[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
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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)
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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 ................ ................
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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 ................
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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 ................
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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 ................
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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
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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
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\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.