagnosis. Chinese men living in
    China have incidence and mortality rates that are 3-10 times
    lower than U.S. men. Reasons for the large racial difference in
    risk are currently unclear. The Committee urges NCI to conduct
    studies to identify risk factors for prostate cancer in several
    populations, including African-Americans and Chinese. The
    Committee also encourages NCI to study the associations of
    dietary patterns with prostate cancer, and variations in the
    role of diet in different racial and ethnic groups.
        The Committee is encouraged by NCI's collaborations with
    the Department of Defense in fighting this devastating disease,
    and urges NCI to continue to strengthen and expand its prostate
    cancer research portfolio. The Committee further expects the
    NCI to accelerate spending on prostate cancer, and consult
    closely with the research community, clinicians and patient
    groups to identify promising new avenues of basic and clinical
    research.
        Transdisciplinary tobacco use research centers.--The
    Committee commends the Institute for its collaboration with the
    National Institute on Drug Abuse and private foundations in
    establishing seven new Transdisciplinary Tobacco Use Research
    Centers. These Centers establish critical links across diverse
    scientific disciplines to evaluate new models of nicotine
    addiction; hereditary factors in vulnerability, treatment
    success, and deleterious consequences of tobacco use; cultural
    determinants of successful prevention efforts; treatment
    resistant populations; and determinants of relapse.

                   NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

    Appropriations, 2000....................................  $2,026,430,000
    Budget estimate, 2001...................................   2,136,757,000
    Committee recommendation................................   2,328,102,000

        The Committee recommendation includes $2,328,102,000 for
    the National Heart, Lung, and Blood Institute [NHLBI]. This is
    $191,345,000 more than the budget request and $301,672,000 more
    than the fiscal year 2000 appropriation. The comparable amounts
    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.
        Advanced Imaging Technology for Heart Disease and Stroke.--
    The Committee is aware that heart perfusion PET scans using
    Rubidium-82 are considered the ``gold standard'' for
    determining the extent of muscle damage to the heart following
    a heart attack. The ability of the heart to survive an event is
    a biochemical question that can be determined through PET,
    which is biological imaging. The Committee encourages NHLBI to
    expand its research efforts into the role of biological imaging
    and PET in delivering more accurate information to determine
    appropriate treatment for heart disease patients.
        Allied Health Personnel.--It has been brought to the
    Committee's attention that there is a growing shortage of
    qualified allied health professions who serve as laboratory
    personnel. The Committee encourages NHLBI to enhance program
    activity at schools training these individuals, and by so doing
    help alleviate this problem.
        Cardiovascular prevention and treatment.--The Committee
    continues to regard research into the causes, cure, prevention
    and treatment of heart attack, stroke and other cardiovascular
    diseases as one of the Nation's top priorities. The Committee
    continues to believe that an intensive research program on
    heart attack, stroke and other cardiovascular diseases should
    be a top priority of the NHLBI and of the NIH. The Committee
    urges the Institute to place the highest priority on
    cardiovascular research to support existing heart and stroke-
    related research and to invest in promising research
    initiatives in this area.
        Cooley's anemia.--This Committee, as well as several
    special emphasis panels, has long recommended the establishment
    of a Thalassemia Clinical Research Network. We are pleased to
    note that the institute issued a successful RFA on the topic
    and that the Network has now been created among some of the
    leading researchers in Cooley's anemia. The Committee
    emphasizes the importance of the institute taking specific
    steps to encourage investigator-initiated research proposals
    addressing the key unresolved scientific issues.
        Cystic Fibrosis.--The NHLBI is to be commended for its
    grants initiative for ``Programs for Genomic Applications
    (PGAs) for Heart, Lung, and Blood Research'' to capitalize on
    the plethora of genetic information arising from the Human
    Genome Project. This will encourage institutions to establish
    informatics infrastructure with expertise in functional
    genomics and proteomics to revolutionize medical treatments.
    This is particularly important for research on rare diseases
    such as cystic fibrosis.
        Heart attack, stroke and other cardiovascular diseases in
    women.--Cardiovascular diseases remain a major cause of
    disability and the leading cause of death of American females.
    The clinical course of cardiovascular disease is different in
    men than in women and current diagnostic capabilities are less
    accurate in women than in men. Despite the seriousness of these
    diseases in women, the problem has gone largely unrecognized by
    women and their doctors. The Committee urges the Institute to
    expand research on cardiovascular diseases in women, including
    studies to develop safe, efficient and cost effective
    diagnostic approaches for women; and to create informational
    and educational programs for female patients and health care
    providers on heart disease and stroke risk factors.
        Hemophilia.--The Committee encourages NHLBI to enhance its
    efforts, working with the National Hemophilia Foundation's
    medical and scientific leadership, to address the needs of
    persons with hemophilia and other bleeding and clotting
    disorders, particularly in the areas of hemophilia gene
    therapy, research to improve blood and blood product safety,
    and treatment for hepatitis C and other complications of
    bleeding and clotting disorders, including women's bleeding
    disorders. The Committee notes the potential of gene therapy to
    dramatically improve the treatment of hemophilia and urges
    NHLBI to provide additional support for expansion of this
    critical effort. The Committee requests a progress report on
    the NHLBI's expanded activities in hemophilia gene therapy
    prior to next year's hearing.
        Hypertension and Kidney Disease.--The Committee is
    concerned that NHLBI is not currently funding or collaborating
    with the NIDDK on any research projects related to hypertension
    and its relationship to kidney disease. Given that hypertension
    is the second most common cause of kidney disease it would seem
    appropriate for the NHLBI to assign this a high priority. The
    Committee urges the NIDDK and the NHLBI to sponsor a workshop
    in collaboration with the renal community to define areas and
    research questions for a series of joint requests for
    applications by the NIDDK and NHLBI targeted at hypertension
    and kidney disease. The Director of the Institute should be
    prepared to testify on the progress in this area at the fiscal
    year 2002 appropriations hearings.
        Immune System Research Program for Heart Disease.--Basic
    knowledge about the body's disease fighting system is
    increasing rapidly, particularly in its involvement in the
    causes and development of heart disease and stroke. Innovative
    approaches are needed to use this knowledge to accelerate
    progress from basic knowledge to clinical applications. The
    Committee urges the Institute to expand research on
    inflammatory response to blood vessel injury that occurs in
    atherosclerosis, the cause of most heart attacks and strokes;
    healing of damaged heart tissues after a heart attack; and
    chronic rejection following heart transplantation.
        Lyme disease.--The Committee urges the Institute to study
    vascular disease with a specific focus on the unique features
    associated with Lyme disease.
        Maintaining Weight Loss.--An estimated 106 million
    Americans age 20 and older are overweight or obese, a condition
    that increases risk of diseases such as heart attack, stroke,
    high blood pressure and diabetes. The guidelines on the
    identification, evaluation, and treatment of overweight and
    obese adults, supported by the NHLBI in collaboration with the
    NIDDK, reviews the evidence that it is possible for overweight
    and obese Americans to lose a significant amount of weight over
    6 months, but only a few maintain their weight loss. The
    Committee urges the Institute to launch studies to improve
    understanding of weight loss maintenance and to examine
    behaviors that influence obesity, weight loss and weight loss
    maintenance.
        National Asthma Education and Prevention Program (NAEPP).--
    The Committee commends NAEPP for its leadership in helping to
    educate physicians, asthma patients, their families, and the
    general public regarding asthma and its management. The
    Committee urges NAEPP to enhance the role that its Advisory
    Committee plays in helping to coordinate asthma education
    throughout the United States. The Committee encourages NAEPP
    and NHLBI to work with other Public Health Service (PHS)
    agencies such as CDC, HRSA and the Office of the Surgeon
    General to develop a PHS-wide plan to control asthma.
        Pediatric Asthma Network.--The Committee recognizes that
    little is known about the optimal treatment for asthma in
    infants and young children. For example, the following issues
    still shroud the management of pediatric asthma: what the most
    effective dose and type of medicine for different types of
    asthma are; what the correct balance is between medical
    benefits and possible side effects; the best time to start
    different types of therapy; whether early therapy can prevent
    asthma from becoming more severe or even eliminate it as a
    child gets older; or the combination of therapies that will
    allow a child to participate fully in childhood activities. The
    Committee urges NHLBI to use the research amassed through the
    Pediatric Asthma Clinical Research Network to provide clearer
    choices for childhood asthma therapy, to encourage the
    development and dissemination of new therapies , and to
    identify optimum asthma management strategies for children.
        Primary Pulmonary Hypertension.--Primary Pulmonary
    Hypertension (PPH) is a rare, progressive and fatal disease
    that predominantly affects women of all ages and races. This
    disease causes deadly deterioration of the heart and lungs and
    is a secondary condition in many other serious and fatal
    conditions such as scleroderma and lupus. The Committee views
    research in this area as a very high priority due to its deadly
    impact and its presumed relevance to many other diseases. These
    include other forms of hypertension, heart and lung diseases,
    and organ transplants. The Committee commends NHLBI's efforts
    to promote research of PPH. The Committee urges the Institute
    to increase funding for basic research, gene therapy and
    clinical trials of promising pharmaceuticals, and to take
    appropriate measures to ensure the submissions of high quality
    proposals in this area.
        Promoting Adherence to Medical and Behavioral Therapies.--
    The Committee notes that failure to follow medical
    recommendations causes tens of thousands of deaths a year,
    increased hospitalizations and delayed recovery. It is
    estimated that 50 percent of patients do not comply with
    prescribed treatments; many life-extending drugs for heart
    attack survivors and heart failure patients are underused; and
    not all patients or doctors take advantage of information known
    to reduce or treat Americans at risk of heart disease or
    stroke. The Committee encourages the Institute to expand
    research on innovative theories about behavioral, cultural,
    social, psychological and environmental methods to increase
    adherence to lifestyle and medical regimen. The Committee
    further encourages the Institute to take steps to inform
    medical personnel of effective indicators to measure the
    standard of delivery of care of health systems and to change to
    change physician behavior and practices.

             NATIONAL INSTITUTE OF DENTAL and craniofacial RESEARCH

    Appropriations, 2000....................................    $269,185,000
    Budget estimate, 2001...................................     284,175,000
    Committee recommendation................................     309,923,000

        The Committee recommendation includes $309,923,000 for the
    National Institute of Dental and Craniofacial Research [NIDCR].
    This is $25,748,000 more than the budget request and
    $40,738,000 more than the fiscal year 2000 appropriation. The
    comparable amounts for the budget estimate include funds to be
    transferred from the Office of AIDS Research.
        Mission.--The NIDCR 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
    individuals 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 disease.--The Committee believes that identifying the
    link between oral bone loss and bone loss in the central part
    of the skeleton should be a priority of the Institute. With
    over 750 million dental x-rays performed in the United States
    each year, it appears that the Institute has a useful tool to
    compare bone loss in the oral cavity with bone loss elsewhere
    in the body. NIDCR is asked to report to the Committee prior to
    next year's hearings on how this information can be used to
    conduct research on the measurement of bone mass, as well as
    research on oral bone loss and its relationship to risk factors
    for osteoporosis. Also, given the large and growing number of
    individuals with periodontal disease and bone loss, increased
    funding for researching the conditions' genetic underpinnings
    should be pursued. A database of normal bone mass measurements
    in the mandible and alveolar crest would help advance further
    research. In addition, the Committee encourages the Institute
    to expand its work on dentinogenesis impefecta and orthodontic
    manipulation in people with osteogenesis imperfecta.
        Oral health.--The Committee commends the Institute for its
    multi-disciplinary approach to oral health promotion,
    particularly in its comprehensive Dental Health Centers. The
    Institute is encouraged to expand its behavioral research on
    reducing health disparities among minority populations. In
    particular, the Committee encourages NIDCR to expand its
    investigation of effective dental care and oral cancer
    prevention programs in minority populations.
        Osseointegration.--The Committee urges the NIDCR to
    consider supporting research that would improve the structure
    of and materials used in the production of dental implants.
        Temporomandibular Joint Disorders (TMJ).--The Committee
    remains deeply interested in research on temporomandibular
    joint disorders (TMJ) and is concerned over the continuing lack
    of resources applied to this area. The Committee is aware that
    NIDCR convened a Technology Assessment Conference on the
    management of TMJ, and urges the Institute to take steps to
    implement the recommendations of that conference. To help
    contribute to further progress on this front, NIDCR also is
    urged to continue its inter-institute committee--including
    representatives of the Office of Women's Health, CDC and AHRQ--
    to develop a short- and long-range TMJ research agenda prior to
    next year's hearings. Furthermore, the Committee urges NIDCR to
    study craniofacial and systemic problems resulting from dental
    implants.

        NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

    Appropriations, 2000....................................  $1,141,415,000
    Budget estimate, 2001...................................   1,209,173,000
    Committee recommendation................................   1,318,106,000

        The Committee recommends an appropriation of $1,318,106,000
    for the National Institute of Diabetes and Digestive and Kidney
    Diseases [NIDDK]. This is $108,933,000 more than the
    administration's request and $176,691,000 more than the fiscal
    year 2000 appropriation. The comparable amounts 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.
        Behavioral and Social Science Research for Diabetes.--The
    Committee would like to learn more about NIDDK's plans for
    setting a behavioral and social sciences research agenda for
    diabetes. In particular, the topics of diet and the prevention
    of obesity have prompted discussion during the Committee's
    hearings. According to some estimates, the prevalence of
    children who are overweight has nearly doubled over the past 20
    years, and minority groups are disproportionately affected.
    NIDDK is encouraged to continue to partner with the Office of
    Behavioral and Social Sciences Research and other institutes,
    to support basic and applied research on prevention and
    treatment of this problem. In addition, NIDDK is encouraged to
    explore partnerships with other institutes on health services
    delivery research that can improve communication among health
    providers, and between health providers and their patients, to
    enhance treatment for diabetes.
        Bladder Disease.--Over 35 million Americans suffer from
    some form of bladder disease, with this number rising as the
    population ages. Bladder cancer is the fourth most common
    cancer found in men, claiming at least 12,000 victims each
    year. Interstitial cystitis still poses a serious threat to its
    victims. Incontinence, although affecting up to 25 million,
    continues to cause shame and embarrassment to its sufferers and
    many will not seek treatment. The Committee is pleased that in
    1999 the NIDDK co-sponsored the International Bladder
    Symposium. However, given the scope and severity of bladder
    diseases, the Committee continues to be very concerned about
    the lack of support for bladder disease research funding within
    the NIDDK. The Committee, therefore, urges the Institute to
    substantially increase its research activity into bladder
    diseases through all available mechanisms. The Committee
    further requests the issuance of a request for applications in
    each of the major bladder disease areas and urges the Institute
    to support multi-center research initiatives. The Committee
    requests that the Urology Program of the NIDDK, in
    collaboration with the bladder cancer program of the NCI
    establish a Bladder Disease Task Force. This Task Force is
    requested to make recommendations on a 3-5 year research
    program within the Institute to increase research into the
    treatments and cures for bladder diseases. The Committee
    further encourages the Institute to report on the establishment
    of the Task Force and its early recommendations during next
    year's hearings.
        Bone disease.--The Committee urges the Institute to focus
    more attention on osteoporosis and other disorders of calcium
    metabolism, including renal osteodystrophy, which occurs in
    patients with chronic kidney disease. Nutritional and hormonal
    influences on calcium and skeletal status should also receive
    increased attention, as should functional genomics in bone. The
    Committee also urges the Institute to work with the National
    Cancer Institute to focus on cancer that spreads to bone.
        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 receive, iron accumulates in
    the major organs, particularly the heart and liver. The
    effective removal of iron by chelating drugs requires an
    accurate assessment of the iron levels in the patient. However,
    accuracy is impeded by the lack of a high-quality, non-invasive
    test to measure iron levels. Technology, known as SQUID, has
    been developed which holds great promise in addressing this
    problem. The Committee urges the institute to acquire this
    technology for use in an intramural research protocol testing
    its efficacy with Cooley's anemia patients, while pursuing
    opportunities to improve the equipment through the use of
    advanced materials and computer applications. In addition, the
    Committee remains interested in the research progress being
    made with regard to the development of safe and effective iron
    chelator drugs that are less troublesome those currently used,
    as well as the development of drugs for the regulation of
    hemoglobin synthesis.
        Cystic Fibrosis.--The Committee understands that the NIDDK
    is conducting a clinical trial to test the safety and
    effectiveness of inhaled tobramycin in infants with cystic
    fibrosis (CF). The NIDDK is to be commended for investing in
    clinical studies, particularly for rare diseases such as CF, as
    they are a priority for the Committee.
        Diabetes.--Diabetes affects 16 million Americans and is
    estimated to cost more than $100,000,000,000 annually. The
    Committee strongly requests that NIDDK, working with NIAID and
    NICHD, create a coordinated international effort to develop a
    vaccine to prevent juvenile, or Type 1, diabetes. The Committee
    is aware that a 1999 Institute of Medicine Report concluded
    that development of a vaccine to treat or prevent Type 1
    diabetes would bring exceptionally high health and economic
    benefits to society and that the Diabetes Research Working
    Group has recommended that a major effort be launched in this
    area. The Committee requests the NIDDK to inform the Committee
    by February 1, 2001 of its plans for implementing this
    initiative.
        The Committee strongly requests that NIDDK, working with
    NHGRI and NICHD, jointly implement a major effort to identify
    the genes associated with juvenile and Type 1 diabetes.
        Diabetes in Hispanic Populations.--Hispanic Americans are
    disproportionately affected by diabetes, with over 1.8 million
    affected by this disease. The Committee encourages the
    Institute to underetake efforts to include this population in
    NIH studies and to expland research to understand why diabetes
    disproportionately affects this population.
        Diabetes in Native Hawaiians.--The Committee recognizes the
    Institute's interest in studying the incidence of diabetes in
    native American, Hawaiian, and Alaskan populations, and
    encourages NIH to include native Hawaiian and Alaskan
    populations, the Mississippi Band of the Choctaw Indians, and
    the Eastern Band of the Cherokee Indians in diabetes studies.
        Digestive Disease Centers.--The Committee recognizes the
    success of NIDDK's Digestive Disease Centers program in
    addressing a wide range of disorders that result in tremendous
    human suffering and economic cost. The Committee continues to
    encourage NIDDK to expand this important program, with an
    increased emphasis on inflammatory bowel disease.
        Digestive Diseases.--Diseases of the digestive system
    continue to affect more than half of all Americans at some time
    in their lives. Serious disorders such as colorectal cancer,
    inflammatory bowel disease, irritable bowel syndrome, and viral
    hepatitis take a significant toll in terms of human suffering,
    mortality, and economic burden. The Committee continues to
    encourage NIDDK to strike an appropriate balance between
    conducting basic studies on digestive diseases and brining
    those research findings to the bedside in the form of improved
    patient care.
        The Committee has been encouraged in recent years by
    discoveries related to Crohn's disease and ulcerative colitis,
    collectively known as inflammatory bowel disease (IBD). These
    extremely complex disorders represent the major cause of
    morbidity and mortality for intestinal illness. The Committee
    continues to encourage NIDDK to give priority consideration to
    the following areas of IBD research; (1) investigation into the
    cellular, molecular and genetic structure of IBD, (2)
    identification of the genes that determine susceptibility or
    resistance to IBD in various patient subgroups, and (3)
    coordination and integration of basic investigations designed
    to clarify mechanisms of action and disease pathogenesis into
    clinical trials, as described in the research agenda developed
    by the scientific community entitled ``Challenges in
    Inflammatory Bowel Disease.''
        End-stage renal disease.--The Committee understand that
    recent studies suggest that patients with end-stage kidney
    disease are far more likely to have close family relatives with
    kidney disease. Certain ethnic populations in America also have
    an increased risk of kidney disease. Hispanics in the western
    United States have a four-fold increased likelihood over
    Caucasian and Asian-Americans for end-stage renal disease
    requiring dialysis. The increased likelihood for African-
    Americans is at least six-fold and in certain urban areas the
    likelihood is far greater. The Committee encourages the NIDDK
    to take advantage of these ``familial clusters'' to create a
    kidney genome anatomy program and to consider funding projects
    to make and sequence DNA libraries from normal and diseased
    tissues. The Committee also encourages NIDDK to supply and
    implement the bioinformatics required to link the gene
    fragments with gene names in NIH-supported databases, and to
    provide this information, with access to the clones, to the
    scientific community.
        Hepatitis C.--The Committee is aware that little is
    understood about the mechanisms that lead to the transition of
    acute hepatitis C into its more chronic forms. Little is also
    known about the most appropriate time to begin treatment of
    those with hepatitis C to prevent the progression of the
    disease. The Committee encourages the Institute to invest
    additional resources into the causes and treatments of this
    disease.
        The Committee is pleased that the NIDDK has made an award
    for a large-scale hepatitis C clinical trial that will involve
    over 1,000 patients and nine sites across the country. This
    trial, known as the HALT-C trial, is expected to yield
    important scientific discoveries, and offer opportunities for
    ancillary studies regarding the relatively low response rate to
    current hepatitis C treatments. Those ancillary studies could
    include the influence of genetic factors, the rate and cause of
    viral mutations, and the wide range of reactions of hepatitis C
    patients to treatment protocols. The Committee urges NIDDK to
    provide the funding necessary to pursue these ancillary
    research opportunities.
        The Committee is aware that nearly all individuals with
    hepatitis C as the primary indication who receive a liver
    transplant become re-infected. While the severity of the re-
    infection typically can be controlled, approximately 10 percent
    of the cases develop severe chronic hepatitis C within 2 years.
    Therefore, the Committee urges additional research focused to
    minimize the re-infection rate, including the evaluation of
    promising pharmaceuticals such as civacir to control hepatitis
    C re-infection. This is of particular importance since
    hepatitis C is the leading cause of liver transplants.
        Hereditary Hemochromatosis.--Hereditary hemochromatosis is
    the most common genetic disease known. It is prevalent in
    persons of northern European, Celtic and Irish extraction and
    is characterized by excessive iron levels. Iron accumulates in
    the internal organs, particularly the liver, and by the time it
    is discovered, it has often caused extensive damage. The
    Committee urges the Institute to expand its research portfolio
    on this disease, particularly as it relates to early diagnosis.
        Hypertension and Kidney Disease.--The Committee is
    concerned that NHLBI is not currently funding or collaborating
    with the NIDDK on any research projects related to hypertension
    and its relationship to kidney disease. Given that hypertension
    is the number two cause of kidney disease it would seem
    appropriate for the NHLBI to have this as a priority area. The
    Committee urges the NIDDK and the NHLBI to sponsor a workshop
    in collaboration with the renal community to define areas and
    research questions for a series of joint requests for
    applications by the NIDDK and NHLBI targeted at hypertension
    and kidney disease. The Director of the Institute should be
    prepared to testify on the progress in this area at the fiscal
    year 2002 appropriations hearings.
        Interstitial cystitis.--The Committee understands that
    research on interstitial cystitis is at a critical juncture,
    with several promising preliminary research findings yet to be
    pursued. The Committee encourages NIDDK to undertake a more
    aggressive approach to this chronic, debilitating disease. The
    Committee is pleased that the NIDDK has initiated in fiscal
    year 2000 a study of the epidemiology of the disease, and
    requests the Institute report to the Committee during next
    year's hearings on the status of this initiative. The Committee
    encourages the Institute to increase research into the basic
    and clinical aspects of interstitial cystitis and to establish
    centers which have a significant minority enrollment.
        Irritable bowel syndrome.--The Committee remains concerned
    about the increasing frequency of irritable bowel syndrome
    (IBS), a chronic complex of disorders that affect the digestive
    system. These common dysfunctions strike people from all walks
    of life and result in tremendous suffering and disability. The
    Committee encourages NIDDK to increase funding for irritable
    bowel syndrome/functional bowel disorders research and to give
    priority consideration to funding IBS education/scientific
    symposiums.
        Kidney disease.--As part of implementing the scientific
    recommendations of the Diabetes Research Working Group, the
    Committee encourages the NIDDK to expand its Diabetes Genome
    Anatomy Project to include a focus on the kidney disease that
    is a major complication of diabetes.
        Kidney disease education.--The Committee urges the NIDDK to
    plan and implement a National Kidney Disease Education Project.
    Given that there are some ways to slow the progress of kidney
    disease if it is identified early, NIDDK is urged to launch an
    effort to reach out to the more than 12 million Americans
    living with chronic renal insufficiency. These individuals are
    often unaware that they suffer from this disease until they
    have already reached end-stage renal disease and require
    dialysis or a transplant. The Committee urges the NIDDK to
    bring these advances in medical care to the consumers. The
    Director of the Institute should be prepared to testify on the
    progress of this initiative at the fiscal year 2002
    appropriations hearings.
        Liver Transplantation Conference.--The Committee is aware
    of the significant and continuing shortage of livers available
    for transplantation, and therefore urges additional research
    that would facilitate the success of liver transplantation and
    the number of livers available for transplantation. Many
    believe that the use of living liver donors may be one of the
    most important surgical and scientific breakthroughs that can
    assist people in the need of liver transplants.
        National Center for Medical Rehabilitation Research.--The
    Committee encourages the NCMRR to expand its clinical trials
    network and program to test the efficacy of medical
    rehabilitation. The Committee believes that additional funds to
    the NCMRR also could support a pediatric trauma initiative and
    a new program regarding tissue and cell plasticity and recovery
    from injury.
        Non-Alcoholic Steatohepatitis.--The Committee is aware that
    non-alcoholic steatohepatitis liver disease is one of the most
    common liver diseases and is often unrecognized and
    undiagnosed. While this form of liver disease is initially
    mild, it may lead to cirrhosis and liver failure. Therefore,
    the Committee urges research into the cause or pathogenesis of
    this disease as well as research on treatments.
        Pediatric kidney disease.--The Committee notes that kidney
    disease remains a persistent problem among infants, children
    and adolescents. An estimated 1,200,000 children under the age
    of seven will develop urinary tract infections that may
    permanently damage kidney tissue. Over 100,000 children will be
    treated for diabetes, many of whom will ultimately suffer renal
    failure and require dialysis. Another 76,000 young people will
    have to be treated for hypertension, a precursor for renal
    failure and cardiovascular disease that disproportionately
    affects minorities. Given the extent of these problems and
    their long-term implications when children reach adulthood, the
    Committee encourages NIDDK to enhance its research efforts into
    the prevention and treatment of chronic renal failure and end-
    stage renal disease in children from all causes, including
    diabetes, hypertension, genetic kidney disease and disorders of
    renal development. NIDDK also is urged to focus on new
    approaches to enhance or accelerate recovery from acute renal
    failure, which commonly occurs in hospitalized pediatric
    patients and accounts for substantial sickness and death.
        Polycystic kidney disease.--The Committee is pleased that
    the NIDDK has established four P-50 inter-disciplinary research
    centers targeting PKD in response to the unprecedented
    scientific momentum in this area and strong support in
    Congress. The Committee is aware that recent advances,
    including the discovery of a drug that virtually stops one form
    of PKD in laboratory animals, presents further evidence that
    dramatic progress toward a treatment and ultimate cure for PKD,
    in as few as 5 years, is now more likely. It is the Committee's
    strongest recommendation that the PKD Strategic Plan, developed
    at NIDDK in early fiscal year 1999, be implemented and fully
    funded as expeditiously as possible. Anything less places in
    greater jeopardy many of the 600,000 Americans with this
    devastating disease whose kidneys are still functioning, the
    ones for whom a treatment to stop the progression of PKD may
    well mean the avoidance of kidney failure and its devastating
    consequences.''
        Pregnancy Complications.--The Committee encourages the
    NICHD to consider sponsoring a planning workshop in fiscal year
    2001 for the purpose of defining research questions in such
    areas as pre-maturity, pre-term labor, pre-eclampsia, amniotic
    fluid embolism, in utero screening for birth defects, post-
    partum hemorrhage, and other complications related to
    pregnancy.
        Prescription and Non-Prescription Medications and Acute
    Liver Failure.--The Committee is aware that the most common
    cause of acute liver failure is a reaction to over-the-counter
    and prescription medications. With the aging of the population,
    and consequently more and more Americans using multiple
    medications, NIDDK is urged to pursue additional research to
    isolate the causes of adverse reactions to medications.
        Prostatitis.--The Committee is pleased that the NIDDK has
    recognized prostatitis as one of the three major diseases of
    the prostate gland. The Committee continues to encourage
    efforts to more aggressively explore the relationship among
    these diseases of the prostate. The familial possibilities of
    the disease of prostatitis have not been thoroughly explored
    and should be combined with similar research being done by
    other agencies into prostate cancer. The Committee believes
    there is mounting evidence that prostatitis is a worldwide
    problem and that millions of American men suffer from the
    disease. The Committee further encourages more solicitation of
    individual applications from investigators with diverse
    backgrounds to address clinical research approaches. Including
    representatives from NCI, NINDS, NINR, and outside medical
    consultants from diverse speciality backgrounds. The Committee
    recommends that NIDDK add two more centers to support this
    work. The Committee also urges the Institute to expand its
    studies of various minority groups, and encourages expanded
    outreach efforts that include educational materials directed at
    primary care physicians, the urology community, patients and
    the general public.

            NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

    Appropriations, 2000....................................  $1,029,743,000
    Budget estimate, 2001...................................   1,084,828,000
    Committee recommendation................................   1,189,425,000

        The Committee recommends an appropriation of $1,189,425,000
    for the National Institute of Neurological Disorders and Stroke
    [NINDS]. This is $104,597,000 more than the budget request and
    $159,682,000 more than the fiscal year 2000 appropriation. The
    comparable amounts 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 those at risk for brain
    disorders.
        Alzheimer's disease.--NINDS continues to play an integral
    part in advancing science's understanding of Alzheimer's, a
    disease that currently afflicts an estimated 4,000,000
    Americans. Within the past year alone, researchers have made
    several critical discoveries about how Alzheimer's destroys the
    brain, discoveries that may eventually open the way to finding
    a cure or halt the progression of this disease. NINDS recently
    co-sponsored two program announcements aimed at increasing the
    number of clinical trials for Alzheimer's disease. The
    Committee encourages NINDS to continue to assign this a high
    priority, and to continue its close working relationship with
    NIA, NIMH and NINR.
        Alzheimer's disease and PET Scans.--The Committee is aware
    that positron emission tomography (PET) has been shown to
    identify Alzheimer's disease at a significantly earlier stage
    than other diagnostic methods. Earlier diagnosis of Alzheimer's
    allows for added treatment options which may delay the onset of
    the more debilitating aspects of this disease. The Committee
    urges NINDS, in collaboration with the National Institute on
    Aging and the National Institute of Mental Health, to expand
    its research into early diagnosis of Alzheimer's using PET
    imaging of the brain.
        Amyotropic Lateral Sclerosis (ALS).--Also known as Lou
    Gehrig's Disease, ALS is a progressive, fatal neurological
    disease for which no cure has been found. The disease strikes
    all demographic and age groups, and 85 percent of those
    diagnosed succumb within 2 to 3 years. Diagnosis is difficult,
    and can take years; there is no simple test for the disease.
    Over the course of this decade, there have been a number of
    research breakthroughs: the identification of a defective gene
    responsible for some cases of ALS and a better understanding of
    how that defective gene may lead to ALS; FDA approval of the
    first drug treatment of ALS; and the development of new tools
    for studying ALS as well as potential therapies. Findings with
    respect to ALS can lead to methods for prevention and treatment
    of many other neurodegenerative disorders, including
    Parkinson's, Alzheimer's, Huntington's, and multiple sclerosis.
    The Committee applauds the Institute for its emphasis on
    research into identification of neurodegeneration. The
    Committee encourages the Institute to consider a research
    planning workshop which would bring together ALS researchers
    and experts from other fields to foster new ideas and research
    directions that might lead to rapid advances in the
    understanding and treatment of ALS and related
    neurodegenerative diseases. The Committee also encourages the
    Institute to continue to expand and intensify its research
    efforts into ALS.
        Ataxia Telangiectasia.--The Committee believes that more
    attention needs to be paid to pediatric neurodegenerative
    disorders. Insight into childhood diseases such as ataxia-
    telangiectasia (A-T) will have applicability to all
    neurological disorders. Because the neurological manifestation
    of A-T is the most pervasive and currently untreatable facet of
    this disease, the Committee encourages NINDS to allocate funds
    to neuroimaging research and other tools aimed at quantifying
    A-T progression as well as assessing strategies for
    neuroprotection and therapies directed towards neural cell
    replacement.
        Batten disease.--The Committee is disappointed with the
    pace of research in Batten disease. The Committee believes that
    the Institute should actively solicit grant applications for
    Batten disease and also take aggressive steps to assure that a
    vigorous research program be established. In recent years,
    funding for this disease has decreased. The Committee requests
    that NINDS be prepared to discuss the funding history and steps
    taken to increase research in this area. The Committee strongly
    urges that increased funding be provided to combat this
    devastating disease.
        Charcot-Marie-Tooth Disorder.--The Committee urges the
    Institute to expand research in Charcot-Marie-Tooth Disorder.
    One of the most common inherited neurological disorders, CMT
    affects approximately 150,000 individuals, who slowly lose
    normal use of their hands and feet as nerves to the extremities
    degenerate.
        Chromosome 18.--The Committee is aware of efforts to
    encourage new scientific work into the molecular genetic,
    clinical and therapeutic aspects of chromosome abnormalities.
    Chromosome abnormalities involving chromosome 18q result in
    growth failure, mental retardation and central nervous system
    dysmyelination. NIH has supported little research into the
    abnormalities of chromosome 18, despite repeated urging by this
    Committee. The Committee again urges the Institute to ensure
    that the review process will adequately assess Chromosome 18
    applications and to devote more research into this genetic
    abnormality.
        Duchene/Becker Muscular Dystrophy.--The Committee urges the
    Institute to collaborate with the NIAMS to intensify research
    into Duchenne/Becker Muscular Dystrophy. The Committee strongly
    encourages NIH to examine ways in which the grant review
    process can expand and sustain research in this area, including
    considering establishing a separate muscle biology section. The
    Committee also urges the NIH to conduct a research conference
    to evaluate the status of research and assist in properly
    directing the critical science investment in muscle research.
    The Committee requests that NIH prepare a report on the
    progress of research related to Duchenne/Becker Muscular
    Dystrophy and outline investment strategies regarding this
    disease. The Institute should actively solicit grant
    applications in this area.
        Dystonia.--The Committee continues to be pleased with
    NINDS's extramural research portfolio with respect to dystonia,
    and encourages NINDS to continue to expand the study of the
    DYT1 gene. In addition, the Committee encourages the Institute
    to expand its collaboration with the dystonia research
    community in supporting epidemiological studies on dystonia and
    in increasing public and professional awareness.
        Epilepsy.--The Committee seeks continued and intensified
    efforts by the Institute to create breakthroughs in the
    prevention, treatment and eventual cure of epilepsy, a disease
    affecting over 2.5 million Americans. Of that number, fully 2
    million Americans experience limited or no relief with existing
    treatment. The Committee encourages the Institute to target
    additional resources specifically to intractable epilepsy,
    which most often begins in childhood and is strongly associated
    with cognitive dysfunction due to the impact of uncontrolled
    seizures on the developing brain. The Committee is pleased that
    the Institute has sponsored the March 2000 conference ``Curing
    Epilepsy: Focus on the Future'' and expects an update on plans
    to advance promising areas of research identified during the
    conference at the fiscal year 2002 appropriations hearing.
        Facioscapulohumeral muscular dystrophy and
    facioscapulohumeral disease (FSHD).--The Committee is extremely
    concerned that funding for FSHD has decreased and that no new
    projects have been funded over the past year. The Committee
    requests that the NIH report to the Committee after the
    upcoming research planning conference on steps it will take to
    create a comprehensive research portfolio in FSHD. The
    Committee further urges that NIH make research in FSHD a high
    priority.
        Holoprosencephaly.--The Committee is pleased that NINDS is
    interested in funding new research for the treatment of
    holoprosencephaly, a severe neurological birth deficit
    affecting 1 in 5000 live births and 1 in 250 of all births.
    Recently, private organizations have made great strides towards
    understanding and treating this disorder, through establishing
    and funding three Clinical Centers of Excellence to treat
    holoprosencephaly. The Committee is encouraged by the recent
    First NIH Symposium on Holoprosencephaly, and encourages the
    NINDS and other relevant institutes to significantly increase
    their multi-disciplinary activities aimed at understanding and
    treating this disease.
        Lyme disease.--The Committee urges the Institute to study
    central nervous system abnormalities associated with Lyme
    disease. Unfortunately, prognosis of patients with cerebral
    involvement is not good; even with antibiotic treatment there
    can be residual disability. The Committee therefore urges that
    diagnostic techniques including brain imaging and improved
    treatment protocols be designated as research priorities. The
    Committee is encouraged by a recent grant for brain imaging in
    neuroborreliosis patients. The Committee also urges the
    Institute to study peripheral nervous system abnormalities
    associated with Lyme disease.
        Neurodegenerative Disorders.--The Committee is encouraged
    by the level of emphasis placed on neurodegenerative disorders
    research within NINDS and across NIH. The Committee continues
    to support research investigating the role of neurotransmitters
    in neurodegenerative disorders.
        Neurofibromatosis.--The Committee is aware that recent
    advances in NF research have linked NF to cancer, brain tumors,
    learning disabilities and heart disease. Because of the
    enormous promise of NF research, the Committee encourages NINDS
    to expand its NF basic and clinical research portfolio
    including clinical trials. The Committee is pleased that the
    Institute has initiated a trans-institute workshop on NF to be
    held this spring and encourages the Institute to continue to
    coordinate its efforts with other Institutes engaged in NF
    research. The Committee also requests that the Institute be
    prepared to report on the status of the NF research portfolio
    at its fiscal year 2002 appropriations hearing.
        Outreach.--The Committee commends NINDS for its public
    education and outreach programs. The Committee encourages NINDS
    to continue these efforts, with special attention to innovative
    approaches to outreach, education, and recruitment and
    retention of staff.
        Paralyzed vocal cords.--The Committee expects the Institute
    to collaborate with NIDCD on the development or adaptation of
    electrical stimulation devices. These devices would activate
    the reflexes of the paralyzed muscles that open the airway
    during breathing in cases of paralyzed vocal cords due to
    trauma or neurodegenerative disease.
        Parkinson's Disease.--The Committee is encouraged by
    continuing discoveries in the cause, pathophysiology and
    treatment of Parkinson's disease, and continues to encourage
    efforts by NINDS to speed the development of effective
    therapies for this devastating disorder. Several recent
    findings demonstrate a strong scientific foundation for a major
    new initiative in Parkinson's research. The Committee also
    recognizes the benefits of research breakthroughs in this area
    on other disorders within the Institute's scope. The Committee
    acknowledges the 1997 enactment of the Morris K. Udall
    Parkinson's Research Act as a timely recognition of the
    scientific potential in this field and a clear statement of
    intent by Congress to make Parkinson's research a priority. The
    Committee is further aware that the NIH has completed a
    Parkinson's-Disease research agenda including professional
    judgement funding projections for the next 5 years. In
    addition, the Committee is pleased with the joint initiative of
    NIEHS and NINDS on investigating environmental determinants of
    Parkinson's disease, and expects the Director to encourage
    further collaboration among Institutes through the Parkinson's
    Disease Coordinating Committee. The NIH director should be
    prepared to discuss Parkinson's disease research planning and
    implementation for fiscal year 2001 and 2002 during the
    hearings on the fiscal year 2002 budget.
        Reflex Sympathetic Dystrophy (RSD).--RSD is a very painful
    and disabling disease that affects an estimated 7 million
    people in the United States. Since it is little understood, RSD
    is often misdiagnosed and therefore not properly treated. The
    early stages of the disease are the most critical time period
    because treatment is highly effective within the early stages.
    These therapies and treatments trigger remission in almost 97
    percent of the cases treated properly in this early stage.
    Nearly 75 percent of the 7 million people affected will be
    forced to suffer with RSD for their entire lives due to
    incorrect diagnosis.
        Given the scope and severity of this disease, the Committee
    is concerned about the lack of support for research and
    development for RSD treatment. Therefore, the Committee urges
    NINDS to increase funding for further research into RSD in the
    hope that early detection can lead to completely effective
    treatment.
        Spinal Cord injury.--The Committee is pleased to learn of
    the exciting scientific advances being made on several fronts
    which hold much promise for progress against the devastating
    and lifelong effects of spinal cord injury. Research to promote
    regeneration and restore function to the injured spinal cord is
    proceeding along two promising and complementary lines--
    implantation of cells and modification of the injury site's
    environment to promote functional recovery. A particularly
    exciting approach involves the implantation of pluripotent,
    neural stem cells--undifferentiated progenitor cells with the
    potential to replace damaged components of the central nervous
    system. In addition to traditional funding mechanisms, the
    Committee understands that this area of research may benefit
    from efforts to promote new types of collaborations and to
    build on currently funded projects that could be expanded to
    include stem cell research. The Committee urges the NINDS to
    aggressively pursue and initiate studies that will hasten
    progress to restore function to the injured spinal cord and
    offer hope to victims of spinal cord injury and their families.
    The Committee expects NINDS to report on its progress in
    promoting research on cell replacement in spinal cord injury at
    its fiscal year 2001 appropriations hearing.
        Stroke.--The Committee continues to regard research into
    the causes, cure, prevention, treatment and rehabilitation of
    stroke as one of the Nation's top priorities. Stroke remains
    the third leading cause of death in the United States, a
    leading cause of permanent disability and a major contributor
    to late-life dementia. Stroke survivors often face years of
    debilitating physical and mental impairment, emotional distress
    and overwhelming medical costs. The Committee continues to
    believe that an intensive research program on stroke should be
    a top priority of the NINDS and the NIH.
        The Committee encourages the NINDS to place the highest
    priority on stroke research and to expand its stroke education
    program, develop acute stroke research or treatment research
    treatment centers, and initiate and continue innovative
    approaches to improve stroke diagnosis, treatment,
    rehabilitation and prevention. The Committee understands that
    the next phase of NINDS strategic planning will include an in-
    depth review of progress and opportunities for specific
    disorders or groups of disorders. The Committee urges NINDS to
    work closely with the research community, clinicians, voluntary
    health organizations and patient advocacy groups to apply this
    approach to stroke. The review should identify promising new
    avenues of basic and clinical stroke research and address
    resources, including infrastructure and funding mechanisms,
    needed for progress against stroke. The Director should be
    prepared to discuss plans and implementation steps for stroke
    research at next year's hearings.
        Stroke and PET scans.--The Committee encourages NINDS to
    expand its research efforts into the utility of PET scans of
    the brains of stroke victims to determine whether brain tissue
    damage from stroke may be reversible.
        Stroke in women.--The Committee is concerned with the pace
    of research on stroke in women. Stroke in women is a major
    public health problem. Traditionally considered a mens'
    disease, over half of all strokes occur in women, and it is now
    the second leading cause of death among women. In fact, stroke
    kills many more women than breast cancer or AIDS. Women are
    three times as likely as men to die of stroke in the hospital,
    and their care is often delayed. In addition, stroke is also a
    leading cause of serious disability among women, and may
    contribute to late-life cognitive decline. Some aspects of the
    disease unique to women include strokes related to pregnancy
    and the use of oral contraceptives. The Committee is pleased to
    learn that NINDS is funding a trial looking at whether
    postmenopausal hormone replacement therapy alters stroke risk
    remains unclear. Furthermore, significant differences exist
    between men and women as to the benefits of surgical procedures
    to open arteries leading to the brain. The Committee urges the
    Institute to increase research specifically in the area of
    stroke-related care, risk factors, preventive strategies, acute
    stroke management and aspects of post-stroke recovery among
    women. The Committee further urges the Institute to take steps
    to increase research into new therapies for stroke in women as
    well as ways of enhancing the vascular health of all Americans.
        The Committee also encourages the creation of acute stroke
    research or treatment research treatment centers to provide
    rapid, early, continuous 24 hour treatment to stroke victims
    including the use of the clot-buster drug TPA, if appropriate.
    A dedicated area in a medical facility with resources,
    personnel team and equipment to treat stroke, would also
    provide an opportunity for early evaluation of stroke
    treatments.
        Traumatic Brain Injury.--The Committee recognizes traumatic
    brain injury (TBI) as a serious public health problem,
    affecting hundreds of thousands of families with 500,000
    hospitalizations and 60,000 deaths per year. The Committee is
    aware of the development of scientific, evidenced-based
    guidelines for TBI and encourages the Institute to educate
    trauma centers staff and others about these guidelines.

             NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

    Appropriations, 2000....................................  $1,796,631,000
    Budget estimate, 2001...................................   1,906,213,000
    Committee recommendation................................   2,066,526,000

        The Committee recommends an appropriation of $2,066,526,000
    for the National Institute of Allergy and Infectious Diseases
    [NIAID]. This is $160,313,000 more than the budget request and
    $269,895,000 more than the fiscal year 2000 appropriation. The
    comparable amounts 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.
        Acute bacterial sinusitis.--The Committee is aware that
    acute bacterial sinusitis is one of the most common infections
    in the United States, and its treatment is one of the major
    contributors to the development of antibiotic-resistant
    organisms. Novel strategies for eliminating infectious diseases
    must be sought, such as systemic vaccination with specific
    bacterial outer membranes; bacterial interference; and mucosal
    vaccination with bacteria or bacterial products.
        AIDS.--AIDS is currently the leading cause of death among
    African-Americans between the ages of 25 and 44, the third
    leading cause of death for Hispanics and the fifth leading
    cause of death for all Americans in that age range. The
    Committee encourages the Institute to continue to expand
    research into HIV/AIDS.
        The Committee is aware that NIAID has conducted more than
    50 clinical studies of HIV vaccines. Among these is the first
    HIV vaccine trial in Africa, a study initiated in Uganda last
    year in a growing effort to collaborate with scientists from
    developing countries to identify safe and effective vaccines
    suitable for worldwide use. The Committee applauds these
    efforts. The Committee also applauds the creation of the Dale
    and Betty Bumpers Vaccine Research Center, dedicated in 1999,
    and located within the NIH intramural research program to
    stimulate multi-disciplinary vaccine research.
        Asthma Research and Management.--The Committee is very
    pleased with NIAID's leadership regarding asthma research and
    management. The Committee recognizes the role the institute has
    played in the Inner City Asthma Study and the importance of
    this effort with regard to morbidity and mortality among
    underserved populations, particularly African-American
    children. The Committee urges NIAID to continue to sharpen its
    focus and effort on asthma management, especially as it relates
    to children.
        Chronic Fatigue Syndrome.--Despite the Committee's
    supportive report language encouraging NIH to provide
    additional resources for CFS research, funding has not
    increased. This is especially disturbing in light of past
    budget increases given to NIH overall. The Committee is pleased
    that the Office of the Director has assumed management of NIH's
    CFS activities and expects that a better coordinated and
    focused CFS research effort will be implemented across NIH. The
    Committee urges NIH officials to identify appropriate NIH
    advisory committees for CFS representation and ensure
    appointment of qualified persons to those committees. The
    Committee is concerned by reported difficulties NIH has had in
    attracting established scientists to this field of study. The
    Committee asks that NIH report within 60 days of enactment of
    this bill its plans for the future of the NIAID intramural CFS
    research program and progress on outreach efforts to public and
    private scientists with the goal of stimulating research
    interest and encouraging investigators to bring their research
    interests to bear on CFS research, such as the February 2000
    and November 2000 CFS ``State of the Science'' meetings. To
    further bolster scientific interest in CFS, the Committee
    strongly encourages NIH to provide additional funds for
    extramural grants focused on promising areas of CFS research,
    such as efforts to define the etiology and pathophysiology of
    the illness and identify diagnostic markers. The Committee also
    encourages the establishment of a special Program Announcement
    dedicated to the study of all facets of pediatric CFS.
        Crohn's Disease.--The Committee notes with interest, the
    NIAID's research recommendations on Crohn's disease and
    encourages the Institute to aggressively support research in
    this important area.
        Diabetes.--The Committee is pleased with the progress of
    the Collaborative Network for Clinical Research on Immune
    Tolerance. The Committee is aware that progress in this area
    could lead to cures for diabetes and other autoimmune diseases.
    The Committee is particularly interested in the application of
    this research to the potential cure of Type 1 diabetes, and
    urges the Institute to continue efforts in this area. The
    Committee strongly urges that NIAID, working with NIDDK and
    NICHD, create a coordinated international effort to develop a
    vaccine to prevent juvenile, or Type 1, diabetes. The Committee
    expects NIAID to report by February 1, 2001 its plan for
    implementation. The Committee is aware of the NIAID's expertise
    and leadership in the development of many vaccines for
    infectious diseases and recognizes that this expertise will be
    instrumental to the success of this effort targeting diabetes.
        Hemophilia.--The Committee is pleased that NIAID, working
    with the National Hemophilia Foundation's medical and
    scientific leadership, has developed recommendations for
    strategies to improve treatment of HIV and associated
    complications, including hepatitis C, in persons with
    hemophilia. The Committee encourages NIAID to continue to work
    with the hemophilia community to carry out the Institute's
    hemophilia research recommendations and requests a report on
    next steps being taken to implement these recommended actions.
        Hepatitis C Vaccine Development.--The Committee encourages
    increased priority on research that will accelerate the
    development of a hepatitis C vaccine. The development of an
    effective vaccine would be greatly assisted by research that
    studies the mechanisms that lead to recovery from initial
    infection, the mechanism that leads to the transition from
    asymptomatic infection to chronic infection and recovery in
    response to therapy. The Committee is aware that the NIAID has
    conceptually approved research in this field encompassed in a
    project titled ``Hepatitis C: Recovery Research Network''. The
    Committee urges that adequate funding be made available to
    initiate this project, a portion of which should be devoted to
    evaluating early treatment or treatment within the first year
    of infection.
        Human Papillomavirus (HPV).--The Committee is aware of the
    recommendations of the expert panel on HPV recently convened by
    CDC and the American Cancer Society. The Committee encourages
    NIAID in collaboration with both NCI and CDC as appropriate, to
    increase research on vaccine and microbicide development to
    prevent HPV infection, establish collaborative research in the
    areas of diagnostic tests and effective management of HPV in
    the clinical setting, and fund epidemiological studies on
    factors contributing to persistent HPV infection.
        Inflammatory Bowel Disease.--The Committee continues to
    note with interest a scientific research agenda for Crohn's
    disease and ulcerative colitis (collectively known as
    inflammatory bowel disease) entitled ``Challenges to
    Inflammatory Bowel Disease (IBD).'' This report identifies
    strong linkages between the immune system and IBD. The
    Committee is pleased that NIAID has recently partnered with the
    IBD community on a research proposal and encourages the
    Institute to expand its support of research focused on the
    immunology of IBD as well as the interaction of genetics and
    environmental factors in the development of the disease.
        Lyme disease.--Rocky Mountain Laboratories (RML) is to be
    congratulated for their excellent work and the Committee
    strongly encourages NIH and other DHHS agencies to include
    these researchers in their activities and meetings. The
    Committee encourages NIAID to conduct broader outreach to the
    medical, scientific and voluntary organizations involved in
    Lyme disease research, treatment, prevention and education in
    order to better understand the broad range of divergent views
    about these illnesses as well as understand the plight of the
    patients affected by tick-borne disorders. This outreach should
    include the involvement of community-based clinicians with
    extensive experience in treating patients, volunteer advocacy
    organizations, and patient advocates in NIH advisory
    committees, meetings and workshops regarding tick-borne
    diseases. The Committee encourages NIH to take measures to
    facilitate cooperation among the Lyme disease community and NIH
    grantee-academic physicians, community-based physicians and the
    patient community.
        Malaria.--The Committee commends the NIAID for making
    malaria research and vaccine development a high priority and
    for pursuing collaborative research efforts with private sector
    partners, including the Malaria Vaccine Initiative. The
    Committee strongly encourages NIAID to continue to follow an
    aggressive malaria research agenda, including not only vaccine
    development but also the pursuit of therapeutics for improved
    treatment of this global killer that claims 2 to 3 million
    lives each year.
        Nutrition therapy and HIV/AIDS.--A growing body of evidence
    suggests that nutritional counseling and nutrition support may
    improve nutritional status in persons with HIV/AIDS (greater
    calorie intake and weight gain). The Committee recommends
    further research to identify optimum combinations of nutrition
    interventions, pharmacologic approaches, and exercise that will
    maximize nutrition status and clinical outcomes in HIV/AIDS in
    a cost-effective manner, particularly in persons age 50 and
    older.
        Pediatric kidney disease.--An estimated 150,000 young
    people currently suffer from kidney diseases for which no cure
    or effective treatment exists. Approximately 10,000 of them
    suffer from chronic kidney failure, are on dialysis or have a
    kidney transplant. NIAID is encouraged to continue research on
    kidney damage caused by vesicoureteral reflux and obstruction,
    and on ways of improving kidney transplant outcomes in children
    and adolescents.
        Postpolio Syndrome.--The Committee encourages the Institute
    to continue and expand research into postpolio syndrome,
    including alternatives for rehabilitation for postpolio
    patients.
        Primary Immunodeficiency Diseases.--The Committee continues
    to feel strongly that the Institute must take steps to address
    the 500,000 undiagnosed or misdiagnosed cases of primary
    immunodeficiency diseases through substantive participation in
    the national education and awareness campaign sponsored by the
    Jeffrey Modell Foundation. The Institute should report to the
    Committee by December 1, 2000 on the steps it is taking to
    address this matter.
        Rabies.--It has been brought to the Committee's attention
    that the menace of rabies-infected bats has become a dangerous
    problem. During the past decade, a number of cases of human
    rabies have resulted in death, without known rabid animal
    exposure. The Committee urges the Institute to expand research
    in the area of contacts between bats and humans in order to
    devise adequate protection techniques for the future. The
    Committee further urges the Institute to expand studies of
    rabies virus variants and their hosts, which are necessary to
    predict trends in pathogenicity which may result from drifts in
    virus subpopulations and to devise new modalities to contend
    with the increasing threat posed by the bat rabies viruses.
        Tropical Medicine Research Centers.--The Committee strongly
    supports the continued sponsorship of these important
    international research collaborations in areas endemic for
    tropical infectious disease. These unique partnerships enhance
    our understanding of and preparedness for emerging, re-emerging
    and other tropical health threats.
        Tropical Parasitic Diseases.--The Committee remains
    concerned about the continuing global health burden of tropical
    diseases, including helminth infections responsible for
    enormous global disease burden, and dengue fever and
    leishmaniasis, which afflict millions of people annually and
    are fatal without treatment. Further, the increasing re-
    emergence of these diseases in the United States is of extreme
    concern. The Committee urges the NIAID to aggressively pursue
    improved prevention and treatment protocols through the NIAID's
    parasitic disease program. Research to develop environmentally
    sound insecticides to control vector-borne diseases is
    particularly encouraged.
        Tuberculosis.--Tuberculosis continues to account for more
    deaths worldwide than any other infectious disease and for over
    a quarter of all preventable adult deaths. The Committee
    commends NIAID for its aggressive program of tuberculosis
    research, and encourages greater emphasis on tuberculosis
    vaccine development.

                 NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

    Appropriations, 2000....................................  $1,353,943,000
    Budget estimate, 2001...................................   1,428,188,000
    Committee recommendation................................   1,554,176,000

        The Committee recommendation includes $1,554,176,000 for
    the National Institute of General Medical Sciences [NIGMS].
    This is $125,988,000 more than the budget request and
    $200,233,000 more than the fiscal year 2000 appropriation. The
    comparable amounts 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 United States leadership in
    biomedical science.
        Behavioral Science Research and Training.--The Committee is
    concerned that NIGMS does not support behavioral science
    research training. As the only Institute mandated to support
    research not targeted to specific diseases or disorders, there
    is a range of basic behavioral research and training that NIGMS
    could be supporting. The Committee urges NIGMS, in consultation
    with the Office of Behavioral and Social Sciences, to develop a
    plan for pursuing the most promising research topics in this
    area.
        Minority Biomedical Research Support.--The Committee
    continues to be pleased with the quality of the NIGMS training
    programs, particularly those that have a special focus on
    increasing the number of minority scientists, such as the
    Minority Access to Research Careers (MARC) and Minority
    Biomedical Research Support (MBRS) programs. The Committee
    understands that NIGMS plans to continue supporting these
    important initiatives.

            NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

    Appropriations, 2000....................................    $859,258,000
    Budget estimate, 2001...................................     904,705,000
    Committee recommendation................................     986,069,000

        The Committee recommends an appropriation of $986,069,000
    for the National Institute of Child Health and Human
    Development [NICHD]. This is $81,364,000 more than the budget
    request and $126,811,000 more than the fiscal year 2000
    appropriation. The comparable amounts 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;
    gynecological health 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.
        Autism.--Autism is a developmental disability that
    typically appears during the first 3 years of life. Presently,
    there is no effective means to prevent the disorder, no fully
    effective treatment and no cure. The Committee is concerned by
    reports indicating an alarming rise in the incidence of autism
    and by the lack of concrete knowledge of the prevalence of this
    disability. Early intervention is critical for affected
    children to gain maximum benefit from current therapies but
    autism is easily misdiagnosed or undiagnosed. The Committee
    commends the Institute for its work to encourage professional
    groups to develop a standardized and universal diagnostic
    criteria in autism to aid in earlier diagnosis. The Committee
    is encouraged by the ongoing collaboration of research advocacy
    groups and the NICHD on the development and implementation of
    an awareness campaign for health professionals and for parents
    to learn to recognize and identify the early symptoms of
    autism.
        The Committee is encouraged by the Institute's rapid
    response to conduct research on the hormone Secretin as a
    treatment for autism, and is pleased with ongoing research
    efforts on the genetics of autism. The Committee recognizes the
    potential of the collaborative programs of excellence in
    autism, which comprise a network of sites for the conduct of
    basic and clinical research into the cause, diagnosis, early
    detection, prevention, control and treatment of autism. The
    Committee strongly encourages the NICHD to expand this network
    so that it is fully engaging in comprehensive autism research,
    including making individuals aware of opportunities to
    participate as subjects in research. Further, the Committee
    continues to encourage the NICHD to coordinate research efforts
    with the NIMH and other Institutes conducting autism research.
        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 urges that researchers be strongly encouraged to
    collaborate and share this important resource and notes that a
    collaborative autism gene bank is already in existence, the
    autism genetic resource exchange. To that end, the Committee is
    encouraged by the efforts of the NIMH to combine data sets and
    directs that all Institutes conducting autism research
    participate in that endeavor.
        The Committee encourages the interagency autism
    coordinating committee to continue to meet regularly and
    encourages annual public participation, including the active
    involvement of patient advocacy groups. The Committee requests
    that the Director be prepared to report to Congress on the
    goals set and progress made regarding autism research during
    the fiscal year 2001 hearings.
        Bone disease in adolescents.--With the high number of teen
    pregnancies, it appears to the Committee that more research is
    needed to understand the relationship between pregnancy and
    lactation and bone mass in adolescents. In particular, the
    Institute is requested to address the impact of chronic
    anticoagulation on bone mass in pregnancy; the effect of oral
    contraceptives on acquisition of peak bone mass and bone loss
    in early adolescents; and the impact on bone status of chronic
    under-nutrition of young women. The Institute is also
    encouraged to continue the dual focus on people and animal
    models for the treatment of osteogenesis imperfecta.
        Child Development and Behavioral Research.--The Committee
    is pleased that NICHD is undertaking a number of initiatives to
    increase understanding of the behavioral and cognitive aspects
    of child development. The Committee encourages these efforts
    and looks forward to receiving updates on their progress.
        Chromosome 18.--The Committee is aware of efforts to
    encourage new scientific work into the molecular genetic,
    clinical and therapeutic aspects of chromosome abnormalities.
    Chromosome abnormalities involving chromosome 18q result in
    growth failure, mental retardation and central nervous system
    dysmyelination. Very little NIH-funded research has been
    devoted to studying the abnormalities of chromosome 18, despite
    the annual presence of report language urging such research.
    The Committee encourages the Institute to place special
    emphasis on funding chromosome 18 research applications.
        Cooley's anemia.--The Committee is pleased to learn that
    NICHD has expressed an interest in expanding its research and
    outreach agenda with regard to Cooley's anemia. The Committee
    has long supported greater activity by NIH related to this
    disease and looks forward to learning about the progress that
    has been made by the Institute.
        Demographic Research.--The Committee commends NICHD's
    aggressive support for research on the causes of demographic
    trends and their impact on our society. The availability of
    objective information about such topics as teen childbearing,
    declining marriage rates, fatherhood, health disparities,
    racial and ethnic diversity, and migration within and across
    our borders remains a high priority. NICHD is encouraged to
    expand its commitment to the training and development of new
    demographic scientists and to assure continued support for the
    research infrastructure that provides the foundation for
    advances in population research in centers around the nation.
    The Committee also commends NICHD's many collaborative projects
    with other Federal agencies--including the Immigration and
    Naturalization Service, the National Center for Health
    Statistics, the Department of Education, and others--which have
    created innovative demographic datasets on topics of critical
    importance to policy makers.
        Diabetes.--More than 120,000 children suffer from diabetes,
    making it the second most common chronic disease affecting
    kids. The Committee is concerned that NICHD has not
    substantially increased its role in this area and believes that
    the Institute should support more juvenile diabetes grants. The
    NICHD is encouraged to work with NIAID and NIDDK on an
    initiative to create a coordinated international effort to
    develop a vaccine to prevent juvenile, or Type 1 diabetes.
        Fragile X.--The Committee commends the NICHD for its
    research activities on Fragile X, the most common inherited
    cause of mental retardation. Fragile X results from the failure
    of a single gene to produce a specific protein. Thus, the
    Committee understands that Fragile X is a ``research portal''
    for other inherited diseases, especially autism, and the
    Committee urges NICHD to coordinate its research and research
    funding with other Institutes, especially NIMH and NINDS to
    pursue the understanding of the functions of the Fragile X
    protein. The Committee encourages NICHD to consider organizing
    a Fragile X Consensus Development Conference (CDC) this year
    and report the results to it as soon as they are available.
        Health behaviors of youth.--The Committee is increasingly
    concerned about youth and health behaviors and their impact on
    society as a whole. Issues relative to school violence, school
    failure, drug and tobacco use and other behavioral issues have
    become public health priorities. The Committee is pleased that
    the NICHD will be collaborating with the Centers for Disease
    Control and Prevention, the Substance Abuse and Mental Health
    Services Administration, and the Health Resources and Services
    Administration to develop a collaborative program in this
    regard. The Committee requests that the agencies involved focus
    a portion of their efforts on discovering approaches to
    intervene and prevent complex behavior problems in children and
    youth which utilize molecular neuroscience, brain mapping,
    behavioral analysis and behavioral analysis.
        Infertility and Contraceptive Research.--The Committee
    continues to place high priority on research to combat
    infertility and speed the development of improved
    contraceptives. It urges NICHD to continue aggressive
    activities in this area, including individual research grants
    and support through the infertility and contraceptive research
    centers.
        Learning Disabilities in Infants and Children.--The
    Committee urges research on the outcome and effectiveness of
    primary and preventive health care for mothers to prevent
    learning disabilities in infants and children.
        Longitudinal study on children's health.--The Committee
    supports the Institute's role to provide sufficient funds to
    lead the effort in designing and developing a pilot for a
    national longitudinal study of environmental influences on
    children's health.
        Maternal-Fetal Medicine.--The Comittee urges the NICHD to
    coordinate a planning workshop in fiscal year 2001 for the
    purpose of defining research questions in such areas as pre-
    maturity, pre-term labor, pre-eclampsia, amniotic fluid
    embolism, in utero screening for birth defects, post-partum
    hemorrhage, and other complications related to pregnancy. The
    outcome should provide the basis for the development of
    appropriate funding mechanisms to implement the recommendations
    of the workshop.
        Neurofibromatosis.--Learning disabilities occur with high
    frequency in children with NF. The Committee recognizes that
    NF1 provides an opportunity to uncover a molecular basis for
    cognitive impairment and to identify a marker for brain
    dysfunction, and that research in understanding the cognitive
    deficits in NF1 patients possesses broad application to
    learning disabilities in the general population. NICHD is
    encouraged to expand its NF research portfolio, to coordinate
    its efforts with other Institutes engaged in NF research, and
    be prepared to report on its NF research portfolio at its
    fiscal year 2001 appropriations hearing.
        Ob-Gyn Research.--The Committee commends NICHD for
    providing grants to ob-gyn departments at 20 U.S. universities
    and hospitals to establish Women's Reproductive Health Research
    Career Development Centers. With the increased funds provided,
    the Committee encourages the Institute to expand the number of
    Women's Reproductive Health Research Career Development
    Centers. At these centers, newly trained ob-gyn clinicians are
    provided training and support to assist in their pursuit of
    research careers to address problems in women's obstetric and
    gynecologic health, thereby improving the health of women and
    infants.
        Pediatric emergency medicine.--The Committee encourages
    NICHD to develop a research initiative on pediatric emergency
    medicine, including both prehospital and emergency care. To
    date, only minimal attention has been paid to addressing this
    costly and important aspect of children's health care. NICHD is
    encouraged to work closely with HRSA in the development of
    national educational programs and conferences to encourage and
    support research in emergency medical services for children.
        Pediatric kidney disease.--Despite scientific advances,
    kidney disease continues to be a major cause of illness and
    death among young people. NICHD is encouraged to enhance
    research on the understanding and treatment of congenital
    diseases and kidney malformations which lead to chronic renal
    failure and end-stage renal disease in children and
    adolescents, as well as the prevention and treatment of the
    adverse effects of chronic renal failure on neurologic and
    physical development in children.
        Pelvic Floor Dysfunction and Incontinence.--The Committee
    commends the NICHD on the outstanding progress it has made in
    establishing a research portfolio in pelvic floor dysfunction
    and incontinence. It is the Committee's understanding that a
    workshop has been held on clinical terminology and that two
    requests for application will be issued this Spring to address
    translational and clinical research, specifically surgical
    interventions. The Committee urges NICHD to continue at this
    level of commitment collaborating with NIDDK, NIA, and the
    Office of Research on Women's Health.
        Primary Immunodeficiency Diseases.--The Committee continues
    to be pleased with the comprehensive commitment that NICHD has
    demonstrated in addressing primary immunodeficiency diseases.
    The combination of peer-reviewed research funded in
    collaboration with the Jeffrey Modell Foundation and active
    participation in the Foundation's national education and
    awareness campaign show a serious commitment that should be
    replicated by other institutes. The Committee urges NICHD to
    remain committed to this collaboration.
        Small Grants.--The Committee is pleased to learn that NICHD
    recently began promoting small grants as a way to attract new
    investigators to child development research. The Committee
    encourages the Institute to examine whether B/START small grant
    awards as used by other Institutes would encourage interest
    among its investigators.
        Sudden Infant Death Syndrome.--The Committee is pleased
    with NICHD's continued efforts to extend the reach of its
    extremely successful ``Back to Sleep'' campaign to underserved
    populations and daycare providers. The Committee also commends
    NICHD's attempts to further its progress in SIDS research by
    initiating a third SIDS 5-year research plan. This third 5-year
    plan will continue the efforts of the past two 5-year plans
    which have been responsible for many of the research
    breakthroughs in the effort to reduce SIDS cases in the United
    States.
        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. In April of 1997, NIH convened an international
    symposium to exchange information and develop a research
    agenda. Since fiscal year 1998 the Committee has called on the
    NICHD to support research on the prevalence, causes and
    treatment of vulvodynia. The Committee is pleased NICHD
    recently published a request for applications in this area, but
    is concerned that additional steps to encourage researcher
    interest and the submission of fundable research proposals
    still have not been taken. The Committee continues to be very
    concerned with the slow pace of research progress made in this
    important area. The Committee has included additional funds in
    fiscal year 2001 for expanded research on vulvodynia.

                             NATIONAL EYE INSTITUTE

    Appropriations, 2000....................................    $450,101,000
    Budget estimate, 2001...................................     473,952,000
    Committee recommendation................................     516,605,000

        The Committee recommends an appropriation of $516,605,000
    for the National Eye Institute [NEI]. This is $42,653,000 more
    than the budget request and $66,504,000 more than the fiscal
    year 2000 appropriation. The comparable amounts 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.
        Diabetic Retinopathy.--The Committee supports the avenues
    of diabetic retinopathy research that the NEI is sponsoring,
    including the study of molecular pathways involved in the
    progression of the disease, and the use of this information to
    develop novel therapies. The Committee encourages the NEI to
    continue funding these areas to decrease the burden of this
    sight-threatening complication of diabetes.
        Glaucoma.--It has come to the Committee's attention that
    glaucoma testing by the congressional Glaucoma Caucus has shown
    that high-risk populations, particularly African-Americans,
    have a higher number of individuals affected by glaucoma. Many
    of these individuals are going untested and untreated. The
    Committee urges the Institute to provide resources for research
    and prevention for these high-risk populations.
        Health Disparities.--The Committee encourages the NEI to
    continue its clinical research and health education activities
    aimed at reducing the disproportionate burden of certain eye
    diseases on minority populations. The Committee is pleased that
    the NEI is making great strides in characterizing eye diseases
    within the Hispanic population, a population for which little
    published data exists. The Committee is also pleased that the
    NEI is conducting a clinical study to help determine whether
    topical medications can reduce intraocular pressure to prevent
    or delay the onset of glaucoma. African-Americans are at much
    higher risk for glaucoma than whites.
        Low Vision.--The Committee commends the low vision
    initiative developed by the NEI National Eye Health Education
    Program. Through this extensive public awareness program that
    includes a traveling exhibit and information on visual
    rehabilitation services and devices, the NEI is providing
    important information to consumers and health professionals
    about successful interventions for the more than 14,000,000
    Americans with uncorrectable visual impairments.
        Lyme disease.--The Committee urges the Institute to study
    the neuro-opthalmalogic abnormalities associated with Lyme
    disease.
        Neurofibromatosis.--The Committee urges the Institute to
    consider the progress being made in research into the causes
    and prevention of neurofibromatosis and to determine whether
    such progress offers new research opportunities consistent with
    the Institute's mission.
        Retinal Degenerative Disease.--The Committee is encouraged
    by the progress that has been made by NEI-sponsored research in
    understanding retinal degenerative diseases, such as retinitis
    pigmentosa and macular degeneration. This family of diseases,
    affecting over 6 million Americans, is associated with visual
    disability and decreased quality of life. The Committee
    strongly supports NEI's pursuit of basic research areas
    including studies of mechanisms of cell survival and
    regeneration, growth factors, and immunologic issues related to
    transplantation. By applying the findings from basic research,
    including genetics, and clinical research, the NEI will be
    closer to preventing or delaying visual loss from these
    diseases. The Institute is strongly encouraged to work closely
    with the voluntary organizations that are also supporting
    research in this area, so as to maximize research outcomes and
    hasten the pace of discovery.
        Vision Research.--The Committee is pleased that the NEI's
    strategic planning process has resulted in some very promising
    recommendations for genomics research, including the creation
    of a visual system web site encompassing the full array of
    databases and resources needed by the vision research
    community. The Committee encourages the NEI to continue to use
    its planning process and focused workshops to stimulate
    research strategies and to implement them with adequate
    resources to the research community, including infrastructure
    support. The Committee also is aware of the tremendous
    scientific opportunities that exist in the field of eye and
    vision research, and urges the NIH to give every consideration
    to these factors when assigning research priorities.

              NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

    Appropriations, 2000....................................    $442,688,000
    Budget estimate, 2001...................................     468,649,000
    Committee recommendation................................     508,263,000

        The Committee recommends an appropriation of $508,263,000
    for the National Institute of Environmental Health Sciences
    [NIEHS]. This is $39,614,000 more than the budget request and
    $65,575,000 more than the fiscal year 2000 appropriation. The
    comparable amounts 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 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.
        Children's health.--The Committee is pleased that the
    NIEHS, in collaboration with the EPA, is supporting eight
    children's health centers focused on the role that
    environmental factors play in asthma and other respiratory
    disorders. The Committee urges the NIEHS, in continued
    collaboration with EPA, to support additional Centers of
    Excellence with a focus on disease endpoints in children.
        Eliminating disparities in health outcomes.--The Committee
    recognizes that many of the populations disproportionately
    exposed to the impact of environmental factors are minority and
    disadvantaged groups. This exposure manifests itself into a
    variety of health problems such as asthma. The Committee
    appreciates the outstanding environmental justice programs of
    the NIEHS, which serve as models in addressing this issue. The
    Committee urges the Institute to continue this excellent
    program and encourages the Institute to work closely with
    minority communities and organizations to enhance the
    participation of special populations in biomedical research.
        Environmental exposures in Parkinson's disease.--The
    Committee applauds NIEHS for its increased emphasis on research
    on the role of environmental exposures in Parkinson's Disease
    and urges NIEHS to continue its efforts in this area.
        Environmental Health Sciences Centers.--The Committee
    continues to strongly support the Environmental Health Sciences
    Centers program and believes that a fully funded Centers
    program is critical to carrying out the mission of NIEHS. The
    Committee expects these Centers to be funded at peer reviewed
    levels.
        Liver disease.--The impact of environmental factors on
    liver disease is an important area that is in need of
    additional attention. The Committee urges the Institute to
    collaborate with NIDDK in an effort to better understand
    environmental factors that may contribute to the development of
    liver disease.
        Lymphoma.--The Committee encourages NIEHS to collaborate
    research efforts with NCI to better understand environmental
    factors, through active involvement and participation in the
    progress review group (PRG) being conducted on lymphoma, which
    may contribute to the cause of the disease.
        Parkinson's Disease.--The Committee supports the
    Institute's increased emphasis on understanding the cause and
    pathophysiology of Parkinson's disease with a goal of
    prevention, effective treatment and a cure for this devastating
    disorder. Evidence continues to accumulate that the environment
    plays a significant role in Parkinson's disease. The
    contributions of aging, genetics, and endogenous neurochemical
    factors in the disorder remain unclear, however, requiring
    further research before ultimate preventive and therapeutic
    solutions are developed. The Committee believes that a strong
    scientific foundation exists for research into the possible
    link between Parkinson's disease and environmental factors to
    better understand the cause and pathophysiology of Parkinson's
    disease. The Committee encourages the NIEHS to consider funding
    an initiative in this area. The Committee further is aware that
    the NIH has completed a Parkinson's disease research agenda
    with professional judgement funding projections for the next 5
    years and that the agenda envisions a significant role for
    NIEHS.
        Waste treatment management.--The Committee urges NIEHS to
    study the issue of waste treatment management by indigenous
    native Hawaiians, and to explore the public health implications
    of this issue and the living machines approach to waste
    management.

                          NATIONAL INSTITUTE ON AGING

    Appropriations, 2000....................................    $687,861,000
    Budget estimate, 2001...................................     725,949,000
    Committee recommendation................................     794,625,000

        The Committee recommendation includes $794,625,000 for the
    National Institute on Aging [NIA]. This is $68,676,000 more
    than the budget request and $106,764,000 more than the fiscal
    year 2000 appropriation. The comparable amounts 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.--Americans enter the new millenium
    facing an imminent epidemic of Alzheimer's disease. Today,
    Alzheimer's disease afflicts 4 million individuals-one in every
    10 of those over 65 and nearly have of those over 85--and the
    toll is rising as the population ages. Scientists have yet to
    determine exactly what causes this brain-destroying condition,
    but two decades of intensive research has begun to pay off in
    rapid discoveries of the basic mechanisms of the Alzheimer's,
    the complex interplay of genetic and environmental risk
    factors, and treatments and interventions that can slow its
    effects. While NIA must continue to pursue these avenues of
    research, the demographics of our society demand that we find
    ways to delay or prevent the onset of Alzheimer's disease.
    According to some research studies, the number of individuals
    with the disease will approach 6 million by the end of this
    decade and could hit 14 million by mid-century. In short, if
    society hopes to avoid widespread suffering and enormous
    demands on our systems of health care, it must act now. With
    funds recommended by the Committee over the past 2 years, NIA
    has launched large-scale clinical trials in search of compounds
    that will prevent Alzheimer's disease from taking hold. The
    Committee strongly encourages NIA to devote more resources to
    this effort. Delaying the onset of Alzheimer's disease by 5
    years will save lives and save at least $50,000,000,000 in
    annual health care costs. More focused studies are also
    encouraged into the relationship between Alzheimer's disease
    and vascular disease, particularly in minority populations. The
    Committee encourages NIA to continue to close collaboration
    with NINDS, NIMH and NINR in this important area of study.
        Alzheimer's disease clinical research and training.--The
    Committee believes that an important step in fighting
    Alzheimer's Disease is the encouragement of clinical research
    and training, which will complement the many excellent research
    efforts currently funded through the National Institutes of
    Health (NIH), the National Institute on Aging (NIA), and in the
    private sector. The creation of Alzheimer's Clinical Research
    and Training Awards program to train physicians to recognize
    and treat Alzheimer's Disease, and to dedicate their careers to
    improving care for Alzheimer's patients by bridging the gap
    that exists between basic and clinical research is critical.
    The awards program will foster physician dedication to a career
    in research, diagnosis, and treatment of Alzheimer's Disease by
    awarding junior and mid-level physicians who have demonstrated
    the potential for a lifelong commitment to researching and
    treating Alzheimer's, with a 1 year stipend to train as an
    Alzheimer's physician/scientist. The awards program will be
    administered through the NIA, and should provide support for
    institutions focused primarily on Alzheimer's research but
    linked to a clinical treatment facility. The awards program
    will complement the Alzheimer's Disease Research Centers
    (currently funded through NIA) or similar institutions that are
    State or privately funded. The awards program will encourage
    institutions implementing the program to specialize in training
    physician/scientists, ultimately becoming physician training
    centers.
        Alzheimer's disease and Pet Scans.--The Committee continues
    to urge NIA to focus on early detection of Alzheimer's disease
    so that clinical interventions to slow or stop the progression
    of the disease may be undertaken. The Committee notes that
    positron emission tomography (PET) has now been shown to
    identify Alzheimer's disease definitively and at a much earlier
    stage than other diagnostic methods and encourages NIA, in
    collaboration with NINDS and NIMH, to expand its research
    efforts into early diagnosis of Alzheimer's using PET imaging
    of the brain.
        Alzheimer's special care units.--NIA is commended for its
    innovative research on effective management of Alzheimer's
    disease patients (special care units) and the needs of
    Alzheimer's care givers. The Committee commends NIA for its
    efforts to plan and map promising topics in cognitive research.
    The Committee also commends NIA for its excellent public
    information materials on encouraging older adults to exercise
    and stay physically active. NIA is encouraged to expand its
    research on health promotion interventions in aging
    populations.
        Bone disease.--The Committee is aware that only 12 years
    from now, 75 million baby-boomers will begin to turn 65. By the
    middle of the 21st century, the number of Americans over the
    age of 65 will double and the number of Americans over the age
    of 85 will increase five-fold, placing a significant number of
    individuals at risk for disease and disability. As such, the
    Committee is concerned that the Institute has not given
    sufficient priority to the aging skeletal system. The Committee
    therefore encourages the Institute to coordinate research with
    the National Institute of Arthritis and Musculoskeletal and
    Skin Diseases on osteoporosis and Paget's disease. The
    Institute is also encouraged to begin a study of the effects of
    aging on people with osteogenesis imperfecta.
        Cardiovascular aging research.--Heart attack, congestive
    heart failure, stroke, and other cardiovascular diseases remain
    America's leading cause of death of older men and women and a
    main cause of disability. Of the Americans who die from
    cardiovascular disease, more than 80 percent are ages 65 and
    older. Heart disease, alone, is the No. 1 killer of Americans
    ages 65 and older and stroke is the No. 3 killer. The number of
    deaths from cardiovascular diseases rise significantly with
    increasing age, as does the number of Americans suffering from
    these diseases. Nearly 539,000 Americans ages 65 and older
    required home and hospice care because of limitations from
    cardiovascular diseases in 1996. The Committee encourages the
    Institute to make cardiovascular research a top priority.
        Claude D. Pepper Older Americans Independence Centers.--The
    Committee continues to strongly support these successful
    centers, which focus on developing innovative and cost
    effective ways to enhance the independence of older Americans.
    The centers also play a critical role in developing top level
    experts in geriatrics. These Centers and the work they do are
    becoming even more important since our population over age 65
    will double by 2030. Thus, the Committee strongly encourages
    NIA to increase the number of centers as well as encourages NIA
    to consider a school of nursing for such a center.
        Cognitive changes during aging.--The Committee understands
    that research on cognitive changes during aging is an important
    focus of the Institute, and that maintaining mental acuity is
    an important concern of aging adults. It is generally
    recognized that research on higher-order mental processing is
    underdeveloped in the field of aging. NIA is working to expand
    its portfolio in this area, and the Committee is interested to
    learn about the institute's progress in building this important
    area at the intersection of behavioral research and
    neuroscience.
        Cognition, health promotion and aging.--The Committee is
    pleased to learn that a study now underway at the Institute of
    Medicine is examining the current knowledge base in the area of
    cognition and aging in order to identify future directions for
    behavioral, cognitive, and neuroscience research in this area.
    The Committee urges NIA to use the IOM recommendations as a
    guide for expanding its portfolio in this critical area of
    research.
        Demographic Research.--The Committee believes the research
    program on the Demography and Economics of Aging, and the
    Office Demography, are vital to the mission of the NIA. These
    activities provide important insights into changing risk
    factors for chronic disease, including socio-economic health
    inequalities, and disease processes at the population-level.
    The Committee congratulates the ten population Demography of
    Aging Centers which were competitively renewed last year. These
    Centers have been efficient in leveraging limited resources.
    The Committee encourages the Institute to consider increasing
    support for these centers.
        Parkinson's Disease.--The Committee recognizes that
    Parkinson's disease continues to exact a costly toll on the
    nation, both in human and financial terms. With the average age
    of diagnosis at 57 years, the demographic surge of the baby
    boomers will vastly increase this problem. The consequences
    will include not only incalculable human suffering but a
    further strain on Federal entitlement programs. The Committee
    is encouraged, however, by continued discoveries in the cause,
    pathophysiology, and treatment of Parkinson's disease, and by
    growing opportunities for collaboration with Alzheimer's
    disease. Given the age-related impact and the tremendous
    potential for development of more effective treatments, the
    Committee encourages new initiatives in this area.
    Additionally, the Committee is aware that the NIH has completed
    a Parkinson's disease research agenda with professional
    judgement funding projections for the next 5 years, and that
    the agenda envisions a critical role for the NIA.

     NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

    Appropriations, 2000....................................    $349,480,000
    Budget estimate, 2001...................................     368,712,000
    Committee recommendation................................     401,161,000

        The Committee recommends an appropriation of $401,161,000
    for the National Institute of Arthritis and Musculoskeletal and
    Skin Diseases [NIAMS]. This is $32,449,000 more than the budget
    request and $51,681,000 more than the fiscal year 2000
    appropriation. The comparable amounts 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 addresses 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, including
    women, minorities, children, and the elderly.
        Arthritis.--Forty-three million Americans have some form of
    arthritis. These painful and disabling degenerative diseases
    wear away protective joint cartilage and are the leading cause
    of disability in the United States. The economic cost to the
    United States for musculoskeletal and skin diseases and
    arthritis is staggering. Between 1988 and 1995, the total cost
    rose by 70 percent.
        Behavioral and social science research.--The Committee
    notes that the portion of the NIAMS research portfolio devoted
    to behavioral and social sciences research is significantly
    lower than the NIH average. Therefore, the Committee urges the
    NIAMS to fund promising behavioral social sciences research.
    Additionally, the Committee urges favorable consideration of
    research in the area of behavioral and social science factors
    relating to the adherence to medical recovery regimes, exercise
    and weight reduction programs.
        Cushing's Syndrome.--Cushing's Syndrome is a hormonal
    disorder caused by prolonged exposure of the body's tissues to
    high levels of the hormone cortisol. Sometimes called
    ``hypercortisolism'', it is relatively rare and most commonly
    affects adults aged 20 to 50. An estimated 10 to 15 of every
    million people are affected each year. The Committee encourages
    the Institute to conduct specific research on Cushing's
    Syndrome, to increase awareness of the disease and improve
    diagnostic tools and treatment.
        Duchenne/Becker Muscular Dystrophy.--The Committee is
    concerned that NIH has not committed adequate funds to sustain
    research in the area of Duchenne/Becker muscular dystrophy. It
    appears that NIH lacks requisite expert peer review of proposed
    DMD/Becker related research and muscle biology in general. The
    Committee recognizes that biomedical research in DMD/Becker
    dystrophy requires a sustained commitment in order to resolve
    key scientific and technical issues leading to further
    advances. This commitment should include measures to ensure
    that the scientific review of applications dealing with muscle
    biology is conducted by experts in that field. Therefore, the
    Committee urges the NIH to consider establishing a Muscle Study
    Section Review. Furthermore, the Committee feels that efforts
    should be made by NIAMS and NINDS to increase the amount of
    research devoted to skeletal muscle, especially DMD/BMD. The
    Committee strongly recommends NIH, in conjunction with all
    appropriate institutes, evaluate the current state of research
    so as to identify the critical path for DMD/Becker research,
    filling in the ``gaps'' in basic muscle science. In this
    regard, the Committee urges NIH to conduct a research
    conference to evaluate the status of research and assist in
    properly directing the critical science investment areas muscle
    research. The Committee requests that NIH prepare a report on
    the progress of research related to Duchenne/Becker Muscular
    Dystrophy and indicate proposed investment strategies to ensure
    that technical progress is sustained. The Committee requests
    the report by January, 2001. The Committee also urges that NIH
    develop trans-institute initiatives for DMD/Becker to ensure
    appropriate coordination across relevant institutes and further
    recommends that additional research be reviewed at the
    consensus conference.
        Ehlers Danlos syndrome.--Ehlers-Danlos syndrome (EDS) is a
    family of genetic disorders whose manifestations include but
    are not limited to the skin, joints and other components of the
    connective tissue. The prevalence of each type and of EDS
    overall is not well defined, although the figure of 1:5-10,000
    individuals for the syndrome is generally accepted. EDS is
    potentially a model for a number of more common medical and
    biological problems stemming from genetic acquired connective
    tissue defect. The Institute is encouraged to provide the
    highest possible funding for continued research of this
    disease.
        Facioscapulohumeral muscular dystrophy and
    facioscapulohumeral disease (FSHD).--The Committee is extremely
    concerned that funding for FSHD has decreased and that no new
    projects have been funded over the past year. The Committee
    requests that the NIH report after the research planning
    conference on steps it will take to create a comprehensive
    research portfolio in FSHD. The Committee further urges that
    NIH make research in FSHD a high priority.
        Fibromyalgia.--Fibromyalgia syndrome (FMS) is a clinically
    diagnosed disorder which is poorly understood and difficult to
    treat. It is a syndrome of chronic, debilitating, widespread
    pain, fatigue, sleep disturbance, and other associated
    disorders. Research in the eight years following the American
    College of Rheumatology's case definition of fibromyalgia and
    four years since the first NIH awards on fibromyalgia has
    created a solid body of knowledge. The Committee urges the
    Institute to support two centers for research into
    fibromyalgia. These centers would conduct multi-disciplinary
    studies which have the potential to add significantly to
    science's understanding of this complex and disabling disease.
        Lupus.--Lupus is a widespread, devastating autoimmune
    disease that affects 1.4 million Americans, most of whom are
    women. Lupus is the prototypical autoimmune disease that, for
    reasons not fully understood, causes the immune system to
    become hyperactive and attack the body's own tissue. The
    disease affects the quality of life and can damage vital organs
    resulting in disability or death. Lupus and other autoimmune
    diseases are the fourth leading cause of disability in women.
    Gaining an understanding of the factors associated with the
    high prevalence of lupus in women and minorities and the
    development of new and innovative treatments should be a high
    priority. The Committee urges NIAMS to explore all available
    scientific opportunities that presently exist in lupus research
    and treatment.
        Minority Populations and Osteoporosis.--The Committee
    encourages NIAMS to devote additional resources to studying
    osteoporosis in the non-white population and is urged to
    increase its work in this area. Moreover, given the large
    number of individuals affected by this disease, including a
    disproportionate number of women, the Institute should focus on
    interventions to improve quality of life. Another area of
    research which deserves attention is the investigation of the
    relationship between hypertension and osteoporosis.
        Nutrition Therapy and Osteoporosis.--Enhanced intake of
    calcium and vitamin D for both the prevention and treatment of
    osteoporosis in the at-risk Medicare population is strongly
    supported by a considerable body of data, including multiple
    randomized controlled trials. However, current data is lacking
    on whether counseling by a nutrition professional improves the
    probability of meeting adequate calcium, vitamin D, protein and
    other micronutrient intake, with or without the use of
    supplements. With the elderly, who take multiple medications
    and supplements, many of these medications/supplements interact
    and work against each other. In addition, many older women have
    a strong intolerance for milk. The Committee recommends that
    research be conducted to determine the effectiveness of
    nutrition counseling in insuring against the intake of excess
    levels of calcium and on the interactions of supplements and
    hormone replacement therapies. The role of calcium, vitamin D,
    protein and other micronutrients in preventing osteoporosis and
    associated problems, such as hip fractures, should also be
    considered.
        Osteoarthritis.--Early diagnosis of a disease is important
    to prevent or reduce long-term disability. For musculoskeletal
    conditions such as osteoarthritis, early diagnosis is hampered
    because of insufficient knowledge of the early stages of the
    disease. Osteoarthritis, which can completely destroy the
    joints of the hips and knees, affects over 20 million
    Americans, most often the elderly. With the aging of the
    population expected to double by the year 2020, a significant
    investment must be made now to reduce the burden of
    osteoarthritis later. If not, the dynamics of this condition in
    the aging population alone will generate an avalanche of costs,
    disability and suffering to the American people in the future.
    The Committee therefore encourages the Institute to assign
    osteoarthritis research a high priority.
        Osteoporosis.--The Committee urges NIAMS to consider
    funding additional specialized Centers for Research for
    osteoporosis. The Committee notes that these centers have made
    significant contributions to the progress of osteoporosis
    research and patient care, and can help in reducing bone
    fractures and other complications from the disease.
        Paget's disease.--The Committee is aware of the importance
    of research on the viral and genetic factors that may cause
    Paget's disease, and encourages the Institute to expand its
    work in this area.
        Psoriasis.--Psoriasis is a genetically-acquired immune-
    mediated disease of the skin and joints that affects over 7
    million American men, women and children. Over 1 million
    Americans suffer from severe psoriasis and psoriatic arthritis,
    which causes cracked, red skin lesions and swollen joints,
    extreme physical and emotional pain, and limited quality of
    life. The Committee encourages NIAMS to continue to support
    additional genetic research to determine which genes are the
    causative genes for psoriasis and psoriatic arthritis, as well
    as to pursue research on the immunological mechanisms of the
    disease. The Committee has been informed that through continued
    support for this research, new knowledge will be gained to
    develop improved therapeutic approaches for the treatment of
    this chronic immune disease.
        Reflex Sympathetic Dystrophy Disorder (RDS).--The Committee
    is aware of the debilitating effects of RDS. Currently, little
    is known about the cause of this disorder, which leads to
    frequent occurrences of misdiagnosis, and ultimately, the
    condition is mistreated or goes untreated. Given that early
    identification and prompt treatment are the keys to recovery,
    the Committee urges the Institute to continue to enhance its
    investigation into the cause of and most effective treatments
    for this condition.
        Scleroderma.--Scleroderma is a chronic, degenerative
    disease which causes the overproduction of collagen in the
    body's connective tissue. It affects between 300,000 and
    500,000 Americans and is often life-threatening, yet it remains
    relatively unknown and under-funded. The Committee urges the
    Institute to provide additional resources to expand the
    research in this area and to work collaboratively with private
    research foundations to coordinate research findings.

        NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

    Appropriations, 2000....................................    $263,661,000
    Budget estimate, 2001...................................     278,009,000
    Committee recommendation................................     303,541,000

        The Committee recommends an appropriation of $303,541,000
    for the National Institute on Deafness and Other Communication
    Disorders [NIDCD]. This is $25,532,000 more than the budget
    request and $39,880,000 more than the fiscal year 2000
    appropriation. The comparable amounts 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.
        Clinical research.--The Committee recognizes that clinical
    research is the cornerstone for the translation of basic
    science to better human health, and applauds NIH for assigning
    this area a high priority. The Committee urges NIDCD to pursue
    the NIH goal and increase its efforts to fund patient-oriented
    clinical research conducted by physician-scientists.
        Dysphonia.--The Committee continues to be pleased with
    NIDCD's expanding intramural research program with respect to
    dysphonia. The Committee encourages NIDCD to explore
    possibilities for a more active extramural research effort on
    dysphonia.
        Neurofibromatosis.--The Committee urges the Institute to
    consider the progress being made in research into the causes
    and prevention of neurofibromatosis, and to determine whether
    such progress offers new research opportunities consistent with
    the Institute's mission.
        Noise-Induced Hearing Loss.--The Committee continues to be
    concerned by the number of Americans suffer from noise-induced
    hearing loss. Thirty million Americans are exposed to dangerous
    levels of noise that can permanently impair their hearing. Ten
    million Americans have suffered irreversible noise induced
    hearing loss. The Committee has been pleased by the Institute's
    efforts to tackle this preventable health problem. The Wise
    Ears campaign has the potential to make significant inroads
    towards educating Americans of all ages. The Committee has
    included sufficient funds to expand this promising new
    initiative.
        Usher Syndrome.--An estimated 30,000 to 40,000 Americans
    suffer from Usher Syndrome, a genetic disorder whose victims
    are born with serious hearing loss and over time suffer a
    progressive loss of vision, called retinitis pigmentosa. Usher
    Syndrome is the most frequently inherited hearing loss syndrome
    and the cause of 50 percent of all deaf-blind cases reported in
    the United States. With support from NIDCD, scientists have
    gained a better understanding of this disorder and how best to
    evaluate and treat its victims. Geneticists at Boys Town
    National Research Hospital, for example, have identified two
    genes associated with Usher Syndrome. The Committee commends
    NIDCD for its continuing efforts to uncover the underlying
    cause and progression of Usher Syndrome.

                     NATIONAL INSTITUTE OF NURSING RESEARCH

    Appropriations, 2000....................................     $89,539,000
    Budget estimate, 2001...................................      92,524,000
    Committee recommendation................................     106,848,000

        The Committee recommends an appropriation of $106,848,000
    for the National Institute of Nursing Research [NINR]. This is
    $14,324,000 more than the budget request and $17,309,000 more
    than the fiscal year 2000 appropriation. The comparable amounts
    for the budget estimate include funds to be transferred from
    the Office of AIDS Research.
        Mission.--The National Institute of Nursing Research [NINR]
    supports clinical and basic research on biological and
    behavioral aspects of critical national health problems. The
    Institute's programs have established a scientific basis for
    research that seeks to reduce the burden of acute and chronic
    illness and disability for individuals of all ages; improve the
    quality of life by preventing and delaying the onset of disease
    or slowing its progression; and establishing better approaches
    to promoting health and preventing disease. The NINR supports
    programs essential to improving clinical environments by
    testing interventions which influence patient health outcomes
    and reduce costs and demands for care.
        New research opportunities in nursing research.--The
    Committee encourages the Institute to take advantage of
    significant new research opportunities in the following areas:
    enhancing adherence to diabetes management behaviors;
    biobehavioral research for effective sleep in health and
    illness; prevention of low birth weight in minorities; improved
    care for children with asthma; collaborative clinical trials
    for adherence, decision-making, and managing symptoms in AIDS
    and cancer; and expanded opportunities for pre and post
    doctoral training in nursing research at schools of nursing
    across the country.
        Nursing Interventions for Psychiatric Populations.--The
    Committee is concerned over the lack of resources for outcomes
    research focused on nursing interventions for psychiatric
    populations. The Committee urges the NINR and the NIMH to
    jointly sponsor a workshop with the psychiatric nursing
    community to identify areas of research and specific questions
    directed at interventions in psychiatric populations that
    directly correlate to enhanced patient care. This workshop
    would lead to a joint request for applications by the NINR and
    the NIMH.
        Volcanic Emissions.--The Committee continues to be
    concerned about the public health aspects of volcanic emissions
    (VOG) in Hawaii and urges the Institute to collaborate with the
    National Institute of Environmental Health Sciences in
    developing a multidisciplinary approach to this problem.

               National Institute on Alcohol Abuse and Alcoholism

    Appropriations, 2000....................................    $293,234,000
    Budget estimate, 2001...................................     308,661,000
    Committee recommendation................................     336,848,000

        The Committee recommends an appropriation of $336,848,000
    for the National Institute on Alcohol Abuse and Alcoholism
    [NIAAA]. This is $28,187,000 more than the budget request and
    $43,614,000 more than the fiscal year 2000 appropriation. The
    comparable amounts 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 of alcohol abuse and alcoholism. 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.
        Alaska native substance abuse.--The Committee is aware of
    serious problems with alcohol and substance abuse in Alaska,
    especially among its Alaska Native population and of the need
    for translating research into clinical applications for this
    population. The Committee urges NIAAA to sponsor a Research to
    Practice Forum with the Substance Abuse and Mental Health
    Services Administration and the State of Alaska to focus on
    bridging the gap between researchers and practitioners and
    translating scientific research into clinical applications, and
    encourages NIAAA to support the implementation of any
    recommendations developed at the forum.
        Alcohol consumption and hepatitis C.--It is well
    established that alcohol consumption in patients with hepatitis
    C increases the damage caused by the disease. Less well known
    is the mechanism by which this happens, as well as why alcohol
    inhibits the success of standard treatments for the disease.
    Both of these areas are important for dealing with this disease
    and the Committee strongly encourages the Institute to pursue
    them both individually and collectively with other interested
    institutes.
        Alcohol treatment services.--Given the rapid growth of
    managed behavioral health care, the Committee is concerned that
    more needs to be known about how alcohol treatment services are
    delivered under managed care arrangements and the specific
    characteristics of behavioral health components of health
    insurance plans and managed care organizations. The Committee
    is supportive of the NIAAA Advisory Council's comprehensive
    plan for health services, particularly its recommendation to
    prioritize research to understand the effects of managed care
    on the access, utilization, quality, costs, and outcomes of
    alcohol treatment services. The Committee acknowledges NIAAA's
    progress in implementing this recommendation and encourages
    NIAAA to consider supporting additional research in this area.
        Binge drinking.--Alcohol abuse, particularly ``binge''
    drinking and drinking with the intent to get drunk, continues
    to pose significant problems for college communities. The
    Committee strongly supports the efforts of NIAAA's Advisory
    Council Subcommittee on College Drinking and encourages the
    Subcommittee to identify the context and consequences of
    college drinking and provide recommendations on the prevention
    and treatment of the problem.
        College drinking.--The Committee continues its strong
    support of the NIAAA Advisory Council's Subcommittee on College
    Drinking and its efforts to create a unique dialogue among
    college presidents, administrators and alcohol researchers. The
    Committee understands that the full report will be submitted to
    the National Advisory Council for approval next February. This
    report will be organized around recommendations from the
    research community and college presidents. The Committee
    requests that the Director of NIAAA be prepared to communicate
    these recommendations at upcoming congressional hearings.
        Fetal alcohol syndrome.--The Committee commends NIAAA for
    its sponsorship of fetal alcohol syndrome (FAS) research and
    prevention activities. The Committee recognizes that
    collaborations between many agencies and organizations are
    needed to address the multiple issues central to FAS. The
    Committee is pleased with membership of the collaborative
    Interagency Coordinating Committee on Fetal Alcohol Syndrome
    (ICCFAS) and with the progress of the ICCFAS. The Committee
    requests that the NIAAA, because of its leadership role in the
    ICCFAS, be prepared to present an update on the progress of the
    ICCFAS at next year's hearings.
        National advertising campaign.--The Committee encourages
    the National Institute on Alcohol Abuse and Alcoholism to
    partner with the appropriate Federal agencies on a national
    advertising campaign against underage drinking.
        National Alcohol Research Centers.--The NIAAA supports 15
    Alcohol Research Centers that conduct interdisciplinary
    research focusing on particular aspects of alcohol abuse,
    alcoholism, or other alcohol-related problems. The Committee
    recognizes the significant contributions these centers have
    made to the understanding of alcohol abuse and alcoholism and
    encourages the NIAAA to continue supporting these centers.
        Neuroscience.--The Committee recognizes the important role
    that basic neuroscience research supported by the NIAAA plays
    in understanding alcohol abuse and alcoholism. The Committee
    encourages the NIAAA to continue supporting research in this
    area.
        Nurse run clinics and advanced practice nurses.--The
    Committee recognizes that alcoholic liver disease (ALD) is a
    major cause of morbidity and mortality in the United States
    today. Developing effective interventions for this disease is
    of paramount importance. The Committee is pleased that the
    institute has begun to focus greater attention on this problem
    and encourages NIAAA to consider sponsoring additional research
    on treatment.
        Prevention and treatment of violence associated with
    alcohol abuse.--The Committee is supportive of NIAAA's efforts
    to understand the relationships between alcohol use and
    violence. The Committee encourages NIAAA to consider supporting
    more research in this area, particularly to understand
    individual characteristics and environmental conditions,
    situations, and circumstances under which alcohol use and
    violent behavior are connected. The Committee also encourages
    NIAAA to consider supporting additional research on the
    prevention and treatment of violence by persons with alcohol
    problems.

                        NATIONAL INSTITUTE ON DRUG ABUSE

    Appropriations, 2000....................................    $687,376,000
    Budget estimate, 2001...................................     725,467,000
    Committee recommendation................................     790,038,000

        The Committee recommends an appropriation of $790,038,000
    for the National Institute on Drug Abuse [NIDA]. This is
    $64,571,000 more than the budget request and $102,662,000 more
    than the fiscal year 2000 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. NIDA's basic research plays a
    fundamental role in furthering knowledge about the ways in
    which drugs act on the brain to produce 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 sciences.--The Committee understands that
    behavioral intervention is a critical, and sometimes only,
    component of drug addiction The Committee continues to support
    NIDA's expansion of its behavioral science portfolio and views
    NIDA as a model of how to approach its behavioral science and
    public health responsibilities.
        Children and adolescents.--Recognizing the devastating
    impact of drug addiction on children and youth, the Committee
    commends NIDA's children and adolescent research initiative.
    The Committee urges NIDA to continue to support its research
    portfolio in areas of co-occurring mental disorders,
    developmental consequences, prenatal exposure, genetic
    vulnerability, and environmental risk factors.
        Clinical trials.--The Committee is pleased with NIDA's
    continuing progress in developing behavioral and
    pharmacological drug abuse treatments, and supports NIDA's
    initiative to establish a national drug abuse treatment
    clinical trials network. The Committee commends NIDA's
    leadership in forging strong partnerships with treatment
    researchers and community-based treatment providers to assure
    that new treatments are tested and incorporated into ongoing
    drug treatment programs.
        Emerging drug problems.--The Committee is pleased that NIDA
    has launched a new Club Drug Research and Dissemination
    Initiative. Given the emergence of club drugs, such as ecstasy,
    methamphetamine, GHB, and ketamine, the Committee is encouraged
    by NIDA's proactive efforts to curtail these emerging drug
    problems and urges NIDA to continue its efforts to develop an
    even broader array of effective new prevention and treatment
    approaches to focus on these emerging drug challenges.
        Genetic vulnerability.--The Committee understands that both
    genes and environment influence drug abuse and addiction. The
    relationship between the two is complex, requiring continued
    research in areas of behavioral genetics, psychiatric and
    epidemiological genetics, molecular genetics, and population
    genetics. The Committee encourages NIDA to continue to pursue
    this area of drug and addiction research.
        Medications development.--The Committee encourages NIDA to
    study the development of anti-addiction medications, to clarify
    the neurological and behavioral benefits of the use of
    pharmacological agents, and develop an understanding of how
    best to use these medications.
        Methamphetamine.--The Committee is very disturbed by the
    explosion in methamphetamine abuse across the nation. The
    problem is essentially acute in Iowa and other Midwestern
    states. The Committee again urges NIDA to expand its research
    on improved methods of prevention and treatment of
    methamphetamine abuse.
        National drug abuse clinical trials network.--The Committee
    commends NIDA's leadership in continuing to recognize the
    importance of behavioral and social science research and is
    especially pleased that this is reflected in the recent NIDA
    reorganization, which elevates behavioral research in both the
    Division of Neuroscience and Behavioral Research and the
    Division of Treatment Research and Development. The Committee
    believes NIDA could consider evaluating these promising
    behavioral treatments in clinical trials through its new
    National Drug Abuse Clinical Trials Network.
        Neuroscience.--The Committee recognizes that basic
    neuroscience provides a foundation for NIDA's research
    portfolio. Basic neuroscience research has advanced the field's
    understanding of drug abuse and addiction. The Committee urges
    NIDA to continue its efforts to develop new areas of
    neuroscience research.
        New genes and drug abuse.--The Committee supports research
    efforts to identify many of the genes that may play a role in
    addiction. Seizing upon these opportunities could lead to a
    more complete picture of the disease of addiction.
        Nicotine research.--The Committee recognizes that the
    consequences of nicotine addiction are substantial to adults,
    children, and adolescents, and commends NIDA's support of
    research yielding effective replacement therapies and
    behavioral interventions. The Committee encourages NIDA to
    continue to support research on the prevention and behavioral
    and pharmacological treatment of nicotine addiction. The
    Committee supports NIDA's ongoing research in the basic
    sciences, behavioral and medical treatments, genetic
    vulnerability, and epidemiology of nicotine use and abuse.
        Transdisciplinary tobacco research centers.--The use of
    tobacco products remains one of the nation's deadliest
    addictions. The Committee strongly supports NIDA's continuing
    efforts to address this major public health problem through its
    comprehensive research portfolio. The Committee is pleased that
    NIDA has teamed with the National Cancer Institute and an
    outside foundation to establish the Transdisciplinary Tobacco
    Use Research Center (TTURC). This multifaceted approach should
    lead to an increased understanding of how nicotine acts in the
    brain and body and lead to new strategies for treating nicotine
    addiction and preventing tobacco use, particularly by teens and
    younger children.
        Vulnerability to addiction initiative.--The Committee
    commends NIDA for launching its ``Vulnerability to Drug
    Addiction Initiative'' and encourages NIDA to support research
    to identify genes associated with drug abuse and addiction.
    Increasing our understanding of why some people are vulnerable
    to drug abuse and addiction while others are not, will speed
    progress in treating and preventing these critical problems.

                      NATIONAL INSTITUTE OF MENTAL HEALTH

    Appropriations, 2000....................................    $974,673,000
    Budget estimate, 2001...................................   1,031,353,000
    Committee recommendation................................   1,117,928,000

        The Committee recommends an appropriation of $1,117,928,000
    for the National Institute of Mental Health [NIMH]. This is
    $86,575,000 more than the budget request and $143,255,000 more
    than the fiscal year 2000 appropriation. The comparable amounts
    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 according to
    a report recently issued by the Surgeon General of the United
    States, afflict more than one in five American adults. 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.
        Alzheimer's disease.--NIMH continues to play an important
    part in efforts to learn more about memory formation. While
    still in early development stages, NIMH-supported scientists
    altered a particular gene in mice that resulted in the mice
    learning faster, remembering more, and applying what they
    learned. This development in the biological study of learning
    and memory may lead to important advances in the fight against
    Alzheimer's disease and age-related memory loss. The Committee
    encourages NIMH to assign a high priority to research on
    Alzheimer's disease, and to continue its collaboration with
    NIA, NINDS and NINR.
        Balance in research portfolio.--The Committee appreciates
    NIMH's research portfolio that seeks to address the major
    issues of concern to the Congress through a balanced approach
    that includes basic neuroscience, behavioral research, health
    services research, and clinical research. The Committee
    supports NIMH's determination to better focus basic researchers
    toward thinking about the public health needs that should drive
    their work. This in turn helps to speed the translation of this
    research and its results into practical societal benefits,
    including improved mental health services for those who need
    them.
        Burden of mental illness.--It is not surprising that mental
    illness emerged from the recent Global Burden of Disease study
    done by the World Bank, the World Health Organization and
    Harvard School of Public Health, as a surprisingly significant
    contributor to the burden of disease--in fact, major depression
    alone ranked second only to ischemic heart disease in magnitude
    of disease burden. The Committee notes that NIMH's research
    portfolio reflects Congressional intent that research supported
    by the institute be relevant to the range of disorders
    affecting such a large proportion of the nation's citizens.
        Children's mental health.--The Committee continues to be
    concerned about behavioral and emotional disorders in children,
    and supports NIMH's efforts to expand research into this
    critical area, and to encourage more scientific investigators
    to consider this area of research. It has become increasingly
    clear that the failure to recognize and adequately treat these
    disorders in children and adolescents can have devastating
    results, including frustration, anger and isolation, which, in
    turn, can lead to substance abuse, involvement with the
    juvenile justice system, or even suicide and other violence.
    The Committee commends NIMH for its efforts to support more
    research into the effects of psychotropic medications in
    children and youth, and encourages continued leadership and
    emphasis in the areas of diagnosis and treatment of ADHD,
    depression and other emotional and behavioral disorders of
    children.
        Collaboration with CMHS.--The Committee supports the
    current efforts of NIMH to encourage researchers to collaborate
    with basic social and behavioral scientists. This collaboration
    benefits scientists and the public by increasing our
    understanding of how characteristics of individuals, families,
    and social and cultural environments affect decisions about
    services use and adherence to treatment, as well as the
    efficacy of treatments and services. NIMH also must collaborate
    more closely with the Center for Mental Health Services (CMHS)
    in order to maximize the benefits of activities conducted by
    both agencies. The Committee encourages NIMH and CMHS to work
    to ensure a smooth handoff of research findings from NIMH to
    CMHS so that communities can use those findings to develop and
    improve services for adults and children with or at risk of
    developing mental health problems.
        Emergency medical services.--The Committee commends the
    work supported by NIMH on mental health issues related to
    emergency medical services for children through the University
    of Tennessee, and also the collaboration of NIMH with HRSA in
    funding the National Congress on EMSC in 1998. The Committee
    encourages NIMH to enhance its support of EMSC-related projects
    and to continue to work with HRSA in educational programs on
    EMSC such as national conferences.
        Fragile X.--Fragile X is the most common inherited cause of
    mental impairment, affecting 1 in 2000 males and 1 in 4000
    females with cognitive impairment and mental disorders such as
    obsessive-compulsive disorder and extreme anxiety. The
    Committee understands that because Fragile X also is the most
    common single-gene neuropsychiatric disease known, it is a
    powerful research model for other neuropsychiatric disorders
    such as schizophrenia, mood disorders, and autism.
        The Committee urges NIMH to devote resources to research on
    the functions of the Fragile X protein and to consider
    including Fragile X in its studies of related neuropsychiatric
    disorders. NIMH also is encouraged to promote rigorous
    scientific study of the currently available treatments commonly
    employed in Fragile X patients and to investigate promising new
    psychopharmacologic interventions. The Committee urges NIMH to
    work with other institutes such as NICHD and NINDS to develop
    cooperative research support mechanisms in this area. The
    Committee commends NIMH for joining NICHD in support of a
    scientific conference on Fragile X neurochemistry and urges the
    NIMH to consider supporting future similar conferences.
        Frontier mental health needs.--The Committee is pleased
    that NIMH continued its series of conferences on the mental
    health needs of remote rural and frontier communities with a
    ``Mental Health at the Frontier'' conference in Alaska in
    August 1999 and commends NIMH on its outreach efforts to
    determine the differences in mental health needs which may
    exist in remote frontier communities. The Committee encourages
    NIMH to expand its research efforts into these communities,
    which are often ignored in research projects, but which
    continue to suffer from high incidences of mental health
    problems including depression, suicide and co-occurring
    disorders with substance abuse.
        HIV/AIDS Prevention for Individuals at High Risk.--The
    Committee commends NIMH for developing research knowledge
    essential for understanding and preventing HIV transmission,
    particularly among people at high risk for infection (such as
    the mentally ill, minority women, youth, and rural populations)
    where the epidemic is spreading most rapidly. The Committee
    encourages NIMH to continue to support studies seeking to
    develop more effective ways to prevent infections and
    strategies to deliver cost-effective services.
        Intramural research.--The Committee is aware of NIMH's
    recent review of its entire intramural research program--a
    review resulting in major changes in research direction within
    that program. The Committee is pleased that these changes mark
    a new era in NIMH intramural research, marked by the best
    scientific stewardship and administration, forward-looking
    research exemplified by its restructured and rebuilt mood
    disorders program, and new emphasis on clinical research. For
    the first time in five years, a complete, permanent leadership
    roster is providing the stability and effective leadership
    needed to effect change. Most important, advances in
    technology, such as in the fields of genomics, integrated
    neuroscience and brain imaging have created exciting research
    opportunities to investigate fundamental mechanisms in the
    brain and psychiatric disorders. The intramural program now has
    the chance serve as a national resource, providing ideas,
    methodology, training, and expertise for the entire nation.
        Joint workshop between NINR & NIMH.--The Committee is
    concerned regarding the lack of resources for outcomes research
    focused on nursing interventions for psychiatric populations.
    The Committee urges the NINR and the NIMH to jointly sponsor a
    workshop with the psychiatric nursing community to identify
    areas of research and specific questions directed at
    interventions in psychiatric populations that directly
    correlate to enhanced patient care.
        Learning disabilities.--The Committee commends NIMH for the
    work conducted to explore the neurological and behavioral
    aspects of learning disabilities. The Committee looks forward
    to learning the results of this work and encourages the
    Institute to continue to coordinate with other Institutes to
    work on related activities.
        Social work research centers.--The Committee continues to
    be supportive of NIMH expanding the number of social work
    research development centers in light of the important work the
    centers do to develop knowledge that informs the delivery of
    mental health services by social workers and other providers.
        The Committee remains very supportive of NIMH's efforts to
    develop a cadre of Native Hawaiian mental health researchers,
    utilizing the expertise of their senior mentors. Native
    Hawaiians have historically experienced a disproportionate
    incidence of various mental health problems, including
    depression. In order to effectively address these issues in the
    long run, NIMH should consider establishing a Native Hawaiian
    center of excellence in mental health.
        Suicide.--The suicide rate has diminished only slightly
    despite the availability of highly effective treatments for
    mental disorders. This could mean that those who need them are
    not receiving effective treatments, or that the current
    treatments are not effective in reducing suicide. The Committee
    encourages NIMH to support research to address these issues,
    including whether patients with mental disorders who are at
    high risk for suicidal behavior are receiving adequate
    treatment. The Committee also is aware that many patients who
    have been suicidal, or become suicidal in a treatment trial,
    are excluded from clinical research studies. If appropriate,
    the committee urges NIMH to encourage researchers to try to
    retain these patients in trials, and to develop studies that
    are designed appropriately to answer the questions of what
    interventions reduce suicidal behavior. In addition, there are
    few researchers with adequate experience to safely test
    treatments for suicidal patients. Therefore, the Committee
    urges NIMH to encourage experienced, as well as new
    investigators, to learn about approaches in treating suicidal
    patients.
        Suicide risk and protective factors.--The Committee urges
    that NIMH and the CDC continue their collaboration to develop
    and implement a consensus agenda of key questions on suicide
    risk and protective factors and that the NIMH consider
    supporting additional research on protective factors to better
    understand phenomena such as why African American women have
    among the lowest suicide rates but have mental disorders at
    rates comparable to those experienced by white women. The
    Committee requests that the NIMH and the CDC submit an updated
    consensus agenda on key research questions on suicide to the
    Committee along with the Administration's fiscal year 2002
    budget proposal.
        Surgeon General's report.--The Surgeon General's report
    points out that about 20 percent of children are estimated to
    have mental disorders with at least mild functional impairment,
    and about 11 percent have significant functional impairment.
    This estimate translates into a total of 4 million youth.
    Mental disorders in children must be considered within the
    context of the family and peers, school, home, and community.
    This is essential if children who are experiencing symptoms of
    depression, anxiety or any other emotional or behavioral
    problem are to be recognized and helped. It is very difficult
    for children who are suffering to learn in school or to form
    normal peer relationships; rather, they may become withdrawn,
    lonely, depressed, or angry. The Committee is very concerned
    that this leads too many of them to end up in the criminal
    justice system rather than in a system which will provide the
    treatment they so badly need. Therefore, the Committee supports
    NIMH's recent efforts to increase research into children's
    mental disorders and to increase the number of trained
    scientists available to do this crucial research.
        The families and school together track (FAST) program.--The
    Committee commends NIMH for building science-based programs,
    such as The Families and School Together Track Program,
    designed to improve school-based mental health delivery
    systems. The Committee encourages NIMH to continue to support
    research on multi-year, multi-component interventions at the
    family, school, and community levels. The Committee also urges
    NIMH to further develop research on early interventions in
    children, with a particular emphasis on problems of mood,
    anxiety and conduct, taking into account informational
    deficits, attitudinal factors, and cultural barriers that
    inhibit use of these services.
        Translational research.--The Committee commends NIMH's new
    initiative in translational research to close the gap between
    basic and clinical research in behavioral science, and
    encourages the consideration of translational research centers
    to support collaboration between behavioral and clinical
    investigators. The Committee understands that such centers
    could provide a core presence for translational research at
    NIMH, and could serve as models for other institutes. In
    addition, the Committee encourages NIMH to consider developing
    a plan for training new investigators in behavioral science
    translational research.

                    NATIONAL HUMAN GENOME RESEARCH INSTITUTE

    Appropriations, 2000....................................    $335,862,000
    Budget estimate, 2001...................................     357,740,000
    Committee recommendation................................     385,888,000

        The Committee recommendation includes $385,888,000 for the
    National Human Genome Research Institute [NHGRI]. This is
    $28,148,000 more than the budget request and $50,026,000 more
    than the fiscal year 2000 appropriation. The comparable amounts
    for the budget estimate include funds to be transferred from
    the Office of AIDS Research.
        Mission.--The NHGRI has the responsibility at the National
    Institutes of Health for providing leadership and support for
    the Human Genome Project and for conducting a vigorous research
    program aimed at understanding and treating both simple and
    complex genetic disorders.
        The Human Genome Project (HGP) is an international
    collaboration to characterize the complete set of genetic
    instructions encoded in the estimated 3 billion base pairs of
    DNA. Begun in October 1990, the HGP is funded in the United
    States by the NHGRI and the Department of Energy (DOE).
    International partners include the United Kingdom, France,
    Germany, Japan, and China. A major goal of the Human Genome
    Project is to read each of the 3 billion bases, or letters, in
    the human genetic instruction book. The rapid availability of
    sequence, deposited every 24 hours into a publicly available
    database, is providing valuable information to the research
    community.
        Human DNA sequencing is not the only goal of the Project.
    The new 5-year Human Genome Project Research Plan, published in
    Science magazine in October 1998, includes another seven
    ambitious goals. These goals are guiding the development of a
    new and more diverse set of genomic research tools for
    researchers in both the public and private sectors in order to
    advance our understanding and treatment of human disease. These
    tools include: (1) optimization of current sequencing
    technologies and development of novel strategies; (2) a catalog
    of common variations, or single-nucleotide polymorphisms
    (SNPs), in human DNA sequence; (3) new technologies and
    strategies for studying the function of genes and genomes; (4)
    completion of the DNA mapping and sequence of additional model
    organisms including fruit fly and mouse; (5) new approaches to
    addressing the ethical, legal, and social implications (ELSI)
    of research; (6) development of improved databases and
    analytical tools in bioinformatics and computational biology;
    and (7) training programs in scientific and ELSI aspects of
    genomic and genetic sciences.
        Using the information and tools produced by the Human
    Genome Project, scientists in the Institute's intramural
    research program are developing techniques to study the
    fundamental mechanisms of genetic disorders and genetic factors
    involved in disease risks. These cutting-edge approaches are
    yielding new knowledge about human genetic diseases, and their
    diagnosis, prevention and treatment.
        Clearinghouse for rare and genetic disorders.--
    Approximately 6,000 of the 7,000 genetic disorders are rare
    disorders. Unfortunately, there is no centralized clearinghouse
    for the public and health professionals on these disorders.
    Last year, the Committee encouraged the NHGRI, in collaboration
    with the Office of Rare Diseases (ORD), to establish an
    information center on rare and genetic disorders to disseminate
    information, knowledge and understanding of rare and genetic
    disorders. The Committee is pleased to learn that the NHGRI and
    the ORD are working on establishing such a center and
    encourages them to move as expeditiously as possible to provide
    this important information service to the public and health
    professionals.
        Diabetes.--The Committee urges the NHGRI to assist the
    NIDDK and NICHD in the consideration of a collaborative project
    to identify the genes associated with juvenile, or Type 1,
    diabetes.
        Human genome project.--It has long been known that diseases
    tend to run in families. In fact, nearly all disease has a
    genetic component, including such common diseases as diabetes,
    schizophrenia, and cancer. The Human Genome Project aims to
    understand the mysteries of disease by unraveling the secrets
    of the DNA instruction book present in nearly every cell in our
    body. The genetic code within DNA holds many potential insights
    for our susceptibilities and resistances to disease and for the
    discovery of novel preventive and therapeutic strategies. The
    Committee understands that a working draft of 90 percent of the
    human genome is on the brink of completion and the finished
    highly accurate product, in which gaps are closed and
    ambiguities resolved, is expected by 2003. All of the DNA
    sequence is available without restriction to any researcher
    with an internet connection through the public database,
    GenBank. The Committee believes that rapid and unfettered
    access by investigators in both the public and private sectors
    to this fundamental data is essential if the Project is to
    realize its full potential for improving human health. The
    Committee also understands that human DNA sequencing is not the
    only goal of the Human Genome Project. The new 5-year research
    plan, published in Science magazine in October 1998, includes
    seven other ambitious goals. These goals are guiding the
    development of a new and more diverse set of genomic research
    tools for scientists to use to advance our understanding,
    prevention, and treatment of human disease.
        Kidney genome anatomy.--The Committee encourages the NHGRI
    to assist the NIDDK in an effort to create a kidney gnome
    anatomy program. Given the NHGRI's expertise in areas such as
    gene sequencing, expression, and microarray technology, the
    Committee believes that NHGRI could provide valuable assistance
    to the NIDDK.

                     NATIONAL CENTER FOR RESEARCH RESOURCES

    Appropriations, 2000....................................    $675,054,000
    Budget estimate, 2001...................................     714,192,000
    Committee recommendation................................     775,212,000

        The Committee recommends an appropriation of $775,212,000
    for the National Center for Research Resources [NCRR]. This is
    $61,020,000 more than the budget request and $100,158,000 more
    than the fiscal year 2000 appropriation. The comparable amounts
    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. 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.
        Cystic fibrosis.--The NCRR is commended for its continued
    support for the clinical trials monitoring center for CF
    research to ensure accurate and timely review of ongoing
    clinical trials into cystic fibrosis. As a model for the
    evaluation of new therapies to treat orphan diseases, the
    clinical trials monitoring center for CF research is laying new
    groundwork for the methods of translating basic research
    discoveries into clinical interventions in a timely manner.
        Developing and improving institutional animal resources.--
    The Committee has carefully reviewed documentation identifying
    the need for upgrading animal research facilities at minority
    health professions schools and has been pleased with NCRR's
    initiative in this area. The Committee has included sufficient
    funds for NCRR to continue its aggressive collaboration with
    minority health professions schools in providing grants to
    upgrade their animal facilities. These upgrades are necessary
    to assist in complying with Federal regulations and attain
    accreditation by the appropriate scientific organizations. In
    addition, the Committee has provided funding for the NIH
    Minority Health Initiative in the Office of the Director and is
    confident that this program can make a contribution to NCRR's
    animal facilities research infrastructure building program.
        Diabetes.--The Committee understands that NCRR plans in
    fiscal year 2001 to fund regional resource centers to focus
    specifically on supplying human islet cells for researchers.
    The Committee believes that this should be a high priority
    project for the Center.
        General Clinical Research Centers.--The General Clinical
    Research Centers program provides regional access to clinical
    research patients in 33 of 50 States to foster opportunities
    for clinical investigators to translate basic science
    discoveries to the care of patients. The Committee understands
    that three major panels that have examined the crisis
    confronting our nation's clinical research programs have
    recommended an expansion of the GCRC program. Over the past
    several years, the Committee has encouraged the NCRR to make
    the GCRC program a high priority within its budget allocations.
    The Committee is concerned that in fiscal year 2000, the GCRC
    budget dropped to an all-time low of 1.15 percent of NIH
    spending, compared to 3 percent of the NIH budget in the late
    1960's. The Committee is concerned about the GCRCs growth rate,
    especially when compared to the overall NCRR budget increases.
    To address the historical underfunding of the GCRCs and
    strengthen their ability to translate scientific discoveries
    into new therapies for the benefit of patients, the Committee
    has provided sufficient funds for the GCRC program for fiscal
    year 2001. The Committee urges the NCRR to consider using these
    funds to increase and enhance the training of clinical
    investigators, to implement the newly established guidelines
    for Informatics, to establish supplemental clinical research
    funds at each center through which the GCRCs can provide seed
    funding for pilot studies, to support GCRC efforts to enhance
    patient access to clinical research through off-site
    activities, community outreach initiatives and patient travel
    support. In addition, as in past years, the Committee once
    again encourages NCRR to continue and accelerate progress
    toward full funding of Centers at Advisory Council approved
    levels.
        High field magnetic resonance imaging equipment.--The
    Committee is aware of the important emerging role that high
    field magnetic resonance imaging systems play in researching
    the causes and progression of Alzheimer's Disease and
    Parkinson's Disease. The Committee encourages NCRR to consider
    supporting these systems, which could benefit both Alzheimer's
    and Parkinson's Disease patients.
        IDeA grants.--The Committee has provided $60,000,000 for
    the Institutional Development Award [IDeA] Program authorized
    by section 402(g) of the Public Health Service Act. This is
    $20,000,000 increase over both fiscal year 2000. The program is
    intended to broaden the geographic distribution of NIH funding
    of biomedical research by enhancing the competitiveness of
    biomedical and behavioral research institutions which
    historically have had low rates of success in obtaining
    funding. The Committee intends that the increase will be used
    in eligible States to co-fund high quality applications for
    shared instrumentation and RO-1 proposals to those who 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.
        Plant-based medicinal products.--The Committee supports the
    need to accelerate the development and commercialization of
    plant-based medicinal products and encourages the NCRR to
    consider collaborating with plant scientists and companies in
    Hawaii to responsibly use that State's unprecedented
    biodiversity in developing new, health-enhancing products.
        Primate centers.--The Committee is pleased with the
    addition of an eighth Regional Primate Research Center during
    fiscal year 1999. The new Center complements existing Centers
    by providing outstanding expertise in primate genetics and
    chronic disease research and by strengthening the current
    program's capabilities in infectious disease research. The
    Committee encourages the Institute to consider supporting this
    Center at the peer reviewed recommended funding level.
        Research centers at minority institutions.--The Committee
    recognizes the critical role played by minority institutions at
    both the graduate and undergraduate level in addressing the
    health research and training needs of our minority populations.
    These programs help facilitate the preparation of a new
    generation of scientists at these institutions. The Research
    Centers in Minority Institutions (RCMI) Program continues to
    impact significantly on these problems. The Committee
    encourages NIH to strengthen participation from minority
    institutions and consider increasing resources available in
    this area. The Committee also encourages NIH to work with
    minority institutions with a track record of producing minority
    scholars in science and technology.
        Research infrastructure in minority institutions (RIMI).--
    The Committee recognizes the importance of increasing the
    participation of minorities in health science careers. Programs
    like RIMI play an important role in achieving this goal by
    improving the research infrastructure that is available to
    prepare students for such careers. By establishing partnerships
    between minority and other institutions, RIMI has assisted
    minority institutions in faculty recruitment and retention,
    student development, enhanced research capacity, and
    administrative acumen. Therefore, the Committee encourages NCRR
    to consider increasing its support for this valuable
    demonstration program.
        Research resource centers and PET scans.--The Committee
    continues to urge NCRR to support research resource centers for
    the development and refinement of positron emission tomography
    (PET) as a unique imaging technology to diagnose and stage
    diseases of the brain, including Alzheimer's disease.

       National Center for Complementary and Alternative Medicine [CCAM]

    Appropriations, 2000....................................     $69,011,000
    Budget estimate, 2001...................................      72,392,000
    Committee recommendation................................     100,089,000

        The Committee has included $100,089,000 for the National
    Center for Complementary and Alternative Medicine, an increase
    of $27,697,000 above the budget request and $31,078,000 over
    the fiscal year 2000 appropriation.
        The Committee strongly supports the work of the National
    Center for Complementary and Alternative Medicine. The Center
    is charged with assuring that complementary and alternative
    therapies be rigorously reviewed to provide consumers reliable
    information.
        Educating health care practitioners.--Recognizing that
    educating health care practitioners in complementary and
    alternative medicine (CAM) is as important as training new
    researchers, the Committee encourages the National Center for
    Complementary and Alternative Medicine to consider providing
    funding for a demonstration project to develop a model
    curriculum for the clinical education of physicians, nurses and
    other health care professionals in CAM practices. The Committee
    encourages NCCAM to consider awarding such funding to an
    institution that offers postgraduate resident fellowships for
    physicians in integrative medicine, continuing education in
    integrative medicine for other healthcare professionals, and
    distance-learning models in complementary and alternative
    medicine for doctors and other health professionals throughout
    the country.
        New centers.--The Committee expects that funding for
    existing and new Centers supported by the Office will be
    expanded. The Committee directs NCCAM to undertake field
    investigations and a program for the collection and evaluation
    of outcome data on promising alternative therapies, including
    new clinical trials of herbal and other CAM therapies. The
    Committee has included adequate funds for NCCAM to renew and
    expand its support of CDC's field investigations program and of
    AHRQ's literature reviews and data analysis efforts.
        Commission on complementary and alternative medicine.--The
    Committee also has included additional funds to be transferred
    to the White House for the operations of the White House
    Commission on Complementary and Alternative Medicine Policy if
    funds provided in previous years prove insufficient.

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

    Appropriations, 2000....................................     $43,328,000
    Budget estimate, 2001...................................      48,011,000
    Committee recommendation................................      61,260,000

        The Committee recommends an appropriation of $61,260,000
    for the Fogarty International Center [FIC]. This is $13,249,000
    more than the budget request and $17,932,000 more than the
    fiscal year 2000 appropriation. The comparable amounts for the
    budget estimate include funds to be transferred from the Office
    of AIDS Research.
        Mission.--Adapting research advances in biomedicine to
    populations at home and abroad requires a continuing commitment
    to basic science as well as rigorous clinical and applied
    (epidemiological) studies. Examples are vaccines, anti-
    infective agents, drugs and more efficient diagnostic tools,
    combinations of interventions, and health policies to reduce
    the risk of disease and its associated human, social and
    economic consequences. These challenges will benefit from a
    more coordinated and multi-disciplinary approach to global
    health needs. It is the mission of the FIC to address these
    challenges by forging collaborations with a range of domestic
    and global partners in international research and training to
    pursue three core objectives. First, to accelerate the pace of
    discovery and its application by special projects enabling
    scientists worldwide to share conceptual insights, analytic
    methods, data sets, patient cohorts, or special environments.
    Second, to engage and assist young as well as more established
    U.S. investigators to address scientific challenges related to
    global health. The third is to help to develop a cadre of
    highly capable young foreign investigators positioned to
    cooperate with U.S. scientists in areas of the world that, due
    to geography, genetics, or disease burdens, provide unique
    opportunities to understand disease pathogenesis, anticipate
    disease trends, or develop interventions of relevance and
    priority for both the U.S. and the collaborating country.
        Clinical research and genomics and genetics.--The Committee
    recognizes that scientific advances that enable researchers to
    determine and explore new targets for drug and vaccine
    interventions will profoundly influence medicine and public
    health. The application of these advances to the disparities in
    health burden faced by developing countries cannot but help to
    reduce the threat of disease to the U.S. population. Thus, the
    Committee encourages FIC to move forward with the development
    of clinical research training programs, international
    collaborations in clinical trials, and the application of
    genetic methodologies to address the determinant genetic
    factors influencing disease susceptibility and disease burden.
    In the arena of genomics/genetics, transcultural studies on the
    ethical, legal and social implications of genome research, the
    identification of genome sequence variations that govern the
    balance between health and disease in the face of inducing
    factors or infectious diseases threats, and the effect of diet
    and environment on gene expression to enhance health and reduce
    disease are to be encouraged.
        Cost-effective methods of preventing HIV.--The Committee
    recognizes the exceptional work of FIC in helping to mobilize
    scientific resources and develop the human capacity to address
    the enormous disproportionate burden of HIV/AIDS in the
    developing world through the FIC AIDS International Training
    and Research Program (AITRP). The Committee encourages further
    productive work, sponsored by FIC together with other
    Institutes at NIH, to develop effective and cost-effective
    interventions to improve the health care options for HIV-
    infected mothers and children in Africa, Asia and Latin
    America.
        Global tuberculosis threat.--The Committee commends the FIC
    for its cooperation and collaboration with the International
    Union Against Tuberculosis and Lung Disease, the American Lung
    Association and the American Thoracic Society in developing a
    program to train TB health professionals. The Committee also
    finds positive the joint U.S. AID and FIC collaboration in
    implementing this effort and encourages the Center to expand
    the effort this fiscal year.
        Health and economic productivity.--The Committee
    appreciates the steps FIC has taken to address the relationship
    between health or demographic status and economic development,
    and to forge linkages with other organizations such as the
    World Bank. It seems clear that our conceptual understanding of
    the long-term influences on economic development and the
    formulation of effective policies for global poverty reduction,
    with its ancillary benefits of social and political stability,
    rely on a deepened understanding of the determinants and
    consequences of public health. The Committee encourages FIC to
    consider making additional investments in this program, in as
    much as the results could impact on so much of the source of
    disparities in health globally.
        Non-communicable global health threats.--The Committee is
    pleased to note the steps that FIC has taken to begin to
    address the global burden of noncommunicable diseases, in
    particular smoking prevention and cessation and the burden of
    mental illness. The Committee looks forward to the further
    development of these initial initiatives into mature and
    productive programs.
        Other emerging infectious diseases.--The Committee commends
    FIC for its leadership in the global efforts to reduce the
    burden of malaria, through its accession to the helm of the
    Multilateral Initiative on Malaria, a global effort focused on
    malaria in Africa. The Committee notes the rapid development of
    an FIC malaria research training program that is geared towards
    the linkage of basic, clinical and epidemiological research in
    Africa with the needs of control programs. It is anticipated
    that this new program will expand the capabilities of
    scientists and health professionals from malaria endemic
    countries to engage in relevant malaria research at their home
    institutions and in partnership with U.S. collaborators that
    will fill the critical gaps in knowledge. The Committee
    encourages FIC to consider targeting additional resources
    towards these goals, in particular to further our knowledge of
    vector biology and insecticide resistance in order to develop
    new ways to approach malaria control.
        Understanding micro and macro environment determinants of
    infectious diseases.--The Committee is pleased to note the
    effective work of FIC to initiate a program to better
    comprehend the consequences of changes in terrestrial and
    marine ecosystems on human health, especially the emergence of
    new infectious diseases and the re-emergence of previously
    controlled infectious diseases. The multi-disciplinary research
    program of FIC, together with several other NIH Institutes and
    NSF, bringing together ecologists, entomologists, marine and
    mammal biologists, biomedical scientists, infectious diseases
    clinicians, and epidemiologists is a creative and timely
    initiative. The Committee recognizes the importance of the
    goal, to elucidate the underlying biology of habitat and bio-
    diversity changes that may lead to increased disease prevalence
    of disease in the United States and elsewhere in the world, in
    order to better predict and prevent new emergence of infectious
    diseases. Further, FIC sponsored efforts to better understand
    the impact of environmental factors such as tobacco smoke and
    other indoor and outdoor pollutants on the establishment of
    diseases such as tuberculosis, which has significant economic
    implications for the workforce and for their families, could
    impact public health and environmental policy.

                          NATIONAL LIBRARY OF MEDICINE

    Appropriations, 2000....................................    $215,199,000
    Budget estimate, 2001...................................     230,135,000
    Committee recommendation................................     256,953,000

        The Committee recommends an appropriation of $256,953,000
    for the National Library of Medicine [NLM]. This is $26,818,000
    more than the budget request and $41,754,000 more than the 2000
    appropriation. The comparable amounts 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 NLM is the world's largest library of the health
    sciences, its holdings numbering more than 5 million items. The
    NLM has pioneered 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.
        Computational molecular biology.--The Committee is pleased
    to learn that NLM will play a key role in the NIH-wide
    Biomedical Information Science and Technology Initiative
    (BISTI). NLM's long history in supporting research and training
    in medical informatics makes it uniquely positioned to assist
    in the further development of the field of computational
    biology. The Committee encourages NLM to consider expanding its
    extramural grant activities in the area of computational
    molecular biology.
        Consumer health.--The Committee is pleased with the actions
    NLM has taken to ensure that the American public has access to
    good health information. It has done this not only by making
    MEDLINE and its other information resources available to
    consumers over the Internet, but by creating MEDLINEplus, a
    consumer health information site specifically for the general
    public. Another new service created by NLM, ClinicalTrials.gov,
    is an easy-to-use database with information on more than 4,000
    Federal and private medical studies involving patients and
    others at more than 47,000 locations nationwide. The Committee
    is pleased that patients, families and members of the public
    now have easy access to information about the location of
    clinical trials, their design and purpose, criteria for
    participation, contact people and, in many cases, further
    information about the disease and treatment under study. The
    Committee encourages NLM to more widely publicize its products
    and services through all appropriate means.
        Genome information.--The Committee is aware of the
    important role NLM's National Center for Biotechnology
    Information plays in making available information from the
    Human Genome Project and other genome activities. The analytic
    tools created by NCBI contribute to the usability of this
    information, making it possible to understand the differences
    between normal and diseased cells at the molecular level. The
    Committee encourages NLM to consider providing additional
    resources to this important effort.
        Home medical consultations.--The Committee strongly
    encourages NLM to support an expansion of a demonstration
    called for in last year's report to test the use of state-of-
    the-art telemedicine technology for home medical consultations.
    This innovative approach could hold great promise for improving
    the care and lowering health care costs for home-bound
    individuals who require frequent monitoring.
        Outreach.--The Committee continues to note the success of
    NLM's MEDLINE database and its new MEDLINE Plus initiative. The
    Committee encourages NLM to continue its outreach activities
    aimed at educating health care professionals and the general
    public about the Library's products and services, in
    coordination with medical librarians and other health
    information specialists.
        PubMed central.--The Committee commends NLM for its
    leadership in establishing PubMed Central, an electronic online
    repository for life science articles. PubMed Central holds
    great promise for increasing access to health care literature
    by health professionals, students, educators, researchers and
    the general public. Because of the high level of expertise
    health information specialists have in the organization,
    collection, and dissemination of medical information, the
    Committee believes that health sciences librarians have a key
    role to play in the further development of PubMed Central. The
    Committee encourages NLM to work with the medical library
    community regarding issues related to copyright, fair use,
    peer-review and classification of information on PubMed
    Central.
        Senior citizen outreach.--The Committee again notes that
    senior citizens would benefit greatly from expanded access to
    NLM's databases and encourages the NLM to take steps to
    consider new ways to improve access for senior citizens, such
    as including Internet access at senior centers and congregate
    meal sites.
        Telemedicine and the next generation internet.--The
    Committee is pleased that NLM remains a world leader in
    supporting the application of computer technology to the
    delivery of health care at a distance and encourages NLM to
    continue its efforts related to medical applications of the
    next generation internet (NGI). This research seeks to improve
    quality, lower costs, and increase effectiveness for delivering
    health care. The Committee commends NLM for its thoughtful
    approach to assuring that, in developing the next generation
    internet, proper attention is given to those unique
    requirements specific to medicine, such as telemedicine,
    digital libraries, and distance learning. The Committee is
    impressed with NLM's success in developing practical
    applications of technology to help hard-to-reach communities.
    Examples include a project that enables remote diagnosing
    middle ear infections in remote areas, thus reducing the use of
    antibiotics and the necessity of evacuating patients; providing
    remote eye screenings in inner cities as a means of identifying
    undiagnosed cases of diabetes; and helping develop patient-
    controlled personal medical records systems. The Committee
    believes the NGI will provide affordable secure information
    delivered at rates thousands of times faster than today and
    will accelerate the introduction of new networked services for
    businesses, schools, libraries and homes. The Committee
    believes that it is imperative that health care be a part of
    these efforts.

                             OFFICE OF THE DIRECTOR

    Appropriations, 2000....................................    $282,000,000
    Budget estimate, 2001...................................     308,978,000
    Committee recommendation................................     352,165,000

        The Committee recommends an appropriation of $352,165,000
    for the Office of the Director [OD]. This is $43,187,000 more
    than the budget request and $70,165,000 more than the fiscal
    year 2000 appropriation. The comparable amounts for the budget
    estimate include funds to be transferred from the Office of
    AIDS Research.
        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 Committee directs the Director of NIH to make a written
    request to the chairman of the Committee prior to reprogramming
    of $1,000,000, between programs, projects, activities,
    institutes, divisions and centers. 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 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.
        Autoimmune Diseases Coordinating Committee.--The Committee
    supports the creation of the coordinating committee for
    autoimmune disease research by the Director. Autoimmunity is at
    the root of eighty interrelated major diseases affecting at
    least 5 percent of the population. Autoimmune diseases also
    disproportionately affect women. The Committee encourages the
    coordinating committee to advise the Director and the various
    Institutes on autoimmune diseases, as wellas to develop a
    consensus research agenda.
        Behavioral science.--There is a growing public awareness of
    the behavioral and underpinnings of disease. Heart disease,
    lung cancer, liver disease, AIDS, suicide, developmental
    disabilities, and many neurological and cognitive disorders can
    be attributed directly or indirectly to unhealthy behavior. The
    Committee urges NIH to incorporate behavioral research as part
    of its core public health mission. The Committee also urges the
    NIH to provide a detailed description of NIH's ongoing work in
    the behavioral sciences, including a breakdown by Institute,
    and funds within each Institute of research and training
    activities included in NIH's behavioral and social science
    portfolio.
        Biomedical information science and technology initiative
    (BISTI).--The Committee is pleased to see that the NIH is
    undertaking the Biomedical Information Science and Technology
    Initiative and is providing full support for the request to
    enhance the availability of computing and computational
    expertise in biomedical research.
        Botanical research centers.--The Committee is pleased that
    the Office has begun a botanical research centers initiative
    with major research institutions across the nation and has
    included funds to expand the number of centers to be supported.
    The Committee encourages such centers to include collaboration
    between agricultural research institutions and biomedical
    research institutions.
        Cancer in ethnic minorities and the medically
    underserved.--The Committee continues to be concerned about the
    disproportionately high incidence and/or mortality rates of
    many cancers in ethnic minority, rural poor and other medically
    underserved populations. Therefore, within the increases for
    NIH, the Committee urges that the Institutes, Centers, and
    Offices with cancer-directed research agendas work together to:
    (1) develop and proceed with a 5-year strategic plan to
    implement the recommendations in the January 1999 Institute of
    Medicine study ``The Unequal Burden of Cancer''; (2) establish
    benchmarks, program evaluations, and accountability procedures;
    (3) allocate necessary resources to address IOM-identified
    priorities; and (4) substantially increase the funding for: (a)
    population, behavioral, socio-cultural, communications and
    community-based research; (b) recruiting and training efforts
    to attract more candidates from ethnic minority and medically
    underserved populations in all areas of cancer research; and
    (c) cancer data collection, management and interagency
    coordination of data collection, with special support for the
    National Cancer Institute's Surveillance, Epidemiology , and
    End Results program.
        Childhood birth defects and developmental disorders.--The
    Committee recognizes the importance of helping children
    suffering from birth defects and developmental disorders.
    Thousands of children each year suffer from birth defects and
    developmental disorders including cleft lip, cleft palate,
    missing limbs and other facial deformities from hemangiomas,
    hemifacial microsomia, microtia and aural atrresia,
    craniosynostosis. The Committee, therefore, urges the
    appropriate Institutes and Centers to expand and better
    coordinate their support of research into the causes,
    incidence, treatment and prevention of these and other
    children's congenital or developmental conditions and to
    consider developing a comprehensive action plan targeting these
    conditions.
        Chronic human diseases.--It has come to the Committee's
    attention that a number of chronic human diseases, for which
    there is no known etiology, are suspected to be caused by
    infectious agents in conjunction with various hereditary,
    environmental, or nutritional factors. Certain cancers, chronic
    lung, neurological and gastrointestinal diseases, as well as
    forms of arthritis are known or suspected to be caused by
    infectious agents. The Committee is pleased to learn that a
    number of NIH research institutes are conducting and/or
    supporting studies in this area to determine the scientific
    validity of such links and to encourage investigators to
    consider studies of the possible infectious nature of chronic
    diseases. Such research has enormous potential benefit to the
    health of chronically ill individuals, in health care cost
    savings, and in economic terms from reductions in lost days of
    work. While the Committee is pleased that the individual
    institutes are exploring relevant avenues of research, the
    Committee also believes that there is a need for a central
    coordinating mechanism to ensure broader communication and
    collaboration. For this reason, the Committee urges the NIH
    Director to establish a trans-NIH coordinating function on
    infectious etiology of chronic diseases. The Committee is aware
    that the NIH has established several trans-NIH coordinating
    activities for various diseases under study and on the broad
    category of autoimmune diseases. The NIH is encouraged to use
    these models to address this need and to promote further
    opportunities for successful research outcomes.
        Coordination.--The Committee is extremely pleased with the
    scientific advances that have been made over the past several
    years due to the Nation's support for biomedical research at
    NIH. However, the Committee also notes the proliferation of new
    entities at NIH, raising concerns about coordination. While the
    Committee continues to have confidence in NIH's ability to fund
    outstanding research and to ensure that new knowledge will
    benefit all Americans, the fundamental changes in science that
    have occurred lead us to question whether the current NIH
    structure and organization are optimally configured for the
    scientific needs of the Twenty-first Century. Therefore, the
    Committee has provided to the NIH Director sufficient funds to
    undertake, through the National Academy of Sciences, a study of
    the structure of NIH. The Committee expects to receive a report
    and recommendations by December 31, 2001.
        Diabetes.--The Committee believes that finding a cure for
    diabetes and its complications--a devastating disease affecting
    16 million Americans--should be a top priority as NIH makes
    funding allocations. The Committee has reviewed the Diabetes
    Research Working Group report and urges the NIH to implement
    the recommendations, in particular those relating to juvenile,
    or Type 1, diabetes, the most severe form of the disease. Given
    the tremendous research opportunities in the field, the
    Committee urges the Director to lead a trans-NIH approach to
    diabetes research. The Committee is aware of the interest in
    having the Director coordinate a trans-NIH project including
    NIAID, NIDDK, and NICHD and other relevant institutes to
    jointly create a coordinated international effort to develop a
    vaccine to prevent juvenile, or Type 1, diabetes.
        Health status of disadvantaged populations.--The Committee
    encourages the Director to provide 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 the MARC, MBRS,
    RCMI, and ORMH programs, and expects that these programs will
    continue to be supported at a level at least consistent with
    that of the overall increase for NIH.
        Lyme disease.--The Committee encourages the NIH to enhance
    outreach to public and private scientists regarding Lyme
    disease in order to stimulate research interest in this field.
        Mental illness.--The Committee is aware of the recent major
    public focus on mental health and mental illnesses that has
    coincided with a dramatic resurgence in research on behavior
    and on the brain and its disorders. Some examples of public
    attention during the past year include the unprecedented White
    House Conference on Mental Health, the first-ever Surgeon
    General's Report on Mental Health, the Initiative for Mental
    Health submitted by the Secretary of HHS as a part of this
    budget request, and the urgent problems such as suicide and
    violence which have served to draw attention to the critical
    needs in this area. For these reasons and because of the
    extraordinary burden caused by mental illness in this country
    and world wide, the Committee views this as an area that should
    be given increased emphasis so as to capitalize both on the
    scientific excitement and momentum in brain research, as well
    as on the public demand to better understand mental illness.
    The Committee encourages that research on mental illness will
    be a high priority area for the NIH.
        Microbicides research.--Recognizing a clear public health
    need for HIV and STD prevention technologies that women can
    control and tremendous scientific opportunity in the field of
    microbicides, the Committee strongly urges the NIH Director, in
    coordination with OAR, NIAID, NICHD, NIMH, NIDA, OAR and OWHR,
    to establish a program to support research to develop
    microbicides, including expanding and intensifying basic
    research on the initial mechanisms of STD/HIV infection,
    identifying appropriate models for evaluating safety and
    efficacy of microbicidal products, enhancing clinical trials,
    and expanding behavioral research on use, acceptability and
    compliance with microbicides. The Committee encourages the NIH
    Director, in consultation with all appropriate NIH institutes
    and offices as well as relevant Federal agencies, to develop a
    5-year implementation plan regarding the microbicides research
    program, to be provided to the Committee by April 1, 2001.
        Minority health initiative.--The Committee is pleased that
    the Minority Health Initiative (MHI) has an interest in
    supporting the improvement of animal research facilities at
    minority health professions schools, and agrees that this
    initiative at the National Center for Research Resources is an
    appropriate utilization of the MHI budget.
        NIH/DOE medical technology partnership.--The Committee
    urges the National Institutes of Health (NIH) to continue to
    collaborate with the Department of Energy (DOE) to evaluate the
    technologies developed within the nuclear weapons program and
    other DOE programs in terms of their potential to enhance
    health sciences, with the goal of achieving clinical
    applications and improved national health care.
        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. Within the funds
    provided, the Committee encourages the Office to support
    research on ephedra.
        Office of Dietary Supplements.--The Committee is pleased
    that the Office has begun a botanical research centers
    initiative with major research institutions across the nation
    and has included funds to consider expanding the number of
    centers to be supported. The Committee again encourages such
    centers to include collaboration between agricultural research
    institutions and biomedical research institutions.
        Office of Research on Women's Health.--The Committee
    continues to stress the importance of women's health and
    gender-based research. ORWH plays the critical role in assuring
    that these essential areas are addressed in a systematic manner
    throughout the NIH. For this reason, the Committee urges that
    adequate funding be supplied to ORWH to assure its ability to
    continue to bring the appropriate focus to these issues. Among
    its important programs is Building Interdisciplinary Research
    Careers in Women's Health (BIRCWH) which supplies funding to
    train the next generation of researchers in this critical
    field. The Committee urges ORWH to support the BIRCWH program
    without limiting its other activities.
        Parkinson's disease research agenda.--The Committee, based
    on advice from NIH as well as leading independent scientists,
    believes there is an extraordinary public health opportunity
    for a breakthrough on Parkinson's disease. Although today no
    neurodegenerative disease has been cured, the science regarding
    Parkinson's disease is at a stage where halting the progression
    of the disease, restoring lost function, and even preventing
    the disease, are all deemed realistic goals by NIH. The
    Committee is very pleased that a credible, thoughtful plan to
    effectively maximize the chances of a near-term cure has been
    developed.
        That plan is the NIH's 5-year ``Parkinson's Disease
    Research Agenda.'' This report was called for by the Conference
    Report on the Fiscal Year 2000 Budget. In response to that
    request, the NIH held a meeting of seven Institutes to discuss
    Parkinson's disease research, and then formed a steering
    committee of external scientists, NIH staff and Parkinson's
    advocates to engage in an intense planning process. This
    culminated in a very successful 2-day interdisciplinary
    workshop involving leading Parkinson's researchers, prominent
    scientists from related fields, industry representatives, and
    Parkinson's advocates. Out of this workshop came a specific 5-
    year research agenda--with professional judgments as to the
    costs that would be entailed--to advance dramatically our
    understanding and treatment of Parkinson's disease and to pave
    the way to its cure.
        The Committee is aware that the NIH report details a range
    of studies that should be undertaken, ranging from basic
    science, genetics, epidemiology and public health studies to
    animal studies and human clinical trials. Some of the research
    identified as needed is broadly applicable to other
    neurodegenerative diseases, indicating that Parkinson's disease
    research may well lead the way to finding the cause and cure of
    these other conditions. To carry out the plan, the professional
    judgment budget estimates call for increases over existing
    Parkinson's research of $71,400,000 in year one (fiscal year
    2001) and larger increases in subsequent years.
        The Committee commends the NIH, and in particular the
    leadership of NINDS, for their expeditious and thoughtful
    response to the Congressional mandate. The inclusive process
    that was followed resulted in a research agenda that was both
    scientifically impressive and at the same time reflective of a
    remarkable degree of consensus regarding the types of research
    that merit funding. The agenda also demonstrates that the
    science regarding Parkinson's disease is at a stage where
    greater management and coordination of the research enterprise
    will yield substantial public health benefits.
        The Committee understands that a key recommendation is that
    the NIH, to deal with inefficiencies and gaps in the research
    landscape, should make greater use of innovative funding
    mechanisms such as accelerated review, targeted research,
    research supplements and seed money grants.
        The Committee strongly supports overall implementation of
    the plan. This will require both clarity in the lines of
    responsibility within the NIH and sufficiency in the level of
    additional funding. The Director should be responsible for
    coordinating the overall implementation of the Agenda within
    the NIH.
        The Committee requests that the NIH develop mechanisms for
    monitoring its implementation of the plan, and to report on its
    progress in implementing the agenda by March 1, 2001. NIH is
    also requested to report on its progress in deploying
    innovative and accelerated funding mechanisms. The Committee
    believes that this plan represents a new paradigm for helping
    manage the Federal research effort on Parkinson's disease and
    merits both sustained support and careful monitoring.
        Pediatric research initiative (PRI).--The Committee
    recognizes the importance of the Pediatric Research Initiative
    within the NIH and encourages the Director to build upon its
    overall investment in research by exploring promising areas of
    extramural pediatric research.
        Promoting private support of biomedical research at the
    National Institutes of Health.--The Committee is aware of
    successful efforts by outside foundations in attracting
    resources from corporations and private foundations to support
    biomedical research at the National Institutes of Health.
        Research training.--The Committee views researcher training
    as a critical element in the nation's health science enterprise
    and believes NIH could increase support for such activities.
    Further, the Committee encourages the NIH to have an overall
    training strategy to promote training in areas that involve all
    institutes, such as interdisciplinary research, behavioral
    science, translational research, and other cross-cutting
    research activities.
        Women's health and gender-based biology.--Biomedical
    research, from the most basic to phase III clinical trials,
    benefits from the broadest possible participation. NIH has
    increasingly emphasized, for example, the importance of
    including women in clinical trials and analyzing research
    results for gender-based differences. However, there remains a
    history of exclusion of women from research to overcome,
    particularly as it relates to phase III clinical trials. The
    Committee has reviewed the recently released report of NIH's
    plan to involve more women and minorities in Phase III clinical
    trials. The Committee would appreciate an update on the
    implementation of the specific plans and projected initiatives
    outlined in the report by January 1, 2001.
        Vision of neuroscience.--The Committee reiterates its
    support for the multi-institute vision to create a National
    Neuroscience Center at the NIH. This bold vision will not only
    increase the pace of discovery in all areas of neuroscience, it
    also will speed the rate at which fundamental discoveries are
    translated into effective therapies for neurological and
    psychiatric disorders. The National Neuroscience Center would
    bring together, under one roof, scientists who are now isolated
    from one another simply because of outdated historical
    precedents. The Committee believes this is a rare opportunity
    for NIH to become a model for the entire nation, one that would
    foster neuroscience without regard to the artificial boundaries
    of Institute, specialty, or organizational boundaries. Beyond
    the obvious medical disciplines involved, this will integrate
    bioengineering, computational science and bioinformatics.

                            BUILDINGS AND FACILITIES

    Appropriations, 2000....................................    $125,376,000
    Budget estimate, 2001...................................     148,900,000
    Committee recommendation................................     148,900,000

        The Committee recommends an appropriation of $148,900,000
    for buildings and facilities [B&F]. The amount recommended is
    the same as the budget request and $23,524,000 more than the
    fiscal year 2000 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.

                            OFFICE OF AIDS RESEARCH

    Appropriations, 2000....................................................
    Budget estimate, 2001...................................................
    Committee recommendation................................................

        The Committee recommendation does not include a direct
    appropriation 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 Director 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 Director of the NIH and the OAR to
    shift up to 3 percent of AIDS research funding among 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 2001. The
    Committee requests that the Director report on the fiscal year
    2001 allocation plans for AIDS research within 60 days of
    enactment and provide notification to the Committee in the
    event the Directors exercise the 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.
        The Committee was pleased with efforts made by OAR in
    fiscal year 2000 to provide additional funding to address AIDS
    in minority communities, to spearhead projects to bring
    research information to minority communities and to increase
    the number of minority investigators conducting AIDS research.

           Substance Abuse and Mental Health Services Administration

    Appropriations, 2000....................................  $2,651,868,000
    Budget estimate, 2001...................................   2,823,016,000
    Committee recommendation................................   2,730,757,000

        The Committee recommends $2,730,757,000 for the Substance
    Abuse and Mental Health Services Administration [SAMHSA] for
    fiscal year 2001, $78,889,000 more than the fiscal year 2000
    level and $92,259,000 below the administration request. SAMHSA
    is responsible for supporting mental health, alcohol 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 agrees with the President's request to
    establish new targeted capacity expansion line items in the
    areas of substance abuse prevention and treatment. These
    programs are intended to ensure that individuals with substance
    abuse problems can access services employing the best practices
    proven to be effective. Targeted capacity programs are designed
    to provide a rapid and strategic response to newly emerging
    substance abuse trends demonstrated by epidemiological data; to
    address serious and persistent gaps in local service capacity;
    and to address prevention and treatment issues particular to
    certain populations or geographic areas. The Committee intends
    that these programs work in a coordinated fashion with the
    block grants to the States to meet the highest priority service
    needs within the States.
        The Committee remains concerned by the disproportionate
    presence of substance abuse in rural and native communities,
    particularly for American Indian, Alaska Native and native
    Hawaiians 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
    $8,000,000 be reserved for CSAP grants, and $12,000,000 be
    reserved for CSAT grants.
        The Committee notes that Alaska has the highest rate of
    alcohol dependency in the nation, the highest rate of suicide,
    and the highest rate of child abuse, especially in Native
    communities in Alaska. The Committee urges the agency to work
    with the Alaska Federation of Natives in consultation with the
    State of Alaska to identify the most effective service delivery
    practices and develop model programs for implementation in the
    Alaska Native community.

                       CENTER FOR MENTAL HEALTH SERVICES

    Appropriations, 2000....................................    $631,424,000
    Budget estimate, 2001...................................     731,424,000
    Committee recommendation................................     662,424,000

        The Committee recommends $662,424,000 for mental health
    services, an increase of $31,000,000 over last year's level.
    Included in this amount is funding for mental health knowledge,
    development, and application demonstrations, the mental health
    performance partnership block grant to the States, children's
    mental health, programs to assist homeless persons with mental
    illnesses, and protection and advocacy services for individuals
    with mental illnesses. The Committee has included funding for
    mental health counselors for school-age children, as part of an
    effort to reduce school violence. The Committee intends that
    $90,000,000 be used for counseling services for school-age
    youth.

    Mental health knowledge development and application

        The Committee recommends $146,875,000 for the mental
    health, knowledge, development, and application program [KDA],
    $10,000,000 more than the fiscal year 2000 amount and
    $20,000,000 below the administration's request. The following
    programs are included in the mental health center KDA: homeless
    and AIDS demonstrations; training and AIDS training programs
    and community action grant program.
        The Committee has included additional funds to continue and
    expand mental health services for schoolchildren that are at
    risk of exhibiting violent behavior. Last year, after the
    tragic shootings at a number of schools across the nation, the
    Congress provided funds to begin to address the problem of
    youth violence. Among other things, the Committee believes that
    mental health counseling for troubled youth can help prevent
    violent acts, and is therefore providing additional funds to
    help schools in that cause. It is again expected that SAMHSA
    will collaborate with the Department of Education to continue a
    coordinated approach.
        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 applauds the interagency partnership to form
    the Safe Schools/Healthy Students initiative and encourages the
    Departments of Health and Human Services, Justice, and
    Education to continue working together to develop empirically-
    supported programs to prevent youth violence and to intervene
    with families, schools, and communities where violence has
    already occurred.
        The Committee is aware that Concord Assabet Family and
    Adolescent Services is committed to finding successful models
    that meet the special education, vocational training, and
    mental health needs of youth who are making the transition from
    institutional living arrangements to independent living.
    Development of these models is a key means of strengthening our
    communities by breaking the cycles of violence, poverty, and
    neglect suffered by many youth with mental disabilities.
        The Committee is aware of the successful history of early
    intervention programs, especially for those programs reaching
    preschool-aged children. The Committee commends the National
    Preschool Anger Management Project for its development of the
    national ``What Do You Do with the Mad that You Feel?''
    program, a 2\1/2\ hour workshop that educates teachers, at all
    levels, on the emotional development of a child's self-control.
    The workshop trains teachers on ways to support children's
    growth in basic skills of self-control and ways to intervene
    and re-direct when children have lost control. The Anger
    Management Project has facilitated teachers to help children
    manage their frustration and anger, which ultimately prevents
    the progression to violent acts. The Committee understands that
    the National Preschool Anger Management Project plans to
    disseminate materials nationwide and conduct training programs
    in communities in Pennsylvania, Illinois, Mississippi,
    Wisconsin, Ohio, Florida, Iowa, and Massachusetts.
        The Committee is aware of the Texas Medication Algorithm
    Project (T-MAP) and the benefit it has demonstrated in
    improving the quality of care for individuals who are
    prescribed psychiatric medications. This disease management
    program for people with serious mental illness synthesizes
    scientific and practitioner consensus into a practical
    guideline for physicians. Since many States have expressed
    interest in adopting the T-MAP program in their States, the
    Committee urges the Administration to explore ways to support
    and facilitate that process, including the establishment of a
    technical assistance center on mental health best practices
    that focuses on best practices development, implementation, and
    evaluation.
        The Committee is aware of efforts undertaken by the City of
    Lynn, Massachusetts to provide intensive counseling,
    evaluation, and investigation to children and adolescents who
    set fires, in recognition of the direct link that has been
    established between firesetting and sexual, physical, and
    mental abuse. The modest Federal support sought by the city
    would enable it to expand this collaborative program to the
    region and develop a model for protecting both children and the
    communities.
        The Committee is concerned that trauma system doctors and
    nurses are not prepared to help family members of trauma
    victims cope with the shock of unexpected death or critical
    injury. The Committee commends the American Trauma Society for
    designing a training program in response to this need and
    believes that SAMHSA should work with HRSA and the American
    Trauma Society to support the implementation of this program.
        The Committee understands that many families in rural areas
    are suffering emotional and psychological distress in the wake
    of the recent farm crisis. The Committee is aware that the Farm
    Partners Project plans to provide mental health and stress
    management outreach programs for farmers in South Central
    Kentucky. The Committee also supports additional funding for
    Iowa State University Extension to develop a program that will
    provide outreach, counseling services, and training to mental
    health providers in rural areas.
        The Committee recognizes the efforts of Chicago's Lakefront
    SRO, Northwest, and Lake County PADS to conduct a metropolitan-
    wide demonstration project known as Break the Cycle of
    Homelessness.
        The Committee understands that the Ch'eghutsen program
    plans to provide comprehensive mental health services for
    children in the interior of Alaska through a joint project with
    Tanana Chiefs Conference and Fairbanks Native Association.
        The recently released Surgeon General's Report on Mental
    Health affirmed the need to improve the mental health services
    available to older adults. The Committee believes that the
    Center for Mental Health Services should explore ways to
    enhance older Americans' access to mental health services,
    including assessing the number of older adults that are served
    under the mental health block grant and how States may better
    serve the unique needs of older adults.
        The Committee is aware of the California School of
    Psychology's efforts to initiate a project to demonstrate ways
    to more effectively provide behavioral and mental health
    services to the prison population of California.
        The Committee believes that CMHS could more closely
    collaborate with the National Institute of Mental Health in
    order to maximize the benefits of activities conducted by both
    agencies. The Committee acknowledges that CMHS and NIMH could
    work together to identify research priorities, disseminate
    research findings, and develop tools to help communities use
    those findings to develop and improve services for adults and
    children with or at risk of developing mental health problems.
        The Committee is pleased that SAMHSA is participating with
    the Office of the Surgeon General to implement the National
    Suicide Prevention Strategy. The Committee urges that SAMHSA
    develop, in cooperation with HRSA, training materials and
    resources related to depression and anxiety assessment and
    intervention for distribution and use by the State partners of
    CMHS and CSAT.
        The Committee recognizes the crucial role that the Minority
    Fellowship Program plays in training mental health
    professionals to provide services to individuals who would
    otherwise go untreated. The Committee encourages SAMHSA to
    increase its effort in this area.
        The Committee understands that prevention and early
    intervention can reduce the need for more intensive services in
    certain individuals. For this reason, the Committee believes
    that CMHS could develop and implement empirically-based models
    for mental health prevention. Prevention and early intervention
    services could be carried out in collaboration with the
    Administration for Children and Families.
        The Committee is aware of a proposal by the Life Quest
    Community Mental Health Center to develop a program of
    treatment for co-occurring disorders for severely and
    persistently mentally ill, severely emotionally disturbed
    adults and children in the Mat-Su Valley region of Alaska. The
    Center, which serves a population of over 56,000, seeks to meet
    the currently unaddressed need to provide a comprehensive range
    of treatment for the increasing number of patients presenting
    with co-occurring disorders including chemical and substance
    abuse, severe depression and severe mental illness.
        The Committee understands that Alaska Native children
    commit suicide at the highest rate in the nation and suffer
    disproportionately from behavioral and mental disorders, some
    caused by fetal alcohol syndrome. The Committee recommends that
    the agency work with the Alaska Federation of Natives, in
    consultation with the State of Alaska, to develop integrated
    systems of community care for these disorders.
        The Committee notes that Anchorage, Alaska has a number of
    individuals, particularly Alaska Natives, suffering from severe
    mental illness and substance abuse disorders who are also
    homeless. The Committee encourages the agency to work with the
    State of Alaska and the Alaska Federation of Natives to develop
    a plan for outreach, screening and diagnostic treatment
    services, rehabilitation, mental health services, alcohol or
    drug treatment, training and case management.

    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 the crucial role that the Minority
    Fellowship Program plays in training mental health
    professionals in providing mental health services for
    individuals who often fail to seek services.

    AIDS demonstrations

        This program provides 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 commends the
    Center for Mental Health Services for its commitment in
    disseminating knowledge gained from these demonstration
    projects. The Committee urges the center to maintain its
    support for projects that provide direct mental health services
    while at the same time using the findings from previous
    projects to develop new knowledge in this area. The Committee
    again commends CMHS 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 $366,000,000 for the mental health
    block grant, $10,000,000 more than the fiscal year 2000 amount
    and $50,000,000 less than 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 $86,763,000 for the Children's
    Mental Health Program, $4,000,000 above the fiscal year 2000
    level and the same as the administration'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 $36,883,000 for the PATH Program,
    $6,000,000 more than the fiscal year 2000 amount and $1,000,000
    above the administration's 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 $25,903,000 for protection and
    advocacy, $1,000,000 more than the fiscal year 2000 amount and
    the same as the administration'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.
        The Committee is aware that patients with mental illnesses
    have died or received life-threatening injuries in treatment
    facilities because of improper restraints and seclusion. The
    Committee has provided resources for protection and advocacy so
    that these deaths can be investigated and future incidences can
    be prevented.

                      CENTER FOR SUBSTANCE ABUSE TREATMENT

    Appropriations, 2000....................................  $1,814,566,000
    Budget estimate, 2001...................................   1,889,420,000
    Committee recommendation................................   1,880,566,000

        The Committee recommends $1,880,566,000 for substance abuse
    treatment programs, an increase of $66,000,000 over last year's
    funding, $8,854,000 below the budget request. This amount funds
    substance abuse treatment knowledge, development, and
    application demonstrations, targeted capacity expansion, and
    the substance abuse block grant to the States.

    Substance abuse treatment knowledge development and application and
            targeted capacity expansion

        The Committee recommends $249,566,000 for the substance
    abuse treatment knowledge, development, and application program
    [KDA] and the targeted capacity expansion program [TCE]. This
    amount is $8,854,000 below the administration's request and
    $35,000,000 above the comparable fiscal year 2000 amount.
        The Committee reiterates its concern about the
    disproportionate impact of substance abuse in rural and native
    communities, and has included $12,000,000 for native and rural
    CSAT programs. The Committee again raises concern about the
    severe shortage of substance abuse treatment services in the
    State of Alaska for Native Alaskans, the pressing need to
    continue support of Alaska programs, and the need to develop
    knowledge about effective techniques for treating substance
    abuse in native populations. The Committee, therefore, expects
    that the increase provided will be reasonably allocated between
    existing programs and initiating new programs, especially in
    Alaska.
        The Committee remains concerned that substance abuse among
    the nation's homeless population remains a serious problem that
    receives limited attention. Existing addiction services are not
    adequately reaching the homeless population and are not
    adequately addressing their unique needs and life
    circumstances.
        Of the funds provided for the Center for Substance Abuse
    Treatment Targeted Capacity Expansion program, the Committee
    recommends that the Department direct additional resources to
    entities that develop or expand addiction services specifically
    for homeless persons. The Committee expects the Department to
    distribute these funds to local public or nonprofit
    organizations through a competitive process. The Department
    should require applicants for the homeless funds to demonstrate
    integration with primary care and mental health services and
    linkages with housing, employment, and social services as a
    condition of the award. Establishment of a homeless TCE program
    should not restrict entities planning to serve homeless persons
    from also competing for funding through the general TCE
    program.
        The Committee is aware that Allegheny County, Pennsylvania
    is undertaking a treatment protocol known as the Supportive
    Recovery Environment (SRE) for underserved populations,
    including women with children known to the child welfare
    system, incarcerated inmates, adolescents for whom traditional
    treatment services have been ineffective, and individuals with
    co-occurring disorders.
        The Committee recognizes the success of the Fairbanks
    Native Association's LifeGivers residential treatment program
    in helping pregnant women with substance abuse problems, and
    their children. The Committee notes that additional funding for
    this important activity will allow more women to conquer their
    substance abuse problems.
        The Committee understands that Mountain View in Huntington,
    Vermont is the only residential treatment center for
    adolescents in the State.
        The Committee reiterates its support of the Southcentral
    Foundation in Anchorage and Norton Sound Health Corporation in
    Nome for providing substance abuse treatment programs for
    Native American adolescents.
        The Committee continues to be supportive of the 5-point
    State of Alaska plan of action to prevent fetal alcohol
    syndrome and other alcohol-related birth defects and to improve
    the State's system of care for those individuals and their
    families already affected by prenatal exposure to alcohol.
    Alaska has one of the highest rates of Fetal Alcohol Syndrome
    in the nation. This demonstration program will provide Alaska
    with a clear understanding of the prevalence of FAS, data on
    the effects of the State's prevention efforts, and clear
    direction on how to improve prevention and treatment services.
        The Committee is aware of the serious problem of drug use
    among the Nation's youth, noting that perhaps only 20 percent
    of youths who require drug treatment actually receive it. The
    Committee supports the funding of grants for national drug
    prevention and treatment for youths, as well as training for
    providers who work with this population.
        The Committee understands that methamphetamine abuse
    continues to be a major problem in many areas of the country,
    in particular, the South and the Midwest. The State of Iowa is
    experiencing a particularly high incidence of methamphetamine
    abuse. The Committee continues to support prevention and
    treatment demonstration projects in Iowa and other parts of the
    Midwest. School-based prevention demonstration projects would
    teach the dangers of methamphetamine abuse and addiction, using
    methods that are effective and evidence-based and include
    initiatives that give students the responsibility to create
    their own anti-drug abuse education programs for their schools.
    Treatment demonstrations would carry out planning,
    establishing, or administering evidence-based methamphetamine
    treatment programs that are designed to assist individuals to
    quit their use of methamphetamine and remain drug-free.
        The Committee continues to be concerned with the serious
    problem of inhalant abuse in Alaska, especially among children
    and teenagers. With approximately 1 in 4 Alaska children having
    used inhalants, it is clearly a critical and widespread
    problem. The Committee is aware that the Yukon-Kuskokwim Health
    Corporation is establishing a facility in Bethel, Alaska to
    treat individuals with inhalant addiction.
        The Committee is aware of Hope Center in Lexington,
    Kentucky, which has a history of providing quality substance
    abuse treatment programs to homeless men. Hope Center is
    developing a similar initiative targeted at providing
    rehabilitation services for homeless women. The Committee
    recognizes that with funding from the Department, the Center
    will be able to provide services to more individuals. to
    provide funding for this initiative.''
        The Committee commends SAMHSA for funding the Fetal Alcohol
    Syndrome Regional Consortium in South Dakota, North Dakota,
    Minnesota, and Montana. The Committee supports continued
    funding for this important program that is helping children and
    families affected by alcohol-related birth defects.
        The Committee applauds the work of the City of San
    Francisco's model ``Treatment on Demand'' program, which
    includes substance abuse and mental health services for
    homeless persons.
        The Committee applauds the work of Center Point, Inc., a
    private non-profit corporation that provides low cost
    comprehensive drug and alcohol services to high risk families
    and individuals in the San Francisco Bay area.
        The Committee is supportive of the Ai Ki Ruti center on the
    Winnebago Reservation in providing innovative substance abuse
    treatment services.
        The Committee is aware that the Pine Ridge Indian
    Reservation in the southwestern corner of South Dakota has a
    high incidence of alcohol addiction and that additional funds
    would allow the center to pursue innovative treatment
    alternatives.
        The Committee acknowledges the efforts of the Allegheny
    County Drug and Alcohol Rehabilitation Program in providing
    innovative drug and alcohol treatment services to patients in
    need.
        The Committee understands that Baltimore is employing
    innovative techniques to enhance drug treatment services in the
    city. Additional funds would allow the city to increase the
    number of outpatients it can serve by providing more
    counselors, extending treatment center hours, and expanding
    program services.
        The Committee applauds the work of Friendship House in
    Kansas City, Missouri for substance abuse and related service
    to high-risk women and children. Friendship House is
    establishing a model program to address what has become a
    severe and obvious need: treating the substance-abusing family
    with a specific focus on children.
        The Committee understands that the Cook Inlet Council on
    Alcohol and Drug Abuse is providing coordinated treatment
    services to meet the needs of an underserved group of women and
    their children who are in the custody of the State of Alaska
    and women affected by domestic violence in the Kenai Peninsula
    area of Alaska and recognizes that funding from the Department
    would help more women and children become drug and alcohol
    free.
        The Committee understands that the Navajo-Farmington
    Alcohol Crisis Response program is using innovative means to
    provide much-needed comprehensive substance abuse treatment
    services.
        The National Household Survey on Drug Abuse (NHSDA) is a
    basic survey providing information on the prevalence and
    incidence of substance abuse and the number of persons who have
    received treatment. This survey is being expanded to provide
    information that will assist State and local agencies with
    responsibility for providing substance abuse treatment and
    prevention services. Last year, NHSDA was expanded to include a
    more comprehensive set of data on tobacco product use,
    including information on user brands. The Committee is pleased
    with the progress made by SAMHSA in gathering data to identify
    emerging substance abuse problems, including tobacco, and
    expanding the survey size. This will enable state-by-state
    comparisons and the tracking of trends within a State. The
    Committee also recognizes the work SAMHSA has done to apply the
    newest technologies to data gathering.

    Substance abuse block grant

        The Committee recommends $1,631,000,000 for the substance
    abuse block grant, $31,000,000 more than the comparable fiscal
    year 2000 level and the same as 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

    Appropriations, 2000....................................    $146,824,000
    Budget estimate, 2001...................................     142,229,000
    Committee recommendation................................     127,824,000

        The Committee recommends $127,824,000 for programs to
    prevent substance abuse, an increase of $19,000,000 below last
    year's level and $14,405,000 less than the budget request. This
    amount funds substance abuse prevention knowledge, development,
    and application demonstrations, targeted capacity expansion,
    and grants for youths at risk of substance abuse.

    Substance abuse prevention, knowledge, development, and application and
            targeted capacity expansion

        The Committee has provided $120,824,000 for the substance
    abuse prevention, knowledge, development, and application
    program [KDA] and the targeted capacity expansion program
    [TCE], $19,000,000 less than the fiscal year 2000 amount and
    $14,405,000 less than the administration's request.
        The Committee has included $7,000,000 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. 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.
        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 $8,000,000 for CSAP programs
    which serve rural communities. 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 allow
    children to 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.
        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.
        The Committee acknowledges the innovative Drug Free
    Families initiative at the University of Missouri-St. Louis in
    providing a comprehensive school-based health and drug abuse
    prevention program that involves parents and targets middle and
    high school students.
        The Committee encourages CSAP to continue support for
    alcohol and substance abuse prevention and education targeting
    Native American children of alcoholics through the National
    Association for Native American Children of Alcoholics
    headquartered in Washington State. The rates for alcohol-
    related deaths among American Indians is seven times the rate
    for the general population. Efforts to prevent the
    multigenerational effects of alcohol and substance abuse in
    Indian communities should continue.

                               PROGRAM MANAGEMENT

        The Committee recommends $59,943,000 for program management
    activities of the agency, the same as the President's request
    and $889,000 more than the 2000 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.

                   Agency for Healthcare Research and Quality

    Appropriations, 2000....................................    $198,799,000
    Budget estimate, 2001...................................     249,943,000
    Committee recommendation................................     269,943,000

        The Committee recommends $269,943,000 for the Agency for
    Healthcare Research and Quality [AHRQ]. The Committee provides
    these funds through transfers available under section 241 of
    the Public Health Service Act.
        The Agency for Healthcare Research and Quality 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. AHRQ 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. AHRQ provides
    policymakers, health care professionals, and the public with
    the information necessary to improve cost effectiveness and
    appropriateness of health care and toreduce the costs of health
    care.

                      Health Costs, Quality, and Outcomes

        The Committee provides $226,593,000 for research on health
    costs, quality and outcomes [HCQO]. HCQO research activity is
    focused upon improving clinical practice, improving the health
    care system's capacity to deliver quality care, and tracking
    progress toward health goals through monitoring and evaluation.

                            MEDICAL ERRORS REDUCTION

        The Committee has held hearings to explore the factors
    leading to medical errors which, according to the Institute of
    Medicine, are responsible for as many as 98,000 deaths each
    year. This ranks medical errors as the fifth leading cause of
    death. Aside from the enormous personal cost, medical errors
    have a substantial economic cost, with estimates ranging as
    high as $29,000,000,000 annually. The Committee is troubled by
    these statistics and directs AHRQ to devote $50,000,000 to
    determining ways to reduce medical errors. Funds should be used
    to develop guideline on the collection of uniform data related
    to patient safety, to establish a competitive demonstration
    program for health care facilities and organizations to test
    best practices for reducing errors, and to determine ways to
    improve provider training in order to reduce errors.

    State reporting

        The Committee instructs AHRQ to support the development of
    guidance on the collection of uniform data related to patient
    safety. The guidance should address issues surrounding how
    providers may report, and how States may collect data. The
    guidance should also address issues surrounding how States may
    collect, analyze, and disseminate such data, including guidance
    to States on appropriate confidentiality rules. In developing
    this guidance, the Committee urges AHRQ to consult with
    interested non-government parties, including patients,
    consumers and health care provider groups. The Committee
    requests ARHQ to report to Congress on this guidance no later
    than December 31, 2000.

    Health system demos

        The Committee encourages the Director to establish a
    competitive demonstration program for health care facilities
    and organizations in geographically diverse locations,
    including rural and urban areas, to determine the causes of
    medical errors. These projects should use technology, staff
    training, and other methods to reduce such errors; develop
    replicable models that minimize the frequency and severity of
    medical errors; develop mechanisms that encourage reporting,
    prompt review, and corrective action with respect to medical
    errors; and develop methods to minimize any additional
    paperwork burden on health care professionals. Health systems
    and providers participating in this demonstration program
    should utilize all available and appropriate technologies to
    reduce the probability of future medical errors.
        To evaluate the best and most effective methods of error
    reporting and use of the collected data, the Committee urges
    the Director to ensure that each of the awarded projects
    examines any one of three types of error reporting parameters:
    voluntary reporting to the Director by participating health
    care providers of any adverse or sentinel events, health care-
    related errors, or medication-related errors; required
    reporting to the Director by participating health care
    providers of any adverse or sentinel events, health care-
    related errors, or medication-related errors; and required
    reporting to the Director and to the affected patient or family
    member by participating health care providers of any adverse or
    sentinel events, health care-related errors, or medication-
    related errors.
        The Committee believes that the Director must ensure that
    information reported within this demonstration program remains
    confidential, and is used only for the purpose of evaluating
    the ability to reduce errors in the delivery of care.
        The Committee further suggests that the Director encourage,
    as part of the demonstration program, the use of appropriate
    technologies to reduce medical errors, such as hand-held
    electronic medication and specimen management systems and
    prescription pads, training simulators for medical education,
    bar-coding of prescription drugs, patient bracelets, and
    automated dispensing of medication in a hospital setting.
        The Committee urges the Director to prepare and submit to
    Congress an interim report concerning the results of this
    medical error reduction demonstration program within 2 years of
    the commencement of the projects.

    Research and training

        The Committee encourages AHRQ to continue its evaluation
    research on ways to improve provider training in the reduction
    of medical errors, including the examination of curriculum
    development, technology training, and continuing medical
    education.
        Centers for Education and Research in Therapeutics.--The
    Committee notes that the introduction of highly effective drugs
    to prevent or treat a wide array of diseases and disorders has
    engendered growing concern about the extent to which drugs and
    devices are used inappropriately. It has been brought to the
    Committee's attention that adverse drug reactions comprise the
    fourth leading cause of death in the United States among
    hospitalized patients. To address this problem, Congress
    established the Centers for Education and Research in
    Therapeutics, which will research and educate the public on the
    use of approved drugs, the prevention of adverse drug
    reactions, and the appropriate use and dosage of specific drugs
    in special populations such as women, children, minorities, and
    the elderly. The Committee encourages the agency to accelerate
    its commitment to these centers.
        Chronic Fatigue Syndrome.--The Committee is pleased that
    AHRQ is conducing an evidence-based research report on chronic
    fatigue syndrome (CFS). The Committee encourages AHRQ to
    appoint qualified advocates, clinicians and researchers to its
    CFS advisory committee and to include information from a
    variety of sources, including peer-reviewed medical literature,
    clinical practice, patient educational materials, unpublished
    research, reports at medical conferences, etc. when compiling
    evidence for its report.
        Development of predictive instruments.--The Committee is
    supportive of work conducted at New England Medical Center to
    develop clinical instruments that predict medical outcomes
    based on mathematical models, providing physicians with
    predictions of the patient's likely diagnosis and likely
    benefit from expensive, yet potentially life-saving
    interventions. Clinical trials show that predictive instruments
    lead to faster recoveries, more cost-effective treatment, and
    fewer medical errors. One such instrument, already available in
    80 percent of American hospitals for cardiac patients without
    acute ischemia, already saves Medicare $400,000,000 each year.
    The Committee is aware that the Agency is currently providing
    support for this effort and believes that additional support
    will enable New England Medical Center to open a Center for
    Predictive Instruments Research and begin developing
    instruments to address cancer chemotherapy for breast cancer
    and other cancers, neonatal monitoring, serious infections,
    liver disease, and pulmonary embolus.
        Minority Health.--The Committee is aware of the initiative
    at the University of Miami/Jackson Memorial Medical Center to
    systematize the development, maintenance, and utilization of
    medical information to mitigate health disparities in minority
    populations by linking the diagnosis, care, and therapeutic
    procedures with patient outcomes to increase the ability to
    enhance the effectiveness and efficiency of dealing with the
    complete spectrum of diseases affecting patients cared for at
    the medical center.
        Pharmaceutical Management.--The Committee is aware of
    efforts by the Center for the Study of Pharmaceutical Marketing
    and Management to conduct research and analysis on the
    appropriate, efficient and effective provision of
    pharmaceutical products and services, the effects of medication
    and therapeutics on patient quality of life, and the safe use
    of complex medication regimens. The Committee is also aware of
    the Center's commitment to educate and train future researchers
    and practitioners in these areas on both the graduate and
    undergraduate level. Furthermore, the Committee recognizes the
    work of the Center for its research and education efforts in
    rural and minority populations in Mississippi. The Committee
    believes that AHRQ could partner with the Center for the Study
    of Pharmaceutical Marketing and Management in its research on
    the safe and appropriate therapeutic use of drugs.
        Pharmaceutical Pricing.--The Committee recognizes the high
    prevalence of chronic diseases such as diabetes, asthma,
    hyperlipidemia, and cardiovascular disease in rural areas. The
    management and control of these chronic diseases through
    medication and lifestyle alteration is essential to controlling
    overall health expenditures. However, the lack of documented
    outcome measures of health improvement and cost savings has
    hindered the progression of disease State management programs
    into the mainstream of both treatment and reimbursement. The
    Mississippi Medicaid model produces significant outcome
    improvements and cost savings in theory and in the limited
    practice settings allowed in small demonstration projects. The
    Committee also recognizes the expertise in outcome and economic
    evaluation of the Center for Pharmaceutical Marketing and
    Management of the University of Mississippi. The Committee
    believes that AHRQ could undertake a research project to
    examine the cost savings and improved clinical outcomes
    associated with the Mississippi Medicaid disease State
    management program that would result from the application of
    this disease management program to a demonstration project in
    the Medicare population of the Mississippi Delta region.
        Rural managed care program.--The Committee encourages the
    agency to support an additional rural managed care
    demonstration grant to build upon the achievements of the past
    five years and for further network development.
        Women's health.--The Committee commends the Agency for
    establishing a portfolio of research projects related to
    women's health under the Center for Outcomes and Effectiveness
    Research. Specifically in the area of gynecologic health, the
    Committee believes AHRQ should consider providing resources for
    prevention and early diagnosis. For example, the use of
    ultrasound to detect the cause(s) of abnormal bleeding or the
    predictors of preterm labor would be excellent areas for
    enhanced focus.
        Vascular Surgery Outcomes Improvement Initiative.--The
    Committee understands that Dartmouth-Hitchcock Medical Center
    in New Hampshire plans to conduct a multi-year study of
    mortality and outcomes of people undergoing major vascular
    surgery in New Hampshire, Vermont, and Maine. While mortality
    rates associated with this disease are higher than coronary
    bypass surgery, there has been little research on the outcomes
    of this surgery.
        Vision Rehabilitation.--More than 10 million Americans
    suffer from macular degeneration, the leading cause of age-
    related vision loss in the United States. The Committee urges
    AHRQ to conduct research into models of care provided by vision
    rehabilitation professionals, the cost effectiveness of this
    care, and the impact it has on the quality of life for those
    with low vision impairments.

                       medical expenditures panel surveys

        The Committee provides $40,850,000 for health insurance and
    medical expenditures panel surveys [MEPS], which is the same as
    the administration request and $4,850,000 above the fiscal year
    2000 level. Within this category of activity, the
    Administration proposes to include activities previously
    designated as research on health insurance and expenditure
    surveys. MEPS is intended to obtain timely national estimates
    of health care use and expenditures, private and public health
    insurance coverage, and the availability, costs and scope of
    private health insurance benefits. It also develops cost and
    savings estimates of proposed changes in policy and identifies
    impact of policy changes on payers, providers, and patients.

    Program support

        The Committee recommends $2,500,000 for program support.
    This amount is the same as the administration request and is
    $16,000 more than the fiscal year 2000 level. This activity
    supports the overall management of the Agency.

                      Health Care Financing Administration

                         GRANTS TO STATES FOR MEDICAID

    Appropriations, 2000.................................... $86,087,393,000
    Budget estimate, 2001...................................  93,586,251,000
    Committee recommendation................................  93,586,251,000

        The Committee recommends $93,586,251,000 for grants to
    States for Medicaid. This amount is $7,498,858,000 more than
    the fiscal year 2000 appropriation and the same as the
    administration's request. This amount excludes $30,589,003,000
    in fiscal year 2000 advance appropriations for fiscal year
    2001. In addition, $36,207,551,000 is provided for the first
    quarter of fiscal year 2002, as requested by the
    administration.
        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.
        The Committee is pleased with HCFA's proposal to provide
    demonstration grants to States to test innovative asthma
    disease management techniques for children enrolled in
    Medicaid.
        The Committee understands that HCFA has revised its
    Medicaid screening and reimbursement policy for childhood lead
    poisoning testing. The Committee urges HCFA to monitor the
    impact of these policy changes and to take every appropriate
    step to ensure that screening rates among children enrolled in
    Medicaid are substantially increased. Moreover, the Committee
    continues to encourage HCFA to consider the development of new
    screening technologies that have the potential to significantly
    increase screening rate when evaluating its reimbursement
    policy.
        The Committee is pleased with the progress of the
    Mississippi Medicaid disease State management plan approved by
    HCFA in 1998 that allows reimbursement of pharmacists working
    under protocol of physicians to manage patients with certain
    chronic diseases. The Committee urges HCFA to consider
    extension of a demonstration project for the Mississippi
    Medicare population. The Committee expects HCFA to continue to
    provide demonstration grants to States for the extension of
    disease State management programs to Medicare demonstration
    projects, giving priority to States with established Medicaid
    models.
        The Committee is aware of the proposed modification by HCFA
    in determining the eligibility status for Medicaid of
    individuals who migrate to Hawaii under the provisions of the
    Compact of Free Association. The State of Hawaii has no control
    over its borders. Thus, there remains a clear Federal
    responsibility for the health of these individuals.
    Accordingly, HCFA should continue its negotiations with the
    appropriate State authorities and inform the Committee of its
    deliberations, prior to making any modifications.
        The Committee is aware that HCFA and the State of Arkansas
    are in consultation on a Medicaid waiver granted in 1999 for
    the ARKids First program. The Committee directs HCFA to work
    with the State to resolve all issues related to this waiver and
    provide the Committee with a status report by June 15, 2000.
    The Committee will monitor these negotiations and take further
    action, if necessary, as the bill moves through the
    appropriations process.

                      PAYMENTS TO HEALTH CARE TRUST FUNDS

    Appropriations, 2000.................................... $69,289,100,000
    Budget estimate, 2001...................................  70,381,600,000
    Committee recommendation................................  70,381,600,000

        The Committee recommends $70,381,600,000 for Federal
    payments to the Medicare trust funds. This amount is the same
    as the administration's request and is an increase of
    $1,092,500,000 from the fiscal year 2000 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 $69,777,000,000 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 $1,087,000,000 more than the fiscal year 2000
    amount.
        The recommendation also includes $321,000,000 for hospital
    insurance for the uninsured. This amount is the same as the
    administration's request and is $28,000,000 less than the 2000
    amount.
        The Committee also recommends $132,000,000 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 $11,000,000
    more than the fiscal year 2000 appropriation.
        The Committee recommendation includes $151,600,000 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 $22,500,000 less than the fiscal year 2000
    level.

                               PROGRAM MANAGEMENT

    Appropriations, 2000....................................  $1,993,334,000
    Budget estimate, 2001...................................   2,086,302,000
    Committee recommendation................................   2,018,500,000

        The Committee recommends $2,018,500,000 for HCFA program
    management. This is $25,166,000 more than the fiscal year 2000
    enacted level.

    Research, demonstrations, and evaluation

        The Committee recommends $65,000,000 for research,
    demonstration, and evaluation activities. This amount is
    $10,000,000 more than the budget request and $3,214,000 more
    than the amount provided in fiscal year 2000.
        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 for the research and
    demonstration program will provide for continuation of current
    activities. Priority areas for HCFA research include access to
    high-quality health care, health service delivery systems, and
    provider payment systems.
        The Committee has included funds to continue at $3,000,000
    the Nursing Home Transition Initiative, to help states carry
    out demonstration projects of developing community-based
    attendant care services that ensure maximum control by
    consumers to select and control their attendant care services.
        The Committee is supportive of the Real Choice Systems
    Change Initiative to fund demonstration projects that test the
    most efficient and effective ways to develop and enhance
    comprehensive statewide systems of long term services and
    supports, including community-based attendant care, that
    provide real consumer choice consistent with the principle that
    service and supports should be provided in the most integrated
    setting. These projects build on the demonstration projects
    included under the Nursing Home Transition Initiatives funded
    over the past few years.
        The Committee encourages the Health Care Financing
    Administration and HHS to review the demonstration project
    initiative developed by Carondolet Health Network, which
    targets the needs for health access and continuity of care for
    the uninsured in urban and rural communities. This initiative
    increases the number of community health clinics and mobile
    health units, outreach services, elder care services, and
    delivery of health care services in ethnic communities.
    Carondolet is Southern Arizona's oldest and largest non-profit
    provider of health care to the uninsured, and their initiative
    merits careful consideration.
        The Committee encourages HCFA to consider a multi-state
    pilot initiative developed by the Lourdes Health Network in
    Pasco, Washington, geared to improving community health access
    and services among the uninsured and medically disenfranchised.
        The Committee continues to be concerned about the
    extraordinary adverse health status and the limited access to
    health services of Alaska Natives and others living in
    Southwestern Alaska, the poorest section of Alaska, and
    encourages HCFA to continue and expand a demonstration project
    in Southwestern Alaska with the State of Alaska and the Yukon-
    Kuskokwim Health Corporation to provide comprehensive managed
    health services to indigent residents of that area.
        The Committee recommends that HCFA study and estimate the
    total unreimbursed costs that hospitals, localities, and States
    incur to treat undocumented aliens for medical emergencies.
        The Committee encourages HCFA to consider a 2-year
    demonstration project conducted by the Regional Nursing Center
    Consortium to determine the potential of nurse-managed health
    clinics as a safety net model in underserved communities.
        The Committee recognizes that abdominal aortic aneurysms
    are the tenth leading cause of death among men over age 60. The
    condition is fatal in over 85 percent of patients despite the
    relatively low level of risk associated with surgical
    intervention when these aneurysms are detected and
    appropriately treated prior to rupture. Population-based
    studies conducted in the United Kingdom have demonstrated a 50
    percent reduction in mortality through use of ultrasound
    screening combined with appropriate surgical intervention. The
    Committee supports implementation of a multi-center, national
    assessment to determine the efficacy of ultrasound screening
    and a multi-institution initiative to study abdominal aortic
    aneurysm screening and treatment options.
        As a follow-up to the Committee's recommendation to HCFA in
    fiscal year 2000, and in order to determine the effectiveness
    of the nurse-managed clinic model, the Committee encourages
    HCFA to conduct a 5-year demonstration project that provides
    financial support for existing nurse-managed clinics and their
    utilization of advance practice registered nurses as primary
    care providers, minimally in Hawaii, Pennsylvania, Delaware,
    and New Jersey. These clinics operate with limited and short
    term funding, limited Medicaid and Medicare reimbursement, and
    yet provide up to 60 percent uncompensated care. Despite
    limited funding, preliminary data from the Regional Nursing
    Center Consortium indicates that nurse-managed health clinics
    have better patient outcomes than conventional primary health
    care models. To determine the potential of nurse-managed health
    clinics as a safety net model in underserved communities, the
    Committee encourages HCFA to consider both operating support
    and funding for clinical and information management systems to
    existing nurse-managed clinics to determine client outcomes and
    the effectiveness of the model.
        The Committee encourages HCFA to consider the concept of
    nurse-run clinics and the utilization of advanced practice
    nurses as primary care providers in its research and
    demonstration activities. As Medicare and Medicaid move 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
    of health care of our aging population.
        The Committee remains concerned about the extraordinary
    adverse health status of Native Hawaiians and encourages HCFA
    to continue its demonstration project at the Waimanalo health
    center exploring the use of preventive and indigenous health
    care expertise. The Committee further recommends that Papa Ola
    Lokahi, the Native Hawaiian health care organization recognized
    in the Native Hawaiian Health Care Act, participate in this
    demonstration project.
        The Committee remains concerned about the extraordinary
    adverse health status of Native Hawaiians and encourages the
    Department to consider a demonstration project on the island of
    Molokai that would integrate health education and prevention
    with the delivery of primary health care services. The
    Committee recommends that the Native Hawaiian Health Care
    Systems, recognized in the Native Hawaiian Health Care Act, be
    considered to participate in this demonstration project, along
    with community health centers whose clientele is primarily
    Native Hawaiian.
        The Committee is aware that heart disease, including
    congestive heart failure, is the leading cause of death among
    Americans and results in costly hospitalizations due to a
    failure to successfully monitor the progression of the disease.
    The Committee is concerned that minority communities, including
    African Americans and Hispanic individuals, appear to be at a
    higher risk for the disease and suffer higher mortality rates
    than other affected populations. Technological approaches may
    assist in the monitoring and maintenance of individuals with
    heart disease, particularly in underserved communities, and can
    more efficiently utilize scarce healthcare resources.
    Therefore, the Committee encourages HCFA to consider a
    demonstration of a technological monitoring system that enables
    healthcare professionals to review congestive heart failure
    symptom changes on a daily basis, and to assess such system's
    ability to improve interaction between elderly African American
    and Hispanic individuals and their physicians. The Committee
    encourages full and fair consideration of a joint application
    from the Mt. Sinai Hospital in Miami, FL, the University of
    Oklahoma, and the University of Pittsburgh.
        The Committee is aware of efforts by the Center for
    Pharmaceutical Marketing and Management to conduct analysis and
    provide research on the effective and efficient pricing and
    marketing of pharmaceutical products through a Medicare drug
    benefit and encourages HCFA to utilize the expertise of the
    center in policy making.
        The Committee is concerned about the low number of Medicare
    beneficiaries who are taking advantage of Medicare's coverage
    of bone density testing. The Committee understands that of the
    almost 22 million women ages 65 and older that Medicare covers,
    only an estimated 9 percent have had a bone density test in the
    last 2 years. Osteoporosis affects 28 million Americans and 90
    percent of fractures in women ages 65 and older are
    osteoporosis-related. The Committee encourages HCFA to develop
    an educational campaign directed at Medicare beneficiaries that
    communicates the risk factors associated with osteoporosis, the
    importance of screening, and the availability of Medicare
    coverage for bone density testing. HCFA is encouraged to use
    creative approaches that effectively reach seniors and work
    with organizations that have direct links to older Americans.
        The Committee is aware that Daniel Freeman Hospital is
    seeking a Federal partnership to pursue necessary program
    expansion directed to improving the health status of multi-
    cultural and medically disenfranchised populations, and
    insuring their access to insurance enrollment, primary care,
    and education.
        The Committee is aware of the award winning program
    ``Improving Care through the End of Life'' of the Franciscan
    Health West system and encourages HCFA to consider a
    demonstration project to show the efficacy of and cost savings
    achieved by such programs for patients and the Medicare
    program.
        The Committee is supportive of efforts by the University of
    Pittsburgh Medical Center Health System (UPMC-HS) to implement
    a state-of-the-art Health System-wide project to electronically
    store and provide all clinical and administrative information
    in a secure and automated manner. The UPMC-HS automation
    project will serve as a national model for reducing medical
    errors; improving medical efficiency; reducing health care
    costs; and improving access to high quality, cost-effective
    care for the elderly and the medically underserved.
        The Committee understands that the State University System
    of Florida plans to create a statewide network of community-
    based professional development hubs in high needs neighborhoods
    to improve access to healthcare services for children.
        The Committee is aware that the Kettering Medical Center
    has a Healthy Hearts 2000 demonstration project that, with
    additional Federal funding, will focus on the effectiveness of
    three levels of prevention: primary (education), secondary
    (screening, detection and education) and tertiary (treatment,
    health maintenance and education).
        The Committee is aware of an innovative program begun by
    the non-profit organization We Are Family/The Family Van in
    Boston, MA, to maintain a periodic presence in low-income urban
    neighborhoods and provide education on how uninsured low-income
    families may access medical insurance and medical care.
        The Committee is aware that Children's Hospital of Boston
    seeks to construct a state-of-the-art research facility that
    will enable it to continue its exemplary record of advancing
    scientific knowledge through biomedical research and improving
    outcomes for children stricken with serious illness or injury.
    Existing research space is used to maximum density and
    productivity. Additional facilities are needed to translate new
    biomedical insights learned daily through basic research into
    new treatments for cancer, neurological diseases, spinal cord
    injuries, and organ failure in the youngest patients, as well
    as for adults.
        The Committee is supportive of a study to estimate the
    total unreimbursed costs that hospitals, localities, and States
    incur to treat undocumented aliens for medical emergencies.
    Hospitals, States, and localities are increasingly financially
    burdened by the costs associated with providing undocumented
    aliens emergency medical care.
        The Committee also understands that Carondolet Health
    Network plans to initiate a project which targets the need for
    health access and continuity of care for the uninsured in urban
    and rural communities.
        The Committee is aware of research being conducted by the
    Appalachian Center for Low Vision Rehabilitation which is aimed
    at testing interventions and improving the quality of life for
    individuals with low vision, with a particular focus on the
    elderly and children.
        The Committee encourages HCFA to consider creating a
    statewide network of community-based early learning and
    professional development hubs located in high needs
    neighborhoods to improve access to early childhood physical and
    mental health services and professional development
    opportunities for childcare professionals.
        The Committee is aware that the Kansas University Human
    Imaging Institute is planning to utilize innovative technology
    to detect abnormal electrical activity in deep brain regions
    invisible to electroencephalography.
        The Committee remains strongly supportive of HCFA's
    telemedicine demonstration projects. Last year the Committee
    provided additional funds for the administrative and evaluation
    costs at these sites in order to ensure that they would be able
    to continue operating through the full period associated with
    HCFA's pilot waiver program. Funding is included for these
    costs in fiscal year 2001. In addition, the Committee is
    concerned that HCFA has not heeded recommendations to support a
    broader range of telehealth services. Adequate funding has been
    provided to fully support the cost of covering all Medicare
    services in these projects, including store and foward and
    telehome care services.
        The Committee encourages the Health Care Financing
    Administration (HCFA) in provider education and training and
    expects HCFA to implement effective and innovative educational
    programs for physicians. The Committee has received testimony
    from the American Medical Association (AMA) noting that, while
    it has had positive discussions with HCFA regarding physician
    education, the current education efforts present overly general
    directions that fail to aid individual physicians in learning
    specific Medicare coding and billing requirements. The
    Committee expects HCFA to work with the AMA and the appropriate
    medical State societies and national medical specialty
    societies to educate physicians about a billing problem and to
    help them understand how to address it in the future. The
    Committee also intends that HCFA implement education efforts
    for individual physicians when the carrier identifies that a
    physician has a billing problem.

    Medicare contractors

        The Committee recommends $1,244,000,000 for Medicare
    contractors, which is $57,287,000 less than the
    administration's request and the same as the comparable fiscal
    year 2000 appropriation. This recommendation does not include
    user fees proposed by the administration, to charge Medicare
    providers for processing paper claims and duplicate or
    unprocessable claims. In addition, $680,000,000 is available
    for the Medicare Integrity Program within the mandatory budget,
    an increase of $50,000,000 over the fiscal 2000 level.
        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 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 maintaining funding for this
    activity in fiscal year 2001. 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.

    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 $219,674,000 for Medicare State
    survey and certification activities, an increase of $15,000,000
    over the fiscal year 2000 level.

    Federal administration

        The Committee recommends $489,826,000 for Federal
    administrative costs. This is $6,952,000 more than the fiscal
    year 2000 enacted level, but $6,042,000 less then the
    administration's request.
        The Committee encourages the Administrator to make
    information available to beneficiaries about their roles in
    reducing medical errors, including educating beneficiaries
    about the benefit of providing information to health care
    providers concerning pre-existing conditions and medications.
    The Committee suggests that the Administrator utilize written
    publications, the Medicare toll-free hotline, and the Agency's
    website in disseminating this information.
        The Committee has given significant attention to the Health
    Care Financing Administration's (HCFA's) efforts to achieve
    improvements in the quality of care in federally certified
    nursing homes via the Nursing Home Initiative (NHI). The
    Committee appreciates the continued commitment the agency has
    demonstrated over the past 2 years to this endeavor.
        The Committee believes the goal of the NHI is measurable
    improvements in the quality of care of the nation's nursing
    homes, therefore, the Committee asked HCFA to track measurable
    indicators of quality of care and to report to the Committee in
    July 2000 on the outcome of that study.
        The Committee looks forward to seeing these efforts
    continue and to seeing measurable improvements to the quality
    of care in nursing homes since the NHI was implemented.
    Currently, 1.6 million individuals reside in nursing homes; in
    just 40 years, that number will jump to 5.5 million as the baby
    boomers age. The problems that have been identified in nursing
    homes in a number of recent GAO reports and other studies must
    be corrected, not only for the millions now residing in nursing
    homes, but for those who want to look forward to their later
    life with hope, not fear.
        The Committee seeks continued assurance that HCFA shares
    the goal of improving the quality of care in the nation's
    nursing homes and that this is the ultimate goal of the NHI. To
    that end, the Committee requests that the Secretary report no
    later than July 15, 2001 to this Committee and appropriate
    committees of Congress on improvements in the quality of care
    in nursing homes throughout the nation.
        The Committee remains concerned over HCFA's continuing
    failure to articulate clear guidelines and to set expeditious
    timetables for consideration of new technologies, procedures
    and products for Medicare coverage. Two particularly troubling
    examples are HCFA's lengthy delays and failure to articulate
    clear standards regarding Medicare coverage of position
    emission tomography (PET) and lung volume reduction surgery
    (LVRS). The effect of these delays in instituting Medicare
    coverage is to continue to deny the benefits of these
    technologies and procedures to Medicare patients. The Committee
    also remains concerned that HCFA appears to be requiring some
    new technologies to repeat clinical trials and testing already
    successfully completed by the new technologies in the process
    of gaining FDA approval or in NIH clinic trials and which serve
    as signals to private insurers to cover new technologies. The
    Committee is also concerned that HCFA appears to be requiring
    substantially different levels of evidence to approve various
    new products for Medicare coverage, requiring, for example,
    very little documentation for approval of MRA (magnetic
    resonance angiography), while at the same time continuing to
    demand voluminous amounts of data to make a coverage decision
    on PET. The Committee remains concerned that the recently
    created 120-person technical advisory committee to review new
    technologies may be further delaying coverage decisions and
    creating unnecessary costs for the Medicare program. Because of
    the possible duplication of efforts among HHS agencies and
    related unnecessary costs to the Medicare program and the
    Department, the Committee again encourages the Secretary to
    take a leadership role in resolving this matter expeditiously.
        In the Balanced Budget Act of 1997, Congress urged the
    Secretary to provide GME reimbursements for clinical
    psychological programs. Last year, Congress again urged HCFA to
    implement this change as soon as possible. To date, HCFA has
    not issued the necessary rule. The Committee expects the agency
    to release the rule immediately.
        The Committee has been informed that HCFA is not responsive
    to the congressional mandate to base malpractice RVUs on the
    resources required to serve Medicare beneficiaries. The
    Committee is concerned that HCFA's proposal will threaten women
    Medicare beneficiaries' access to medically necessary care.
    HCFA's methodology appears to treat obstetrics and gynecology
    as two separate medical specialties by using separate
    malpractice premium date for obstetric services and gynecology
    services. The Committee urges HCFA to consider altering it
    methodology for determining resource-based malpractice RVUs by
    using malpractice premium data for the single specialty of ob-
    gyn.
        The Committee is aware of the progress made in translating
    selected HCFA material into Chinese and disseminating to
    selected communities, and encourages the agency expand these
    efforts by broadening dissemination to a national basis and
    including additional Asian and Pacific languages. The Committee
    further encourages the agency to continue its collaboration
    with national aging organizations with proven experience in
    serving minority elders.
        The Committee encourages HCFA to consider creating an
    interim two-digit specialty code recognizing maternal-fetal
    medicine. The Committee has been advised that creating this
    interim specialty code is important to ensure that pregnant
    women receive risk-appropriate care.
        The Committee urges HCFA to ensure that all health
    professions are recognized in the allocations for Graduate
    Medical Education.
        The Committee understands there have been recent changes in
    the Medicare policy on critical care physician work values. The
    Committee is aware that historically HCFA has convened Multi-
    Specialty Refinement Panels to make recommendations on issues
    regarding CPT work values impacting the physician community,
    and encourages HCFA to consider convening such a panel.
        The Committee is pleased with recent improvements in the
    rate of mispayments by the Medicare program. Additional
    resources and efforts have begun to make a difference. However,
    the Committee remains very concerned with the amount of money
    that continues to be lost to fraud, waste and abuse in the
    Medicare program. The Committee has held many hearings and
    taken other corrective actions over a 10-year period to expose
    and reduce these losses. The 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 and improved beneficiary
    information so that savings to Medicare will accrue as quickly
    as possible.
        There is strong evidence, through reports by the General
    Accounting Office, the Department and others that Medicare is
    significantly overpaying for many medical supplies. Therefore,
    the Committee strongly urges prompt use of the Secretary's
    enhanced inherent reasonableness authority on a national basis.
        The Committee is aware that HCFA completed tests of
    commercial off-the-shelf computer software designed to reduce
    Medicare mispayments and found that significant savings could
    be achieved by employing edits from the tested software. The
    Committee urges HCFA to undertake testing of other similar
    commercial software and to incorporate those edits found to
    achieve savings within current Medicare regulations and without
    harming quality of care.
        The Committee is pleased that HCFA has moved ahead to
    establish program integrity contracts. These contractors have
    significant potential to reduce losses to the Medicare program.
    The Committee encourages HCFA to fully utilize these
    contractors and to explore the use of companies to recover
    mispayments that have significant experience providing this
    service to major commercial insurers and major employers.
        The Committee believes that compliance with Medicare
    reimbursement policies would be enhanced by an expansion of
    provider education. Such an expansion would also aid health
    professionals who often feel overwhelmed by the volume and
    complexity of Medicare requirements. Therefore, the Committee
    urges that a portion of the increase in MIP funds be used to
    expand provider education and assistance.
        It has come to the Committee's attention that during post-
    payment review of certain chiropractic claims, there have been
    misunderstandings between the profession and HCFA carriers
    regarding reimbursable services. The Committee understands that
    HCFA considers the management of chronic symptoms to constitute
    maintenance therapy. However, according to standard
    chiropractic professional guidelines, there is substantial
    difference between treatment to address an acute exacerbation
    of a chronic condition and maintenance therapy. The Committee
    therefore urges HCFA to clarify its definition of maintenance
    therapy to exclude the treatment for the exacerbations of a
    chronic condition.

    Medicare+Choice

        Due to a change in the authorizing language for the
    Medicare+Choice user fee, the Committee no longer establishes
    the amount of Medicare+Choice user fees HCFA may collect in a
    given year. Section 522 of the Balanced Budget Refinement Act
    (Public Law 106-479) amended section 1857(e)(2) of the Social
    Security Act so that the amount of Medicare+Choice user fees
    HCFA may collect in a fiscal year is base on a formula in the
    statute and ``any amounts collected shall be available without
    further appropriation to the Secretary.''

                    Administration for Children and Families

      PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
                                    PROGRAMS

    Appropriations, 2000....................................  $2,584,800,000
    Budget estimate, 2001...................................   2,888,800,000
    Committee recommendation................................   2,888,800,000

        The Committee recommends that $2,888,800,000 be made
    available in fiscal year 2001 for payments to States for child
    support enforcement and family support programs, the same as
    the administration request. These payments support the States'
    efforts to promote the self-sufficiency and economic security
    of low-income families. The Committee does not agree with the
    President's recommendation to change the match rate for
    paternity testing or to repeal the provision in statute that
    holds the States harmless from receiving less than the fiscal
    year 1995 State share of collections.
        The Committee recommendation also provides $1,000,000,000
    in advance funding for the first quarter of fiscal year 2001
    for the child support enforcement program. These funds support
    efforts to locate noncustodial parents, determine paternity
    when necessary, and establish and enforce orders of support.
        The Committee recognizes that, because of continued
    uncertainty regarding the actual native populations within each
    State, the funding amounts provided to tribal governments for
    administering TANF may be inadequate.

                   low-income home energy assistance program

    Appropriations, 2000....................................  $1,100,000,000
    Budget estimate, 2001...................................   1,100,000,000
    Committee recommendation................................   1,100,000,000

        The Committee recommendation maintains funding for LIHEAP
    at $1,100,000,000, the same as the fiscal year 2000
    appropriation, and the same as the budget request. The
    Committee has not included an advance for fiscal year 2002.
        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 for the total funding amount
    for LIHEAP 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 Balanced Budget and Emergency
    Deficit Control Act. This is the same level as the emergency
    allocation available in fiscal year 2000.
        The Committee intends that up to $27,500,000 of the amounts
    appropriated for LIHEAP for fiscal year 2001 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.
        Total funding for fiscal year 2002 will be included as part
    of the fiscal year 2002 bill.

                         refugee and entrant assistance

    Appropriations, 2000....................................    $425,891,000
    Budget estimate, 2001...................................     432,569,000
    Committee recommendation................................     425,586,000

        The Committee recommends $425,586,000 for refugee and
    entrant assistance, $305,000 less than the fiscal year 2000
    level and $6,983,000 below the budget request.
        Based on an estimated refugee admission ceiling of 116,000,
    this appropriation, together with bill language allowing prior-
    year funds to be available for 2001 costs, will enable States
    to continue to provide at least 8 months of cash and medical
    assistance to refugees and entrants, as well as foster care for
    refugee and entrant unaccompanied minors.
        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
    $220,693,000 for transitional and medical assistance, including
    State administration and the voluntary agency program;
    $143,316,000 for social services; $4,835,000 for preventive
    health; and $49,477,000 for targeted assistance.
        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.
        The Committee recommends $7,265,000 to treat and assist
    victims of torture. These funds may also be used to provide
    training to healthcare providers to enable them to treat the
    physical and psychological effects of torture. The Committee
    believes that the Department should use the funds provided for
    torture victims relief in a way that can provide the greatest
    impact. One way to do this is to consider funding organizations
    specifically established to address the rehabilitation and
    social services needs of these victims.

                     child care and development block grant

    Appropriations, 2000....................................  $1,182,672,000
    Budget estimate, 2001...................................   2,000,000,000
    Committee recommendation................................   2,000,000,000

        The Committee recommendation provides an additional
    $817,328,000 for child care services, together with the
    $1,182,672,000 provided for fiscal year 2001 in last year's
    bill, raises the funding level for this program to
    $2,000,000,000 for fiscal year 2001.
        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.
        The bill provides that $19,120,000 of the amount
    appropriated shall be 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. The Committee recommendation includes $60,000,000 for
    an infant care quality initiative.
        The Committee understands that the National Association of
    Child Care Resource and Referral Agencies is currently
    operating Child Care Aware, the national toll-free information
    hotline, which links families to local child care services and
    programs. The Committee recognizes that funding from the
    resource and referral programs would allow the Association to
    continue to provide this critical assistance to parents
    returning to the workforce.
        The Committee is aware of the shortage of trained early
    childhood workers in Alaska, denying Alaskan children the
    opportunity for stimulating and appropriate childcare in the
    critical early years of zero to six. The Committee notes that
    the University of Alaska and the State of Alaska are proposing
    to train early childhood workers from communities throughout
    Alaska.
        The Committee has not included an advance for fiscal year
    2002. Total funding for fiscal year 2002 will be included as
    part of the fiscal year 2002 bill.

                          social services block grant

    Appropriations, 2000....................................  $1,775,000,000
    Budget estimate, 2001...................................   1,700,000,000
    Committee recommendation................................     600,000,000

        The Committee recommends an appropriation of $600,000,000
    for the social services block grant. The recommendation is
    $1,100,000,000 below the budget request and $1,175,000,000
    below the 2000 enacted level. The Committee has reduced funding
    for the block grant because of extremely tight budget
    constraints. The Committee believes that the States can
    supplement the block grant amount with funds received through
    the recent settlements with tobacco companies. The Committee
    also expects that States will be able to use other funding
    sources such as TANF to supplement their SSBG grants.
        The Committee encourages the Department to provide
    technical assistance and guidance to those States not
    maximizing the number of children served under the Child and
    Adult Care Food Program in their jurisdiction. These States
    should be encouraged to follow the example of those States that
    pool a limited amount of Title XX with CCDBG funds to meet the
    technical requirement of the current law. The Committee also
    believes the Department could coordinate with the Department of
    Agriculture where an extensive technical outreach effort is
    already in place.

                    children and families services programs

    Appropriations, 2000....................................  $6,828,991,000
    Budget estimate, 2001...................................   7,805,717,000
    Committee recommendation................................   7,881,586,000

        The Committee recommends an appropriation of $7,881,586,000
    for children and families services programs. This is
    $75,869,000 more than the administration request and
    $1,052,595,000 more than the fiscal year 2000 appropriation.
        This appropriation provides funding for 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 $6,267,000,000 for the Head Start
    Program, an increase of $1,000,000,000 above the 2000 level and
    the same as the budget request.
        The Committee recommendation includes funding for the
    expansion of the Head Start Program in an amount consistent
    with the bipartisan balanced budget agreement. The 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
    to focus on full-day, full-year services to children and
    families in need who are presently enrolled in the program.
        The Committee applauds the Department's inclusion of
    seasonal farmworker children within the Migrant Head Start
    program. However, the Committee continues to be concerned that
    funding for Migrant Head Start programs has not kept pace with
    other elements of Head Start and has kept children of
    farmworkers from gaining access to Head Start services. On
    average, 40 to 50 percent of eligible children receive Head
    Start services. By comparison, only about 10 percent of
    children of farmworkers who are eligible receive Migrant Head
    Start services. The Committee has provided the President's
    request for Head Start, therefore, the Committee believes that
    Head Start should increase the level of assistance to migrant
    and seasonal farmworkers by $41,000,000, as included in the
    President's budget.
        The Committee is aware of the unique circumstances rural
    areas face in designing Early Head Start programs to meet the
    needs of families. Rural areas experience higher costs per
    child, either due to the higher cost of transporting infants
    and children to Early Head Start Centers, or because of higher
    rents due to the lack of adequate and licensable facilities in
    rural areas. In selecting new grantees under this program, the
    Committee believes the Department should give consideration to
    applicants serving rural areas that meet or exceed all
    performance criteria but propose a higher cost per child due to
    these factors.
        The Committee is alarmed by the growing disparity among
    States in Head Start coverage. While 42 percent of eligible
    children nationwide participate in the program, in States like
    Alaska only 23 percent are able to participate, only 50 percent
    of the national average. The Committee has learned that of the
    approximately $600,000,000 increase for the program provided
    last year, Alaska received only $350,000 for program expansion.
    Other States may be similarly situated. The Committee
    encourages the agency to provide a substantial portion of the
    increase above fiscal year 2000 funds to expand coverage in
    States with low participation rates. The Committee expects the
    agency to report back to the Committee by March 1, 2001 on the
    results of its efforts and provide a State-by-State breakdown
    of participation rates to show what progress it is making.
        The Committee is aware that, over the past 2 years,
    approximately $340,000,000 was included in Head Start funding
    to improve staff salaries and professional development. This
    has increased both teacher compensation and retention rates
    among Head Start staff. The Committee expects the Department to
    continue to focus quality improvement efforts on improving Head
    Start teacher compensation such that teacher salaries more
    equitably reflect educational level and experience.
        The Committee is aware of the need to strengthen the
    qualifications of Head Start teachers. At least 50 percent of
    teachers in center-based Head Start programs must have an
    associate, baccalaureate, or advanced degree in early childhood
    education or a degree in a related field, with experience in
    teaching preschool children, by September 30, 2003. The
    Committee expects the Department to focus staff development
    efforts on increasing the educational level of Head Start
    teachers in order to meet this goal.
        The Committee is aware that the goal of the Head Start
    program is to ensure the school readiness of children upon
    completion of the program. The Committee expects the Department
    of Health and Human Services to continue to promote learning
    and brain development to accelerate and improve the cognitive
    development of Head Start children. The Committee expects the
    Department to monitor Head Start programs to ensure that a
    majority of children participating in Head Start programs meet
    the minimum educational performance measures and standards upon
    completion of the program as outlined in the Head Start Act, as
    amended in 1998.
        The Committee is concerned that the new training
    requirements for Head Start personnel, including teachers and
    aides, cannot be met in rural and remote communities,
    particularly in Native American and Alaska Native communities.
    The agency is urged to provide the resources necessary for
    training to meet program requirements. The Committee is also
    aware that pay in remote locations is extremely low, making
    retention of qualified teachers and aides extremely difficult.
    The Committee urges the agency to conduct a pilot project in
    consultation with the Alaska Federation of Natives to determine
    whether improving salary and benefits results in higher
    retention rates.
        The Committee is aware of the critical need for Head Start
    teachers with Associate degrees to meet new Head Start teacher
    training requirements. This is a difficult requirement for
    small rural communities in Alaska. The Committee notes that the
    University of Alaska has developed an innovative program using
    distance delivery to remote villages in conjunction with on-
    site mentoring. This will enable local residents to obtain
    Associate degrees so that they will be qualified to be Head
    Start teachers in their own villages.
        The Committee is aware of the serious need for additional
    and expanded Head Start facilities in rural areas and among
    Native American populations. The Committee believes that the
    Department could help serve these needy communities by
    providing minor construction funding for facilities in the
    Southcentral Foundation in the Anchorage area, in Kawerak, and
    in 8 villages in the Bering Straits area: Brevig Mission,
    Gambell, Golovin, Koyuk, Nome, Shishmaref, St. Michael, and
    Teller.
        The Committee believes that Head Start funds should be
    spent to maximize the number of children served. Therefore,
    Head Start should limit its own operation of vehicles for the
    transportation of Head Start children, working to increase
    coordination with publicly-funded transit agencies or other
    public entities when such agencies can provide for the safe
    transportation of Head Start children at a reasonable cost. The
    Committee is aware of cases where Head Start has purchased
    buses when local transit authorities have been able to provide
    that service at a lower cost. In some cases, buses have been
    sold after being significantly underutilized. The Committee
    directs Head Start programs to purchase their own vehicles to
    transport children only when it can be demonstrated that such
    an approach is safer, more cost effective and more responsive
    to family needs than alternative approaches, including vehicle
    leasing and contracting with local transportation providers.
    The Committee directs that Head Start provide the Committee, on
    a quarterly basis, with a list of all bus purchases made fiscal
    years 2001 and 2002.
        The Committee has also been concerned to learn that some
    children are transported in vehicles without child safety
    seats. The Committee believes Head Start should encourage local
    providers to equip vehicles with the appropriate child safety
    seats.
        Research shows that a child's brain is wired and his
    ability to learn and interact successfully in society is
    determined largely during the first 5 years of life. Long term
    studies by the Rand Corporation and the General Accounting
    Office examining data over a 30 year period indicate that for
    every dollar invested in early childhood learning programs,
    taxpayers save between $4 and $7 later by reducing the child's
    need for special education, mental health intervention, drug
    and alcohol treatment programs, and incarceration and
    rehabilitation costs.
        The Senate is considering bipartisan legislation to
    establish a block grant program to enable States and local
    organizations, including faith based institutions, to improve
    and promote early childhood learning programs. While the
    Committee has not provided funding for this block grant
    program, it supports this effort and will consider funding in
    the future, pending the outcome of this legislation. In
    recognition of the benefits of early learning programs, the
    Committee has provided a $1,000,000,000 increase over last
    year's funding level for the Head Start program.

    Runaway and homeless youth

        The Committee recommends $46,152,000 for this program, an
    increase of $2,500,000 above the fiscal year 2000 level and the
    same as the administration request. The Committee has also
    provided an additional $14,999,000 from the violent crime
    reduction program.
        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 is aware of the progress of the California
    Child, Youth, and Family Coalition in providing runaway and
    homeless youth with a safe place to sleep, food and clothing,
    counseling, educational opportunities, and job training.

    Runaway youth--transitional living

        The Committee recommends $23,003,000 for the transitional
    living grant program, an increase of $2,500,000 over last
    year's level. This program provides grants to local public and
    private organizations to address shelter and service needs of
    homeless youth, ages 16-21. The program's goals are to have
    youth safe at home or in appropriate alternative settings and
    to help them develop into independent, contributing members of
    society.
        A homeless youth accepted into the program is eligible to
    receive shelter and services continuously for up to 540 days.
    The services include counseling; life skills training, such as
    money management and housekeeping; interpersonal skill
    building, such as decision-making and priority setting;
    educational advancement; job preparation attainment; and mental
    and physical health care.
        The Committee recognizes a significant unmet need among
    transitional living programs for youth after they leave
    residential care and applaud the successful work of the House
    of Mercy. The Committee believes that continuing this program
    will allow more young people to receive the support that they
    need.

    Child abuse prevention programs

        The Committee has included $39,054,000 for child abuse and
    neglect prevention and treatment activities, including
    $21,026,000 for State grants and $18,028,000 for discretionary
    activities. This is the same as the fiscal year 2000 level and
    the administration request. 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. The Committee believes that the agency
    should fund activities aimed at developing and disseminating
    research-based models for child abuse prevention.
        The Committee believes that there could be a collaborative
    project among a few Children's Advocacy Centers and the
    Department, aimed at improving child abuse prevention,
    identification, assessment and treatment. Children's Advocacy
    Centers are comprehensive, child-focused programs based in
    facilities that allow law enforcement, prosecutors, child
    protective services, and medical and mental health
    professionals to work together on a collaborative multi-
    disciplinary team to handle child abuse cases. The Committee
    understands a collaborative effort would be dedicated to
    developing, strengthening, and carrying out child abuse and
    neglect prevention and treatment programs with a specific focus
    on a multi-disciplinary team approach to the investigation and
    prosecution of child abuse cases through the use of current and
    emerging technology, technical assistance and training.
        The Committee understands that the Farm Resource Center
    provides a mechanism of early intervention for rural families
    suffering from the stress associated with the loss of
    employment. This early intervention will help prevent child
    abuse, which is too often a response to stress.
        The Committee applauds the efforts of Project Escape at
    Santa Rosa Memorial Hospital in Santa Rosa, California.
        The Committee is aware of studies that have shown an
    increased incidence of abuse and neglect in families with
    chronically ill and medically fragile members when no respite
    is available to family caregivers. The Committee is further
    aware of indications that there are substantial public savings
    involved, including avoidance or limitation of hospitalization,
    when respite care is available to such families. The Committee
    recognizes that the nationally-recognized Family Friends
    Project has been working with the Allegheny County, PA Respite
    Care Coalition to develop a respite care model. Such a
    demonstration could involve a variety of volunteer and for-
    profit respite care agencies and would provide a point of
    access for families requiring respite care, and reduce the cost
    of care by introducing trained volunteers as caregivers.
        The Committee understands that Ohel Family Services,
    located in Brooklyn, seeks to develop a therapeutic foster care
    program which would provide specialized services to enable
    children to be cared for in a family setting in which they
    would have the opportunity to reach their potential. These
    services include intensive psychiatric and psychological
    treatment to both children and biological parents, crisis
    intervention, frequent treatment conferences, in-home behavior
    therapy and in-home parenting support.
        The Committee is aware of the Center for Research in Early
    Childhood Development at the University of Louisville's
    national reputation for conducting interdisciplinary research
    in diagnosing and treating conditions which hinder the
    development of infants and preschool children. The Committee
    believes that additional funds will allow the Center to conduct
    further research in the early diagnosis of reading disabilities
    and the role sleep disorders play in children with those
    disabilities.
        The Committee is supportive of the expansion of early
    childhood services for children in Alaska ages 0-6 and their
    families. Such services would include parent training and
    grants to small communities to raise the awareness of child
    abuse and neglect.
        The Committee recognizes that Operation Breakthrough in
    Kansas City is offering parenting training and counseling to
    homeless, teenage, and working poor mothers in an effort to
    help them cope with the daunting challenges of being single
    parents. The Committee recognizes that such training will
    provide much-needed crisis management skills.
        The Committee recognizes the work of Parents Anonymous, the
    oldest and largest child abuse prevention organization. Through
    funding from the Child Abuse Prevention Act, Parents Anonymous
    works in community-based settings to help at-risk parents
    develop good coping skills. The Committee notes that continued
    funding of Parents Anonymous will strengthen families and their
    communities in the fight against child abuse.
        The Committee is supportive of a resource center to be
    conducted with the State of Alaska and the Alaska Federation of
    Natives that would consolidate Federal, State, and local social
    service programs in order to serve at-risk families.
        The Committee is also aware of the efforts of other parent
    self-help organizations that are working to prevent child
    abuse. The Committee recognizes that Child Abuse Prevention Act
    funds would allow these organizations to help more families in
    crisis.
        The Committee applauds the success of the Healthy Families
    Home Visiting Program in Alaska for its success in preventing
    child abuse. The Committee understands that Alaska has one of
    the highest rates of child abuse in the nation, and believes
    that one of the best methods of preventing child abuse is the
    one-on-one interaction represented by this program. Expanding
    on previous efforts, the Committee urges the Department to
    provide funding to the State of Alaska to work with the Alaska
    Federation of Natives and Alaska Native regional non-profit
    organizations to continue and expand the Healthy Families Home
    Visiting Program in Alaska.
        The Committee noted that Alaska has the highest rate of
    child abuse in the nation, which is often tied to alcohol
    abuse. The Committee urges the Department to support a proposal
    by the Alaska Federation of Natives to develop a statewide
    child abuse prevention and treatment plan to identify, prevent,
    and treat child abuse and neglect through technical assistance,
    research, demonstration and service improvement.

    Abandoned infants assistance

        The Committee concurs with the budget request in
    recommending an appropriation of $12,207,000 for abandoned
    infants assistance, the same as the 2000 level and the
    administration request. 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.

    Child welfare

        The Committee recommends an appropriation of $291,986,000
    for child welfare services, the same as the administration
    request and the 2000 level. 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 and development of alternative
    placements like foster care or adoption if children cannot
    remain at home.
        For child welfare training, the Committee recommends
    $7,000,000, the same as the administration request. 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.
        The Committee supports efforts by colleges and universities
    to enroll American Indian and/or Alaska Natives in masters
    degree programs in social work. The Committee recognizes the
    need to provide field practicum placements of masters degree
    candidates in Indian reservation and rural Indian community
    settings.

    Adoption opportunities

        The Committee recommends $27,419,000 for adoption
    opportunities, the same as the fiscal year 2000 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.
        The Committee recognizes that, under the Adoption and Safe
    Families Act, States are required to use all available
    resources to find homes for children. The Committee is aware
    that the National Adoption Center operates a multi-state,
    technology-based adoption clearinghouse to facilitate placement
    of needy children with adoptive parents.
        The Committee understands that the Department plans to
    implement a national adoption photo listing service on the
    internet to help increase the number of adoptions. The
    Committee supports the idea that a national web site could
    include all youngsters available in public adoptions and will
    increase the likelihood that children will find loving, stable
    homes. The National Adoption Center has been at the forefront
    of developing and implementing technology-based resources to
    help facilitate adoptions and could be instrumental in creating
    a national adoption web site.

    Adoption incentives

        The Committee recommends $41,791,000 for adoption
    incentives, the same as the budget request. These funds are
    used to pay States bonuses for increasing their number of
    adoptions. The purpose of this program is to double the number
    of children adopted or permanently placed out of public child
    welfare systems by the year 2002.

    Social services research

        The Committee recommends $27,491,000 for social services
    and income maintenance research, $20,991,000 above the
    administration request. These funds support cutting-edge
    research and evaluation projects in areas of critical national
    interest. Research includes determining services that are more
    cost-effective and alternative ways to increase the economic
    independence of American families.
        Recognizing that TANF assigns significant responsibilities
    to States for meeting complex information systems and reporting
    requirements, the Committee 2 years ago urged ACF to help
    States address those issues. ACF turned to the State
    information technology consortium to determine best practices
    for addressing new TANF requirements. As a result, a knowledge
    base will soon be available that will enable each State to
    review an array of best practices and determine which best suit
    their information system needs. The Committee is especially
    pleased that this knowledge base is built upon the practical
    experiences of States. Focus should now turn to helping States
    implement the lessons learned by others. The Committee
    encourages continuation of this effort at the current level of
    support.
        The Committee understands that Iowa plans to initiate a
    State-level welfare survey initiative that will allow Iowa
    State University's College of Family and Consumer Sciences to
    support the information needs of the State and local welfare
    policy makers, among others.
        The Committee understands that the National Fatherhood
    Initiative, in collaboration with the Alabama Policy Institute
    and the National Physician's Center for Family Resources plans
    to research the social and economic effects of the decline in
    marriage and determine ways to increase marriage, strengthen
    and improve the quality of marriage, reduce divorce, and reduce
    sexual activity at an early age.
        The Committee understands that the Institute for
    Responsible Fatherhood and Family Revitalization plans to
    conduct an intensive seven-city demonstration involving married
    couple role models and provision of in-home services for non-
    custodial fathers and their families.
        The Committee recognizes the work of the National Family
    Policy Assessment Center at Oregon State University.
        The Committee remains interested in the University of
    Hawaii Center on the Family's use of Hawaii's ethnically
    diverse population to investigate family coping and resiliency
    in the face of economic distress and changes in social
    policies. The Committee is particularly interested in the role
    of family dynamics and its implications for containment of
    social program costs.
        The Committee continues to support a 5-year demonstration,
    authorized last year, to establish individual development
    accounts (IDAs). IDAs are savings accounts that encourage low-
    income families and individuals to acquire productive assets.
    IDAs use private matching funds to promote economic self-
    sufficiency by encouraging savings for investments in small
    businesses, homes, and education.

    Community-based resource centers

        The Committee recommends $32,835,000 for community-based
    resource centers. This amount, the same as the administration
    request, funds 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 $127,347,000 for developmental
    disabilities programs, which is $5,019,000 higher than the
    request. 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.
        The Committee has recently learned that persons with
    developmental disabilities have died or received life-
    threatening injuries because of improper restraints and
    seclusion. The Committee has provided additional resources to
    programs serving the developmentally disabled to help prevent
    the occurrence of any future incidences.
        The Committee understands that Parent to Parent of Vermont
    in Winooski, Vermont plans to establish a Family Faculty
    Institute to train primary care physicians in family centered
    health and to recruit and train respite care providers.

    State councils

        For State councils, the Committee recommends $65,803,000.
    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 $31,000,000. 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.

    Projects of national significance

        The Committee recommends $10,244,000 for projects of
    national significance to assist persons with developmental
    disabilities. 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.
        The Committee recognizes the work of the Family Friends
    program in training senior volunteers to provide respite to
    families whose members have disabilities. The Committee
    believes that additional funds from the Department will assist
    in the development of a Family Friends pilot project to provide
    technical assistance and training in the application of the
    successful Family Friends volunteer respite care model to the
    needs of aging parents of adult individuals with developmental
    disabilities.
        The Committee recognizes the efforts of the Special
    Learning Center in Jefferson City, Missouri in seeking
    innovative ways to provide a variety of services to children
    with developmental problems or disabilities.

    University-affiliated programs

        For university-affiliated programs, the Committee
    recommends $20,300,000. 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 $40,420,000 for Native American programs,
    $5,000,000 more than the 2000 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 recognizes the efforts of the Inter-Tribal
    Bison Cooperative in rebuilding bison herds on Indian
    reservations. The Cooperative's efforts have not only restored
    a national treasure, but have brought significant economic
    benefits to participating tribes.
        The Committee is supportive of the efforts of Red Star,
    Inc. to establish a Shawnee language immersion program. The
    Committee is concerned that fewer than 500 of the 12,000
    members of the three Shawnee tribes are fluent speakers of the
    Shawnee language. The Committee encourages ANA to give serious
    consideration to this proposal to preserve the endangered
    Shawnee language through a system of instruction known as total
    immersion provided to preschool, school-aged and adult members
    of the three Shawnee tribes.
        The Committee applauds the Department for its efforts in
    capacity building for Cook Inlet Tribal Council and Kawerik,
    Inc. to assume responsibility for Native foster care (IV-E)
    services in the Anchorage area. These funds were not taken from
    ANA's Alaska set-aside. The Committee is supportive of a
    continuation of these efforts.
        The Committee is aware that in Alaska Native villages,
    disparate programs exist to deal with problems of infants,
    children, the disabled, the elderly and others, as well as for
    alcohol and drug use, physical and sexual abuse, and mental
    health, and that the Alaska Federation of Natives has proposed
    a program to bring together the resources of all such programs
    to help Native communities in Alaska heal themselves and their
    members on a holistic basis, without social stigma attached to
    any individual or family.

    Community services

        The Committee recommends an appropriation of $606,676,000
    for the community services programs. This is $12,300,000 above
    the fiscal year 2000 level and $66,176,000 higher than the
    administration request.
        Within the funds provided, the Committee recommends
    $550,000,000 for the community services block grant [CSBG].
    These funds are used to make 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 believes that CSBG is a unique tool for
    addressing the causes and effects of poverty at the local
    level. The Committee has provided for increases in CSBG
    appropriations in each of the last 5 fiscal years in support of
    this mission. However, the Committee is aware of local
    communities that have not benefitted from this investment.
    There are a number of local eligible entities that have not
    received an equitable share of past increases in the block
    grant. The Committee believes that all eligible entities that
    are in good standing in the Community Services Block Grant
    program should receive increases in funding proportionate to
    the appropriations increase provided for CSBG for fiscal year
    2001.
        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 2000
    appropriations bill.
        The Committee also expects fiscal year 2001 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 programs is recommended at the
    following levels for fiscal year 2001: rural community
    facilities, $5,321,000; national youth sports, $15,000,000;
    community food and nutrition, $6,315,000; and community
    economic development, $30,040,000. Community economic
    development grants are made to private, nonprofit community
    development corporations, which in turn provide technical and
    financial assistance to business and economic development
    projects that target job and business opportunities for low
    income citizens. Of the total provided, the Committee has
    included $5,500,000 for the Job Creation Demonstration
    authorized under the Family Support Act to target community
    development activities to create jobs for people on public
    assistance. As in the past, the Committee expects that a
    priority for grants under this program go to experienced
    community development corporations. The Committee reiterates
    its expectation that national youth sports funds be awarded
    competitively.
        The Committee has provided funding for Rural Community
    Facilities Technical Assistance. Most of the drinking water and
    waste water systems in the country that are not in compliance
    with federal standards are in communities of 3,000 or fewer.
    Rural Community Assistance Programs [RCAPs] use these funds to
    assist a number of communities in gaining access to adequate
    community facilities, gaining financing for new or improved
    water and waste water systems and in complying with federal
    standards.
        The Committee is aware of the excellent work of the
    Community Loan Fund of Southwestern Pennsylvania, Inc. [CLF] in
    serving low-income communities through loans to nonprofit
    organizations and small to medium-sized businesses. CLF targets
    enterprises that are owned or controlled by women, minorities,
    the unemployed, or the underemployed. The Committee believes
    that additional funds from the Department will provide more
    opportunities to serve these disadvantaged groups in struggling
    neighborhoods.
        The Committee continues to support the Job Creation
    Demonstration program, authorized by the Family Support Act.
    Approximately 46 nonprofit organizations have been funded under
    this program since 1990, providing welfare recipients and low
    income individuals an estimated 4,000 new jobs and allowing
    them to start 2,000 new micro-businesses. The Committee
    recognizes that continued and additional funding of the Job
    Creation Demonstration program would provide opportunities for
    more low-income individuals.

    Violent crime reduction programs

        The Committee recommends $134,074,000 for violent crime
    reduction programs, the same as the fiscal year 2000
    appropriation. The Committee notes that an additional
    $50,225,000 for crime bill activities is provided under the
    Centers for Disease Control and Prevention.
        For the runaway youth prevention program, the Committee
    recommends $14,999,000, which is the same as the fiscal year
    2000 appropriation and 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 these youths, many of whom have
    been subjected to or are at risk of being subjected to sexual
    abuse.
        For the national domestic violence hotline, the Committee
    recommends $2,157,000, which is the same as 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 $116,918,000 for the grants for
    battered women's shelters program, $15,800,000 above the fiscal
    year 2000 program level. 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.

    Program administration

        The Committee recommends $157,131,000 for program
    administration, $9,223,000 above the fiscal year 2000
    appropriation and $7,317,000 below the administration request.

                       promoting safe and stable families

    Appropriations, 2000....................................    $295,000,000
    Budget estimate, 2001...................................     305,000,000
    Committee recommendation................................     305,000,000

        The Committee recommends $305,000,000 for fiscal year 2001,
    the same as the amount requested by the administration and
    $10,000,000 above the fiscal year 2000 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, 2000....................................  $5,697,300,000
    Budget estimate, 2001...................................   6,406,100,000
    Committee recommendation................................   6,406,100,000

        The Committee recommends $6,406,100,000 for this account,
    which is the same as the budget request and $708,800,000 more
    than the 2000 comparable level. Also included is the
    administration's request of $1,735,900,000 for an advance
    appropriation for the first quarter of fiscal year 2002 as
    requested by the administration. 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, 2000....................................    $932,848,000
    Budget estimate, 2001...................................   1,083,619,000
    Committee recommendation................................     954,619,000

        The Committee recommends an appropriation of $954,619,000
    for aging programs, $21,771,000 above the 2000 appropriation
    and $129,000,000 below the administration request.

    Supportive services and senior centers

        The Committee recommends an appropriation of $325,082,000
    for supportive services and senior centers, $125,000,000 less
    than the administration and $15,000,000 more than the amount
    appropriated in fiscal year 2000. The increased funding will
    provide additional in-house services for frail older
    individuals. 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. Under 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 recommends $9,449,000 for the ombudsman
    services program and $4,732,000 for the prevention of elder
    abuse program. The amount recommended for the ombudsman
    services program is $1,000,000 more than the fiscal year 2000
    level. The amount recommended for the elder abuse prevention
    program is the same as the fiscal year 2000 level. 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.
        The Committee supports continued and additional funding for
    the long-term care ombudsman resource center and its training
    and clearinghouse functions, which provide information,
    technical assistance, programmatic, and other support for State
    and regional long-term care ombudsmen.

    Preventive health services

        The Committee recommends $16,123,000 for preventive health
    services, the same amount as the budget request and the amount
    appropriated in fiscal year 2000. Funds appropriated for this
    activity are part of the comprehensive and coordinated service
    systems targeted to those elderly most in need. Preventive
    health services include nutritional counseling and education,
    exercise programs, health screening and assessments, and
    prevention of depression.

    Congregate and home-delivered nutrition services

        For congregate nutrition services, the Committee recommends
    an appropriation of $374,412,000, the same amount as the budget
    request and the amount appropriated in fiscal year 2000. For
    home-delivered meals, the Committee recommends $147,000,000,
    the same as the amount recommended by the administration and
    the amount appropriated in fiscal year 2000. 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-home services for frail older individuals

        The Committee agrees with the President's request to
    include in-home services for frail older individuals in the
    supportive services and centers program. The Committee has
    provided additional funds in that program to allow these in-
    home services to continue.

    Aging grants to Indian tribes and native Hawaiian organizations

        The Committee recommends $23,457,000 for grants to Indian
    tribes, the same amount as the budget request and $5,000,000
    above the amount appropriated in fiscal year 2000. 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.

    State and local innovations/projects of national significance

        The Committee recommends $31,162,000 for aging research,
    training, and discretionary programs, the same as the fiscal
    year 2000 enacted level and $5,000,000 less than 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. The Committee has included funding for a
    national program of statewide senior legal services hotlines
    and related elder rights projects.
        The Committee has provided last year's level of funding to
    continue the ``Senior Waste Patrol'' pilot project to test the
    best ways of using the skills of retired nurses, doctors,
    accountants and other professionals to train seniors and to
    serve as expert resources to detect and stop Medicare fraud,
    waste and abuse. The Committee expects that these funds will be
    used to make grants and that administrative costs will be
    minimized. In addition, the Committee expects that an improved
    system will be developed and implemented in coordination with
    HCFA and the OIG to track cases referred by this initiative.
        The Committee recognizes the efforts of the National Asian
    Pacific Center on Aging to develop, strengthen, and expand
    linkages of a rapidly growing Asian Pacific aging community
    with local, State, and national community service providers and
    organizations.
        The Committee recommendation includes sufficient funds for
    the pension information and counseling demonstration program,
    authorized under title IV of the Older Americans Act, to
    continue the existing demonstration projects, technical
    assistance and training projects. Pension counseling projects
    provide information, advice, and assistance to workers and
    retirees about pension plans, benefits, and pursuing claims
    when pension problems arise.
        The Committee recognizes the efforts of the City of
    Norwalk's Adult Day Care Services to individuals afflicted with
    Alzheimer's Disease and other dementia. The Adult Day Care
    Program allows families to rest 8 hours per week from the
    strains of care-giving.
        The Committee commends the Family Friends Project for its
    work in training senior volunteers to provide respite to
    families whose members have chronic illnesses, disabilities,
    and related problems. The Committee is aware that the program
    provides obvious benefits to families receiving the assistance,
    as well as savings of public dollars by allowing families to
    continue to provide in-home care.
        The Committee is aware of the Anchorage Senior Center's
    success in providing services to elderly Alaskans. The Center
    provides fitness facilities, educational opportunities, and
    leisure activities to seniors that would not otherwise have
    access to these services. With additional funds, the Center
    would be able to make the lives of more seniors active and
    productive.
        The Committee is aware that counties in southern Illinois
    have twice the national percentage of individuals aged 65 and
    over who suffer from chronic diseases. The Committee recognizes
    that the Aging and Outreach Institute at Southern Illinois
    University in Carbondale could address these problems with
    post-graduate training for healthcare workers; support,
    training, and information to family members; and guidance for
    facilities that care for the elderly.
        The Committee understands that the newly-established Texas
    Tech University Center for Aging is a state-of-the-art teaching
    nursing home and geriatric outpatient clinic that is providing
    comprehensive care to patients, training, and education to care
    providers, and research on health and aging issues. With
    additional funds, the Center will be able to provide services
    for more patients and training for more students specializing
    in geriatric care.
        The Committee continues to support the efforts of the
    Northwest Area Center for Studies on Aging, which is currently
    using existing telemedicine and video conferencing technology
    to improve the health status of aging Americans residing in
    underserved rural areas and is educating physicians and health
    care professionals in those areas.
        The Committee is aware that Montana State University-
    Billings proposes to develop a telemedicine program in
    collaboration with the area's medical facilities. The focus of
    the project would be on serving nursing homes and assistive
    care facilities.
        The Committee is supportive of the University of Missouri-
    Columbia School of Medicine's research and demonstration
    project to develop innovative care programs for rural elderly
    at risk of disability.
        The Committee applauds the work of the Senior Outreach
    Center at the Sinai Family Health Centers in Chicago. The
    program, which features physician-led health screening visits
    to seniors in low-income housing facilities, could provide
    services to additional seniors if adequate funding were
    provided.
        The Committee is aware of the efforts of the National
    Resource Centers on Native American Aging, located at the
    University of North Dakota and the University of Colorado, in
    providing aging-related research, training, and technical
    assistance to American Indians, Alaskan Natives, and Native
    Hawaiians.
        The Committee continues to have a strong interest in
    efforts to promote seniors' access to health information and
    senior services through the World Wide Web. In this regard, the
    Committee recognizes the continued efforts of the Setting
    Priorities for Retirement Years Foundation [SPRY], and looks
    forward to the results of such outreach efforts.
        The Committee supports the efforts of the agency in
    implementing the Government Performance and Results Act and
    believes that the agency should continue work in this area.
        The Committee supports the continuation of the elder care
    locator program, a toll-free telephone service for older
    Americans and their caregivers. The Committee notes that the
    National Association of Area Agencies on Aging is currently
    providing this service.
        The Committee understands that a consortium of leading
    health systems proposes to develop, test, and evaluate tools
    and methods to maintain and improve the health status of
    elderly persons living at home who are frail and at risk of
    long term disability resulting from multiple chronic
    conditions. If the progression of a chronic disease and/or
    disability can be reversed, halted, or delayed, the need for
    high cost hospital and nursing home care can be reduced.
        The Committee is aware that the University of Montana plans
    to partner with local, tribal, regional, and national senior
    advocates to provide a state-of-of-the-art Internet portal and
    community-based support system for seniors located in remote
    communities. The goal of the Center is to promote the well
    aging process and help seniors remain in their homes and local
    communities by supporting their personal and community
    independence. The Committee recognizes the plans of the Center
    for Aging at the University of Montana to create information
    systems and related support programs that are culturally and
    geographically relevant for seniors living in Native American
    and rural communities.
        The Committee commends the progress of the Texas Tech
    University Center for Healthy Aging in establishing a unique
    center of excellence, combining academic and clinical
    innovation in the study of the human aging process and state-
    of-the-art geriatric care on an in-patient and out-patient
    basis.
        The Committee recognizes that the Public Policy Institute
    on Aging in Arkansas provides an excellent link between public
    policy and medical research on aging issues. It will be
    associated with the Donald Reynolds Center on Aging at the
    University of Arkansas Medical School, the country's newest and
    second-only national center for geriatrics.
        The Committee supports continued funding of Nutrition 2030,
    Florida International University's program to reduce
    malnutrition in older Americans.
        The Committee recognizes the efforts of the Champlain
    Valley Area Agency on Aging's efforts to establish a statewide
    senior mental health project and notes that additional
    resources would allow more seniors to be served.
        Last year, the Committee supported the efforts of the West
    Virginia University's Year 2000 International Aging Conference.
    The Committee understands that WVU plans to test some of the
    recommended policies in rural communities to develop best
    practices for addressing issues that affect senior citizens.
    The Committee is supportive of these efforts.
        The Committee applauds the work of the Senior Fitness and
    Wellness program at the East Providence Senior Center in
    helping seniors to delay the degeneration of their health
    through exercise and flexibility training.
        The Committee understands that the Motion Picture and
    Television Fund (MPTF) has identified a new way of thinking
    about the needs of older individuals that can improve the
    quality of living and can also reduce the cost of medical
    interventions, known as the Eden Alternative. The Committee is
    aware that this represents a new paradigm by creating
    surroundings that are as similar as possible to those of an
    individual's earlier life.
        The Committee understands that the City of Compton was
    recently ranked as having the highest percentage of elderly
    persons at risk of disease and malnutrition. Over the last
    decade, funding for nutritional services has declined while the
    demand has increased. Moreover, there are no adult day care
    programs available for the elderly. The Committee believes
    that, with additional funding, the needs of more seniors will
    be met.
        The Committee understands that the elderly population in
    the southwest suburbs of Cleveland is growing at a faster rate
    than the national average. The Committee is supportive of the
    model work of the Southwest General Health Center Gatekeeper
    Program in identifying older individuals in the community that
    need assistance.
        The Committee understands that Southern Illinois University
    plans to expand its Aging and Outreach Institute in Carbondale.
        The Committee is aware that the Sinai Family Health Center
    is continuing to operate a Senior Outreach Program and is
    supportive of those efforts.
        The Committee understands that the County of Mecklenburg in
    North Carolina is developing an innovative program to provide a
    comprehensive nutritional care model at the local level for
    homebound senior citizens.
        The Committee recognizes the innovative efforts of the
    research initiative at the Center for Enhancing Quality of Life
    in Chronic Illness at Indiana University.
        The Committee is impressed with the development of models
    of nursing care for patients with Alzheimer's Disease through
    Florida Atlantic University Department of Nursing.
        The Committee recognizes that Medicare provides coverage
    for bone density tests for five qualified groups of ``at risk''
    individuals. However, a low number of beneficiaries have taken
    advantage of this benefit. The Committee believes the
    Department could work in conjunction with the national
    osteoporosis foundation to develop educational materials for
    Area Agencies on Aging (AAA) to modify, adopt and share with
    older Americans to inform them of this benefit. Materials such
    as posters, brochures, videos or guides should include
    information on the risk factors for osteoporosis, the value and
    benefit of screening, the options available for the prevention
    and treatment of the disease and the existence of Medicare
    coverage for bone density testing. The Committee believes that
    the AoA could work with the AAA to use the materials to
    effectively reach older Americans, particularly those at
    greatest risk of osteoporosis.
        The Committee is supportive of the Life Center in
    Germantown Pennsylvania which is providing dayhealth services
    for senior citizens.
        The Committee is aware of programs by the Champlain Senior
    Center in Burlington, Vermont to ensure that low income seniors
    are able to maintain active and independent lives as they age.
    These programs are intended to reduce the ``digital divide'' by
    providing low income seniors with access to the internet and to
    expand an innovative Adult Day Care program to allow medically
    ill seniors to continue interacting with their peers through
    participation in the Senior center programs.
        The Committee is aware of the efforts of the NW Parkinson's
    Foundation to develop comprehensive care for seniors affected
    by Parkinson's disease.

    Alzheimer's Disease Demonstration Grants to States

        As a result of the aging of the Baby Boom generation, the
    number of individuals affected by Alzheimer's Disease will
    double in the next twenty years. The Committee recommends a
    funding level of $5,970,000, the same as the fiscal year 2000
    level and the Administration's request.
        Currently, an estimated 70 percent of individuals with
    Alzheimer's disease live at home, where families provide the
    preponderance of care. For these families, care giving comes at
    enormous physical, emotional and financial sacrifice. The
    Alzheimer's disease demonstration grant program provides
    matching grants to 15 States to stimulate and better coordinate
    services for families coping with Alzheimer's. With a
    relatively small amount of Federal support to provide the
    stimulus, States have found innovative ways to adapt existing
    health, long-term care, and community services to reach
    previously underserved populations, particularly minorities and
    those living in rural communities.

    National Family Caregiver Support

        The Committee does not recommend funding for the National
    Family Caregiver Support Program because this program requires
    new authorizing legislation.

    Health Disparities Interventions

        The Committee has included $30,000,000 for a health
    disparities demonstration within the Centers for Disease
    Control and Prevention [CDC]. These funds will support
    prevention activities to eliminate health disparities among
    racial and ethnic minorities. The Committee expects that CDC
    will use a portion of these funds to partner with the
    Administration on Aging to provide culturally appropriate
    prevention activities aimed at minority elders.

    Program administration

        The Committee recommends $17,232,000 to support Federal
    staff that administer the programs in the Administration on
    Aging, the same amount as the budget request and $771,000 above
    the 2000 level. These funds provide administrative and
    management support for programs administered by the Department.

                            Office of the Secretary

                        GENERAL DEPARTMENTAL MANAGEMENT

    Appropriations, 2000....................................    $231,424,000
    Budget estimate, 2001...................................     229,592,000
    Committee recommendation................................     212,617,000

        The Committee recommends $212,617,000 for general
    departmental management [GDM]. This is $16,975,000 below the
    administration request and $18,807,000 below the fiscal year
    2000 level, which included new funding from an emergency fund.
    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 2000 level.
        This appropriation supports those activities that are
    associated with the Secretary's role as policy officer and
    general manager of the Department. It supports certain health
    activities performed by the Office of Public Health and
    Science, including the Office of the Surgeon General. GDM funds
    also 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.
        Last year, the Committee expressed its concern over the
    fact that the Surgeon General does not have direct authority
    over all PHS officers, and the impact that lack of authority
    may have on the ability of the Corps to respond to biosecurity
    or other emergency situations. The Committee urges the
    Secretary to review this situation and act to ensure that, in
    the event of a biosecurity incident or other national
    emergency, the Surgeon General has the necessary authority to
    direct the response of all Commissioned Corps officers,
    regardless of the agency to which the officer is assigned.
        U.S.-Mexico Border Health Commission.--The Committee has
    provided $2,000,000 to support the activities of the United
    States-Mexico Border Health Commission as authorized by Public
    Law 103-400. 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
    Committee again encourages the Commission and the Secretary to
    support the effort underway at the Baylor College of Dentistry
    to study, diagnose, and treat craniofacial deformities of U.S./
    Mexico border residents, which represents the kind of
    collaborative academic and clinical effort that could be
    pursued by the Commission in the future.
        Leadership for the National Suicide Prevention Strategy.--
    The Committee is pleased with the leadership of the Surgeon
    General in issuing the Call to Action to Prevent Suicide and
    the subsequent successful effort to bring together suicide
    prevention experts, advocates, and practitioners to develop a
    National Strategy for the Prevention of Suicide with a timeline
    for its progress and completion. The Committee notes that
    several Public Health Agencies including NIH, CDC, HRSA and
    SAMHSA are involved in this effort and the Committee expects
    the Office of the Assistant Secretary for Public Health-Surgeon
    General to continue to lead and coordinate this effort through
    the implementation phase. The Committee requests that the
    National Strategy for the Prevention of Suicide along with the
    specific action steps and the associated fiscal year 2001 and
    2002 resources for each of the participating public health
    agencies be submitted to the Committee along with the
    submission of the President's fiscal year 2002 budget.
        The Committee commends the Secretary's recent action to
    convene a National Suicide Prevention Strategy Steering Group
    to begin work on a National Suicide Prevention Strategy (NSPS).
    The Committee appreciates the fact that an effective NSPS
    requires broad collaboration between the Federal Government and
    the private sector. Past experience has shown that broad
    involvement is critical for implementation of effective suicide
    prevention programs. The Committee believes that SPAN USA could
    play an important role in the development of an NSPS.
        The Committee has included funding for the Human Services
    Transportation Technical Assistance Program. As in previous
    years, this program is to be administered by a national
    membership organization with expertise in working with local
    transit organizations. The program provides technical
    assistance and training to organizations that provide
    transportation services to the elderly, people with physical
    and developmental disabilities, and the economically
    disadvantaged. With these funds, the Committee expects a
    continued emphasis on assisting communities with transportation
    issues related to welfare reform since in many rural
    communities the largest obstacle in gaining employment is
    transportation to work sites. The Committee further expects the
    technical assistance to be provided include developing
    strategies for cost-effective transportation under Medicaid.
    The Committee also notes that the technical assistance provided
    by the Community Transportation Association of America is vital
    to the success of this project. To improve coordination, the
    Committee will expect that the funds made available under this
    program be allocated to a national membership organization with
    a demonstrated record of achievement in this area.
        The Committee reiterates its support of the Chronic Fatigue
    Syndrome Coordinating Committee [DHHS CFSCC]. The Committee
    urges the DHHS CFSCC to coordinate CFIDS research across the
    Public Health Service by defining priorities and creating a
    yearly action plan.
        The yearly action plan should focus attention on expanding
    research on CFS, augment health care provider education, and
    execute the CFSCC's charter to provide coordination and ensure
    accountability of the federal agencies' CFS programs. The
    Committee also urges DHHS and the agencies represented on the
    CFSCC to take a leadership role in informing health care
    professionals and the general public about CFS, focusing on the
    prevalent and serious nature of CFS. The Committee believes
    that it is important that the Secretary and the Surgeon General
    undertake a prominent educational campaign to inform the public
    that CFS is a serious, prevalent and disabling illness. The
    Committee is pleased that during fiscal year 2001
    Appropriations Hearings, the Secretary committed to ensuring
    that the accounts of CFS research activity and spending
    reported to Congress are thorough and accurate. The Committee
    directs the Secretary to ensure that all of the Public Health
    Service agencies' CFS research programs are effective and
    ambitious. The Committee understands that the General
    Accounting Office (GAO) is studying and reporting on overall
    CFS activities at CDC and expects that the Secretary will
    respond swiftly to correct problems revealed by the GAO study.
        Cancer registries.--The Committee understands that cancer
    registries monitor trends in cancer--by site of the cancer, age
    and ethnicity of the patient, geographic region, and treatment
    outcome. Enhancing statewide cancer registries and providing
    national support for quality assurance and reporting standards
    ensures that critical information on cancer trends and outcomes
    is available. It has been brought to the Committee's attention
    that inadequate resources and a changing health care
    environment have strained cancer registries around the country,
    limiting the States' ability to collect data; forcing certain
    data (e.g., occupational history) to be no longer collected;
    and in some cases, forcing the closure of regional cancer
    registries. The Committee encourages increasing the support for
    these registries in order to enable States to more aggressively
    utilize State cancer data integrating the registries into their
    cancer prevention and control programs. The Committee also
    encourages NIH to work with CDC, the States and national
    organizations on this issue.
        The Committee is supportive of efforts by the Secretary to
    give priority to projects that will promote the development of
    a national strategy for the prevention of alcohol-related birth
    defects and for the provision and coordination of appropriate
    interventions for affected individuals and their families. The
    Committee recognizes the prevalence of secondary disabilities
    among those with alcohol-related birth defects, including
    interaction with the criminal justice system, mental health
    problems, failure to live independently, and difficulties in
    school. The Committee understands that many of these secondary
    disabilities can be prevented, and it supports grant projects
    that will improve our ability to help children and families
    minimize the impact of alcohol-related birth defects. The
    Committee urges the Secretary to target appropriate funding to
    areas that demonstrate significant need and a high incidence or
    risk of alcohol-related birth defects. Special consideration
    could be given to Native American applicants, with recognition
    of the value of non-traditional or culturally-based treatment
    methods and reservation-based substance abuse treatment
    services. The Committee also urges the National Institute of
    Alcohol Abuse and Alcoholism, the Centers for Disease Control,
    the Indian Health Service and the Substance Abuse and Mental
    Health Services Administration to work collaboratively on
    administration of the grant program.
        The Committee is pleased that a representative of the
    primary immune deficiency community has been appointed to the
    Department's Advisory Committee on Blood Safety and
    Availability. The Committee encourages the Advisory Committee
    to continue to address the longstanding shortage of intravenous
    immune globulin (IGIV), a pooled plasma derivative that primary
    immune deficient patients need to maintain their health.
        Delivery of Healthcare.--The health care industry in Alaska
    is a major employer in Alaska, but there currently is no
    capacity to evaluate health care delivery and training needs
    for health care workers in order to use this information to
    improve the health status of Alaskans. The Committee encourages
    the Department to consider funding a project to evaluate and
    assess on a statewide basis the health care delivery and
    training needs in Alaska. The Committee is aware of the
    University of Alaska's capabilities for undertaking such a
    project.
        The Committee encourages the development of an innovative
    service delivery model and day health center facility to care
    for the elderly. The Committee recognizes the multi-
    disciplinary management program operated by the Albert Einstein
    Healthcare Network in Philadelphia, PA.
        The Committee is aware of the planned project, supported by
    a consortium including the Texas A&M Health Science Center,
    Texas A&M Colleges of Veterinary Medicine and Engineering,
    Texas Children's Hospital, and the Baylor College of Medicine,
    to establish a national institute for the study of
    cardiovascular disease and the development of associated
    biomedical devices.
        The Committee urges the Secretary to consider consulting
    with the National Academy of Sciences to provide an evaluation
    on childrens' health. This evaluation could assess the adequacy
    of currently available methods for assessing risks to children,
    identify scientific uncertainties associated with these
    methods, and develop a prioritized research agenda to reduce
    such uncertainties and improve risk assessment for children's
    health and safety.
        The Committee is aware of a model initiative by Delta State
    University which plans to focus on the developmental needs of
    children beginning at birth until kindergarten enrollment. The
    plan will consider the intellectual, social, psychological, and
    physical development of children in the Mississippi Delta. The
    Committee understands that a key aspect of this model will be
    to address the parenting needs of mothers and fathers regarding
    child rearing, nutrition, healthcare, and child development.
        Reducing IV medication errors.--The Committee is aware of
    efforts by Harvard clinical Technology, Inc. to reduce medical
    errors by developing an automated drug infusion system that
    uses a bar code on the medication to determine appropriate
    dosages.
        The Committee is aware of a program called Children's
    Health Life Skills Initiative as proposed by UNC Chapel Hill,
    UNC Greensboro, NC A&T, NC State, East Carolina University, and
    Appalachian State University.
        The Committee is aware of the interest in an integrative
    medicine program which combines conventional medical science
    with promising alternative therapies.
        The Committee recognizes the unique programs being
    conducted at the Center for Integrative Medicine at Thomas
    Jefferson University Hospital (TJUH) in Philadelphia, PA,
    especially in treating oncology, cardio-vascular and
    rheumatology patients.
        The Committee is aware of the Program for Training Research
    in Preventive Maternal Health and Child Health Services at the
    Lawton and Reah Chiles Center for Healthy Mothers and Babies,
    co-located at the University of Florida and the University of
    South Florida.
        Internet and Grant Applications.--The Committee has been
    impressed with the efforts of the NIH to apply the technology
    of the Internet and specifically its weekly electronic mail
    service announcing grant opportunities. The Committee
    encourages the Department and those components that make funds
    available through grants and cooperative agreements to
    supplement the publication in the Federal Register with a
    weekly listserv to all interested parties, that links back to
    the full document. In addition, the Department should announce
    such availability in the Federal Register and at each of the
    Department's component pages. The Committee expects that this
    will improve the flow to all potential applicants concurrently
    in urban as well as in isolated communities, for example,
    Hawaii, Alaska, the western Pacific and rural America that must
    now rely on the Federal Register to arrive in a timely manner
    to obtain the knowledge to apply for grant programs.

    Adolescent family life

        The Committee has provided $19,327,000 for the Adolescent
    Family Life Program [AFL]. This is $11,700,000 more than the
    administration request and is the same as the fiscal year 2000
    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 continues the
    prevention projects begun in fiscal year 1998, as well as new
    prevention projects. The Committee again expects 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 again expects the Department, when announcing
    grant competitions, to provide a reasonable length of time for
    applicants 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 $1,091,000 for the Federal staff
    which supports the President's Council on Physical Fitness and
    Sports. This is the same as the fiscal year 2000 appropriation
    and $61,000 less than the budget request.
        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 $37,638,000 for the Office of
    Minority Health. This is $1,000,000 less than the budget
    request and the same as the fiscal year 2000 appropriation.
        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.
        Health care fairness.--The Committee supports efforts to
    increase understanding of health disparities among minority
    communities, because increased public awareness of minority
    health issues will improve public health throughout the nation.
    Many current public health efforts and medical breakthroughs
    are not accessed by minority communities. Establishing
    awareness and an agenda for minority health through research
    and curriculum development for cultural competency are an
    essential part of quality medical care for minority
    communities. The Committee is aware that there are significant
    differences in health outcomes in minority communities and
    supports the additional resources needed to effectively address
    the high incidences in diseases such as diabetes and asthma in
    Hispanics, lower life expectancy and higher infant mortality
    and cancer rates for African Americans, and cervical cancer and
    tuberculosis rates in Asian Americans.
        The Committee is aware of the initiative at the University
    of Miami/Jackson Memorial Medical Center to systematize the
    development, maintenance, and utilization of medical
    information to mitigate health disparities in minority
    populations by linking the diagnosis, care, and therapeutic
    procedures with patient outcomes to increase the ability to
    enhance the effectiveness and efficiency of dealing with the
    complete spectrum of diseases affecting patients cared for at
    the medical center.
        The Committee is aware of The Community Medical Centers of
    Fresno, California. These Centers offer a comprehensive program
    of diabetes and renal dialysis educational outreach and care to
    address the needs of the underserved populations in the Central
    San Joaquin Valley.
        The Committee is aware of Santa Marta Hospital in Los
    Angeles. The hospital provides outreach and offers health
    education to underserved populations suffering from diabetes.
    The program is culturally and linguistically sensitive and
    primarily serves the Latino community.
        The Committee is pleased that the HHS Office of Minority
    Health has taken a leadership role in conducting and
    coordinating a study on managed care and historically minority
    health professions schools and encourages continued support.
        The Committee is aware of the University of Florida's
    interest in creating a center for Human Brain Imaging
    Technology. The goal of the center would be to accelerate the
    pace of invention and improvement of imaging technologies, to
    enhance their applications to the diagnosis and treatment of
    brain diseases and to enhance guided imagery for neurosurgery.
        The Committee is aware of The Jessie Trice Cancer
    Prevention Project, a cancer prevention, education and early
    detection program which provides comprehensive primary and
    preventive health care to low-income and uninsured African-
    American and Hispanic populations in south Florida.
        The Committee is aware of Jackson State University's
    Epidemiological Research Institute.
        The Committee is aware of efforts by the CORE Center at
    Cook County Hospital in Chicago, Illinois to develop a model
    HIV/AIDS education and training initiative that incorporates
    modern technology.
        The Committee is aware of the University of Pennsylvania
    School of Dental Medicine Minority Outreach Oral Health
    Initiative.

    Office on Women's Health

        The Committee recommends $16,895,000 for the Office on
    Women's Health. This is $400,000 more than the administration
    request and $1,400,000 more than the fiscal year 2000
    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.
        The Committee is aware of the unique and important role
    played by the various offices, advisors and coordinators
    throughout HHS dedicated to women's health and women's health
    research. This includes the NIH, CDC, FDA, AHRQ, HRSA, SAMHSA,
    IHS and HCFA, as well as in the Office of the Secretary. The
    Committee believes that it is essential to the mission of the
    Department and that these offices, advisors and coordinators be
    adequately supported to accomplish their goals. For this
    reason, the Committee requests the Secretary provide a report
    by January 1, 2001, outlining in detail the major programs of
    each of these entities and the Department's plans for the
    future.
        Osteoporosis.--The Committee commends the commitment of the
    Public Health Service's Office on Women's Health to the
    National Bone Health Campaign aimed at adolescent girls, which
    is being developed and implemented in partnership with the
    National Osteoporosis Foundation (NOF) and the Centers for
    Disease Control and Prevention (CDC) and urges continued
    support of that program. The Committee also recognizes that
    eating disorders and autoimmune diseases impact bone health and
    are associated with the development of osteoporosis and
    encourages the Office of Women's Health and the National
    Osteoporosis Foundation to develop information and outreach
    activities on these conditions. In addition, the Committee
    urges the Office of Women's Health to support development and
    dissemination of these education materials and information
    through the NIH Osteoporosis and Related Bone Diseases-National
    Resource Center (ORBD-NRC).
        The Committee is aware of Spelman College's African-
    American Women's Health and Wellness Project to assist national
    efforts to close the health disparity gaps that exist between
    African-Americans and other communities.

    Office of Emergency Preparedness

        The Committee has provided $9,668,000, which is the same as
    last year's level and $2,000,000 less than the budget 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 metropolitan medical strike teams
    in key uncovered urban areas of the country. The Committee has
    provided additional funding for bioterrorism within the public
    health and social services emergency fund.
        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.

                          OFFICE OF INSPECTOR GENERAL

    Appropriations, 2000....................................     $31,394,000
    Budget estimate, 2001...................................      33,849,000
    Committee recommendation................................      33,849,000

        The Committee recommends an appropriation of $33,849,000
    for the Office of Inspector General. This is the same as the
    administration request and $2,455,000 higher than the fiscal
    year 2000 level. In addition to discretionary funds, the Health
    Insurance Portability and Accountability Act of 1996 provides
    $130,000,000 in mandatory funds for the Office of the Inspector
    General in fiscal year 2001; the total funds provided to the
    Office by this bill and the authorizing bill would be
    $$163,849,000 in fiscal year 2001.
        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 continued good work to reduce waste, fraud and abuse in
    Department programs. The Committee expects efforts to reduce
    Medicare mispayments will be continued and expanded. The
    Committee urges the OIG to perform an analysis of Medicare
    payment rates for medical supplies and equipment to compare
    these rates to those of other Federal and State health programs
    as well as wholesale and retail prices. Medicare, as the
    largest purchaser of supplies and equipment should use this
    purchasing power to achieve taxpayer savings. The Committee
    also wants to assure that seniors calling into the toll-free
    telephone line to report Medicare fraud, waste and abuse get a
    prompt and complete response. Finally, the Committee has
    provided increased funding for the OIG's work in other critical
    areas such as child support enforcement and discretionary
    program audits.

                            OFFICE FOR CIVIL RIGHTS

    Appropriations, 2000....................................     $18,774,000
    Budget estimate, 2001...................................      20,742,000
    Committee recommendation................................      20,742,000

        The Committee recommends $20,742,000 for the Office for
    Civil Rights. This is the same as the administration request
    and $1,968,000 more than the the fiscal year 2000 level.
        This recommendation includes the transfer of $3,314,000
    from the Medicare trust funds, which is the same as the
    administration request and the fiscal year 2000 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, 2000....................................     $16,738,000
    Budget estimate, 2001...................................      16,738,000
    Committee recommendation................................      16,738,000

        The Committee recommends an appropriation of $16,738,000
    for policy research. This is the same as the administration
    request and the same as the fiscal year 2000 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.

         RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

    Appropriations, 2000....................................    $214,905,000
    Budget estimate, 2001...................................     219,772,000
    Committee recommendation................................     219,772,000

        The Committee provides an estimated $219,772,000 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 $4,867,000 over the estimated
    payments for fiscal year 2000.
        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.

                PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

    Appropriations, 2000....................................    $488,280,000
    Budget estimate, 2001...................................     264,600,000
    Committee recommendation................................     264,600,000

        The Committee recommendation includes $264,600,000 for the
    public health and social services emergency fund. This is the
    same as the administration request and $223,680,000 below the
    fiscal year 2000 level.
        The Committee recommendation includes the following
    adjustments to the administration request:
      --Worker safety research is increased from $1,200,000 to
            $2,000,000.
      --$10,000,000 is included, for transfer to the Department of
            Labor, for the Global HIV/AIDS Workplace Initiative of
            the Bureau of International Labor Affairs.
      --$35,000,000 is provided for the Health Alert Network, an
            increase of $5,000,000 over the fiscal year 2000 level.
      --$6,000,000 to combat the spread of malaria worldwide.
        The recommended increases over the budget request are
    offset by a reduction in the $91,733,000 requested for research
    and development activities. Specifically, the Committee
    recommendation defers consideration of the $30,237,000
    requested for basic research, genomics and pathogenesis,
    pending submission of an operations plan for this activity. The
    recommendation also defers funding for FDA review and approval
    activities which are under the jurisdiction of a separate
    subcommittee.
        The Committee recommendation of $6,000,000 for the Centers
    for Disease Control and Prevention is to continue surveillance
    for resistance, to evaluate new drugs and insecticides, develop
    and use assays to test the malaria parasite for drug resistance
    and mosquitoes for insecticide resistance and other associated
    activities. The Committee is aware of the promising work
    conducted by the University of Mississippi Laboratory for
    Applied Drug Design and Synthesis in conjunction with the CDC's
    Global Malaria Initiative, and recognizes that Federal funding
    could support continued malaria research at the University of
    Mississippi with collaboration from Tulane University.
        Biosecurity.--For activities relating to the protection of
    civilian populations against potential biological threats
    (``bioterrorism'') and to the building of the nation's public
    health infrastructure, the Committee recommends $249,333,000,
    including funds in this account as well as other components of
    the Department of Health and Human Services. The administration
    requested separate funding in this account for the Centers for
    Disease Control and Prevention, Office of Emergency
    Preparedness, Food and Drug Administration and the authority to
    distribute funding to other HHS agencies. Funds were requested
    for biosecurity activities among these agencies including:
    deterrence, disease surveillance, medical and public health
    response preparation and planning, the national pharmaceutical
    stockpile, and research and development.
        The Committee expects that, within the amount provided to
    the Secretary for biosecurity, the rebuilding of the nation's
    public health infrastructure be given the highest priority.
    Communications, information technology, laboratories and
    associated technologies, hospital capacity, and trained
    professionals are essential elements of a national public
    health infrastructure which protects the civilian population
    against both bioterrorist threats and the rapid onset of
    naturally occurring diseases.
        The Committee has deferred funding of $10,700,000
    identified in the administration request for the Food and Drug
    Administration, whose appropriations are under the jurisdiction
    of a separate subcommittee.
        The Committee reiterates its support of the Health Alert
    Network, which is administered by CDC and assists State and
    local public health entities to establish a working
    communications network dedicated to rapid response, analysis
    and information sharing. The Committee's intent remains that
    Health Alert Network funds be used to build electronic
    information and communications capacity at local public health
    agencies to support prompt, effective responses to episodes of
    bioterrorism and the public health threats. CDC has required
    that State grantees spend 85 percent of Health Alert Network
    funds at the local level and that State and local public health
    officials plan Health Alert Network activities jointly. The
    Committee expects that this requirement will be enforced and
    that CDC will require States to report on the proportion of
    funds spent to improve local capacities and the mechanisms by
    which local public health agencies have been consulted and
    involved in Health Alert Network planning.
        The Committee recommends continuation of the following
    fiscal year 2000 projects and activities in the fiscal year
    2000 conference request:
      --Carnegie Mellon Research Institute
      --St. Louis University School of Public Health
      --University of Texas Medical Branch at Galveston
      --John Hopkins University Center for Civilian Biodefense
      --Noble Army Hospital of Alabama bioterorism program
        The Committee is aware of the following projects that it
    encourages the Department to consider supporting:
      --The University of Findlay National Center for Terrorism
            Preparedness, Findlay, Ohio
      --The University of Maryland Medical and Shock Trauma Center,
            emergency preparedness response guidelines
      --Rhode Island research effect to establish a best practices
            model for effective disaster preparedness
      --Louisville and Jefferson County Health Alert Network/
            Training Exemplar Project
        The Committee is aware of the need for Federal support, in
    cooperation with the Environmental and Public Health Alliance,
    to perform necessary public health services during the 2002
    Winter Olympic Games.
        The Committee recognizes the critical need to ensure a
    highly trained public health workforce in the United States,
    particularly in the event of a possible bioterrorist attack,
    and the important role public health officials play as first
    responders. The Committee encourages the Centers for Disease
    Control and Prevention to provide training for public health
    department employees nationwide using distance learning
    technologies. Such training should focus on detecting and
    responding to bioterrorist threats.
        HIV/AIDS in minority communities.--To address high-priority
    HIV prevention and treatment needs of minority communities
    heavily impacted by HIV/AIDS, the Committee recommends
    $50,000,000. These funds are available to key operating
    divisions of the department with capability and expertise in
    HIV/AIDS services to assist minority communities with
    education, community linkages, and technical assistance.

                               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 included in
    fiscal year 2000 which limits assignment of certain public
    health personnel (sec. 202).
        The Committee recommendation retains language carried in
    fiscal year 2000 regarding set-asides in the authorizing
    statute of the National Institutes of Health (sec. 203).
        The Committee recommendation retains a provision carried in
    fiscal year 2000 to limit use of grant funds to pay individuals
    more than an annual rate of Executive level III (sec. 204).
        The Committee recommendation retains language from fiscal
    year 2000 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 1.6 percent of the
    appropriations provided for programs authorized under the act
    for evaluation activities.
        The Committee recommendation retains language included in
    fiscal year 2000 restricting transfers of appropriated funds
    among accounts and requiring a 15-day notification of both
    Appropriations Committees prior to any transfer (sec. 206).
        The Committee recommendation includes language included in
    fiscal year 2000 permitting the transfer of up to 3 percent of
    AIDS funds among Institutes and Centers (sec. 207) 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 1999 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. 208).
        The Committee recommendation includes a provision (sec.
    209) regarding family planning applicants to certify to the
    Secretary to encourage family participation in the decision of
    a minor who seeks family planning services.
        The Committee recommendation includes a provision included
    in fiscal year 2000 which restricts the use of funds to carry
    out the Medicare+Choice Program if the Secretary denies
    participation to an otherwise eligible entity (sec. 210).
        The Committee includes a provision to ensure that States
    receive no less than the amount they received in fiscal year
    2000 for substance abuse and mental health services (sec. 211).
        The Committee includes a provision (sec. 212) which states
    that no provider of services under Title X of the PHS Act
    except from State laws regarding child abuse.
        The Committee includes a provision (sec. 213) extending the
    refugee status for persecuted religious groups.
        The Committee has continued last year's prohibition on
    administering or implementing a Medicare Competitive Pricing
    Demonstration (sec. 214).
        The Committee continues to include a provision prohibiting
    the Secretary from withholding substance abuse treatment funds
    (sec. 215).
        The Committee has included a provision, requested by the
    President, which cuts Temporary Assistance to Needy Families
    (TANF) by $240,000,000 in fiscal year 2001. TANF Supplemental
    Grants are bonus payments to 17 States with high population
    increases and low levels of welfare spending per person. At the
    time TANF was enacted, States expecting large population
    increases were concerned that under a block grant they would
    not be able to meet the demands of increased caseloads since
    the basic TANF grant amount was based on historical AFDC
    caseloads. However, States receiving supplemental grants have
    experienced the same caseload declines as other States (sec.
    216).
        The Committee has shifted unspent fiscal year 1998 State
    Children's Health Insurance Program (SCHIP) funds to fiscal
    year 2003 to more closely reflect State spending patterns. The
    Committee understands that as many as 37 States with unspent
    fiscal year 1998 allocations would otherwise lose these funds
    at the end of fiscal year 2000. The funds appropriated for
    fiscal year 2003 are made available for 2 years. The Committee
    believes that the remaining appropriations from fiscal years
    1999, 2000, and 2001 will be sufficient to meet the needs of
    States in fiscal year 2001 (sec. 217).

                       TITLE III--DEPARTMENT OF EDUCATION

                                education reform

    Appropriations, 2000....................................  $1,765,182,000
    Budget estimate, 2001...................................   2,106,000,000
    Committee recommendation................................   1,434,500,000

        The Committee has provided $1,434,500,000 in this account
    for education reform initiatives. The recommendation includes
    $40,000,000 for education reform activities authorized by title
    IV of the Goals 2000: Educate America Act, $794,500,000 for
    education technology authorized by the Elementary and Secondary
    Education Act and $600,000,000 for 21st century community
    learning centers.
        The Committee understands that programs authorized by the
    Elementary and Secondary Education Act of 1965, as amended,
    currently are under consideration for reauthorization. Until
    this process is completed, appropriations generally will be
    made consistent with the current authorization for these
    programs. The Committee defers action on all new programs
    proposed by the Administration pending the outcome of the
    reauthorization process.

    Goals 2000: State and local education systemic improvement grants

        The Committee recommendation does not include resources for
    activities authorized by title III of the Goals 2000: Educate
    America Act. This action is consistent with the Department of
    Education Appropriations Act, 2000, which repealed this program
    effective September 30, 2000. The recommendation is
    $458,000,000 less than the fiscal year 2000 comparable level
    and the same as the amount requested by the Administration.
        Funds from the fiscal year 2000 appropriation will 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 $40,000,000 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 children, including those aged
    birth through 5.
        Under the Administration's reauthorization proposal, the
    Administration requested $33,000,000 for parental information
    resource centers (PIRCs) in the school improvement programs
    account for fiscal year 2001, the same level as provided last
    year for parent assistance centers. Instead of providing direct
    assistance to parents of students in low income communities as
    is currently authorized, the PIRCs would disseminate
    information and provide training and support to State and local
    educational agencies and schools. The Committee defers action
    on this proposal pending reauthorization of elementary and
    secondary education programs.
        The increase of $7,000,000, which is above the
    administration request and the fiscal year 2000 amount, is
    provided as part of the Committee's youth violence prevention
    initiative. Sociological and scientific studies show that the
    first 3 years of a child's cognitive development set the
    foundation for life-long learning and can determine an
    individual's emotional capabilities. Parents, having the
    primary and strongest influence on their child, play a pivotal
    role at this stage of development. Scientists have found that
    parental relationships affect their child's brain in many ways.
    Research further indicates that a secure connection with the
    parent will better equip a child to handle stressful events
    throughout life.
        Statistics show that the Department of Education's parental
    assistance program in particular has helped to lower the
    incidence of child abuse and neglect, reduces placement of
    children in special education programs, and involves parents
    more actively throughout their child's school years. The
    Committee recognizes that early intervention activities
    conducted through the Parental Assistance Program can make a
    critical difference in addressing the national epidemic of
    youth violence, and therefore includes additional funds to
    expand its services to educate parents to work with
    professionals in preventing and identifying violent behavioral
    tendencies in their children.
        The Committee strongly urges the Department to stipulate
    that at least 50 percent of each grant award shall be used only
    for parents as teachers Programs.
        The Committee notes that Alaska is the only State which
    does not currently have a Parents as Teachers program in place
    to provide ongoing parent education and support in parents'
    home communities. Studies have shown that children whose
    parents participate in PAT training perform significantly above
    national norms on measures of intellectual abilities. The
    Committee urges the Department to provide funding for the State
    of Alaska to establish a PAT program in conjunction with a
    ``Read With Your Child'' program workshop and continuing follow
    up.

    Recognition and Reward

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration request includes $50,000,000 for the
    proposed Recognition and Reward program for fiscal year 2001.
    This new program would reward States that demonstrate
    significant gains in student achievement and reduce the
    achievement gap in mathematics between high- and low-performing
    students.

    School-to-work opportunities

        The Committee recommendation does not include funding for
    this program. The School-to-Work Opportunities Act authorized
    appropriations through September 30, 1999. Funds appropriated
    under the School-to-Work Opportunities Act, made available
    through both the Departments of Labor and Education, provided
    every State with access to seed money to design and implement a
    comprehensive school-to-work transition system. The Committee
    recommendation is $55,000,000 less than the amount provided to
    the Department of Education for fiscal year 2000 and the same
    as the budget request.
        Local school-to-work programs 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 established 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, the same as the fiscal
    year 2000 comparable and $25,000,000 below 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.
    Grants are made according to each State's share of funds
    appropriated under part A of title I. To be eligible for funds,
    each State submitted a statewide technology plan describing
    long-term strategies for financing technology education in the
    State, including private-sector participation and initiatives
    targeting funds to school districts with the greatest need.

    Regional technology consortia

        The Committee recommends $10,000,000, the same as the
    amount appropriated in fiscal year 2000 and the administration
    request, to continue the regional technology in education
    consortia program. 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.

    Technology innovation challenge grants

        The Committee recommends $100,000,000 for the technology
    challenge grants authorized under part A of title III of the
    ESEA, $46,255,000 less than the fiscal year 2000 comparable.
        The administration requested $170,000,000 for the Next-
    Generation Innovation program for fiscal year 2001. Under the
    Administration's reauthorization proposal, the Technology
    Innovation Challenge Grants program and Star Schools program
    would be replaced by the Next-Generation Innovation program to
    encourage the use of educational technologies to provide access
    to challenging content. The request is $26,805,000 less than
    the fiscal year 2000 comparable level for these programs. The
    Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
        Technology innovation challenge grants support 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.
        It has been brought to the Committee's attention that
    grants issued since this program's creation in fiscal year
    1995, appear to be made disproportionately to States with high
    access to technology, high levels of private funding, and high
    concentrations of disadvantaged students, while the
    applications from predominantly rural, less populated States
    have been turned down, citing a lack of community resource
    contributions and low numbers of children benefiting from the
    proposals. The Committee encourages the Department to reexamine
    the criteria by which review panels score applications to
    ensure that the community resource contribution effort is taken
    into account and, that true innovation is also considered. Such
    innovation might include new applications of software, state-
    of-the-art professional training programs and multicounty and
    multistate consortia affecting underprivileged children in
    technologically underserved areas and rural demographic
    limitations, for example in Mississippi.
        The Committee is pleased to see that schools are engaging
    in resource-sharing to build collaborations with nonprofit
    organizations and the business community to bring technology
    into the classroom. Several innovative projects that are
    currently being developed to meet specific regional needs and
    pursue the goals described above have been brought to the
    Committee's attention. The Committee is aware of the following
    projects and encourages the Department to give them full and
    fair consideration:
        The C*R*E*A*T*E* for Mississippi project developed by the
    Tupelo Public School District in Tupelo, Mississippi will join
    teachers in several districts in a network to model successful,
    replicable technology application and utilization in classrooms
    throughout the State.
        The LINKS project, a collaborative effort between education
    entities in Arkansas, California, Illinois, Pennsylvania, and
    Washington, is designed to increase learning opportunities
    through the integration of educational technology and reform.
        Northern Kentucky University continues to enhance its
    collaboration with area school districts to support technology-
    based math and science instruction.
        Concord College, located in Athens, West Virginia, has
    developed an innovative program designed to equip new teachers
    with the technical skills essential for the utilization of
    information technologies in the classroom. This program would
    foster collaboration between the teacher education community
    and local elementary and secondary schools to enhance the
    technological skills of current teachers through campus
    programs and distance learning. A special emphasis would be
    given to math and science instruction.
        The Technological Research and Development Authority of
    Florida has developed a Mathematics, Science & Technology
    Teacher Education program for mathematics, science and
    technology teacher education for grades 9 through 12. Teachers
    will get hands-on experience with new technologies that can be
    incorporated into math, science and technology curriculum.
        The Westside Community School's ``The Community Discovered
    Project'' will integrate technology and the arts into the core
    curriculum for enhancing student learning.
        Bozeman High School in Montana will utilize portable
    computer labs, laptop computers, and wireless Internet
    connections to accommodate the growth in student populations
    and improve student competency in the use of educational
    technology.
        The Northwood School District in cooperation with the local
    community, businesses, families, and community service groups
    in rural northwestern Wisconsin will bring needed distance
    education programs into the area. This effort will enhance
    learning opportunities, and provide useful skill development
    through a high-technology wireless computer network.
        The University of Vermont is developing a distance learning
    professional development program to increase teacher
    proficiency in utilizing technology.
        Western Kentucky University's collaboration with area
    school districts is designed to ensure that new and existing
    teachers are trained to effectively use technology in the
    classroom.
        The Houston Independent School District continues to
    develop and maintain an advanced telecommunications system for
    all the district's schools. This will help HISD achieve its
    goal of having all its 12,000 teachers and other education
    professionals linked to key voice, video, and data systems in
    support of classroom instruction.
        The Montgomery Public School system will enhance the
    technological capabilities of the Brewbaker Technology Magnet
    High School in support of improved educational outcomes.
        The Learning with Laptops program developed by the Beaufort
    County Public School District in South Carolina utilizes
    technology to improve academic achievement.
        The Bridges Demonstration Project, a private-public
    collaboration, will involve parents and teachers in developing
    new models for using technology to improve student achievement.
        The Maine Center for Educational Services will utilize
    Maine's State-wide telecommunications infrastructure to
    implement the Schools & Technology for Assessment & Reflection
    program.
        The Interactive Computer Aided Natural Learning program
    continues to enhance access to and support for computer
    assisted learning activities.
        The Project Family Net: Linking Providence Students and
    Their Parents as Partners in Learning has established a
    private-public partnership with the Metropolitan Regional
    Career and Technical Center in Rhode Island to provide training
    and support in computer technology for parents in low income
    areas, which ultimately improves their children's educational
    opportunities by bringing computers into the home.
        The Webster School District in collaboration with the Lake
    Area Vocational Schools and Waubay, Roslyn, Bristol, and Enemy
    Swim Day School will utilize advanced software and computer
    technology to integrate the power of the Internet with an
    advanced database to provide personalized instruction to
    students, and increase their access to technology.
        Loyola University-Chicago is enhancing the distance
    learning opportunities of underserved populations in the
    Chicago area.
        The Discovery Center in partnership with the Springfield
    Public School district and other area schools will utilize
    advanced technologies to continue to enhance student access to
    and effective use of technology-based learning in the
    Springfield, Missouri area.
        The Fairfax County Public Schools Computer for Families
    program will increase student understanding of computer
    technology through repair of donated computers that can then be
    used by students and their families.
        The Hospitals, Universities, Businesses, and Schools (HUBS)
    program has developed a distance learning pilot initiative
    utilizing videoconferencing and other technology-based systems.
        SpaceNet, a program developed by Fairfax County Public
    Schools, in collaboration with schools in Texas, California,
    and Wisconsin, will enhance science and mathematics instruction
    through the use of data gathered from NASA missions to simulate
    space exploration.
        Baltimore City Public School System continues to implement
    its education technology plan to provide each public school
    classroom with the tools necessary to bridge the digital
    divide, and ensure that every student in the system receives a
    quality, high-tech education.
        The Montana TREK Center at Flathead Community College
    supports a collaboration between government, education and
    business to improve technology literacy through professional
    development and educational training.
        The non-profit organization Tequity will work with
    elementary and secondary schools located within the
    Philadelphia-Camden and Boston Empowerment Zones to increase
    access to educational technology.
        The Committee recognizes the significant policy benefits of
    the Digital Education Content Collaborative program which would
    provide matching funds to establish partnerships creating
    digital teaching resources based on State curriculum
    requirements. These resources would be distributed through the
    Public Broadcasting System's expanded digital transmission
    system and through new school digital networks. Digital content
    resources are necessary for schools to make use of the major
    Federal and State investments in school networks and computer
    equipment. The Committee will take action on this proposal
    subsequent to the outcome of the reauthorization of elementary
    and secondary education programs.

    National activities

        The Committee recommends $192,000,000 for educational
    technology national activities, $82,500,000 more than the
    fiscal year 2000 appropriation. The administration requested
    $252,000,000 for the activities authorized by title III, part A
    of the ESEA. Funds support Federal leadership activities that
    promote the use of technology in education, and may be used for
    teacher training in technology, community-based technology, and
    technology leadership activities.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The City of Philadelphia in collaboration with community
    partners will improve access to and training in technology for
    city residents through its community technology center
    initiative.
        The New Iberia Community Technology Center will provide
    access to technology including two teaching labs, a lab for
    individual use, and distance learning and technology education
    activities for residents of the community.
        The Township of North Bergen, New Jersey, in collaboration
    with other community partners, will establish three Technology
    Literacy Centers to provide access to and instruction in
    computer technology to area residents.
        Carl Sandburg College, in partnership with Knox College and
    the Galesburg Public Schools, will increase access to
    technology in the Galesburg area through development of a
    community technology center.

    Star schools

        For the star schools program, the Committee recommends
    $43,000,000, a decrease of $7,550,000 from the fiscal year 2000
    comparable level. The administration did not request any funds
    for this program, and instead requested under its
    reauthorization proposal to fund similar activities under the
    Next Generation Technology Innovation program. The Committee
    defers action on the administration proposal.
        This program is designed to improve instruction in math,
    science, foreign languages, and other subjects such as
    vocational education, to underserved populations by means of
    telecommunications technologies. The program supports eligible
    telecommunications partnerships to develop and acquire
    telecommunications facilities and equipment, instructional
    programming, teacher training programs and technical
    assistance.
        The Committee recognizes the efforts of the Star Schools
    Program to provide educational resources for traditionally
    underserved populations, including disadvantaged, illiterate,
    and limited-English proficient persons, and individuals with
    disabilities through the use of distance learning technologies.
    The Committee is aware of the following projects and encourages
    the Department to give them full and fair consideration:
        The Florida School Net at the Florida Department of
    Education has developed an on-line web site to provide
    comprehensive information to Florida parents, teachers and
    school administrators interested and involved in school and
    community partnerships dedicated to student achievement.
        The Committee continues to be supportive of innovative
    voice-video-data systems that will enable institutions of
    higher education to extend their reach into K-12 education with
    programs such as teacher training, access to faculty,
    libraries, and research facilities, and distance learning
    opportunities for students. Rutgers--The State University of
    New Jersey has been a particular leader in this field.
        Interactive statewide educational networks provide great
    promise for expanding access to high quality academic programs
    for all students, especially students in rural areas as
    demonstrated by the Iowa Communications Network, which now
    includes nearly 700 interactive classrooms throughout the
    State. However, few are located in elementary or middle schools
    and assistance is needed to bring these schools on-line. These
    connections would provide elementary and secondary schools with
    high-speed Internet access; desktop conference capabilities;
    and connections to digital libraries, teacher training and
    other educational resources.
        The Vermont Institute of Science, Math and Technology and
    the Vermont Department of Education have developed the
    statewide Vermont Distance Learning Project.
        The New Mexico Department of Education will create a
    dynamic student-centered learning environment utilizing
    advanced technologies to provide all New Mexico students with
    access to a strong academic foundation.
        The Illinois Century Network is being developed by the
    Federation of Illinois Colleges and Universities to establish a
    high bandwidth network and implement training programs to link
    all Illinois educational institutions.

    Ready to learn television

        The Committee recommends an appropriation of $16,000,000
    for the ready to learn television program, the same amount as
    the fiscal year 2000 level and the administration request.
        This program has supported 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 supported the development, production, and
    dissemination of educational materials designed to help
    parents, children, and caregivers obtain the maximum advantage
    from educational programming. Since its inception in 1994,
    participation in the program has grown from 10 to 132 local
    public television stations. Local educational workshops have
    reached approximately 5 million children, and research
    indicates that the program is meeting its goals in encouraging
    family literacy activities. Funding will support the growth in
    demand for local educational activities, improve training for
    professional caregivers, provide new Spanish language
    translations of children's programs, enhance the internet
    components of the program, and demonstrate the use of digital
    broadcasting to provide programming and training to underserved
    populations.

    Telecommunications demonstration project for mathematics

        The Committee recommends $8,500,000 for the continuation of
    this PBS initiative called Mathline, $8,500,000 more than the
    amount recommended by the administration and the same as the
    fiscal year 2000 comparable amount. 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.
        The administration requested $5,000,000 for the proposed
    Telecommunications Program for Professional Development in
    fiscal year 2001. The proposal is similar to the current
    authorization for Mathline, except that it would broaden the
    focus to include core content areas and expand the category of
    eligible partner agencies. The Committee defers action on this
    proposal pending reauthorization of elementary and secondary
    education programs.
        The Mathline program provides state-of-the-art training for
    math teachers through video, print, and online, leader-led,
    group discussions. The Committee is pleased with the
    independent research that indicates that teachers value the
    program highly because it allows them to improve their teaching
    skills on their own schedules, and it breaks down the isolation
    of the classroom. The project has begun to expand to pre-
    service, as well as in-service teacher training in technology
    through the existing PBS satellite links at colleges and
    schools across the country. The Committee is encouraged by the
    effectiveness of the program and its potential to reach most of
    our nation's current teachers, as well as those undergoing
    training in colleges and universities.
        Funding is needed to expand the program to reach 30,000
    teachers directly, make additional resources available online
    and on-demand through new school networks, update materials for
    new mathematics teaching standards, and continue to offer pre-
    service and in-service training in the use of technology in the
    classroom.

    21st Century Community Learning Centers

        The Committee recommends an appropriation of $600,000,000
    for the 21st Century Community Learning Centers program, an
    increase of $146,623,000 over the comparable level for 2000 and
    $400,000,000 below the administration request.
        The Committee has included bill language permitting funds
    to be provided to community-based organizations that,
    individually or in partnership with a school district, apply
    for funding for activities authorized under this program.
        The Committee urges the Department to support projects that
    emphasize safety, crime awareness, and substance abuse
    prevention in their after-school plans. The Committee provides
    an additional $146,623,000 for the 21st Century Community
    Learning Centers Program to conduct programs that include such
    activities as part of the Youth Violence Prevention Initiative.
        The purpose of the program is to support rural and inner-
    city public elementary and secondary schools, or consortia of
    such schools, to implement or expand projects that benefit the
    educational, health, social service, cultural, and recreational
    needs of the community.
        The Committee has been alerted to the increasing demands
    made by parents and school administrators for after-school
    programming and encourages local innovation to remedy the
    multitude of social problems that arise after school hours. The
    Committee encourages the Secretary to target funds to areas of
    high need that have low-achieving students and lack resources
    to establish after-school centers. The Committee notes that
    successful after-school programs often combine academic
    enrichment, through the use of supplementary educational
    materials and instruction, with other extracurricular
    activities.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The SafeKids initiative in South Bend, Indiana, a
    collaboration between the City of South Bend, the Boys and
    Girls Club and the South Bend School Corporation will support
    extended learning opportunities for area youth.
        Fayette County Public Schools has developed an innovative
    approach to addressing the educational, health, cultural and
    recreational needs of the community.
        The Schools Uniting Neighborhoods (SUN), Portland program
    provides educational and social support to students in the
    Portland, Oregon area.
        In partnership with the Boys and Girls Clubs of
    Springfield, the Discovery Center in Springfield, Missouri will
    expand after school science education programs provided to at
    risk youth.
        The City of Cranston, Rhode Island has formed a successful
    partnership with the Cranston Public Schools, the YMCA, and the
    ``Teen Center'' to enhance the use of technology offered in
    after school programs and will ensure that parents are full
    participants in this innovative arrangement.
        The 21st Century Learning Center in Macon, Georgia has
    contributed significantly to supporting safer learning
    environments, to reducing juvenile crime, and helping bridge
    the digital divide.
        The ARC of East Central Iowa is developing a promising
    project in Cedar Rapids which will provide a comprehensive
    center designed to meet the learning, medical and day care
    needs of children and adolescents with disabilities.
        John A. Logan College plans to enhance the educational and
    social support provided to the community through development of
    a community learning center.
        The Right Start program proposed by the State of Alaska
    will help kindergarten-age schoolchildren prepare for success.
    The program will provide extended day programs for young
    children who are behind expected developmental levels and will
    hire academic intervention program coordinators.
        The Boys and Girls Club of Palmer and Wasilla have proposed
    an outreach program to provide before and after-school programs
    for four schools in the Mat-Su Valley, including a summer
    school element, to ensure that children residing in the rural
    Mat-Su Valley region of Alaska have access to high quality
    before and after school care.

    Small, Safe and Successful High Schools

        The Committee defers actions on this proposal pending the
    outcome of the reauthorization of elementary and secondary
    education programs. The administration requested $120,000,000
    for this new program for fiscal year 2001. This new initiative
    would allow the Department to make competitive grants to local
    educational agencies on behalf of the high schools that they
    serve to assist them in implementing smaller, safer learning
    environments. Two types of grants would be made under this
    program: planning award to assist schools with developing an
    approach for creating smaller learning environments; and
    implementation awards for schools that have developed an
    approach and generated requisite community support.

                        Education for the Disadvantaged

    Appropriations, 2000....................................  $8,700,986,000
    Budget estimate, 2001...................................   9,149,500,000
    Committee recommendation................................   8,986,800,000

        The Committee recommends an appropriation of $8,986,800,000
    for education for the disadvantaged. This is $285,814,000 more
    than the fiscal year 2000 appropriation and $162,700,000 less
    than the administration request. In fiscal year 2000
    $6,204,763,000 was made available for this account in fiscal
    year 2001 funds. This year, the Committee recommendation
    includes $6,223,342,000 in advance funding.
        Programs financed under this account are authorized under
    title I 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 [LEAs] 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 most of these programs 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 LEAs.
        The Committee recognizes that elementary and secondary
    education programs authorized by the Elementary and Secondary
    Education Act of 1965, as amended, currently are under
    consideration for reauthorization. Until this process is
    completed, appropriations generally will be made consistent
    with the current authorization for these programs. The
    Committee defers action on all new programs proposed by the
    Administration pending reauthorization of elementary and
    secondary education programs.

    Grants to local educational agencies

        Title I grants to local educational agencies provide
    supplemental education funding to LEAs 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 11 million
    children. The formula for basic grants is based on the number
    of children from low-income families in each LEA, weighted by
    per-pupil expenditures for education in the State. The
    Department makes Federal allocations to the LEA level. States
    have the option to reallocate funds to LEAs serving areas with
    fewer than 20,000 residents 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 LEAs 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 $7,113,403,000. This amount is
    $330,403,000 more than appropriated in fiscal year 2000 and
    $1,430,303,000 more than the budget request.
        The Committee has provided no funding for the targeted
    grants program. The administration requested $1,671,500,000 for
    this program which distributes funds in a manner that provides
    higher per-child amounts for LEAs with the highest percentage
    of poor children.
        The Committee recommends $1,222,397,000 for concentration
    grants, $64,000,000 more than the amount appropriated in fiscal
    year 2000 and $219,497,000 more than the budget request. Funds
    under this program are distributed according to the basic
    grants formula, except that they only go to LEAs where the
    number of poor children equals at least 6,500, or 15 percent,
    of the total school-aged population. Approximately 66 percent
    of LEAs nationally receive funds.
        The Committee has included hold harmless bill language for
    local educational agencies that would be affected by the use of
    updated census data in making Concentration Grants awards for
    academic year 2001-02. The Committee has also included bill
    language clarifying that any funds appropriated in excess of
    the fiscal year 2000 appropriation for Title I basic and
    concentration grants be used first to fund the hold harmless
    provision, and then be allocated to LEAs in accordance with the
    Title I statutory formula. The Committee recommendation
    provides $58,400,000 to accommodate the estimated effect of the
    hold harmless provision.
        The Department of Education Appropriations Act, 2000 also
    set aside $134,000,000 within the appropriation for the Title I
    basic grant program for States to help schools in improvement
    status increase student achievement through various mechanisms,
    including public school choice. The Administration requested a
    $250,000,000 set aside for fiscal year 2001. The Committee
    defers action on this proposal pending reauthorization of
    elementary and secondary education programs.

    Capital expenses for private school students

        The Committee recommends $6,000,000 for the capital
    expenses program, a decrease of $6,000,000. The Administration
    has requested no funds and has proposed eliminating the
    program. It has been brought to the Committee's attention that
    several states require continued assistance under this program
    and in some cases, states have declared a need for additional
    funds to cover administrative costs incurred in serving private
    school students.
        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
    $185,000,000, an increase of $35,000,000 above the fiscal year
    2000 appropriation and 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 and Family Literacy 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, 40
    percent in the fourth year, 50 percent in years 5 through 8,
    before reaching a cap of 65 percent after 8 years.

    Migrant

        For the State agency migrant program, the Committee
    recommends $380,000,000, an increase of $25,311,000 over the
    amount appropriated in fiscal year 2000 and the same as the
    budget request.
        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 624,000 migrant
    students; however, 720,000 are eligible to receive services and
    that number is increasing since states have been actively
    identifying and recruiting migrant children into educational
    programs.
        This appropriation also supports activities to improve
    interstate and intrastate coordination of migrant education
    programs.

    Neglected and delinquent

        The Committee recommends $50,000,000 for the title I
    neglected and delinquent program, an increase of $8,000,000
    more than amount recommended by the administration and the 2000
    fiscal year level. The Committee recognizes this program as an
    essential component of the Youth Violence Prevention
    Initiative.
        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 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.

    Evaluation

        The Committee bill includes no funds for title I evaluation
    activities, $8,900,000 less than the amount appropriated in
    fiscal year 2000. The administration did not request any funds
    for evaluation within this line item. Under its reauthorization
    proposal and fiscal year 2001 budget, set asides are
    established within each individual program's appropriation. The
    Committee defers actions on this proposal pending
    reauthorization of elementary and secondary education programs.
        Evaluation funds are used to support large-scale national
    surveys that examine how the title I program is contributing to
    student performance.

    Comprehensive school reform

        The Committee recommends no funds for the comprehensive
    school reform program which was created through the fiscal year
    1998 appropriations act and is funded under the title I
    demonstration authority. The administration requested
    $190,000,000 for this purpose in fiscal year 2001. This program
    provides schools with funding to develop or adopt, and
    implement, comprehensive school reforms based on reliable
    research and effective teaching practices.

    High school equivalency program

        The Committee bill includes $20,000,000 for the high school
    equivalency program [HEP]. This amount is $5,000,000 more than
    the amount appropriated in fiscal year 2000 and the same as the
    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 serves
    about 6,000 migrants.

    College assistance migrant program

        For the college assistance migrant program [CAMP], the
    Committee recommends $10,000,000, an increase of $3,000,000
    over the fiscal year 2000 appropriation and the same as the
    amount requested by the administration.
        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 serves about 1,000 students.

                                   impact aid

    Appropriations, 2000....................................    $906,452,000
    Budget estimate, 2001...................................     770,000,000
    Committee recommendation................................   1,030,000,000

        The Committee recommends an appropriation of $1,030,000,000
    for impact aid for the Department of Education. This amount is
    $123,548,000 above the 2000 appropriation and $260,000,000
    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 1,400 school districts
    will receive payments on behalf of 1.2 million eligible
    children.
        The Committee recognizes that the Impact Aid program is
    under review as part of reauthorization of the Elementary and
    Secondary Education Act of 1965, as amended. The Committee
    defers actions on the Administration proposals for this program
    pending the outcome of the reauthorization of elementary and
    secondary education programs.
        Basic support payments.--The Committee recommends
    $818,000,000 for basic support payments, $80,800,000 more than
    the amount appropriated in fiscal year 2000 and $98,000,000
    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
    $50,000,000 for this purpose, the same as the 2000 level and
    $10,000,000 more than the administration request.
        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 $82,000,000, an
    increase of $9,800,000 over the amount appropriated in fiscal
    year 2000. No funds were requested by the administration for
    this activity.
        Facilities maintenance.--This activity provides funding for
    maintaining certain school facilities owned by the Department
    of Education. The Committee recommends $8,000,000 for this
    purpose in fiscal year 2001, $3,000,000 more than the budget
    request and the amount appropriated in fiscal year 2000.
        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 $25,000,000 for this
    program, $14,948,000 more than the amount appropriated in
    fiscal year 2000 and $20,000,000 more than requested by the
    administration.
        The Committee is aware of conditions at the Cannon Ball
    Elementary School, one of two schools that comprise the Solen,
    North Dakota school district. The school, which is located on
    the Standing Rock Sioux Reservation is more than 70 years old,
    with classrooms and other school facilities inadequate to
    support an environment conducive to learning. The Committee
    encourages the Department to provide assistance to the school
    district to remedy this situation.
        The Committee recognizes that the Harlem Elementary School
    in Harlem Public School District, Montana serves students in
    drastically deteriorating facilities and portable classrooms
    that are not conducive to student learning. The Committee
    encourages the Department to work with the school district to
    identify possible solutions to this situation.
        The Committee is aware that Brockton School in Montana is
    experiencing significant problems with its K-8 facility,
    including a leaking roof, faulty boilers, deteriorating pipes
    and plumbing, and asbestos removal. These conditions at
    Brockton School need to be remedied in order to promote the
    academic success of its students. The Committee encourages the
    Department to provide assistance to the Brockton School in
    identifying appropriate measures to improve the learning
    environment at the school.
        The Committee understands that schools of the Knob Noster
    and Waynesville Public School systems are in need of
    improvement given the increasing student population related to
    the military presence on the military bases of Whiteman Air
    Force Base and Fort Leonard Wood. The Committee urges the
    Department to work with the school districts to explore
    potential solutions that will provide an appropriate
    educational environment for students attending school in these
    districts.
        The Committee is aware of the critical construction needs
    for a new high school in the City of Craig, Alaska. The
    Committee requests that the Department work with this school
    district to address this issue and ensure that all possible
    solutions are explored.
        It has come to the Committee's attention that schools in
    the Eminence R-1 School District in Missouri are in urgent need
    of upgrade and expansion. The high school building that serves
    the district was constructed in 1910 and the cafeteria is
    capable of handling just one-third of the students at any one
    time. The Committee requests that the Department provide
    assistance to the School District in addressing this issue.
        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
    $47,000,000 for this activity in 2001, $15,000,000 more than
    the fiscal year 2000 amount. No funds were requested by the
    administration for this activity.
        The Committee is aware of the unique circumstances that the
    Kadoka School District in Jackson County, South Dakota faces in
    proving eligibility for an appropriate level of funding for
    this program. Over time, the consolidation of two counties that
    form the current school district boundaries and the transfer of
    land ownership have made it difficult to produce the
    documentation required to prove eligibility for the all of the
    property within the school district's boundaries. The Committee
    encourages the Department to work with the school district and
    local officials to address this situation.

                          school improvement programs

    Appropriations, 2000....................................  $3,006,884,000
    Budget estimate, 2001...................................   3,869,034,000
    Committee recommendation................................   4,672,534,000

        The Committee recommends an appropriation of $4,672,534,000
    for school improvement programs. This amount is $1,665,650,000
    more than the 2000 appropriation and $803,500,000 more than the
    administration's request.

    Teaching to High Standards

        The Committee defers action on this proposal pending the
    outcome of reauthorization of elementary and secondary
    education programs. The administration requested $690,000,000
    for the proposed Teaching to High Standards State grants
    program for fiscal year 2001. This new program would replace
    the Eisenhower Professional Development State Grants program,
    and distribute funds by formula to State educational agencies.
    Grants would support State and local efforts to align curricula
    and assessments with content standards, and provide teachers
    with high quality professional development in the core academic
    subjects.
        Eisenhower professional development State grants.--The
    Committee recommends $435,000,000 for Eisenhower professional
    development State grants, $100,000,000 more than the fiscal
    year 2000 appropriation. 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.
        The Committee emphasizes the priority of professional
    development in the fields of Math and Science. It also
    encourages state and local educational agencies to scrutinize
    the appropriateness and quality of training in all fields to be
    funded by this program.

    School Leadership Initiative

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $40,000,000 for a new School
    Leadership Initiative. This new program is designed to provide
    professional development opportunities to current and
    prospective school administrators through a network of
    leadership development centers established by program grantees.

    National Activities for the Improvement of Teaching and School
            Leadership

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $25,000,000 for the proposed
    National Activities for the Improvement of Teaching and School
    Leadership program. This initiative would replace the
    Eisenhower Professional Development Federal Activities program.
    The proposed program seeks to provide Federal leadership in
    support of improvement in classroom instruction so that all
    students are prepared to meet challenging State content and
    student performance standards in the core academic areas.

    Hometown Teachers

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $75,000,000 for the proposed
    Hometown Teachers initiative. This new program would provide
    competitive grants to high-poverty school districts to develop
    a comprehensive approach to teacher recruitment and retention.

    Higher Standards, Higher Pay

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $50,000,000 for a new initiative
    on Higher Standards, Higher Pay. This new program would provide
    competitive grants to high-poverty school districts to help
    them attract and retain high-quality teachers and principals by
    increasing pay for all teachers in school districts that formed
    partnerships that design and implement reforms to raise teacher
    performance.

    Teacher Quality Incentives

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $50,000,000 for the new Teacher
    Quality Incentives program. The purpose of this new initiative
    is to provide monetary rewards to school districts in high-
    poverty areas for increasing the percentage of certified
    teachers and decreasing the percentage of teachers who are
    teaching out of field.

    Transition to Teaching: Troops to Teachers

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $25,000,000 for the new Transition
    to Teaching: Troops to Teachers program. This new proposal
    would authorize the Secretary of Education to award grants or
    contracts to institutions of higher education, public agencies
    and nonprofit organizations to recruit, prepare, place and
    support mid-career professionals for teaching positions in
    high-poverty school districts.

    Early Childhood Educator Professional Development

        The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
    The administration requested $30,000,000 for the proposed Early
    Childhood Educator Professional Development program. This new
    initiative would award competitive grants to improve the
    knowledge and skills of early childhood educators and
    caregivers who work in communities with high concentrations of
    young children living in poverty.
        Innovative education program strategies State grants.--The
    Committee recommends $3,100,000,000, of which $2,585,000,000
    will become available on October 1, 2001 for innovative
    education program strategies State grants. This represents an
    increase of $1,434,250,000 over the 2000 level. 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.
        Within the Committee recommendation, $2,700,000,000 has
    been provided under the title VI block grant for purposes
    consistent with Title VI to be determined by the local
    education agency as part of a local strategy to help improve
    academic achievement of students. Funds may also be used to
    address the shortage of highly qualified teachers to reduce
    class sizes, particularly in early grades, using highly
    qualified teachers to improve educational achievement for
    regular and special needs children; to support efforts to
    recruit, train and retrain highly qualified teachers; or for
    renovating and constructing school facilities. It shall be the
    sole discretion of the LEA to determine how best to use these
    funds.

    Safe and drug free schools and communities

        The Committee remains extremely concerned about the
    frequent and horrific occurrence of violence in our Nation's
    schools. Last year, the Committee provided $163,000,000 within
    this account for a school violence prevention initiative. As
    part of an enhanced and more comprehensive effort, the
    Committee has provided $195,000,000 within the safe and drug
    free schools and communities program to support activities that
    promote safe learning environments for students. Such
    activities should include: targeted assistance, through
    competitive grants, to local educational agencies for community
    wide approaches to creating safe and drug free schools; and
    training for teachers and school security officers to help them
    identify students who exhibit signs of violent behavior, and
    respond to disruptive and violent behavior by students. The
    Committee continues to encourage the Department to coordinate
    its efforts with children's mental health programs.
        The Committee urges the Department to include in its
    research on risk behavior, students from both the elementary
    and secondary grades. The Committee also urges the Department
    to expand studies to include research on gambling attitudes and
    behavior.
        State grant program.--The Committee bill provides
    $447,000,000 for the safe and drug free schools and communities
    State grant program. The amount recommended is $7,750,000 more
    than the fiscal year 2000 appropriation and the budget request.
    Of the funds provided, $330,000,000 will become available on
    October 1, 2001 for the 2001-02 academic year.
        National programs.--The Committee has included $145,000,000
    for the national programs portion of the safe and drug free
    schools program, $5,750,000 less than the budget request and
    $34,250,000 more than the fiscal year 2000 appropriation. The
    Committee has provided resources for this program as part of
    its youth violence prevention initiative. Funds for this
    program are used for discretionary grants, joint projects with
    other Federal agencies, development and dissemination of
    materials, data collection and evaluation and a variety of
    other activities designed to improve the field of drug and
    violence prevention at the elementary and secondary school
    level. Discretionary grants also are provided for campus-based
    projects.
        The Committee is aware of the increasing problem of alcohol
    and drug abuse on college campuses, and therefore, has included
    $850,000 to continue the National Recognition Awards program
    under the same guidelines outlined by Section 120(f) of Public
    Law 105-244. This amount is the same as the administration
    request and the fiscal year 2000 level. This program identifies
    and provides models of alcohol and drug abuse prevention and
    education programs in higher education. The Committee
    encourages the Secretary to make fiscal year 2001 awards to
    institutions of higher education not having received an award
    in the fiscal year 2000 competition.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The SAFE HAVENS Training Project provides child care givers
    with the necessary tools and skills to mitigate the effects of
    violence through a video-based training program and workshops.
    SAFE HAVENS will expand its program to teach caregivers in more
    States across the country about children's responses to
    violence and practical strategies to supporting both children
    and co-workers, beginning with a demonstration program
    involving the States of Pennsylvania, Mississippi,
    Massachusetts, Missouri, and California.
        Ashland Community College and Southern Oregon University
    continue efforts to research and pilot a comprehensive program
    for preventing alcohol and drug use.
        The Montana Division of Educational Research and Service
    and the Board of Crime Control will collaborate to facilitate a
    statewide community-based curriculum development initiative
    that promotes responsible behavior and prevents violence in
    schools.
        The National Youth Safety Corps, a partnership program
    involving the National Crime Prevention Council and the Crime
    Prevention Coalition of America, will be piloted in 4 States:
    Nevada, Illinois, Iowa, and Texas, and is designed to improve
    the learning environment of America's schools by implementing
    youth crime, violence, and drug abuse prevention strategies.
        The Fairfax County Public School system, in collaboration
    with Fairfax County Police Department, are developing an
    innovative, automated system for improving coordination and
    information sharing in order to improve school safety.

    Coordinator initiative

        The Committee has included $50,000,000 for the Coordinator
    Initiative. This is the same as the fiscal year 2000
    appropriation and the budget request. The Committee has
    provided resources for this program as part of its youth
    violence prevention initiative. The Committee recommendation
    will enable the Department to provide assistance to LEAs to
    recruit, hire, and train drug prevention and school safety
    program coordinators in middle schools with significant drug
    and school safety problems. These coordinators will be
    responsible for developing, conducting and analyzing
    assessments of their school's drug and crime problems, and
    identifying promising research-based drug and violence
    prevention strategies and programs to address these problems.

    Project SERV

        The Committee has deferred action for the new Project SERV
    (School Emergency Response to Violence), pending enactment of
    authorizing legislation. The administration requested
    $10,000,000 for this purpose in fiscal year 2001.
        Under this initiative, the Department would collaborate
    with the Departments of Justice and Health and Human Services
    and the Federal Emergency Management Administration to help
    school districts respond to major crises.

    Inexpensive book distribution

        For the inexpensive book distribution program, the
    Committee provides $23,000,000, an increase of $3,000,000 over
    the 2000 appropriation and the amount recommended by the
    administration. The increase has been provided as part of the
    Committee's youth violence prevention initiative. This program
    is operated by Reading Is Fundamental [RIF], a private
    nonprofit organization associated with the Smithsonian
    Institution. RIF supports over 5,600 projects at over 26,000
    sites to distribute books to children from low-income families
    to help motivate them to read. In 2000, an estimated 10.8
    million books will be distributed to 3.4 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. As mentioned earlier, the Committee believes that
    literacy promotion is important to preventing violence among
    youth.

    Arts in education

        For the arts in education program, the Committee recommends
    $18,000,000, an increase of $6,500,000 more than the 2000
    appropriation and $5,000,000 less than the administration
    request. The amount recommended will support grant awards:
    $6,500,000 for a grant to USAarts which supports the
    development of programs to integrate the arts into the lives of
    children and adults with disabilities; and $5,500,000 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, and for
    youth violence prevention activities. Funds provided in this
    account also support model professional development activities
    to support the increasing demand for arts and music teachers.
        The Committee has provided sufficient resources for
    additional grants to support programs targeting youth violence,
    delinquency and substance abuse, both in-school and during the
    after school hours, through innovative arts programming and
    youth arts education initiatives.
        The Committee is aware that recent data and empirical
    evidence indicate that specific instruction in music, art, and
    dance improves the success of K-12 students. The Committee
    supports grants, authorized under this program, to eligible
    recipients for: the development and implementation of
    curriculum frameworks for arts education; the development of
    model preservice and inservice professional development
    programs for arts educators and other instructional staff;
    specific instruction in music, art, theatre, and dance; the
    development of model arts education assessments based on high
    standards; and supporting model projects and programs to
    integrate arts education into the regular elementary and
    secondary school curriculum. The Committee encourages the
    Department to give full and fair consideration to proposals
    from any Mississippi LEA, and Mississippi State and local arts
    agency implementing the Whole Schools Program model and
    training provided by the Mississippi Arts Commission.
        The Committee recognizes the merits of the Kennedy Center
    working with the Salt Lake Organizing Committee in creating a
    National Commission and participating in the Olympic
    Imagination Celebration for the Winter Olympic and Paralympic
    Games of 2002.

    Magnet schools assistance

        For the magnet schools assistance program, the Committee
    bill provides $110,000,000, the same as the amount recommended
    by the administration and the 2000 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.
        Within the amount provided, the Committee has included
    $5,000,000 for innovative programs, the same as the budget
    request and the fiscal year 2000 appropriation.
        Fiscal year 2001 marks the beginning of a new round of
    competition for Magnet School grant awards. The Committee is
    aware that the Yakima, Tacoma and Seattle School Districts will
    be applying for grant awards to continue the education reform
    that began with a previous Magnet School grant. The Committee
    urges that full and fair consideration be given to these grant
    requests.

    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 $31,700,000, an increase of $2,900,000
    over the fiscal year 2000 amount and the same as 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 $3,000,000 for the women's
    educational equity program, the same as the fiscal year 2000
    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 2000 appropriation and the
    administration's request.
        The funds provided will continue the 10 regional equity
    assistance centers [EACs] formerly known as regional
    desegregation assistance centers. Each EACs provides services
    to school districts upon request. Activities include
    disseminating information on successful practices and legal
    requirements related to nondiscrimination on the basis of race,
    color, sex, or national origin in education programs. 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 2000 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 $28,000,000, which is $5,000,000 above
    the 2000 appropriation and the administration request.
        Education for Native Hawaiians.--The programs for the
    education of native Hawaiians, the Committee bill includes
    $28,000,000. The Committee urges the Department when allocating
    these funds to provide the following: $6,500,000 for curricula
    development, teacher training, and recruitment programs,
    including native language revitalization and encourages
    priority be given to the University of Hawaii at Hilo Native
    Language College, aquaculture, prisoner education initiatives,
    waste management, computer literacy, big island astronomy, and
    indigenous health programs; $1,600,000 for the community based
    learning centers; $3,200,000 for the Hawaii higher education
    program; $2,700,000 for the gifted and talented programs;
    $2,600,000 for the special education programs; $500,000 for the
    native Hawaiian education councils, $10,900,000 for family
    based education centers, including early childhood education
    for native Hawaiian children.
        Child Literacy Initiative.--The Committee is concerned that
    Hawaiian students are significantly behind in quantitative
    literacy and encourages teachers to promote teacher training in
    this area. The Committee is aware that the Hawaii State
    Department of Education, the American Statistical Association,
    and the Kamehameha school district have collaborated to design
    and implement workshops for teachers in quantitative.
        Education for Native Hawaiians in Agriculture and
    Business.--The Committee supports the expansion of the
    partnerships between community-based agricultural businesses
    and cooperating Hawaii high schools where agricultural and
    business practices are integrated into the curriculum,
    resulting in hands-on agribusiness training, exposure to
    entrepreneurship, and marketable products. For timely and
    efficient use of these funds, the Committee recommends that the
    funds be administered by the Economic Development Alliance of
    Hawaii, a not for profit corporation capable of administering
    Federal funds.
        Education for Native Hawaiians in Community Education.--The
    Committee is aware of the Malama Hawaii initiative and the
    effort to provide for community education programs that address
    issues of education, health, justice, environment, culture, and
    the economy through experiential and outdoor education programs
    that involve children, youth and families. These community-led
    outreach projects foster community stewardship of geographic
    areas and natural resources employing cultural practices and
    protocols in programs that train formal and informal teachers
    to educate others about critical issues facing the Hawaii
    community, and through interpretive programs that educate the
    public and increase appreciation and support for significant
    cultural and natural heritage sites. The Committee recommends
    that $300,000 be made available in fiscal year 2001 under the
    authority of the Native Hawaiian Education Act for the Malama
    Hawaii Community Education Initiative.
        Native Hawaiian agriculture partnership.--The Committee is
    aware of the dismal economic and social conditions in the rural
    areas of Hawaii resulting from the closure of several sugar
    cane plantations that formerly provided infrastructure for
    these communities. The Committee favors and continues to
    support the expansion of the partnerships between community-
    based agricultural businesses and cooperating high schools,
    where agricultural and business practices are integrated into
    the curriculum and products that are ultimately purchased by
    the cooperating businesses.
        Computer literacy and access for Hawaiian and part-Hawaiian
    children.--The importance of literacy for success in school has
    been clearly demonstrated. Disadvantaged native Hawaiian and
    part-Hawaiian children struggle for opportunities. The
    Committee urges that students interested in becoming elementary
    and high school teachers be strongly encouraged to pursue these
    fields of study.
        Indigenous health.--The Native Hawaiian Health Care
    Improvement Act provides authority for inclusion of native
    Hawaiian traditional healers in the comprehensive health care
    delivery system. There is similar recognition of traditional
    healing within the Indian Health Service health care delivery
    system. Because of a lack of available instruction in
    traditional medicine, this knowledge is being lost for younger
    generations of native Americans and native Hawaiians. The
    Committee is aware of the benefits of educating health care
    practitioners in traditional medicines and techniques in native
    Indian and native Hawaiian communities.
        Hawaii Marine Resource Management.--The Committee notes
    that the Hui Malama o Mo'omoni has been working to document the
    traditional fishery management techniques used in the Hawaiian
    culture. These techniques have both scientific and cultural
    relevance to the efficient management of Hawaii's marine
    resources. The Committee understands the value of a community-
    based outreach program that could teach Hawaiian children these
    traditional marine management practices and recognizes the
    expertise that Hui Malama o Mo'omoni and their consortium
    partners have in this area.

    Alaska Native educational equity

        The Committee recommends $15,000,000 for the Alaska Native
    educational equity assistance program, authorized under title
    IX, part C, of the Elementary and Secondary Education Act. This
    amount is $2,000,000 over the 2000 appropriation and the budget
    request. Additional funds in fiscal year 2001 will allow
    expansion of this program to include cultural education
    programs operated by the Alaska Native Heritage Center and for
    continued operation of the Rose program, including publication
    and distribution of literature, operated by the Alaska
    Humanities Forum to expose urban students to Native culture in
    rural Alaska. These funds address the severe educational
    handicaps of Alaska Native schoolchildren. Funds are used for
    development of supplemental educational programs to benefit
    Alaska Natives. The Committee directs the Department to consult
    with the Alaska Federation of Natives in developing criteria
    for grant proposals, in developing a simplified and streamlined
    application form, and in developing criteria for evaluating
    projects.
        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 that 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 $210,000,000 for support of
    charter schools, an increase of $65,000,000 over the 2000
    appropriation and $35,000,000 more than 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, not more
    than 2 years for the initial implementation of a charter
    school, and not more than 2 years to carry out dissemination
    activities.
        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.

    Opportunities to Improve Our Nation's Schools

        The administration requested $20,000,000 for the proposed
    Opportunities to Improve Our Nation's Schools program. Under
    this new initiative, the Department would make grants to States
    and local school districts to support innovative approaches to
    high-quality public school choice within school districts and
    States. The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.

    Comprehensive regional assistance centers

        The Committee recommends $28,000,000 for the comprehensive
    regional technical assistance centers. This recommendation is
    the same as the fiscal year 2000 level and will continue to
    fund all current activities. The administration recommended no
    funding 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, up to $750,000 is for an evaluation to collect
    performance indicator data that would improve the delivery of
    technical assistance centers.

    Strengthening Technical Capacity Grants

        The administration requested $38,000,000 for the new
    Strengthening Technical Capacity Grants program. The Department
    proposal would replace the Comprehensive Regional Assistance
    Center. This new proposal would make formula grants to States
    and the 100 LEAs with the largest number of children in poverty
    that would enable them to purchase appropriate technical
    assistance and strengthen their capacity to acquire and use it.
    The Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.

    Advanced placement test fees

        The Committee recommends $20,000,000 for the advanced
    placement test fees program, the same as the amount requested
    by the administration and an increase of $5,000,000 more than
    the amount appropriated in fiscal year 2000. 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. The Committee is aware
    of the benefits of Internet-based AP pilot programs in rural
    parts of the country or other underserved districts where
    students would otherwise not have access to AP instruction and
    encourages the Department to consider proposals that meet the
    needs of students in these areas of the country.

                               reading excellence

    Appropriations, 2000....................................    $260,000,000
    Budget estimate, 2001...................................     286,000,000
    Committee recommendation................................     286,000,000

        The Committee recommends $286,000,000 for Reading
    Excellence Act programs, $26,000,000 more than fiscal year 2000
    appropriation and the same as the budget request. These funds
    support reading and literacy grants to State and local
    educational agencies to build upon what they are already
    providing to promote literacy and to establish new efforts to
    link parents, teachers, trained reading professionals, and
    trained tutors in school, library, and community literacy
    efforts. In addition, the program includes an emphasis on
    improving the quality of teaching in the area through
    professional development and by using scientifically based
    reading research.

                                indian education

    Appropriations, 2000....................................     $77,000,000
    Budget estimate, 2001...................................     115,500,000
    Committee recommendation................................     115,500,000

        The Committee recommends $115,500,000 for Indian education
    programs, an increase of $38,500,000 above the fiscal year 2000
    appropriation and the same as the budget request.

    Grants to local education agencies

        For grants to local education agencies, the Committee
    recommends $92,765,000, an increase of $30,765,000 over the
    fiscal year 2000 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.

    Special programs for Indian children

        The Committee recommends $20,000,000 for special programs
    for Indian children, the same as the budget request and
    $6,735,000 above the amount appropriated in fiscal year 2000.
    Funds will be used for demonstration grants to improve Indian
    student achievement through early childhood and preschool
    education programs, and professional development grants for
    training Indians who are preparing to begin careers in teaching
    and school administration.

    National activities

        The Committee recommends $2,735,000 for national
    activities, the same as the budget request and $1,000,000 more
    than the fiscal year 2000 appropriation. Funds are used for
    research, evaluation, and data collection to provide
    information on the educational status for the Indian population
    and on the effectiveness of Indian education programs.

                               School Renovation

    Appropriations, 2000....................................................
    Budget estimate, 2001...................................  $1,300,000,000
    Committee recommendation................................................

        The Committee recommends no funding for the
    Administration's proposed School Renovation program. The
    Administration requested $1,300,000,000 for this purpose.
        Under the budget request, $50,000,000 would be available to
    118 LEAs with 50 percent or more of their children in average
    daily attendance residing on Indian lands. The budget request
    also requested $125,000,000 for direct grants and
    $1,125,000,000 in loan subsidies for other LEAs.

                       bilingual and immigrant education

    Appropriations, 2000....................................    $406,000,000
    Budget estimate, 2001...................................     460,000,000
    Committee recommendation................................     443,000,000

        The Committee recommends an appropriation of $443,000,000
    for bilingual and immigrant education. This is $37,000,000
    above the 2000 appropriation and $17,000,000 below 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. The Committee defers action on all new
    programs and programmatic changes proposed by the
    Administration pending reauthorization of elementary and
    secondary education programs.

    Instructional services

        The Committee bill includes $180,000,000 for bilingual
    instructional programs, $17,500,000 above the 2000 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, the same as the fiscal year 2000 appropriation and
    $2,000,000 less than 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.

    Professional development

        The Committee recommends $85,000,000 for professional
    development, an increase of $13,500,000 above the fiscal year
    2000 appropriation and $15,000,000 below the budget request.
        These funds support the training and retraining of
    bilingual education teachers and teacher aides, graduate
    fellowships related to the field 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 the
    fiscal year 2000 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
    educational 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 $14,000,000 for competitive
    foreign language assistance grants, $6,000,000 above the amount
    appropriated in fiscal year 2000 and the same as the amount
    requested by the administration. This activity provides grants
    to increase the quantity and quality of instruction in foreign
    languages.
        The Committee notes the lack of Federal incentives to
    provide adequate instruction in second language acquisition to
    elementary and secondary students. Recent research shows that
    the optimum human learning time for all languages is between
    birth and age 10. The Committee is especially concerned that
    the nation's educational system is not meeting a critical need
    for speakers of foreign languages to fill sensitive Federal
    agency jobs, and is not preparing enough students to face an
    internationally competitive business environment.
        The Committee supports an increase in funding for this
    program by $6,000,000 for total funding in fiscal year 2001 of
    $14,000,000 to help encourage local and State school agencies
    to meet the challenges of foreign language instruction.
    However, the Committee is distressed that the only Federal
    program designed to help schools meet this need is unavailable
    to the poorest schools. The Administration's description of the
    continuation of this program does not include incentive grants
    for initiating elementary level programs and nor does it
    provide special assistance to needy schools. The Committee
    encourages the Secretary to utilize his ability to waive the
    matching requirement for qualifying schools and to increase
    awareness of this accommodation among the affected school
    population.

                               Special education

    Appropriations, 2000....................................  $6,036,196,000
    Budget estimate, 2001...................................   6,368,841,000
    Committee recommendation................................   7,352,341,000

        The Committee recommends a program level of $7,352,341,000
    for special education. This is $1,316,145,000 more than the
    2000 appropriation and $983,500,000 above the administration
    request. This amount includes $4,624,000,000 advance funded in
    fiscal year 2002.
        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 programs that provide a
    streamlined structure to help States improve educational and
    early intervention results for children with disabilities.

    Grants to States

        The Committee bill provides $6,279,685,000, including
    $4,624,000,000 in advanced funding for fiscal year 2002 for
    special education grants to States. The amount recommended is
    $1,290,000,000 more than the fiscal year 2000 appropriation and
    $1,000,000,000 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 15 percent of the estimated average per-pupil
    expenditure and 13 percent of excess costs, and would provide
    an estimated Federal share of $984 per child for the 6.4
    million children expected to receive special education
    services.

    Preschool grants

        The Committee recommends $390,000,000 for preschool grants,
    the same as the fiscal year 2000 appropriation and the budget
    request. The preschool grants 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 aged 3 through 5
    living in poverty.
        The amount provided by the Committee is approximately $672
    per child for the 580,500 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, cumulatively adjusted upward by the lesser of
    inflation or the percentage increase in the State's allocation,
    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; 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 $383,567,000 for the part C
    grants for infants and families program, an increase of
    $8,567,000 above the fiscal year 2000 appropriation and the
    same as 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 fiscal year 2000 appropriation and $10,000,000
    below the budget request. This 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.

    Research and innovation

        The Committee has included $74,433,000 for research and
    innovation, $10,000,000 more than the fiscal year 2000
    appropriation and the same as the budget request. This program
    supports competitive awards to produce and advance the use of
    knowledge to improve services and results for children with
    disabilities.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The Baird Center, Burlington, Vermont has developed
    programs that educate students with serious emotional and
    behavioral problems.
        The Yukon-Kuskokwim Community Parent Resource Center has
    developed an plan for utilizing distance communication
    technology to serve the parents of special education children
    in the Yukon-Kuskokwim area of western Alaska.
        The National Easter Seal Society and the Easter Seal
    Societies of Arkansas, Louisiana and Mississippi have targeted
    remote areas in the Mississippi Delta Region to improve early
    intervention and child development services.
        The Mat-Su Borough High School has developed a high-tech
    pilot program for special education high school students in the
    Borough to expose them to and provide training in technology-
    related career opportunities.
        The Texas A&M International Reading Research Center and
    Clinic in Laredo, Texas supports a dual-purpose reading
    research center and clinic, concentrating on reading
    disabilities and disorders experienced by language minority
    students.
        Children requiring special education in rural Alaska are
    frequently not able to access needed services because
    specialists in teaching learning disabled children are not
    located in these remote areas. Parents, Inc. in Alaska is
    developing a network of mobile video conferencing kits to bring
    expert trainers and specialists in special education to
    multiple remote sites in Alaska, and to train parents,
    facilitators and advocates who live in these remote sites in
    Alaska.

    Technical assistance and dissemination

        The Committee bill provides $45,481,000, the same as the
    fiscal year 2000 level and $8,000,000 less than the budget
    request. These funds provide 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.
        The Committee recognizes the efforts of the University of
    Northern Iowa, through its We Build Communications Access
    through Technology program, which seeks to provide technical
    information and support on accessing and using assistive
    technology for families of children and youth with
    disabilities.

    Personnel preparation

        The Committee recommends $81,952,000 for the personnel
    preparation program. The amount recommended is the same as the
    fiscal year 2000 appropriation and the budget request. Funds
    support competitive awards to help address State-identified
    needs for qualified personnel to work with children with
    disabilities, and to ensure that these personnel have the
    skills and knowledge they need to serve these children.
        The appropriation includes funds to provide preparation for
    personnel to serve children with 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 $26,000,000 for parent
    information centers, $7,465,000 more than the fiscal year 2000
    appropriation and the same as the budget request. This program
    makes awards to parent organizations to support parent training
    and information centers, including community parent resource
    centers. These centers provide training and information to meet
    the needs of parents of children with disabilities living in
    the areas served by the centers, particularly underserved
    parents, and parents of children who may be inappropriately
    identified.

    Technology and media services

        The Committee recommends $34,523,000 for technology and
    media services, $113,000 above the fiscal year 2000
    appropriation and same as the budget request. This program
    makes competitive awards to support the development,
    demonstration, and use of technology, and educational media
    activities of value to children with disabilities.
        The Committee recommendation includes $8,000,000 for
    Recording for the Blind and Dyslexic (RFB&D), an increase of
    $500,000 over the amount appropriated for fiscal year 2000.
    These funds support continued production and circulation of
    recorded textbooks, increased outreach activities to print-
    disabled students and their teachers, and accelerated use of
    digital technology. The Committee believes that the increase
    recommended will enable RFB&D to significantly expand its
    outreach activities, and to accelerate its efforts to digitize
    its vast storehouse of materials.

    Readline

        The Committee recommends $1,500,000 for the Readline
    Program. The amount recommended is the same as the fiscal year
    2000 appropriation for this activity. This activity is
    authorized by section 687(b)(2)(G) of the Individuals With
    Disabilities Education Act, as amended. The Committee
    recognizes the progress of the Readline Program, which is
    developing a wide range of media resources to 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. These resources include an
    extensive Internet website, videos, and programming for
    television and radio broadcast. The Committee includes funding
    for the continued development and distribution of media
    resources to reach the parents and teachers of children with
    reading disabilities.

                rehabilitation services and disability research

    Appropriations, 2000....................................  $2,706,989,000
    Budget estimate, 2001...................................   2,798,651,000
    Committee recommendation................................   2,799,519,000

        The Committee recommends $2,799,519,000 for rehabilitation
    services and disability research, $92,530,000 more than the
    2000 appropriation and $868,000 more than the administration
    request.

    Vocational rehabilitation State grants

        The Committee provides $2,399,790,000 for vocational
    rehabilitation grants to States, which is $60,813,000 more than
    the fiscal year 2000 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 significant 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 State's share is 50 percent
    for the cost of construction of a facility for community
    rehabilitation program purposes.
        The Rehabilitation Act requires that no less than 1.0
    percent and not more than 1.5 percent of the appropriation in
    fiscal year 2001 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 or near
    reservations.
        The Committee is concerned that the agency may be
    considering a change in policy which would result in
    prohibiting State vocational rehabilitation agencies from
    counting blind or visually impaired persons as successfully
    rehabilitated if they are placed in a noncompetitive
    environment, even if the individual made an informed choice to
    accept employment in a noncompetitive environment, at the
    Federal minimum wage or higher. Such a decision by the agency
    would result in thousands of blind and visually impaired
    persons at risk of loss of services. However, the Committee
    believes that if the blind or visually impaired individual
    makes an informed choice to accept employment in a
    noncompetitive environment, at the Federal minimum wage or
    higher, the placement should be treated the same as any other
    successful Rehabilitation Employment Placement, and urges the
    agency not to change existing policy.

    Client assistance

        The Committee bill recommends $11,147,000 for the client
    assistance program, an increase of $219,000 over the fiscal
    year 2000 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 that
    minimum grants of $100,000 are guaranteed to each of the 50
    States, the District of Columbia, and Puerto Rico and $45,000
    is guaranteed to each of the outlying areas, 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 2000 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, hard of hearing and deaf-blind.

    Demonstration and training programs

        The Committee bill includes $21,671,500 for demonstration
    and training programs for persons with disabilities, the same
    as the fiscal year 2000 appropriation and 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. Demonstration
    programs support projects for individuals with a wide array of
    disabilities.
        The Salt Lake Organizing Committee seeks to offer
    comparable programs and services for the VIII Paralympic Winter
    Games as those being planned for the 2002 Olympic Games. The
    Committee encourages the Department to help meet this objective
    by providing assistance with Paralympic planning and
    implementing programs, consistent with the goals of the
    Rehabilitation Act.
        The Committee is aware of the profound un-met need to
    upgrade and keep current the skills of the cadre of teachers
    across the country that teach visually impaired children and
    adults. This critical need can best be met by the establishment
    of a training center to support all the teachers of visually
    impaired children and adults across the nation. The National
    Literacy Center for the Visually Impaired in Atlanta, Georgia,
    a project associated with the American Foundation for the Blind
    is well suited to address this growing need.
        The Committee recognizes the unique and progressive work of
    the University of Southern Mississippi's Center for Literacy
    and Assessment. For over 30 years, this Center has served as
    the South's only comprehensive resource for reading disabled
    students. The National Reading Panel is currently assessing and
    establishing a measurable evaluation of current research based
    practices in the teaching of reading. In providing Federal
    assistance to broaden the scope of the Center to a national
    level, it is expected that it will use the information provided
    by the National Reading Panel. Reading difficulty is the most
    prevalent disability, and recent research by the National
    Institute of Health suggests that it is treatable, and most
    important, preventable in a large portion of the population.
    The Center will continue to increase its research
    dissemination, teacher and parent training, development of
    replicable models for reading assessment and intervention.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The Training, Research and Assistive Technology Center at
    the University of New Orleans has developed a model
    demonstration program for entrepreneurship training for
    disabled individuals.
        The Way Station, Inc. provides vocational programs for
    ethnically diverse disabled adults and after school programs
    for adolescents with serious emotional disturbances. The
    program also evaluates the efficacy of the application of
    technology in providing education and training to these
    individuals in order to identify better models for increasing
    academic and employment success.
        The National Research and Training Institute for the Blind
    (NRTIB) will support ongoing efforts to reduce the illiteracy
    rate among blind and visually-impaired children, encourage
    independent living among senior citizens losing vision, develop
    speech and Braille access technology, and reduce the 70 percent
    unemployment rate among blind people of working-age.
        The Lighthouse for the Blind, in Seattle, WA, plans to
    expand orientation and mobility services, assistive technology
    training and independent living services specifically for Deaf-
    Blind adults.
        The Virtual Reality-Based Education and Training for Deaf
    and Hearing Impaired Children and Adults Project allows hearing
    impaired children and adults to gain life experience skills
    through the use of virtual reality and military simulation
    technology. The project will also provide a medium for adults
    to acquire job skills and allow teacher training and
    professional development.

    Migrant and seasonal farmworkers

        The Committee recommends $2,850,000 for migrant and
    seasonal farmworkers, $500,000 more than the 2000 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, $925,000 less than the 2000 appropriation and the
    same as 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 $13,000,000 for protection and
    advocacy of individual rights, an increase of $1,106,000 over
    the 2000 appropriation and $868,000 more than 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 2000 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's bill includes $38,152,000 for the supported
    employment State grant program, the same as the 2000
    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.

    Independent living State grants

        The Committee recommends $22,296,000 for independent living
    State grants, which is the same as the amount appropriated in
    2000 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
    $58,000,000, which is $10,000,000 more than the 2000
    appropriation and the same as the budget request.
        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 $20,000,000 for independent living
    services to older blind individuals, an increase of $5,000,000
    above the 2000 appropriation and the administration request.
        States participating in the program must match every $9 of
    Federal funds with not less than $1 in non-Federal resources.
    Assistance is provided to persons aged 55 or older to adjust to
    their blindness, continue living independently and avoid
    societal costs associated with dependent care. Services may
    include the provision of eyeglasses and other visual aids,
    mobility training, braille instruction and other communication
    services, community integration, and information and referral.
    These services help older individuals age with dignity,
    continue to live independently and avoid significant societal
    costs associated with dependent care. The services most
    commonly provided by this program are daily living skills
    training, counseling, the provision of low-vision devices
    community integration, information and referral, communication
    devices, and low-vision screening. The Committee notes that
    there are 5 million Americans in this country age 55 and older
    who are experiencing vision loss and that the number of
    Americans in this category is expected to double in the next 30
    years. The Committee recognizes the very important and cost-
    effective work carried out through this program. By allowing
    older individuals to remain in their homes and communities,
    substantial savings are achieved. The Committee is informed
    that the yearly savings to society for just ten percent of the
    clients now receiving independent living services is
    $56,000,000. The Committee believes this program is deserving
    of future increases.

    Program improvement activities

        For program improvement activities, the Committee provides
    $1,900,000, the same as the budget request and the 2000
    appropriation. In fiscal year 2001, 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. The
    funds provided are sufficient to support ongoing program
    improvement activities and to support a national conference on
    the findings of the longitudinal study of the vocational
    rehabilitation program.

    Evaluation

        The Committee recommends $1,587,000 for evaluation
    activities, the same as the 2000 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 $8,717,000 for the Helen Keller
    National Center for Deaf-Blind Youth and Adults, $167,000 more
    than the 2000 appropriation and the same as 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 47 agencies. At
    the recommended level, the center would serve approximately 102
    persons with deaf-blindness at its headquarters facility and
    provide field services to approximately 1,825 individuals and
    families.

    National Institute on Disability and Rehabilitation Research

        The Committee recommends $95,000,000 for the National
    Institute on Disability and Rehabilitation Research [NIDRR],
    $8,538,000 more than the amount appropriated in 2000 and
    $5,000,000 below the budget request.
        NIDRR develops and implements a comprehensive and
    coordinated approach to the conduct of research, demonstration
    projects, and related activities that enable 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.
        The Committee is aware of an effort to establish an
    American Center for International Rehabilitation Research,
    which would promote an international exchange of information
    and rehabilitation experts. The Center would collaborate with
    the World Health Organization to develop rehabilitation
    curricula and training materials necessary to support WHO
    rehabilitation services worldwide. The Committee encourages
    NIDRR to support this effort, and suggests the convening of an
    international conference to explore the best means to attain
    these goals.
        The Committee recommends that the Department inform
    educators about Chronic Fatigue and Immune Dysfunction Syndrome
    (CFIDS) and the special educational needs required by students
    with CFIDS. The Committee is pleased that the National
    Institute on Disability and Rehabilitation Research has
    recognized Chronic Fatigue Syndrome (CFS) as an unmet area of
    research and encourages NIDRR to actively solicit CFS-related
    research proposals.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        Minot State University has initiated a program designed to
    meet the unique needs of persons with disabilities living in
    remote rural communities through the use of telecommunications
    technology and ongoing training for families and professionals.
        The Cerebral Palsy Research Foundation and The Wichita
    State University will study and recommend incentives for
    employers to hire persons with significant disabilities.

    Assistive technology

        The Committee bill provides $41,112,000 for assistive
    technology, the same as the budget request and $7,112,000 more
    than the fiscal year 2000 appropriation.
        The Assistive Technology 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.
        The Committee recommendation includes $7,000,000 to support
    grants to States and technical assistance activities,
    authorized under Title III of the Assistive Technology Act, to
    establish or maintain alternative loan financing programs, an
    increase of $2,972,225 over the fiscal year 2000 level.
    Currently, major service programs such as Medicaid, Medicare,
    special education, and vocational rehabilitation cannot meet
    the growing demand for assistive technology. Loan programs
    offer individuals with disabilities attractive options that
    significantly enhance their ability to purchase assistive
    technology devices and services.

               Special Institutions for Persons With Disabilities

                     American printing house for the blind

    Appropriations, 2000....................................     $10,100,000
    Budget estimate, 2001...................................      10,265,000
    Committee recommendation................................      12,500,000

        The Committee recommends $12,500,000 for the American
    Printing House for the Blind [APH], $2,235,000 above the budget
    request and an increase of $2,400,000 above the 2000
    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 49
    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, 2000....................................     $48,151,000
    Budget estimate, 2001...................................      51,786,000
    Committee recommendation................................      54,366,000

        The Committee recommends an appropriation of $54,366,000
    for the National Technical Institute for the Deaf [NTID], an
    increase of $6,215,000 over the 2000 appropriation and
    $2,580,000 above the budget request.
        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. Within the amount provided, $7,176,000 is for
    construction.
        It has come to the Committee's attention that the
    Administration request of $5,376,000 for the second of three
    installments towards NTID's $13,568,000 dormitory renovations
    project has been reduced by a total of $1,800,000 to reflect
    its expectation that NTID raise 15 percent of the funds
    necessary from private sources. It is NTID's professional
    judgment, based on extensive discussions with potential donors,
    that they are far better served using their very limited
    fundraising resources on raising funds for scholarships,
    classroom technology and new academic programs. The Committee
    notes that NTID has been very successful in raising nearly
    $12,000,000 for these purposes over the past 5 years.
        Given NTID's efforts in reducing its appropriation needs in
    these other areas through fundraising, the fact that it has
    already contributed $1,100,000 from its operating funds to
    supplement the dormitory project and the hardship placed upon
    the institution to raise private funds for this purpose, the
    Committee directs the Department of Education to waive the 15
    percent matching requirement imposed on this construction
    project.

                              gallaudet university

    Appropriations, 2000....................................     $85,980,000
    Budget estimate, 2001...................................      87,650,000
    Committee recommendation................................      87,650,000

        The Committee recommends $87,650,000 for Gallaudet
    University, an increase of $1,670,000 above the amount
    appropriated in 2000 and the same as the administration
    request.
        Gallaudet University is a private, nonprofit institution
    offering 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, 2000....................................  $1,672,750,000
    Budget estimate, 2001...................................   1,751,250,000
    Committee recommendation................................   1,726,600,000

        The Committee recommendation includes a total of
    $1,726,600,000 for vocational and adult education, consisting
    of $1,214,100,000 for vocational education and $490,500,000 for
    adult education, and $22,000,000 for State grants for
    incarcerated youth offenders. Of the total, $791,000,000 is
    advanced funded in fiscal year 2002.

                              Vocational education

        The Committee recommendation of $1,214,100,000 for
    vocational education is $30,350,000 more than the
    administration's request and $21,350,000 more than the fiscal
    year 2000 amount.
        Basic grants.--The Committee has included $1,071,000,000
    for basic grants, $15,350,000 more than the 2000 appropriation
    and $215,350,000 more than the administration request. Of the
    recommended amount, $791,000,000 will become available on
    October 1, 2001.
        Funds provided under the State grant program assist States,
    localities, and outlying areas to expand and improve their
    programs of vocational education and provide 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 $106,000,000
    for tech-prep programs. This is the same as the 2000
    appropriation and $200,000,000 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 $5,600,000 on a
    current-funded basis for tribally controlled postsecondary
    vocational institutions. This is an increase of $1,000,000 over
    the fiscal year 2000 appropriation and the administration
    recommendation. 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.
        National programs, research.--The Committee recommends
    $26,500,000 for national research programs, an increase of
    $9,000,000 above the 2000 appropriation and the administration
    request.
        The amount of $9,000,000 has been provided to continue
    activities authorized by Section 118 of the Carl Perkins Act.
    The Act requires that at least 85 percent of the amount be
    provided directly to State Occupational Information
    Coordinating Committees (SOICC) to develop and deliver
    occupational and career information to students, job seekers,
    employers, education, employment and training programs. Of the
    total, up to $2,000,000 will support continuation of national
    and State career development and related capacity building
    programs that 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 skills requirements, and to make more
    informed and effective career decisions. The remaining funds
    may be used by a National entity to support the efforts of the
    SOICCs, including paying the costs of Federal salaries and
    expenses.
        The National Research Center for Career and Technical
    Education and the National Dissemination Center for Career and
    Technical 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 the
    provision of state-of-the-art job-related instruction that, in
    turn, will strengthen our Nation's economy.

    Tech Prep Education Demonstration Program

        The Committee recommendation includes $5,000,000 for this
    program. The Administration did not request funding for this
    program, nor did it receive funding in fiscal year 2000. Under
    this program, the Secretary must award grants competitively to
    consortia that involve a business as a member, locate a
    secondary school on the site of a community college, and
    require voluntary participation of secondary school students.
    The purpose of the consortia is to link educators and employers
    to provide high school students the academic and vocational
    skills they need in a practical work-based learning
    environment.
        The Committee is aware of the collaborative efforts between
    the College of Rural Alaska at the Mat-Su campus, the Borough
    and School District of Mat-Su, the Alaska Human Resource
    Development Council and other private-and public-sector
    partners to develop vocational educational programs, where none
    currently exist, to address the local needs of the community.

                                Adult Education

        The Committee has included $490,500,000 for adult
    education, $65,000,000 less than the administration request and
    $20,500,000 above the 2000 appropriation.
        Adult education State programs.--For adult education State
    programs, the Committee recommends $470,000,000, an increase of
    $10,000,000 over the administration request and $20,000,000
    above the 2000 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 activities.--The Committee has included
    $14,000,000, the same as the 2000 appropriation and a decrease
    of $75,000,000 below the administration request.
        National Institute for Literacy.--The Committee recommends
    $6,500,000 for the National Institute for Literacy, authorized
    under section 242 of the Adult Education and Family Literacy
    Act, $500,000 more than the amount appropriated in 2000 and the
    same as 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.

    State grants for incarcerated youth offenders

        The Committee has included $22,000,000 for a program
    authorized by part D of title VIII of the Higher Education Act,
    $3,000,000 above the amount appropriated in fiscal year 2000
    and $10,000,000 more than the administration requested. This
    program provides grants to State correctional education
    agencies to assist and encourage incarcerated youth to acquire
    functional literacy, life and job skills, through the pursuit
    of a postsecondary education certificate or 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.
        The Committee also has included bill language providing
    $5,000,000 to continue the prisoner literacy initiative as part
    of the Youth Violence Prevention Initiative. The Committee
    notes that the extremely high rates of illiteracy or marginal
    reading skills among inmates is a national problem and
    therefore encourages the development of a uniform model to
    evaluate literacy programs across the country.

                          STUDENT FINANCIAL ASSISTANCE

    Appropriations, 2000....................................  $9,364,717,000
    Budget estimate, 2001...................................  10,258,000,000
    Committee recommendation................................  10,624,000,000

        The Committee recommends an appropriation of
    $10,624,000,000 for student financial assistance, an increase
    of $1,259,283,000 over the fiscal year 2000 appropriation and
    $366,000,000 over the administration request.

    Federal Pell Grant Program

        For Pell grant awards in the 2001-2002 academic year, the
    Committee recommends $8,692,000,000.
        Pell grants provide need-based financial assistance that
    helps low- and middle-income undergraduate students and their
    families pay the costs of postsecondary education and
    vocational training. Awards are determined according to a
    statutory need analysis formula that takes into account a
    student's family income and assets, household size, and the
    number of family members, excluding parents, attending
    postsecondary institutions. Pell grants are considered the
    foundation of Federal postsecondary student aid.
        The amount recommended is sufficient to raise the maximum
    Pell grant to $3,650 the highest level in the program's history
    and an increase of $350 over the maximum grant for the 2000-
    2001 academic year.

    Federal supplemental educational opportunity grants

        The Committee recommends $691,000,000 for Federal
    supplemental educational opportunity grants [SEOG], an increase
    of $70,000,000 above the 2000 appropriation level and the same
    as 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 $1,011,000,000 for the Federal
    Work-Study Program, an increase of $77,000,000 above the 2000
    level and the same as the administration request. This program
    provides grants to approximately 3,400 institutions to help an
    estimated 1 million 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 at least 25
    percent of student earnings. Institutions also must use at
    least 7 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.
    These funds help support comprehensive work-service-learning
    programs at qualifying institutions around the Nation. Of the
    funds provided, the Committee has included $3,000,000 to
    continue and expand the work colleges program.

    Federal Perkins loans

        The Committee bill includes $100,000,000 for Federal
    Perkins loans capital contributions, which is the same as the
    2000 appropriation and the budget request. The amount
    recommended when combined with institutional revolving funds,
    would maintain the 2001 loan volume at the current estimated
    level of $1,058,000,000. At this funding level nearly 700,000
    loans would be made.
        The Federal Perkins Loan Program supports student loan
    revolving funds built up with capital contributions to about
    2,000 participating institutions. Institutions use these
    revolving funds, which also include Federal capital
    contributions (FCC), institutional contributions equal to one-
    third of the FCC, 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 $60,000,000 for loan
    cancellations, an increase of $30,000,000 over the 2000 level
    and the same amount requested by the administration. These
    funds reimburse institutional revolving funds on behalf of
    borrowers whose loans are cancelled in exchange for
    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 qualified low-income school.

    Leveraging educational assistance partnership program

        For the Leveraging educational assistance partnership
    [LEAP] program, formerly known as the State Student Incentive
    Grant Program [SSIG], the Committee includes $70,000,000,
    $30,000,000 more than the 2000 appropriation and the
    administration request. This program provides a Federal match
    to States as an incentive for providing need-based grant and
    work-study assistance to eligible students.

                     FEDERAL FAMILY EDUCATION LOAN PROGRAM

    Appropriations, 2000....................................     $48,000,000
    Budget estimate, 2001...................................      48,000,000
    Committee recommendation................................      48,000,000

        The Committee recommends $48,000,000 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 the same as the
    budget request and the amount appropriated in fiscal year 2000.
        Funds appropriated for Federal administrative expenses will
    partially cover the fiscal year 2000 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 guaranty agencies that insure loans directly, collect
    defaulted loans, and provide various services to lenders. The
    Federal Government supports the guaranty agencies by providing
    loan advances and reinsurance payments for borrower default,
    death, disability, and bankruptcy. The Federal Government also
    pays guaranty agencies loan processing and issuance fees out of
    the FFEL subsidy and account maintenance fees in the
    administrative funds 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, be
    enrolled at least half time, and not be incarcerated. 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 a
    statutory need analysis system.
        An 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.

                                HIGHER EDUCATION

    Appropriations, 2000....................................  $1,529,579,000
    Budget estimate, 2001...................................   1,795,973,000
    Committee recommendation................................   1,694,520,000

        The Committee recommends an appropriation of $1,694,520,000
    for higher education programs, $164,941,000 more than the 2000
    amount and $101,453,000 below the budget request.

    Aid for institutional development

        The Committee recommends $352,500,000 for aid for
    institutional development authorized by titles III and V of the
    Higher Education Act, $59,250,000 above the 2000 appropriation
    and $36,000,000 below the budget request.
        The Committee encourages the Department to provide
    technical assistance and conduct research on issues germane to
    predominately and Historically Black Colleges and Universities
    (HBCUs) and other institutions of higher education that have
    large minority student populations, ranging from disseminating
    best practices information to the most efficient and cost-
    effective use of title III funding, reducing student loan
    default rates, increasing graduation rates, and grant writing
    training.
        Strengthening institutions.--The Committee bill includes
    $65,000,000 for the part A strengthening institutions program,
    an increase of $4,750,000 over the 2000 level and $2,000,000
    more than 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 $62,500,000 for institutions at which Hispanic
    students make up at least 25 percent of enrollment, $20,250,000
    above the 2000 level and the same as the administration
    request. Institutions applying for title V funds must meet the
    regular part A requirements and show that at least one-half of
    their Hispanic students are low-income college students. Funds
    may be used for acquisition, rental or lease of scientific or
    laboratory equipment, renovation of instructional facilities,
    development of faculty, support for academic programs,
    strengthen institutional management, and purchase of
    educational materials. Title V recipients are not eligible for
    other awards provided under title III, parts A and B.

    Dual Degree Programs for Minority-Serving Institutions

        The Administration requested $40,000,000 for the new Dual
    Degree Programs for Minority-Serving Institutions. This
    initiative intends to make grants available to consortia of
    minority-serving institutions and partner institutions that
    have or will establish 5-year dual-degree programs. The
    Committee defers action on this proposal pending
    reauthorization of elementary and secondary education programs.
        Strengthening historically black colleges and
    universities.--The Committee provides $169,000,000 for part B
    grants, $20,250,000 above the 2000 level and the same as 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 $40,000,000 for the part B, section
    326 program, $9,000,000 above the 2000 level and the same
    amount as the administration request. The section 326 program
    provides 5-year grants to strengthen historically black
    graduate institutions [HBGI's]. The Higher Education Amendments
    of 1998 increased the number of recipients to 18 named
    institutions, but reserved the first $26,600,000 appropriated
    each year to the first 16 institutions included in the previous
    authorization. Grants may be used for any part B purpose and to
    establish an endowment.

    Strengthening Alaska native and native Hawaiian-serving institutions

        The Committee recommends $6,000,000 for this program, an
    increase of $1,000,000 over the fiscal year 2000 appropriation
    and the budget request. The purpose of this program is to
    improve and expand the capacity of institutions serving Alaska
    Native and Native Hawaiian students. Funds may be used to plan,
    develop, and implement activities that encourage: faculty and
    curriculum development; better fund and administrative
    management; renovation and improvement of instructional
    facilities, student services, and the purchase of library books
    and other educational materials.

    Strengthening tribal colleges and universities

        Over the past three decades, tribal colleges and
    universities (TCUs) have emerged to play a pivotal role in
    meeting the educational needs of American Indian students.
    Driven by the premise that education is the key to social
    renewal, TCUs have demonstrated their ability to educate
    students who might not otherwise be served by mainstream
    postsecondary institutions. However, TCUs are among the most
    poorly funded institutions in America. Unlike non-Indian
    institutions, TCUs cannot rely on endowments, State
    appropriations or wealthy alumni to defray costs. Consequently,
    the Committee recommends $10,000,000, an increase of $4,000,000
    over the fiscal year 2000 appropriation and $1,000,000 more
    than the President's budget request. The funds will enable the
    nation's 32 TCUs to continue to address basic infrastructure
    needs, enhance their facilities, support faculty and curriculum
    development and provide vital services to a growing number of
    students.

    Fund for the improvement of postsecondary education

        The Committee recommends $56,247,000 for the fund for the
    improvement of postsecondary education [FIPSE], which is
    $18,002,000 less than the 2000 appropriation and $25,047,000
    more than 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 non-profit institutions and organizations concerned with
    education beyond high school. The Committee has included a
    number of report language items and requests that the
    Department afford them the opportunity to compete through the
    regular peer review competitive process.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The Howard Baker School of Government at the University of
    Tennessee would comprise political science, public
    administration, regional planning, and social science research
    programs; house manuscript collections and institute a lecture
    series on public policy issues.
        The 2+2 program developed through a partnership of 18
    community colleges in Florida will provide access to
    baccalaureate degrees to community college students through the
    expansion of their distance learning education program.
        Stetson University is planning equipment and technology
    infrastructure investments to support contemporary standards
    for university level teaching and research in various science
    areas.
        Minnesota State Colleges and Universities' Emerging
    Curriculum project supports the development and design of
    emerging curriculum, professional development, development of
    an e-monitoring environment to support e-learning needs and
    formulating and implementing pilot policies for the new era of
    e-learning.
        The Post-Secondary Technical Degree Distance Education
    Consortium is a collaboration involving Iowa community colleges
    and the University of Northern Iowa, and will provide exemplary
    distance education courses and support services for individuals
    pursuing a 2 year technical or 4 year technology management
    degree.
        The Applied Technology Learning Center at the University of
    Northern Iowa will assess the use of technology in effective
    learning and identify best practices for dissemination
    nationally.
        The University of Oklahoma has taken an innovative approach
    to increase the number of students studying mathematics and
    science through the expansion of its unique practical robotics
    program.
        The University of Hawaii's efforts support development of a
    Globalization Research Consortium.
        Brandeis University continues to develop a National Center
    for the Study of Behavioral Genetics and Genomics.
        Pennsylvania Technologies, a consortium of 105 Pennsylvania
    universities, will improve access to learning opportunities
    through a statewide distance learning and training program.
        The Alaska Distance Education Consortium continues to work
    with the State's colleges, school districts and other public
    and private organizations to develop a plan to utilize distance
    education technologies to serve all of the students in the
    State.
        The Corpus Christi Early Childhood Development Center at
    Texas A&M University operates an innovative and effective
    program to serve its unique roll as both a childhood
    development center for at-risk children, a professional
    training and education center for the Center's and the
    surrounding school district's teachers, and a clinical research
    facility in the study of early childhood development.
        Edmonds Community College Center has developed supportive
    services for students and innovative programs to increase
    access to postsecondary education for nontraditional students.
        The State of Alaska and the University of Alaska are
    planning a practical, occupation-based curriculum and distance
    learning program in an alternative boarding school setting to
    provide a seamless transition for students in grades 11 to 14.
    Students will earn associate degrees after completing the
    program and be better prepared to assume jobs available in
    Alaskan businesses.
        A joint proposal of the Galena City School District, Mt.
    Edgecumbe High School, the University of Alaska Southeast and
    the Alaska Association of School Boards has been developed to
    address the needs of Alaska Native students attending boarding
    schools and colleges because they are frequently unsuccessful
    in making the transition from rural village life to an
    educational residence facility.
        The National Center for Competency-Based Distance Learning,
    administered by the Association of Jesuit Colleges and
    Universities, will address competency-based assessment,
    delivery and cost-effectiveness for online instruction.
        The Pennsylvania Digital Greenhouse has developed an
    electronic design education program that would establish a set
    of courses that cover all aspects of system of chip (SOC) for
    practicing engineers.
        The Enterprise State Junior College Center for High
    Technology will support distance learning and other activities
    to improve educational opportunities of area residents.
        The Philadelphia University supports the development and
    evaluation of the highest and best uses of technology through
    implementation of demonstration programs aimed at full
    integration of technology in the classroom.
        The University of Nebraska-Omaha School of Criminal Justice
    will continue its program expansion and curriculum development.
        The Crime Victims Law Institute at the Lewis and Clark
    College, in Portland, Oregon will pursue a study of and
    enhancement of the role of victims in the criminal justice
    system.
        The Community Law Program at Rutgers University's Newark
    campus will continue providing practical experience for program
    students, while also supporting community involvement.
        The Technology Enhanced Learning Project will help meet the
    critical need in California and in the nation for teachers,
    engineers, and computer professionals.
        The Ivy-Tech State College--Central Indiana will expand
    distance learning capabilities and other postsecondary
    education enhancements to increase access to the institution's
    postsecondary programs.
        The Indiana State University has engaged in a collaboration
    designed to enhance postsecondary technology management
    programs.
        The Project TEAM at Indiana University will continue
    expansion of model teacher preparation programs.
        The Professional Development School partnership of Indiana
    State University in collaboration with the Indianapolis Public
    Schools and other schools will support teacher retention
    activities in low income communities.
        Campblesville University in Campblesville, Kentucky for the
    Kentucky Heartland Institute for Public Policy and Issues will
    prepare students, faculty and the community in public policy.
        The College of Rural Alaska-Interior Aleutians Campus and
    the University of Alaska Fairbanks in partnership with the
    Galena City School District have developed an innovative
    technology training program to support distance learning in
    remote Alaskan communities.
        City University, based in Bellevue, Washington, continues
    to enhance its distance learning capability, infrastructure,
    course offerings, and personnel to students in Eastern Europe,
    and support student exchange opportunities between its
    Washington and Eastern European campuses.
        The Western Montana College, through its Rural Education
    Technology Center, will infuse technology to positively impact
    teaching and learning on this rural campus, bring the resources
    of various other schools to Western, and export course
    offerings to underserved student audiences.
        Northern Kentucky University's Metropolitan Education and
    Training Services Center continues to develop innovative
    educational programming to respond to local community needs.
        The University of Louisville's Metropolitan Scholars
    Project will increase access to postsecondary education by
    extending educational opportunities for nontraditional
    students.
        Huntingdon College in Montgomery, Alabama has developed a
    creative program for enhancing effective integration of
    computer technology in math and science instruction.
        Washington and Jefferson College Center of Excellence in
    Teaching and Learning will address kindergarten through
    postsecondary education in Western Pennsylvania through
    partnerships with three local school districts, and enhance the
    quality of student instruction in skill competencies.
        WNVT and MNVC in Virginia in collaboration with several
    area universities will utilize digital and advanced technology
    to make high-tech education and career training available
    through digital broadcast.
        The Central Virginia Council of Chambers is undertaking a
    study to develop an effective delivery system for improving
    access to quality postsecondary education programs in South
    Central Virginia.
        Neumann College will continue providing the community at
    large a range of cultural and educational resources, and
    continue outreach programs for under-served and needy
    populations in Chester County, Pennsylvania through an
    innovative combination of technology utilization and
    programmatic outreach.
        Virginia Tech University and the Future of the Piedmont
    Foundation are utilizing advanced technologies to improve
    professional development and increase the efficacy of
    technology-based education programs.
        Washington and Lee University is increasing the learning
    opportunities of low income communities through its Shepherd
    Program for the Interdisciplinary Study of Poverty.
        The College of William and Mary, in collaboration with
    Colonial Williamsburg, will create the Institute of American
    History and Democracy to help improve history education and
    scholarship.
        The Oregon Graduate Institute will enhance its academic
    offerings through the development of programs in environmental
    information technology.
        The Native American Tribal Government Center at Portland
    State University will provide academic and professional
    development opportunities for Tribal governments.
        Suomi College in Hancock, Michigan continues to provide
    unique higher educational opportunities as the only Finish
    heritage institution operating outside of Finland.
        The University of Great Falls seeks to utilize distance
    learning technologies to increase access to higher education
    for students in geographically isolated areas.
        The Western Governors University is a unique initiative
    involving 19 States which seeks to increase student access to
    postsecondary education through use of advanced technologies
    and distance learning.
        The Polytechnic Institute located at Southeast Missouri
    State University will continue to support the technical
    education needs of a 24-county area in the Lower Mississippi
    Delta region.
        The Campus Technology Infrastructure initiative at Western
    New Mexico University will enable it to increase educational
    access and opportunity for students living in underserved
    areas.
        Delaware County Community College seeks to expand access to
    high quality postsecondary education in previously underserved
    areas.
        The Idaho Urban Research and Design Center (IURDC) in Boise
    is operated by the University of Idaho (UI) and emphasizes
    public-private-educational collaboration, thereby serving the
    dual purpose of providing practical training and experience for
    UI students and graduates, as well as serving the needs of
    growing communities as traditionally rural areas adjust to
    urban growth and community and demographic changes.
        Cleveland State University continues to implement
    technology infrastructure enhancements that will enable it to
    support technology-based instruction and effective
    communication with the community.
        The Advanced Computing and Modeling Laboratory at the
    University of Idaho in Boise, Idaho supports advanced computing
    and computer modeling, which are increasingly important to
    research and education in U.S. institutions of higher
    education. The University has been working to expand and
    enhance its advanced computing and modeling capabilities in
    order to provide a state-of-the-art educational experience for
    students.
        The Regents University Center in Sioux Falls, South Dakota
    will provide higher educational opportunities to non-
    traditional students and working adults by using technology to
    provide access to faculty from Dakota State, South Dakota State
    University, the University of South Dakota, and others from the
    State university system.
        The Center for the Advancement of Distance Education in
    Rural America (CADERA) will continue its set of pilot projects
    in New Mexico and Pennsylvania which connect rural Americans to
    distance education and on-line career training through the use
    of education technology.
        Regents College, Albany, New York, is developing a model of
    services for distance learners that will promote high quality
    learning, and increase student retention and degree attainment.
        Albany Technical Institute has developed a distance
    learning program to reach out to rural communities and other
    underserved areas to increase access to postsecondary
    education. The Institute will partner with the Dougherty
    County, Georgia public school system, and other private and
    public organizations.
        The Washington Virtual Classroom--Foreign Language Project
    is expanding access to foreign language instruction in rural
    areas through development of a distance learning program.
        The Kansas State University is developing virtual college
    and graduate level courses for national and international
    students to improve access to University programs.
        The collaborative efforts of the University of Charleston
    and the Clay Center for Arts and Sciences will promote access
    to and effective use of technology equipment for arts and
    science education and outreach.
        The North Dakota State University will continue to address
    the need for technical personnel through its Tech Based
    Industry Traineeship program designed to enhance student
    postsecondary experience while providing innovative solutions
    to small business needs.
        The Electronic Commerce Education program at the North
    Dakota State University will enhance the educational experience
    of students and the academic portfolio of the University, while
    helping stimulate the economy of North Dakota and other rural
    States.
        The Ohio State University John Glenn Public Policy Center
    will stimulate student participation in public service, support
    scholarly research of public policy, and enhance organizational
    skills and policy making abilities of public officials.
        The Lorain County Community College Learning Technology
    Center will provide students with access to interactive
    distance learning opportunities through cooperation with Kent
    State, Ohio State, Youngstown State, and other schools.
        The Johnson C. Smith University and University of North
    Carolina at Charlotte have developed a model program to move
    minority students into graduate programs in engineering,
    computer science, and information technology.
        The University of Missouri-St. Louis, through its Teacher
    Workforce Replenishment Program, will promote networking and
    sharing of knowledge among veteran educators, new teachers and
    high school students, and recruit new teachers and generate
    reform in high need school districts.
        The Eastern New Mexico University in Roswell, New Mexico is
    providing valuable education and training to New Mexico
    students in a field where, given the growth in the aviation
    industry, jobs are currently at a premium. The University will
    expand and enhance its program to respond to this growing need.
        The Pittsburgh Tissue Engineering Institute (PTEI) is
    developing a national demonstration project to prepare
    biotechnology-based science education for grades K-12, and a
    Postdoctoral Fellowship Program in tissue engineering.
        Michigan Technological University, renown for its high
    quality engineering research and education, will build on its
    expertise by increasing student exposure to high-tech
    instructional and advanced learning technologies through its
    Center for Microsystems Technology.
        The Lehigh University Integrated Product, Project, and
    Process Development program provides students with a complete,
    interdisciplinary education in industrial design, engineering,
    and business through a model collaboration involving three
    colleges and area employers.
        Efforts by Marquette University to establish joint
    curricula programs with the sixteen technical colleges in the
    State of Wisconsin could allow graduates of the technical
    colleges to enter Marquette University as juniors prepared to
    finish their bachelors' degrees in their fields of study. By
    linking libraries and distance education technology, this model
    program will be an effective way to increase the skills of
    workers throughout the State, and allow more non-traditional
    students an opportunity to pursue 4-year degrees.
        The partnership of Jackson State University, located in
    Jackson, Mississippi, with three other Historically Black
    Universities, Alabama A & M, Prairie View A&M University in
    Texas and Southern University and A&M College in Louisiana will
    establish four Minority Centers of Excellence for Math &
    Science Teacher Preparation. This concerted effort to prepare
    minority teachers of math and science will help reduce the
    disproportionate representation of minorities in the math and
    science teaching field, where less than 6 percent of teachers
    are minorities.

    Minority science and engineering improvement

        The Committee recommends $8,500,000 for the minority
    science and engineering improvement program [MSEIP], $1,000,000
    more than the 2000 level and the same as 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 and
    engineering 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 $73,022,000 for international
    education programs, $3,320,000 above the 2000 level and the
    same as the budget request.
        Domestic programs.--The Committee recommends $62,000,000
    for domestic program activities related to international
    education and foreign language studies, including international
    business education, under title VI of the HEA, the same as the
    2000 appropriation and the administration request. Domestic
    programs include national resource centers, undergraduate
    international studies and foreign language programs,
    international research and studies projects, international
    business education projects and centers, American overseas
    research centers, language resource centers, foreign language
    and area studies fellowships, and technological innovation and
    cooperation for foreign information access.
        Overseas programs.--The bill includes $10,000,000 for
    overseas programs authorized under the Mutual Educational and
    Cultural Exchange Act of 1961, popularly known as the
    Fulbright-Hays Act. This is $3,320,000 above the 2000 level and
    the same as 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 and students in order to improve
    foreign language and area studies education in the United
    States. The Committee intends that most of the additional
    funding being provided be used to strengthen and expand
    programs in the emerging democracies of Central and Eastern
    Europe and the former Soviet Union, the purpose for which the
    original legislation was enacted.
        Institute for International Public Policy.--The Committee
    bill recommends $1,022,000 for the Institute for International
    Public Policy. This is the same amount as the 2000 level 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 50 percent is
    required.

    Interest subsidy grants

        The Committee recommends $10,000,000 for interest subsidy
    grants, the same as the administration request and $2,000,000
    less than the 2000 level. This appropriation is required to
    meet the Federal commitment to pay interest subsidies on
    approximately 160 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.

    Federal TRIO programs

        The Committee bill includes $736,500,000 for Federal TRIO
    programs, an increase of $91,500,000 above the fiscal year 2000
    appropriation and $11,500,000 more than the administration
    request.
        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 11 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.

    Gaining Early Awareness and Readiness For Undergraduate Programs [GEAR
            UP]

        The Committee recommends $225,000,000, an increase of
    $25,000,000 more than the amount provided in fiscal year 2000.
    The administration requested $325,000,000 for this program.
    Under this program funds would be used by States and
    partnerships of colleges, middle and high schools, and
    community organizations to assist middle and high schools
    serving a high percentage of low-income students. Services
    provided would help students to prepare for and pursue a
    postsecondary education.

    Byrd honors scholarships

        The Committee recommends $41,001,000 for the Byrd honors
    scholarship program, $1,142,000 more than the 2000
    appropriation and the same as the budget request.
        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 funds provided will support a new cohort of
    first-year students in 2001, and continue support for the 1998,
    1999, and 2000 cohorts of students in their fourth, third and
    second years of study, respectively. The amount recommended
    will provide scholarships of $1,500 to 27,334 students.

    Javits Fellowships

        The Committee recommends $11,000,000 for the Javits
    Fellowships program, a decrease of $9,000,000 from the fiscal
    year 2000 amount and $1,000,000 more than the budget request.
    Last year, the Committee provided an additional $10,000,000 for
    this program in order to operate the program on an advance
    funded basis, thus resulting in an apparent decrease in funding
    available to this program.
        The Javits Fellowships program provides fellowships of up
    to 4 years to students of superior ability who are pursuing
    doctoral degrees in the arts, humanities, and social sciences
    at any institution of their choice. Each fellowship consists of
    a student stipend to cover living costs, and an institutional
    payment to cover each fellow's tuition and other expenses.
    Funds provided in the fiscal year 2001 appropriation support
    fellowships for the 2002-2003 academic year, and up to
    $1,000,000 may be used for continuation of 2000-2001 awards.

    Graduate assistance in areas of national need [GAANN]

        The Committee recommends $33,000,000 for graduate
    assistance in areas of national need, $2,000,000 more than the
    2000 level and $2,000,000 more than the request. 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, geology and related sciences and computer and
    information sciences. Recipients must demonstrate financial
    need and academic excellence, and seek the highest degree in
    their fields.

    Learning anytime anywhere partnerships

        The Committee recommends $30,000,000 for the learning
    anytime anywhere partnerships (LAAP), $6,731,000 more than the
    fiscal year 2000 level. The administration requested
    $30,000,000 for this program. Funds support projects using
    technology and other innovations to enhance the delivery of
    postsecondary education and lifelong learning opportunities.
        LAAP will develop an on-line internet based university
    curriculum for learners of all ages, create and assess
    appropriate teaching methodologies for distance learning,
    develop an appropriate method for testing the knowledge of
    students who learn through distance education, and create a
    computerized assessment method for this and other learning
    models. The partnership will consist of universities, community
    colleges, secondary schools, NASA, and may include private
    companies and other community based groups.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The ATLAS Program at the University of Colorado, Boulder
    continues to develop new curricula and teaching methods that
    employ leading technologies for use in classrooms throughout
    the country.
        The University of Idaho continues to support development of
    interactive learning environments through the design,
    development, evaluation, and use of Internet technologies. The
    University has been an early leader in Internet-based
    interactive learning environment in Idaho and nationally, is
    providing technology leadership in the 40-university NOVA
    consortium and in the Idaho Virtual Campus, and has a team of
    nationally recognized educators and scientists.

    Teacher quality enhancement grants

        The Committee recommends $98,000,000 for the teacher
    quality enhancement grants program, the same amount as the 2000
    level and the budget request. The program was established to
    support statewide initiatives that best meet their specific
    teacher preparation and recruitment needs. Further, the Act
    provides and designates funding for the program in three focus
    areas: 45 percent of resources support a state grant program,
    45 percent of funds are used for a partnership program, and 10
    percent is designated for a recruitment grant program.
        Within this amount, the Committee recommends $43,770,000
    for the state grant program. Funds may be used for a variety of
    state-level reforms, including more rigorous teacher
    certification and licensure requirements; provision of high-
    quality alternative routes to certification; development of
    systems to reward high-performing teachers and principals; and
    development of efforts to reduce the shortage of qualified
    teachers in high-poverty areas.
        The Committee also recommends that $43,770,000 shall be
    used for the teacher training partnership grants, which are
    awarded to local partnerships comprised of at least one school
    of arts and science, one school or program of education, a
    local education agency, and a K-12 school.
        Partnerships may work with other entities, with those
    involving businesses receiving priority consideration.
    Partnerships are eligible to receive a one-time-only grant to
    encourage reform and improvement at the local level. Funds may
    be used for a variety of activities designed to improve teacher
    preparation and performance, including efforts to provide
    increased academic study in a proposed teaching specialty area;
    to prepare teachers to use technology effectively in the
    classroom; to provide preservice clinical experiences; and to
    integrate reliable research-based teaching methods into the
    curriculum.
        The Committee recommends $9,725,000 for the teacher
    recruitment grants. The recruitment grant program supports
    efforts to reduce shortages of qualified teachers in high-need
    school districts as well as provide assistance for high-quality
    teacher preparation and induction programs to meet the specific
    educational needs of the local area.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The Great Cities' Universities, a coalition of 17 public
    research universities, have collaborated with their local
    educational partners on an Urban Educator Corps Partnership to
    recruit, prepare, and induct more high quality, fully certified
    teachers and principals in urban elementary, middle and
    secondary schools, and provide in-service professional
    development to current teachers and principals.
        The Mississippi Delta Education Initiative of Delta State
    University is a comprehensive effort to improve access to and
    the quality of education in the Delta area. The Committee
    encourages the Department to assist the University in
    developing a component of the program to meet the
    qualifications of a Teacher Quality Enhancement Grant.

    Child care means parents in schools

        The Committee recommends an appropriation of $10,000,000
    for the Child Care Access Means Parents in School (CAMPUS)
    program, which is $5,000,000 more than the 2000 appropriation
    and $5,000,000 below the budget request. This program was
    established in the Higher Education Amendments of 1998 to
    support the efforts of a growing number of non-traditional
    students who are struggling to complete their college degrees
    at the same time that they take care of their children.

    Demonstration projects to ensure quality higher education for students
            with disabilities

        The Committee recommends $5,000,000 for this program, the
    same as the budget request and the fiscal year 2000
    appropriation. This program's purpose is to ensure that
    students with disabilities receive a high-quality postsecondary
    education. Grants are made to support model demonstration
    projects that provide technical assistance and professional
    development activities for faculty and administrators in
    institutions of higher education.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        Muhlenberg College is proposing to develop a national model
    program to effectively teach higher education students with
    disabilities. Specifically, emphasizing curriculum development
    centered on collaborative-based instruction and active
    learning, Muhlenberg College will expand its existing emphasis
    on reaching at-risk students and evaluate the effectiveness of
    the specialized teaching techniques employed with criteria
    including increased grade point averages, increased enrollment
    and retention in concentrations in which the learning disabled
    are traditionally underrepresented, such as physics, math,
    science, and foreign language, and placement in competitive
    workforce careers or graduate school.
        The University of Northern Colorado, a leader in disability
    education, provides needed support to special education
    teachers through its teacher training program and by providing
    professional development activities for existing teachers
    through innovative approaches, including distance learning.
    This support will be coordinated through its new National
    Center for Low Incidence Disabilities.

    Underground railroad program

        The Committee recommends $1,750,000, the same as the budget
    request and the fiscal year 2000 appropriation. The program was
    newly authorized by the Higher Education Amendments Act of 1998
    and was funded for the first time in fiscal year 1999. Grants
    are provided to research, display, interpret, and collect
    artifacts relating to the history of the underground railroad.
    Educational organizations receiving funds must demonstrate
    substantial private support through a public-private
    partnership, create an endowment fund that provides for ongoing
    operation of the facility, and establish a network of satellite
    centers throughout the United States to share information and
    teach people about the significance of the underground railroad
    in American history.

    Community Scholarship Mobilization Program

        The Committee recommendation does not include funding for
    this program, the same as the budget request. Funds
    appropriated for fiscal year 2000 will be used to provide one
    or two grants to establish centers in high poverty areas that
    promote higher education goals for low-income families.

    GPRA/Higher Education Act Program Evaluation

        The Committee recommends $3,000,000 for the Government
    Performance and Results Act data collection and for the Higher
    Education Act Program Evaluation program, the same as the 2000
    appropriation and the budget request. The administration
    requested these additional funds to comply with the Government
    Performance and Results Act, which requires the collection of
    data and evaluation of Higher Education programs and the
    performance of recipients of Higher Education funds.

                               howard university

    Appropriations, 2000....................................    $219,444,000
    Budget estimate, 2001...................................     224,000,000
    Committee recommendation................................     224,000,000

        The Committee recommends an appropriation of $224,000,000
    for Howard University, which is the same as the budget request
    and an increase of $4,556,000 over the fiscal year 2000
    appropriation. Howard University is located in the District of
    Columbia and offers undergraduate, graduate, and professional
    degrees through 12 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 54 percent of the university's projected educational and
    general expenditures, excluding the hospital. The Committee
    agrees with the administration and recommends, within the funds
    provided, $3,530,000 for the endowment program.
        Howard University Hospital.--Within the funds provided, the
    Committee recommends $30,374,000 for the Howard University
    Hospital, the same as the budget request and the fiscal year
    2000 level. 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, 2000....................................        $737,000
    Budget estimate, 2001...................................         737,000
    Committee recommendation................................         737,000

        Federal administration.--The Committee bill includes
    $737,000 for Federal administration of the CHAFL program, the
    same as the 2000 level and the same as 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 2001. 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, 2000....................................        $207,000
    Budget estimate, 2001...................................         208,000
    Committee recommendation................................         208,000

        Federal administration.--The Committee recommends $208,000
    for Federal administration of the Historically Black College
    and University [HBCU] Capital Financing Program, the same as
    the administration request and an increase of $1,000 above the
    2000 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, 2000....................................    $591,081,000
    Budget estimate, 2001...................................     517,567,000
    Committee recommendation................................     496,519,000

        The bill includes $496,519,000 for educational research,
    statistics, assessment, and improvement programs. This amount
    is $94,562,000 less than the 2000 appropriation and $21,048,000
    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, development, and dissemination

        The Committee recommends $103,567,000 for educational
    research and national dissemination activities, the same as the
    2000 appropriation level. The Committee has also included
    $65,000,000 for regional educational laboratories, the same as
    the 2000 appropriation. These activities are administered by
    the Office of Educational Research and Improvement [OERI],
    which was reauthorized by the Educational Research,
    Development, Dissemination, and Improvement Act of 1994. The
    administration requested $198,567,000 for research, development
    and dissemination activities under proposed legislation which
    would establish a new National Institute for Education
    Research. The Committee defers action on this proposal pending
    the outcome of reauthorization of elementary and secondary
    education programs.
        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.
        On April 13, 2000, the Committee was pleased to receive the
    National Reading Panel report, ``Teaching Children to Read: An
    Evidence-Based Assessment of the Scientific Research Literature
    on Reading and its Implications for Reading Instruction.'' The
    Committee supports the development of a Strategic Plan for the
    Dissemination and Implementation of the work of NICHD and the
    Department of Education in order to ensure that research
    findings on effective reading instructional approaches are
    fully implemented to improve the education of our Nation's
    children. The Committee suggests that the Director of the
    National Institute of Child Health and Human Development and
    the Assistant Secretary for Educational Research and
    Improvement convene a strategic planning team, the members of
    which should include the Chairman of the National Reading Panel
    and citizen members representative of elementary and secondary
    education professionals, higher education administrators, State
    education officials, parents, private business and publishers
    of text books and other classroom materials. The Committee
    expects the plan to be completed by December 31, 2000. The
    Secretary of Education should begin implementation of the plan
    immediately thereafter.

    Statistics

        The Committee recommends $68,000,000 for data gathering and
    statistical analysis activities of the National Center for
    Education Statistics [NCES], the same as the fiscal year 2000
    appropriation and a decrease of $16,000,000 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 $40,000,000 for assessment, the
    same as the amount appropriated in fiscal year 2000 and
    $2,500,000 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 $4,000,000 for the National Assessment
    Governing Board, $500,000 less than the administration request
    and the same as the fiscal year 2000 appropriation.

    Fund for the improvement of education

        The Committee bill provides $142,152,000 for the fund for
    the improvement of education [FIE], which is $101,712,000 below
    the 2000 appropriation and $5,002,000 more than 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.
        Within the amount recommended, the Committee includes
    $30,000,000 for the Elementary School Counseling Demonstration
    Program to establish or expand counseling programs in
    elementary schools as part of the Youth Violence Prevention
    Initiative. The Committee continues to be concerned about the
    inaccessibility of school counselors for young children. Many
    students who are having a difficult time handling the pressures
    of social and academic demands could benefit from having mental
    health care readily available. The Committee believes that
    increasing the visibility of mental health care professionals
    would legitimize their role as part of the school's
    administrative framework, thereby encouraging students to seek
    assistance before resorting to violence.
        Within the amount recommended, the Committee has included
    $12,262,000 for character education partnership grants,
    $3,000,000 more than the amount requested by the
    administration. Of that amount, the Committee recommends
    $5,000,000 be designated to conduct activities as part of the
    Youth Violence Prevention Initiative. The funds will be used to
    encourage states and school districts to develop pilot projects
    that promote strong character, which is fundamental to violence
    prevention. Character education programs should be designed to
    equip young individuals with a greater sense of responsibility,
    respect, trustworthiness, caring, civic virtue, citizenship,
    justice and fairness, and a better understanding of the
    consequences of their actions and the effects they may impose
    on family and society.
        The Committee has included sufficient funds to continue and
    expand the Student/Parent Mock Election, a national,
    nonpartisan organization noted for its achievements in
    promoting voter education activities for students and their
    parents. In 1996, 6 million students and parents participated
    in the Presidential Mock Election, and with more than 70
    million youths in our country today, the Mock Election of 2000
    has the potential to engage more youth in the political process
    than any time in the program's history.
        The Committee continues to be concerned about the
    increasing rates of obesity among children as well as the
    overall lack of activity and physical fitness in today's
    lifestyle, which can lead to obesity and other health risks.
    The Committee believes that the strengthening of physical
    education programs for elementary and secondary school students
    could improve academic achievement, prevent health problems,
    and deter children from crime. The Committee encourages the
    Department to demonstrate programs that reintroduce physical
    education into our nation's schools.
        The Committee is encouraged by the continued development of
    the National Constitution Center. Funds will support the
    design, planning and operation of the center, which is
    incorporated by the National Park Service as a part of the
    Independence National Historical Park.
        The Committee is aware of the following projects and
    encourages the Department to give them full and fair
    consideration:
        The Reading as Tutors program, an innovative approach
    developed by the Northwest Regional Education Laboratory, will
    train seniors as reading tutors for K-12 school settings.
        CALARTS will upgrade and expand its communications with its
    nine satellite campuses to conduct distance learning classes at
    night.
        California State University at Long Beach in collaboration
    with other California State University campuses and
    organizations established the Technology Enhanced Learning
    Project to prototype innovative methods of applying new
    instructional technologies to enhance teaching and learning.
        Alameda County is establishing the Castlemont Multi-Service
    Center, which will service youth and families of East Oakland
    through job training, college prep and occupational skills
    programs.
        ACCESS 2000 will continue to enhance the programs it offers
    to students in more than 30 school districts in Northwest
    Missouri with educational services designed to improve their
    career planning opportunities, leadership development, and
    evaluation of personal skills.
        Self-Enhancement, Inc. supports alternatives for kids
    through the after school programs it offers in the Portland,
    Oregon community.
        Babyland Family Services of Newark, New Jersey, will
    enhance its telecommunications infrastructure and technology
    training to strengthen children's and family's educational
    skills and promote self sufficiency.
        The Riverside School for the Arts provides an incentive for
    students to stay in high school while training them for careers
    in the entertainment/technology industry.
        The Yosemite National Institutes (YNI) is a private, non-
    profit organization dedicated to providing educational
    adventures. Through the Diversity initiative, YNI aggressively
    develops programs and funding that address the educational
    needs of communities that have historically had very limited
    access to quality science-based environmental education.
        The ``I Have a Dream'' Foundation provides needed academic
    and social support to at-risk students to ensure that students
    complete their high school education. The Foundation plans to
    develop a professional training program for project
    coordinators, and to expand the Project Support Team in the New
    York National Office, which serves as a clearinghouse of
    information for the 65 projects which still have children in
    grade school or high school.
        The Miami-Dade County Public School career academies offer
    students the opportunity to specialize in international
    business, travel and tourism, financial services, arts, film,
    entertainment or biomedical research programs to better prepare
    them for postsecondary education, technical training, and
    successful employment.
        The California School of Professional Psychology (CSPP) in
    cooperation with school districts in the San Diego, Los Angles,
    San Francisco and Fresno metropolitan areas plan to develop and
    implement model teacher training programs regarding using
    technology in the classroom, violence prevention and brain
    functioning. The Committee believes the CSPP model will serve
    as an important demonstration for other areas of the country.
        Through the Vermont Education Leadership Initiative,
    Vermont School Boards, Superintendents, Principals, and the
    State Department of Education have come together to address the
    shortage of school leaders in the State.
        The Committee is aware that ``From the Top,'' a nationally
    broadcast public radio program featuring the stories and
    performances of young classical musicians, serves as a national
    resource for pre-college music education, creating greater
    awareness of how music catalyzes young people to collaborate,
    create, and learn--both at home and in public schools.
        The model program developed by the Hampshire College of
    Amherst, Massachusetts at the National Center for Science
    Education will serve as a national model for inquiry-based
    science learning as a foundation upon which to help guide
    reform of science education in the United States. This
    framework will provide a unique environment in which K-16
    science educators and researchers can learn alongside students.
        Reach Out and Read continues to generate strong demand for
    its expansion into offices where pediatricians provide literacy
    training to low-income, at-risk children and their parents.
    Reach Out and Read programs are now operating in 46 States and
    serve nearly one million children per year. The program is
    seeking to expand its services which allow doctors and nurses,
    during health care visits, to provide books and talk with
    parents about the benefits of reading to their children at a
    young age.
        The Alaska Initiative for Community Engagement (Alaska ICE)
    program will utilize community resources to develop sound value
    bases for schoolchildren to increase academic performance and
    involve them in their own communities.
        The Southwest Texas State University Center for School
    Improvement, in conjunction with a consortium of universities
    from other States, will develop innovative and pragmatic
    programs to address specific kindergarten through 12th grade
    educational problems facing teachers and students in
    underperforming school districts in Texas and nationally. The
    Center will directly assist teachers and other education
    professionals through the use of response teams in the areas of
    reading, math, and science.
        The Houston Public Library ASPIRE Program targets at-risk
    students in grades five through nine for after-school tutorial
    assistance in public libraries, and has demonstrated
    encouraging early results with regard to improved student
    performance.
        The Committee is aware that Sheldon Jackson College Center
    for Life-Long Learning has proposed a program to train
    teachers, especially Alaska Natives, to teach in remote Alaskan
    villages to alleviate the critical shortage of teachers and
    lack of Alaska Native teachers in remote Alaskan villages.
        The ``I Can Learn'' computer-based tutorial learning system
    has demonstrated positive results for students in a number of
    school districts across the country, including at the Fort
    Worth Independent School District.
        The State of Alaska has developed a comprehensive proposal
    to address the severe shortage of qualified teachers in Alaska,
    especially in remote arctic communities. The initiative will
    promote development of rural teacher support consortia,
    preparation of teachers new to Alaska, career ladder programs
    for educators in their own villages, and teacher signing and
    retention bonuses.
        The Tonasket School District, Washington has developed the
    Learning Plan, which supports staff development and lesson plan
    integration, in order to improve student achievement in
    reading, writing, math and science.
        The Educational Technology Leadership Institute in Montana
    will provide training to school administrators and educators in
    rural areas to improve their skills to make effective use of
    technology.
        The Sunnyside School District, Washington has developed a
    motivational reading program that dramatically increases
    literature-based reading practices of students.
        Big Brothers Big Sisters of America continues to expand its
    capacity to serve more children through their school based
    mentoring project.
        The Committee notes that the Challenger Learning Center in
    Kenai, AK has proposed a pilot program to develop curricula in
    science and space technology for distance delivery to primary
    and secondary schools across the country.
        The Rose Urban Rural Alaska Partnership Program, created by
    the Alaska Humanities Forum, is taking urban youth to rural
    villages. This initiative will provide a greater awareness and
    understanding by urban Alaska residents of the rural and Native
    way of life in some of Alaska's more than 200 villages and will
    broaden the educational experiences of Alaskan schoolchildren.
        The Necessarily Existent Small Schools Assistance Program
    provides assistance to schools who qualify for assistance due
    to their isolation and small number of students. The program
    ensures that much needed education student services, such as
    books in elementary school libraries or courses necessary for
    high school students to qualify for University admittance are
    available.
        Imaginarium in Anchorage, Alaska plans to develop new
    courses in math and science for students and teachers in rural
    communities in Alaska using distance delivery in order to
    improve access to coursework, teaching materials and teacher
    training in science and mathematics, for students and teachers
    in remote and rural areas.
        Carnegie Hall has engaged in instrumental work providing
    educational outreach and plans to expand this outreach to the
    entire nation through the use of modern technology.
        The Alaska Department of Education's intense summer reading
    program for high school students supports school efforts to
    ensure that students graduate on time and with their
    classmates. This initiative is designed to eliminate the
    problem of low literacy skills that challenge and often
    discourage American youth from continuing their education,
    which ultimately prevents them from securing productive and
    gainful employment.
        The Southeastern Louisiana University's Alternate Teacher
    Certification Technology Program will utilize distance learning
    to improve access to and the quality of teacher training.
        The Mid-South Center for Applied Teaching and Learning to
    Yield Scientific Thinking (CATALYST) program will serve as a
    regional center dedicated to improving the scientific literacy
    of the citizens of primarily rural areas of Louisiana,
    Arkansas, Texas, and New Mexico.
        Project LIFE, a professional development program developed
    by Louisiana Tech University, will improve the teaching skills
    of life science and biology teachers in grades 5-12.
        Grambling State University has developed the Science and
    Mathematics Pipeline Program which offers monthly math and
    science workshops and a summer science camp for junior and
    senior high school students.
        The William L. Gilbert Academy, an initiative undertaken by
    Dillard University, offers a summer program for low income,
    high achieving high school students to provide them with a life
    enriching educational environment.
        The Rock School of Pennsylvania Ballet will continue to
    expand its innovative arts education program for at-risk and
    developmentally disabled youth from Greater Philadelphia and
    the Camden, New Jersey area.
        The New Jersey Historical Society's innovative program,
    Engaging New Jersey's Children in the Past, supports
    experiential-based learning utilizing technology-based
    programs.
        Western Kentucky University's Middle School Development
    Initiative seeks to redesign support programs for middle
    schools and disseminate best practices on a national basis.
        The Alaska Native Heritage Center has developed innovative
    cultural education programs designed to teach Alaskan
    schoolchildren in grades K to 12 the rich history and cultural
    traditions of the Alaska Native people. The Center plans to
    design curricula on Alaska Native history, culture and the arts
    for grades K to 12, and will incorporate new technology to
    provide the courses to schoolchildren across the country.
        The Charter Friends National Network, DC Public Charter
    School Resource Center, and DC Public Charter School
    Cooperative collaboration will document, disseminate, and
    replicate innovative models for providing technical assistance
    to charter schools related to financing and delivering special
    education services to students attending charter schools.
        The Temple University Center for Research in Human
    Development and Education has developed innovative models to
    address teacher recruitment, training and mentoring that will
    enhance student achievement and raise the capabilities of low-
    performing schools.
        The National Science Center Foundation continues to develop
    computer-based software for assisting non-English speaking
    students learn English and pass exit exams required to
    graduate.
        The University of Alabama continues to support its
    technology-based initiative to improve mathematics instruction
    and education.
        Alabama A&M University's Center for Science, Mathematics
    and Technology Education will prepare prospective and current
    teachers for effective use of technology in the classroom.
        The Teacher Education Reform Mentoring project and related
    technology education initiative at Auburn University in
    Montgomery, Alabama will improve educational outcomes through
    preservice support to new teachers and professional development
    opportunities for existing teachers.
        The Alabama Reading Initiative seeks to improve reading
    instruction, particularly effective intervention instruction,
    in order to achieve the goal of 100 percent literacy among
    public school students.
        The University of Maine will build on its current efforts
    to improve math and science teacher training by developing a
    national, research-based model math and science teacher
    training program.
        An Achievable Dream in Newport News, Virginia continues to
    provide unique and innovative services to prepare at-risk youth
    to succeed in school and in life.
        The Virginia Living Museum in Newport News, Virginia will
    build on its proven track record of providing outstanding,
    hands-on science education experiences to support area school
    systems.
        The Virginia Marine Science Museum's Marine Science Camp
    for schools provides hands-on marine science activities to
    thousands of students to help them meet rigorous science
    education standards.
        The Youth Leadership Initiative sponsored by the University
    of Virginia's Center for Governmental Studies utilizes high-
    tech interactive software and other educational programming to
    increase student awareness of their role in our democracy and
    prepares them for a lifetime of political participation.
        Lewis and Clark College's Life of the Mind Education
    initiative will develop educational programming celebrating the
    200th anniversary of the Lewis and Clark Expedition and the
    Louisiana Purchase.
        The American Village in Montavallo, Alabama has developed
    an innovative program to provide students with a better
    understanding of the Constitution and the foundation of
    American self-government.
        The New York Historical Society, in collaboration with area
    high schools, has developed the American Revolution Project, a
    technology-based program designed to enhance teaching and
    learning.
        KidsPeace, the National Center for Kids Overcoming Crisis
    in Orefield, Pennsylvania has designed special education
    programs and expressive treatment activities to support
    recovery for and academic achievement of at-risk students.
        Project 2000 will provide academic support services and
    mentoring programs for inner city African-American youth to
    ensure that they receive a quality high school education and
    are fully prepared for post secondary education.
        The Milton S. Eisenhower Foundation has developed a
    scientific evaluation for public schools which have established
    partnerships with local health, social service, and other
    community agencies to meet the myriad of needs of children and
    their families. The study will specifically evaluate and
    replicate full community school programs that emphasized the
    school as the central point of the community, particularly
    schools which have extended hours and remain open on the
    weekends and the summer.
        MICROSOCIETY is recognized in the Northwest Regional
    Educational Laboratory's Catalog of School Reform Models as a
    whole school reform model meeting the nine criteria of the
    Comprehensive School Reform Model. MICROSOCIETY should further
    develop and disseminate the MICROSOCIETY whole school model of
    comprehensive school reform.
        The National Foundation for Teaching Entrepreneurship
    introduces low-income teens from local communities to the world
    of business and entrepreneurship by teaching them how to
    develop and operate their own legitimate business.
        Big Brothers Big Sisters provides one-to-one services to
    boys and girls in need of additional adult support and
    guidance. These services have been proven to help adolescents
    say no to drugs, improve school attendance, and get along
    better with their peers. Big Brothers Big Sisters seeks
    assistance to expand these services, and establish 5,000 new
    school based mentoring programs.
        The Freedom Foundation at Valley Forge will sustain and
    expand its educational mission by developing new programs
    integrating citizenship education, character and leadership
    development, literacy, and patriotism.
        The Avian Conservation Center for Educational Development
    at the Philadelphia Zoo will advance discovery, understanding,
    and stewardship of the natural world through compelling
    exhibition and interpretation of living things.
        The Martin Luther King Foundation has created a College for
    Teens Program in response to the continuing achievement gap of
    poor, minority and disadvantaged students, escalating crime,
    and violence among youth.
        The Southeastern Pennsylvania Consortium for Higher
    Education has developed an Institute for Lifelong Learning
    which is designed to prepare faculty and students for a
    technology-based future.
        The Washington Jefferson College Center for Excellence in
    Teaching will address kindergarten through post-secondary
    education in the Western Pennsylvania region.
        The George C. Marshall Foundation continues to pilot
    programs focused on at-risk youth involved in the JR ROTC
    program through leadership development and related activities,
    including convening the best JR ROTC students from around the
    country in Lexington, Virginia for briefings by State
    Department, Foreign Service and Pentagon officials.
        Jazz in the Schools outreach project in Philadelphia,
    Pennsylvania is an educational outreach program for students of
    all ages designed to teach students to express themselves
    through the creative arts and to apply the skills and
    disciplines learned through personal creativity to the
    traditional areas of study. The program engages inner-city high
    school students in a hands-on program that uses jazz, as
    America's classic music, as a means to maintain student
    interest in academic subjects in the core curriculum.
        Lock Haven University in collaboration with the Keystone
    Central School District are collaborating to form a successful
    alternative education program to provide educational
    opportunities for students who are not able to succeed in the
    conventional classroom. To extend the impact of this program,
    the Center will also create and operate an extensive ``lending
    library'' with state-of-the-art teaching materials, references,
    and instructional technology.
        The Mississippi Writing and Thinking Institute strives to
    improve the teaching of writing across the State of
    Mississippi, and has identified a road map to reach this goal
    through its Mississippi Strategic Plan for Writing Improvement
    (MWTI). The MWTI through its partnership with State
    universities, local education agencies and schools throughout
    Mississippi will establish a research based network of
    professional development, classroom material and lesson plan
    development, and support services including community
    awareness, and online support for teachers and students.
        The University of Notre Dame's Institute for Educational
    Initiatives plans a research initiative to explore the ways
    that institutional, organizational and social factors affect
    how students learn.
        The Albuquerque Public Schools 2nd Grade Reading Academy
    has developed an innovative program for improving student
    literacy skills through early intervention and extended
    learning activities.
        The Montana State University-Billings has created a model
    program designed to prepare and assist Native Americans,
    Hispanics, and low-income individuals to help them succeed in
    college or other postsecondary education programs.
        The NASA Center for Educational Technologies in West
    Virginia has developed a program to provide all West Virginia
    elementary and secondary math and science teachers with first-
    phase interactive technology training. This training will
    permit enhanced classroom interfacing between teachers and
    students with the computer technology necessary for a well-
    equipped 21st Century workforce.
        The world scholar-athlete competitions to be conducted in
    2001 will engage students from a variety of countries and from
    throughout the United States. Participants should be athletes
    who are talented in the arts and accomplished academically.
        The Providence Public School District has developed a
    comprehensive and innovative plan to ensure that all school
    children are reading at grade level.
        The Educational Leadership Initiative undertaken by Spelman
    College in Atlanta, Georgia is a collaboration with Atlanta
    public schools to provide literacy training to students and
    parents, professional development, and technical support for
    the design of school reform and curricula.
        The Georgia Project, a unique partnership among the Dalton
    and Whitfield County, Georgia public school systems, the local
    business community, and the University of Monterrey in Mexico,
    seeks to effectively assimilate Hispanic immigrant children
    into the mainstream curriculum to improve the education of all
    its students and to build bridges across social and political
    lines.
        The Native American Community Board has developed an
    innovative approach to reducing the school drop out rate and
    improving educational opportunities of Native American youth by
    developing and applying culturally-relevant curriculum in Lake
    Andes South Dakota on the Yankton Sioux reservation.
        The John Carroll University Center for Mathematics, Science
    Education, Teaching, and Technology continues to develop
    creative and effective programs for advancing the quality of
    science and mathematics teaching in K-12, particularly in urban
    schools.
        The University of Findlay Intergenerational Studies
    programs, a recognized leader in its field, has developed its
    distance learning capacity in order to expand access to course
    offerings and ensure that qualified and certified professionals
    are available to work with children, youth, adults, and senior
    adults.
        The National Aviation Hall of Fame continues to provide
    innovative educational programming to area students to support
    and enhance their understanding of science, physics, math, and
    engineering.
        Chicago's John G. Shedd Aquarium, Baltimore's National
    Aquarium and Seattle Aquarium are working together to establish
    the Young Naturalist National Program, an innovative
    conservation education and youth mentoring initiative. Through
    job training, mentoring, and on-site exposure to the workings
    and conservation ethic of an Aquarium, the Program will spur
    the academic and professional advancement of minority and other
    traditionally underserved youths, and foster the next
    generation of scientists.
        The University of Southern Illinois at Carbondale has
    developed an innovative teacher preparation program designed
    specifically for the needs of urban school districts.
        The Digital Media Center at the Illinois Institute of
    Technology will increase access to technology for area school
    children.
        Parkland College, in support of the Illinois Prairie
    Internet Consortium, will develop a Regional Center for Virtual
    Learning to enhance educational opportunities in the community.
        The Center for Black Music Research at Columbia College
    will enhance its use of technology and launch a national
    education and outreach program by the New Black Music Repertory
    Ensemble.
        Barat College, through its Center for Teaching and
    Learning, will establish a technology center to support student
    use and understanding of technology.
        The North Carolina State University Science House will
    continue to develop its outreach efforts to area school
    students and teachers by providing computer-based instruction
    and demonstration programs directly to middle and high schools.
        The ExplorNet Technology Learning Project involves
    educational, governmental, and industrial organizations in a
    collaborative effort to provide students with a strong
    foundation in technology and practical technical skills. The
    program has expanded from its base in North Carolina to serve
    students in North Dakota and Mississippi.
        Reading Together USA at the University of North Carolina at
    Greensboro engages 5th graders in the tutoring of 2nd grade
    students in order to improve their fluency and comprehension
    with the goal of creating successful, independent readers and
    proficient learners. The program has been operating for 4 years
    and has expanded to school districts in Florida, Illinois,
    Pennsylvania, and Carrollton, Texas.
        The State of New Mexico's Department of Education continues
    to explore innovative ways of developing and implementing
    accountability systems to help schools increase student
    performance through proven models of success.
        The New Mexico Department of Education will continue to
    expand use of the Individual Services Model to help reduce the
    rate of drop out for high school students in the State.
        Museums & Universities Supporting Educational Enrichment,
    Inc. has developed an innovative program that integrates
    educational technology and museum content to help improve
    school curriculum and provide additional educational tools for
    schools nationwide.
        The Northwest Natural Resources Institute will provide
    additional curricular material for teachers attending the
    Natural Resources Teacher Institute; expand the Ag Kids who
    Care program to Western Washington; enhance the Model Farm
    program to provide participating teachers with curricular
    materials before and after visits to the farm; and export the
    Model Farm Program to other parts of Washington State.
        The Cook Inlet Tribal Council proposes to stimulate
    interest in science among disadvantaged Alaska Native middle
    school students from urban areas through a science-based,
    culturally relevant summer educational program in the Alaska
    wilderness, with instruction in culture and traditional values
    provided by Native elders and Native college students.
        The Integrated Performance and Benchmarking System (IPBS)
    has been successfully tested in the States of Nebraska and
    Oregon where it fostered quicker data collection and sharing
    among and between the States and Federal Government. An eight-
    State demonstration program would evaluate more fully the
    efficacy of the IPBS.
        The Odyssey Maritime Discovery Center in Seattle is an
    educational center that offers interactive exhibits and serves
    as a focal point for Washington State's maritime, fishing and
    international trade sectors. Odyssey can serve as a gateway
    connecting the worlds of school and work, creating new
    partnerships between business, labor, K-12 schools, post
    secondary education institutions to improve academic
    achievement.
        The Education, Social and Public Services Association
    (ESPSA) plans to develop a targeted communications effort to
    educate low income parents about Washington State's new
    academic standards as well as information about district
    assessments, Advance Placement courses and tests, a glossary of
    new terminology, and the rights and responsibilities of
    students, teachers, and the school district in Seattle,
    Washington.
        The Washington Virtual Classroom Consortium (WVCC), a
    coalition of nine school districts each representing a
    different educational service district in the State of
    Washington, will continue to demonstrate its leadership in the
    area of distance learning with the development of Internet-
    based learning modules and coursework on the topic of water
    quality and Salmonid restoration. The WVCC now proposes to
    expand their course offerings to include Forest Ecosystem
    Management and Agriculture Management and the Environment.
        The Sounds-of-Learning Education Program in Philadelphia,
    Pennsylvania has developed a hands-on program that engages high
    school students in opera as a means to maintain student
    interested in academic subjects in the core curriculum. This
    program responds to the needs created by the elimination of
    performing arts programs in public schools and provides
    children with the opportunity to experience the performing arts
    and preserve music and arts education.
        First Book has developed an innovative program distributing
    books to and promoting improved literacy skills for
    disadvantaged students.
        The teacher induction program developed by the New Mexico
    Department of Education combines professional development, peer
    interaction, and mentoring and intervention for new teachers to
    help retain qualified teachers in the State's public schools.
        Programming developed by Semos Unlimited, Inc. will utilize
    the Internet and other technology-based media to improve
    literacy skills and support academic achievement of residents
    of New Mexico and throughout the United States.
        The University of Northern Iowa, in collaboration with the
    Waterloo Community Schools and other partners, are developing a
    model early childhood development program to prepare children
    from low income communities for success in school.
        The nonprofit organization, Create a World Class School,
    will expand access to its national clearinghouse to facilitate
    the distribution and implementation of the methodology and
    pedagogy utilized by blue ribbon schools.
        The Partners for Literacy program administered by the
    University of South Carolina works with at-risk children and
    their parents to improve family literacy.
        The Pee Dee Education Center has developed an innovative
    program, Science South, which will offer innovative approaches
    to teaching math, science, and technology for students of the
    Pee Dee region.
        The Southeastern New Mexico Educational Resource Center, a
    collaboration of 11 school districts, increases the educational
    opportunities of students through hands-on science instruction
    and other activities.
        Western Village Elementary School located in Oklahoma City,
    Oklahoma has engaged in an innovative community partnership to
    meet the educational needs of the students served by this
    school.
        Hofstra University, located on Long Island, is developing a
    demonstration program for early grade elementary school
    students to provide an enriched curriculum that integrates
    math, science, technology, and literacy studies with arts and
    cultural studies.
        The Center for Excellence in Urban and Rural Education at
    Buffalo State College is working in partnership with area
    school districts and other community organizations to improve
    teacher recruitment and preparedness for service in urban and
    rural school districts.
        ReadNet is promoting literacy through an innovative
    computer curriculum, including web-based educational
    programming, that supports individualized instruction to at-
    risk youth.
        The Boys and Girls Club of Whatcom County, in partnership
    with public schools, community organizations, parents, and the
    private sector, has forged a demonstration program to help
    disadvantaged students overcome the barriers to learning by
    providing health and social services programs located within
    local public schools.
        The Olympic Park Institute in Washington State provides
    high-quality science education programs to traditionally
    underserved populations through its Diversity Initiative.
        The Wilderness Technology Alliance, a non profit created by
    Trinity Technology, has implemented a statewide demonstration
    project designed to address four major issues in education
    today: funding, access to technology, school violence and
    character education, and preparing students for success in a
    high-tech labor market.
        The Alabama On-line High School is an initiative designed
    to use high technology to afford all students an opportunity to
    access the courses needed to graduate from high school, and
    increase technological competence in working with computers.
        The Hattie I. Farrow Children's Center Literacy and Drop
    Out Prevention program continues to develop successful
    approaches to literacy, mentoring, and tutoring for at-risk
    youth in inner-city South Providence.
        The 24 Challenge/Jumping Levels Math Program will bring 24
    program tools to over 3 million new elementary and secondary
    students in Pennsylvania and in Southern California.
        The RAVEN project, a collaboration led by the National
    Aviary in partnership with the Carnegie Mellon University
    Robotics Institute will increase access to environmental
    education programs at the National Aviary through a unique
    technology network that provides real time audio and visual
    accessible to anyone via the Internet.
        The American Visionary Art Museum in Baltimore continues to
    support innovative learning opportunities for under-served
    communities through its educational and out-reach programs.
        The Institute for Student Achievement in Lake Success, New
    York, and Fairfax, Virginia plans to nationalize its model
    program designed to support school districts' overall strategy
    for helping students overcome academic, personal and social
    challenges adversely affecting their achievement.
        The Chester Upland School District, Pennsylvania is
    developing an innovative approach for recruiting, preparing,
    and retaining teachers and teacher candidates in this high
    poverty school district.
        The Los Angeles County Office of Education will design and
    implement a pilot project, Early Advantage, to promote school
    readiness by maximizing the early learning experience of young
    children.
        KCTS in Seattle will combine DVD technology and the
    Internet with KCTS's video library with thematically related
    social studies content to make the media library available to
    area schools for use in classroom projects.
        The Minot State University is developing an Institute for
    Rural Human Services to study and develop systems designed to
    meet the unique needs of persons with disabilities living in
    rural communities, with a special emphasis on working with
    hearing-impaired children.

    International education exchange

        The Committee has provided $10,000,000 for the
    International Education Exchange Program authorized by section
    601(c) of Public Law 103-227. These funds are $2,000,000 more
    than the amount recommended by the administration and
    $3,000,000 more than the amount appropriated in fiscal year
    2000. 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.
        Included within this amount is $1,000,000 to continue a
    civic education program begun in fiscal year 1999 for the
    Republic of Ireland and Northern Ireland and civic education
    assistance to democracies in developing countries. The
    Committee also provides sufficient funds for the initiative
    underway in Bosnia-Herzegovina.

    Civic education

        The Committee recommends $12,000,000 for the Center for
    Civic Education, $2,150,000 more than in fiscal year 2000 and
    $2,150,000 more than the administration request. The Committee
    intends that the authorized programs be funded at least at the
    fiscal year 2000 level. 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.
        Within the amounts provided, the Committee has included
    $1,500,000 to continue the violence prevention initiative begun
    in fiscal year 1999. The Committee encourages that funds be
    used to conduct a five State violence prevention demonstration
    program on public and private elementary, middle, and secondary
    schools involving students, parents, community leaders,
    volunteers, and public and private sector agencies, such as law
    enforcement, courts, bar associations, and community based
    organizations.

    Eisenhower professional development Federal activities

        The Committee recommends $23,300,000 for the Eisenhower
    Professional Development Federal Activities Program, the same
    as the 2000 appropriation and $1,700,000 below the
    administration request.
        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 continues funding for the National Board for
    Professional Teaching Standards.
        The Committee has included $5,000,000 for the Eisenhower
    National Clearinghouse for Mathematics and Science Education,
    an increase of $200,000 over the fiscal year 2000 level. 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 2000 and the 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.

    Javits gifted and talented students education

        The Committee has included $7,500,000 for the Javits Gifted
    and Talented Students Education Program, the same amount
    recommended by the administration and $1,000,000 more than the
    fiscal year 2000 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 conducts research on methods and techniques
    for identifying and teaching gifted and talented students.

    National writing project

        The Committee bill provides $10,000,000 for the National
    Writing Project, an increase of $1,000,000 above the 2000
    appropriation and the same as the administration request.
        These funds are awarded to the National Writing Project in
    Berkeley, CA, which in turn funds projects in 47 States,
    Washington, DC and Puerto Rico, to train teachers of all
    subjects how to teach effective writing.
        The writing project is the only federally funded program
    for the teaching of writing skills at all grade levels. The
    additional funds provided will expand the sites from 160 to
    177, creating the ability to reach almost every teacher in the
    Nation. The Committee is pleased with the continued success of
    this program, and for its ability to leverage up to seven times
    its Federal appropriation from State, local, and private funds.
    The Committee encourages the Department to continue its close
    association with this project, and to use it as a model for
    teacher training initiatives in other disciplines, taking
    advantage of the infrastructure and network of facilities and
    personnel already in place.

                            Departmental Management

                             program administration

    Appropriations, 2000....................................    $382,934,000
    Budget estimate, 2001...................................     413,184,000
    Committee recommendation................................     396,672,000

        The Committee recommends $396,672,000 for program
    administration, an increase of $13,738,000 above the 2000
    appropriation and $16,512,000 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 approximately 170
    Federal education programs. Support for program evaluation and
    studies and advisory councils is also provided under this
    activity.

                            office for civil rights

    Appropriations, 2000....................................     $71,200,000
    Budget estimate, 2001...................................      76,000,000
    Committee recommendation................................      73,224,000

        The Committee bill includes $73,224,000 for the Office for
    Civil Rights [OCR], $2,024,000 above the 2000 appropriation and
    $2,776,000 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, 2000....................................     $34,000,000
    Budget estimate, 2001...................................      36,500,000
    Committee recommendation................................      35,456,000

        The Committee recommends $35,456,000 for the Office of the
    Inspector General, $1,456,000 above the 2000 appropriation and
    $1,044,000 less than 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 (sec. 301).
        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 (sec. 302).
        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 (sec. 303).
        The Committee bill includes a provision giving the
    Secretary of Education authority to transfer up to 1 percent of
    any discretionary funds between appropriations (sec. 304).

                           TITLE IV--RELATED AGENCIES

                       Armed Forces Retirement Home Board

    Appropriations, 2000....................................     $68,295,000
    Budget estimate, 2001...................................      69,832,000
    Committee recommendation................................      69,832,000

        The Committee recommends authority to expend $69,832,000
    from the Armed Forces Home Trust Fund to operate and maintain
    the United States Soldiers' and Airmens' Home and the United
    States Naval Home. This amount is equal to the budget request.

                 Corporation for National and Community Service

                      domestic volunteer service programs

    Appropriations, 2000....................................    $294,521,000
    Budget estimate, 2001...................................     312,616,000
    Committee recommendation................................     302,504,000

        The Committee recommends an appropriation of $302,504,000
    for the domestic volunteer service programs of the Corporation
    for National and Community Service. The Committee
    recommendation is $7,983,000 above the fiscal year 2000
    comparable level, and $10,112,000 less than the budget request.

    VISTA

        The Committee bill provides $83,074,000 for the Volunteers
    in Service to America (VISTA) Program, $2,500,000 above the
    fiscal year 2000 level and $2,926,000 below 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 $187,330,000 for the National
    Senior Volunteer Corps programs, $4,512,000 above the fiscal
    year 2000 level and $5,186,000 less than the budget request.
        The Committee has included $1,494,000 for senior
    demonstration programs. The Committee has provided these
    resources solely for the purpose of continuing grants for
    existing demonstration activities and its recommendation does
    not include resources for any new grants or activities.
        The Committee recognizes the valuable contributions of
    seniors participating in the Foster Grandparent (FGP), Retired
    and Senior Volunteer (RSVP) and Senior Companion Programs
    (SCP). In accordance with the Domestic Volunteer Service Act
    (DVSA), the Committee intends that one-third of each program's
    increase over the fiscal year 2000 level shall be used to fund
    Program of National Significance (PNS) expansion grants to
    allow existing FGP, RSVP and SCP programs to expand the number
    of volunteers serving in areas of critical need as identified
    by Congress in the DVSA. Within the appropriation, sufficient
    funding has been included to provide adequate resources for
    administrative cost increases realized by all current grantees
    in each DVSA program. Remaining funds should be used to begin
    new FGP, RSVP and SCP programs in geographic areas currently
    underserved. The Committee expects these projects to be awarded
    via a nationwide competition among potential community-based
    sponsors.

    Foster Grandparent Program

        The Committee recommends $97,500,000 for the Foster
    Grandparent Program, $1,512,000 above the fiscal year 2000
    appropriations level and $282,000 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.
        The Committee notes that the southeastern portion of Iowa
    is without a Foster Grandparent program (FGP), and urges the
    Corporation to give full and fair consideration to a new FGP
    project in Ottumwa, Iowa.

    Senior Companion Program

        For the Senior Companion Program, the Committee bill
    includes $40,219,000, an increase of $1,000,000 over the fiscal
    year 2000 appropriations level and $1,450,000 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.
        The Committee recognizes the work of the Civic Venture's
    Experience Corps in developing a model program that mobilizes
    the time, talent, and experience of older adults in service to
    the younger generation. The Committee encourages the
    Corporation to give full and fair consideration to this project
    which is already operating in San Francisco, Kansas City, and
    Philadelphia among other areas, and will expand to sixteen
    other sites this year.

    Retired and Senior Volunteer Program

        The Committee bill provides $48,117,000 for the Retired and
    Senior Volunteer Program (RSVP), $2,000,000 above the fiscal
    year 2000 level and $2,448,000 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 $32,100,000 for program
    support, $971,000 above the fiscal year 2000 appropriation and
    $2,000,000 less than the budget request.

                      Corporation for Public Broadcasting

    Appropriations, 2000....................................    $340,000,000
    Appropriations, 2001....................................     350,000,000
    Budget estimate, 2002...................................     365,000,000
    Committee recommendation................................     365,000,000

        The Committee recommends an appropriation of $365,000,000
    for the Corporation for Public Broadcasting (CPB), an advance
    appropriation for fiscal year 2003. This amount is $15,000,000
    more than the fiscal year 2002 appropriation and the same as
    the budget request.
        The Committee recommends $20,000,000 for the conversion to
    digital broadcasting. The recommendation is the same as the
    administration request for fiscal year 2001 and $10,000,000
    more than provided last year. These funds are contingent upon
    enactment of specific authorization.
        The Committee encourages 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, 2000....................................     $36,693,000
    Budget estimate, 2001...................................      39,001,000
    Committee recommendation................................      38,200,000

        The Committee recommends an appropriation of $38,200,000
    for the Federal Mediation and Conciliation Service (FMCS),
    $1,507,000 above the fiscal year 2000 appropriation and
    $801,000 less than 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, 2000....................................      $6,136,000
    Budget estimate, 2001...................................       6,320,000
    Committee recommendation................................       6,320,000

        The Committee recommends an appropriation of $6,320,000 for
    the Federal Mine Safety and Health Review Commission, an
    increase of $184,000 over the fiscal year 2000 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.

             Office of Library Services: Grants and Administration

    Appropriations, 2000....................................    $166,251,000
    Budget estimate, 2001...................................     173,000,000
    Committee recommendation................................     168,000,000

        The Committee recommends an appropriation of $168,000,000
    for the Office of Library Services: Grants and Administration.
    This is $1,749,000 more than the 2000 level and $5,000,000 less
    than the administration request.

    Office of Library Services State Grants

        The Committee recommends $143,118,000 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, $3,030,000 has been provided for library
    services to Native Americans and Native Hawaiians.

    National leadership projects

        The Committee recommends $13,000,000 for national
    leadership projects. 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, digitization of library
    materials, partnerships between libraries and museums and other
    activities that enhance the quality of library services
    nationwide.
        The Committee recognizes the unique, collaborative
    initiative, between the Alaska Native Heritage Center and the
    Bishop Museum, the ``New Trade Winds'' project, to establish an
    educational and cultural demonstration project to help youth
    strengthen their appreciation and knowledge of regional
    heritage. The institutions are participating in the resource-
    sharing of educational materials, telecommunications
    technology, and Alaska Native art. The Committee encourages the
    Department to give the project full and fair consideration for
    continued support.
        The Committee has included sufficient funds to assist the
    National Women's History Museum in improving its internet
    website, which serves as a national repository for virtual
    exhibits on issues like women's suffrage and women's
    achievements in fields such as science, politics, education,
    healthcare, and business.
        The following programs under this account have been brought
    to the Committee's attention. The Committee believes that each
    will support improvements to the quality of services provided
    to communities, consistent with the priorities of the
    Institute.
        The Committee encourages the Department to give each of the
    following projects full and fair consideration:
      --the Clay Center for Arts and Science for a planetarium
            multimedia display screen, and the fabrication and
            design of a science exhibit;
      --the Wisconson Maritime Museum to enhance its facility with
            interactive exhibits;
      --the Weis Earth Science Museum at the University of
            Wisconsin-Fox Valley for exhibits and interactive
            simulations of lead and iron mine tunnels, and other
            gem and mineral educational displays;
      --The Walt Whitman Cultural Arts Center (WWCAC) in Camden,
            New Jersey to expand its cultural education programs;
      --the Plainfield Public Library's Technology Tower to upgrade
            and expand computer and internet services;
      --the New York Public Library's Schomburg Center for Research
            in Black Culture to digitize material about African
            American migration to the United States;
      --Robert T. Stafford Institute for Public Policy to implement
            and expand the education program to foster appreciation
            of public service;
      --Newark Museum's New Science Education Initiative to create
            major science exhibits, develop innovative uses of
            existing resources for teaching and training of
            educators, and enhance science education in New Jersey;
      --for digitalization and cataloging of the collection at the
            George Eastman House in New York;
      --a collaborative effort being lead by the New Bedford
            Whaling Museum to enhance and expand the collection and
            historical artifacts educating students and scholars
            about maritime history;
      --the Perkins Geology Museum at the University of Vermont to
            digitalize its collection;
      --for technology upgrades at the Kellogg-Hubbard Library in
            Montpelier, Vermont;
      --Old Sturbridge Village educational museum for a digital
            exhibit which will be made available on the Internet;
      --the Center for New Deal Studies at Roosevelt University in
            Chicago, Illinois for exhibits and library improvements
            for the Franklin and Eleanor Roosevelt collection;
      --the George C. Page Museum in Los Angeles, California to
            implement educational programs based on the work at
            Rancho La Brea Tar Pits;
      --the Dian Fossey Mountain Gorilla Program at the Louisville
            Zoo;
      --expansion of the Newsline for the Blind service, including
            the West Virginia and the Iowa Federation of the Blind
            Newslines, to distribute national and local newspapers
            to libraries in all States with access provided through
            dial-in distribution sites maintained and served by a
            national network;
      --the American Visionary Art Museum in Baltimore, Maryland;
      --the American Museum of Natural History for specimen and
            library collection storage and expansion of the
            digitization effort;
      --the Pollock Krasner House in New York;
      --the Discovery Square project in Erie, Pennsylvania;
      --the Please Touch Museum in Philadelphia, Pennsylvania to
            develop hands-on learning experiences for young
            children and their families;
      --the Franklin Institute to enhance the Design of Life
            exhibition;
      --the Wayne Arts Center for a program designed as a community
            resource for teachers;
      --Ursinus College for expansion of college-based community,
            cultural, and education programs in the arts;
      --Temple University Library in Philadelphia, Pennsylvania for
            digitization of photographs, manuscripts, video and
            audio interviews, among other resources, from its Urban
            History and African American Collections;
      --Mobile Public Library to update and expand its reference
            system and electronic databases;
      --Southeast Missouri State University River Campus and Museum
            to restore the historic former St. Vincent Seminary to
            focus on the arts, sciences, and technology through
            quality teaching, education, outreach and museum
            programs;
      --the Institute for the Historic Study of Jazz at the
            University of Idaho to develop an archival library.
            Funding would help with the digitalization process,
            development of an online database, and preservation of
            archival materials;
      --the City of Rancho Cucamonga, California to expand reading
            and educational opportunities for its citizens through
            the use of bookmobiles;
      --Taft Branch Library in the City of Orange, California to
            provide ADA accessibility;
      --a collaborative, multicultural institution being formed in
            Rhode Island known as the Heritage Harbor Museum. Any
            funds would be used for cataloging of materials;
      --the National Museum of American Jewish History for
            expansion of its exhibition core in Philadelphia,
            Pennsylvania;
      --the Life Center at Franklin Pierce College in Rindge, New
            Hampshire to be used to acquire collections and for
            various programming needs;
      --the Montana State Library to coordinate and develop an
            online library catalog to ensure access for residents,
            patrons, and visitors to Montana's libraries.

    Administration

        The Committee recommends $5,190,000 for program
    administration, the same as the budget request. Funds support
    personnel compensation and benefits, travel, rent,
    communications, utilities, printing, equipment and supplies,
    automated data processing, and other services.

                      Medicare Payment Advisory Commission

    Appropriations, 2000....................................      $7,015,000
    Budget estimate, 2001...................................       8,000,000
    Committee recommendation................................       8,000,000

        The Committee recommends an appropriation of $8,000,000 for
    the Medicare Payment Advisory Commission, $985,000 more than
    the fiscal year 2000 appropriation and the same as the budget
    request.
        The Medicare Payment Advisory Commission (MedPAC) was
    established by Congress as part of the Balanced Budget Act of
    1997 (Public Law 105-33). Congress merged the Physician Payment
    Review Commission with the Prospective Payment Assessment
    Commission to create MedPAC.
        The Committee has included sufficient funds for the
    Commission to complete a study of the differences in total fee-
    for-service payment on behalf of Medicare beneficiaries
    residing in different States, and in different regions of the
    same States. This study shall focus on identity differences
    attributable to: (a) use and mix of services, by major category
    (e.g., inpatient hospital care, outpatient services, home
    health, ambulatory); (b) site of service delivery; (c) price of
    services, by major category; (d) severity of illness at time of
    service; (e) gender and race; (f) regional practice variations.
    The study shall include recommendations for changes in public
    policy to reduce these disparities.

            National Commission on Libraries and Information Science

    Appropriations, 2000....................................      $1,295,000
    Budget estimate, 2001...................................       1,495,000
    Committee recommendation................................       1,495,000

        The Committee recommends an appropriation of $1,495,000 for
    the National Commission on Libraries and Information Science,
    an increase of $200,000 over the fiscal year 2000 appropriation
    and the same as 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 library and information
    sciences.

                         National Council on Disability

    Appropriations, 2000....................................      $2,391,000
    Budget estimate, 2001...................................       2,615,000
    Committee recommendation................................       2,615,000

        The Committee recommends an appropriation of $2,615,000 for
    the National Council on Disability, $224,000 above the fiscal
    year 2000 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, 2000....................................      $2,241,000
    Budget estimate, 2001...................................       2,350,000
    Committee recommendation................................       2,350,000

        The Committee recommends $2,350,000 for the national
    education goals panel, $109,000 above the 2000 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 eight annual reports delineating National and State
    progress toward the national education goals.

                         National Labor Relations Board

    Appropriations, 2000....................................    $205,717,000
    Budget estimate, 2001...................................     216,438,000
    Committee recommendation................................     216,438,000

        The Committee recommends an appropriation of $216,438,000
    for the National Labor Relations Board (NLRB), $10,721,000 more
    than the fiscal year 2000 comparable level and the same as the
    budget request.
        While the bulk of this increase is intended to meet built
    in costs, such as the mandatory cost of living adjustments, the
    Committee recommendation also includes the requested increases
    for field operations and the National Board to help reduce
    backlogged cases.
        The NLRB is a law enforcement agency which adjudicates
    disputes under the National Labor Relations Act.

                            National Mediation Board

    Appropriations, 2000....................................      $9,562,000
    Budget estimate, 2001...................................      10,400,000
    Committee recommendation................................      10,400,000

        The Committee recommends an appropriation of $10,400,000
    for the National Mediation Board, $838,000 more than the fiscal
    year 2000 appropriation and the same as 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, 2000....................................      $8,470,000
    Budget estimate, 2001...................................       8,720,000
    Committee recommendation................................       8,720,000

        The Committee recommends an appropriation of $8,720,000 for
    the Occupational Safety and Health Review Commission, $250,000
    above the fiscal year 2000 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.

                           Railroad Retirement Board

                         dual benefits payments account

    Appropriations, 2000....................................    $173,339,000
    Budget estimate, 2001...................................     160,000,000
    Committee recommendation................................     160,000,000

        The Committee has provided a total of $160,000,000 for dual
    benefits, including $10,000,000 in income tax receipts on dual
    benefits as authorized by law. The Committee recommendation is
    $13,339,000 less than the fiscal year 2000 level and 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, 2000....................................        $150,000
    Budget estimate, 2001...................................         150,000
    Committee recommendation................................         150,000

        The Committee recommends $150,000 for interest earned on
    unnegotiated checks. This is the same as the fiscal year 2000
    appropriation and budget request.

                          limitation on administration

    Appropriations, 2000....................................     $90,655,000
    Budget estimate, 2001...................................      92,500,000
    Committee recommendation................................      92,500,000

        The Committee recommends an appropriation of $92,500,000
    for the administration of railroad retirement/survivor benefit
    programs. This amount is $1,845,000 more than the fiscal year
    2000 comparable level, and the same as 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, 2000....................................      $5,380,000
    Budget estimate, 2001...................................       5,700,000
    Committee recommendation................................       5,700,000

        The Committee recommends $5,700,000 for the Office of the
    Inspector General, $320,000 above the 2000 appropriation and
    the same as the budget request.

                         Social Security Administration

                    PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

    Appropriations, 2000....................................     $20,764,000
    Budget estimate, 2001...................................      20,400,000
    Committee recommendation................................      20,400,000

        The Committee recommends an appropriation of $20,400,000
    for payments to Social Security trust funds, the same as the
    administration request. This amount reimburses the old age and
    survivors 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.

                   SPECIAL BENEFITS FOR DISABLED COAL MINERS

    Appropriations, 2000....................................    $383,638,000
    Budget estimate, 2001...................................     365,748,000
    Committee recommendation................................     365,748,000

        The Committee recommends an appropriation of $365,748,000
    for special benefits for disabled coal miners. This is in
    addition to the $124,000,000 appropriated last year as an
    advance for the first quarter of fiscal year 2000. 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.
        The Social Security Administration holds primary
    responsibility for claims filed before July 1973, with the
    Department of Labor responsible for claims filed after that. By
    law, increases in black lung benefit payments 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 appropriation of
    $114,000,000 for the first quarter of fiscal year 2002, the
    same as the administration request. These funds will ensure
    uninterrupted benefit payments to coal miners, their widows,
    and dependents.

                          SUPPLEMENTAL SECURITY INCOME

    Appropriations, 2000.................................... $22,150,085,000
    Budget estimate, 2001...................................  23,354,000,000
    Committee recommendation................................  23,354,000,000

        The Committee recommends an appropriation of
    $23,354,000,000 for supplemental security income. This is in
    addition to the $9,890,000,000 appropriated last year as an
    advance for the first quarter of fiscal year 2001 and includes
    funds for continuing disability reviews. The recommendation is
    the same as the administration's request and $1,203,915,000
    more than the fiscal year 2000 level. The Committee also
    recommends an advance appropriation of $10,470,000 for the
    first quarter of fiscal year 2002 to ensure uninterrupted
    benefits 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
    6.4 million persons will receive SSI benefits each month during
    fiscal year 2001. In many cases, SSI benefits supplement income
    from other sources, including Social Security benefits. The
    funds are also used to reimburse the Social Security trust
    funds for the administrative costs for the program with a final
    settlement by the end of the subsequent fiscal year as required
    by law, to reimburse vocational rehabilitation agencies for
    costs incurred in successfully rehabilitating SSI recipients
    and for research and demonstration projects.

    Beneficiary services

        The Committee recommendation includes $71,000,000 for
    beneficiary services, which is the same as the administration
    request and $7,000,000 above the fiscal year 2000 level. This
    amount is available for reimbursement of State vocational
    rehabilitation agencies and alternate public or private
    providers. In 1994 SSA published a regulation permitting direct
    reimbursement of alternate public and private providers to
    provide vocational rehabilitation services. Vocational
    rehabilitation services are now more readily available to a
    larger number of people with disabilities, since the regulation
    allows SSA to use an alternate public or private sector
    provider, if a State vocational rehabilitation agency has not
    accepted an SSA-referred person for services or extended
    evaluation.

    Research and demonstration projects

        The Committee recommendation includes $30,000,000 for
    research and demonstration projects conducted under sections
    1110 and 1115 of the Social Security Act. This is $4,915,000
    above the fiscal year 2000 level and the same as the
    administration request.
        This amount will support SSA's efforts to strengthen its
    policy evaluation capability and focus on research of: program
    solvency issues, the impact of demographic changes on future
    workloads and effective return-to-work strategies for disabled
    beneficiaries.
        The Committee understands that some patients with Lyme
    disease and other tick-borne disorders have encountered some
    difficulty when applying for assistance through SSA offices,
    due to SSA employees' unfamiliarity with these illnesses. SSA
    is encouraged to work on developing educational materials for
    SSA employees to facilitate a better understanding of the
    potential debilitating effects of these disorders. The
    Committee suggests that SSA collaborate with clinicians who
    have expertise on the multi-system chronic effects of Lyme, as
    well as patient and voluntary communities, to accomplish this
    goal.
        The Committee is pleased that the Social Security
    Administration, in coordination with the Health Care Financing
    Administration and appropriate State agencies, has undertaken a
    demonstration program designed to identify potential Medicare
    buy-in eligibles, including widowed spouses who may have
    recently become eligible due to the recalculation of their
    Social Security benefits based on their spouses' death. The
    Committee encourages the Adminstration to incorporate findings
    from this effort when considering any changes required to
    protect this vulnerable population and ensure that they receive
    the benefits to which they are entitled.
        The Committee is pleased that SSA officials have created
    muliple opportunities to educate adjudicators at all levels of
    the SSA process about the April 1999 CFS ruling (99-2p). The
    Committee encourages SSA to continue these educational efforts,
    to ensure SSA employees are properly informed about CFS and the
    functional limitations it imposes. Finally, the Committee
    encourages SSA to continue its investigation of obstacles to
    benefits for persons with CFIDS, to assess the impact of the
    new ruling on CFS patients' access to benefits, and to keep
    medical information updated throughout all levels of the
    application and review process.
        The Committee is aware that minority seniors face added
    challenges in accessing Social Security and Supplemental
    Security Income benefits to which they are entitled because of
    linguistic, cultural, and other barriers. The Committee also
    recognizes that the Social Security Administration (SSA) has
    initiated steps to lower or reduce these barriers. To speed
    this process, however, the Committee urges SSA to aggressively
    demonstrate ways that enable the agency to enhance the services
    that it provides to all of its customers. Such a demonstration
    could include: (1) innovative ways to utilize the experience
    and talents of other seniors, including but not limited to
    those having knowledge of a familiarity with the linguistic and
    cultural backgrounds of underserved minority senior
    populations, an approach successfully demonstrated at the
    Environmental Protection Agency; and (2) cooperative
    agreements, especially with national aging organizations with
    proven experience in serving minority seniors, in conducting
    these outreach demonstrations.

    Administration

        The Committee recommendation includes $2,359,000 for
    payment to the Social Security trust funds for the SSI
    Program's share of SSA's base administrative expenses. This is
    $217,000,000 above the fiscal year 2000 level and the same as
    the administration request.

    Continuing disability reviews

        The recommendation includes $210,000,000 for payments to
    the Social Security trust fund to process continuing reviews
    and redeterminations of the disability and nondisability
    eligibility factors of entitlement for individuals receiving
    supplemental security income on the basis of their disability.

                     LIMITATION ON ADMINISTRATIVE EXPENSES

    Appropriations, 2000....................................  $6,572,036,000
    Budget estimate, 2001...................................   7,134,000,000
    Committee recommendation................................   7,010,800,000

        The Committee recommends a program funding level of
    $7,010,800,000 for the limitation on administrative expenses,
    which is $123,200,000 less than the administration request and
    $438,764,000 higher than the fiscal year 2000 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 initial and continuing
    disability determinations on behalf of the Social Security
    Administration. Additionally, the limitation provides funding
    for computer support, and other administrative costs.
        The limitation includes $6,469,800,000 for routine
    operating expenses of the agency, which is $123,200,000 less
    than the amount requested by the President and $362,764,000
    over the 2000 comparable amount. These funds, as well as those
    derived from an increase in the user fees which are discussed
    below, cover the mandatory costs of maintaining equipment and
    facilities, as well as staffing.
        The Committee recognizes the significant problems facing
    the Social Security Appeals Council, due to their overwhelming
    workload. Although the amount of appeals processed by the
    Council has almost doubled in the past four years, the number
    of pending cases has doubled as well. Since improvements have
    been made to other aspects of the hearings process of the
    Social Security Administration, the Committee understands that
    more resources could be directed towards the appeals council
    workload. By doing this, the Committee believes that many of
    the cases still pending will be processed in a more timely
    manner.

    Social Security Advisory Board

        The Committee has included $1,800,000 within the limitation
    on administrative expenses account for the Social Security
    Advisory Board for fiscal year 2001, the same level as the
    administration request and the same as the fiscal year 2000
    level.

    User fees

        In addition to other amounts provided, the Committee
    recommends $91,000,000 for administrative activities funded
    from user fees that were authorized in fiscal year 1998. This
    is the same as the administration's request and an increase of
    $11,000,000 over the fiscal year 1999 level.

                        OFFICE OF THE INSPECTOR GENERAL

    Appropriations, 2000....................................     $65,752,000
    Budget estimate, 2001...................................      73,000,000
    Committee recommendation................................      69,444,000

        The Committee recommends $69,444,000 for activities for the
    Office of the Inspector General, $3,692,000 more than fiscal
    year 2000 and $3,556,000 below the administration request. This
    includes a general fund appropriation of $16,944,000 together
    with an obligation limitation of $52,500,000 from the Federal
    old-age and survivors insurance trust fund and the Federal
    disability insurance trust fund.
        Protecting the Privacy of Social Security Numbers.--The
    Committee is concerned that with the advent of the Internet,
    there are new challenges to protecting the privacy of
    individuals' Social Security Numbers (SSNs). The number of
    complaints of identity theft and other abuses due to the
    inappropriate sale or misuse of SSNs has risen dramatically.
    The Committee commends the Office of Inspector General for
    their work on the inappropriate sale and misuse of SSNs and has
    included additional funds to allow an expansion of these
    important consumer protection efforts and to appropriately
    respond to the rapidly rising number of complaints.

                            U.S. Institute of Peace

    Appropriations, 2000....................................     $12,951,000
    Budget estimate, 2001...................................      14,450,000
    Committee recommendation................................      12,951,000

        The Committee recommends an appropriation of $12,951,000
    for the U.S. Institute of Peace, the same as the fiscal year
    2000 appropriation and $1,499,000 less than 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.

                          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 (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 (sec. 507); and limit use of funds for abortion (sec. 508
    and sec. 509).
        The Committee recommendation includes language on human
    embryo research (sec. 510).
        The Committee recommendation retains the limitation on use
    of funds for promotion of legalization of controlled substances
    included last year (sec. 511).
        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. 512).
        The Committee recommendation continues authority for
    agencies to use unobligated balances through the first quarter
    of fiscal year 2002 (sec. 513).
        The Committee bill includes language regarding the
    individual health identifier (sec. 514).
        The Committee has included bill language which repeals the
    provision in Public Law 105-33 which delays the October SSI
    payment until October 2, 2000. Consequently, the SSI benefit
    due October 1, 2000 (Sunday) will be paid September 29, 2000
    (Friday) consistent with the normal rules for making SSI
    payments which come due on a weekend or non-banking day and
    preventing a hardship on beneficiaries who may be depending on
    the regular payment date in order to meet their expenses for
    food and shelter (sec. 515).
        Current law provides that effective for months after
    September 2009, a State that has entered into an agreement with
    the Social Security Administration for Federal administration
    of State supplementary payments will be required to remit
    payments and fees no later than the business day preceding the
    SSI payment date. The Committee has included bill language
    which accelerates the effective date to the months after
    September 2001. SSI and State supplementary payment
    beneficiaries will not be affected by this proposal (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 2001: Subcommittee on Labor, Health and
     Human Services, Education, and Related Agencies:
        General purpose non-defense discretion-  ary............  ...........       97,820  ...........   \1\ 93,074
        Mandatory...............................................  ...........      237,067  ...........      236,568
    Projections of outlays associated with the recommendation:
        2001....................................................  ...........  ...........  ...........  \2\ 221,717
        2002....................................................  ...........  ...........  ...........       39,666
        2003....................................................  ...........  ...........  ...........        9,286
        2004....................................................  ...........  ...........  ...........        1,421
        2005 and future year....................................  ...........  ...........  ...........          394
    Financial assistance to State and local governments for 2001           NA      133,220  ...........      114,294
    ----------------------------------------------------------------------------------------------------------------
    \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 adoption
      assistance, and in accordance with section 314 of the Congressional Budget Act of 1974, the Committee
      anticipates that the Budget Committee will file a revised section 302(a) allocation for the Committee on
      Appropriations reflecting an upward adjustment of $470,000,000 in budget authority and $408,000,000 in
      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,
            $440,200,000;
              National Skills Standards Board, $3,500,000;
              Family Planning, $253,932,000;
              Preventive Health and Health Services Block Grant,
            $130,899,000;
              Sexually transmitted diseases, $131,978,000;
              Injury Prevention and Control (Traumatic Brain Injury
            Research), $68,000,000;
              Substance Abuse and Mental Health Services
            Administration (except Program Management),
            $2,680,814,000;
              Runaway and Homeless Youth; Homeless Youth
            Transitional Living, $69,155,000;
              Developmental Disabilities, $127,347,000;
              Administration on Aging, $954,619,000;
              Adolescent Family Life, $19,327,000;
              Nursing Loan Payment, $2,279,000;
              Universal Newborn Hearing, $4,000,000;
              Organ Transplantation, $15,000,000;
              Prostate Cancer, $8,721,000;
              Research on Health Care Systems Cost and Access
            Federal Funds, $24,326,000;
              Violent Crime Reduction Programs, $118,500,000.

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

        Pursuant to paragraph 7(c) of rule XXVI, the bill S. 2553
    was ordered reported from the Committee, subject to amendment
    and subject to the section 302(b) allocation, 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
    Mrs. Hutchison
    Mr. Kyl
    Mr. Byrd
    Mr. Inouye
    Mr. Hollings
    Mr. Leahy
    Mr. Lautenberg
    Mr. Harkin
    Ms. Mikulski
    Mr. Reid
    Mr. Kohl
    Mrs. Murray
    Mr. Dorgan
    Mrs. Feinstein
    Mr. Durbin

     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 8--ALIENS AND NATIONALITY

               *       *       *       *       *       *       *

    CHAPTER 12--IMMIGRATION AND NATIONALITY

               *       *       *       *       *       *       *

                           SUBCHAPTER II--IMMIGRATION

    Part I--Selection System

               *       *       *       *       *       *       *

    Sec. 1157. Annual admission of refugees and admission of emergency
                        situation refugees

               *       *       *       *       *       *       *

           Establishing Categories of Aliens for Purposes of Refugee
    Determinations

               *       *       *       *       *       *       *

        ``(a) * * *

               *       *       *       *       *       *       *

        ``(b) Establishment of Categories.--
                ``(1) * * *
                ``(3) Within the number of admissions of refugees
            allocated for for [sic] each of fiscal years [1997,
            1998, 1999, and 2000] 1997, 1998, 1999, 2000 and 2001
            for refugees who are nationals of the Soviet Union
            under section 207(a)(3) of the Immigration and
            Nationality Act [8 U.S.C. 1157(a)(3)] and within the
            number of such admissions allocated for each of fiscal
            years 1993, 1994, 1995, and 1996 for refugees who are
            nationals of the independent states of the former
            Soviet Union, Estonia, Latvia, and Lithuania under such
            section, notwithstanding any other provision of law,
            the President shall allocate one thousand of such
            admissions for such fiscal year to refugees who are
            within the category of aliens described in paragraph
            (2)(B).

               *       *       *       *       *       *       *

        ``(e) Period of Application.--
                ``(1) Subsections (a) and (b) shall take effect on
            the date of the enactment of this Act [Nov. 21, 1989]
            and shall only apply to applications for refugee status
            submitted before [October 1, 2000] October 1, 2001.
                ``(2) Subsection (c) shall apply to decisions made
            after the date of the enactment of this Act and before
            [October 1, 2000] October 1, 2001.
                ``(3) Subsection (d) shall take effect on the date
            of the enactment of this Act and shall only apply to
            reapplications for refugee status submitted before
            [October 1, 2000] October 1, 2001.''

               *       *       *       *       *       *       *

    Sec. 1255. Adjustment of status of nonimmigrant to that of person
                        admitted for permanent residence

               *       *       *       *       *       *       *

        Adjustment of Status for Certain Soviet and Indochinese Parolees

        ``(a) * * *

               *       *       *       *       *       *       *

        ``(b) Aliens Eligible for Adjustment of Status.--The
    benefits provided in subsection (a) shall only apply to an
    alien who--
                ``(1) was a national of an independent state of the
            former Soviet Union, Estonia, Latvia, Lithuania,
            Vietnam, Laos, or Cambodia, and
                ``(2) was inspected and granted parole into the
            United States during the period beginning on August 15,
            1988, and ending on [September 30, 2000] September 30,
            2001, after being denied refugee status.

               *       *       *       *       *       *       *

    Public Health Service Act

               *       *       *       *       *       *       *

    TITLE XIX--BLOCK GRANTS

               *       *       *       *       *       *       *

    SEC. 1918. DETERMINATION OF AMOUNT OF ALLOTMENT.

        (a) * * *

               *       *       *       *       *       *       *

        [(b) Minimum Allotments for States.--For each of the fiscal
    years 1993 and 1994, the amount of the allotment required in
    section 1911 for a State for the fiscal year involved shall be
    the greater of--
                [(1) the amount determined under subsection (a) for
            the State for the fiscal year; and
                [(2) an amount equal to 20.6 percent of the amount
            received by the State from allotments made pursuant to
            this part for fiscal year 1992 (including reallotments
            under section 205(a) of the ADAMHA Reorganization
            Act).]
        (b) Minimum Allotments for States.--Each State's allotment
    for fiscal year 2001 for programs under this subpart shall not
    be less than such State's allotment for such programs for
    fiscal year 2000.

               *       *       *       *       *       *       *

    SEC. 1933. DETERMINATION OF AMOUNT OF ALLOTMENT.

        (a)  * * *

               *       *       *       *       *       *       *

        [(b) Minimum Allotments for States.--For each of the fiscal
    years 1993 and 1994, the amount of the allotment required in
    section 1921 for a State for the fiscal year involved shall be
    the greater of--
                [(1) the amount determined under subsection (a) for
            the State for the fiscal year; and
                [(2) an amount equal to 79.4 percent of the amount
            received by the State from allotments made pursuant to
            this part for fiscal year 1992 (including reallotments
            under section 205(a) of the ADAMHA Reorganization
            Act).]
        (b) Minimum Allotments for States.--Each State's allotment
    for fiscal year 2001 for programs under this subpart shall not
    be less than such State's allotment for such programs for
    fiscal year 2000.

               *       *       *       *       *       *       *

    Social Security Act

               *       *       *       *       *       *       *

    TITLE IV OF THE SOCIAL SECURITY ACT

               *       *       *       *       *       *       *

    SEC. 403. GRANTS TO STATES.

        (a) Grants.--
                (1) Family assistance grant.--

               *       *       *       *       *       *       *

                (3) Supplemental grant for population increases in
            certain states.--
                        (A) In general.--Each qualifying State
                    shall, subject to subparagraph (F), be entitled
                    to receive from the Secretary--
                                (i) for fiscal year 1998 a grant in
                            an amount equal to 2.5 percent of the
                            total amount required to be paid to the
                            State under former section 403 (as in
                            effect during fiscal year 1994) for
                            fiscal year 1994; [and]
                                (ii) for each of fiscal years
                            [1999, 2000, and 2001] 1999 and 2000, a
                            grant in an amount equal to the sum
                            of--
                                        (I) the amount (if any)
                                    required to be paid to the
                                    State under this paragraph for
                                    the immediately preceding
                                    fiscal year; and
                                        (II) 2.5 percent of the sum
                                    of--
                                                (aa) the total
                                            amount required to be
                                            paid to the State under
                                            former section 403 (as
                                            in effect during fiscal
                                            year 1994) for fiscal
                                            year 1994; and
                                                (bb) the amount (if
                                            any) required to be
                                            paid to the State under
                                            this paragraph for the
                                            fiscal year preceding
                                            the fiscal year for
                                            which the grant is to
                                            be made[.] ; and
                                (iii) for fiscal year 2001, a grant
                            in an amount equal to the amount of the
                            grant to the State under clause (i) for
                            fiscal year 1998.

               *       *       *       *       *       *       *

                        (G) Budget scoring.--Notwithstanding
                    section 257(b)(2) of the Balanced Budget and
                    Emergency Deficit Control Act of 1985, the
                    baseline shall assume that no grant shall be
                    made under this paragraph after fiscal year
                    2001. Upon enactment, the provisions of this
                    Act that would have been estimated by the
                    Director of the Office of Management and Budget
                    as changing direct spending and receipts for
                    fiscal year 2001 under section 252 of the
                    Balanced Budget and Emergency Deficit Control
                    Act of 1985 (Public Law 99-177), to the extent
                    such changes would have been estimated to
                    result in savings in fiscal year 2001 of
                    $240,000,000 in budget authority and
                    $122,000,000 in outlays, shall be treated as if
                    enacted in an appropriations act pursuant to
                    Rule 3 of the Budget Scorekeeping Guidelines
                    set forth in the Joint Explanatory Statement of
                    the Committee of Conference accompanying
                    Conference Report No. 105-217, thereby changing
                    discretionary spending under section 251 of
                    that Act.

               *       *       *       *       *       *       *

                (5) Welfare-to-work grants.--* * *
                        (A) Formula grants.--* * *
                                (i) Entitlement.--A State shall be
                            entitled to receive from the Secretary
                            of Labor a grant for each fiscal year
                            specified in [subparagraph (I)]
                            subparagraph (H) of this paragraph for
                            which the State is a welfare-to-work
                            State, in an amount that does not
                            exceed the lesser of--

               *       *       *       *       *       *       *

                                (iv) * * *
                                        (I) 75 percent of the sum
                                    of--
                                                (aa) the amount
                                            specified in
                                            subparagraph [(I)] (H)
                                            for the fiscal year,
                                            minus the total of the
                                            amounts reserved
                                            pursuant to
                                            subparagraphs (E), (F),
                                            [(G), and (H)] and (G)
                                            for the fiscal year;
                                            and
                                                (bb) any amount
                                            reserved pursuant to
                                            subparagraph [(F)] (E)
                                            for the immediately
                                            preceding fiscal year
                                            that has not been
                                            obligated; and

               *       *       *       *       *       *       *

                        (B) * * *
                                (i) * * *

               *       *       *       *       *       *       *

                                (v) Funding.--For grants under this
                            subparagraph for each fiscal year
                            specified in subparagraph [(I)] (H),
                            there shall be available to the
                            Secretary of Labor an amount equal to
                            the sum of--
                                        (I) 25 percent of the sum
                                    of--
                                                (aa) the amount
                                            specified in
                                            subparagraph [(I)] (H)
                                            for the fiscal year,
                                            minus the total of the
                                            amounts reserved
                                            pursuant to
                                            subparagraphs (E), (F),
                                            [(G), and (H)] and (G)
                                            for the fiscal year;
                                            and
                                                (bb) any amount
                                            reserved pursuant to
                                            subparagraph [(F)] (E)
                                            for the immediately
                                            preceding fiscal year
                                            that has not been
                                            obligated; and

               *       *       *       *       *       *       *

                        (C) Limitations on use of funds.--
                                (i) * * *

               *       *       *       *       *       *       *

                                (viii) Deadline for expenditure.--
                            An entity to which funds are provided
                            under this paragraph shall remit to the
                            Secretary of Labor any part of the
                            funds that are not expended within [3
                            years] 5 years after the date the funds
                            are so provided.

               *       *       *       *       *       *       *

                        [(E) Set-aside for successful performance
                    bonus.--
                                (i) In general.--The Secretary of
                            Labor shall award a grant in accordance
                            with this subparagraph to each
                            successful performance State in fiscal
                            year 2000, but shall not make any
                            outlay to pay any such grant before
                            October 1, 2000.
                                (ii) Amount of grant.--The
                            Secretary of Labor shall determine the
                            amount of the grant payable under this
                            subparagraph to a successful
                            performance State, which shall be based
                            on the score assigned to the State
                            under clause (iv)(I)(aa) for such prior
                            period as the Secretary of Labor deems
                            appropriate.
                                (iii) Formula for measuring state
                            performance.--Not later than 1 year
                            after the date of the enactment of this
                            paragraph, the Secretary of Labor, in
                            consultation with the Secretary of
                            Health and Human Services, the National
                            Governors' Association, and the
                            American Public Welfare Association,
                            shall develop a formula for measuring--
                                        (I) the success of States
                                    in placing individuals in
                                    private sector employment or in
                                    any kind of employment, through
                                    programs operated with funds
                                    provided under subparagraph
                                    (A);
                                        (II) the duration of such
                                    placements;
                                        (III) any increase in the
                                    earnings of such individuals;
                                    and
                                        (IV) such other factors as
                                    the Secretary of Labor deems
                                    appropriate concerning the
                                    activities of the States with
                                    respect to such individuals.
                            The formula may take into account
                            general economic conditions on a State-
                            by-State basis.
                                (iv) Scoring of state performance;
                            setting of performance thresholds.--
                                        (I) In general.--The
                                    Secretary of Labor shall--
                                                (aa) use the
                                            formula developed under
                                            clause (iii) to assign
                                            a score to each State
                                            that was a welfare-to-
                                            work State for fiscal
                                            years 1998 and 1999;
                                            and
                                                (bb) prescribe a
                                            performance threshold
                                            in such a manner so as
                                            to ensure that the
                                            total amount of grants
                                            to be made under this
                                            paragraph equals
                                            $50,000,000.
                                        (II) Availability of
                                    welfare-to-work data submitted
                                    to the secretary of hhs.--The
                                    Secretary of Health and Human
                                    Services shall provide the
                                    Secretary of Labor with the
                                    data reported by States under
                                    this part with respect to
                                    programs operated with funds
                                    provided under subparagraph
                                    (A).
                                (v) Successful performance state
                            defined.--As used in this subparagraph,
                            the term ``successful performance
                            State'' means a State whose score
                            assigned pursuant to clause (iv)(I)(aa)
                            equals or exceeds the performance
                            threshold prescribed under clause
                            (iv)(I)(bb).
                                (vi) Set-aside.--$50,000,000 of the
                            amount specified in subparagraph (I)
                            for fiscal year 1999 shall be reserved
                            for grants under this subparagraph.]
                        [(F)] (E) Funding for indian tribes.--1
                    percent of the amount specified in subparagraph
                    [(I)] (H) for fiscal year 1998 and $1,500,000
                    of the amount so specified for fiscal year 1999
                    shall be reserved for grants to Indian tribes
                    under section 412(a)(3).
                        [(G)] (F) Funding for evaluations of
                    welfare-to-work programs.--0.6 percent of the
                    amount specified in subparagraph [(I)] (H) for
                    fiscal year 1998 and $900,000 of the amount so
                    specified for fiscal year 1999 shall be
                    reserved for use by the Secretary to carry out
                    section 413(j).
                        [(H)] (G) Funding for evaluation of
                    abstinence education programs.--
                                (i) In general.--0.2 percent of the
                            amount specified in subparagraph [(I)]
                            (H) for fiscal year 1998 and $300,000
                            of the amount so specified for fiscal
                            year 1999 shall be reserved for use by
                            the Secretary to evaluate programs
                            under section 510, directly or through
                            grants, contracts, or interagency
                            agreements.
                                (ii) Authority to use funds for
                            evaluations of welfare-to-work
                            programs.--Any such amount not required
                            for such evaluations shall be available
                            for use by the Secretary to carry out
                            section 413(j).
                                (iii) Deadline for outlays.--
                            Outlays from funds used pursuant to
                            clause (i) for evaluation of programs
                            under section 510 shall not be made
                            after fiscal year 2001.
                        [(I)] (H) Appropriations.--
                                (i) In general.--Out of any money
                            in the Treasury of the United States
                            not otherwise appropriated, there are
                            appropriated for grants under this
                            paragraph--
                                        (I) $1,500,000,000 for
                                    fiscal year 1998; and
                                        (II) [$1,450,000,000]
                                    $1,400,000,000 for fiscal year
                                    1999.
                                (ii) Availability.--The amounts
                            made available pursuant to clause (i)
                            shall remain available for such period
                            as is necessary to make the grants
                            provided for in this paragraph.
                        [(J)] (I) Worker protections.--
                                (i) Nondisplacement in work
                            activities.--
                                        (I) General prohibition.--
                                    Subject to this clause, an
                                    adult in a family receiving
                                    assistance attributable to
                                    funds provided under this
                                    paragraph may fill a vacant
                                    employment position in order to
                                    engage in a work activity.
                                        (II) Prohibition against
                                    violation of contracts.--A work
                                    activity engaged in under a
                                    program operated with funds
                                    provided under this paragraph
                                    shall not violate an existing
                                    contract for services or a
                                    collective bargaining
                                    agreement, and such a work
                                    activity that would violate a
                                    collective bargaining agreement
                                    shall not be undertaken without
                                    the written concurrence of the
                                    labor organization and employer
                                    concerned.
                                        (III) Other prohibitions.--
                                    An adult participant in a work
                                    activity engaged in under a
                                    program operated with funds
                                    provided under this paragraph
                                    shall not be employed or
                                    assigned--
                                                (aa) when any other
                                            individual is on layoff
                                            from the same or any
                                            substantially
                                            equivalent job;
                                                (bb) if the
                                            employer has terminated
                                            the employment of any
                                            regular employee or
                                            otherwise caused an
                                            involuntary reduction
                                            in its workforce with
                                            the intention of
                                            filling the vacancy so
                                            created with the
                                            participant; or
                                                (cc) if the
                                            employer has caused an
                                            involuntary reduction
                                            to less than full time
                                            in hours of any
                                            employee in the same or
                                            a substantially
                                            equivalent job.
                                (ii) Health and safety.--Health and
                            safety standards established under
                            Federal and State law otherwise
                            applicable to working conditions of
                            employees shall be equally applicable
                            to working conditions of other
                            participants engaged in a work activity
                            under a program operated with funds
                            provided under this paragraph.
                                (iii) Nondiscrimination.--In
                            addition to the protections provided
                            under the provisions of law specified
                            in section 408(c), an individual may
                            not be discriminated against by reason
                            of gender with respect to participation
                            in work activities engaged in under a
                            program operated with funds provided
                            under this paragraph.
                                (iv) Grievance procedure.--
                                        (I) In general.--Each State
                                    to which a grant is made under
                                    this paragraph shall establish
                                    and maintain a procedure for
                                    grievances or complaints from
                                    employees alleging violations
                                    of clause (i) and participants
                                    in work activities alleging
                                    violations of clause (i), (ii),
                                    or (iii).
                                        (II) Hearing.--The
                                    procedure shall include an
                                    opportunity for a hearing.
                                        (III) Remedies.--The
                                    procedure shall include
                                    remedies for violation of
                                    clause (i), (ii), or (iii),
                                    which may continue during the
                                    pendency of the procedure, and
                                    which may include--
                                                (aa) suspension or
                                            termination of payments
                                            from funds provided
                                            under this paragraph;
                                                (bb) prohibition of
                                            placement of a
                                            participant with an
                                            employer that has
                                            violated clause (i),
                                            (ii), or (iii);
                                                (cc) where
                                            applicable,
                                            reinstatement of an
                                            employee, payment of
                                            lost wages and
                                            benefits, and
                                            reestablishment of
                                            other relevant terms,
                                            conditions and
                                            privileges of
                                            employment; and
                                                (dd) where
                                            appropriate, other
                                            equitable relief.
                                        (IV) Appeals.--
                                                (aa) Filing.--Not
                                            later than 30 days
                                            after a grievant or
                                            complainant receives an
                                            adverse decision under
                                            the procedure
                                            established pursuant to
                                            subclause (I), the
                                            grievant or complainant
                                            may appeal the decision
                                            to a State agency
                                            designated by the State
                                            which shall be
                                            independent of the
                                            State or local agency
                                            that is administering
                                            the programs operated
                                            with funds provided
                                            under this paragraph
                                            and the State agency
                                            administering, or
                                            supervising the
                                            administration of, the
                                            State program funded
                                            under this part.
                                                (bb) Final
                                            determination.--Not
                                            later than 120 days
                                            after the State agency
                                            designated under item
                                            (aa) receives a
                                            grievance or complaint
                                            made under the
                                            procedure established
                                            by a State pursuant to
                                            subclause (I), the
                                            State agency shall make
                                            a final determination
                                            on the appeal.
                                (v) Rule of interpretation.--This
                            subparagraph shall not be construed to
                            affect the authority of a State to
                            provide or require workers'
                            compensation.
                                (vi) Nonpreemption of state law.--
                            The provisions of this subparagraph
                            shall not be construed to preempt any
                            provision of State law that affords
                            greater protections to employees or to
                            other participants engaged in work
                            activities under a program funded under
                            this part than is afforded by such
                            provisions of this subparagraph.
                        [(K)] (J) Information disclosure.--If a
                    State to which a grant is made under section
                    403 establishes safeguards against the use or
                    disclosure of information about applicants or
                    recipients of assistance under the State
                    program funded under this part, the safeguards
                    shall not prevent the State agency
                    administering the program from furnishing to a
                    private industry council the names, addresses,
                    telephone numbers, and identifying case number
                    information in the State program funded under
                    this part, of noncustodial parents residing in
                    the service delivery area of the private
                    industry council, for the purpose of
                    identifying and contacting noncustodial parents
                    regarding participation in the program under
                    this paragraph.

               *       *       *       *       *       *       *

    SEC. 412. DIRECT FUNDING AND ADMINISTRATION BY INDIAN TRIBES.

        (a) * * *
                (1) * * *

               *       *       *       *       *       *       *

                (3) Welfare-to-work grants.--
                        (A) In general.--The Secretary of Labor
                    shall award a grant in accordance with this
                    paragraph to an Indian tribe for each fiscal
                    year specified in section [403(a)(5)(I)]
                    403(a)(5)(H) for which the Indian tribe is a
                    welfare-to-work tribe, in such amount as the
                    Secretary of Labor deems appropriate, subject
                    to subparagraph (B) of this paragraph.

               *       *       *       *       *       *       *

    Balanced Budget Act of 1997, Public Law 105-33

               *       *       *       *       *       *       *

    TITLE V--WELFARE AND RELATED PROVISIONS

               *       *       *       *       *       *       *

    Subtitle F--Welfare Reform Technical Corrections

               *       *       *       *       *       *       *

    CHAPTER 2--SUPPLEMENTAL SECURITY INCOME

               *       *       *       *       *       *       *

    [SEC. 5527. TIMING OF DELIVERY OF OCTOBER 1, 2000, SSI BENEFIT
                        PAYMENTS.

        Notwithstanding the provisions of section 708(a) of the
    Social Security Act (42 U.S.C. 908(a)), the day designated for
    delivery of benefit payments under title XVI of such Act for
    October 2000 shall be the second day of such month.]

               *       *       *       *       *       *       *

    Ticket to Work and Work Incentives Improvement Act of 1999, Public Law
    106-170

               *       *       *       *       *       *       *

    TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

               *       *       *       *       *       *       *

    SEC. 410. SCHEDULE FOR PAYMENTS UNDER SSI STATE SUPPLEMENTATION
                        AGREEMENTS.

        (a) * * *
        (b) Effective Date.--the amendments made by subsection (a)
    shall apply to payments and fees arising under an agreement
    between a State and the Commissioner of Social Security under
    section 1616 of the Social Security Act (42 U.S.C. 1382e) or
    under section 212 of Public Law 93-66 (42 U.S.C. 1382 note)
    with respect to monthly benefits paid to individuals under
    title XVI of the Social Security Act for months after September
    [2009] 2001 (October [2009] 2001 in the case of a State with a
    fiscal year that coincides with the Federal fiscal year),
    without regard to whether the agreement has been modified to
    reflect such amendments or the Commissioner has promulgated
    regulations implementing such amendments.

               *       *       *       *       *       *       *

      COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2000 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                            YEAR 2001
                                                                    [In thousands of dollars]
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Senate Committee recommendation
                                                                                                                                 compared with ( or )
                                 Item                                     2000         Budget estimate      Committee    -----------------------------------
                                                                      appropriation                      recommendation         2000
                                                                                                                            appropriation    Budget estimate
    --------------------------------------------------------------------------------------------------------------------------------------------------------

                     TITLE I--DEPARTMENT OF LABOR

                EMPLOYMENT AND TRAINING ADMINISTRATION

                   TRAINING AND EMPLOYMENT SERVICES

    Grants to States:
        Adult Training, current year..............................          238,000           238,000           238,000   ................  ................
            Advance from prior year...............................  ................         (712,000)         (712,000)        (+712,000)  ................
            Fiscal year 2002......................................          712,000           712,000           712,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
              Adult Training, program level.......................          950,000           950,000           950,000   ................  ................

        Youth Training............................................        1,000,965         1,022,465         1,000,965   ................          -21,500

        Dislocated Worker Assistance, current year................          529,025           710,510           529,025   ................         -181,485
            Advance from prior year...............................  ................       (1,060,000)       (1,060,000)      (+1,060,000)  ................
            Fiscal year 2002......................................        1,060,000         1,060,000         1,060,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
              Dislocated Worker Assistance, program level.........        1,589,025         1,770,510         1,589,025   ................         -181,485

    Federally administered programs:
        Native Americans..........................................           58,436            55,000            55,000            -3,436   ................
        Migrant and Seasonal Farmworkers..........................           74,195            74,445            76,770            +2,575            +2,325

        Job Corps:
            Operations............................................          633,140           681,669           652,408           +19,268           -29,261
                Advance from prior year...........................  ................         (591,000)         (591,000)        (+591,000)  ................
                Fiscal year 2002..................................          591,000           591,000           591,000   ................  ................
            Construction and Renovation \1\.......................           33,636            20,375            20,375           -13,261   ................
                Advance from prior year...........................  ................         (100,000)         (100,000)        (+100,000)  ................
                Fiscal year 2002..................................          100,000           100,000           100,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
                  Subtotal, Job Corps, program level..............        1,357,776         1,393,044         1,363,783            +6,007           -29,261

        National activities:
            Pilots, Demonstrations and Research...................           65,095            35,000            70,000            +4,905           +35,000
            Responsible Reintegration of Youthful Off.............           13,907            75,000            30,000           +16,093           -45,000
            Evaluation............................................            9,098            12,098             9,098   ................           -3,000
            Fathers Work/Families Win.............................  ................          255,000   ................  ................         -255,000
            Incumbent Workers.....................................  ................           30,000            20,000           +20,000           -10,000
            Safe Schools/Healthy Students.........................  ................           40,000            20,000           +20,000           -20,000
            Youth Opportunity Grants..............................          250,000           375,000           250,000   ................         -125,000
            Other.................................................            5,000            15,000            15,000           +10,000   ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, National activities.......................          343,100           837,098           414,098           +70,998          -423,000
                                                                   =========================================================================================
              Subtotal, Federal activities........................        1,833,507         2,359,587         1,909,651           +76,144          -449,936
                                                                   =========================================================================================
              Total, Workforce Investment Act.....................        5,373,497         6,102,562         5,449,641           +76,144          -652,921

        Women in Apprenticeship...................................              927   ................  ................             -927   ................
        Skills Standards..........................................            7,000             3,500             3,500            -3,500   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, National activities, TES......................          351,027           840,598           417,598           +66,571          -423,000

        School-to-Work \2\........................................           55,000   ................  ................          -55,000   ................
                                                                   =========================================================================================
          Total, Training and Employment Services.................        5,436,424         6,106,062         5,453,141           +16,717          -652,921

    COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS..............          440,200           440,200           440,200   ................  ................

             FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

    Trade Adjustment..............................................          349,000           342,400           342,400            -6,600   ................
    NAFTA Activities..............................................           66,150            64,150            64,150            -2,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Total...................................................          415,150           406,550           406,550            -8,600   ................

    STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

    Unemployment Compensation:
        State Operations..........................................        2,256,375         2,349,283         2,273,515           +17,140           -75,768
        National Activities.......................................           10,000            10,000            10,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Unemployment Comp (trust funds)...............        2,266,375         2,359,283         2,283,515           +17,140           -75,768

    Employment Service:
        Allotments to States:
            Federal Funds.........................................           23,452            23,452            23,452   ................  ................
            Trust Funds...........................................          738,283           788,283           763,283           +25,000           -25,000
                                                                   -----------------------------------------------------------------------------------------
              Subtotal............................................          761,735           811,735           786,735           +25,000           -25,000

        National Activities:
            Trust Funds...........................................           55,670            44,180            49,180            -6,490            +5,000
                                                                   =========================================================================================
          Subtotal, Employment Service............................          817,405           855,915           835,915           +18,510           -20,000

              Federal funds.......................................           23,452            23,452            23,452   ................  ................
              Trust funds.........................................          793,953           832,463           812,463           +18,510           -20,000

    One stop Career/Labor Market Information: Federal Funds.......          110,000           154,000           110,000   ................          -44,000
    Work Incentives Grants........................................           20,000            20,000            20,000   ................  ................
                                                                   =========================================================================================
          Total, State Unemployment...............................        3,213,780         3,389,198         3,249,430           +35,650          -139,768
              Federal Funds.......................................          153,452           197,452           153,452   ................          -44,000
              Trust Funds.........................................        3,060,328         3,191,746         3,095,978           +35,650           -95,768

    ADVANCES TO THE UI AND OTHER TRUST FUNDS \1\..................          356,000           435,000           435,000           +79,000   ................

                        PROGRAM ADMINISTRATION

    Adult Employment and Training.................................           29,986            33,113            31,986            +2,000            -1,127
        Trust Funds...............................................            2,420             2,797             2,797              +377   ................
    Youth Employment and Training.................................           34,086            37,660            34,086   ................           -3,574
    Employment Security...........................................            4,952             5,119             5,119              +167   ................
        Trust Funds...............................................           41,302            43,855            44,351            +3,049              +496
    Apprenticeship Services.......................................           19,141            22,069            22,069            +2,928   ................
    Executive Direction...........................................            6,348             6,660             7,960            +1,612            +1,300
        Trust Funds...............................................            1,334             1,383             1,359               +25               -24
    Welfare to Work...............................................            6,431             6,655             6,431   ................             -224
                                                                   -----------------------------------------------------------------------------------------
          Total, Program Administration...........................          146,000           159,311           156,158           +10,158            -3,153
              Federal funds.......................................          100,944           111,276           107,651            +6,707            -3,625
              Trust funds.........................................           45,056            48,035            48,507            +3,451              +472
                                                                   =========================================================================================
          Total, Employment and Training Administration...........       10,007,554        10,936,321        10,140,479          +132,925          -795,842
              Federal funds.......................................        6,902,170         7,696,540         6,995,994           +93,824          -700,546
                  Current Year....................................       (4,439,170)       (5,233,540)       (4,532,994)         (+93,824)        (-700,546)
                  Advance Year, fiscal year 2002..................       (2,463,000)       (2,463,000)       (2,463,000)  ................  ................
              Trust funds.........................................        3,105,384         3,239,781         3,144,485           +39,101           -95,296

              PENSION AND WELFARE BENEFITS ADMINISTRATION

                         SALARIES AND EXPENSES

    Enforcement and Compliance....................................           78,283            83,652            81,995            +3,712            -1,657
    Policy, Regulation and Public Service.........................           16,803            20,205            17,372              +569            -2,833
    Program Oversight.............................................            3,848             3,975             3,975              +127   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, PWBA.............................................           98,934           107,832           103,342            +4,408            -4,490

                 PENSION BENEFIT GUARANTY CORPORATION

    Program Administration subject to limitation (TF).............           11,148            11,871            11,652              +504              -219
    Termination services not subject to limitation (NA)...........         (153,599)         (164,834)         (161,499)          (+7,900)          (-3,335)
                                                                   -----------------------------------------------------------------------------------------
          Total, PBGC (Program level).............................         (164,747)         (176,705)         (173,151)          (+8,404)          (-3,554)

                  EMPLOYMENT STANDARDS ADMINISTRATION

                         SALARIES AND EXPENSES

    Enforcement of Wage and Hour Standards........................          141,893           152,688           148,329            +6,436            -4,359
    Office of Labor-Management Standards..........................           29,308            30,556            30,413            +1,105              -143
    Federal Contractor EEO Standards Enforcement..................           73,250            76,308            75,808            +2,558              -500
    Federal Programs for Workers' Compensation....................           79,968            88,873            83,163            +3,195            -5,710
        Trust Funds...............................................            1,740             1,985             1,985              +245   ................
    Program Direction and Support.................................           12,611            13,066            13,066              +455   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, ESA salaries and expenses........................          338,770           363,476           352,764           +13,994           -10,712
              Federal funds.......................................          337,030           361,491           350,779           +13,749           -10,712
              Trust funds.........................................            1,740             1,985             1,985              +245   ................

                           SPECIAL BENEFITS

    Federal employees compensation benefits.......................           75,000            53,000            53,000           -22,000   ................
    Longshore and harbor workers' benefits........................            4,000             3,000             3,000            -1,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Special Benefits.................................           79,000            56,000            56,000           -23,000   ................

                   BLACK LUNG DISABILITY TRUST FUND

    Benefit payments and interest on advances.....................          963,506           975,343           975,343           +11,837   ................
    Employment Standards Adm. S&E.................................           28,676            30,393            30,393            +1,717   ................
    Departmental Management S&E...................................           20,783            21,590            21,590              +807   ................
    Departmental Management, Inspector General....................              312               318               318                +6   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Black Lung Disability.........................        1,013,277         1,027,644         1,027,644           +14,367   ................

    Treasury Administrative Costs.................................              356               356               356   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Black Lung Disability Trust Fund.................        1,013,633         1,028,000         1,028,000           +14,367   ................
                                                                   =========================================================================================
          Total, Employment Standards Administration..............        1,431,403         1,447,476         1,436,764            +5,361           -10,712
              Federal funds.......................................        1,429,663         1,445,491         1,434,779            +5,116           -10,712
              Trust funds.........................................            1,740             1,985             1,985              +245   ................

             OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

                         SALARIES AND EXPENSES

    Safety and Health Standards...................................           12,700            15,093            15,093            +2,393   ................
    Federal Enforcement...........................................          141,000           153,073           153,073           +12,073   ................
    State Programs................................................           82,000            88,493            88,493            +6,493   ................
    Technical Support.............................................           17,959            20,149            20,149            +2,190   ................
    Compliance Assistance:
        Federal Assistance........................................           54,154            67,073            67,073           +12,919   ................
        State Consultation Grants.................................           42,854            47,903            47,903            +5,049   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................           97,008           114,976           114,976           +17,968   ................

    Safety and Health Statistics..................................           22,753            25,637            25,637            +2,884   ................
    Executive Direction and Administration........................            8,200             8,562             8,562              +362   ................
                                                                   =========================================================================================
          Total, OSHA.............................................          381,620           425,983           425,983           +44,363   ................

                 MINE SAFETY AND HEALTH ADMINISTRATION

                         SALARIES AND EXPENSES

    Coal Enforcement..............................................          110,570           114,774           114,774            +4,204   ................
    Metal/Non-Metal Enforcement...................................           49,693            55,240            55,240            +5,547   ................
    Standards Development.........................................            1,509             1,762             1,762              +253   ................
    Assessments...................................................            3,896             4,267             4,267              +371   ................
    Educational Policy and Development............................           26,855            26,977            29,477            +2,622            +2,500
    Technical Support.............................................           25,312            27,069            27,069            +1,757   ................
    Program Administration........................................           10,222            12,158            12,158            +1,936   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Mine Safety and Health Administration............          228,057           242,247           244,747           +16,690            +2,500

                      BUREAU OF LABOR STATISTICS

                         SALARIES AND EXPENSES

    Employment and Unemployment Statistics........................          125,329           137,317           135,317            +9,988            -2,000
    Labor Market Information (Trust Funds)........................           66,363            67,257            67,257              +894   ................
    Prices and Cost of Living.....................................          128,753           135,408           133,444            +4,691            -1,964
    Compensation and Working Conditions...........................           68,921            71,186            71,186            +2,265   ................
    Productivity and Technology...................................            7,785             9,262             8,078              +293            -1,184
    Economic Growth and Employment Projections....................            5,047             6,721             5,321              +274            -1,400
    Executive Direction and Staff Services........................           24,693            26,481            25,981            +1,288              -500
    Consumer Price Index Revision \3\.............................            6,986   ................  ................           -6,986   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Bureau of Labor Statistics.......................          433,877           453,632           446,584           +12,707            -7,048
              Federal Funds.......................................          367,514           386,375           379,327           +11,813            -7,048
              Trust Funds.........................................           66,363            67,257            67,257              +894   ................

                        DEPARTMENTAL MANAGEMENT

                         SALARIES AND EXPENSES

    Executive Direction...........................................           26,436            46,491            27,341              +905           -19,150
    Departmental IT Crosscut......................................  ................           54,444            30,000           +30,000           -24,444
    Legal Services................................................           68,928            74,502            72,087            +3,159            -2,415
        Trust Funds...............................................              310               319   ................             -310              -319
    International Labor Affairs...................................           70,000           167,006           115,000           +45,000           -52,006
    Administration and Management.................................           26,609            24,768            24,768            -1,841   ................
    Adjudication..................................................           23,664            25,070            24,745            +1,081              -325
    Women's Bureau................................................            8,824             9,596             9,201              +377              -395
    Civil Rights Activities.......................................            5,684             6,384             5,848              +164              -536
    Chief Financial Officer.......................................            5,793             5,972             5,972              +179   ................
    Disability Policy.............................................            8,641            23,002            23,002           +14,361   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Salaries and expenses............................          244,889           437,554           337,964           +93,075           -99,590
              Federal funds.......................................          244,579           437,235           337,964           +93,385           -99,271
              Trust funds.........................................              310               319   ................             -310              -319

                   VETERANS EMPLOYMENT AND TRAINING

    State Administration:
        Disabled Veterans Outreach Program........................           80,215            81,615            81,615            +1,400   ................
        Local Veterans Employment Program.........................           77,253            77,253            77,253   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, State Administration..........................          157,468           158,868           158,868            +1,400   ................

    Federal Administration........................................           26,873            29,045            28,045            +1,172            -1,000
    Homeless Veterans Program.....................................            9,636            15,000            12,500            +2,864            -2,500
    Veterans Workforce Investment Programs........................            7,300             7,300             7,300   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Veterans Employment and Training.................          201,277           210,213           206,713            +5,436            -3,500
              Federal Funds.......................................           16,936            22,300            19,800            +2,864            -2,500
              Trust Funds.........................................          184,341           187,913           186,913            +2,572            -1,000

                    OFFICE OF THE INSPECTOR GENERAL

    Program Activities............................................           42,346            44,563            43,201              +855            -1,362
        Trust Funds...............................................            3,830             4,770             4,770              +940   ................

    Executive Direction and Management............................            5,749             6,814             6,814            +1,065   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Office of the Inspector General..................           51,925            56,147            54,785            +2,860            -1,362
              Federal funds.......................................           48,095            51,377            50,015            +1,920            -1,362
              Trust funds.........................................            3,830             4,770             4,770              +940   ................
                                                                   =========================================================================================
          Total, Departmental Management..........................          498,091           703,914           599,462          +101,371          -104,452
              Federal funds.......................................          309,610           510,912           407,779           +98,169          -103,133
              Trust funds.........................................          188,481           193,002           191,683            +3,202            -1,319
                                                                   =========================================================================================
          Total, Labor Department.................................       13,090,684        14,329,276        13,409,013          +318,329          -920,263
              Federal funds.......................................        9,717,568        10,815,380         9,991,951          +274,383          -823,429
                  Current Year....................................       (7,254,568)       (8,352,380)       (7,528,951)        (+274,383)        (-823,429)
                  Advance Year, fiscal year 2002..................       (2,463,000)       (2,463,000)       (2,463,000)  ................  ................
              Trust funds.........................................        3,373,116         3,513,896         3,417,062           +43,946           -96,834

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

             HEALTH RESOURCES AND SERVICES ADMINISTRATION

                     HEALTH RESOURCES AND SERVICES

    Health centers................................................        1,018,700         1,068,700         1,118,700          +100,000           +50,000

    National Health Service Corps:
        Field placements..........................................           38,182            38,116            38,116               -66   ................
        Recruitment...............................................           78,625            78,625            78,625   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................          116,807           116,741           116,741               -66   ................

                          Health Professions

    Training for Diversity:
        Centers of excellence.....................................           25,641            30,641   ................          -25,641           -30,641
        Health careers opportunity program........................           27,799            32,799   ................          -27,799           -32,799
        Faculty loan repayment....................................            1,100             1,100   ................           -1,100            -1,100
        Scholarships for disadvantaged students...................           38,099            38,099   ................          -38,099           -38,099
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................           92,639           102,639   ................          -92,639          -102,639

    Training in Primary Care Medicine and Dentistry...............           78,267   ................  ................          -78,267   ................

    Interdisciplinary Community-Based Linkages:
        Area health education centers.............................           28,587            28,587   ................          -28,587           -28,587
        Health education and training centers.....................            3,765             3,765   ................           -3,765            -3,765
        Allied health and other disciplines.......................            7,355             3,838   ................           -7,355            -3,838
        Geriatric programs........................................           10,640   ................  ................          -10,640   ................
        Quentin N. Burdick pgm for rural training.................            5,132             4,720   ................           -5,132            -4,720
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................           55,479            40,910   ................          -55,479           -40,910

    Health Professions Workforce Info and Analysis................              714               714               714   ................  ................

    Public Health Workforce Development:
        Public health, preventive med. and dental pgms............            8,121             8,121   ................           -8,121            -8,121
        Health administration programs............................            1,112   ................  ................           -1,112   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................            9,233             8,121   ................           -9,233            -8,121

    Children's Hospitals Graduate Medical Educ....................           40,000            80,000   ................          -40,000           -80,000
    Advanced Education Nursing....................................           50,597            50,597   ................          -50,597           -50,597
    Basic nurse education and practice............................           10,968            10,968   ................          -10,968           -10,968
    Nursing workforce diversity...................................            4,010             4,010   ................           -4,010            -4,010
    Consolidated Health professions...............................  ................  ................          230,000          +230,000          +230,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Health professions............................          341,907           297,959           230,714          -111,193           -67,245

    Other HRSA Programs:
        Hansen's Disease Services.................................           20,042            17,016            17,016            -3,026   ................
        Maternal and Child Health Block Grant.....................          704,130           704,130           704,130   ................  ................
        Healthy Start.............................................           90,000            90,000            90,000   ................  ................
        Universal Newborn Hearing.................................            3,375             3,375             4,000              +625              +625
        Organ Transplantation.....................................           10,000            15,000            15,000            +5,000   ................
        Health Teaching Facilities Interest Subsidies.............              150   ................  ................             -150   ................
        Bone Marrow Program.......................................           18,000            17,959            17,959               -41   ................
        Rural outreach grants.....................................           35,880            38,892            38,892            +3,012   ................
        Rural Health Research.....................................           12,679             6,101             5,000            -7,679            -1,101
        Telehealth................................................           20,522             5,612            25,000            +4,478           +19,388
        Critical care programs: Emergency medical services for               17,000            15,000            15,000            -2,000   ................
         children.................................................
        Trauma care system........................................  ................  ................            3,000            +3,000            +3,000
        Traumatic brain injury....................................            5,000             5,000             5,000   ................  ................
            Poison control........................................            3,000             1,500             6,000            +3,000            +4,500
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Critical care programs....................           25,000            21,500            29,000            +4,000            +7,500

        Black lung clinics........................................            5,943             5,943             6,000               +57               +57
        Nursing loan repayment for shortage area service..........            2,279             2,279             2,279   ................  ................
        Payment to Hawaii, treatment of Hansen's..................            2,045             2,045             2,045   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Other HRSA programs...........................          950,045           929,852           956,321            +6,276           +26,469

    Ryan White AIDS Programs:
        Emergency Assistance......................................          546,500           586,500           556,500           +10,000           -30,000
        Comprehensive Care Programs...............................          824,000           864,000           834,000           +10,000           -30,000
            AIDS Drug Assistance Program (ADAP) (NA)..............         (528,000)         (554,000)         (538,000)         (+10,000)         (-16,000)
        Early Intervention Program................................          138,400           171,400           166,400           +28,000            -5,000
        Pediatric HIV/AIDS........................................           51,000            60,000            58,450            +7,450            -1,550
        AIDS Dental Services......................................            8,000             8,500             8,000   ................             -500
        Education and Training Centers............................           26,650            29,150            26,650   ................           -2,500
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Ryan White AIDS programs......................        1,594,550         1,719,550         1,650,000           +55,450           -69,550

    Family Planning...............................................          238,932           273,932           253,932           +15,000           -20,000
    Health Care Facilities........................................          112,408   ................           10,000          -102,408           +10,000
    Buildings and Facilities......................................              250               250               250   ................  ................
    Rural Hospital Flexibility Grants.............................           25,000            25,000            25,000   ................  ................
    National Practitioner Data Bank...............................           16,000            17,200            17,200            +1,200   ................
        User Fees.................................................          -16,000           -17,200           -17,200            -1,200   ................
    Health Care Access for the Uninsured..........................           40,000           125,000            25,000           -15,000          -100,000
    Program Management............................................          124,766           124,353           135,766           +11,000           +11,413
                                                                   =========================================================================================
          Total, Health resources and services....................        4,563,365         4,681,337         4,522,424           -40,941          -158,913

    RICKY RAY HEMOPHILIA ACT FUND PROGRAM.........................           75,000           100,000            85,000           +10,000           -15,000
    MEDICAL FACILITIES GUARANTEE AND LOAN FUND: Interest subsidy              1,000   ................  ................           -1,000   ................
     program......................................................
    HEALTH EDUCATION ASSISTANCE LOANS PROGRAM (HEAL):
        Liquidating account.......................................          (15,000)          (10,000)          (10,000)          (-5,000)  ................
        Program management........................................            3,687             3,679             3,679                -8   ................

    VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:
        Post-fiscal year 1988 claims..............................           62,301           114,355           114,355           +52,054   ................
        HRSA administration.......................................            2,999             2,992             2,992                -7   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Vaccine injury...................................           65,300           117,347           117,347           +52,047   ................
                                                                   =========================================================================================
          Total, Health Resources and Services Admin..............        4,708,352         4,902,363         4,728,450           +20,098          -173,913

              CENTERS FOR DISEASE CONTROL AND PREVENTION

                DISEASE CONTROL, RESEARCH AND TRAINING

    Preventive Health Services Block Grant Program................          131,824           130,899           130,899              -925   ................
        Salaries and Expenses.....................................            3,380             4,246             3,380   ................             -866
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Preventive Health Services Block Grant........          135,204           135,145           134,279              -925              -866

    Prevention Centers Program....................................           17,119            14,080            14,080            -3,039   ................
        Salaries and Expenses.....................................              633               665               633   ................              -32
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Prevention Centers............................           17,752            14,745            14,713            -3,039               -32

    CDC/HCFA vaccine program Childhood immunization Program.......          432,966           467,505           467,505           +34,539   ................
        Salaries and Expenses.....................................           56,909            62,138            56,909   ................           -5,229
        From PHSSEF...............................................           20,000   ................  ................          -20,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Childhood immunization........................          509,875           529,643           524,414           +14,539            -5,229

        HCFA vaccine purchase (NA)................................         (545,043)         (469,054)         (469,054)         (-75,989)  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, CDC/HCFA vaccine program level................        1,054,918           998,697           993,468           -61,450            -5,229

    Communicable Diseases:
        AIDS:
             Program..............................................          572,715           669,791           640,000           +67,285           -29,791
            Salaries and Expenses.................................          122,036           125,612           122,036   ................           -3,576
            From PHSSEF...........................................           35,000   ................  ................          -35,000   ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, HIV/AIDS..................................          729,751           795,403           762,036           +32,285           -33,367

        Tuberculosis:
            Program...............................................          120,420           113,413           113,413            -7,007   ................
            Salaries and Expenses.................................            7,308            14,259             7,308   ................           -6,951
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Tuberculosis..............................          127,728           127,672           120,721            -7,007            -6,951

        Sexually Transmitted Diseases:
            Program...............................................          121,809           131,978           135,978           +14,169            +4,000
            Salaries and Expenses.................................           13,925            18,690            13,925   ................           -4,765
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Sexually Transmitted Diseases.............          135,734           150,668           149,903           +14,169              -765

    Chronic Diseases:
        Chronic and Environmental Disease Prevention:
            Program...............................................          286,545           293,114           304,553           +18,008           +11,439
            Salaries and Expenses.................................           78,180            91,440            78,180   ................          -13,260
            From PHSSEF...........................................           10,000   ................  ................          -10,000   ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Chronic and Environmental.................          374,725           384,554           382,733            +8,008            -1,821

        Breast and Cervical Cancer Screening:
            Program...............................................          156,016           160,235           167,016           +11,000            +6,781
            Salaries and Expenses.................................           10,479            11,185            10,479   ................             -706
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Breast and Cervical Cancer Screening......          166,495           171,420           177,495           +11,000            +6,075

    Infectious Diseases:
        Program...................................................           86,610           112,068           106,000           +19,390            -6,068
        Salaries and Expenses.....................................           80,000            89,454            80,000   ................           -9,454
            From PHSSEF...........................................            9,000   ................  ................           -9,000   ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Infectious diseases.......................          175,610           201,522           186,000           +10,390           -15,522

    Lead Poisoning Prevention:
        Program...................................................           30,995            30,978            30,978               -17   ................
        Salaries and Expenses.....................................            7,248             7,248             7,248   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Lead Poisoning Prevention.....................           38,243            38,226            38,226               -17   ................

    Injury Control:
        Program...................................................           60,432            65,197            63,000            +2,568            -2,197
        Salaries and Expenses.....................................           23,840            24,035            23,840   ................             -195
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Injury Control................................           84,272            89,232            86,840            +2,568            -2,392

    Occupational Safety and Health (NIOSH): \4\
        Program...................................................           86,819            91,534            95,000            +8,181            +3,466
        Salaries and Expenses.....................................          127,833           128,022           127,833   ................             -189
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Occupational Safety and Health................          214,652           219,556           222,833            +8,181            +3,277

    Epidemic Services:
        Program...................................................           48,414            30,254            30,254           -18,160   ................
        Salaries and Expenses.....................................           55,484            55,568            55,484   ................              -84
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Epidemic Services.............................          103,898            85,822            85,738           -18,160               -84

    Office of the Director:
        Budget Authority..........................................           37,620            35,564            16,125           -21,495           -19,439
        Evaluation funds (NA).....................................  ................  ................          (19,439)         (+19,439)         (+19,439)
    National Center for Health Statistics Program Operations:
        Budget Authority..........................................           15,069            13,981            13,981            -1,088   ................
        Salaries and expenses:
            Budget Authority......................................           18,241            19,314            18,241   ................           -1,073
            Evaluation funds (NA).................................          (71,690)          (76,690)          (71,690)  ................          (-5,000)
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Health Statistics program level...........         (105,000)         (109,985)         (103,912)          (-1,088)          (-6,073)

    Buildings and Facilities......................................           57,131           127,074           175,000          +117,869           +47,926

    Prevention research:
        Program...................................................           12,000            13,386            13,386            +1,386   ................
        Salaries and Expenses.....................................            3,000             1,607             1,607            -1,393   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Prevention research...........................           15,000            14,993            14,993                -7   ................

    Health disparities demonstration:
        Program...................................................           27,000            31,468            27,000   ................           -4,468
        Salaries and Expenses.....................................            3,000             3,517             3,000   ................             -517
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Health disparities demonstration..............           30,000            34,985            30,000   ................           -4,985
                                                                   =========================================================================================
          Subtotal, Centers for Disease Control...................        2,987,000         3,189,519         3,154,271          +167,271           -35,248

    Violent Crime Reduction programs:
        Rape Prevention and Education.............................           44,125            44,105            44,225              +100              +120
        Domestic Violence Community Demonstrations................            5,866             5,863             6,000              +134              +137
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Crime trust fund..............................           49,991            49,968            50,225              +234              +257
                                                                   =========================================================================================
          Total, Disease Control..................................        3,036,991         3,239,487         3,204,496          +167,505           -34,991

                     NATIONAL INSTITUTES OF HEALTH

    National Cancer Institute.....................................        3,311,687         3,505,072         3,804,084          +492,397          +299,012
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NCI...........................................       (3,311,687)       (3,505,072)       (3,804,084)        (+492,397)        (+299,012)

    National Heart, Lung, and Blood Institute.....................        2,026,430         2,136,757         2,328,102          +301,672          +191,345
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NHLBI.........................................       (2,026,430)       (2,136,757)       (2,328,102)        (+301,672)        (+191,345)

    National Institute of Dental and Craniofacial Research........          269,185           284,175           309,923           +40,738           +25,748
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIDR..........................................         (269,185)         (284,175)         (309,923)         (+40,738)         (+25,748)

    National Institute of Diabetes and Digestive and Kidney               1,141,415         1,209,173         1,318,106          +176,691          +108,933
     Diseases.....................................................
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIDDK.........................................       (1,141,415)       (1,209,173)       (1,318,106)        (+176,691)        (+108,933)

    National Institute of Neurological Disorders and Stroke.......        1,029,743         1,084,828         1,189,425          +159,682          +104,597
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NINDS.........................................       (1,029,743)       (1,084,828)       (1,189,425)        (+159,682)        (+104,597)

    National Institute of Allergy and Infectious Diseases.........        1,796,631         1,906,213         2,066,526          +269,895          +160,313
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIAID.........................................       (1,796,631)       (1,906,213)       (2,066,526)        (+269,895)        (+160,313)

    National Institute of General Medical Sciences................        1,353,943         1,428,188         1,554,176          +200,233          +125,988
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIGMS.........................................       (1,353,943)       (1,428,188)       (1,554,176)        (+200,233)        (+125,988)

    National Institute of Child Health and Human Development......          859,258           904,705           986,069          +126,811           +81,364
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NICHD.........................................         (859,258)         (904,705)         (986,069)        (+126,811)         (+81,364)

    National Eye Institute........................................          450,101           473,952           516,605           +66,504           +42,653
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NEI...........................................         (450,101)         (473,952)         (516,605)         (+66,504)         (+42,653)

    National Institute of Environmental Health Sciences...........          442,688           468,649           508,263           +65,575           +39,614
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIEHS.........................................         (442,688)         (468,649)         (508,263)         (+65,575)         (+39,614)

    National Institute on Aging...................................          687,861           725,949           794,625          +106,764           +68,676
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIA...........................................         (687,861)         (725,949)         (794,625)        (+106,764)         (+68,676)

    National Institute of Arthritis and Musculoskeletal and Skin            349,480           368,712           401,161           +51,681           +32,449
     Diseases.....................................................
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIAMS.........................................         (349,480)         (368,712)         (401,161)         (+51,681)         (+32,449)

    National Institute on Deafness and Other Communication                  263,661           278,009           303,541           +39,880           +25,532
     Disorders....................................................
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIDCD.........................................         (263,661)         (278,009)         (303,541)         (+39,880)         (+25,532)

    National Institute of Nursing Research........................           89,539            92,524           106,848           +17,309           +14,324
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NINR..........................................          (89,539)          (92,524)         (106,848)         (+17,309)         (+14,324)

    National Institute on Alcohol Abuse and Alcoholism............          293,234           308,661           336,848           +43,614           +28,187
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIAAA.........................................         (293,234)         (308,661)         (336,848)         (+43,614)         (+28,187)

    National Institute on Drug Abuse..............................          687,376           725,467           790,038          +102,662           +64,571
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIDA..........................................         (687,376)         (725,467)         (790,038)        (+102,662)         (+64,571)

    National Institute of Mental Health...........................          974,673         1,031,353         1,117,928          +143,255           +86,575
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NIMH..........................................         (974,673)       (1,031,353)       (1,117,928)        (+143,255)         (+86,575)

    National Human Genome Research Institute......................          335,862           357,740           385,888           +50,026           +28,148
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NHGRI.........................................         (335,862)         (357,740)         (385,888)         (+50,026)         (+28,148)

    National Center for Research Resources........................          675,054           714,192           775,212          +100,158           +61,020
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NCRR..........................................         (675,054)         (714,192)         (775,212)        (+100,158)         (+61,020)

    National Center for Complementary and Alternative Medicine....           69,011            72,392           100,089           +31,078           +27,697

    John E. Fogarty International Center..........................           43,328            48,011            61,260           +17,932           +13,249
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, FIC...........................................          (43,328)          (48,011)          (61,260)         (+17,932)         (+13,249)

    National Library of Medicine..................................          215,199           230,135           256,953           +41,754           +26,818
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, NLM...........................................         (215,199)         (230,135)         (256,953)         (+41,754)         (+26,818)

    Office of the Director........................................          282,000           308,978           352,165           +70,165           +43,187
        AIDS (NA).................................................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, OD............................................         (282,000)         (308,978)         (352,165)         (+70,165)         (+43,187)

    Buildings and facilities:
        Current year..............................................          125,376           148,900           148,900           +23,524   ................
        Advance from prior year...................................          (40,000)  ................  ................         (-40,000)  ................

    Office of AIDS Research.......................................  ................  ................  ................  ................  ................
                                                                   =========================================================================================
          Total, National Institutes of Health:
              Current Year, fiscal year 2001......................       17,772,735        18,812,735        20,512,735        +2,740,000        +1,700,000
              Advance from prior year.............................           40,000   ................  ................          -40,000   ................
                                                                   -----------------------------------------------------------------------------------------
                Total N.I.H. program level........................       17,812,735        18,812,735        20,512,735        +2,700,000        +1,700,000

       SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

    Mental Health:
        Knowledge development and application.....................          136,875           166,875           146,875           +10,000           -20,000
        Mental Health Performance Partnership.....................          356,000           416,000           366,000           +10,000           -50,000
        Children's Mental Health..................................           82,763            86,763            86,763            +4,000   ................
        Grants to States for the Homeless (PATH)..................           30,883            35,883            36,883            +6,000            +1,000
        Protection and Advocacy...................................           24,903            25,903            25,903            +1,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, mental health.................................          631,424           731,424           662,424           +31,000           -69,000

    Substance Abuse Treatment:
        Knowledge Development and Application.....................          100,259            95,259           125,259           +25,000           +30,000
        Targeted capacity expansion...............................          114,307           163,161           124,307           +10,000           -38,854
        Substance Abuse Performance Partnership...................        1,600,000         1,631,000         1,631,000           +31,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Substance Abuse Treatment.....................        1,814,566         1,889,420         1,880,566           +66,000            -8,854

    Substance Abuse Prevention:
        Knowledge Development and Application.....................           59,541            50,022            40,541           -19,000            -9,481
        Targeted capacity expansion...............................           80,283            85,207            80,283   ................           -4,924
        High Risk Youth Grants....................................            7,000             7,000             7,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Substance abuse prevention....................          146,824           142,229           127,824           -19,000           -14,405

    Program Management and Buildings and Facilities...............           59,054            59,943            59,943              +889   ................
                                                                   =========================================================================================
          Total, Substance Abuse and Mental Health................        2,651,868         2,823,016         2,730,757           +78,889           -92,259

              AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

    Research on Health Care Systems Cost and Access:
        Federal Funds.............................................          107,739   ................  ................         -107,739   ................
        Evaluation funding (NA)...................................          (52,576)         (206,593)         (226,593)        (+174,017)         (+20,000)
        Reducing Medical Errors (NA)..............................  ................          (20,000)          (50,000)         (+50,000)         (+30,000)
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................          (52,576)         (206,593)         (226,593)        (+174,017)         (+20,000)

    Medical expenditure surveys: Evaluation funding (NA)..........          (36,000)          (40,850)          (40,850)          (+4,850)  ................
    Program Support...............................................            2,484   ................  ................           -2,484   ................
        Evaluation funding (NA)...................................  ................           (2,500)           (2,500)          (+2,500)  ................
                                                                   =========================================================================================
          Total, AHRQ.............................................         (198,799)         (249,943)         (269,943)         (+71,144)         (+20,000)
              Federal Funds.......................................          110,223   ................  ................         -110,223   ................
              Evaluation funding (NA).............................          (88,576)         (249,943)         (269,943)        (+181,367)         (+20,000)
                                                                   =========================================================================================
          Total, Public Health Service............................       28,280,169        29,777,601        31,176,438        +2,896,269        +1,398,837

                 HEALTH CARE FINANCING ADMINISTRATION

                     GRANTS TO STATES FOR MEDICAID

    Medicaid current law benefits.................................      109,321,600       116,507,700       116,507,700        +7,186,100   ................
    State and local administration................................        6,379,800         7,258,500         7,258,500          +878,700   ................
    Vaccines for Children.........................................          465,383           469,054           469,054            +3,671   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Medicaid program level, current year..........      116,166,783       124,235,254       124,235,254        +8,068,471   ................
              Less funds advanced in prior year...................      -28,733,605       -30,589,003       -30,589,003        -1,855,398   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, request, current year............................       87,433,178        93,646,251        93,646,251        +6,213,073   ................
          New advance 1st quarter, fiscal year 2002...............       30,589,003        36,207,551        36,207,551        +5,618,548   ................
                                                                   =========================================================================================
                  PAYMENTS TO HEALTH CARE TRUST FUNDS

    Supplemental medical insurance................................       68,690,000        69,777,000        69,777,000        +1,087,000   ................
    Hospital insurance for the uninsured..........................          349,000           321,000           321,000           -28,000   ................
    Federal uninsured payment.....................................          121,000           132,000           132,000           +11,000   ................
    Program management............................................          129,100           151,600           151,600           +22,500   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Payments to Trust Funds, current law.............       69,289,100        70,381,600        70,381,600        +1,092,500   ................

                          PROGRAM MANAGEMENT

    Research, demonstration, and evaluation: Regular Program......           61,786            55,000            65,000            +3,214           +10,000

    Medicare Contractors..........................................        1,244,000         1,301,287         1,244,000   ................          -57,287
        H.R. 3103 funding (NA)....................................         (630,000)         (680,000)         (680,000)         (+50,000)  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Contractors program level.....................       (1,874,000)       (1,981,287)       (1,924,000)         (+50,000)         (-57,287)

    State Survey and Certification................................          204,674           234,147           219,674           +15,000           -14,473

    Federal Administration:
        Federal Administration....................................          484,900           497,942           491,900            +7,000            -6,042
        User Fees.................................................           -2,026            -2,074            -2,074               -48   ................
        User fee legislative proposal.............................  ................  ................  ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Federal Administration........................          482,874           495,868           489,826            +6,952            -6,042
                                                                   =========================================================================================
          Total, Program management...............................        1,993,334         2,086,302         2,018,500           +25,166           -67,802
          Total, Program management, program level................       (2,623,334)       (2,766,302)       (2,698,500)         (+75,166)         (-67,802)
                                                                   =========================================================================================
          Total, Health Care Financing Administration.............      189,304,615       202,321,704       202,253,902       +12,949,287           -67,802
              Federal funds.......................................      187,311,281       200,235,402       200,235,402       +12,924,121   ................
                  Current year....................................     (156,722,278)     (164,027,851)     (164,027,851)      (+7,305,573)  ................
                  New advance, 1st quarter, fiscal year 2002......      (30,589,003)      (36,207,551)      (36,207,551)      (+5,618,548)  ................
              Trust funds.........................................        1,993,334         2,086,302         2,018,500           +25,166           -67,802
                                                                   =========================================================================================
               ADMINISTRATION FOR CHILDREN AND FAMILIES

                   FAMILY SUPPORT PAYMENTS TO STATES

    Payments to territories.......................................           23,000            23,000            23,000   ................  ................
    Emergency assistance..........................................           98,000   ................  ................          -98,000   ................
    State and Local Administrative Training.......................            2,000   ................  ................           -2,000   ................
    Repatriation..................................................            1,000             1,000             1,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Welfare payments..............................          124,000            24,000            24,000          -100,000   ................

    Child Support Enforcement:
        State and local administration............................        2,818,800         3,089,800         3,089,800          +271,000   ................
        Federal incentive payments................................          371,000           404,000           404,000           +33,000   ................
        Hold Harmless payments....................................           11,000            11,000            11,000   ................  ................
        Access and visitation.....................................           10,000            10,000            10,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Welfare payments..............................        3,210,800         3,514,800         3,514,800          +304,000   ................
                                                                   =========================================================================================
          Total, Payments, current year program level.............        3,334,800         3,538,800         3,538,800          +204,000   ................
              Less funds advanced in previous years...............         -750,000          -650,000          -650,000          +100,000   ................
                                                                   -----------------------------------------------------------------------------------------
                Total, payments, current request..................        2,584,800         2,888,800         2,888,800          +304,000   ................
                New advance, 1st quarter, fiscal year 2002........          650,000         1,000,000         1,000,000          +350,000   ................
                                                                   =========================================================================================
               LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

    Advance from prior year (NA)..................................       (1,100,000)       (1,100,000)       (1,100,000)  ................  ................
    Emergency Allocation..........................................          300,000           300,000           300,000   ................  ................
    Advance funding fiscal year 2002..............................        1,100,000         1,100,000   ................       -1,100,000        -1,100,000

                    REFUGEE AND ENTRANT ASSISTANCE

    Transitional and Medical Services.............................          220,693           225,176           220,693   ................           -4,483
    Social Services...............................................          143,621           143,316           143,316              -305   ................
    Preventive Health.............................................            4,835             4,835             4,835   ................  ................
    Targeted Assistance...........................................           49,477            49,477            49,477   ................  ................
    Victims of Torture............................................            7,265             9,765             7,265   ................           -2,500
                                                                   -----------------------------------------------------------------------------------------
          Total, Refugee and entrant assistance...................          425,891           432,569           425,586              -305            -6,983

                   CHILD CARE AND DEVELOPMENT GRANT

    Advance funding from prior year (NA)..........................       (1,182,672)       (1,182,672)       (1,182,672)  ................  ................
    Current year additional request...............................  ................          817,328           817,328          +817,328   ................
    Advance funding fiscal year 2002..............................        1,182,672         2,000,000   ................       -1,182,672        -2,000,000

    SOCIAL SERVICES BLOCK GRANT (TITLE XX)........................        1,775,000         1,700,000           600,000        -1,175,000        -1,100,000

                CHILDREN AND FAMILIES SERVICES PROGRAMS

    Programs for Children, Youth, and Families:
        Head Start, current funded................................        3,867,000         4,867,000         4,867,000        +1,000,000   ................
            Advance from prior year...............................  ................       (1,400,000)       (1,400,000)      (+1,400,000)  ................
            Fiscal year 2002......................................        1,400,000         1,400,000         1,400,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Head Start program level..................        5,267,000         6,267,000         6,267,000        +1,000,000   ................

        Runaway and Homeless Youth................................           43,652            43,652            46,152            +2,500            +2,500

        Runaway Youth Transitional Living.........................           20,503            20,503            23,003            +2,500            +2,500
        Strengthening Parent/Child Relationships..................  ................           10,000   ................  ................          -10,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, runaway.......................................           64,155            74,155            69,155            +5,000            -5,000

        Child Abuse State Grants..................................           21,026            21,026            21,026   ................  ................
        Child Abuse Discretionary Activities......................           18,028            18,028            18,028   ................  ................
        Abandoned Infants Assistance..............................           12,207            12,207            12,207   ................  ................
        Child Welfare Services....................................          291,986           291,986           291,986   ................  ................
        Child Welfare Training....................................            7,000             7,000             7,000   ................  ................
        Adoption Opportunities....................................           27,419            27,419            27,419   ................  ................
        Adoption Incentive........................................           20,000            20,000            20,000   ................  ................
        Adoption Incentive (no cap adjustment)....................           21,791            21,791            21,791   ................  ................
    Social Services and Income Maintenance Research...............           27,491             6,500            27,491   ................          +20,991
    Community Based Resource Centers..............................           32,835            32,835            32,835   ................  ................

    Developmental disabilities program:
        State Councils............................................           65,750            65,803            65,803               +53   ................
        Protection and Advocacy...................................           28,110            28,110            31,000            +2,890            +2,890
        Developmental Disabilities Special Projects...............           10,244            10,244            10,244   ................  ................
        Developmental Disabilities University Affiliated..........           18,171            18,171            20,300            +2,129            +2,129
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Developmental disabilities....................          122,275           122,328           127,347            +5,072            +5,019

    Native American Programs......................................           35,420            44,420            40,420            +5,000            -4,000
    Community services:
        Grants to States for Community Services...................          527,700           510,000           550,000           +22,300           +40,000

        Community initiative program:
            Economic Development..................................           30,040             5,500            30,040   ................          +24,540
            Individual Development Account Initiative.............           10,000            25,000   ................          -10,000           -25,000
            Rural Community Facilities............................            5,321   ................            5,321   ................           +5,321
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, discretionary funds.......................           45,361            30,500            35,361           -10,000            +4,861

        National Youth Sports.....................................           15,000   ................           15,000   ................          +15,000
        Community Food and Nutrition..............................            6,315   ................            6,315   ................           +6,315
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Community services............................          594,376           540,500           606,676           +12,300           +66,176

    Violent Crime Reduction Programs:
        Crime Trust Funds:
             Runaway Youth Prevention.............................           14,999            14,999            14,999   ................  ................
            Domestic Violence Hotline.............................            1,957             2,157             2,157              +200   ................
            Battered Women's Shelters.............................          101,118           116,918           116,918           +15,800   ................
                                                                   -----------------------------------------------------------------------------------------
              Total, Violent crime reduction programs.............          118,074           134,074           134,074           +16,000   ................

    Program Direction.............................................          147,908           164,448           157,131            +9,223            -7,317
                                                                   =========================================================================================
          Total, Children and Families Services Programs..........        6,828,991         7,805,717         7,881,586        +1,052,595           +75,869
              Current Year........................................       (5,428,991)       (6,405,717)       (6,481,586)      (+1,052,595)         (+75,869)
              Advance Year, fiscal year 2002......................       (1,400,000)       (1,400,000)       (1,400,000)  ................  ................

    Rescission of permanent appropriations........................          -21,000   ................          -21,000   ................          -21,000
    PROMOTING SAFE AND STABLE FAMILIES............................          295,000           305,000           305,000           +10,000   ................

      PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE

    Foster Care...................................................        4,537,200         5,063,500         5,063,500          +526,300   ................
    Adoption Assistance...........................................        1,020,100         1,197,600         1,197,600          +177,500   ................
    Independent living............................................          140,000           140,000           140,000   ................  ................
    Child Welfare Tribal Initiative...............................  ................            5,000             5,000            +5,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Payments, current year program level.............        5,697,300         6,406,100         6,406,100          +708,800   ................
              Less Advances from Prior Year.......................       -1,355,000        -1,538,000        -1,538,000          -183,000   ................
                                                                   -----------------------------------------------------------------------------------------
                Total, payments, current request..................        4,342,300         4,868,100         4,868,100          +525,800   ................
                New Advance, 1st quarter, fiscal year 2002........        1,538,000         1,735,900         1,735,900          +197,900   ................
                                                                   =========================================================================================
          Total, Administration for Children and Families.........       21,001,654        24,953,414        20,801,300          -200,354        -4,152,114
              Current year........................................      (15,130,982)      (17,717,514)      (16,665,400)      (+1,534,418)      (-1,052,114)
              Advance Year, fiscal year 2002......................       (5,870,672)       (7,235,900)       (4,135,900)      (-1,734,772)      (-3,100,000)

                        ADMINISTRATION ON AGING

    Grants to States:
        Supportive Services and Centers...........................          310,082           450,082           325,082           +15,000          -125,000
        Preventive Health.........................................           16,123            16,123            16,123   ................  ................
        Title VII.................................................           13,181            13,181            14,181            +1,000            +1,000
        Nutrition:
            Congregate Meals......................................          374,412           374,412           374,412   ................  ................
            Home Delivered Meals..................................          147,000           147,000           147,000   ................  ................
    Grants to Indians.............................................           18,457            23,457            23,457            +5,000   ................
    Aging Research, Training and Special Projects.................           31,162            36,162            31,162   ................           -5,000
    Alzheimer's Initiative........................................            5,970             5,970             5,970   ................  ................
    Program Administration........................................           16,461            17,232            17,232              +771   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Administration on Aging..........................          932,848         1,083,619           954,619           +21,771          -129,000

                        OFFICE OF THE SECRETARY

    GENERAL DEPARTMENTAL MANAGEMENT:
        Federal Funds.............................................          116,561           127,685           121,747            +5,186            -5,938
            NAS study.............................................              414   ................  ................             -414   ................
        Trust Funds...............................................            5,851             5,851             5,851   ................  ................
        1% Evaluation funds (ASPE) (NA)...........................          (20,552)          (20,552)          (20,552)  ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................         (143,378)         (154,088)         (148,150)          (+4,772)          (-5,938)

        Adolescent Family Life (Title XX).........................           19,327             7,627            19,327   ................          +11,700
            Advance from prior year...............................  ................          (20,000)  ................  ................         (-20,000)
            Fiscal year 2002......................................           20,000   ................  ................          -20,000   ................
        Physical Fitness and Sports...............................            1,091             1,152             1,091   ................              -61
        Minority health...........................................           37,638            38,638            37,638   ................           -1,000
        Office of Women's Health..................................           15,495            16,495            16,895            +1,400              +400
        U.S. Surgeon General violence initiative..................              457               476               400               -57               -76
        Office of Emergency Preparedness..........................            9,668            11,668             9,668   ................           -2,000
        Other Health Activities...................................            4,922   ................  ................           -4,922   ................
        Health Informatics Initiative.............................  ................           20,000   ................  ................          -20,000
                                                                   -----------------------------------------------------------------------------------------
          Total, General Departmental Management..................          231,424           229,592           212,617           -18,807           -16,975
              Federal funds.......................................          205,573           223,741           206,766            +1,193           -16,975
              Trust funds.........................................            5,851             5,851             5,851   ................  ................
              Federal funds, fiscal year 2002.....................           20,000   ................  ................          -20,000   ................

    OFFICE OF THE INSPECTOR GENERAL:
        Federal Funds.............................................           31,394            33,849            33,849            +2,455   ................
        HIPAA funding (NA)........................................         (120,000)         (130,000)         (130,000)         (+10,000)  ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Inspector General program level..................         (151,394)         (163,849)         (163,849)         (+12,455)  ................

    OFFICE FOR CIVIL RIGHTS:
        Federal Funds.............................................           18,774            20,742            20,742            +1,968   ................
        Trust Funds...............................................            3,314             3,314             3,314   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Office for Civil Rights..........................           22,088            24,056            24,056            +1,968   ................

    POLICY RESEARCH...............................................           16,738            16,738            16,738   ................  ................

    RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS:
        Retirement payments.......................................          172,045           175,405           175,405            +3,360   ................
        Survivors benefits........................................           11,906            12,204            12,204              +298   ................
        Dependents' medical care..................................           29,626            30,811            30,811            +1,185   ................
        Military services credits.................................            1,328             1,352             1,352               +24   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Retirement pay and medical benefits..............          214,905           219,772           219,772            +4,867   ................

            PUBLIC HEALTH AND SOCIAL SERVICE EMERGENCY FUND

    Public Health/Social service fund.............................          488,280           264,600           264,600          -223,680   ................
                                                                   =========================================================================================
          Total, Office of the Secretary..........................        1,004,829           788,607           771,632          -233,197           -16,975
              Federal funds.......................................          975,664           779,442           762,467          -213,197           -16,975
              Trust funds.........................................            9,165             9,165             9,165   ................  ................
              Federal funds, fiscal year 2002.....................           20,000   ................  ................          -20,000   ................
                                                                   =========================================================================================
          Total, Department of Health and Human Services..........      240,524,115       258,924,945       255,957,891       +15,433,776        -2,967,054
              Federal Funds.......................................      238,521,616       256,829,478       253,930,226       +15,408,610        -2,899,252
                  Current year....................................     (202,041,941)     (213,386,027)     (213,586,775)     (+11,544,834)        (+200,748)
                  Advance Year, fiscal year 2002..................      (36,479,675)      (43,443,451)      (40,343,451)      (+3,863,776)      (-3,100,000)
              Trust funds.........................................        2,002,499         2,095,467         2,027,665           +25,166           -67,802

                  TITLE III--DEPARTMENT OF EDUCATION

                           EDUCATION REFORM

    Goals 2000: Educate America Act:
        State Grants forward funded...............................          456,500   ................  ................         -456,500   ................
        State Grants current funded...............................            1,500   ................  ................           -1,500   ................
        Parental Assistance.......................................           33,000            33,000            40,000            +7,000            +7,000
        Recognition and Reward....................................  ................           50,000   ................  ................          -50,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Goals 2000....................................          491,000            83,000            40,000          -451,000           -43,000

    School-to-Work Opportunities..................................           55,000   ................  ................          -55,000   ................

    Educational Technology:
        Technology Literacy Challenge Fund........................          425,000           450,000           425,000   ................          -25,000
        Technology Innovation Challenge Fund......................          146,255   ................          100,000           -46,255          +100,000
        Regional Technology in Education Consortia................           10,000            10,000            10,000   ................  ................
        Next Generation Technology Innovation.....................  ................          170,000   ................  ................         -170,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................          581,255           630,000           535,000           -46,255           -95,000

        National Activities:
            Technology Leadership Activities......................            2,000             2,000             2,000   ................  ................
            Teacher Training in Technology........................           75,000           150,000           125,000           +50,000           -25,000
            Community-Based Technology Centers....................           32,500           100,000            65,000           +32,500           -35,000
                                                                   -----------------------------------------------------------------------------------------
              Subtotal............................................          109,500           252,000           192,000           +82,500           -60,000

            Star Schools..........................................           50,550   ................           43,000            -7,550           +43,000
            Ready to Learn Television.............................           16,000            16,000            16,000   ................  ................
            Telcom Demo Project for Mathematics...................            8,500   ................            8,500   ................           +8,500
            Telcom Program for Professional Devlep................  ................            5,000   ................  ................           -5,000
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Educational technology....................          765,805           903,000           794,500           +28,695          -108,500

    21st Century Community Learning Centers.......................          453,377         1,000,000           600,000          +146,623          -400,000
    Small, Safe, and Successful High Schools......................  ................          120,000   ................  ................         -120,000
                                                                   =========================================================================================
          Total, Education Reform.................................        1,765,182         2,106,000         1,434,500          -330,682          -671,500

          Subtotal, Forward funded................................         (511,500)  ................  ................        (-511,500)  ................

                    EDUCATION FOR THE DISADVANTAGED

    Grants to Local Education Agencies (LEAs):
        Basic Grants:
             Advance from prior year..............................       (5,046,366)       (5,046,366)       (5,046,366)  ................  ................
            Forward funded........................................        1,733,134           481,237         2,108,958          +375,824        +1,627,721
            Current funded........................................            3,500   ................            3,500   ................           +3,500
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Basic grants current year funding.........        1,736,634           481,237         2,112,458          +375,824        +1,631,221

            Basic Grants fiscal year 2002 Advance.................        5,046,366         5,201,863         5,000,945           -45,421          -200,918
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, Basic grants, program level...............        6,783,000         5,683,100         7,113,403          +330,403        +1,430,303

        Concentration Grants--Advance from prior year.............       (1,158,397)       (1,158,397)       (1,158,397)  ................  ................
        Concentration Grants fiscal year 2002 Advance.............        1,158,397         1,002,900         1,222,397           +64,000          +219,497
        Targeted Grants...........................................  ................        1,671,500   ................  ................       -1,671,500
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Grants to LEAs................................        7,941,397         8,357,500         8,335,800          +394,403           -21,700

    Capital Expenses for Private School Children..................           12,000   ................            6,000            -6,000            +6,000
    Even Start....................................................          150,000           150,000           185,000           +35,000           +35,000
    State agency programs:
        Migrant...................................................          354,689           380,000           380,000           +25,311   ................
        Neglected and Delinquent/High Risk Youth..................           42,000            42,000            50,000            +8,000            +8,000
    Evaluation....................................................            8,900   ................  ................           -8,900   ................
    Comprehensive School Reform Demonstration.....................          170,000           190,000   ................         -170,000          -190,000
                                                                   =========================================================================================
          Total, ESEA.............................................        8,678,986         9,119,500         8,956,800          +277,814          -162,700

    Migrant education:
        High School Equivalency Program...........................           15,000            20,000            20,000            +5,000   ................
        College Assistance Migrant Program........................            7,000            10,000            10,000            +3,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, migrant education.............................           22,000            30,000            30,000            +8,000   ................
                                                                   =========================================================================================
          Total, Education for the disadvantaged..................        8,700,986         9,149,500         8,986,800          +285,814          -162,700
              Current Year........................................       (2,496,223)       (2,944,737)       (2,763,458)        (+267,235)        (-181,279)
              Advance Year, fiscal year 2002......................       (6,204,763)       (6,204,763)       (6,223,342)         (+18,579)         (+18,579)
          Subtotal, forward funded................................       (2,461,823)       (2,914,737)       (2,729,958)        (+268,135)        (-184,779)
                                                                   =========================================================================================
                              IMPACT AID

    Basic Support Payments........................................          737,200           720,000           818,000           +80,800           +98,000
    Payments for Children with Disabilities.......................           50,000            40,000            50,000   ................          +10,000
    Payments for Heavily Impacted Districts (Sec. f)..............           72,200   ................           82,000            +9,800           +82,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................          859,400           760,000           950,000           +90,600          +190,000

    Facilities Maintenance (Sec. 8008)............................            5,000             5,000             8,000            +3,000            +3,000
    Construction (Sec. 8007)......................................           10,052             5,000            25,000           +14,948           +20,000
    Payments for Federal Property (Sec. 8002).....................           32,000   ................           47,000           +15,000           +47,000
                                                                   =========================================================================================
          Total, Impact aid.......................................          906,452           770,000         1,030,000          +123,548          +260,000

                      SCHOOL IMPROVEMENT PROGRAMS

    Teaching to High Standards, current...........................  ................          405,000   ................  ................         -405,000
        Fiscal year 2002..........................................  ................          285,000   ................  ................         -285,000
    Eisenhower Professional Development...........................          335,000   ................          435,000          +100,000          +435,000
    National Programs:
        School Leadership Initiative..............................  ................           40,000   ................  ................          -40,000
        Improvement of Teaching and School Leadership.............  ................           25,000   ................  ................          -25,000
        Hometown Teachers.........................................  ................           75,000   ................  ................          -75,000
        Higher Standards/Higher Pay...............................  ................           50,000   ................  ................          -50,000
        Teacher Quality Incentives................................  ................           50,000   ................  ................          -50,000
        Troops to Teachers........................................  ................           25,000   ................  ................          -25,000
        Early Childhood Educator Professional Develp..............  ................           30,000   ................  ................          -30,000
    Innovative Education (Education Block Grant)..................          480,750           850,000           515,000           +34,250          -335,000
        Advance from prior year...................................  ................         (285,000)       (1,185,000)      (+1,185,000)        (+900,000)
        Fiscal year 2002..........................................        1,185,000           900,000         2,585,000        +1,400,000        +1,685,000
                                                                   -----------------------------------------------------------------------------------------
            Education Block Grant, program level..................        1,665,750         1,750,000         3,100,000        +1,434,250        +1,350,000
                                                                   -----------------------------------------------------------------------------------------
            Class Size Red'n/Teacher Assist, program level........  ................  ................  ................  ................  ................

    Safe and Drug Free Schools:
        State Grants, current funded..............................          109,250           109,250           117,000            +7,750            +7,750
            Advance from prior year...............................  ................         (330,000)         (330,000)        (+330,000)  ................
            Fiscal year 2002......................................          330,000           330,000           330,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
                State Grants, program level.......................          439,250           439,250           447,000            +7,750            +7,750

        National Programs.........................................          110,750           150,750           145,000           +34,250            -5,750
        Coordinator Initiative....................................           50,000            50,000            50,000   ................  ................
        Project SERV..............................................  ................           10,000   ................  ................          -10,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Safe and drug free schools....................          600,000           650,000           642,000           +42,000            -8,000

    Inexpensive Book Distribution (RIF)...........................           20,000            20,000            23,000            +3,000            +3,000
    Arts in Education.............................................           11,500            23,000            18,000            +6,500            -5,000

    Other school improvement programs:
        Magnet Schools Assistance.................................          110,000           110,000           110,000   ................  ................
        Education for Homeless Children and Youth.................           28,800            31,700            31,700            +2,900   ................
        Women's Educational Equity................................            3,000             3,000             3,000   ................  ................
        Training and Advisory Services (Civil Rights).............            7,334             7,334             7,334   ................  ................
        Ellender Fellowships/Close Up.............................            1,500   ................            1,500   ................           +1,500
        Education for Native Hawaiians............................           23,000            23,000            28,000            +5,000            +5,000
        Alaska Native Education Equity............................           13,000            13,000            15,000            +2,000            +2,000
        Charter Schools...........................................          145,000           175,000           210,000           +65,000           +35,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, other school improvement programs.............          331,634           363,034           406,534           +74,900           +43,500

    Opportunities to Improve our Nation's Schools(OPTIONS)........  ................           20,000   ................  ................          -20,000
    Strengthening Technical assistance Capacity Grants............  ................           38,000   ................  ................          -38,000
    Comprehensive Regional Assistance Centers.....................           28,000   ................           28,000   ................          +28,000
    Advanced Placement Fees.......................................           15,000            20,000            20,000            +5,000   ................
                                                                   =========================================================================================
          Total, School improvement programs......................        3,006,884         3,869,034         4,672,534        +1,665,650          +803,500
              Current Year........................................       (1,491,884)       (2,354,034)       (1,757,534)        (+265,650)        (-596,500)
              Advance Year, fiscal year 2002......................       (1,515,000)       (1,515,000)       (2,915,000)      (+1,400,000)      (+1,400,000)
          Subtotal, forward funded................................         (955,300)       (1,020,950)       (1,100,200)        (+144,900)         (+79,250)

                          READING EXCELLENCE

    Reading Excellence Act........................................           65,000            91,000            91,000           +26,000   ................
        Advance from prior year...................................  ................         (195,000)         (195,000)        (+195,000)  ................
        Fiscal year 2002..........................................          195,000           195,000           195,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
            Reading Excellence, program level.....................          260,000           286,000           286,000           +26,000   ................

                           INDIAN EDUCATION

    Grants to Local Educational Agencies..........................           62,000            92,765            92,765           +30,765   ................
    Federal Programs:
         Special Programs for Indian Children.....................           13,265            20,000            20,000            +6,735   ................
        National Activities.......................................            1,735             2,735             2,735            +1,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal................................................           15,000            22,735            22,735            +7,735   ................
                                                                   =========================================================================================
          Total, Indian Education.................................           77,000           115,500           115,500           +38,500   ................

                           SCHOOL RENOVATION

    Grants to Indian LEAs.........................................  ................           50,000   ................  ................          -50,000
        Grants to Other High-Need LEAs............................  ................          125,000   ................  ................         -125,000
        School Renovation Loan Subsidies..........................  ................        1,125,000   ................  ................       -1,125,000
                                                                   -----------------------------------------------------------------------------------------
          Total, School Renovation................................  ................        1,300,000   ................  ................       -1,300,000

                   BILINGUAL AND IMMIGRANT EDUCATION

    Bilingual education:
        Instructional Services....................................          162,500           180,000           180,000           +17,500   ................
        Support Services..........................................           14,000            16,000            14,000   ................           -2,000
        Professional Development..................................           71,500           100,000            85,000           +13,500           -15,000
    Immigrant Education...........................................          150,000           150,000           150,000   ................  ................
    Foreign Language Assistance...................................            8,000            14,000            14,000            +6,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Bilingual and Immigrant Education................          406,000           460,000           443,000           +37,000           -17,000

                           SPECIAL EDUCATION

    State grants:
        Grants to States Part B advance funded....................        3,742,000         3,742,000         4,624,000          +882,000          +882,000
            Part B advance from prior year........................  ................       (3,742,000)       (3,742,000)      (+3,742,000)  ................
        Grants to States Part B current year......................        1,247,685         1,537,685         1,655,685          +408,000          +118,000
                                                                   -----------------------------------------------------------------------------------------
            Grants to States program level........................        4,989,685         5,279,685         6,279,685        +1,290,000        +1,000,000

        Preschool Grants..........................................          390,000           390,000           390,000   ................  ................
        Grants for Infants and Families...........................          375,000           383,567           383,567            +8,567   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, State grants program level....................        5,754,685         6,053,252         7,053,252        +1,298,567        +1,000,000

    IDEA National Activities (current funded):
        State Program Improvement Grants..........................           35,200            45,200            35,200   ................          -10,000
        Research and Innovation...................................           64,433            74,433            74,433           +10,000   ................
        Technical Assistance and Dissemination....................           45,481            53,481            45,481   ................           -8,000
        Personnel Preparation.....................................           81,952            81,952            81,952   ................  ................
        Parent Information Centers................................           18,535            26,000            26,000            +7,465   ................
        Technology and Media Services.............................           34,410            34,523            34,523              +113   ................
            Public Telecom Info/Training Dissemination............            1,500   ................            1,500   ................           +1,500
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, IDEA special programs.....................          281,511           315,589           299,089           +17,578           -16,500
                                                                   =========================================================================================
              Total, Special education............................        6,036,196         6,368,841         7,352,341        +1,316,145          +983,500
                  Current Year....................................       (2,294,196)       (2,626,841)       (2,728,341)        (+434,145)        (+101,500)
                  Advance Year, fiscal year 2002..................       (3,742,000)       (3,742,000)       (4,624,000)        (+882,000)        (+882,000)
              Subtotal, Forward funded............................       (2,047,885)       (2,356,452)       (2,464,452)        (+416,567)        (+108,000)

            REHABILITATION SERVICES AND DISABILITY RESEARCH

    Vocational Rehabilitation State Grants........................        2,338,977         2,399,790         2,399,790           +60,813   ................
    Client Assistance State grants................................           10,928            11,147            11,147              +219   ................
    Training......................................................           39,629            39,629            39,629   ................  ................
    Demonstration and training programs...........................           21,672            21,672            21,672   ................  ................
    Migrant and seasonal farmworkers..............................            2,350             2,850             2,850              +500   ................
    Recreational programs.........................................            3,521             2,596             2,596              -925   ................
    Protection and advocacy of individual rights (PAIR)...........           11,894            12,132            13,000            +1,106              +868
    Projects with industry........................................           22,071            22,071            22,071   ................  ................
    Supported employment State grants.............................           38,152            38,152            38,152   ................  ................

    Independent living:
        State grants..............................................           22,296            22,296            22,296   ................  ................
        Centers...................................................           48,000            58,000            58,000           +10,000   ................
        Services for older blind individuals......................           15,000            15,000            20,000            +5,000            +5,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Independent living............................           85,296            95,296           100,296           +15,000            +5,000

    Program Improvement...........................................            1,900             1,900             1,900   ................  ................
    Evaluation....................................................            1,587             1,587             1,587   ................  ................
    Helen Keller National Center for Deaf-Blind Youths and Adults.            8,550             8,717             8,717              +167   ................
    National Institute for Disability and Rehabilitation Research            86,462           100,000            95,000            +8,538            -5,000
     (NIDRR)......................................................
    Assistive Technology..........................................           34,000            41,112            41,112            +7,112   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, discretionary programs........................          368,012           398,861           399,729           +31,717              +868
                                                                   =========================================================================================
          Total, Rehabilitation services..........................        2,706,989         2,798,651         2,799,519           +92,530              +868

          SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

    AMERICAN PRINTING HOUSE FOR THE BLIND.........................           10,100            10,265            12,500            +2,400            +2,235

    NATIONAL TECHNICAL INSTITUTE FOR THE DEAF:
         Operations...............................................           45,500            46,410            47,190            +1,690              +780
        Construction..............................................            2,651             5,376             7,176            +4,525            +1,800
                                                                   -----------------------------------------------------------------------------------------
          Total...................................................           48,151            51,786            54,366            +6,215            +2,580

    GALLAUDET UNIVERSITY:
        Operations................................................           83,480            87,650            87,650            +4,170   ................
        Construction..............................................            2,500   ................  ................           -2,500   ................
                                                                   -----------------------------------------------------------------------------------------
          Total...................................................           85,980            87,650            87,650            +1,670   ................
                                                                   =========================================================================================
          Total, Special institutions.............................          144,231           149,701           154,516           +10,285            +4,815

                    VOCATIONAL AND ADULT EDUCATION

    Vocational education:
        Basic State Grants, current funded........................          264,650           264,650           280,000           +15,350           +15,350
            Advance from prior year...............................  ................         (791,000)         (791,000)        (+791,000)  ................
            Fiscal year 2002......................................          791,000           591,000           791,000   ................         +200,000
                                                                   -----------------------------------------------------------------------------------------
              Basic State Grants, program level...................        1,055,650           855,650         1,071,000           +15,350          +215,350
        Tech-Prep Education.......................................          106,000           106,000           106,000   ................  ................
            Fiscal year 2002......................................  ................          200,000   ................  ................         -200,000
        Tribally Controlled Postsecondary Vocational Institutions.            4,600             4,600             5,600            +1,000            +1,000
        National Programs.........................................           17,500            17,500            26,500            +9,000            +9,000
        Tech Prep Education Demonstration.........................  ................  ................            5,000            +5,000            +5,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Vocational education..........................        1,183,750         1,183,750         1,214,100           +30,350           +30,350

    Adult education:
        State Grants, current funded..............................          450,000           460,000           470,000           +20,000           +10,000

        National programs:
            National Leadership Activities........................           14,000            89,000            14,000   ................          -75,000
            National Institute for Literacy.......................            6,000             6,500             6,500              +500   ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, National programs.........................           20,000            95,500            20,500              +500           -75,000
                                                                   =========================================================================================
              Subtotal, adult education...........................          470,000           555,500           490,500           +20,500           -65,000

    State Grants for Incarcerated Youth Offenders.................           19,000            12,000            22,000            +3,000           +10,000
                                                                   =========================================================================================
          Total, Vocational and adult education...................        1,672,750         1,751,250         1,726,600           +53,850           -24,650
              Current Year........................................         (881,750)         (960,250)         (935,600)         (+53,850)         (-24,650)
              Advance Year, fiscal year 2002......................         (791,000)         (791,000)         (791,000)  ................  ................
          Subtotal, forward funded................................         (858,150)         (943,650)         (908,000)         (+49,850)         (-35,650)

                     STUDENT FINANCIAL ASSISTANCE

    Pell Grants--maximum grant (NA)...............................           (3,300)           (3,500)           (3,650)            (+350)            (+150)
    Pell Grants--Regular Program..................................        7,639,717         8,356,000         8,692,000        +1,052,283          +336,000
    Federal Supplemental Educational Opportunity Grants...........          621,000           691,000           691,000           +70,000   ................
    Federal Work Study............................................          934,000         1,011,000         1,011,000           +77,000   ................
    Federal Perkins loans:
        Capital Contributions.....................................          100,000           100,000           100,000   ................  ................
        Loan Cancellations........................................           30,000            60,000            60,000           +30,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Federal Perkins loans.........................          130,000           160,000           160,000           +30,000   ................

    LEAP program..................................................           40,000            40,000            70,000           +30,000           +30,000
                                                                   =========================================================================================
          Total, Student financial assistance.....................        9,364,717        10,258,000        10,624,000        +1,259,283          +366,000

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

    Federal Administration........................................           48,000            48,000            48,000   ................  ................

                           HIGHER EDUCATION

    Aid for institutional development:
        Strengthening Institutions................................           60,250            63,000            65,000            +4,750            +2,000
        Hispanic Serving Institutions.............................           42,250            62,500            62,500           +20,250   ................
        Dual-Degree Programs for Minority Institutions............  ................           40,000   ................  ................          -40,000
        Strengthening Historically Black Colleges (HBCUs).........          148,750           169,000           169,000           +20,250   ................
        Strengthening historically black graduate insts...........           31,000            40,000            40,000            +9,000   ................
        Strengthening Alaska / Native Hawaiian Instit.............            5,000             5,000             6,000            +1,000            +1,000
        Strengthening Tribal Colleges.............................            6,000             9,000            10,000            +4,000            +1,000
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Institutional development.....................          293,250           388,500           352,500           +59,250           -36,000

    Program development:
        Fund for the Improvement of Postsec. Ed. (FIPSE)..........           74,249            31,200            56,247           -18,002           +25,047
        Minority Science and Engineering Improvement..............            7,500             8,500             8,500            +1,000   ................

        International education and foreign language:
            Domestic Programs.....................................           62,000            62,000            62,000   ................  ................
            Overseas Programs.....................................            6,680            10,000            10,000            +3,320   ................
            Institute for International Public Policy.............            1,022             1,022             1,022   ................  ................
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, International education...................           69,702            73,022            73,022            +3,320   ................

    Interest Subsidy Grants.......................................           12,000            10,000            10,000            -2,000   ................
    Federal TRIO Programs.........................................          645,000           725,000           736,500           +91,500           +11,500
    GEAR UP.......................................................          200,000           325,000           225,000           +25,000          -100,000
    Byrd Honors Scholarships......................................           39,859            41,001            41,001            +1,142   ................
    Javits Fellowships............................................           20,000            10,000            11,000            -9,000            +1,000
    Graduate Assistance in Areas of National Need.................           31,000            31,000            33,000            +2,000            +2,000
    Learning Anytime Anywhere Partnerships........................           23,269            30,000            30,000            +6,731   ................
    Teacher Quality Enhancement Grants............................           98,000            98,000            98,000   ................  ................
    Child Care Access Means Parents in School.....................            5,000            15,000            10,000            +5,000            -5,000
    Demonstration in Disabilities/Higher Education................            5,000             5,000             5,000   ................  ................
    Underground Railroad Program..................................            1,750             1,750             1,750   ................  ................
    Community Scholarship Mobilization............................            1,000   ................  ................           -1,000   ................
    GPRA data/HEA program evaluation..............................            3,000             3,000             3,000   ................  ................
                                                                   =========================================================================================
          Total, Higher education.................................        1,529,579         1,795,973         1,694,520          +164,941          -101,453

                           HOWARD UNIVERSITY

    Academic Program..............................................          185,540           190,096           190,096            +4,556   ................
    Endowment Program.............................................            3,530             3,530             3,530   ................  ................
    Howard University Hospital....................................           30,374            30,374            30,374   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Total, Howard University................................          219,444           224,000           224,000            +4,556   ................

    COLLEGE HOUSING and ACADEMIC FACILITIES LOANS PROGRAM: Federal              737               737               737   ................  ................
     Administration...............................................

     HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING,
                            PROGRAM ACCOUNT

    HBCU Capital Financing Program Federal Adm....................              207               208               208                +1   ................

            EDUCATION RESEARCH, STATISTICS, AND IMPROVEMENT

    Research and statistics:
        Research, Development, and Dissemination..................  ................          198,567   ................  ................         -198,567
        Research..................................................          103,567   ................          103,567   ................         +103,567
        Regional Educational Laboratories.........................           65,000   ................           65,000   ................          +65,000
        Statistics................................................           68,000            84,000            68,000   ................          -16,000

        Assessment:
            National Assessment...................................           36,000            38,000            36,000   ................           -2,000
            National Assessment Governing Board...................            4,000             4,500             4,000   ................             -500
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Assessment....................................           40,000            42,500            40,000   ................           -2,500
                                                                   =========================================================================================
          Subtotal, Research and statistics.......................          276,567           325,067           276,567   ................          -48,500

    Fund for the Improvement of Education.........................          243,864           137,150           142,152          -101,712            +5,002
    International Education Exchange..............................            7,000             8,000            10,000            +3,000            +2,000
    Civic Education...............................................            9,850             9,850            12,000            +2,150            +2,150
    Eisenhower Professional Dvp. Federal Activities...............           23,300   ................           23,300   ................          +23,300
    Eisenhower Regional Math and Science Ed. Consortia............           15,000            15,000            15,000   ................  ................
    Javits Gifted and Talented Education..........................            6,500             7,500             7,500            +1,000   ................
    America's Tests...............................................  ................            5,000   ................  ................           -5,000
    National Writing Project......................................            9,000            10,000            10,000            +1,000   ................
                                                                   =========================================================================================
          Total, ERSI.............................................          591,081           517,567           496,519           -94,562           -21,048

                        DEPARTMENTAL MANAGEMENT

    PROGRAM ADMINISTRATION........................................          382,934           413,184           396,672           +13,738           -16,512
    OFFICE FOR CIVIL RIGHTS.......................................           71,200            76,000            73,224            +2,024            -2,776
    OFFICE OF THE INSPECTOR GENERAL...............................           34,000            36,500            35,456            +1,456            -1,044
                                                                   -----------------------------------------------------------------------------------------
          Total, Departmental management..........................          488,134           525,684           505,352           +17,218           -20,332

                             STUDENT LOANS

    New Annual Loan Volume (including consolidation):
        Federal Family Education Loans (FFEL).....................      (25,540,000)      (26,902,000)      (26,902,000)      (+1,362,000)  ................
        Federal Direct Student Loans (FDSL).......................      (14,855,000)      (15,613,000)      (15,613,000)         (+58,000)  ................
    Total Outstanding Loan Volume:
        Federal Family Education Loans (FFEL).....................     (281,700,000)     (303,900,000)     (303,900,000)     (+22,200,000)  ................
        Federal Direct Student Loans (FDSL).......................      (54,200,000)      (65,400,000)      (65,400,000)     (+11,200,000)  ................
                                                                   =========================================================================================
          Total, Department of Education..........................       37,924,569        42,494,646        42,594,646        +4,670,077          +100,000
              Current year........................................      (25,476,806)      (30,046,883)      (27,846,304)      (+2,369,498)      (-2,200,579)
              Advance Year, fiscal year 2002......................      (12,447,763)      (12,447,763)      (14,748,342)      (+2,300,579)      (+2,300,579)

                      TITLE IV--RELATED AGENCIES

                     ARMED FORCES RETIREMENT HOME

    Operations and Maintenance....................................           55,599            60,000            60,000            +4,401   ................
    Capital Program...............................................           12,696             9,832             9,832            -2,864   ................
                                                                   -----------------------------------------------------------------------------------------
          Total, AFRH.............................................           68,295            69,832            69,832            +1,537   ................

          CORPORATION FOR NATIONAL AND COMMUNITY SERVICE \5\

    Domestic Volunteer Service Programs:
        Volunteers in Service to America (VISTA)..................           80,574            86,000            83,074            +2,500            -2,926

        National Senior Volunteer Corps:
            Foster Grandparents Program...........................           95,988            97,782            97,500            +1,512              -282
            Senior Companion Program..............................           39,219            41,669            40,219            +1,000            -1,450
            Retired Senior Volunteer Program......................           46,117            50,565            48,117            +2,000            -2,448
            Senior Demonstration Program..........................            1,494             2,500             1,494   ................           -1,006
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Senior Volunteers.............................          182,818           192,516           187,330            +4,512            -5,186

        Program Administration....................................           31,129            34,100            32,100              +971            -2,000
                                                                   =========================================================================================
          Total, Domestic Volunteer Service Programs..............          294,521           312,616           302,504            +7,983           -10,112

    CORPORATION FOR PUBLIC BROADCASTING:
        Fiscal year 2003 (current request) with fiscal year 2002            350,000           365,000           365,000           +15,000   ................
         comparable...............................................
            Digitalization program \6\............................  ................           30,000   ................  ................          -30,000
        Fiscal year 2002 advance with fiscal year 2001 comparable          (340,000)         (350,000)         (340,000)  ................         (-10,000)
         (NA).....................................................
            Digitalization program \6\............................  ................           35,000   ................  ................          -35,000
        Fiscal year 2001 advance with fiscal year 2000 comparable          (300,000)         (340,000)         (300,000)  ................         (-40,000)
         (NA).....................................................
            Fiscal year 2000 reduction............................           -1,243   ................           -1,243   ................           -1,243
            Digitalization program \6\............................           10,000            20,000            20,000           +10,000   ................
            Satellite replacement supplemental fiscal year 2000...          (17,300)  ................          (17,300)  ................         (+17,300)
                                                                   -----------------------------------------------------------------------------------------
              Subtotal, fiscal year 2000/01 appropriation.........         (326,057)         (360,000)         (336,057)         (+10,000)         (-23,943)

    FEDERAL MEDIATION AND CONCILIATION SERVICE....................           36,693            39,001            38,200            +1,507              -801
    FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION..............            6,136             6,320             6,320              +184   ................
    INSTITUTE OF MUSEUM AND LIBRARY SERVICES......................          166,251           173,000           168,000            +1,749            -5,000
    MEDICARE PAYMENT ADVISORY COMMISSION (TF).....................            7,015             8,000             8,000              +985   ................
    NATIONAL COMMISSION ON LIBRARIES AND INFO SCIENCE.............            1,295             1,495             1,495              +200   ................
    NATIONAL COUNCIL ON DISABILITY................................            2,391             2,615             2,615              +224   ................
    NATIONAL EDUCATION GOALS PANEL................................            2,241             2,350             2,350              +109   ................
    NATIONAL LABOR RELATIONS BOARD................................          205,717           216,438           216,438           +10,721   ................
    NATIONAL MEDIATION BOARD......................................            9,562            10,400            10,400              +838   ................
    OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION..............            8,470             8,720             8,720              +250   ................

                       RAILROAD RETIREMENT BOARD

    Dual Benefits Payments Account................................          173,339           160,000           160,000           -13,339   ................
    Less Income Tax Receipts on Dual Benefits.....................          -10,000           -10,000           -10,000   ................  ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Dual Benefits.................................          163,339           150,000           150,000           -13,339   ................

    Federal Payment to the RR Retirement Account..................              150               150               150   ................  ................
    Limitation on administration:
        Consolidated Account......................................           90,655            92,500            92,500            +1,845   ................
        Inspector General.........................................            5,380             5,700             5,700              +320   ................

                    SOCIAL SECURITY ADMINISTRATION

    Payments to Social Security Trust Funds.......................           20,764            20,400            20,400              -364   ................

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

    Benefit payments..............................................          520,000           484,078           484,078           -35,922   ................
    Administration................................................            4,638             5,670             5,670            +1,032   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, Black Lung, current year program level........          524,638           489,748           489,748           -34,890   ................

              Less funds advanced in prior year...................         -141,000          -124,000          -124,000           +17,000   ................
                                                                   -----------------------------------------------------------------------------------------
                Total, Black Lung, current request................          383,638           365,748           365,748           -17,890   ................
                New advances, 1st quarter fiscal year 2002........          124,000           114,000           114,000           -10,000   ................
                                                                   =========================================================================================
                     SUPPLEMENTAL SECURITY INCOME

    Federal benefit payments......................................       29,189,000        30,483,000        30,483,000        +1,294,000   ................
    Beneficiary services..........................................           64,000            71,000            71,000            +7,000   ................
    Research and demonstration....................................           25,085            30,000            30,000            +4,915   ................
    Administration................................................        2,142,000         2,359,000         2,359,000          +217,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, SSI current year program level................       31,420,085        32,943,000        32,943,000        +1,522,915   ................
              Less funds advanced in prior year...................       -9,550,000        -9,890,000        -9,890,000          -340,000   ................
                                                                   =========================================================================================
          Subtotal, regular SSI current year (2000/2001)..........       21,870,085        23,053,000        23,053,000        +1,182,915   ................
              Additional CDR funding \3\..........................          200,000           210,000           210,000           +10,000   ................
              User Fee Activities.................................           80,000            91,000            91,000           +11,000   ................
                                                                   -----------------------------------------------------------------------------------------
                Total, SSI, current request.......................       22,150,085        23,354,000        23,354,000        +1,203,915   ................
                New advance, 1st quarter, fiscal year 2002........        9,890,000        10,470,000        10,470,000          +580,000   ................
                                                                   =========================================================================================
                 LIMITATION ON ADMINISTRATIVE EXPENSES

    OASDI Trust Funds.............................................        2,925,236         3,138,200         3,015,000           +89,764          -123,200
    HI/SMI Trust Funds............................................        1,038,000         1,094,000         1,094,000           +56,000   ................
    Social Security Advisory Board................................            1,800             1,800             1,800   ................  ................
    SSI...........................................................        2,142,000         2,359,000         2,359,000          +217,000   ................
                                                                   -----------------------------------------------------------------------------------------
          Subtotal, regular LAE...................................        6,107,036         6,593,000         6,469,800          +362,764          -123,200

    User Fee Activities (SSI).....................................           80,000            91,000            91,000           +11,000   ................
                                                                   =========================================================================================
          Total, REGULAR LAE......................................        6,187,036         6,684,000         6,560,800          +373,764          -123,200
              Additional CDR funding: \3\
                  OASDI...........................................          185,000           240,000           240,000           +55,000   ................
                  SSI.............................................          200,000           210,000           210,000           +10,000   ................
                                                                   -----------------------------------------------------------------------------------------
                    Subtotal, CDR funding.........................          385,000           450,000           450,000           +65,000   ................
                                                                   =========================================================================================
          Total, LAE..............................................        6,572,036         7,134,000         7,010,800          +438,764          -123,200

                      OFFICE OF INSPECTOR GENERAL

    Federal Funds.................................................           14,944            17,000            16,944            +2,000               -56
    Trust Funds...................................................           50,808            56,000            52,500            +1,692            -3,500
                                                                   -----------------------------------------------------------------------------------------
          Total, Office of the Inspector General..................           65,752            73,000            69,444            +3,692            -3,556

    Adjustment: Trust fund transfers from general revenues........       -2,422,000        -2,660,000        -2,660,000          -238,000   ................
                                                                   =========================================================================================
          Total, Social Security Administration...................       36,784,275        38,871,148        38,744,392        +1,960,117          -126,756
              Federal funds.......................................       32,583,431        34,341,148        34,341,092        +1,757,661               -56
                  Current year....................................      (22,569,431)      (23,757,148)      (23,757,092)      (+1,187,661)             (-56)
                  New advances, 1st quarter fiscal year 2001......      (10,014,000)      (10,584,000)      (10,584,000)        (+570,000)  ................
              Trust funds.........................................        4,200,844         4,530,000         4,403,300          +202,456          -126,700

    UNITED STATES INSTITUTE OF PEACE..............................           12,951            14,450            12,951   ................           -1,499
                                                                   =========================================================================================
          Total, Title IV, Related Agencies.......................       38,224,094        40,434,735        40,224,324        +2,000,230          -210,411
              Federal funds.......................................       33,920,200        35,798,535        35,714,824        +1,794,624           -83,711
                  Current year....................................      (23,556,200)      (24,784,535)      (24,765,824)      (+1,209,624)         (-18,711)
                  Advance Year, fiscal year 2002..................      (10,014,000)      (10,619,000)      (10,584,000)        (+570,000)         (-35,000)
                  Advance Year, fiscal year 2003..................         (350,000)         (395,000)         (365,000)         (+15,000)         (-30,000)
              Trust funds.........................................        4,303,894         4,636,200         4,509,500          +205,606          -126,700
                                                                   =========================================================================================
                                SUMMARY
    Grand bill total..............................................      329,763,462       356,183,602       352,185,874       +22,422,412        -3,997,728
        Federal Funds.............................................      320,083,953       345,938,039       342,231,647       +22,147,694        -3,706,392
            Current year..........................................     (258,329,515)     (276,569,825)     (273,727,854)     (+15,398,339)      (-2,841,971)
            Advance Year, fiscal year 2002........................      (61,404,438)      (68,973,214)      (68,138,793)      (+6,734,355)        (-834,421)
            Advance Year, fiscal year 2003........................         (350,000)         (395,000)         (365,000)         (+15,000)         (-30,000)
        Trust Funds...............................................        9,679,509        10,245,563         9,954,227          +274,718          -291,336
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\ Three year forward funded availability.
    \2\ 15 month forward funded availability.
    \3\ Two year availability.
    \4\ Includes Mine Safety and Health.
    \5\ Appropriations for Americorps are provided in the VA-HUD bill.
    \6\ Unauthorized. Funding is subject to enactment of authorization by September 30, 2000.