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



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


                                    


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

                               ----------                              

                              R E P O R T

                              to accompany

                                S. 2553




                  May 12, 2000.--Ordered to be printed

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

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



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

                                _______
                                

                  May 12, 2000.--Ordered to be printed

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

                                _______
                                

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

                              R E P O R T

                         [To accompany S. 2553]

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



Amount of budget authority

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


                            C O N T E N T S

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

       Summary of Budget Estimates and Committee Recommendations

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

                           allocation ceiling

    Consistent with Congressional Budget Office scorekeeping, 
the recommendations result in full use of the $97,350,000,000 
in discretionary budget authority pursuant to section 302(b) of 
the Congressional Budget Act of 1974, as amended. In addition, 
the recommendations include $450,000,000 in budget authority 
for the Social Security Administration to conduct continuing 
disability reviews provided consistent with Public Law 104-124 
and Public Law 104-193 and $20,000,000 for adoption incentive 
programs conducted by the Administration on Children and 
Families, provided consistent with Public Law 95-266.

                      Overview and Bill Highlights

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

                         Highlights of the Bill

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

                        reducing medical errors

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

                       women's health initiative

    As we enter the 21st century, the Committee is pleased to 
note the tremendous progress achieved by women over the past 
100 years. But there is yet more progress to be made.
    In the past century, women have seen a 30 year gain in life 
expectancy, from 48.3 years in 1900 to 79.4 years in 1997. 
Women currently represent 51 percent of the total United States 
population, 59 percent of the over-65 population and 71 percent 
of Americans older than 85. Within the next 30 years, we can 
expect that 1 in 4 women in the U.S. will be 65 or older.
    As women live longer, our nation has made tremendous 
advances to delay or avoid the onset of the chronic conditions 
once thought to be the inevitable consequence of aging. Yet too 
many of these conditions continue to reduce the quality of life 
for millions of women. These conditions include osteoporosis, 
arthritis, cancer, heart failure, hypertension, urinary 
incontinence and diabetes. Among women aged 65-85, at least 27 
percent suffer from two chronic diseases, and 24 percent suffer 
from three or more. These debilitating conditions often result 
in activity limitations, loss of work and productivity, 
economic consequences as a result of needing supportive 
services for daily tasks, and increased risks to personal 
safety.
    In past years, the Committee has placed a high priority on 
women's health, emphasizing the prevention, detection, 
treatment and cure of diseases and conditions prevalent in 
female populations. The Committee has has included 
$4,175,200,000 to better understand and treat conditions such 
as cardiovascular disease, stroke, cancers of the breast, 
cervix, ovary and uterus, osteoporosis, lupus and other 
autoimmune diseases, sexually transmitted diseases, chronic 
fatigue syndrome, depression, incontinence, irritable bowel 
syndrome, temporomandibular joint (TMJ) disorders, vulvadynia, 
and conditions related to reproduction and contraception and 
other issues specifically affecting women.
    Other areas addressed by this Committee relate to 
environmental, social, cultural, racial, ethnic and lifestyle 
issues important to women and their families. These include 
initiatives that combat violence against women, reduce health 
disparities, eliminate tobacco addiction and substance abuse, 
provide for child care needs and early childhood education, and 
address conditions related to diet, exercise and nutrition.
    In the 1980's, public health leaders and this Committee 
drew attention to inequities in the health research agenda and 
the fact that women and minorities were being excluded from 
research studies. Many of the major research studies the 
National Institutes of Health funded included only men, making 
it uncertain whether the studies' results applied also to 
women. In 1990, the U.S. General Accounting Office (GAO) found 
that the NIH had been slow and ineffective in implementing a 
policy to include women in research study populations. At the 
urging of this Committee, and in response to passage of the NIH 
Revitalization Act of 1993, the NIH began to take more 
comprehensive measures to increase research on health problems 
affecting women.
    The GAO has now published a report assessing the NIH's 
progress on conducting research on women's health in the past 
decade. The GAO's report found that NIH has made significant 
progress in implementing a strengthened policy on including 
women in clinical research. However, the Committee is deeply 
concerned to learn that NIH has made little progress in 
implementing the requirement that clinical trials be designed 
and carried out to permit valid analysis by sex, which could 
reveal whether interventions affect women and men differently. 
In addition, the report found that NIH's data tracking system 
for monitoring the inclusion policy is inaccurate and 
inconsistent.
    The Committee is pleased to note that the budget for the 
Office of Research on Women's Health has more than doubled 
since 1993. While the Committee recognizes the central role 
played by ORWH in the implementation of NIH's 1994 guidelines, 
it is concerned that ORWH has not provided regular training and 
education of NIH staff and researchers on the inclusion policy 
and the data tracking system.
    In light of the GAO report's disturbing findings, the 
Committee urges NIH to adopt GAO's recommendations to implement 
the requirement that phase III clinical trials be designed and 
carried out to allow for the valid analysis of differences 
between women and men. To improve the accuracy of NIH's 
tracking data system on the inclusion of women and minorities, 
the Committee urges NIH to ensure their staff receive ongoing 
training on the requirements and purpose of the system.
    Unfortunately, women often face a fragmentation of health 
care services to meet their reproductive and other health 
needs. Women are also highly interested and informed about 
health care issues, but reliable health information needed to 
make informed choices has not been widely available.
    A number of recent studies describe a health care system 
that treats women like second-class citizens. In many cases, 
health care providers treat women differently than men by 
giving women less thorough evaluations for similar complaints, 
minimizing their symptoms, providing fewer interventions for 
the same diagnoses, prescribing some types of medications more 
often, such as anti-anxiety drugs, or providing less 
explanation in response to questions.
    The Committee wishes to address inequities in our national 
research agenda and our health care delivery system. Progress 
has been made to improve women's health status because of 
public pressure and Congressional attention, but more must be 
done. The Committee has therefore provided level or increased 
funding for existing programs for a women's health initiative.
    1. National Institutes of Health.--The Committee has 
provided a $2,700,000,000 increase for the NIH, the largest 
increase in history. Funds are therefore available for 
implementation of the recommendations detailed in the GAO 
Report of May 2000 titled ``Women's Health: NIH Has Increased 
Its Efforts to Include Women in Research'' and to expand 
research into a range of women's health concerns, including 
cardiovascular disease, stroke, cancers of the breast, cervix, 
ovary and uterus, osteoporosis, lupus and other autoimmune 
diseases, sexually transmitted diseases, chronic fatigue 
syndrome, depression, incontinence, irritable bowel syndrome, 
temporomandibular joint (TMJ) disorders, vulvadynia, and 
conditions related to reproduction and contraception.
    2. Breast and cervical cancer.--The Committee has provided 
$164,016,000, an increase of $8,000,000, for CDC's National 
Breast and Cervical Cancer Early Detection Program, which 
guides public health programs in formulating an aggressive 
response to these cancers. CDC further supports the delivery of 
screening services to underserved women, quality assurance, 
referral and follow-up services, surveillance and partnership 
development.
    3. Wisewoman.--The Committee is pleased with the progress 
of CDC's Wisewoman Program. This demonstration program provides 
low-income women participating in the national breast and 
cervical cancer early detection program with additional 
preventive screenings and medical referrals. The Committee has 
provided sufficient funds for a continued expansion of the 
program to additional States.
    4. Osteoporosis.--The Committee recommends the commitment 
of the Office on Women's Health to the National Bone Health 
Campaign aimed at adolescent girls. The Committee also 
recognizes that eating disorders and autoimmune diseases impact 
bone health and encourages the Office of Women's Health to 
develop information and outreach activities on these 
conditions.
    5. Maternal and child health.--The Committee recommends 
$704,130,000 for the maternal and child health (MCH) block 
grant. The MCH block grant funds are provided to States to 
support health care for mothers and children.
    6. Ryan White--pediatric AIDS.--The Committee recommends 
$58,450,000 for title IV pediatric AIDS. This program supports 
demonstration grants to develop innovative models that foster 
collaboration between clinical research institutions and 
primary/community based medical and social service providers 
for underserved children, youth, pregnant women and their 
families.
    7. Family planning.--The Committee recommends $253,932,000 
for the title X family planning program. The title X grants 
support primary health services at more than 4,000 clinics 
nationwide. About 85 percent of family planning clients are 
women at or below 150 percent of poverty level.
    8. Substance abuse prevention and treatment for pregnant 
and post-partum women.--The Committee has provided funding to 
combat the tragic results of drug abuse among pregnant women. 
The Committee encourages continued funding for new and existing 
residential treatment facilities for pregnant and post-partum 
women and continues to be supportive of efforts to prevent and 
treat mothers with substance abuse problems.
    9. Child care.--The Committee recommends an increase of 
$817,328,000 for the Child Care and Development Block Grant in 
fiscal year 2001. This brings the total funding level to 
$2,000,000,000.
    10. Violence Against Women.--The Committee has provided 
$116,918,000 for Battered Women's Shelters, an increase of 
$15,800,000 over last year's appropriation. The Committee also 
recommends $2,157,000 for the Domestic Violence Hotline.

                    drug demand reduction initiative

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

                  youth violence prevention initiative

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

              reprogramming and initiation of new programs

    Reprogramming is the utilization of funds for purposes 
other than those contemplated at the time of appropriation 
enactment. Reprogramming actions do not represent requests for 
additional funds from the Congress, rather, the reapplication 
of resources already available.
    The Committee has a particular interest in approving 
reprogrammings which, although they may not change either the 
total amount available in an account or any of the purposes for 
which the appropriation is legally available, represent a 
significant departure from budget plans presented to the 
Committee in an agency's budget justification.
    Consequently, the Committee directs that the Departments 
and agencies funded through this bill make a written request to 
the chairman of the Committee prior to reprogramming of funds 
in excess of 10 percent, or $500,000, whichever is less, 
between programs, activities, or elements unless an alternate 
amount for the agency in question is specified elsewhere in 
this report. The Committee desires to have the requests for 
reprogramming actions which involve less than the above-
mentioned amounts if such actions would have the effect of 
changing an agency's funding requirements in future years, if 
programs or projects specifically cited in the Committee's 
reports are affected or if the action can be considered to be 
the initiation of a new program.
    The Committee directs that it be notified regarding 
reorganization of offices, programs, or activities prior to the 
planned implementation of such reorganizations.
    The Committee further directs that each agency under its 
jurisdiction submit to the Committee statements on the effect 
of this appropriation act within 60 days of final enactment of 
this act.

                           transfer authority

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

                        Claims Processing Costs

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

                 GOVERNMENT PERFORMANCE AND RESULTS ACT

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

                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

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

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

            community service employment for older americans

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

    The Committee recommends $440,200,000, the same as the 
budget request and the fiscal year 2000 appropriation for 
community service employment for older Americans. The Committee 
recommends 78 percent of the funds for national sponsors and 22 
percent for State sponsors; this is the same percentage 
distribution as has been required by apropriations law for the 
past several years. This program, authorized by title V of the 
Older Americans Act, provides part-time employment in community 
service activities for unemployed, low-income persons aged 55 
and over. It is forward-funded from July to June, and the 2001 
appropriation will support the program from July 1, 2001, 
through June 30, 2002. These funds are to be distributed in the 
same manner as currently authorized under the Older Americans 
Act, unless this law is subsequently altered. Current law 
states that title V funds should be targeted to eligible 
individuals with the greatest economic need. The Committee 
believes that within the title V community service employment 
for older Americans, special attention should be paid to 
providing community service jobs for older Americans with poor 
employment prospects, including individuals with a long-term 
detachment from the labor force, older displaced homemakers, 
aged minorities, limited English-speaking persons, and legal 
immigrants.
    The Committee is concerned about alleged program 
irregularities reported by the Inspector General, attributed to 
a national sponsor, and notes a resolution is being pursued. 
Currently, grants are awarded annually to sponsoring 
organizations and agencies on a non-competitive basis. The 
Committee recommends that if satisfactory resolution of 
irregularities with a national sponsor is not accomplished, 
that consideration be given to awarding such grant funds, 
competitively or through other means, among the other national 
sponsors, taking into consideration performance and the 
difficulty in reaching target populations. Implementing such a 
modification must, however, be sensitive to the need to avoid 
disruption to program participants in the event of a change in 
grantee.

              federal unemployment benefits and allowances

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

    The Committee recommends $406,550,000, the same as the 
budget request and a decrease of $8,600,000 below the 2000 
enacted level for Federal unemployment benefits and allowances. 
These are entitlement funds.
    The trade adjustment line item has two activities totaling 
$342,400,000 in fiscal year 2000.
    The first activity, trade adjustment assistance benefits, 
provides for special unemployment benefit payments to workers 
as authorized by the Trade Act of 1974, as amended. For this 
activity the Committee recommends $248,000,000. This is the 
same as the budget request and a decrease of $7,000,000 below 
the 2000 comparable level. These funds will permit payment of 
benefits, averaging $224 per week, to 36,400 workers for 2000. 
Of these workers, 21,200 will participate in training programs, 
receiving benefits for an average of 30.5 weeks. The remaining 
15,200 workers receiving benefits will receive training waivers 
and collect benefits.
    The second activity, trade adjustment assistance training, 
provides training, job search, and job relocation allowances to 
workers adversely affected by imports. The funding for this 
activity is also authorized under the Trade Act of 1974, as 
amended. The Committee recommends $94,400,000 for this 
activity, the same as the budget request and an increase of 
$400,000 above the 2000 comparable level. These funds will 
provide services for an estimated 22,700 workers.
    For NAFTA activities, $64,150,000 is provided, in two 
components.
    The first component, NAFTA transitional adjustment 
assistance benefits, provides for weekly benefit payments to 
workers affected by imports from Mexico and Canada. These 
payments are also authorized by the Trade Act of 1974, as 
amended as a result of the signing of the North American Free 
Trade Agreement [NAFTA]. The Committee recommends $27,000,000 
for this activity. This is the same as the budget request and a 
decrease of $2,000,000 below the 2000 comparable level and 
represents the current services funding level.
    The second component, NAFTA transitional adjustment 
assistance training, provides funds for training, job search 
and job relocation to workers affected by imports from Mexico 
and Canada. The fiscal year 2000 current services 
recommendation is $37,150,000, the same as the fiscal year 2000 
enacted level and the budget request.
    Resources related to the Administration's legislative 
proposals will be considered upon enactment of the requested 
legislation.

     state unemployment insurance and employment service operations

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

    The Committee recommends $3,249,430,000 for this account. 
This is $139,768,000 below the budget request and $35,650,000 
above the 2000 comparable level. Included in the total 
availability is $3,095,978,000 authorized to be drawn from the 
``Employment Security Administration'' account of the 
unemployment trust fund, and $153,452,000 to be provided from 
the general fund of the Treasury.
    The funds in this account are used to provide 
administrative grants and assistance to State agencies which 
administer Federal and State unemployment compensation laws and 
operate the public employment service.
    For unemployment insurance (UI) services, the bill provides 
$2,283,515,000. This includes $2,273,515,000 for State 
Operations, which is $75,768,000 below the President's request 
and $17,140,000 above the fiscal year 2000 level. The Committee 
expects the Department to manage these resources to ensure 
equitable funding to States to handle total workload, which is 
estimated to be 2,396,000 average weekly insured unemployment 
(AWIU) claims. The Committee recommendation includes the 
Administration's proposal to restructure the UI budget 
activities. This amount also includes $10,000,000 for UI 
national activities, the same as the fiscal year 2000 level and 
the President's request, which is directed to activities that 
benefit the State/Federal unemployment insurance program. The 
bill continues to provide for a contingency reserve amount 
should the unemployment workload exceed an average weekly 
insured claims volume of 2,396,000. This contingency amount 
would fund the administrative costs of unemployment insurance 
workload over the level of 2,396,000 insured unemployed per 
week at a rate of $28,600,000 per 100,000 insured unemployed, 
with a pro rata amount granted for amounts of less than 100,000 
insured unemployed.
    For the employment service, the Committee recommends 
$835,915,000 which includes $23,452,000 in general funds 
together with an authorization to spend $812,463,000 from the 
``Employment security administration'' account of the 
unemployment trust fund.
    Included in the recommendation for the employment service 
[ES] is $786,735,000 for Grants to States, available for the 
program year of July 1, 2001, through June 30, 2002. This is 
$25,000,000 less than the budget request and $25,000,000 above 
the 2000 comparable level. Included in the Grants to States 
activity is $761,735,000 for Wagner-Peyser formula grants to 
States, and $25,000,000 for Reemployment Services Grants as 
part of the Universal Reemployment Initiative to insure that 
all unemployed workers get the services they need to become 
reemployed. The latter will provide staff-assisted services to 
UI claimants, targeted on those identified as likely to exhaust 
their eligibility for benefits, insuring that those who need 
help in finding new jobs receive it so they can return more 
quickly to employment. Also included is $49,180,000 for 
national activities, an increase of $5,000,000 above the budget 
request. Funding previously provided in this activity for alien 
labor certification occupational employment statistics is 
appropriated directly to the Bureau of Labor Statistics in 
fiscal year 2001, and comparative amounts for fiscal year 2000 
are reflected therein.
    The recommendation includes $110,000,000 for one-stop 
career centers, which is the same as the 2000 comparable level. 
This Committee recommendation includes funding for America's 
Labor Market Information System, including core employment 
statistics, universal access for customers, improving 
efficiency in labor market transactions, and measuring and 
displaying WIA performance information. Funding previously 
provided in this activity for occupational employment 
statistics is appropriated directly to the Bureau of Labor 
Statistics in fiscal year 2001, and comparative amounts for 
fiscal year 2000 are reflected therein.
    The recommendation includes $20,000,000 for part of the 
proposed new Work Incentives Grants program, the same as last 
year's level and the President's request to help persons with 
disabilities find and retain jobs through the One-Stop Career 
Center system mandated by the Workforce Investment Act. Funding 
will support systems building grants intended to ensure that 
one-stop systems integrate and coordinate mainstream employment 
and training programs with essential employment-related 
services for persons with disabilities.
    The Committee continues to be concerned about the current 
state of the permanent labor certification program. This 
program, which provides access to needed workers in those cases 
where a shortage of American workers can be shown, is suffering 
from a lack of a streamlined process for handling both the 
backlog and significant increase in applications received, 
which has led to problems in administering the program. 
Although the Department has indicated that a complete new 
streamlined system will be implemented in 2001 and has reduced 
its budget to reflect this new process, the Committee wants to 
ensure that no further delays are encountered in processing 
applications. Therefore, the Committee is providing an increase 
of $5,000,000 over the request for State grants and directs the 
Employment and Training Administration and the States to work 
diligently to improve the administration of this important 
program, with the intent of eliminating backlogs by the end of 
2001 and implementing a new streamlined system during 2001. In 
addition, the Committee is restoring the $1,772,000 and 21 FTE 
in the Program Administration account to ensure that there are 
sufficient Federal staff to handle both the old system and 
certification system. The Committee wants a report by March 1, 
2001 of the progress made in reducing backlogs and the 
implementation of the new system.
    The Committee agrees that the work opportunity tax credit 
[WOTC], and the welfare-to-work tax credit provide important 
resources to create new jobs, particularly for those Americans 
who would otherwise be dependent on welfare. Therefore, the 
Committee recommendation includes $20,000,000 for the 
administration of these initiatives, the same as the 2000 
level.

        advances to the unemployment trust fund and other funds

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

    The Committee recommends $435,000,000 an increase of 
$79,000,000 above the 2000 comparable level, for this account. 
The appropriation is available to provide advances to several 
accounts for purposes authorized under various Federal and 
State unemployment compensation laws and the black lung 
disability trust fund, whenever balances in such accounts prove 
insufficient. The bill anticipates that fiscal year 1998 
advances will be made to the black lung disability trust fund.
    The separate appropriations provided by the Committee for 
all other accounts eligible to borrow from this account in 
fiscal year 2000 are expected to be sufficient. Should the need 
arise, due to unanticipated changes in the economic situation, 
laws, or for other legitimate reasons, advances will be made to 
the needy accounts to the extent funds are available. Funds 
advanced to the black lung disability trust fund are now 
repayable with interest to the general fund of the Treasury.

                         program administration

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

    The Committee recommendation includes $107,651,000 in 
general funds for this account, as well as authority to expend 
$48,507,000 from the ``Employment Security Administration'' 
account of the unemployment trust fund, for a total of 
$156,158,000. This is $10,158,000 greater than the 2000 
comparable level.
    The Committee recommendation also includes restoration of 
$1,772,000 and 21 FTE for the foreign labor certification 
activity to ensure that there are sufficient Federal staff to 
handle both the old system and certification system.
    The Committee recommendation includes $1,300,000 for the 
management and oversight of the various pilot and demonstration 
projects funded as part of this year's appropriation and to 
support those projects that continue to be implemented from 
past years' administered by the Employment and Training 
Administration. These funds will be used exclusively for 
financial, technical, program and general administration 
provided by staff responsible for grant management, oversight, 
monitoring, guidance/operation and reporting and evaluation for 
the earmark activities.
    General funds in this account provide the Federal staff to 
administer employment and training programs under the Workforce 
Investment Act, the Older Americans Act, the Trade Act of 1974, 
and the National Apprenticeship Act. Trust funds provide for 
the Federal administration of employment security functions 
under title III of the Social Security Act and the Immigration 
and Nationality Act, as amended. Federal staff costs related to 
the Wagner-Peyser Act in this account are split 97 percent to 3 
percent between unemployment trust funds and general revenue, 
respectively.
    The Committee recognizes the Home Builders Institute's 
Project CRAFT (Community Restitution and Apprenticeship-Focused 
Training) program as a successful model and proven intervention 
technique in the rehabilitation and reduced recidivism of 
accused and adjudicated juvenile offenders. The Committee 
encourages the Department of Labor to work in cooperation with 
the Department of Justice to replicate Project CRAFT in order 
to offer at-risk and adjudicated youth preapprenticeship 
training and job placement in the residential construction 
trades.

              Pension and Welfare Benefits Administration


                         SALARIES AND EXPENSES

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

    The Committee recommendation provides $103,342,000 for this 
account, which is $4,408,000 above the 2000 comparable level.
    The Pension and Welfare Benefits Administration [PWBA] is 
responsible for the enforcement of title I of the Employee 
Retirement Income Security Act of 1974 [ERISA] in both civil 
and criminal areas. PWBA is also responsible for enforcement of 
sections 8477 and 8478 of the Federal Employees' Retirement 
Security Act of 1986 [FERSA]. PWBA provides funding for the 
enforcement and compliance; policy, regulation, and public 
services; and program oversight activities.
    Implementation of the new EFAST (ERISA Filing and 
Acceptance System) devoted to processing form 5500 series 
financial data required under the Employee Retirement Income 
Security Act will enable employees to submit annual benefit 
plan reports electronically, reducing the cost, paperwork 
burden, and enhancing protection of pension funds. The 
Committee intends for the Internal Revenue Service and the 
Department of Labor to continue to share the ongoing operating 
costs of the system in the same manner as under the old system.

                  Pension Benefit Guaranty Corporation

    The Corporation's estimate for fiscal year 2000 includes 
benefit payments of $987,609,000, multiemployer financial 
assistance of $6,266,000, administrative expenses limitation of 
$11,871,000, and services related to terminations expenses of 
$164,834,000.
    The Pension Benefit Guaranty Corporation is a wholly owned 
Government corporation established by the Employee Retirement 
Income Security Act of 1974. The law places it within the 
Department of Labor and makes the Secretary of Labor the Chair 
of its Board of Directors. The Corporation receives its income 
primarily from insurance premiums collected from covered 
pension plans, collections of employer liabilities imposed by 
the act, and investment earnings. It is also authorized to 
borrow up to $100,000,000 from the Treasury. The primary 
purpose of the Corporation is to guarantee the payment of 
pension plan benefits to participants if covered plans fail or 
go out of existence.

                  Employment Standards Administration


                         SALARIES AND EXPENSES

Appropriations, 2000....................................    $338,770,000
Budget estimate, 2001...................................     363,476,000
Committee recommendation................................     352,764,000

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

                            SPECIAL BENEFITS

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

    The Committee recommends continuation of appropriation 
language to provide authority to require disclosure of Social 
Security account numbers by individuals filing claims under the 
Federal Employees' Compensation Act or the Longshore and Harbor 
Workers' Compensation Act and its extensions.
    The recommendation includes $56,000,000, the same as the 
budget request and a decrease of $23,000,000 below the 2000 
comparable level. This appropriation primarily provides 
benefits under the Federal Employees' Compensation Act [FECA]. 
The payments are prescribed by law.
    The total amount to be available in fiscal year 2001, 
including anticipated reimbursements from Federal agencies of 
$1,955,000,000 is $2,011,000,000, an increase of $9,000,000 
above the 2000 comparable level.
    The Committee recommends continuation of appropriation 
language that provides authority to use the FECA fund to 
reimburse a new employer for a portion of the salary of a newly 
reemployed injured Federal worker. The FECA funds will be used 
to reimburse new employers during the first 3 years of 
employment not to exceed 75 percent of salary in the worker's 
first year, declining thereafter. Costs will be charged to the 
FECA fund.
    The Committee again includes appropriation language that 
retains the drawdown date of August 15. The drawdown authority 
enables the agency to meet any immediate shortage of funds 
without requesting supplemental appropriations. The August 15 
drawdown date allows maximum flexibility for continuation of 
benefit payments without interruption.
    The Committee recommends continuation of appropriation 
language to provide authority to deposit into the special 
benefits account of the employees' compensation fund those 
funds that the Postal Service, the Tennessee Valley Authority, 
and other entities are required to pay to cover their fair 
share of the costs of administering the claims filed by their 
employees under FECA. The Committee concurs with requested bill 
language to allow the Secretary to use fair share collections 
to fund capital investment projects and specific initiatives to 
strengthen compensation fund control and oversight.

                    black lung disability trust fund

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

    The bill includes authority to obligate $1,028,000,000 from 
the black lung disability trust fund in fiscal year 2001. This 
is an increase of $14,367,000 over the 2000 comparable level 
and the same as the administration request.
    The total amount available for fiscal year 2000 will 
provide $409,343,000 for benefit payments, and $52,657,000 for 
administrative expenses for the Department of Labor. Also 
included is $566,000,000 for interest payments on advances. In 
fiscal year 2000, comparable obligations for benefit payments 
are estimated to be $430,506,000 while administrative expenses 
for the Departments of Labor and Treasury, respectively, are 
$49,771,000 and $356,000. The Committee reiterates its 
directive to prevent the closing of and to ensure the staffing 
of black lung field offices.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
can be assigned liability for such benefits, or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs which are incurred in administering the benefits program 
and operating the trust fund.
    It is estimated that 59,500 people will be receiving black 
lung benefits financed from the trust fund by the end of fiscal 
year 2001. This compares with an estimated 63,200 receiving 
benefits in fiscal year 2000.
    The basic financing for the trust fund comes from a coal 
excise tax for underground and surface-mined coal. Additional 
funds come from reimbursement payments from mine operators for 
benefit payments made by the trust fund before the mine 
operator is found liable, and advances. The advances to the 
fund assure availability of necessary funds when liabilities 
may exceed other income. The Omnibus Budget Reconciliation Act 
of 1987 continues the current tax structure until 2014.
    The Committee notes favorably the administration's response 
to last year's conference report direction to provide a 
recommended solution to the structural deficit in the Black 
Lung Disability Trust Fund. The Committee is pleased that the 
administration has submitted a comprehensive legislative 
proposal to this end. The Committee urges the administration to 
work closely with Congress in pursuing a legislative solution 
to this problem.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

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

    The Committee recommendation includes $425,983,000 for this 
account. This is the same as the budget request and an increase 
of $44,363,000 above the 2000 comparable level. This agency is 
responsible for enforcing the Occupational Safety and Health 
Act of 1970 in the Nation's workplaces.
    Among the increases provided by the Committee are funds for 
a variety of compliance assistance activities, including the 
State consultation grants providing free consultation visits to 
small businesses, the Susan Harwood education and training 
grants, and completion of the effort to place a compliance 
assistance specialist in each Federal area office. Funding 
included for increased inspections are targeted to specific 
sites with the highest injury and illness rates. The 
recommendation also includes funds to support the State of New 
Jersey's proposed Public Employee Occupational Safety and 
Health Program. The recommendation continues the important 
balance between compliance assistance and enforcement 
activities, which has proven essential to improving 
occupational safety and health.
    In addition, the Committee has included language to allow 
OSHA to retain up to $750,000 per fiscal year of training 
institute course tuition fees to be utilized for occupational 
safety and health training and education grants in the private 
sector.
    The Committee retains language carried in last year's bill 
effectively exempting farms employing 10 or fewer people from 
the provisions of the act except those farms having a temporary 
labor camp. The Committee also retains language exempting small 
firms in industry classifications having a lost workday injury 
rate less than the national average from general schedule 
safety inspections. These provisions have been in the bill for 
many years.
    The Committee is very pleased with OSHA's efforts in 
placing high priority on the voluntary protection programs 
(VPP) and other voluntary cooperative programs. The agency's 
work in expanding participation in the programs, and promoting 
prompt review and processing of applications is particularly 
noteworthy. In fiscal year 2001 the Committee expects OSHA to 
continue to place high priority on the VPP, making every effort 
to ensure 25 percent growth in participation by sites covered 
under federal OSHA jurisdiction. Cooperative voluntary 
programs, especially the VPP, are an important part of OSHA's 
ability to assure worker safety and health and should be 
administered in conjunction with an effective strong 
enforcement program.
    The Committee also intends that the Office of Regulatory 
Analysis continued to be funded as close as possible to its 
present level.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

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

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

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

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

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

                        Departmental Management


                         SALARIES AND EXPENSES

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

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

                    Veterans Employment and Training

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

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

                    OFFICE OF THE INSPECTOR GENERAL

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

    The bill includes $54,785,000 for this account, a decrease 
of $1,362,000 below the budget request and $2,860,000 above the 
2000 comparable level. This funding will cover the agency's 
built in increases. The bill includes $50,015,000 in general 
funds and authority to transfer $4,770,000 from the 
``Employment Security Administration'' account of the 
unemployment trust fund. In addition, an amount of $318,000 is 
available by transfer from the black lung disability trust 
fund. The reduction from the request was necessary due to 
severe budget constraints facing the Committee in fiscal year 
2001.
    The Office of the Inspector General [OIG] was created by 
law to protect the integrity of departmental programs as well 
as the welfare of beneficiaries served by those programs. 
Through a comprehensive program of audits, investigations, 
inspections, and program evaluations, the OIG attempts to 
reduce the incidence of fraud, waste, abuse, and mismanagement, 
and to promote economy, efficiency, and effectiveness.

                           General Provisions

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

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     health resources and services

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

    The Committee recommends an appropriation of $4,522,424,000 
for health resources and services. This is $117,972,000 below 
the administration request and $40,941,000 less than than the 
fiscal year 2000 allowance.
    Health Resources and Services Administration [HRSA] 
activities support programs to provide health care services for 
mothers and infants; the underserved, elderly, homeless; 
migrant farm workers; and disadvantaged minorities. This 
appropriation supports cooperative programs in community 
health, AIDS care, health provider training, and health care 
delivery systems and facilities.

                             HEALTH CENTERS

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

Community health centers

    The community health centers provide comprehensive, case-
managed primary health care services to medically indigent and 
underserved populations in rural and urban areas. Of the 
clients served by community health centers, about 44 percent 
are children and 66 percent have incomes below the poverty 
line.
    The Committee understands that nearly forty percent of 
patients served by health centers have no health insurance. The 
Committee expects that funding increases will be reasonably 
allocated to increase grant levels for existing grantees 
(particularly those serving greater numbers of uninsured 
persons) and to initiate new sites in underserved areas, 
particularly in rural regions.
    The Committee notes the expeditious manner in which HRSA 
has distributed a substantial portion of the additional 
resources provided to the health center program in fiscal year 
2000 and with the use of a funding methodology that targets 
these funds to centers with the highest burden of uninsured 
patients. The Committee encourages that new funding made 
available in fiscal year 2001 be given to stabilizing existing 
health centers and to enlarging existing health centers to 
serve the needs of communities without access to primary and 
preventive care.
    The Committee does not set aside any additional 
appropriations for loan guarantee authority under Section 
330(d) of the Public Health Service Act. The Committee intends 
that loan guarantee authority made available from the 
$160,000,000 allocation both fiscal year 1997 and fiscal year 
1998 which continues to be available for guarantees of both 
loan principal and interest.
    The Committee is concerned about the low number of centers 
in rural areas where shortages of health professionals are the 
greatest. The Committee encourages the agency to place 
appropriate priority on applications for new centers on rural 
areas which fall within the service area of an existing center 
but where no satellite clinic has been established.
    The Committee repeats bill language from previous years 
limiting the amount of funds available for the payment of 
claims under the Federal Tort Claims Act to $5,000,000.
    Within the consolidated health center line, sufficient 
funds have been provided to support the activities intended to 
reduce health disparities among ethnic/racial groups with high 
rates of adverse health outcomes.
    The Committee understands that Spelman College in Atlanta 
is seeking to expand its African American Women's Health and 
Wellness Project. This project is an effort to close the health 
disparity gaps that exist between African Americans and other 
communities.
    The Committee believes that HRSA could undertake a 
demonstration project in Alaska to bring community health 
center services to small and isolated communities in Alaska 
using core providers with satellite operations. The Committee 
notes that the State of Alaska, the Southeast Alaska Regional 
Health Corporation, and Ketchikan General Hospital have 
proposals to serve the needs of many of these isolated 
medically underserved communities.
    The Committee recognizes the efforts of the University of 
Texas, Houston Health Science Center, M.D. Anderson Cancer 
Center, Rice University, Baylor College of Medicine, and the 
University of Houston in establishing a unique pilot program 
which uses a community-based approach to assess healthcare 
needs and deliver services through the use of community health 
workers. The consortium plans to examine what factors 
contribute to good health and will channel resources 
accordingly.
    The Committee believes the agency could establish a 
demonstration project in Hawaii to develop an integrated health 
and social services model, to include traditional healing, 
prevention, and disease management, that addresses the 
disparities in health status and barriers to accessing health 
and social services among native Hawaiians and other minority 
populations at the Waimanalo Health Center.
    The Committee understands that a coalition of the Nebraska 
chapter of the American Academy of Pediatrics, the U.S. Bureau 
of Primary Health Care, and the Creighton University Medical 
School are working to promote patient access to healthcare.
    The Committee acknowledges that the New York University's 
Program in Women's Cancer (PWC) plans to create a new program 
to treat women's cancer, including etiology and biology, risk 
identification and prevention, screening, diagnosis and 
staging, treatment, palliation and rehabilitation, and 
psychosocial support.
    The Committee is supportive of the efforts of the Brain 
Trauma Foundation in developing an innovative program to 
significantly decrease mortality and morbidity due to severe 
traumatic brain injury and reduce the economic costs of caring 
for individuals with head injury.
    The Committee is aware that the McLaughlin Research 
Institute's Office of Rural Health Policy has developed a 
cancer genetic education program in north-central Montana to 
assess the need for genetic counseling to support the education 
of physicians, staff, patients, and families while exploring 
the ethical, social, and legal impacts of genetics discoveries 
on rural healthcare.
    The Committee understands that the University of Montana 
aspires to assist health care professionals statewide so that a 
significant improvement can be made in the effective use of 
medications and dietary supplements.
    The Committee recognizes that the frontier environment of 
rural Montana presents significant challenges to emergency 
responders. The Committee understands that Montana State 
University in Billings plans to research the current emergency 
system software and hardware systems, adapt current software to 
meet the information needs of emergency responders in rural 
Montana, and provide training to emergency responders.
    The Committee recognizes the high prevalence of chronic 
diseases such as diabetes, asthma, hyperlipidemia, and 
cardiovascular disease in rural areas. Furthermore, the 
management and control of these chronic diseases through 
medication and lifestyle alteration is essential to controlling 
overall health expenditures. Because of a shortage of primary 
care in rural areas, many patients do not have consistent 
access to practitioners to guide them in the provision of 
complicated medications and the accompanying lifestyle 
necessary to achieve a high quality of life through the 
management of these diseases. The Committee believes that HRSA 
should undertake a demonstration project in the rural 
Mississippi Delta area applying the Mississippi Medicaid 
disease State management program to the area's Medicare 
population.
    The Committee continues to be supportive of the 
demonstration programs of the Center for Sustainable Health 
Outreach in developing model health access programs, health-
related jobs and sustainability of community-based providers of 
health services in rural and urban communities.
    The Committee recognizes the increasing demand for 
comprehensive primary health care by individuals and families 
in Utah who lack access to affordable services. The Committee 
suggests that HRSA continue support for a primary care 
residencies program at remote and frontier sites. The Committee 
believes that HRSA could give special attention and 
consideration to allocating resources to the implementation of 
projects that have demonstrated cooperative State and medical 
education efforts to support primary care residences in 
underserved urban and rural/frontier areas in Utah.
    The Committee is aware of a proposal by the Community 
Health Centers of Fresno, California to develop an enhanced 
model ambulatory care facility to meet the growing demands of 
the economically distressed, culturally diverse Central Valley 
of California.
    The Committee also recognizes that the Los Angeles Eye 
Institute, the nation's first minority-founded eye institute, 
will focus on providing increased access to high quality eye 
care for underserved minority and socio-economically 
disadvantaged children and adults.
    The Committee understands that Santa Marta Hospital in Los 
Angeles is providing outreach and offering health education to 
underserved populations suffering from diabetes. This 
innovative program is culturally and linguistically sensitive 
and primarily serves the Latino community.
    The Committee acknowledges that the Henry Ford Health 
Services' African American Initiative for Male Health 
Improvement (AIM-HI), a program designed to address the level 
and consequences of undiagnosed and untreated chronic diseases 
affecting the African American community through a network of 
community-based health resource centers that would represent a 
partnership between the program and grass roots organizations 
within the African American community. The program would 
initially focus on Detroit.
    The Committee understands that the University of Kentucky's 
Appalachian Health Promotion Disease Prevention Project is 
helping local Appalachian communities identify health problems, 
develop plans, and implement solutions through community-
initiated decision-making.
    The Committee recognizes that asthma is a growing problem 
nationwide, particularly among minorities and the underserved. 
The Committee encourages HRSA, through its Community Health 
Centers program, to enhance its efforts aimed at reducing the 
incidence of asthma among ethnic and racial minorities.
    The Committee understands that the agency has funded the 
Hui and encourages continued and increased support to address 
the unique health care needs of Hawaii's underserved 
population. Native Hawaiian indigenous populations continue to 
experience significant health problems, including asthma and 
diabetes. The Committee urges HRSA to implement a program under 
which the systematic utilization of native Hawaiian health 
expertise may effectively impact the health status in these 
populations. The Committee recommends that community health 
centers serve as a safety net for this program, utilizing nurse 
practitioners and psychologists as care providers for these 
underserved populations.
    The Committee notes the high prevalence of hepatitis C 
(HCV) in the low income communities served by Community Health 
Centers (CHC). The Committee urges adequate funding to permit 
CHCs to train their medical personnel on the risks and 
treatment protocols for HCV as well as resources for culturally 
appropriate educational materials for CHC clientele.
    The Committee is also concerned that regulations and 
application procedures currently governing distribution of 
community health center funds are preventing remote rural areas 
in states like Alaska and Hawaii from applying for and 
receiving funding for health centers despite severe shortages 
of health professionals and great need. The Committee urges the 
agency to give appropriate priority to locating new health 
centers in such remote communities and to developing a flexible 
approach to working with Native health providers and other 
similar groups to help meet the health needs of low income 
persons living in extremely remote locations.
    The Committee is aware of an effort by Health Choice 
Network, based in South Florida, to integrate an innovative 
system of clinical data management. The use of an automated 
medical record system is critical to improving outcomes and 
reducing ethnic disparities in the health in our patient 
population. Use of this system can improve the health care 
delivery system by improving the ability to track and manage 
key health factors of our vulnerable patients. Included in the 
project will be a document imaging system, automated medical 
records, and computer hardware and software. The Committee 
encourages full and fair consideration of this request.
    The Committee is aware of the proposal by the Madison, 
Wisconsin Community Health Center to establish an effective 
model for culturally sensitive, fiscally viably primary health 
care which would include health promotion and prevention of 
high risk behaviors in at-risk and hard-to-reach populations. 
The proposal would focus on preventive care, follow-up medical 
services, patient education and case management. This project, 
which could be replicated in other communities across the 
Nation, would involve extensive collaboration between public 
and private health care organizations, public health 
departments and schools, university medical and nursing schools 
and the public. The agency is encouraged to identify steps that 
would assist this entity in attaining its operational goals.

School-based health centers

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

Migrant health program

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

Health care for the homeless

    The program provides project grants for the delivery of 
primary health care services, substance abuse services, and 
mental health services to homeless adults and children. About 
one-half of the projects are administered by community health 
centers. The other one-half are administered by nonprofit 
coalitions, inner-city hospitals, and local public health 
departments.
    It has been brought to the Committee's attention that the 
Department may be developing a regulation to revise the process 
for designating health professions shortage areas and medically 
underserved populations. Recognizing the adverse impact of 
residential instability and poverty on access to health care, 
the Committee urges the department to consider designating 
homeless persons, migrant and seasonal farm workers, as 
medically underserved populations. The Committee further urges 
the Department to take steps to make health services provided 
by the department as fully accessible as possible to persons 
experiencing homelessness.

Public housing health service grants

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

Native Hawaiian health care

    The Committee again includes the legal citation in the bill 
for the Native Hawaiian Health Care Program. The Committee has 
included sufficient funding so that health care activities 
funded under the Native Hawaiian Health Care Program can be 
supported under the broader community health centers line. The 
Committee expects that not less than $7,000,000 be provided for 
these activities in fiscal year 2001.
    The purpose of this activity is to improve the health 
status of native Hawaiians by making primary care, health 
promotion, and disease prevention services available through 
the support of native Hawaiian health systems. Services 
provided include health screening, nutrition programs, and 
contracting for basic primary care services. This activity also 
supports a health professions scholarship program for native 
Hawaiians.
    The Committee continues to support the concept of malama. 
This innovative, culturally sensitive community partnership 
program addresses the prenatal needs of minorities in rural 
Hawaii. The Committee encourages the HRSA to support the 
replication of this project to include teen pregnancies. The 
ever increasing epidemic of teen pregnancy makes the maximum 
utilization of effective strategies a necessity.
    The Committee believes the agency could establish a 
demonstration project in Hawaii to develop an integrated health 
and social services model, to include traditional healing, 
prevention, and disease management, that addresses the 
disparities in health status and barriers to accessing health 
and social services among native Hawaiians and other minority 
populations at the Waimanalo Health Center.
    The Committee encourages the development of a Center of 
Excellence for Indigenous Health and Healing at the University 
of Hawaii School of Public Health and on other schools serving 
a large population of native peoples including American 
Indians, Alaska Natives, native Hawaiians and Pacific Islanders 
to incorporate traditional medicine and healing practices into 
their training for medical, nursing, social work, psychology, 
and public health students. The Committee encourages HRSA, CDC, 
and SAMSHA to support this effort in their grants by including 
traditional practitioners as providers of care where there are 
native and indigenous people residing in the service area of 
the grantee.

Native and rural Alaskan health care

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

National Health Service Corps: Field placements

    The Committee provides $38,116,000 for field placement 
activities, which is $66,000 below the 2000 level and the same 
as the administration request. The funds provided for this 
program are used to support the activities of National Health 
Service Corps obligors and volunteers in the field, including 
travel and transportation costs of assignees, training and 
education, recruitment of volunteers, and retention activities. 
Salary costs of most new assignees are paid by the employing 
entity.

National Health Service Corps: Recruitment

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

                           HEALTH PROFESSIONS

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

A. Workforce information and analysis

Health professions data and analysis

    This program supports the collection and analysis of data 
on the labor supply in various health professions and on future 
work force configurations.

Research on certain health professions issues

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

B. Training for diversity

Centers of excellence

    This program was established to fund institutions that 
train a significant portion of the Nation's minority health 
professionals. Funds are used for the recruitment and retention 
of students, faculty training, and the development of plans to 
achieve institutional improvements. The institutions that are 
designated as centers of excellence are private institutions 
whose mission is to train disadvantaged minority students for 
service in underserved areas. Located in poor communities and 
usually with little State funding, they serve the health care 
needs of their patients often without remuneration. The 
Committee is pleased that the agency has refocused the minority 
centers of excellence program on providing support to 
historically minority health professions institutions.
    The Committee believes HRSA should consider applications 
for the Centers of Excellence program that are responsive to 
allied health professions. These allied health professions are 
experiencing shortages and high vacancy rates, such as 
laboratory personnel.
    The Committee urges the agency to consider establishing at 
least one center for excellence focused on training Alaska 
Natives as community health aides to serve as sole community 
health providers in remote Alaska Native villages across 
Alaska.
    The Committee continues to be supportive of the work of the 
American Foundation for Negro Affairs in providing early 
intervention training.
    The Committee supports the existing INPSYCH programs at the 
University of North Dakota, the University of Montana and 
Oklahoma State University, which have established outreach and 
training programs to provide social, financial and academic 
support for American Indian high school students and mental 
health paraprofessionals who wish to continue their education 
at the bachelors or graduate degree level in psychology. 
Currently, Alaska and other states with large Native 
populations are experiencing a critical shortage of mental 
health and substance abuse providers with advanced training and 
degree credentials to serve Native populations in a culturally 
relevant way. The Committee urges the Department to consider 
establishing additional INPSYCH centers at the University of 
Alaska Anchorage, the University of Alaska Fairbanks, the 
University of South Dakota, and Utah State University.

Health careers opportunity program

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

Faculty loan repayment

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

Scholarships for disadvantaged students

    This program provides grants to health professions schools 
for student scholarships to individuals who are from 
disadvantaged backgrounds and are enrolled as full-time 
students in such schools. The Committee continues to intend 
that all health professions disciplines made eligible by 
statute be able to participate in the scholarships program.
    The Committee continues to recognize the importance of 
training greater numbers of psychologists and other health 
professionals from disadvantaged backgrounds to participate on 
interdisciplinary primary care teams addressing a range of 
behavioral and mental health needs.

C. Training in primary care medicine and dentistry

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

Family medicine training

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

General internal medicine and pediatrics training

    This program provides funds to public and private nonprofit 
hospitals and schools of medicine and osteopathic medicine to 
support residencies in internal medicine and pediatrics. Grants 
may also include support for faculty.

Physician assistants

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

General dentistry and pediatric dental residencies

    This program assists dental schools and postgraduate dental 
training institutions to meet the costs of planning, 
developing, and operating residency training and advanced 
education programs in general practice of dentistry and funds 
innovative models for postdoctoral general dentistry and 
pediatric dentistry.
    The Committee recognizes the need to increase the number of 
dentists in rural and underserved areas, and particularly 
increase the number of pediatric dentists in those areas. Rural 
States are disproportionately underserved by pediatric 
dentists.

D. Public health workforce development

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

Public health, preventive medicine and dental public health

    This program supports awards to schools of medicine, 
osteopathic medicine, public health, and dentistry for support 
of residency training programs in preventive medicine and 
dental public health; and for financial assistance to trainees 
enrolled in such programs.
    The Committee encourages the increase of residency training 
opportunities in dental public health so that Federal, State, 
and community-based programs have the leadership capabilities 
to prevent dental disease, promote oral health, and improve 
treatment outcomes.

Health administration traineeships and special projects

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

E. Interdisciplinary, community-based linkages

Area health education centers

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

Health education and training centers

    These centers provide training to improve the supply, 
distribution, and quality of personnel providing health 
services in the State of Florida or along the border between 
the United States and Mexico and in other urban and rural areas 
with populations with serious unmet health care needs.

Allied health and other disciplines

    The Committee expects this program to continue to support 
schools or programs with projects designed to plan, develop, or 
expand postbaccalaureate programs for the advanced training of 
allied health professions; and provide traineeships or 
fellowships to postbaccalaureate students who are participating 
in the program and who commit to teaching in the allied health 
profession involved. The administration requested termination 
of funding. This program also provides funds to expand existing 
training programs or develop new ones, recruit individuals into 
allied professions with the most severe shortages or whose 
services are most needed by the elderly, and increase faculty 
recruitment and education, and research.
    The Committee intends that the program receive funding from 
the consolidated appropriations allocated for fiscal year 2001 
in proportion to the amount provided in fiscal year 2000, 
relative to the other health professions accounts. It has been 
brought to the Committee's attention that shortages of allied 
health personnel exist in medically underserved and rural 
communities, especially those who assist the elderly. The 
Committee understands that a workforce database is being 
developed that could detail the extent of these shortages. The 
Committee continues to recommend that the agency continue to 
play a role in partnership with state governments and private 
institutions in raising the number of allied health 
professionals.
    The Committee continues to encourage HRSA to give priority 
consideration to those projects for schools training allied 
health professionals experiencing shortages, such as medical 
technologists and cytotechnologists.
    The Committee understands that the Northeastern 
University's Bouve College of Health Sciences plans to develop 
models for training physicians to serve low-income communities. 
Northeastern has been recognized as a leader in low-income 
health delivery models by providing services to communities 
with high rates of uninsured people.
    It has been brought to the Committee's attention that there 
is a lack of trained health professionals in Nevada. Given the 
large increase in Nevada's population, especially the elderly, 
the Committee encourages the agency to contribute technical 
assistance to the University of Nevada at Reno and Las Vegas 
toward the establishment of educational channels for a school 
of pharmacy.

Geriatric education centers and training

    The Committee expects this program to continue to support 
grants to health professions schools to establish geriatric 
education centers and to support geriatric training projects. 
The administration requested termination of funding. These 
centers and geriatric training programs play a vital role in 
enhancing the skill-base of health care professionals to care 
for our Nation's growing elderly population. The Committee is 
concerned about the shortage of trained geriatricians and urges 
the agency to give priority to building the work force 
necessary to care for the Nation's elderly.
    The Committee recognizes the Des Moines University 
Osteopathic Medical Center for its development of a model 
program for training and education in the field of geriatrics.

Quentin N. Burdick program for rural health interdisciplinary training

    This program addresses shortages of health professionals in 
rural areas through interdisciplinary training projects that 
prepare students from various disciplines to practice together, 
and offers clinical training experiences in rural health and 
mental health care settings to expose students to rural 
practice.
    The Committee notes its continuing support for the rural 
interdisciplinary training program designed to improve access 
to health care and health professionals in rural areas and has 
included sufficient funds to maintain this program at current 
levels. The Committee expects that this program will continue 
its current levels of support for addressing the issue of how 
the delivery of chiropractic health care can be enhanced in 
rural areas, and how more women and minorities can be recruited 
as chiropractic health care practitioners in rural areas.
    The Committee also urges the bureau to consider 
implementation of telecommunications and telehealth initiatives 
for providing distance education and training for nurses, 
community health aides, and other health professionals serving 
rural areas.
    The Committee is aware of the Global Health Corps at the 
University of Northern Iowa in training students in health 
promotion, health education, nursing, pre-medicine, and related 
areas to conduct culturally appropriate health programs with 
underserved populations.
    The Committee understands that Texas A&M/Texas Agricultural 
Extension Service is operating an innovative Health Education 
and Outreach (HERO) Program. The program is enabling health 
professionals to conduct public health research in areas 
traditionally under served and under represented in such 
studies.

Podiatric primary care training

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

Chiropractic demonstration grants

    The program provides grants to colleges and universities of 
chiropractic to carry out demonstration projects in which 
chiropractors and physicians collaborate to identify and 
provide effective treatment of spinal and lower back 
conditions. The Committee recommends that the program be 
continued and funded at current levels.

Children's hospital graduate medical education program

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

F. Nursing workforce development

Advanced education nursing

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

Nurse practitioner/nurse midwife education

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

Professional nurse traineeships

    Traineeships fund registered nurses in programs of advanced 
nursing education, including preparation for teaching, 
administration, supervision, clinical specialization, research, 
and nurse practitioner and nurse midwife training.

Nurse anesthetist traineeships

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

Basic nurse education and practice

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

Nursing workforce diversity

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

                          other hrsa programs


Hansen's disease services

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

Maternal and child health block grant

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

Healthy start initiative

    The Committee recommends $90,000,000 for the healthy start 
infant mortality initiative. This amount is the same as the 
fiscal year 2000 amount and the comparable administration 
request.
    The healthy start initiative was developed to respond to 
persistently high rates of infant mortality in this Nation. The 
initiative was expanded in fiscal year 1994 by a special 
projects program, which supported an additional seven urban and 
rural communities to implement infant mortality reduction 
strategies and interventions.
    The Committee is pleased with the achievements of the 
healthy schools, healthy communities initiative which has been 
particularly effective in providing comprehensive school-based, 
school-linked, family centered, community based primary care to 
approximately 24,000 children.
    Since 1990, the Maternal and Child Health Bureau has worked 
in collaboration with the American College of Obstetricians and 
Gynecologists (ACOG) to run the National Fetal and Infant 
Mortality Program. NFIMR is a national activity where 
professionals review community fetal and infant mortality rates 
and work to address identified problems leading to mortality 
and establish systems of support for women and children. The 
public-private initiative also works to address problems with 
health disparities in minority health, as related to fetal and 
infant mortality rates. The Committee believes NFIMR should 
continue to be supported through the MCHB and notes that 
additional funds would allow more communities to be served. 
Adequate funding has been provided for NFIMR through the 
Healthy Start initiative. The Committee is aware that in order 
to meet the demand of serving an expanded number of 
communities, NFIMR must be able to continue its activities at 
an adequate funding level.

Universal newborn hearing screening and early intervention

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

Organ procurement and transplantation

    The Committee provides $15,000,000 for organ transplant 
activities. This is the same as the administration request and 
$5,000,000 more than the fiscal year 2000 appropriation.
    The Committee considers increasing the supply of organs, 
particularly livers, available for voluntary donation to be a 
top public health priority. Last year the Committee doubled the 
administration request to catalyze an aggressive, nationwide 
effort to improve public awareness and educate health care 
providers.
    These funds support a scientific registry of organ 
transplant recipients and kidney dialysis patients, and the 
National Organ Procurement and Transplantation Network to match 
donors and potential recipients of organs. A portion of the 
appropriated funds may be used for education of the public and 
health professionals about organ donations and transplants, and 
to support agency staff providing clearinghouse and technical 
assistance functions. The Committee encourages the agency to 
establish linkages with state and federal transportation 
officials to improve coordination of donation following 
vehicular accidents.
    To increase the rate of organ donation, the Committee urges 
increased behavioral research to better target and increase the 
effectiveness of public awareness campaigns.
    The Committee is aware of the proposal by the University of 
Alabama at Birmingham to conduct research on measures that 
could increase the number and quality of organs obtained from 
donors.
    The Committee considers increasing the supply of organs, 
particularly livers, available from voluntary donations to be a 
top public health priority and expects that funds be committed 
to those activities having the greatest demonstrable impact on 
donation rates.

Health teaching facilities interest subsidies

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

National bone marrow donor program

    The Committee has included $17,959,000 for the national 
bone marrow donor program. This is the same as the 
administration request and $41,000 below the fiscal year 2000 
level. The National Bone Marrow Donor Registry is a network, 
operated under contract, that helps patients suffering from 
leukemia or other blood diseases find matching volunteer 
unrelated bone marrow donors for transplants. The program also 
conducts research on the effectiveness of unrelated marrow 
transplants and related treatments.

Rural health outreach grants

    The Committee recommends $38,892,000 for health outreach 
grants. This amount is $3,012,000 higher than the fiscal year 
2000 level and the same as the administration request. This 
program supports projects that demonstrate new and innovative 
models of outreach in rural areas such as integration and 
coordination of health services. The Health Care Consolidation 
Act of 1996 authorized a new rural network development program 
intended to develop integrated organizational capabilities 
among three or more rural health provider entities.
    The Committee understands that the University of Colorado 
School of Dentistry plans to conduct an oral health prevention 
and treatment program in several counties in South Dakota that 
would test innovative ways to provide services to low-income 
children.
    The Committee continues to be supportive of the diabetes 
lower extremity amputation prevention program run by the 
University of South Alabama, the Louisiana State University 
medical school, the Roosevelt Institute for Rehabilitation and 
Jackson Medical Mall.
    The Committee is supportive of the La Crosse Health Science 
Consortium proposal to address severe shortages in dental 
access. The Committee is aware that only 30 percent of 
Medicaid-eligible persons in La Crosse County received dental 
services in 1997. The project will utilize the La Crosse Allied 
Health Sciences facility, the services of the Western Wisconsin 
Technical College Dental Hygiene and Dental Assistant Program 
and volunteer dentists, to increase access to dental care for 
individuals living in La Crosse County.

Telehealth

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

Critical care programs

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

Black lung clinics

    The Committee includes $6,000,000 for black lung clinics. 
This is $57,000 above both the fiscal year 2000 amount and the 
administration request. This program funds clinics which treat 
respiratory and pulmonary diseases of active and retired coal 
miners. These clinics reduce the incidence of high-cost 
inpatient treatment for these conditions.

Nurse loan repayment for shortage area service

    The Committee includes $2,279,000 for nurse loan payment 
for shortage area services. This is the same level as last year 
and the administration request.
    This program offers student loan repayment to nurses in 
exchange for an agreement to serve not less than 2 years in an 
Indian health service health center, native Hawaiian health 
center, public hospital, community or migrant health center, or 
rural health clinic.

Payment to Hawaii, Hansen's disease treatment

    Within the amount provided for Hansen's disease services, 
the Committee has provided $2,045,000 for the fiscal year 2001 
payment to the State of Hawaii for the medical care and 
treatment in its hospital and clinic facilities of persons with 
Hansen's disease at a per diem rate not greater than the 
comparable per diem operating cost per patient at the Gillis W. 
Long National Hansen's Disease Center in Carville, LA. This 
amount is the same as the administration request and the 2000 
level.
    The Committee appreciates the Institute of Medicine study 
of the Pacific Basin health care delivery system, conducted in 
1998. It is the Committee's understanding that the IOM cited 
findings for all health indicators for the people residing in 
the freely associated states, as being significantly worse than 
those for mainland Americans. The Committee, therefore, expects 
the Department to review the IOM findings and initiate 
implementation of its recommendations which include: 
jurisdictional coordination by the Pacific Islanders Health 
Officers Association; use of Tripler Army Medical Center and 
Guam Naval Hospital for care coordination, with emphasis on 
telehealth assessment and management; development of and 
participation in a regional health information system for 
information tracking and storage; continuing education for all 
health providers; and increased involvement in health care, 
particularly womens' health issues.

                  acquired immune deficiency syndrome


                        Ryan White AIDS programs

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

Emergency assistance--title I

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

Comprehensive care programs--title II

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

Early intervention program--title III-B

    The Committee recommends $166,400,000 for early 
intervention grants. This is $28,000,000 above the 2000 level 
and $5,000,000 below the administration request. These funds 
are awarded competitively to primary health care providers to 
enhance health care services available to people at risk of HIV 
and AIDS. Funds are used for comprehensive primary care, 
including counseling, testing, diagnostic, and therapeutic 
services.
    To the extent practicable, the Committee encourages HRSA to 
fairly allocate the increase for title III-B between existing 
grantees and new providers. The Committee understands that 
existing grantees have been level-funded throughout the history 
of the CARE Act. By providing additional funds to current 
grantees, the Committee intends to strengthen the HIV care 
infrastructure already established in title III-B clinics. The 
Committee also supports expansion of the number of communities 
receiving assistance from this title.
    Priority should be placed on funding new projects in rural, 
medically underserved areas, and secondary cities outside of 
major metropolitan areas in order to build clinical capacity 
for the delivery of HIV care among clinicians serving high-risk 
populations, minorities, and those who are unable to access 
clinical HIV care for economic reasons. In building capacity, 
the goal is to develop regional centers of knowledgeable 
clinicians to improve access to quality HIV treatment based 
upon the evolving HIV treatment guidelines of DHHS.
    As noted for the last 2 years, the Committee is aware that 
the FDA has approved at-home telemedicine diagnostic testing 
methods which seem to offer important fiscal, privacy and 
public health advantages. A study published by CDC indicates 
that a significant percentage of individuals using public 
clinics for on-site HIV testing do not return for their 
results. HRSA data indicates that the average cost for on-site 
testing, counseling and referral services is about $160 per 
person, compared with the $40 cost for at-home telemedicine 
testing. The Committee is concerned by the lack of an adequate 
effort in this area and again asks HRSA to evaluate and report 
on the benefits and costs of varying testing methods, including 
at-home telemedicine and to make program changes that are 
warranted. The Committee would like to be briefed by HRSA on 
their progress by November 1, 2000.

Pediatric AIDS demonstrations--title IV

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

AIDS dental services

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

AIDS education and training centers

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

Family planning

    The Committee recommends $253,932,000 for the title X 
family planning program. This is $20,000,000 below the 
administration request and $15,000,000 above the 2000 level. 
Title X grants support primary health care services at more 
than 4,000 clinics nationwide. About 85 percent of family 
planning clients are women at or below 150 percent of poverty 
level.
    Title X of the Public Health Service Act, which established 
the family planning program, authorizes the use of a broad 
range of acceptable and effective family planning methods and 
services. The Committee believes this includes oral, 
injectable, and other preventive modalities.
    The Committee remains concerned that programs receiving 
title X funds ought to have access to these resources as 
quickly as possible. The Committee, therefore, again instructs 
the Department to distribute to the regional offices all of the 
funds available for family planning services no later than 60 
days following enactment of this bill.
    The Committee intends that at least 90 percent of funds 
appropriated for Title X activities be for clinical services 
authorized under section 1001 of the Act. All such funds for 
section 1001 activities are to be provided to the regional 
offices to be awarded to grantees to provide family planning 
methods and services as specified by the Title X statute. The 
Committee further expects the Office of Family Planning to 
spend all available year-end funds in section 1001 activities.
    Over the past 2 years, the Committee has provided 
significant funding increases for Title X. The Committee has 
also provided instruction for the distribution of these funds. 
Therefore, the Committee requests the Secretary to submit a 
report detailing how the funds were allocated for section 1001 
(by Federal region), 1003, and 1004 for fiscal years 1999 and 
2000. The report should also contain the total Federal expenses 
for program administration, including the number of FTEs being 
supported by Title X. This report shall also include a list of 
all grantees, their funding, and the main activities to be 
undertaken with Title X funds.

Rural health research

    The Committee recommends $5,000,000 for the Office of Rural 
Health Policy. This is $28,201,000 below the fiscal year 2000 
level and $6,713,000 less than the comparable administration 
request. The funds provide support for the Office as the focal 
point for the Department's efforts to improve the delivery of 
health services to rural communities and populations. Funds are 
used for rural health research centers, grants to telemedicine 
projects, the National Advisory Committee on Rural Health, and 
a reference and information service.
    The Committee is supportive of efforts to expand and 
integrate the services of behavioral and mental health 
professionals, including psychologists, in underserved rural 
areas, particularly in areas affected by the current farm 
crisis.
    The Committee is supportive of continuing funds to the 
Children's Health Fund to implement a rural health initiative 
that would expand availability and accessibility of pediatric 
care to underserved rural communities.
    The Committee is supportive of efforts by the Iowa 
Department of Public Health to demonstrate the use of portable 
technology to improve the delivery of health care in rural 
areas by public health nurses.

Health care facilities

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

National Hansen's Disease Program buildings and facilities

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

Rural hospital flexibility grants

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

National practitioner data bank

    The Committee has not provided Federal funding for the 
national practitioner data bank, which is the same as the 
administration request. The Committee and the administration 
assume that $17,200,000 will be provided entirely through the 
collection of user fees and will cover the full cost of 
operating the data bank, an amount that is $1,200,000 higher 
than what was authorized to be collected in fiscal year 2000. 
Traditional bill language is included to ensure that user fees 
are collected to cover all costs of processing requests and 
providing such information to data bank users.

Health care integrity and protection data bank

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

Healthcare access for the uninsured

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

Program management

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

               medical facilities guarantee and loan fund

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

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

                   health education assistance loans

    The Committee recommends no additional guarantee authority 
for new HEAL loans in fiscal year 2001, which is the same as 
the President's request.
    The Committee recommends $10,000,000 to liquidate 1999 
obligations from loans guaranteed before 1992, which is the 
same as the administration request and $5,000,000 below the 
2000 appropriation.
    For administration of the HEAL Program including the Office 
of Default Reduction, the Committee recommends $3,679,000, 
which is $8,000 below the 2000 appropriation and the same as 
the administration request.
    The HEAL Program insures loans to students in the health 
professions and helps to ensure graduate student access to 
health professions education, especially among minority, 
disadvantaged students, and those from behavioral and mental 
health fields. The Budget Enforcement Act of 1990, changed the 
accounting of the HEAL Program. One account is used to pay 
obligations arising from loans guaranteed prior to 1992. A 
second account was created to pay obligations and collect 
premiums on loans guaranteed in 1992 and after. Administration 
of the HEAL Program is separate from administration of other 
HRSA programs.

                 vaccine injury compensation trust fund

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

    The Committee recommends that $117,347,000 be released from 
the vaccine injury compensation trust fund in fiscal year 2001, 
of which $2,992,000 is for administrative costs. This amount is 
the same as the budget request and $7,000 less than the fiscal 
year 2000 amount.
    The National Vaccine Injury Compensation Program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and a death 
benefit. The vaccine injury compensation trust fund is funded 
by excise taxes on certain childhood vaccines.

              RICKY RAY HEMOPHILIA RELIEF ACT FUND PROGRAM

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

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

               Centers for Disease Control and Prevention


                disease control, research, and training

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

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

Preventive health and health services block grant

    The Committee recommends $134,279,000 for the preventive 
health and health services block grant. Of the amount provided, 
$130,899,000 is for program activities, which is $925,000 below 
the 2000 level and the same as the administration request. For 
salaries and expenses within this category of activities, 
$3,380,000 has been provided, which is the same as the 2000 
level and $866,000 below the request. The Committee 
recommendation includes an additional $7,000,000 for rape 
prevention activities to be carried out through the preventive 
health and health services block grant. This amount is the same 
as the 2000 appropriation.
    The preventive health and health services block grant 
provides States with funds for services to reduce preventable 
morbidity and mortality and improve the quality of life. The 
grants give States flexibility in deciding how available 
funding can be used to meet State preventive health priorities. 
Programs eligible for funding include screening, laboratory 
services, health education, and outreach programs for such 
conditions as high blood pressure and cholesterol, and breast 
and uterine cancer.

Prevention centers

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

Sexually transmitted diseases

    The Committee recommends $149,903,000 for sexually 
transmitted disease prevention and control. Of the amount 
provided, $135,978,000 is for program activities, which is 
$14,169,000 above the 2000 level and is $4,000,000 above the 
administration request. For salaries and expenses within this 
category of activities, $13,925,000 has been provided, which is 
the same as the 2000 level and $4,765,000 below the 
administration request.
    The mission of the STD program is to survey, prevent, and 
control the transmission of STD's by providing national 
leadership for: prevention and control programs; monitoring 
disease trends; behavioral and clinical research; education and 
training; building partnerships for STD prevention; the STD 
accelerated prevention campaign; and infertility. Grants are 
awarded to State and local health departments and other 
nonprofit entities to support primary prevention activities, 
surveillance systems, screening programs, partner notification 
and counseling, outbreak control, and clinical skills training.
    Syphilis and chlamydia elimination.--The agency has 
requested $33,750,168 to fully implement a comprehensive 
strategy to eliminate the prevalence of the disease. The 
Committee recognizes the opportunity to eliminate syphilis but 
also directs the agency to also address chlamydia as a disease 
with widespread prevalence among teens and young adults.
    Both of these activities require additional resources to be 
successful. Therefore, the Committee directs that 50 percent of 
the fiscal year 2001 increase requested be used to implement 
the National Plan to Eliminate Syphilis. The Committee further 
directs that the chlamydia funds be distributed to expand 
services to women and support pilot programs to initiate 
screening and treatment services for men. The Committee urges 
that the remainder of the increased provided in this account be 
directed for infertility prevention programs.
    Tuskegee activities.--The administration proposes 
$2,000,000 in support of bioethics activities at Tuskegee 
University.

Immunization

    The Committee recommends $993,468,000 for immunization 
activities in fiscal year 2001 authorized under section 317 of 
the Public Health Service Act. Of the amount provided, 
$467,505,000 is for program activities, which is $34,539,000 
above the 2000 level and is the same as the administration 
request. For salaries and expenses within this category of 
activities, $56,909,000 has been provided, which is the same as 
the 2000 level and $5,229,000 below the administration request.
    The Omnibus Reconciliation Act [OBRA] of 1993 established a 
new vaccine purchase and distribution system that provides, 
free of charge, all pediatric vaccines recommended for routine 
use by the Advisory Committee on Immunization Practices to all 
Medicaid-eligible children, uninsured children, underinsured, 
and native Americans through program-registered providers. 
Included in the Medicaid estimate for fiscal year 2001 is 
$469,054,000 for the purchase and distribution of vaccines for 
a total immunization program level of $993,468,000 in the bill.
    The administration of safe and effective vaccines remains 
the most cost-effective method of preventing human suffering 
and reducing economic costs associated with vaccine-preventable 
diseases. Through the immunization program, the CDC provides 
leadership and support for national and international efforts 
to prevent and/or control vaccine-preventable diseases.
    Many States are experiencing significant instability in 
immunization efforts and had have to cutback on vaccine 
delivery activities as a result of budgetary constraints. 
States continue to struggle to maintain immunization rates and 
in some areas of the country immunization rates of declined. 
These pockets of need create pools of susceptible children and 
increase the risk of dangerous disease outbreaks.
    Alaska's statewide immunization program.--The Committee 
urges CDC to increase section 317 grant support for 
infrastructure development and purchase of vaccines for the 
State of Alaska's universal immunization program. It has been 
brought to the Committee's attention that infrastructure costs 
of delivering vaccines to children in Alaska are substantially 
higher than in other areas of the country because of the many 
small, remote communities which must be served. The Committee 
encourages CDC to support Alaska's request for sufficient 
funding for the purchase of vaccines needed for 90 percent of 
Alaskan children and to provide infrastructure support needed 
to support delivery of these vaccines at the community level.
    Within the amounts appropriated, sufficient funds are 
provided for the purchase of vaccine under the 317 program. As 
in previous years, the Director has discretion to make 
transfers from among funds provided for 317 vaccine purchase 
and infrastructure grants based upon the program requirements. 
This will ensure that States receive up to their maximum 
estimates for vaccine purchases and provide CDC with sufficient 
flexibility to reallocate vaccine purchase dollars if States' 
needs prove lower than the amount provided. The Committee 
continues to expect that the CDC provide notification of the 
amount of any transfer, the latest State carryover balance 
estimates, and the justification for the transfer.
    The Committee recommendation assumes the continuation of 
the bonus program to improve immunization rates. Using State-
specific immunization coverage data, CDC provides payments to 
States for 2-year-olds who have been fully immunized.
    Measles.--The recommendation includes sufficient funds for 
the CDC, as part of their global polio eradication efforts, to 
provide measles vaccine for supplemental measles immunization 
campaigns and to expand epidemiologic, laboratory, and 
programmatic/operational support to the WHO and its member 
countries. Such support should build on the global disease 
control and surveillance infrastructure developed for polio 
eradication in a manner that does not compromise ongoing global 
polio eradication activities. The Committee also encourages the 
Director to provide sufficient staff support for this 
accelerated international measles control effort.
    Polio.--The Committee recommendation includes the 
President's budget request for polio eradication to assist with 
the accelerated effort and continued need for National 
Immunization Days. The Committee is encouraged by the progress 
which has made the Americas, the Western Pacific including 
China, and virtually all of Europe polio-free, but recognizes 
that South Asia and Sub-Saharan Africa remain major reservoirs 
for the polio virus. The Committee believes the recommended 
increase is needed to ensure that African countries meet the 
goal of polio eradication as soon as possible.

Infectious diseases

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

Tuberculosis elimination

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

Chronic and environmental disease prevention

    The Committee's recommendation includes $382,733,000 for 
chronic disease prevention activities. Of the amount provided, 
$304,553,000 is for program activities, which is $18,008,000 
above the 2000 level and $11,439,000 above the administration 
request. For salaries and expenses within this category of 
activities, $78,180,000 has been provided, which is the same as 
the 1999 level and $13,260,000 below the administration 
request.
    In many instances, premature death, avoidable illness, and 
disability are caused by personal behavior, exposure to toxic 
substances, and/or natural disasters. Prevention of the 
occurrence and progression of chronic diseases, therefore, is 
based on reducing or eliminating behavioral risk factors, 
increasing the prevalence of health promoting practices, 
detecting disease early to avoid complications, assessing human 
risks from environmental exposures, and reducing or eliminating 
exposures to environmental hazards. The focus of the programs 
in this activity includes diabetes, cardiovascular diseases, 
developmental disabilities, tobacco use, comprehensive school 
health, teen pregnancy, birth defects, fetal alcohol syndrome, 
spina bifida, chronic fatigue syndrome, prostate cancer, 
women's health, cancer registries, oral health, skin cancer, 
arthritis, and epilepsy.
    Alaska's study of environmental health contaminants.--The 
Committee encourages CDC-supported evaluations and 
interventions regarding the health effects from inadequate 
provision of safe drinking water in remote arctic communities. 
The Committee recommends the CDC consider building upon and 
expanding existing cooperative agreements with State 
departments of health in the region when undertaking this 
initiative to expand it to include field studies of the effects 
of environmental chemical contaminants and naturally occurring 
metals in subsistence foods in remote arctic communities, 
measurement of PCB levels in such communities, document mercury 
levels in ancient humans, documentation of incidence of 
childhood asthma and development of public health 
recommendations on food consumption in arctic subsistence 
users.
    Animal modeling.--The Committee encourages the CDC to 
provide increased dollars for research on animal modeling of 
chronic human diseases such as cancer, cystic fibrosis, 
hypertension and other diseases. The University of North 
Carolina at Chapel Hill has been operating animal modeling 
programs and the Committee urges that the CDC give this project 
full and fair consideration.
    Arthritis Action Plan.--This National Arthritis Action 
Plan, developed jointly between the Arthritis Foundation and 
the CDC, is just beginning to translate the recently gained 
knowledge about early diagnosis and treatment of arthritis into 
tangible clinical results in the treatment of the 43 million 
Americans with arthritis. The Committee supports these efforts 
and encourages the CDC to increase funds for States to expand 
their Arthritis Action Plan activities and help educate more 
Americans about the options in treating arthritis.
    Asthma.--The Committee is pleased with the work that the 
CDC has done to address the increasing prevalence of asthma. 
However, the increase in asthma among children, particularly 
among inner-city minorities, remains alarming. The Committee 
urges CDC to expand its outreach aimed at increasing public 
awareness of asthma control and prevention strategies, 
particularly among at risk minorities populations in undeserved 
communities. The Committee also encourages CDC to work with 
other Public Health Service (PHS) agencies at NIH, HRSA, and 
the Office of the Surgeon General to develop a PHS-wide plan to 
control asthma. The Committee urges the CDC to provide 
additional monies for asthma activities.
    The Committee is aware of an effort by the Cook County 
Bureau of Health Services, the Asthma Champion Initiative, to 
reduce morbidity and morality from asthma in the community 
areas in Cook County, Illinois with the highest prevalence and 
inadequate service.
    Asthma research centers.--It has been brought to the 
Committee's attention that the Meridian Health System's 
Pediatric Asthma Research Center (PARC) was developed to 
provide family community outreach and education via a mobile 
asthma learning center, as well as providing on-site education 
at all system hospitals and health centers. The Committee also 
notes that Forum Health is currently operating a pediatric 
asthma disease management program to better diagnose children. 
The Committee encourages CDC to give both of these projects 
full and fair consideration.
    Autism.--The Committee is pleased with the work being done 
by Marshall University's Autism Training Center. The Committee 
encourages the CDC to give full and fair consideration to the 
Center to expand and implement similar programs focused on 
infants, toddlers, and preschoolers.
    Biomonitoring program.--The Committee supports the CDC 
Biomonitoring Program and the study of environmental toxins and 
their relationship to chronic diseases, such as asthma, many 
birth defects, and cancer to increase our understanding of the 
cause of many chronic diseases and conditions and to facilitate 
the development of effective prevention strategies. The 
Committee is interested in pursuing the development of a 
coordinated system among all of the States to identify and 
track disease and conditions caused by exposure to 
environmental toxins and asks that the Director prepare a plan 
to implement such a system, coordinated with existing efforts, 
for presentation at the fiscal year 2002 appropriations 
hearings.
    Birth defects.--The Committee recognizes that human and 
economic toll of birth defects is significant and tragic. Birth 
defects are the leading cause of infant mortality and also a 
leading cause of childhood disability. The Committee encourages 
the agency to increase funding to continue its current programs 
and to expand its efforts in birth defects surveillance, 
research and prevention. The Committee is especially interested 
in efforts to prevent neural tube defects (NTDs). These birth 
defects, such as spina bifida, are among the most serious, 
costly and preventable birth defects. The Committee commends 
the CDC for initiating a folic acid education campaign and 
encourages CDC to expand its efforts to enhance State and local 
activities to educate women about this effective prevention 
strategy.
    Cancer.--Many of the cancer trials conducted to date are 
skewed toward younger persons even though older persons 
comprise the majority of cancer patients. Recent studies have 
shown that older persons could benefit and should be included 
in more aggressive cancer treatment research and prevention, so 
the number and range of eligible older persons is expected to 
dramatically increase over the next few years. Research is also 
needed to assess changes in patient quality of life as a result 
of nutrition intervention. More prospective, randomized 
clinical trials of older cancer patients are necessary to 
determine whether a relationship exists between nutrition 
support and clinical outcomes for cancer patients.
    The Committee is encouraged by the progress made by the 
Medical University of South Carolina toward establishing a 
cancer prevention and control program to develop various high-
risk registries for patients with family histories of cervical, 
oral, esophageal, pancreatic, or lung cancer, and screen for 
genes that may be conveying this increased risk.
    Cancer epidemiology research.--The Committee encourages the 
CDC to establish a cancer epidemiology research training 
program. Funds could be used to provide training in designing 
and conducting multidisciplinary population-based basic and 
applied cancer epidemiology research for graduate and 
undergraduate students.
    Cancer in ethnic minorities and the medically 
underserved.--The Committee encourages the CDC to increase the 
funding for cancer control programs, including increases for 
the prostate, colorectal, and other cancer screening programs. 
The Committee also directs CDC to evaluate and document: (1) 
the barriers to access and implementation of effective 
screening and prevention programs it coordinates with the 
programs of States, tribes, and community health organizations; 
and (2) the subsequent linkages between detection, treatment 
and follow up to screening. The Committee also urges 
improvements in cancer surveillance efforts and directs 
substantial increases for the National Program of Cancer 
Registries, the Behavioral Risk Factors Surveillance Survey, 
and expansion of the National Health Nutritional and 
Examination Survey (HANES) to all ethnic minority and medically 
underserved populations.
    Cardiovascular disease.--The Committee is aware that 
despite improved detection and treatment of cardiovascular 
disease over the past two decades, severe hypertension is 
prevalent throughout the Southeastern United States, with 
recent data showing that the death rates from cardiovascular 
disease in this region remain significantly above the national 
average. The disparity in treatment control rates in the South 
as compared to the nation indicates a compelling need for an 
aggressive approach to reduce the excess risk of cardiovascular 
death. The Committee is aware of the work of the Southeastern 
Centers of Cardiovascular Excellence Program headquartered at 
the Wake Forest University School of Medicine and encourages 
CDC to provide funding to expand this program.
    Cardiovascular and other chronic diseases in African-
American populations.--The Committee recognizes the high 
prevalence of cardiovascular and other chronic diseases in the 
Mississippi Delta's minority populations. The Committee also 
recognizes the work of the Jackson Heart Study in allowing the 
examination of cardiovascular disease in the African-American 
population. A needed component of this research is the 
examination of epidemiological risk factors contributing to the 
extremely high prevalence and incidence of cardiovascular and 
other chronic diseases in these minority populations. The 
prevention center would allow collaboration with the Jackson 
Heart Study as well as independent research activities to 
combat these chronic diseases through the epidemiological 
identification of risk factors and disease predictors. The 
Committee encourages the CDC to establish a cardiovascular and 
chronic disease research prevention center for the purpose of 
fostering epidemiological research among minorities with 
chronic diseases.
    Chronic fatigue syndrome.--The Committee is pleased that 
CDC intends to restore $12,900,000 to the CFS research program, 
in addition to CDC's base CFS funding in fiscal years 2000, 
2001, 2002, and 2003. The Committee will continue to monitor 
CDC's CFS research program to ensure that the funds are used in 
priority areas in CFS research and education.
    The Committee strongly encourages CDC to provide the funds 
and the infrastructure to support its ``reinvigorated'' CFS 
research plan, which includes the estimation of sex-, age-, 
race/ethnic-, and socioeconomic-specific prevalence of CFS 
through a national CFS survey; surveillance projects on 
children and adolescents and minorities with CFS; a national 
CFS patient registry; development and testing of an empirically 
derived case definition; studies of etiologic agents, 
diagnostic markers, natural history, and risk factors using 
specialized molecular epidemiology techniques and advanced 
surveillance methodologies; and CFS public education programs 
with special emphasis on general public service announcements 
and specialized efforts to educate primary care providers about 
the detection, diagnosis and treatment of CFS.
    Cardiovascular physical activity promotion program.--The 
Committee is aware that current funding and regulatory 
restrictions have prevented the State of Alaska from applying 
for a statewide cardiovascular disease prevention program, but 
notes that mortality is only one means of assessing the public 
health burden of diseases, and other factors, such as 
prevalence of risk factors for CVD should be considered in 
making State grants. The Committee encourages the agency to 
work with the State of Alaska to implement the Take Heart 
Alaska Cardiovascular Disease Prevention Plan to address 
critical risk factors in Alaska including teen smoking, obesity 
and lack of physical activity.
    Comprehensive health promotion.--The Committee is aware of 
the ``Healthlink'', a program that works to develop and 
implement a comprehensive health promotion initiative for 
senior retirees in Rhode Island. The Committee encourages the 
CDC to give full and fair consideration to this program.
    Craniofacial birth defects research center.--The Committee 
is aware of the University of Louisville Health Sciences 
Center's work to improve the diagnosis, treatment, and 
prevention of congenital craniofacial birth defects. The 
Committee encourages the CDC to give full and fair 
consideration to designating the Craniofacial Birth Defects 
Research Center as one of its National Centers on Birth Defects 
Research.
    Colorectal cancer.--Colorectal cancer is the third most 
commonly diagnosed cancer for both men and women in the United 
States, and the second leading cause of cancer related deaths. 
In 2000, 133,600 new cases will be diagnosed and 56,800 people 
will die from the disease. When colorectal cancer is detected 
and treated early, survival is greatly enhanced. However, 
despite the availability of proven screening tests, only 37 
percent of colorectal cancers are diagnosed while the disease 
is still in a localized stage. The Committee is very pleased 
with the leadership of CDC's National Colorectal Cancer 
Roundtable in promoting the availability and advisability of 
screening to both health care providers and the general public. 
The Committee encourages CDC to expand its partnerships with 
State health departments, professional and patient 
organizations, and private industry to combat this devastating 
disease.
    Complementary and alternative medicine.--As more and more 
Americans use alternative and complementary therapies to 
maintain and improve their health, there is a growing need for 
better consumer information about these therapies. The 
Committee is encouraged by CDC's plans to initiate an expansion 
of their effort in this area. Practice-based assessments and 
the identification and study of promising and heavily used 
complementary and alternative therapies and practices should be 
undertaken and results published. The Committee expects CDC to 
collaborate with the National Center for Complementary and 
Alternative Medicine to assure that its efforts complements 
efforts by this Center. The Committee is also pleased with the 
CDC's efforts to use quantitative policy methods to improve 
public health decision-making to ensure that public health and 
health care programs and policies deliver the greatest possible 
improvement in human health and quality of life and encourages 
CDC to expand these efforts. The Committee further encourages 
the CDC to include national surveillance of CAM utilization and 
health outcomes, mind body medicine, support for academic 
research centers, such as the prevention research centers, 
assess the determinants and outcomes of CAM prevention 
practices.
    Diabetes.--The incidence of diabetes affects more than 16 
million persons in America. Research has demonstrated that 
controlling blood sugar levels prevents diabetes-related 
complications. While the CDC supports local diabetes prevention 
and control programs in all States, additional support could 
further reduce the number of diabetes complications. The 
Committee supports this work and has included sufficient funds 
to enable the CDC to expand its diabetes prevention effort. 
Funds are provided as proposed in the request to: establish 
comprehensive State diabetes prevention programs; implement the 
public health components of the National Diabetes Education 
Prevention Program; develop and implement public health 
surveillance systems; and conduct applied prevention research.
    The Committee remains acutely concerned over the high 
incidence of diabetes within the native American, Native 
Alaskan and native Hawaiian populations. The Committee urges 
the CDC to continue to develop a targeted prevention and 
treatment program for these culturally unique yet similar 
groups. The Committee encourages the CDC to continue to work 
with native Americans and native Hawaiians to incorporate 
traditional healing and develop partnerships with community 
centers as a safety net during program development. The 
Committee is pleased with CDC's efforts to work with the 
leadership of native Hawaiian and Pacific Basin Islander 
communities in these efforts.
    Diabetes and weight management.--The Committee is aware of 
efforts at the University of South Carolina School of Public 
Health to develop strategies for weight management in Type II 
diabetes.
    Diabetes Prevention Center.--The Committee urges the CDC to 
provide additional funds for the National Diabetes Prevention 
Center in Gallup, New Mexico, for implementation, design and 
dissemination of successful diabetes prevention models to 
Native American tribes and pueblos.
    The Committee is aware of the efforts of the Texas Tech 
University Health Sciences Center to establish its Center for 
Diabetes Prevention and Control--a national model for the 
prevention and control of diabetes in Hispanic and elderly 
populations. The model Center will use the Health Sciences 
Center's expertise and resources to: create access to 
comprehensive diabetes care; conduct in-depth surveys of the 
incidence, prevalence, and treatment of diabetes in the 
Hispanic population; clinical investigations; and the use of 
telemedicine as a means of delivering diabetes education to 
patients in remote communities and rural areas.
    Disabilities prevention.--The Committee continues to 
strongly support the CDC disabilities prevention program which 
provides support to States and academic centers to reduce the 
incidence and severity of disabilities, especially 
developmental and secondary disabilities.
    Epilepsy.--Although the CDC has developed public health 
strategies to address epilepsy, additional investment is 
required to effectively implement these initiatives. The 
Committee calls on CDC to enhance its epilepsy efforts, with a 
focus on expanding disease surveillance; increasing public 
awareness activities; public and provider education; prevention 
research; and, importantly, to more aggressively address the 
stigma often associated with the disorder. Further, the 
Committee recognizes the recent commitment by CDC to partner 
with a national voluntary health organization dedicated to 
improving the lives of persons with epilepsy and expects CDC to 
work with this.
    Fetal alcohol.--The Committee commends CDC for its efforts 
to research fetal alcohol syndrome prevention and for its 
overall commitment to studying and addressing FAS and the range 
of alcohol-related birth defects. The Committee is pleased that 
CDC is convening a National FAS Task Force and urges them to 
allocate sufficient funds for the project.
    Fetal alcohol syndrome.--The Committee continues to 
encourage the agency to work with the State of Alaska to 
develop a comprehensive statewide strategy to prevent, detect 
and treat fetal alcohol syndrome and notes that Alaska has the 
highest rate of fetal alcohol syndrome in the nation.
    Folic acid education campaign.--The Committee is especially 
interested in efforts to prevent birth defects. Neural tube 
defects (NTD), such as spina bifida, are among the most 
serious, costly and preventable birth defects. Up to 70 percent 
of NTDs could be prevented if all women of childbearing age 
consumed 400 micrograms of folic acid daily before pregnancy. 
The Committee commends the CDC for initiating a folic acid 
education campaign and encourages CDC to expand its efforts to 
enhance State and local activities to educate women and health 
professionals about this effective prevention strategy.
    Glaucoma.--It has come to the Committee's that glaucoma 
testing by the Congressional Glaucoma Caucus has shown that 
high-risk populations, particularly African-Americans, have a 
higher number of individuals affected by glaucoma. Many of 
these individuals are going untested and untreated. The 
Committee urges the agency to provide resources for education, 
prevention and research for these high-risk populations.
    Global micronutrient malnutrition initiative.--The 
Committee is concerned that an international public health 
emergency exists in many regions of the world because of acute 
and chronic illnesses arising from preventable causes such as 
malnutrition. In particular, there are certain crucial 
micronutrients with high impact on a developing child or a 
pregnant women. Micronutrient malnutrition resulting from war 
or poverty, for example, can permanently damage a population's 
physical and mental development. Small amounts of essential 
vitamins and minerals, when delivered through dietary 
diversification, food fortification, and supplementation can 
prevent or reverse many illnesses. The Committee understand 
that no other technology offers as large an opportunity to 
improve lives at such low per-person cost and in such a short a 
period of time. The committee has encouraged NIH and CDC to use 
additional funds to establish international research, 
prevention and intervention strategies for micronutrient 
malnutrition. The Committee encourages the CDC to work with NIH 
and AID to work toward elimination of nutrition-dependent 
diseases such as goiter, cretinism, iron and vitamin A 
deficiencies. The Committee further encourages these agencies 
to coordinate efforts in innercity areas of the United States 
and certain minority populations.
    Health promotion partnerships.--The Committee recognizes 
the successful efforts of the University of Rhode Island's 
Health Promotion Partnership to encourage and promote positive 
behavioral change in college age students as well as in other 
populations. The Committee notes that in 1997 the University 
was one of only 9 colleges out of 116 nationally that showed a 
statistically significant decline in binge drinking. The 
Committee therefore urges the CDC in consultation with the 
National Institute for Alcoholism and Alcohol Abuse at the 
National Institutes of Health to favorably consider proposals 
by the Health Promotion Partnership to build upon these 
successful efforts to develop models that promote positive 
behavior change that can be applied at other institutions.
    Hemophilia.--The Committee urges the CDC to work with the 
National Hemophilia Foundation, to provide additional support 
to meet the disease management, prevention, and outreach needs 
of persons with hemophilia and other bleeding and clotting 
disorders, and in particular, to enhance efforts to address the 
needs of women with bleeding disorders. The Committee requests 
a progress report from CDC on the expanded activities to be 
implemented in fiscal year 2001 to reduce the complications of 
hemophilia.
    Hereditary hemochromatosis.--The Committee recognizes 
hereditary hemochromatosis is one of the most common genetic 
disorders. We appreciate CDC's effort and encourage their 
continued efforts to address hemochromatosis and other iron 
related disorders.
    Heart attack, stroke and other cardiovascular diseases.--
Cardiovascular diseases remain the leading cause of death of 
men and women and across all racial and ethnic groups in the 
United States, killing more than 950,000 Americans each year. 
Heart disease, alone, is America's No.1 killer and stroke is 
the No. 3 killer. In fiscal year 2000, 18 States will have 
received Federal funding to design and/or deliver 
cardiovascular disease prevention and control programs to meet 
local needs. The Committee is encouraged by CDC's work with 
State and national health organizations to develop an 
integrated and comprehensive national cardiovascular health 
program. The Committee encourages CDC to support prevention 
activities in more than half of the States. State programs 
could target reduction of heart disease and stroke risk factors 
through efforts to promote physical activity and good nutrition 
and to prevent or control high blood pressure, elevated 
cholesterol and obesity.
    Inflammatory bowel disease.--It is estimated that up to 1 
million people in the United States suffer from Crohn's disease 
or ulcerative colitis, collectively know as inflammatory bowel 
disease. The Committee recognizes the need for enhanced 
epidemiological research in this area, especially in light of 
recent advancements in treatment for these diseases and the 
increased risk that IBD patients have for developing colorectal 
cancer. The Committee continues to encourage CDC to work to 
further our understanding of the prevalence of these diseases 
through appropriate epidemiological and surveillance 
activities.
    Limb loss prevention.--The Committee recognizes the 
importance of rehabilitation information in improving outcomes 
among persons with limb loss and the role of the National Limb 
Loss Information Center in addressing this need. To date, the 
Center has received thousands of requests for information.
    Lymphoma.--The Committee encourages CDC to expand its 
support into investigating the potential of environmental, 
bacterial, and viral factors that are associated with the 
development of lymphoma and encourages continued and expanded 
collaborative research efforts including active involvement in 
the National Cancer Institutes' progress review group (PRG) on 
lymphoma and with other Institutes at the National Institutes 
of Health. The Committee also includes the President's request 
for programs related to environmental factors relating to 
cancer at the CDC's Environmental Health Lab and the Committee 
is particularly supportive of research on the environmental 
causes of lymphoma.
    Newborn Screening.--Recent advances in genetic screening 
for newborns allow identification at birth of underlying 
conditions which can cause or contribute to disease, 
disabilities, and death. The Committee supports further 
intramural and extramural research and development projects to 
facilitate the translation of new scientific knowledge into 
applied newborn public health screening programs, particularly 
in the areas of fragile X syndrome and cystic fibrosis. The 
Committee urges the CDC to coordinate with HRSA in translating 
the results of these efforts into guidance for public health 
programs, including State newborn screening programs.
    Nutrition Therapy.--The Committee encourages the agency to 
expand research on the impact of nutrition therapy in the 
prevention and management of cancer, HIV/AIDS and osteoporosis. 
The Institute of Medicine has recommended that medical 
nutrition therapy with physician referral be a covered benefit 
under the Medicare program. IOM indicated that nutrition 
therapy has been effective in the management and treatment of 
many chronic conditions which affect Medicare beneficiaries, 
including dyslipidemia, hypertension, heart failure, diabetes 
and chronic renal insufficiency. However, IOM cited 
insufficient or inconclusive data with regards to the role of 
nutrition in the prevention or treatment of cancer, HIV/AIDS 
and osteoporosis and called for additional research in these 
areas.
    Obesity.--The Committee encourages the CDC to provide funds 
for promoting healthy eating and physical activity and 
preventing obesity. The Committee is concerned that the 
National Center for Chronic Disease Prevention and Health 
Promotion at CDC is not providing adequate resources to address 
the nation's obesity problem. The Committee is aware of the 
University of Iowa's efforts to improve youth health through 
the establishment of a National Youth Fitness Obesity 
Institute.
    Omega-3 fatty acids.--The Committee is aware of the health 
benefits of Omega-3 fatty acids and recognizes that fish and 
seafood produces are the primary source of Omega-3 fatty acids 
in the diet. The Committee encourages the CDC to support public 
education campaigns to promote the consumption of fish and 
seafood products.
    Oral Health.--Americans will make approximately 500 million 
dental visits this year. In the year 2000, an estimated 
$60,000,000,000 will be spent on dental services. Much of the 
health and economic burden associated with oral diseases and 
conditions could be prevented. The Committee urges the CDC to 
enhance oral health activities at CDC. Increases would enable 
CDC to implement proven strategies to help eliminate dental 
decay and reduce tooth loss at a substantial cost savings. CDC 
should also expand surveillance activities to help States 
target their prevention efforts at schools, in the community 
and in clinical settings. CDC should enhance efforts to reduce 
disparities and the health burden from oral cancers, gum 
disease and oral health conditions that are closely linked to 
chronic diseases such as diabetes and heart disease. 
Fluoridation is one of the most efficient and cost effective 
ways to promote oral health. Tragically, California and six 
other States have extremely low fluoridation rates. The 
Committee also urges CDC to work with States to assist them in 
implementing fluoridation plans.
    The Committee encourages the CDC to establish a preventive 
dentistry effort to improve the oral health of low income 
children. A preventive dentistry program could offer a 
screening assessment of dental needs, the placement of either 
dental sealants or varnishes on permanent teeth, and referral 
for care as indicated.
    Osteoporosis.--Current data is lacking on whether 
counseling by a nutrition professional improves the probability 
of meeting adequate calcium, vitamin D, protein and other 
micronutrient intake either through the use of supplements or 
without supplements. With the elderly in particular, who take 
multiple medications and supplements, many of these 
medications/supplements interact and work against each other. 
In addition, many older women have a strong intolerance for 
milk. Research should be conducted to determine the 
effectiveness of nutrition counseling in insuring against the 
intake of excess levels of calcium (>2500mg/day) and on the 
interactions of supplements and hormone replacement therapies. 
The role of calcium, vitamin D, protein and other 
micronutrients in preventing osteoporosis and associated 
problems, such as hip fractures, should also be considered.
    Prevention Research.--The Committee supports CDC's efforts 
to expand prevention research. There are many areas of research 
that can pay dividends in both improved health and reduced 
health care costs. The Committee expects some of these funds to 
be used to support research on ways to prevent disease and 
disability in rural areas and to better utilize nurses and 
allied health professionals in prevention and health promotion 
efforts.
    Primary Immunodeficiency Diseases.--The Committee continues 
to be concerned that up to 500,000 cases of primary 
immunodeficiency diseases remain undiagnosed or misdiagnosed. 
The Committee has reviewed the national education and awareness 
campaign created by the Jeffrey Modell Foundation in 
collaboration with a variety of government agencies and 
believes that the deeper the CDC commitment to the project, the 
more successful it will be in identifying those patients. The 
Committee strongly recommends that CDC adopt this program as a 
model education and awareness program and collaborate with its 
other partners to assure the maximum benefit is obtained from 
it. The agency should provide the Committee with a report 
updating its efforts by December 1, 2000.
    Primary Immune Deficiency Diseases national surveillance 
program.--The Committee is pleased that CDC is working to 
establish a primary immune deficiency diseases national 
surveillance program. These diseases, which impair the body's 
immune system, strike most severely at children, many of whom 
do not survive beyond their teens or early twenties. Primary 
immune deficient patients require regular infusions of immune 
globulin intravenous (IGIV) to bolster their immune systems and 
maintain their health. Given the serious public health problems 
caused by the longstanding shortage of IGIV in the United 
States, the Committee encourages the National Center for 
Infectious Diseases to continue its partnership with the 
primary immune deficiency community and the National Center for 
Health Statistics with respect to surveillance and 
epidemiological activities designed to further our 
understanding of the prevalence of these diseases and the 
difficulties that patients have encountered in receiving 
treatment.
    Promoting Healthy Eating and Physical Activity and 
Preventing Obesity.--The Committee encourages the agency to 
provide funding for promoting healthy eating and physical 
activity and preventing obesity. Unhealthy eating habits and 
physical inactivity are major causes of heart disease, cancer, 
stroke, and diabetes, four out of the seven leading causes of 
death and disability in the United States. According to the 
U.S. Department of Agriculture, healthier eating habits could 
reduce the costs of heart disease, cancer, and diabetes by at 
least $71,000,000,000 each year.
    Sleep disorders.--The Committee encourages the agency to 
provide increased funding for research on the effects and 
prevalence of sleep deprivation and other sleep chronic 
disorders. Sleep deprivation and other disorders have been 
identified as a causal factors in a growing number of vehicular 
and on-the-job injuries. The Committee further encourages the 
agency to validate existing data on sleep deprivation and 
disorders, develop injury prevention programs, and disseminate 
information to States.
    Smoking and Health.--Tobacco use is the single most 
preventable cause of death and disease in our society. It 
causes more than 400,000 deaths in the United States each year, 
and costs the nation $50,000,000,000 in medical expenses alone. 
Children are especially hard hit by tobacco. Ninety percent of 
adult smokers begin their habit as children. The Committee 
believes that a significantly increased effort to curtail youth 
tobacco use is needed. Therefore, the Committee has included 
the President's requested level of funding for tobacco control. 
These funds are intended to expand the capacity of all State 
and local health departments, education agencies, and national 
organizations to build comprehensive tobacco control programs 
and to develop and begin implementation of a national public 
education campaign to reduce access to and the appeal of 
tobacco products among young people. The Committee has included 
$103,347,636, the same amount requested by the administration 
and an increase of $5,000,000 above the fiscal year 2000 
appropriation for tobacco prevention.
    Sudden Infant Death Syndrome.--The Committee notes the work 
of CDC, the National Institute of Child Health and Human 
Development and the Health Resources and Services 
Administration in developing a model guidelines for death scene 
protocol for Sudden Infant Death Syndrome. The Committee 
encourages CDC to implement projects to demonstrate the 
effectiveness of the death scene protocol in a variety of 
locales (urban, suburban, and rural) throughout the nation. 
Funding is available through the CDC infant mortality program 
and through the health disparities initiative, which focuses on 
infant mortality. The Committee expects CDC to be prepared to 
report on progress on this initiative during the fiscal year 
2002 hearings.
    Thyroid cancer.--The Committee has included sufficient 
funds to continue the next phase of a study on radioactive 
Iodine-131 and thyroid cancer. This study will look at 
individuals exposed to fallout from the Nevada Nuclear Weapons 
Test Site. The Committee further expects the administrative 
costs charged to this project to be further minimized.
    Underage drinking.--The Committee notes with substantial 
concern the continuing problem of underage drinking. Evidence 
indicates that if a young American child begins using alcohol 
at the age of 13, that individual is at far greater risk of 
becoming dependent on alcohol and other illegal drugs in their 
adult years. Those who postpone the use of alcohol until they 
reach the national legal drinking age of 21 are at 
substantially less risk. Last year, the Congress rejected 
attempts to incorporate anti-underage drinking messages into 
the Office of National Drug Control Policy (ONDCP) media 
campaign against illegal drug use. In doing so, many Members of 
Congress made clear that a parallel effort to combat underage 
alcohol use was needed. The Committee encourages CDC to fund a 
campaign to be developed by Mothers Against Drunk Driving in 
conjunction with other appropriate organizations to lay the 
groundwork for a successful media campaign aimed at underage 
drinking. It is the Committee's intention that this be the 
first step in creating a media campaign at least on a par with 
the current ONDCP effort as regards illegal drugs.
    Vision screening.--The Committee encourages the CDC to 
continue the child vision screening program to provide vision 
screening to economically distressed students in public 
schools. The Committee is aware of the Chicago Public Schools' 
Expanded Vision Program that is designed to help provide 
students with quality vision care.
    The Committee is also aware of the ChildSight vision 
screening program created by Helen Keller Worldwide to improve 
the educational performance of low-income junior high school 
students by providing them with eyeglasses.

Lead poisoning

    The Committee recommendation includes $38,226,000 for lead 
poisoning prevention activities. Of the amount provided, 
$30,978,000 is for program activities, which is $17,000 below 
the 2000 level and is the same as the administration request. 
For salaries and expenses within this category of activities, 
$7,248,000 has been provided, which is the same as the 2000 
level and the administration's request.
    Since its inception in fiscal year 1990, the CDC program 
has expanded to about 40 project areas that encompass States, 
local areas, and numerous communities and screens an estimated 
1,750,000 children annually.
    Lead Poisoning Screening.--The General Accounting Office 
has estimated that more than 400,000 children eligible for 
Federal health care programs have undetected harmful levels of 
lead in their blood, despite a Federal law requiring that they 
be screened for lead poisoning. During appropriations hearings, 
the Committee learned about the benefits of a portable, easy to 
use lead screening device developed with the support and 
participation of CDC. The Committee continues to believe that 
this device holds great promise for increasing childhood 
screening rates in underserved communities in the United States 
and throughout the world and encourages CDC to support its 
further development for application in community public health 
settings.

Breast and cervical cancer mortality prevention

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

Injury control

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

Occupational safety and health

    The Committee's recommendation includes $222,833,000 for 
the National Institute for Occupational Safety and Health 
[NIOSH]. Of the amount provided, $95,000,000 is for program 
activities, which is $8,181,000 above the 2000 level and 
$3,466,000 above the administration request. For salaries and 
expenses within this category of activities, $127,833,000 has 
been provided, which is the same as the 2000 level and $189,000 
less than the administration request.
    The National Institute for Occupational Safety and Health 
[NIOSH] in CDC is charged with conducting a national program of 
occupational safety and health research and information 
dissemination to ensure safe and healthful working conditions 
for American working men and women. Occupational injuries occur 
at twice the rate of injuries in the home or in public places. 
Severe occupational trauma is second only to motor vehicle 
incidents as a cause of unintentional death in the United 
States. The majority of all of these deaths and injuries are 
preventable.
    To prevent work-related hazards, NIOSH conducts applied 
research with a corps of occupational safety and health 
professionals operating in multidisciplinary teams comprised of 
engineers, epidemiologists, industrial hygienists, physicians, 
and toxicologists. Intramural efforts are complemented by 
grants, contracts, and cooperative agreements to form a 
comprehensive and integrated program consisting of four 
components: Identification of hazards; research on causes and 
prevention of occupational injuries and illnesses, 
dissemination of research findings and recommendations; and 
training of those involved in preventing disease and injury at 
work.
    The Committee encourages NIOSH to provide full and fair 
consideration to the National Children's Center on Rural 
Agricultural Health and Safety (NCCRAHS) in Marshfield, 
Wisconsin for a National Summit on Child and Adolescent Rural 
Injury Control in September 2001.
    Aviation safety.--The Committee continues to be pleased 
that the National Transportation Safety Board has taken an 
aggressive approach to address the recent rash of injuries and 
deaths from aircraft accidents in Alaska. The Committee 
supports continuation of the joint interagency initiative which 
involves the Federal Aviation Administration, the NTSB, and the 
National Institute of Occupational Safety and Health. The 
Committee encourages NIOSH to continue to implement the Board's 
recommendations to improve aviation safety in Alaska.
    Construction safety and health initiative.--The Committee 
notes that since the inception of the NIOSH, construction 
safety and health initiative, the rate of serious injury and 
illness in construction dropped 38 percent from 1992 to 1998, 
according to the Bureau of Labor Statistics. This drop is one 
of the highest compared to all other industries. Moreover, 
among the goods-producing industries, construction is the only 
industry where the rate has dropped consistently over the 7-
year period. The Committee is pleased with NIOSH's focus on 
active implementation and evaluation of safety and health 
interventions designed to prevent accidents, adverse health 
effects and fatalities and for NORA for establishing research 
priorities and encourages CDC to continue the targeted 
construction program at its current level. However, the 
Committee is concerned with the continued high fatality rate in 
the industry, and has included funds to continue the program at 
no less than current levels.
    Education and Research Centers.--The Committee commends the 
work of the 15 university-based Education and Research Centers 
(ERC's) and the smaller single discipline Training Project 
Grants (TPG's). These regional centers are integral to the 
nation's efforts to improve the health and safety of working 
men and women, and important to the future efforts of NIOSH to 
implement the National Occupational Research Agenda (NORA).
    Farm Health and Safety.--The Committee has included funding 
to continue the farm health and safety initiative at its 
current level. This important initiative, begun in fiscal year 
1990, has a primary focus of reducing the incidence of fatal 
and nonfatal injuries and occupational diseases among the 
millions of agricultural workers and their families in the 
United States. The Committee is particularly pleased with the 
research being undertaken by the Agricultural Research Centers.
    Mine safety.--The Committee encourages the CDC to provide 
sufficient funds to improve safety and health for American 
miners. The Spokane Research Laboratory is working to improve 
miners safety and the Committee encourages CDC to provide full 
and fair consideration for this project.
    Mine safety research.--The Committee is concerned that 
funds and research for mine safety and health are no longer 
separately identified in the Department of Health and Human 
Services, Centers for Disease Control and Prevention fiscal 
year 2001 congressional justification. The Committee continues 
to recognize that many mine safety and health research needs 
are either unique to mining or require mining-specific 
emphasis. The Committee expects that the fiscal year 2002 
congressional justification will separately identify the funds 
and research activities dedicated to mine safety and health, as 
well as report to the Committee on the funding and research 
activities devoted to mine safety and health in fiscal year 
2001.
    National Occupational Research Agenda.--The Committee 
recognizes that the National Occupational Research Agenda 
(NORA) is the largest stakeholder-based research agenda in the 
United States, targeting 21 priorities considered by the 
nation's occupational safety and health community as the most 
critical for improving the safety and health of the American 
workforce. Representatives of over 200 organizations from the 
public and private sectors are working with NIOSH to implement 
NORA. Therefore, the Committee urges the CDC to provide NIOSH 
with the necessary resources to sustain the momentum of NORA 
and continue to expand the overall scientific effort to address 
occupational safety and health research, collaborate with NIH 
and other agencies, target important new initiatives to prevent 
and reduce work-related hazards and conduct evaluations of the 
impact of prevention strategies.
    National Laboratory for Personal Protective Equipment.--It 
has been brought to the Committee's attention the need for 
design, testing and state-of-the-art equipment for this 
nation's 50 million miners, firefighters, healthcare, 
agricultural and industrial workers. The Institute of Medicine 
identifies personal protective equipment as a critical need and 
had called for increased research to test commercial products, 
develop more protective respirators, develop better protective 
suites and uniform testing standards and guidelines for 
personal protective equipment use in hospitals. The Committee 
encourages NIOSH to carry out research, testing and related 
activities aimed at protecting workers, who respond to public 
health needs in the event of a terrorist incident. The 
Committee encourages CDC to organize and implement a national 
personal protective equipment laboratory. The city of 
Pittsburgh would be especially suited to carry out this 
initiative.
    Worker health and safety research.--The Committee 
recognizes the need for worker health and safety research at 
the Federal level, and to continue funding the laboratory in 
Morgantown, West Virginia.
    University of Hawaii at Hilo.--The Committee encourages 
NIOSH to give full and consideration to the work being done on 
environmental toxins at the University of Hawaii at Hilo.

Epidemic services

    The Committee's recommendation includes $85,738,000 for 
epidemic services. Of the amount provided, $30,254,000 is for 
program activities, which is $18,160,000 below the 2000 level 
and is the same as the administration request. For salaries and 
expenses within this category of activities, $55,484,000 has 
been provided, which is the same as the 2000 level and the 
administration request.
    The objectives of the epidemic services activity are to: 
provide for the investigation, prevention, or control of 
epidemics, develop, operate, and maintain surveillance systems, 
analyze data, and respond to public health problems when 
indicated; train public health epidemiologists [EIS]; carryout 
quarantine regulations; reduce the importation of disease from 
developing countries; publish the morbidity and mortality 
weekly report; develop, coordinate, and provide efficacious, 
effective, and economic prevention strategies; and assist in 
the improvement of State infrastructure.

Health statistics

    The recommendation of the Committee includes $103,912,000 
for the National Center for Health Statistics. This is 
$6,073,000 below the administration request and $1,088,000 
below the fiscal year 2000 program level.
    CDC's National Center for Health Statistics [NCHS] is the 
Nation's principal health statistics agency, whose mission is 
to provide statistical information that will guide actions and 
policies to improve the health of the American people.
    The amount provided includes an increase for the national 
health and nutrition examination survey [NHANES]. This is the 
same as the request and will provide for full funding of this 
important component of the Nation's health information 
strategy. When fully implemented, NHANES provides unique 
information from direct physical examinations, biochemical 
measures, interviews, and nutritional analysis from a large, 
representative sample of persons. This survey is the only 
national source of objectively measured health status data, and 
is essential to interpreting information from other survey 
components.
    Primary immune deficiency national surveillance.--The 
Committee is pleased that NCHS is working to establish a 
primary immune deficiency national surveillance program, in 
collaboration with the National Center for Infectious Diseases.

Human immunodeficiency virus

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

Building and facilities

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

Prevention research

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

Office of the Director

    For the Office of the Director, the Committee recommends 
$35,564,000, which is the same as the President's request and 
$2,056,000 below the fiscal year 2000 appropriation. This line 
item includes amounts previously attributed to program 
management activities.
    This level includes $19,439,000 to be provided from PHS 
evaluation funds.
    The ``Program management'' account primarily supports the 
activities of the Office of the Director of the CDC. The vast 
majority of administrative costs are captured throughout the 
program accounts within the CDC.
    The recommendation includes bill language providing the 
Director with authority to transfer funds available from the 
sale of surplus vaccine from the vaccine stockpile to other 
activities within the jurisdiction of the Centers for Disease 
Control and Prevention. In the event the Director exercises 
this transfer authority, the Committee is to be notified 
immediately.

Health disparities demonstration

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

Violent crime reduction programs

    The Committee recommendation includes $50,225,000 for 
violent crime reduction programs, which is $234,000 above the 
fiscal year 2000 level and $257,000 above the budget request 
for activities authorized by the Violence Against Women Act. 
Funds are used to augment rape prevention services supported by 
the States through the preventive health and health services 
block grant and for grants to public and private nonprofit 
organizations to support community programs to prevent domestic 
violence.
    The Committee has also included $6,000,000 for Domestic 
Violence Community Demonstrations, an increase of $134,000 
above the fiscal year 2000 appropriation, and $137,000 above 
the amount requested by the Administration.
    The funds for rape prevention and services will be used by 
States to expand support for rape crisis centers and State 
coalitions, to support rape crisis hotlines, victim counseling, 
professional training of police officers and investigators, and 
education programs in colleges and secondary schools.
    Distribution of funds.--The Committee is concerned with the 
distribution of funds for rape prevention and education that 
are provided with funds from violent crime reduction programs 
and sent to the States through the preventive health and health 
services block grant. States should comply with the statutory 
language and congressional recommendations accompanying the use 
of these funds. Funds should be used to supplement rape crisis 
centers and State sexual assault coalition's rape prevention 
and education efforts and not to supplant funds from other 
sources.
    Domestic violence crisis intervention.--The Committee is 
aware that Portal to Hope, operates an innovative system of 
services, including counseling by licensed social workers, 
therapists, a 24-hour crisis intervention service that includes 
a hotline, a community outreach project, job placement 
assistance, legal services, and shelter and housing placement 
services. The Committee encourages CDC to give full and fair 
consideration to this project.
    Domestic violence hotline.--The Committee applauds the work 
of the DV Hotline and encourages their efforts to expand 
services to victims of sexual assault
    Psychosocial factors of violence.--It is the Committee's 
expectation that the Centers for Disease Control and Prevention 
take the lead in a collaborative effort between CDC and the 
Department of Justice in researching the behavioral and 
psychosocial factors relating to violence against women.
    Teen smoking.--The Committee is aware of the approach by 
the University of Pennsylvania School of Social Work to develop 
models for curtailing teenage smoking as a mechanism for 
reducing the number of teens in the juvenile justice system.
    Violent crime grants.--The Committee urges CDC to ensure 
that States receiving funds from the grants for assistance to 
victims of sexual assault, support State sexual assault 
coalitions and community-based rape crisis centers whose work 
is focused on ending sexual violence, operating hotlines for 
victims of sexual violence and their families, and those who 
provide crisis intervention, advocacy, and self-help services 
to victims. The Committee also urges that similar 
nongovernmental nonprofit agencies show a demonstrated 
effectiveness in carrying out the work achieving these goals in 
order to receive funds. The Committee further encourages CDC 
work to have States devote adequate resources from their 
allocation for rape prevention and education for middle, 
junior, and high school youth in both school and nonschool 
settings.

                     National Institutes of Health

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

                       NATIONAL CANCER INSTITUTE

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

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

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

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

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

         NATIONAL INSTITUTE OF DENTAL and craniofacial RESEARCH

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

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

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

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

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

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

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

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

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

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

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

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

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

    The Committee recommendation includes $1,554,176,000 for 
the National Institute of General Medical Sciences [NIGMS]. 
This is $125,988,000 more than the budget request and 
$200,233,000 more than the fiscal year 2000 appropriation. The 
comparable amounts for the budget estimate include funds to be 
transferred from the Office of AIDS Research.
    Mission.--NIGMS supports research and research training in 
the basic biomedical sciences. Institute grantees, working in 
such fields as cell biology, biophysics, genetics, 
developmental biology, pharmacology, physiology, and biological 
chemistry, study normal biological processes to better 
understand what goes wrong when disease occurs. In this way, 
NIGMS supplies the new knowledge, theories, and technologies 
that can then be applied to the disease-targeted studies 
supported by other NIH components. NIGMS-supported basic 
research advances also regularly find applications in the 
biotechnology and pharmaceutical industries. The Institute's 
training programs help provide the scientists needed by 
industry and academia to maintain United States leadership in 
biomedical science.
    Behavioral Science Research and Training.--The Committee is 
concerned that NIGMS does not support behavioral science 
research training. As the only Institute mandated to support 
research not targeted to specific diseases or disorders, there 
is a range of basic behavioral research and training that NIGMS 
could be supporting. The Committee urges NIGMS, in consultation 
with the Office of Behavioral and Social Sciences, to develop a 
plan for pursuing the most promising research topics in this 
area.
    Minority Biomedical Research Support.--The Committee 
continues to be pleased with the quality of the NIGMS training 
programs, particularly those that have a special focus on 
increasing the number of minority scientists, such as the 
Minority Access to Research Careers (MARC) and Minority 
Biomedical Research Support (MBRS) programs. The Committee 
understands that NIGMS plans to continue supporting these 
important initiatives.

        NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

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

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

                         NATIONAL EYE INSTITUTE

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

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

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

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

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

                      NATIONAL INSTITUTE ON AGING

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

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

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

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

    The Committee recommends an appropriation of $401,161,000 
for the National Institute of Arthritis and Musculoskeletal and 
Skin Diseases [NIAMS]. This is $32,449,000 more than the budget 
request and $51,681,000 more than the fiscal year 2000 
appropriation. The comparable amounts for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The NIAMS conducts and supports basic and 
clinical research and research training, and the dissemination 
of health information on the more than 100 forms of arthritis; 
osteoporosis and other bone diseases; muscle biology and muscle 
diseases; orthopedic disorders, such as back pain and sports 
injuries; and numerous skin diseases. The research agenda of 
the NIAMS addresses many devastating and debilitating diseases 
that afflict millions of Americans. These diseases of the 
joints, muscles, bones, connective tissues, and skin, in the 
aggregate, will affect nearly every American at some point in 
their lives, causing tremendous human suffering and costing the 
Nation billions of dollars in both health care and lost 
productivity. The research activities of this Institute serve 
the concerns of many different special populations, including 
women, minorities, children, and the elderly.
    Arthritis.--Forty-three million Americans have some form of 
arthritis. These painful and disabling degenerative diseases 
wear away protective joint cartilage and are the leading cause 
of disability in the United States. The economic cost to the 
United States for musculoskeletal and skin diseases and 
arthritis is staggering. Between 1988 and 1995, the total cost 
rose by 70 percent.
    Behavioral and social science research.--The Committee 
notes that the portion of the NIAMS research portfolio devoted 
to behavioral and social sciences research is significantly 
lower than the NIH average. Therefore, the Committee urges the 
NIAMS to fund promising behavioral social sciences research. 
Additionally, the Committee urges favorable consideration of 
research in the area of behavioral and social science factors 
relating to the adherence to medical recovery regimes, exercise 
and weight reduction programs.
    Cushing's Syndrome.--Cushing's Syndrome is a hormonal 
disorder caused by prolonged exposure of the body's tissues to 
high levels of the hormone cortisol. Sometimes called 
``hypercortisolism'', it is relatively rare and most commonly 
affects adults aged 20 to 50. An estimated 10 to 15 of every 
million people are affected each year. The Committee encourages 
the Institute to conduct specific research on Cushing's 
Syndrome, to increase awareness of the disease and improve 
diagnostic tools and treatment.
    Duchenne/Becker Muscular Dystrophy.--The Committee is 
concerned that NIH has not committed adequate funds to sustain 
research in the area of Duchenne/Becker muscular dystrophy. It 
appears that NIH lacks requisite expert peer review of proposed 
DMD/Becker related research and muscle biology in general. The 
Committee recognizes that biomedical research in DMD/Becker 
dystrophy requires a sustained commitment in order to resolve 
key scientific and technical issues leading to further 
advances. This commitment should include measures to ensure 
that the scientific review of applications dealing with muscle 
biology is conducted by experts in that field. Therefore, the 
Committee urges the NIH to consider establishing a Muscle Study 
Section Review. Furthermore, the Committee feels that efforts 
should be made by NIAMS and NINDS to increase the amount of 
research devoted to skeletal muscle, especially DMD/BMD. The 
Committee strongly recommends NIH, in conjunction with all 
appropriate institutes, evaluate the current state of research 
so as to identify the critical path for DMD/Becker research, 
filling in the ``gaps'' in basic muscle science. In this 
regard, the Committee urges NIH to conduct a research 
conference to evaluate the status of research and assist in 
properly directing the critical science investment areas muscle 
research. The Committee requests that NIH prepare a report on 
the progress of research related to Duchenne/Becker Muscular 
Dystrophy and indicate proposed investment strategies to ensure 
that technical progress is sustained. The Committee requests 
the report by January, 2001. The Committee also urges that NIH 
develop trans-institute initiatives for DMD/Becker to ensure 
appropriate coordination across relevant institutes and further 
recommends that additional research be reviewed at the 
consensus conference.
    Ehlers Danlos syndrome.--Ehlers-Danlos syndrome (EDS) is a 
family of genetic disorders whose manifestations include but 
are not limited to the skin, joints and other components of the 
connective tissue. The prevalence of each type and of EDS 
overall is not well defined, although the figure of 1:5-10,000 
individuals for the syndrome is generally accepted. EDS is 
potentially a model for a number of more common medical and 
biological problems stemming from genetic acquired connective 
tissue defect. The Institute is encouraged to provide the 
highest possible funding for continued research of this 
disease.
    Facioscapulohumeral muscular dystrophy and 
facioscapulohumeral disease (FSHD).--The Committee is extremely 
concerned that funding for FSHD has decreased and that no new 
projects have been funded over the past year. The Committee 
requests that the NIH report after the research planning 
conference on steps it will take to create a comprehensive 
research portfolio in FSHD. The Committee further urges that 
NIH make research in FSHD a high priority.
    Fibromyalgia.--Fibromyalgia syndrome (FMS) is a clinically 
diagnosed disorder which is poorly understood and difficult to 
treat. It is a syndrome of chronic, debilitating, widespread 
pain, fatigue, sleep disturbance, and other associated 
disorders. Research in the eight years following the American 
College of Rheumatology's case definition of fibromyalgia and 
four years since the first NIH awards on fibromyalgia has 
created a solid body of knowledge. The Committee urges the 
Institute to support two centers for research into 
fibromyalgia. These centers would conduct multi-disciplinary 
studies which have the potential to add significantly to 
science's understanding of this complex and disabling disease.
    Lupus.--Lupus is a widespread, devastating autoimmune 
disease that affects 1.4 million Americans, most of whom are 
women. Lupus is the prototypical autoimmune disease that, for 
reasons not fully understood, causes the immune system to 
become hyperactive and attack the body's own tissue. The 
disease affects the quality of life and can damage vital organs 
resulting in disability or death. Lupus and other autoimmune 
diseases are the fourth leading cause of disability in women. 
Gaining an understanding of the factors associated with the 
high prevalence of lupus in women and minorities and the 
development of new and innovative treatments should be a high 
priority. The Committee urges NIAMS to explore all available 
scientific opportunities that presently exist in lupus research 
and treatment.
    Minority Populations and Osteoporosis.--The Committee 
encourages NIAMS to devote additional resources to studying 
osteoporosis in the non-white population and is urged to 
increase its work in this area. Moreover, given the large 
number of individuals affected by this disease, including a 
disproportionate number of women, the Institute should focus on 
interventions to improve quality of life. Another area of 
research which deserves attention is the investigation of the 
relationship between hypertension and osteoporosis.
    Nutrition Therapy and Osteoporosis.--Enhanced intake of 
calcium and vitamin D for both the prevention and treatment of 
osteoporosis in the at-risk Medicare population is strongly 
supported by a considerable body of data, including multiple 
randomized controlled trials. However, current data is lacking 
on whether counseling by a nutrition professional improves the 
probability of meeting adequate calcium, vitamin D, protein and 
other micronutrient intake, with or without the use of 
supplements. With the elderly, who take multiple medications 
and supplements, many of these medications/supplements interact 
and work against each other. In addition, many older women have 
a strong intolerance for milk. The Committee recommends that 
research be conducted to determine the effectiveness of 
nutrition counseling in insuring against the intake of excess 
levels of calcium and on the interactions of supplements and 
hormone replacement therapies. The role of calcium, vitamin D, 
protein and other micronutrients in preventing osteoporosis and 
associated problems, such as hip fractures, should also be 
considered.
    Osteoarthritis.--Early diagnosis of a disease is important 
to prevent or reduce long-term disability. For musculoskeletal 
conditions such as osteoarthritis, early diagnosis is hampered 
because of insufficient knowledge of the early stages of the 
disease. Osteoarthritis, which can completely destroy the 
joints of the hips and knees, affects over 20 million 
Americans, most often the elderly. With the aging of the 
population expected to double by the year 2020, a significant 
investment must be made now to reduce the burden of 
osteoarthritis later. If not, the dynamics of this condition in 
the aging population alone will generate an avalanche of costs, 
disability and suffering to the American people in the future. 
The Committee therefore encourages the Institute to assign 
osteoarthritis research a high priority.
    Osteoporosis.--The Committee urges NIAMS to consider 
funding additional specialized Centers for Research for 
osteoporosis. The Committee notes that these centers have made 
significant contributions to the progress of osteoporosis 
research and patient care, and can help in reducing bone 
fractures and other complications from the disease.
    Paget's disease.--The Committee is aware of the importance 
of research on the viral and genetic factors that may cause 
Paget's disease, and encourages the Institute to expand its 
work in this area.
    Psoriasis.--Psoriasis is a genetically-acquired immune-
mediated disease of the skin and joints that affects over 7 
million American men, women and children. Over 1 million 
Americans suffer from severe psoriasis and psoriatic arthritis, 
which causes cracked, red skin lesions and swollen joints, 
extreme physical and emotional pain, and limited quality of 
life. The Committee encourages NIAMS to continue to support 
additional genetic research to determine which genes are the 
causative genes for psoriasis and psoriatic arthritis, as well 
as to pursue research on the immunological mechanisms of the 
disease. The Committee has been informed that through continued 
support for this research, new knowledge will be gained to 
develop improved therapeutic approaches for the treatment of 
this chronic immune disease.
    Reflex Sympathetic Dystrophy Disorder (RDS).--The Committee 
is aware of the debilitating effects of RDS. Currently, little 
is known about the cause of this disorder, which leads to 
frequent occurrences of misdiagnosis, and ultimately, the 
condition is mistreated or goes untreated. Given that early 
identification and prompt treatment are the keys to recovery, 
the Committee urges the Institute to continue to enhance its 
investigation into the cause of and most effective treatments 
for this condition.
    Scleroderma.--Scleroderma is a chronic, degenerative 
disease which causes the overproduction of collagen in the 
body's connective tissue. It affects between 300,000 and 
500,000 Americans and is often life-threatening, yet it remains 
relatively unknown and under-funded. The Committee urges the 
Institute to provide additional resources to expand the 
research in this area and to work collaboratively with private 
research foundations to coordinate research findings.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

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

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

                 NATIONAL INSTITUTE OF NURSING RESEARCH

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

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

           National Institute on Alcohol Abuse and Alcoholism

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

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

                    NATIONAL INSTITUTE ON DRUG ABUSE

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

    The Committee recommends an appropriation of $790,038,000 
for the National Institute on Drug Abuse [NIDA]. This is 
$64,571,000 more than the budget request and $102,662,000 more 
than the fiscal year 2000 appropriation. The comparable numbers 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--Created in 1974, NIDA supports about 85 percent 
of the world's biomedical research in the area of drug abuse 
and addiction. The Committee commends NIDA for demonstrating 
through research that drug use is a preventable behavior and 
addiction is a treatable disease. NIDA's basic research plays a 
fundamental role in furthering knowledge about the ways in 
which drugs act on the brain to produce dependence, and 
contributes to understanding how the brain works. In addition, 
NIDA research identifies the most effective pharmacological and 
behavioral drug abuse treatments. NIDA conducts research on the 
nature and extent of drug abuse in the United States and 
monitors drug abuse trends nationwide to provide information 
for planning both prevention and treatment services. An 
important component of NIDA's mission is also to study the 
outcomes, effectiveness, and cost benefits of drug abuse 
services delivered in a variety of settings.
    Behavioral sciences.--The Committee understands that 
behavioral intervention is a critical, and sometimes only, 
component of drug addiction The Committee continues to support 
NIDA's expansion of its behavioral science portfolio and views 
NIDA as a model of how to approach its behavioral science and 
public health responsibilities.
    Children and adolescents.--Recognizing the devastating 
impact of drug addiction on children and youth, the Committee 
commends NIDA's children and adolescent research initiative. 
The Committee urges NIDA to continue to support its research 
portfolio in areas of co-occurring mental disorders, 
developmental consequences, prenatal exposure, genetic 
vulnerability, and environmental risk factors.
    Clinical trials.--The Committee is pleased with NIDA's 
continuing progress in developing behavioral and 
pharmacological drug abuse treatments, and supports NIDA's 
initiative to establish a national drug abuse treatment 
clinical trials network. The Committee commends NIDA's 
leadership in forging strong partnerships with treatment 
researchers and community-based treatment providers to assure 
that new treatments are tested and incorporated into ongoing 
drug treatment programs.
    Emerging drug problems.--The Committee is pleased that NIDA 
has launched a new Club Drug Research and Dissemination 
Initiative. Given the emergence of club drugs, such as ecstasy, 
methamphetamine, GHB, and ketamine, the Committee is encouraged 
by NIDA's proactive efforts to curtail these emerging drug 
problems and urges NIDA to continue its efforts to develop an 
even broader array of effective new prevention and treatment 
approaches to focus on these emerging drug challenges.
    Genetic vulnerability.--The Committee understands that both 
genes and environment influence drug abuse and addiction. The 
relationship between the two is complex, requiring continued 
research in areas of behavioral genetics, psychiatric and 
epidemiological genetics, molecular genetics, and population 
genetics. The Committee encourages NIDA to continue to pursue 
this area of drug and addiction research.
    Medications development.--The Committee encourages NIDA to 
study the development of anti-addiction medications, to clarify 
the neurological and behavioral benefits of the use of 
pharmacological agents, and develop an understanding of how 
best to use these medications.
    Methamphetamine.--The Committee is very disturbed by the 
explosion in methamphetamine abuse across the nation. The 
problem is essentially acute in Iowa and other Midwestern 
states. The Committee again urges NIDA to expand its research 
on improved methods of prevention and treatment of 
methamphetamine abuse.
    National drug abuse clinical trials network.--The Committee 
commends NIDA's leadership in continuing to recognize the 
importance of behavioral and social science research and is 
especially pleased that this is reflected in the recent NIDA 
reorganization, which elevates behavioral research in both the 
Division of Neuroscience and Behavioral Research and the 
Division of Treatment Research and Development. The Committee 
believes NIDA could consider evaluating these promising 
behavioral treatments in clinical trials through its new 
National Drug Abuse Clinical Trials Network.
    Neuroscience.--The Committee recognizes that basic 
neuroscience provides a foundation for NIDA's research 
portfolio. Basic neuroscience research has advanced the field's 
understanding of drug abuse and addiction. The Committee urges 
NIDA to continue its efforts to develop new areas of 
neuroscience research.
    New genes and drug abuse.--The Committee supports research 
efforts to identify many of the genes that may play a role in 
addiction. Seizing upon these opportunities could lead to a 
more complete picture of the disease of addiction.
    Nicotine research.--The Committee recognizes that the 
consequences of nicotine addiction are substantial to adults, 
children, and adolescents, and commends NIDA's support of 
research yielding effective replacement therapies and 
behavioral interventions. The Committee encourages NIDA to 
continue to support research on the prevention and behavioral 
and pharmacological treatment of nicotine addiction. The 
Committee supports NIDA's ongoing research in the basic 
sciences, behavioral and medical treatments, genetic 
vulnerability, and epidemiology of nicotine use and abuse.
    Transdisciplinary tobacco research centers.--The use of 
tobacco products remains one of the nation's deadliest 
addictions. The Committee strongly supports NIDA's continuing 
efforts to address this major public health problem through its 
comprehensive research portfolio. The Committee is pleased that 
NIDA has teamed with the National Cancer Institute and an 
outside foundation to establish the Transdisciplinary Tobacco 
Use Research Center (TTURC). This multifaceted approach should 
lead to an increased understanding of how nicotine acts in the 
brain and body and lead to new strategies for treating nicotine 
addiction and preventing tobacco use, particularly by teens and 
younger children.
    Vulnerability to addiction initiative.--The Committee 
commends NIDA for launching its ``Vulnerability to Drug 
Addiction Initiative'' and encourages NIDA to support research 
to identify genes associated with drug abuse and addiction. 
Increasing our understanding of why some people are vulnerable 
to drug abuse and addiction while others are not, will speed 
progress in treating and preventing these critical problems.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

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

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

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

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

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

                 NATIONAL CENTER FOR RESEARCH RESOURCES

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

    The Committee recommends an appropriation of $775,212,000 
for the National Center for Research Resources [NCRR]. This is 
$61,020,000 more than the budget request and $100,158,000 more 
than the fiscal year 2000 appropriation. The comparable amounts 
for the budget estimate include funds to be transferred from 
the Office of AIDS Research.
    Mission.--The NCRR develops and supports critical research 
technologies and shared resources that underpin research to 
maintain and improve the health of our Nation. The NCRR 
programs develop a variety of research resources; provide 
biomaterial and resources for complex biotechnologies, clinical 
research, and specialized primate research; develop research 
capacity in minority institutions; and enhance the science 
education of precollege students and the general public.
    Cystic fibrosis.--The NCRR is commended for its continued 
support for the clinical trials monitoring center for CF 
research to ensure accurate and timely review of ongoing 
clinical trials into cystic fibrosis. As a model for the 
evaluation of new therapies to treat orphan diseases, the 
clinical trials monitoring center for CF research is laying new 
groundwork for the methods of translating basic research 
discoveries into clinical interventions in a timely manner.
    Developing and improving institutional animal resources.--
The Committee has carefully reviewed documentation identifying 
the need for upgrading animal research facilities at minority 
health professions schools and has been pleased with NCRR's 
initiative in this area. The Committee has included sufficient 
funds for NCRR to continue its aggressive collaboration with 
minority health professions schools in providing grants to 
upgrade their animal facilities. These upgrades are necessary 
to assist in complying with Federal regulations and attain 
accreditation by the appropriate scientific organizations. In 
addition, the Committee has provided funding for the NIH 
Minority Health Initiative in the Office of the Director and is 
confident that this program can make a contribution to NCRR's 
animal facilities research infrastructure building program.
    Diabetes.--The Committee understands that NCRR plans in 
fiscal year 2001 to fund regional resource centers to focus 
specifically on supplying human islet cells for researchers. 
The Committee believes that this should be a high priority 
project for the Center.
    General Clinical Research Centers.--The General Clinical 
Research Centers program provides regional access to clinical 
research patients in 33 of 50 States to foster opportunities 
for clinical investigators to translate basic science 
discoveries to the care of patients. The Committee understands 
that three major panels that have examined the crisis 
confronting our nation's clinical research programs have 
recommended an expansion of the GCRC program. Over the past 
several years, the Committee has encouraged the NCRR to make 
the GCRC program a high priority within its budget allocations. 
The Committee is concerned that in fiscal year 2000, the GCRC 
budget dropped to an all-time low of 1.15 percent of NIH 
spending, compared to 3 percent of the NIH budget in the late 
1960's. The Committee is concerned about the GCRCs growth rate, 
especially when compared to the overall NCRR budget increases. 
To address the historical underfunding of the GCRCs and 
strengthen their ability to translate scientific discoveries 
into new therapies for the benefit of patients, the Committee 
has provided sufficient funds for the GCRC program for fiscal 
year 2001. The Committee urges the NCRR to consider using these 
funds to increase and enhance the training of clinical 
investigators, to implement the newly established guidelines 
for Informatics, to establish supplemental clinical research 
funds at each center through which the GCRCs can provide seed 
funding for pilot studies, to support GCRC efforts to enhance 
patient access to clinical research through off-site 
activities, community outreach initiatives and patient travel 
support. In addition, as in past years, the Committee once 
again encourages NCRR to continue and accelerate progress 
toward full funding of Centers at Advisory Council approved 
levels.
    High field magnetic resonance imaging equipment.--The 
Committee is aware of the important emerging role that high 
field magnetic resonance imaging systems play in researching 
the causes and progression of Alzheimer's Disease and 
Parkinson's Disease. The Committee encourages NCRR to consider 
supporting these systems, which could benefit both Alzheimer's 
and Parkinson's Disease patients.
    IDeA grants.--The Committee has provided $60,000,000 for 
the Institutional Development Award [IDeA] Program authorized 
by section 402(g) of the Public Health Service Act. This is 
$20,000,000 increase over both fiscal year 2000. The program is 
intended to broaden the geographic distribution of NIH funding 
of biomedical research by enhancing the competitiveness of 
biomedical and behavioral research institutions which 
historically have had low rates of success in obtaining 
funding. The Committee intends that the increase will be used 
in eligible States to co-fund high quality applications for 
shared instrumentation and RO-1 proposals to those who would 
otherwise not receive support under the normal peer-review 
cycle. The Committee believes that the existing Shannon Awards 
Program can serve as the model for deciding which grants should 
be selected by NCRR for funding under the expanded IdeA 
Program.
    Plant-based medicinal products.--The Committee supports the 
need to accelerate the development and commercialization of 
plant-based medicinal products and encourages the NCRR to 
consider collaborating with plant scientists and companies in 
Hawaii to responsibly use that State's unprecedented 
biodiversity in developing new, health-enhancing products.
    Primate centers.--The Committee is pleased with the 
addition of an eighth Regional Primate Research Center during 
fiscal year 1999. The new Center complements existing Centers 
by providing outstanding expertise in primate genetics and 
chronic disease research and by strengthening the current 
program's capabilities in infectious disease research. The 
Committee encourages the Institute to consider supporting this 
Center at the peer reviewed recommended funding level.
    Research centers at minority institutions.--The Committee 
recognizes the critical role played by minority institutions at 
both the graduate and undergraduate level in addressing the 
health research and training needs of our minority populations. 
These programs help facilitate the preparation of a new 
generation of scientists at these institutions. The Research 
Centers in Minority Institutions (RCMI) Program continues to 
impact significantly on these problems. The Committee 
encourages NIH to strengthen participation from minority 
institutions and consider increasing resources available in 
this area. The Committee also encourages NIH to work with 
minority institutions with a track record of producing minority 
scholars in science and technology.
    Research infrastructure in minority institutions (RIMI).--
The Committee recognizes the importance of increasing the 
participation of minorities in health science careers. Programs 
like RIMI play an important role in achieving this goal by 
improving the research infrastructure that is available to 
prepare students for such careers. By establishing partnerships 
between minority and other institutions, RIMI has assisted 
minority institutions in faculty recruitment and retention, 
student development, enhanced research capacity, and 
administrative acumen. Therefore, the Committee encourages NCRR 
to consider increasing its support for this valuable 
demonstration program.
    Research resource centers and PET scans.--The Committee 
continues to urge NCRR to support research resource centers for 
the development and refinement of positron emission tomography 
(PET) as a unique imaging technology to diagnose and stage 
diseases of the brain, including Alzheimer's disease.

   National Center for Complementary and Alternative Medicine [CCAM]

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

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

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

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

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

                      NATIONAL LIBRARY OF MEDICINE

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

    The Committee recommends an appropriation of $256,953,000 
for the National Library of Medicine [NLM]. This is $26,818,000 
more than the budget request and $41,754,000 more than the 2000 
appropriation. The comparable amounts for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The National Library of Medicine is the Federal 
institution that for more than 150 years has collected, 
organized, preserved, and disseminated the world's output of 
biomedical literature in all forms. As a result of this 
activity NLM is the world's largest library of the health 
sciences, its holdings numbering more than 5 million items. The 
NLM has pioneered innovative methods to disseminate 
bibliographic information. Basic to the mission of the NLM is a 
wide-ranging research program to improve how medical 
information is communicated. This responsibility is aided by a 
grants program and by specialized services in toxicology, 
environmental health, and biotechnology.
    Computational molecular biology.--The Committee is pleased 
to learn that NLM will play a key role in the NIH-wide 
Biomedical Information Science and Technology Initiative 
(BISTI). NLM's long history in supporting research and training 
in medical informatics makes it uniquely positioned to assist 
in the further development of the field of computational 
biology. The Committee encourages NLM to consider expanding its 
extramural grant activities in the area of computational 
molecular biology.
    Consumer health.--The Committee is pleased with the actions 
NLM has taken to ensure that the American public has access to 
good health information. It has done this not only by making 
MEDLINE and its other information resources available to 
consumers over the Internet, but by creating MEDLINEplus, a 
consumer health information site specifically for the general 
public. Another new service created by NLM, ClinicalTrials.gov, 
is an easy-to-use database with information on more than 4,000 
Federal and private medical studies involving patients and 
others at more than 47,000 locations nationwide. The Committee 
is pleased that patients, families and members of the public 
now have easy access to information about the location of 
clinical trials, their design and purpose, criteria for 
participation, contact people and, in many cases, further 
information about the disease and treatment under study. The 
Committee encourages NLM to more widely publicize its products 
and services through all appropriate means.
    Genome information.--The Committee is aware of the 
important role NLM's National Center for Biotechnology 
Information plays in making available information from the 
Human Genome Project and other genome activities. The analytic 
tools created by NCBI contribute to the usability of this 
information, making it possible to understand the differences 
between normal and diseased cells at the molecular level. The 
Committee encourages NLM to consider providing additional 
resources to this important effort.
    Home medical consultations.--The Committee strongly 
encourages NLM to support an expansion of a demonstration 
called for in last year's report to test the use of state-of-
the-art telemedicine technology for home medical consultations. 
This innovative approach could hold great promise for improving 
the care and lowering health care costs for home-bound 
individuals who require frequent monitoring.
    Outreach.--The Committee continues to note the success of 
NLM's MEDLINE database and its new MEDLINE Plus initiative. The 
Committee encourages NLM to continue its outreach activities 
aimed at educating health care professionals and the general 
public about the Library's products and services, in 
coordination with medical librarians and other health 
information specialists.
    PubMed central.--The Committee commends NLM for its 
leadership in establishing PubMed Central, an electronic online 
repository for life science articles. PubMed Central holds 
great promise for increasing access to health care literature 
by health professionals, students, educators, researchers and 
the general public. Because of the high level of expertise 
health information specialists have in the organization, 
collection, and dissemination of medical information, the 
Committee believes that health sciences librarians have a key 
role to play in the further development of PubMed Central. The 
Committee encourages NLM to work with the medical library 
community regarding issues related to copyright, fair use, 
peer-review and classification of information on PubMed 
Central.
    Senior citizen outreach.--The Committee again notes that 
senior citizens would benefit greatly from expanded access to 
NLM's databases and encourages the NLM to take steps to 
consider new ways to improve access for senior citizens, such 
as including Internet access at senior centers and congregate 
meal sites.
    Telemedicine and the next generation internet.--The 
Committee is pleased that NLM remains a world leader in 
supporting the application of computer technology to the 
delivery of health care at a distance and encourages NLM to 
continue its efforts related to medical applications of the 
next generation internet (NGI). This research seeks to improve 
quality, lower costs, and increase effectiveness for delivering 
health care. The Committee commends NLM for its thoughtful 
approach to assuring that, in developing the next generation 
internet, proper attention is given to those unique 
requirements specific to medicine, such as telemedicine, 
digital libraries, and distance learning. The Committee is 
impressed with NLM's success in developing practical 
applications of technology to help hard-to-reach communities. 
Examples include a project that enables remote diagnosing 
middle ear infections in remote areas, thus reducing the use of 
antibiotics and the necessity of evacuating patients; providing 
remote eye screenings in inner cities as a means of identifying 
undiagnosed cases of diabetes; and helping develop patient-
controlled personal medical records systems. The Committee 
believes the NGI will provide affordable secure information 
delivered at rates thousands of times faster than today and 
will accelerate the introduction of new networked services for 
businesses, schools, libraries and homes. The Committee 
believes that it is imperative that health care be a part of 
these efforts.

                         OFFICE OF THE DIRECTOR

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

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

                        BUILDINGS AND FACILITIES

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

    The Committee recommends an appropriation of $148,900,000 
for buildings and facilities [B&F]. The amount recommended is 
the same as the budget request and $23,524,000 more than the 
fiscal year 2000 appropriation.
    Mission.--The buildings and facilities appropriation 
provides for the NIH construction programs including design, 
construction, and repair and improvement of the clinical and 
laboratory buildings and supporting facilities necessary to the 
mission of the NIH. This program maintains physical plants at 
Bethesda, Poolesville, Baltimore, and Frederick, MD; Research 
Triangle Park, NC; Hamilton, MT; Perrine, FL; New Iberia, LA; 
and Sabana Seca, PR.

                        OFFICE OF AIDS RESEARCH

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

    The Committee recommendation does not include a direct 
appropriation for the Office of AIDS Research [OAR] as proposed 
in the budget request. Instead, funding for AIDS research is 
included within the appropriation for each Institute, Center, 
and Division of the NIH. The recommendation also includes a 
general provision which directs that the funding for AIDS 
research, as determined by the Director of the National 
Institutes of Health and the OAR, be allocated directly to the 
OAR for distribution to the Institutes consistent with the AIDS 
research plan. The recommendation also includes a general 
provision permitting the Director of the NIH and the OAR to 
shift up to 3 percent of AIDS research funding among Institutes 
and Centers throughout the year if needs change or 
unanticipated opportunities arise. These modifications to the 
budget recommendation are consistent with the manner in which 
funding for AIDS research was provided in fiscal year 2001. The 
Committee requests that the Director report on the fiscal year 
2001 allocation plans for AIDS research within 60 days of 
enactment and provide notification to the Committee in the 
event the Directors exercise the 3 percent transfer authority.
    The NIH Office of AIDS Research [OAR] coordinates the 
scientific, budgetary, legislative, and policy elements of the 
NIH AIDS research program. Congress provided new authorities to 
the OAR to fulfill these responsibilities in the NIH 
Revitalization Act Amendments of 1993. The law mandates the OAR 
to develop an annual comprehensive plan and budget for all NIH 
AIDS research and to prepare a Presidential bypass budget.
    The Committee was pleased with efforts made by OAR in 
fiscal year 2000 to provide additional funding to address AIDS 
in minority communities, to spearhead projects to bring 
research information to minority communities and to increase 
the number of minority investigators conducting AIDS research.

       Substance Abuse and Mental Health Services Administration

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

    The Committee recommends $2,730,757,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 2001, $78,889,000 more than the fiscal year 2000 
level and $92,259,000 below the administration request. SAMHSA 
is responsible for supporting mental health, alcohol and other 
drug abuse prevention and treatment services throughout the 
country, primarily through categorical grants and block grants 
to States. The Committee has provided funding for the Knowledge 
Development and Application Program to each of three 
authorities: mental health, substance abuse treatment, and 
substance abuse prevention. Separate funding is provided for 
the Children's Mental Health Program, the PATH formula grant, 
the Protection and Advocacy Formula Grant Program, and for the 
two block grant programs.
    The Committee agrees with the President's request to 
establish new targeted capacity expansion line items in the 
areas of substance abuse prevention and treatment. These 
programs are intended to ensure that individuals with substance 
abuse problems can access services employing the best practices 
proven to be effective. Targeted capacity programs are designed 
to provide a rapid and strategic response to newly emerging 
substance abuse trends demonstrated by epidemiological data; to 
address serious and persistent gaps in local service capacity; 
and to address prevention and treatment issues particular to 
certain populations or geographic areas. The Committee intends 
that these programs work in a coordinated fashion with the 
block grants to the States to meet the highest priority service 
needs within the States.
    The Committee remains concerned by the disproportionate 
presence of substance abuse in rural and native communities, 
particularly for American Indian, Alaska Native and native 
Hawaiians communities. The Committee reiterates its belief that 
funds for prevention and treatment programs should be targeted 
to those persons and communities most in need of service. 
Therefore, the Committee has provided sufficient funds to fund 
projects to increase knowledge about effective ways to deliver 
services to rural and native communities. Within the funds 
reserved for rural programs, the Committee intends that 
$8,000,000 be reserved for CSAP grants, and $12,000,000 be 
reserved for CSAT grants.
    The Committee notes that Alaska has the highest rate of 
alcohol dependency in the nation, the highest rate of suicide, 
and the highest rate of child abuse, especially in Native 
communities in Alaska. The Committee urges the agency to work 
with the Alaska Federation of Natives in consultation with the 
State of Alaska to identify the most effective service delivery 
practices and develop model programs for implementation in the 
Alaska Native community.

                   CENTER FOR MENTAL HEALTH SERVICES

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

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

Mental health knowledge development and application

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

Clinical and AIDS training

    The Committee is aware of the need for more trained health 
providers, including allied health professionals and social 
workers, to work with people suffering from HIV/AIDS. To the 
extent that funds are available, the Committee encourages 
SAMHSA to continue funding existing grants and contracts 
approved by SAMHSA under the current AIDS Training Program.
    The Clinical Training Program trains mental health 
personnel to deliver services to designated underserved 
populations in exchange for a repayment through service to 
underserved or priority populations, including severely 
mentally ill adults, children, and adolescents with serious 
emotional disorders, and the elderly. The AIDS Training Program 
provides training for mental health providers to address the 
neuropsychiatric aspects of HIV spectrum infection.
    The Committee recognizes the crucial role that the Minority 
Fellowship Program plays in training mental health 
professionals in providing mental health services for 
individuals who often fail to seek services.

AIDS demonstrations

    This program provides grants to public and nonprofit 
private organizations to provide innovative mental health 
services to individuals who are experiencing severe 
psychological distress and other psychological sequelae as a 
result of infection with HIV. One coordinating center is 
supported to independently evaluate the quality and 
effectiveness of these services. The Committee commends the 
Center for Mental Health Services for its commitment in 
disseminating knowledge gained from these demonstration 
projects. The Committee urges the center to maintain its 
support for projects that provide direct mental health services 
while at the same time using the findings from previous 
projects to develop new knowledge in this area. The Committee 
again commends CMHS for its leadership in working cooperatively 
in demonstrating the efficacy of delivering mental health 
services to individuals affected by and living with HIV/AIDS. 
The Committee encourages the Secretary to maintain these 
agencies' support for this program.

Mental health block grant

    The Committee recommends $366,000,000 for the mental health 
block grant, $10,000,000 more than the fiscal year 2000 amount 
and $50,000,000 less than the President's request. States use 
these funds to support the development and implementation of 
innovative community-based services and maintain continuity of 
community programs. Funds are allocated to States by formula.

Children's mental health

    The Committee recommends $86,763,000 for the Children's 
Mental Health Program, $4,000,000 above the fiscal year 2000 
level and the same as the administration's request. This 
program provides grants and technical assistance to support 
community-based services for children and adolescents with 
serious emotional, behavioral or mental disorders. States must 
provide matching funds, and services must involve the 
educational, juvenile justice, and health systems.

Projects for assistance in transition from homelessness [PATH]

    The Committee recommends $36,883,000 for the PATH Program, 
$6,000,000 more than the fiscal year 2000 amount and $1,000,000 
above the administration's request.
    PATH is a critical program which provides outreach, mental 
health, and case management services and other assistance to 
persons who are homeless and have serious mental illnesses. The 
PATH Program makes a significant difference in the lives of 
homeless persons with mental illnesses. PATH services eliminate 
the revolving door of episodic inpatient and outpatient 
hospital care. Multidisciplinary teams address client needs 
within a continuum of services, providing needed stabilization 
so that mental illnesses and co-occurring substance abuse and 
medical issues can be addressed. Assistance is provided to 
enhance access to housing, rehabilitation and training, and 
other needed supports, assisting homeless people in returning 
to secure and stable lives.

Protection and advocacy

    The Committee recommends $25,903,000 for protection and 
advocacy, $1,000,000 more than the fiscal year 2000 amount and 
the same as the administration's request. This program helps 
ensure that the rights of mentally ill individuals are 
protected while they are patients in treatment facilities and 
for 90 days following their discharge. Funds are allocated to 
States according to a formula based on population and relative 
per capita income.
    The Committee is aware that patients with mental illnesses 
have died or received life-threatening injuries in treatment 
facilities because of improper restraints and seclusion. The 
Committee has provided resources for protection and advocacy so 
that these deaths can be investigated and future incidences can 
be prevented.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

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

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

Substance abuse treatment knowledge development and application and 
        targeted capacity expansion

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

Substance abuse block grant

    The Committee recommends $1,631,000,000 for the substance 
abuse block grant, $31,000,000 more than the comparable fiscal 
year 2000 level and the same as the administration's request.
    The substance abuse block grant provides funds to States to 
support alcohol and drug abuse prevention, treatment, and 
rehabilitation services. Funds are allocated to the States 
according to formula. State plans must be submitted and 
approved annually.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

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

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

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

    The Committee has provided $120,824,000 for the substance 
abuse prevention, knowledge, development, and application 
program [KDA] and the targeted capacity expansion program 
[TCE], $19,000,000 less than the fiscal year 2000 amount and 
$14,405,000 less than the administration's request.
    The Committee has included $7,000,000 for the purpose of 
making grants to public and nonprofit private entities for 
projects to demonstrate effective models for the prevention, 
treatment, and rehabilitation of drug abuse and alcohol abuse 
among high risk youth, as authorized by section 517 of the 
Public Health Service Act as amended. The Committee is highly 
concerned about the extent of substance abuse among high risk 
youth. This population is vulnerable to initiating criminal 
activity against people and property, especially following the 
acute and chronic use of illicit substances and the abuse of 
alcohol. These grants are intended to strengthen local 
capabilities in confronting the complex interrelationships 
between substance and alcohol abuse and other activities that 
may predispose young individuals toward criminal, self-
destructive, or antisocial behavior.
    The Committee expects that States receiving funding under 
the State Incentive Grant Program will give priority in the use 
of the 20 percent prevention set-aside in the block grant to: 
(1) working with community coalitions to develop communitywide 
strategic plans and needs assessments; and (2) filling program 
and service gaps identified by these community plans.
    The Committee reiterates its concern about the 
disproportionate impact of substance abuse in rural and native 
communities, and has included $8,000,000 for CSAP programs 
which serve rural communities. The Committee intends this 
increase to be reasonably allocated between expanding existing 
programs and initiating new programs, especially in Alaska.
    The Committee believes that prevention programs need to 
start when children are young, and need to continue to allow 
children to make successful transitions. The Committee has 
included sufficient funds for evaluations of established 
school-based early prevention and transition programs and 
continues to be supportive of the efforts of the Corporate 
Alliance for Drug Education [CADE] which has been operating a 
program providing education and prevention services to 120,000 
elementary school-aged children in Philadelphia.
    Within the funds available, the Committee urges CSAP to 
continue the national effort to provide alcohol and substance 
abuse prevention and education to children of native Americans 
with alcoholism.
    The Committee acknowledges the innovative Drug Free 
Families initiative at the University of Missouri-St. Louis in 
providing a comprehensive school-based health and drug abuse 
prevention program that involves parents and targets middle and 
high school students.
    The Committee encourages CSAP to continue support for 
alcohol and substance abuse prevention and education targeting 
Native American children of alcoholics through the National 
Association for Native American Children of Alcoholics 
headquartered in Washington State. The rates for alcohol-
related deaths among American Indians is seven times the rate 
for the general population. Efforts to prevent the 
multigenerational effects of alcohol and substance abuse in 
Indian communities should continue.

                           PROGRAM MANAGEMENT

    The Committee recommends $59,943,000 for program management 
activities of the agency, the same as the President's request 
and $889,000 more than the 2000 level.
    The program management activity includes resources for 
coordinating, directing, and managing the agency's programs. 
Program management funds support salaries, benefits, space, 
supplies, equipment, travel, and departmental overhead required 
to plan, supervise, and administer the programs.

               Agency for Healthcare Research and Quality

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

    The Committee recommends $269,943,000 for the Agency for 
Healthcare Research and Quality [AHRQ]. The Committee provides 
these funds through transfers available under section 241 of 
the Public Health Service Act.
    The Agency for Healthcare Research and Quality was 
established in 1990 to promote improvements in clinical 
practice and patient outcomes, promote improvements in the 
financing, organization, and delivery of health care services, 
and increase access to quality care. AHRQ is the Federal agency 
charged to produce and disseminate scientific and policy-
relevant information about the cost, quality, access, and 
medical effectiveness of health care. AHRQ provides 
policymakers, health care professionals, and the public with 
the information necessary to improve cost effectiveness and 
appropriateness of health care and toreduce the costs of health 
care.

                  Health Costs, Quality, and Outcomes

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

                        MEDICAL ERRORS REDUCTION

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

State reporting

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

Health system demos

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

Research and training

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

                   medical expenditures panel surveys

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

Program support

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

                  Health Care Financing Administration


                     GRANTS TO STATES FOR MEDICAID

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

    The Committee recommends $93,586,251,000 for grants to 
States for Medicaid. This amount is $7,498,858,000 more than 
the fiscal year 2000 appropriation and the same as the 
administration's request. This amount excludes $30,589,003,000 
in fiscal year 2000 advance appropriations for fiscal year 
2001. In addition, $36,207,551,000 is provided for the first 
quarter of fiscal year 2002, as requested by the 
administration.
    The Medicaid Program provides medical care for eligible 
low-income individuals and families. It is administered by each 
of the 50 States, the District of Columbia, Puerto Rico, and 
the territories. Federal funds for medical assistance are made 
available to the States according to a formula which determines 
the appropriate Federal matching rate for State program costs. 
This matching rate, which may range from 50 to 90 percent, is 
based upon the State's average per capita income relative to 
the national average.
    The Committee is pleased with HCFA's proposal to provide 
demonstration grants to States to test innovative asthma 
disease management techniques for children enrolled in 
Medicaid.
    The Committee understands that HCFA has revised its 
Medicaid screening and reimbursement policy for childhood lead 
poisoning testing. The Committee urges HCFA to monitor the 
impact of these policy changes and to take every appropriate 
step to ensure that screening rates among children enrolled in 
Medicaid are substantially increased. Moreover, the Committee 
continues to encourage HCFA to consider the development of new 
screening technologies that have the potential to significantly 
increase screening rate when evaluating its reimbursement 
policy.
    The Committee is pleased with the progress of the 
Mississippi Medicaid disease State management plan approved by 
HCFA in 1998 that allows reimbursement of pharmacists working 
under protocol of physicians to manage patients with certain 
chronic diseases. The Committee urges HCFA to consider 
extension of a demonstration project for the Mississippi 
Medicare population. The Committee expects HCFA to continue to 
provide demonstration grants to States for the extension of 
disease State management programs to Medicare demonstration 
projects, giving priority to States with established Medicaid 
models.
    The Committee is aware of the proposed modification by HCFA 
in determining the eligibility status for Medicaid of 
individuals who migrate to Hawaii under the provisions of the 
Compact of Free Association. The State of Hawaii has no control 
over its borders. Thus, there remains a clear Federal 
responsibility for the health of these individuals. 
Accordingly, HCFA should continue its negotiations with the 
appropriate State authorities and inform the Committee of its 
deliberations, prior to making any modifications.
    The Committee is aware that HCFA and the State of Arkansas 
are in consultation on a Medicaid waiver granted in 1999 for 
the ARKids First program. The Committee directs HCFA to work 
with the State to resolve all issues related to this waiver and 
provide the Committee with a status report by June 15, 2000. 
The Committee will monitor these negotiations and take further 
action, if necessary, as the bill moves through the 
appropriations process.

                  PAYMENTS TO HEALTH CARE TRUST FUNDS

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

    The Committee recommends $70,381,600,000 for Federal 
payments to the Medicare trust funds. This amount is the same 
as the administration's request and is an increase of 
$1,092,500,000 from the fiscal year 2000 appropriation.
    This entitlement account includes the general fund subsidy 
to the supplementary medical insurance trust fund (Medicare 
part B), plus other reimbursements to the hospital insurance 
trust fund (Medicare part A), for benefits and related 
administrative costs which have not been financed by payroll 
taxes or premium contributions.
    The Committee has provided $69,777,000,000 for the Federal 
payment to the supplementary medical insurance trust fund. This 
payment provides matching funds for premiums paid by Medicare 
part B enrollees. This amount is the same as the administration 
request, and is $1,087,000,000 more than the fiscal year 2000 
amount.
    The recommendation also includes $321,000,000 for hospital 
insurance for the uninsured. This amount is the same as the 
administration's request and is $28,000,000 less than the 2000 
amount.
    The Committee also recommends $132,000,000 for the Federal 
uninsured benefit payment. This payment reimburses the hospital 
insurance trust fund for the cost of benefits provided to 
Federal annuitants who are eligible for Medicare. This amount 
is the same as the administration's request and is $11,000,000 
more than the fiscal year 2000 appropriation.
    The Committee recommendation includes $151,600,000 to be 
transferred to the hospital insurance trust fund as the general 
fund share of HCFA's program management administrative 
expenses. This amount is the same as the administration's 
request and is $22,500,000 less than the fiscal year 2000 
level.

                           PROGRAM MANAGEMENT

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

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

Research, demonstrations, and evaluation

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

Medicare contractors

    The Committee recommends $1,244,000,000 for Medicare 
contractors, which is $57,287,000 less than the 
administration's request and the same as the comparable fiscal 
year 2000 appropriation. This recommendation does not include 
user fees proposed by the administration, to charge Medicare 
providers for processing paper claims and duplicate or 
unprocessable claims. In addition, $680,000,000 is available 
for the Medicare Integrity Program within the mandatory budget, 
an increase of $50,000,000 over the fiscal 2000 level.
    Medicare contractors, who are usually insurance companies, 
are responsible for reimbursing Medicare beneficiaries and 
providers in a timely fashion and a fiscally responsible 
manner. These contractors also provide information, guidance, 
and technical support to both providers and beneficiaries.
    The Committee agrees that contracts with States for health 
advisory services programs for Medicare beneficiaries is an 
allowable activity under the Medicare contractor beneficiary 
services budget, and recommends maintaining funding for this 
activity in fiscal year 2001. These contracts would provide 
assistance, counseling, and information activities relating to 
Medicare matters as well as Medicare supplemental policies, 
long-term care insurance, and other health insurance benefit 
information.

State survey and certification

    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety, and program 
standards. Onsite surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys.
    The Committee recommends $219,674,000 for Medicare State 
survey and certification activities, an increase of $15,000,000 
over the fiscal year 2000 level.

Federal administration

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

Medicare+Choice

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

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

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

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

               low-income home energy assistance program

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

    The Committee recommendation maintains funding for LIHEAP 
at $1,100,000,000, the same as the fiscal year 2000 
appropriation, and the same as the budget request. The 
Committee has not included an advance for fiscal year 2002.
    LIHEAP grants are awarded to the States, territories, and 
Indian tribes to assist low-income households in meeting the 
costs of home energy. States receive great flexibility in how 
they provide assistance, including direct payments to 
individuals and vendors and direct provision of fuel. LIHEAP 
grants are distributed by a formula defined by statute, based 
in part on each State's share of home energy expenditures by 
low-income households nationwide.
    The Committee recommendation for the total funding amount 
for LIHEAP includes an emergency allocation of up to 
$300,000,000 to be made available, only upon submission of a 
formal request designating the need for the funds as an 
emergency, as defined by the Balanced Budget and Emergency 
Deficit Control Act. This is the same level as the emergency 
allocation available in fiscal year 2000.
    The Committee intends that up to $27,500,000 of the amounts 
appropriated for LIHEAP for fiscal year 2001 be used for the 
leveraging incentive fund, which will provide a percentage 
match to States for private or non-Federal public resources 
allocated to low-income energy benefits.
    Total funding for fiscal year 2002 will be included as part 
of the fiscal year 2002 bill.

                     refugee and entrant assistance

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

    The Committee recommends $425,586,000 for refugee and 
entrant assistance, $305,000 less than the fiscal year 2000 
level and $6,983,000 below the budget request.
    Based on an estimated refugee admission ceiling of 116,000, 
this appropriation, together with bill language allowing prior-
year funds to be available for 2001 costs, will enable States 
to continue to provide at least 8 months of cash and medical 
assistance to refugees and entrants, as well as foster care for 
refugee and entrant unaccompanied minors.
    The Refugee Assistance Program is designed to assist States 
in their efforts to assimilate refugees into American society 
as quickly and effectively as possible. The program funds 
State-administered cash and medical assistance, the voluntary 
agency matching grant program, employment services, targeted 
assistance, and preventive health.
    In order to carry out the program, the Committee recommends 
$220,693,000 for transitional and medical assistance, including 
State administration and the voluntary agency program; 
$143,316,000 for social services; $4,835,000 for preventive 
health; and $49,477,000 for targeted assistance.
    Section 412(a)(7) of title IV of the Immigration and 
Nationality Act authorizes the use of funds appropriated under 
this account to be used to carry out monitoring, evaluation, 
and data collection activities to determine the effectiveness 
of funded programs and to monitor the performance of States and 
other grantees.
    The Committee recommends $7,265,000 to treat and assist 
victims of torture. These funds may also be used to provide 
training to healthcare providers to enable them to treat the 
physical and psychological effects of torture. The Committee 
believes that the Department should use the funds provided for 
torture victims relief in a way that can provide the greatest 
impact. One way to do this is to consider funding organizations 
specifically established to address the rehabilitation and 
social services needs of these victims.

                 child care and development block grant

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

    The Committee recommendation provides an additional 
$817,328,000 for child care services, together with the 
$1,182,672,000 provided for fiscal year 2001 in last year's 
bill, raises the funding level for this program to 
$2,000,000,000 for fiscal year 2001.
    These funds provide grants to States to provide low-income 
families with financial assistance for child care; for 
improving the quality and availability of child care; and for 
establishing or expanding child development programs. The funds 
are used to both expand the services provided to individuals 
who need child care in order to work or attend job training or 
education and allow States to continue funding the activities 
previously provided under the consolidated programs.
    The bill provides that $19,120,000 of the amount 
appropriated shall be for the purposes of supporting resource 
and referral programs and before and afterschool services. This 
represents the Federal commitment to the activities previously 
funded under the dependent care block grant. The Committee 
further expects that these funds will not supplant current 
funding dedicated to resource and referral and school age 
activities provided by the child care and development block 
grant. The Committee strongly encourages States to address the 
matters of before and afterschool care and the establishment of 
resource and referral programs with the funds provided in this 
program. The Committee recommendation includes $60,000,000 for 
an infant care quality initiative.
    The Committee understands that the National Association of 
Child Care Resource and Referral Agencies is currently 
operating Child Care Aware, the national toll-free information 
hotline, which links families to local child care services and 
programs. The Committee recognizes that funding from the 
resource and referral programs would allow the Association to 
continue to provide this critical assistance to parents 
returning to the workforce.
    The Committee is aware of the shortage of trained early 
childhood workers in Alaska, denying Alaskan children the 
opportunity for stimulating and appropriate childcare in the 
critical early years of zero to six. The Committee notes that 
the University of Alaska and the State of Alaska are proposing 
to train early childhood workers from communities throughout 
Alaska.
    The Committee has not included an advance for fiscal year 
2002. Total funding for fiscal year 2002 will be included as 
part of the fiscal year 2002 bill.

                      social services block grant

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

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

                children and families services programs

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

    The Committee recommends an appropriation of $7,881,586,000 
for children and families services programs. This is 
$75,869,000 more than the administration request and 
$1,052,595,000 more than the fiscal year 2000 appropriation.
    This appropriation provides funding for programs for 
children, youth, and families, the developmentally disabled, 
and Native Americans, as well as Federal administrative costs.

Head Start

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

Runaway and homeless youth

    The Committee recommends $46,152,000 for this program, an 
increase of $2,500,000 above the fiscal year 2000 level and the 
same as the administration request. The Committee has also 
provided an additional $14,999,000 from the violent crime 
reduction program.
    This program addresses the crisis needs of runaway and 
homeless youth and their families through support to local and 
State governments and private agencies. The Runaway and 
Homeless Youth Act requires that 90 percent of the funds be 
allocated to States for the purpose of establishing and 
operating community-based runaway and homeless youth centers, 
on the basis of the State youth population under 18 years of 
age in proportion to the national total. The remaining 10 
percent funds networking and research and demonstration 
activities including the National Toll-Free Communications 
Center. Consolidated within this line item is the transitional 
living for homeless youth program, which awards grants to 
public and private nonprofit entities to address the shelter 
and service needs of homeless youth. Grants are used to develop 
or strengthen community-based programs which assist homeless 
youth in making a smooth transition to productive adulthood and 
social self-sufficiency; and to provide technical assistance to 
transitional living programs for the acquisition and 
maintenance of resources and services.
    The Committee is aware of the progress of the California 
Child, Youth, and Family Coalition in providing runaway and 
homeless youth with a safe place to sleep, food and clothing, 
counseling, educational opportunities, and job training.

Runaway youth--transitional living

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

Child abuse prevention programs

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

Abandoned infants assistance

    The Committee concurs with the budget request in 
recommending an appropriation of $12,207,000 for abandoned 
infants assistance, the same as the 2000 level and the 
administration request. This program provides financial support 
to public and private entities to develop, implement, and 
operate demonstration projects that will prevent the 
abandonment of infants and young children. Grants provide 
additional services such as identifying and addressing the 
needs of abandoned infants, especially those who are drug 
exposed or HIV positive; providing respite care for families 
and care givers; and assisting abandoned infants and children 
to reside with their natural families or in foster care.

Child welfare

    The Committee recommends an appropriation of $291,986,000 
for child welfare services, the same as the administration 
request and the 2000 level. This program helps State public 
welfare agencies improve their child welfare services with the 
goal of keeping families together. State services include: 
preventive intervention, so that, if possible, children will 
not have to be removed from their homes; reunification so that 
children can return home and development of alternative 
placements like foster care or adoption if children cannot 
remain at home.
    For child welfare training, the Committee recommends 
$7,000,000, the same as the administration request. Under 
section 426, title IV-B discretionary grants are awarded to 
public and private nonprofit institutions of higher learning to 
develop and improve education/training programs and resources 
for child welfare service providers. These grants upgrade the 
skills and qualifications of child welfare workers.
    The Committee supports efforts by colleges and universities 
to enroll American Indian and/or Alaska Natives in masters 
degree programs in social work. The Committee recognizes the 
need to provide field practicum placements of masters degree 
candidates in Indian reservation and rural Indian community 
settings.

Adoption opportunities

    The Committee recommends $27,419,000 for adoption 
opportunities, the same as the fiscal year 2000 level and the 
administration request. This program eliminates barriers to 
adoption and helps find permanent homes for children who would 
benefit by adoption, particularly children with special needs. 
Since the Committee recommendation exceeds $5,000,000, grants 
for placement of minority children and postlegal adoption 
services, as well as grants for improving State efforts to 
increase placement of foster children legally free for 
adoption, should be made, as required by law.
    The Committee recognizes that, under the Adoption and Safe 
Families Act, States are required to use all available 
resources to find homes for children. The Committee is aware 
that the National Adoption Center operates a multi-state, 
technology-based adoption clearinghouse to facilitate placement 
of needy children with adoptive parents.
    The Committee understands that the Department plans to 
implement a national adoption photo listing service on the 
internet to help increase the number of adoptions. The 
Committee supports the idea that a national web site could 
include all youngsters available in public adoptions and will 
increase the likelihood that children will find loving, stable 
homes. The National Adoption Center has been at the forefront 
of developing and implementing technology-based resources to 
help facilitate adoptions and could be instrumental in creating 
a national adoption web site.

Adoption incentives

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

Social services research

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

Community-based resource centers

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

Developmental disabilities

    The Committee recommends $127,347,000 for developmental 
disabilities programs, which is $5,019,000 higher than the 
request. The Administration on Developmental Disabilities 
supports community-based delivery of services which promote the 
rights of persons of all ages with developmental disabilities. 
Developmental disability is defined as severe, chronic 
disability attributed to mental or physical impairments 
manifested before age 22, which causes substantial limitations 
in major life activities.
    The Committee has recently learned that persons with 
developmental disabilities have died or received life-
threatening injuries because of improper restraints and 
seclusion. The Committee has provided additional resources to 
programs serving the developmentally disabled to help prevent 
the occurrence of any future incidences.
    The Committee understands that Parent to Parent of Vermont 
in Winooski, Vermont plans to establish a Family Faculty 
Institute to train primary care physicians in family centered 
health and to recruit and train respite care providers.

State councils

    For State councils, the Committee recommends $65,803,000. 
In 1987, the Developmental Disabilities Act changed the focus 
of State councils from services provision and demonstration to 
planning and services coordination directed to effecting 
systems change. Since that time, the States have been shifting 
away from their original role of services provision to their 
current mission to effect system change on behalf of persons 
with developmental disabilities.

Protection and advocacy grants

    For protection and advocacy grants, the Committee 
recommends $31,000,000. This formula grant program provides 
funds to States to establish protection and advocacy systems to 
protect the legal and human rights of persons with 
developmental disabilities who are receiving treatment, 
services, or rehabilitation within the State.

Projects of national significance

    The Committee recommends $10,244,000 for projects of 
national significance to assist persons with developmental 
disabilities. This program funds grants and contracts providing 
nationwide impact by developing new technologies and applying 
and demonstrating innovative methods to support the 
independence, productivity, and integration into the community 
of persons with developmental disabilities.
    The Committee recognizes the work of the Family Friends 
program in training senior volunteers to provide respite to 
families whose members have disabilities. The Committee 
believes that additional funds from the Department will assist 
in the development of a Family Friends pilot project to provide 
technical assistance and training in the application of the 
successful Family Friends volunteer respite care model to the 
needs of aging parents of adult individuals with developmental 
disabilities.
    The Committee recognizes the efforts of the Special 
Learning Center in Jefferson City, Missouri in seeking 
innovative ways to provide a variety of services to children 
with developmental problems or disabilities.

University-affiliated programs

    For university-affiliated programs, the Committee 
recommends $20,300,000. This program provides operational and 
administrative support for a national network of university-
affiliated programs and satellite centers. Grants are made 
annually to university-affiliated programs and satellite 
centers for interdisciplinary training, exemplary services, 
technical assistance, and information dissemination activities.

Native American programs

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

Community services

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

Violent crime reduction programs

    The Committee recommends $134,074,000 for violent crime 
reduction programs, the same as the fiscal year 2000 
appropriation. The Committee notes that an additional 
$50,225,000 for crime bill activities is provided under the 
Centers for Disease Control and Prevention.
    For the runaway youth prevention program, the Committee 
recommends $14,999,000, which is the same as the fiscal year 
2000 appropriation and the administration request. This is a 
discretionary grant program open to private nonprofit agencies 
for the provision of services to runaway, homeless, and street 
youth. Funds may be used for street-based outreach and 
education, including treatment, counseling, provision of 
information, and referrals for these youths, many of whom have 
been subjected to or are at risk of being subjected to sexual 
abuse.
    For the national domestic violence hotline, the Committee 
recommends $2,157,000, which is the same as the administration 
request. This is a cooperative agreement which funds the 
operation of a national, toll-free, 24-hours-a-day telephone 
hotline to provide information and assistance to victims of 
domestic violence.
    The Committee recommends $116,918,000 for the grants for 
battered women's shelters program, $15,800,000 above the fiscal 
year 2000 program level. This is a formula grant program to 
support community-based projects which operate shelters for 
victims of domestic violence. Emphasis is given to projects 
which provide counseling, advocacy, and self-help services to 
victims and their children.

Program administration

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

                   promoting safe and stable families

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

    The Committee recommends $305,000,000 for fiscal year 2001, 
the same as the amount requested by the administration and 
$10,000,000 above the fiscal year 2000 level. These funds will 
support: (1) community-based family support services to assist 
families before a crisis arises; and (2) innovative child 
welfare services such as family preservation, family 
reunification, and other services for families in crisis. These 
funds include resources to help with the operation of shelters 
for abused and neglected children, giving them a safe haven, 
and providing a centralized location for counseling.

       payments to states for foster care and adoption assistance

Appropriations, 2000....................................  $5,697,300,000
Budget estimate, 2001...................................   6,406,100,000
Committee recommendation................................   6,406,100,000

    The Committee recommends $6,406,100,000 for this account, 
which is the same as the budget request and $708,800,000 more 
than the 2000 comparable level. Also included is the 
administration's request of $1,735,900,000 for an advance 
appropriation for the first quarter of fiscal year 2002 as 
requested by the administration. The Foster Care Program 
provides Federal reimbursement to States for: maintenance 
payments to families and institutions caring for eligible 
foster children, matched at the Federal medical assistance 
percentage [FMAP] rate for each State; and administration and 
training costs to pay for the efficient administration of the 
Foster Care Program, and for training of foster care workers 
and parents.
    The Adoption Assistance Program provides funds to States 
for maintenance costs and the nonrecurring costs of adoption 
for children with special needs. The goal of this program is to 
facilitate the placement of hard-to-place children in permanent 
adoptive homes, and thus prevent long, inappropriate stays in 
foster care. As in the Foster Care Program, State 
administrative and training costs are reimbursed under this 
program.

                        Administration on Aging

Appropriations, 2000....................................    $932,848,000
Budget estimate, 2001...................................   1,083,619,000
Committee recommendation................................     954,619,000

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

Supportive services and senior centers

    The Committee recommends an appropriation of $325,082,000 
for supportive services and senior centers, $125,000,000 less 
than the administration and $15,000,000 more than the amount 
appropriated in fiscal year 2000. The increased funding will 
provide additional in-house services for frail older 
individuals. This State formula grant program funds a wide 
range of social services for the elderly, including 
multipurpose senior centers and ombudsman activities. State 
agencies on aging award funds to designated area agencies on 
aging who in turn make awards to local services providers. All 
individuals age 60 and over are eligible for services, 
although, by law, priority is given to serving those who are in 
the greatest economic and social need, with particular 
attention to low-income minority older individuals. Under the 
basic law, States have the option to transfer up to 20 percent 
of funds appropriated between the senior centers program and 
the nutrition programs which allows the State to determine 
where the resources are most needed.

Ombudsman/elder abuse

    The Committee recommends $9,449,000 for the ombudsman 
services program and $4,732,000 for the prevention of elder 
abuse program. The amount recommended for the ombudsman 
services program is $1,000,000 more than the fiscal year 2000 
level. The amount recommended for the elder abuse prevention 
program is the same as the fiscal year 2000 level. Both 
programs provide formula grants to States to prevent the abuse, 
neglect, and exploitation of older individuals. The ombudsman 
program focuses on the needs of residents of nursing homes and 
board and care facilities, while elder abuse prevention targets 
its message to the elderly community at large.
    The Committee supports continued and additional funding for 
the long-term care ombudsman resource center and its training 
and clearinghouse functions, which provide information, 
technical assistance, programmatic, and other support for State 
and regional long-term care ombudsmen.

Preventive health services

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

Congregate and home-delivered nutrition services

    For congregate nutrition services, the Committee recommends 
an appropriation of $374,412,000, the same amount as the budget 
request and the amount appropriated in fiscal year 2000. For 
home-delivered meals, the Committee recommends $147,000,000, 
the same as the amount recommended by the administration and 
the amount appropriated in fiscal year 2000. These programs 
address the nutritional need of older individuals. Projects 
funded must make home-delivered and congregate meals available 
at least once a day, 5 days a week, and each meal must meet 
one-third of the minimum daily dietary requirements. While 
States receive separate allotments of funds for congregate and 
home-delivered nutrition services and support services, they 
are permitted to transfer up to 30 percent of funds between 
these programs.
    The Committee has included a provision carried in last 
year's bill which requires the Assistant Secretary to provide 
the maximum flexibility to applicants who seek to take into 
account subsistence, local customs, and other characteristics 
that are appropriate to the unique cultural, regional, and 
geographic needs. The provision clarifies that applicants who 
serve American Indian, native Hawaiian, and Alaska Native 
recipients in highly rural and geographically isolated areas 
are permitted to continue to tailor nutrition services that are 
appropriate to the circumstances associated with the served 
population.

In-home services for frail older individuals

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

Aging grants to Indian tribes and native Hawaiian organizations

    The Committee recommends $23,457,000 for grants to Indian 
tribes, the same amount as the budget request and $5,000,000 
above the amount appropriated in fiscal year 2000. Under this 
program awards are made to tribal and Alaskan Native 
organizations and to public or nonprofit private organizations 
serving native Hawaiians which represent at least 50 percent 
Indians or Alaskan Natives 60 years of age or older to provide 
a broad range of services and assure that nutrition services 
and information and assistance services are available.

State and local innovations/projects of national significance

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

Alzheimer's Disease Demonstration Grants to States

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

National Family Caregiver Support

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

Health Disparities Interventions

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

Program administration

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

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

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

    The Committee recommends $212,617,000 for general 
departmental management [GDM]. This is $16,975,000 below the 
administration request and $18,807,000 below the fiscal year 
2000 level, which included new funding from an emergency fund. 
Within this amount, the Committee includes the transfer of 
$5,851,000 from Medicare trust funds, which is the same as the 
administration request and the fiscal year 2000 level.
    This appropriation supports those activities that are 
associated with the Secretary's role as policy officer and 
general manager of the Department. It supports certain health 
activities performed by the Office of Public Health and 
Science, including the Office of the Surgeon General. GDM funds 
also support the Department's centralized services carried out 
by several Office of the Secretary staff divisions, including 
personnel management, administrative and management services, 
information resources management, intergovernmental relations, 
legal services, planning and evaluation, finance and 
accounting, and external affairs.
    The Office of the Surgeon General, in addition to its other 
responsibilities, provides leadership and management oversight 
for the PHS Commissioned Corps, including the involvement of 
the Corps in departmental emergency preparedness and response 
activities.
    Last year, the Committee expressed its concern over the 
fact that the Surgeon General does not have direct authority 
over all PHS officers, and the impact that lack of authority 
may have on the ability of the Corps to respond to biosecurity 
or other emergency situations. The Committee urges the 
Secretary to review this situation and act to ensure that, in 
the event of a biosecurity incident or other national 
emergency, the Surgeon General has the necessary authority to 
direct the response of all Commissioned Corps officers, 
regardless of the agency to which the officer is assigned.
    U.S.-Mexico Border Health Commission.--The Committee has 
provided $2,000,000 to support the activities of the United 
States-Mexico Border Health Commission as authorized by Public 
Law 103-400. The Commission is authorized to assess and resolve 
current and potential health problems that affect the general 
population of the United States-Mexico border area. The 
Committee again encourages the Commission and the Secretary to 
support the effort underway at the Baylor College of Dentistry 
to study, diagnose, and treat craniofacial deformities of U.S./
Mexico border residents, which represents the kind of 
collaborative academic and clinical effort that could be 
pursued by the Commission in the future.
    Leadership for the National Suicide Prevention Strategy.--
The Committee is pleased with the leadership of the Surgeon 
General in issuing the Call to Action to Prevent Suicide and 
the subsequent successful effort to bring together suicide 
prevention experts, advocates, and practitioners to develop a 
National Strategy for the Prevention of Suicide with a timeline 
for its progress and completion. The Committee notes that 
several Public Health Agencies including NIH, CDC, HRSA and 
SAMHSA are involved in this effort and the Committee expects 
the Office of the Assistant Secretary for Public Health-Surgeon 
General to continue to lead and coordinate this effort through 
the implementation phase. The Committee requests that the 
National Strategy for the Prevention of Suicide along with the 
specific action steps and the associated fiscal year 2001 and 
2002 resources for each of the participating public health 
agencies be submitted to the Committee along with the 
submission of the President's fiscal year 2002 budget.
    The Committee commends the Secretary's recent action to 
convene a National Suicide Prevention Strategy Steering Group 
to begin work on a National Suicide Prevention Strategy (NSPS). 
The Committee appreciates the fact that an effective NSPS 
requires broad collaboration between the Federal Government and 
the private sector. Past experience has shown that broad 
involvement is critical for implementation of effective suicide 
prevention programs. The Committee believes that SPAN USA could 
play an important role in the development of an NSPS.
    The Committee has included funding for the Human Services 
Transportation Technical Assistance Program. As in previous 
years, this program is to be administered by a national 
membership organization with expertise in working with local 
transit organizations. The program provides technical 
assistance and training to organizations that provide 
transportation services to the elderly, people with physical 
and developmental disabilities, and the economically 
disadvantaged. With these funds, the Committee expects a 
continued emphasis on assisting communities with transportation 
issues related to welfare reform since in many rural 
communities the largest obstacle in gaining employment is 
transportation to work sites. The Committee further expects the 
technical assistance to be provided include developing 
strategies for cost-effective transportation under Medicaid. 
The Committee also notes that the technical assistance provided 
by the Community Transportation Association of America is vital 
to the success of this project. To improve coordination, the 
Committee will expect that the funds made available under this 
program be allocated to a national membership organization with 
a demonstrated record of achievement in this area.
    The Committee reiterates its support of the Chronic Fatigue 
Syndrome Coordinating Committee [DHHS CFSCC]. The Committee 
urges the DHHS CFSCC to coordinate CFIDS research across the 
Public Health Service by defining priorities and creating a 
yearly action plan.
    The yearly action plan should focus attention on expanding 
research on CFS, augment health care provider education, and 
execute the CFSCC's charter to provide coordination and ensure 
accountability of the federal agencies' CFS programs. The 
Committee also urges DHHS and the agencies represented on the 
CFSCC to take a leadership role in informing health care 
professionals and the general public about CFS, focusing on the 
prevalent and serious nature of CFS. The Committee believes 
that it is important that the Secretary and the Surgeon General 
undertake a prominent educational campaign to inform the public 
that CFS is a serious, prevalent and disabling illness. The 
Committee is pleased that during fiscal year 2001 
Appropriations Hearings, the Secretary committed to ensuring 
that the accounts of CFS research activity and spending 
reported to Congress are thorough and accurate. The Committee 
directs the Secretary to ensure that all of the Public Health 
Service agencies' CFS research programs are effective and 
ambitious. The Committee understands that the General 
Accounting Office (GAO) is studying and reporting on overall 
CFS activities at CDC and expects that the Secretary will 
respond swiftly to correct problems revealed by the GAO study.
    Cancer registries.--The Committee understands that cancer 
registries monitor trends in cancer--by site of the cancer, age 
and ethnicity of the patient, geographic region, and treatment 
outcome. Enhancing statewide cancer registries and providing 
national support for quality assurance and reporting standards 
ensures that critical information on cancer trends and outcomes 
is available. It has been brought to the Committee's attention 
that inadequate resources and a changing health care 
environment have strained cancer registries around the country, 
limiting the States' ability to collect data; forcing certain 
data (e.g., occupational history) to be no longer collected; 
and in some cases, forcing the closure of regional cancer 
registries. The Committee encourages increasing the support for 
these registries in order to enable States to more aggressively 
utilize State cancer data integrating the registries into their 
cancer prevention and control programs. The Committee also 
encourages NIH to work with CDC, the States and national 
organizations on this issue.
    The Committee is supportive of efforts by the Secretary to 
give priority to projects that will promote the development of 
a national strategy for the prevention of alcohol-related birth 
defects and for the provision and coordination of appropriate 
interventions for affected individuals and their families. The 
Committee recognizes the prevalence of secondary disabilities 
among those with alcohol-related birth defects, including 
interaction with the criminal justice system, mental health 
problems, failure to live independently, and difficulties in 
school. The Committee understands that many of these secondary 
disabilities can be prevented, and it supports grant projects 
that will improve our ability to help children and families 
minimize the impact of alcohol-related birth defects. The 
Committee urges the Secretary to target appropriate funding to 
areas that demonstrate significant need and a high incidence or 
risk of alcohol-related birth defects. Special consideration 
could be given to Native American applicants, with recognition 
of the value of non-traditional or culturally-based treatment 
methods and reservation-based substance abuse treatment 
services. The Committee also urges the National Institute of 
Alcohol Abuse and Alcoholism, the Centers for Disease Control, 
the Indian Health Service and the Substance Abuse and Mental 
Health Services Administration to work collaboratively on 
administration of the grant program.
    The Committee is pleased that a representative of the 
primary immune deficiency community has been appointed to the 
Department's Advisory Committee on Blood Safety and 
Availability. The Committee encourages the Advisory Committee 
to continue to address the longstanding shortage of intravenous 
immune globulin (IGIV), a pooled plasma derivative that primary 
immune deficient patients need to maintain their health.
    Delivery of Healthcare.--The health care industry in Alaska 
is a major employer in Alaska, but there currently is no 
capacity to evaluate health care delivery and training needs 
for health care workers in order to use this information to 
improve the health status of Alaskans. The Committee encourages 
the Department to consider funding a project to evaluate and 
assess on a statewide basis the health care delivery and 
training needs in Alaska. The Committee is aware of the 
University of Alaska's capabilities for undertaking such a 
project.
    The Committee encourages the development of an innovative 
service delivery model and day health center facility to care 
for the elderly. The Committee recognizes the multi-
disciplinary management program operated by the Albert Einstein 
Healthcare Network in Philadelphia, PA.
    The Committee is aware of the planned project, supported by 
a consortium including the Texas A&M Health Science Center, 
Texas A&M Colleges of Veterinary Medicine and Engineering, 
Texas Children's Hospital, and the Baylor College of Medicine, 
to establish a national institute for the study of 
cardiovascular disease and the development of associated 
biomedical devices.
    The Committee urges the Secretary to consider consulting 
with the National Academy of Sciences to provide an evaluation 
on childrens' health. This evaluation could assess the adequacy 
of currently available methods for assessing risks to children, 
identify scientific uncertainties associated with these 
methods, and develop a prioritized research agenda to reduce 
such uncertainties and improve risk assessment for children's 
health and safety.
    The Committee is aware of a model initiative by Delta State 
University which plans to focus on the developmental needs of 
children beginning at birth until kindergarten enrollment. The 
plan will consider the intellectual, social, psychological, and 
physical development of children in the Mississippi Delta. The 
Committee understands that a key aspect of this model will be 
to address the parenting needs of mothers and fathers regarding 
child rearing, nutrition, healthcare, and child development.
    Reducing IV medication errors.--The Committee is aware of 
efforts by Harvard clinical Technology, Inc. to reduce medical 
errors by developing an automated drug infusion system that 
uses a bar code on the medication to determine appropriate 
dosages.
    The Committee is aware of a program called Children's 
Health Life Skills Initiative as proposed by UNC Chapel Hill, 
UNC Greensboro, NC A&T, NC State, East Carolina University, and 
Appalachian State University.
    The Committee is aware of the interest in an integrative 
medicine program which combines conventional medical science 
with promising alternative therapies.
    The Committee recognizes the unique programs being 
conducted at the Center for Integrative Medicine at Thomas 
Jefferson University Hospital (TJUH) in Philadelphia, PA, 
especially in treating oncology, cardio-vascular and 
rheumatology patients.
    The Committee is aware of the Program for Training Research 
in Preventive Maternal Health and Child Health Services at the 
Lawton and Reah Chiles Center for Healthy Mothers and Babies, 
co-located at the University of Florida and the University of 
South Florida.
    Internet and Grant Applications.--The Committee has been 
impressed with the efforts of the NIH to apply the technology 
of the Internet and specifically its weekly electronic mail 
service announcing grant opportunities. The Committee 
encourages the Department and those components that make funds 
available through grants and cooperative agreements to 
supplement the publication in the Federal Register with a 
weekly listserv to all interested parties, that links back to 
the full document. In addition, the Department should announce 
such availability in the Federal Register and at each of the 
Department's component pages. The Committee expects that this 
will improve the flow to all potential applicants concurrently 
in urban as well as in isolated communities, for example, 
Hawaii, Alaska, the western Pacific and rural America that must 
now rely on the Federal Register to arrive in a timely manner 
to obtain the knowledge to apply for grant programs.

Adolescent family life

    The Committee has provided $19,327,000 for the Adolescent 
Family Life Program [AFL]. This is $11,700,000 more than the 
administration request and is the same as the fiscal year 2000 
appropriation.
    AFL is the only Federal program focused directly on the 
issue of adolescent sexuality, pregnancy, and parenting. 
Through demonstration grants and contracts, AFL focuses on a 
comprehensive range of health, educational, and social services 
needed to improve the health of adolescents, including the 
complex issues of early adolescent sexuality, pregnancy, and 
parenting.
    Within the total provided, the Committee continues the 
prevention projects begun in fiscal year 1998, as well as new 
prevention projects. The Committee again expects the Department 
to fund new prevention projects which enable smaller 
communities to begin the organization and implementation of 
coalitions to implement abstinence-based education programs. 
The Committee again expects the Department, when announcing 
grant competitions, to provide a reasonable length of time for 
applicants to complete application packages, provide extensive 
technical assistance to applicants, with special assistance 
given to new applicants, and revise the terminology and 
instructions in grant applications to assure that the 
information being requested is as clear as possible.

Physical fitness and sports

    The Committee recommends $1,091,000 for the Federal staff 
which supports the President's Council on Physical Fitness and 
Sports. This is the same as the fiscal year 2000 appropriation 
and $61,000 less than the budget request.
    The President's Council on Physical Fitness and Sports 
serves as a catalyst for promoting increased physical activity/
fitness and sports participation for Americans of all ages and 
abilities, in accordance with Executive Order 12345, as 
amended. The programs sponsored by PCPFS are supported largely 
through private sector partnerships.

Minority health

    The Committee recommends $37,638,000 for the Office of 
Minority Health. This is $1,000,000 less than the budget 
request and the same as the fiscal year 2000 appropriation.
    The Office of Minority Health [OMH] focuses on strategies 
designed to decrease the disparities and to improve the health 
status of racial and ethnic minority populations in the United 
States. OMH establishes goals, and coordinates all departmental 
activity related to improving health outcomes for disadvantaged 
and minority individuals. OMH supports several demonstration 
projects, including the Minority Community Health Coalition, 
the Bilingual/Bicultural Service, the Center for Linguistic and 
Cultural Competency in Health Care, and the Family and 
Community Violence Prevention Program.
    Health care fairness.--The Committee supports efforts to 
increase understanding of health disparities among minority 
communities, because increased public awareness of minority 
health issues will improve public health throughout the nation. 
Many current public health efforts and medical breakthroughs 
are not accessed by minority communities. Establishing 
awareness and an agenda for minority health through research 
and curriculum development for cultural competency are an 
essential part of quality medical care for minority 
communities. The Committee is aware that there are significant 
differences in health outcomes in minority communities and 
supports the additional resources needed to effectively address 
the high incidences in diseases such as diabetes and asthma in 
Hispanics, lower life expectancy and higher infant mortality 
and cancer rates for African Americans, and cervical cancer and 
tuberculosis rates in Asian Americans.
    The Committee is aware of the initiative at the University 
of Miami/Jackson Memorial Medical Center to systematize the 
development, maintenance, and utilization of medical 
information to mitigate health disparities in minority 
populations by linking the diagnosis, care, and therapeutic 
procedures with patient outcomes to increase the ability to 
enhance the effectiveness and efficiency of dealing with the 
complete spectrum of diseases affecting patients cared for at 
the medical center.
    The Committee is aware of The Community Medical Centers of 
Fresno, California. These Centers offer a comprehensive program 
of diabetes and renal dialysis educational outreach and care to 
address the needs of the underserved populations in the Central 
San Joaquin Valley.
    The Committee is aware of Santa Marta Hospital in Los 
Angeles. The hospital provides outreach and offers health 
education to underserved populations suffering from diabetes. 
The program is culturally and linguistically sensitive and 
primarily serves the Latino community.
    The Committee is pleased that the HHS Office of Minority 
Health has taken a leadership role in conducting and 
coordinating a study on managed care and historically minority 
health professions schools and encourages continued support.
    The Committee is aware of the University of Florida's 
interest in creating a center for Human Brain Imaging 
Technology. The goal of the center would be to accelerate the 
pace of invention and improvement of imaging technologies, to 
enhance their applications to the diagnosis and treatment of 
brain diseases and to enhance guided imagery for neurosurgery.
    The Committee is aware of The Jessie Trice Cancer 
Prevention Project, a cancer prevention, education and early 
detection program which provides comprehensive primary and 
preventive health care to low-income and uninsured African-
American and Hispanic populations in south Florida.
    The Committee is aware of Jackson State University's 
Epidemiological Research Institute.
    The Committee is aware of efforts by the CORE Center at 
Cook County Hospital in Chicago, Illinois to develop a model 
HIV/AIDS education and training initiative that incorporates 
modern technology.
    The Committee is aware of the University of Pennsylvania 
School of Dental Medicine Minority Outreach Oral Health 
Initiative.

Office on Women's Health

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

Office of Emergency Preparedness

    The Committee has provided $9,668,000, which is the same as 
last year's level and $2,000,000 less than the budget request, 
for activities to counter the adverse health and medical 
consequences from major terrorist events. Within this amount, 
sufficient funds are provided for the Office of Emergency 
Preparedness to staff and administer this program, as well as 
the other OEP activities specified in the administration's 
request. The amount provided by the Committee is intended to 
continue the formation of new metropolitan medical strike teams 
in key uncovered urban areas of the country. The Committee has 
provided additional funding for bioterrorism within the public 
health and social services emergency fund.
    The Department has lead responsibility for health, medical, 
and health-related support under the Federal response plan to 
catastrophic disasters. On behalf of the Department, the Office 
of Emergency Preparedness assesses the potential health and 
medical consequences of a terrorist incident and to formulate 
necessary responses. The funds provided would support 
activities to build local, State, and Federal capacity to 
respond to terrorist acts with public health implications. Such 
activities would include assisting local emergency managers 
through the MMST system to build an enhanced capability to 
detect and identify biologic and chemical agents.

                      OFFICE OF INSPECTOR GENERAL

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

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

                        OFFICE FOR CIVIL RIGHTS

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

    The Committee recommends $20,742,000 for the Office for 
Civil Rights. This is the same as the administration request 
and $1,968,000 more than the the fiscal year 2000 level.
    This recommendation includes the transfer of $3,314,000 
from the Medicare trust funds, which is the same as the 
administration request and the fiscal year 2000 level.
    The Office for Civil Rights is responsible for enforcing 
civil rights-related statutes in health care and human services 
programs. To enforce these statutes, OCR investigates 
complaints of discrimination, conducts program reviews to 
correct discriminatory practices, and implements programs to 
generate voluntary compliance among providers and constituency 
groups of health and human services.

                            POLICY RESEARCH

Appropriations, 2000....................................     $16,738,000
Budget estimate, 2001...................................      16,738,000
Committee recommendation................................      16,738,000

    The Committee recommends an appropriation of $16,738,000 
for policy research. This is the same as the administration 
request and the same as the fiscal year 2000 amount.
    Funds appropriated under this title provide resources for 
research programs that examine broad issues which cut across 
agency and subject lines, as well as new policy approaches 
outside the context of existing programs. This research can be 
categorized into three major areas: health policy, human 
services policy, and disability, aging and long-term care 
policy.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

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

    The Committee provides an estimated $219,772,000 for 
retirement pay and medical benefits for commissioned officers 
of the U.S. Public Health Service. This is the same as the 
administration request and is $4,867,000 over the estimated 
payments for fiscal year 2000.
    This account provides for: retirement payments to U.S. 
Public Health Service officers who are retired for age, 
disability, or length of service; payments to survivors of 
deceased officers; medical care to active duty and retired 
members and dependents and beneficiaries; and for payments to 
the Social Security Administration for military service 
credits.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

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

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

                           General Provisions

    The Committee recommendation includes language placing a 
$37,000 ceiling on official representation expenses (sec. 201), 
the same as existing law.
    The Committee recommendation includes language included in 
fiscal year 2000 which limits assignment of certain public 
health personnel (sec. 202).
    The Committee recommendation retains language carried in 
fiscal year 2000 regarding set-asides in the authorizing 
statute of the National Institutes of Health (sec. 203).
    The Committee recommendation retains a provision carried in 
fiscal year 2000 to limit use of grant funds to pay individuals 
more than an annual rate of Executive level III (sec. 204).
    The Committee recommendation retains language from fiscal 
year 2000 restricting the use of taps (sec. 205) for program 
evaluation activities by the Secretary prior to submitting a 
report on the proposed use of the funds to the Appropriations 
Committee. Section 241 of the Public Health Service Act 
authorizes the Secretary to redirect up to 1.6 percent of the 
appropriations provided for programs authorized under the act 
for evaluation activities.
    The Committee recommendation retains language included in 
fiscal year 2000 restricting transfers of appropriated funds 
among accounts and requiring a 15-day notification of both 
Appropriations Committees prior to any transfer (sec. 206).
    The Committee recommendation includes language included in 
fiscal year 2000 permitting the transfer of up to 3 percent of 
AIDS funds among Institutes and Centers (sec. 207) by the 
Director of NIH and the Director of the Office of AIDS Research 
of NIH.
    The recommendation also includes language included in 
fiscal year 1999 which directs that the funding for AIDS 
research as determined by the Directors of the National 
Institutes of Health and the Office of AIDS Research be 
allocated directly to the OAR for distribution to the 
Institutes and Centers consistent with the AIDS research plan 
(sec. 208).
    The Committee recommendation includes a provision (sec. 
209) regarding family planning applicants to certify to the 
Secretary to encourage family participation in the decision of 
a minor who seeks family planning services.
    The Committee recommendation includes a provision included 
in fiscal year 2000 which restricts the use of funds to carry 
out the Medicare+Choice Program if the Secretary denies 
participation to an otherwise eligible entity (sec. 210).
    The Committee includes a provision to ensure that States 
receive no less than the amount they received in fiscal year 
2000 for substance abuse and mental health services (sec. 211).
    The Committee includes a provision (sec. 212) which states 
that no provider of services under Title X of the PHS Act 
except from State laws regarding child abuse.
    The Committee includes a provision (sec. 213) extending the 
refugee status for persecuted religious groups.
    The Committee has continued last year's prohibition on 
administering or implementing a Medicare Competitive Pricing 
Demonstration (sec. 214).
    The Committee continues to include a provision prohibiting 
the Secretary from withholding substance abuse treatment funds 
(sec. 215).
    The Committee has included a provision, requested by the 
President, which cuts Temporary Assistance to Needy Families 
(TANF) by $240,000,000 in fiscal year 2001. TANF Supplemental 
Grants are bonus payments to 17 States with high population 
increases and low levels of welfare spending per person. At the 
time TANF was enacted, States expecting large population 
increases were concerned that under a block grant they would 
not be able to meet the demands of increased caseloads since 
the basic TANF grant amount was based on historical AFDC 
caseloads. However, States receiving supplemental grants have 
experienced the same caseload declines as other States (sec. 
216).
    The Committee has shifted unspent fiscal year 1998 State 
Children's Health Insurance Program (SCHIP) funds to fiscal 
year 2003 to more closely reflect State spending patterns. The 
Committee understands that as many as 37 States with unspent 
fiscal year 1998 allocations would otherwise lose these funds 
at the end of fiscal year 2000. The funds appropriated for 
fiscal year 2003 are made available for 2 years. The Committee 
believes that the remaining appropriations from fiscal years 
1999, 2000, and 2001 will be sufficient to meet the needs of 
States in fiscal year 2001 (sec. 217).

                   TITLE III--DEPARTMENT OF EDUCATION

                            education reform

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

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

Goals 2000: State and local education systemic improvement grants

    The Committee recommendation does not include resources for 
activities authorized by title III of the Goals 2000: Educate 
America Act. This action is consistent with the Department of 
Education Appropriations Act, 2000, which repealed this program 
effective September 30, 2000. The recommendation is 
$458,000,000 less than the fiscal year 2000 comparable level 
and the same as the amount requested by the Administration.
    Funds from the fiscal year 2000 appropriation will provide 
incentives for States to devise their own strategies for 
comprehensive reform of elementary and secondary education. 
Grants are distributed to States through a formula based on 
relative shares each State received in the previous year under 
titles I and VI of the Elementary and Secondary Education Act. 
By law, 1 percent is reserved for the outlying areas, schools 
supported by the Bureau of Indian Affairs and the Alaska 
Federation of Natives.

Parental assistance

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

Recognition and Reward

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

School-to-work opportunities

    The Committee recommendation does not include funding for 
this program. The School-to-Work Opportunities Act authorized 
appropriations through September 30, 1999. Funds appropriated 
under the School-to-Work Opportunities Act, made available 
through both the Departments of Labor and Education, provided 
every State with access to seed money to design and implement a 
comprehensive school-to-work transition system. The Committee 
recommendation is $55,000,000 less than the amount provided to 
the Department of Education for fiscal year 2000 and the same 
as the budget request.
    Local school-to-work programs include a combination of 
work-based learning involving job training and school-based 
learning tied to both occupational skill standards and the 
voluntary academic standards States established under Goals 
2000. Students who complete a school-to-work program will 
receive a high school diploma, a certificate recognizing 1 or 2 
years of postsecondary education, if appropriate, and a 
portable, industry-recognized skill certificate.

Technology literacy challenge fund

    The Committee recommends $425,000,000 for the technology 
literacy challenge fund authorized by section 3132 of the 
Elementary and Secondary Education Act, the same as the fiscal 
year 2000 comparable and $25,000,000 below the budget request.
    The fund helps States put into practice strategies to 
enable schools to integrate technology into school curricula. 
Funds are used to enhance students' critical thinking skills, 
support training for teachers, connect classrooms to the 
information superhighway, and purchase computers and software. 
Grants are made according to each State's share of funds 
appropriated under part A of title I. To be eligible for funds, 
each State submitted a statewide technology plan describing 
long-term strategies for financing technology education in the 
State, including private-sector participation and initiatives 
targeting funds to school districts with the greatest need.

Regional technology consortia

    The Committee recommends $10,000,000, the same as the 
amount appropriated in fiscal year 2000 and the administration 
request, to continue the regional technology in education 
consortia program. These consortia assist States and local 
educational agencies in the identification and procurement of 
resources necessary to implement technology plans; develop 
training resources for both elementary and secondary and adult 
education; provide referrals to sources of technical assistance 
and professional development; and assist institutions of higher 
education to establish preservice training programs in the 
appropriate use of educational technology.

Technology innovation challenge grants

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

National activities

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

Star schools

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

Ready to learn television

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

Telecommunications demonstration project for mathematics

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

21st Century Community Learning Centers

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

Small, Safe and Successful High Schools

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

                    Education for the Disadvantaged

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

    The Committee recommends an appropriation of $8,986,800,000 
for education for the disadvantaged. This is $285,814,000 more 
than the fiscal year 2000 appropriation and $162,700,000 less 
than the administration request. In fiscal year 2000 
$6,204,763,000 was made available for this account in fiscal 
year 2001 funds. This year, the Committee recommendation 
includes $6,223,342,000 in advance funding.
    Programs financed under this account are authorized under 
title I of the Elementary and Secondary Education Act [ESEA] 
and section 418A of the Higher Education Act. ESEA title I 
programs provide financial assistance to State and local 
educational agencies [LEAs] to meet the special educational 
needs of educationally disadvantaged children, migrant 
children, neglected and delinquent children in State 
institutions, and juveniles in adult correctional institutions. 
In addition, the Even Start Program supports projects that 
integrate early childhood education with parenting and adult 
literacy training. Funds for most of these programs are 
allocated through formulas that include the number of eligible 
children and each State's average per-pupil expenditure. Even 
Start funds are allocated according to each State's proportion 
of title I grants to LEAs.
    The Committee recognizes that elementary and secondary 
education programs authorized by the Elementary and Secondary 
Education Act of 1965, as amended, currently are under 
consideration for reauthorization. Until this process is 
completed, appropriations generally will be made consistent 
with the current authorization for these programs. The 
Committee defers action on all new programs proposed by the 
Administration pending reauthorization of elementary and 
secondary education programs.

Grants to local educational agencies

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

Capital expenses for private school students

    The Committee recommends $6,000,000 for the capital 
expenses program, a decrease of $6,000,000. The Administration 
has requested no funds and has proposed eliminating the 
program. It has been brought to the Committee's attention that 
several states require continued assistance under this program 
and in some cases, states have declared a need for additional 
funds to cover administrative costs incurred in serving private 
school students.
    The Supreme Court's 1985 Aguilar v. Felton decision 
prohibited districts from sending public schoolteachers or 
other employees to private sectarian schools for the purpose of 
providing title I services. The capital expenses program has 
helped districts comply with Felton by paying a portion of the 
additional capital costs associated with serving religious 
school students outside school premises. Funds are used by 
districts for noninstructional goods and services such as 
renting classroom space in neutral sites, renting or purchasing 
mobile vans for title I instruction, or transporting private 
schoolchildren to the place of title I instruction.
    On June 23, 1997, the Court reversed its earlier ruling, 
and districts may now provide title I instruction in private 
schools. However, many school districts will continue, over the 
short term, to incur costs as a result of the original 1985 
decision. For example, some may have entered into multiyear 
leases for vans, portable classrooms, or other neutral 
instructional sites. The Committee, therefore, has recommended 
continuation of this program until an assessment has been made 
as to what the final costs are for Felton compliance.
    Funds are allocated to States according to the proportion 
of nonpublic school students served under the title I LEA 
grants program in the most recent year for which satisfactory 
data are available.

Even Start

    For the Even Start program, the Committee recommends 
$185,000,000, an increase of $35,000,000 above the fiscal year 
2000 appropriation and the budget request.
    The Even Start program provides grants for family literacy 
programs that serve disadvantaged families with children under 
8 years of age and adults eligible for services under the Adult 
Education and Family Literacy Act. Programs combine early 
childhood education, adult literacy, and parenting education.
    States receive funds on the basis of their proportion of 
title I LEA grant allocations and make competitive 4-year 
grants to partnerships of local educational agencies and 
community-based organizations. Grant funds must be equitably 
distributed among urban and rural areas and the local share of 
program costs increases from 10 percent in the first year, 40 
percent in the fourth year, 50 percent in years 5 through 8, 
before reaching a cap of 65 percent after 8 years.

Migrant

    For the State agency migrant program, the Committee 
recommends $380,000,000, an increase of $25,311,000 over the 
amount appropriated in fiscal year 2000 and the same as the 
budget request.
    The title I migrant program authorizes grants to State 
educational agencies for programs to meet the special 
educational needs of the children of migrant agricultural 
workers and fishermen. Funds are allocated to the States 
through a statutory formula based on each State's average per-
pupil expenditure for education and counts of migratory 
children aged 3 through 21 residing within the States. Only 
migratory children who have moved within the last 3 years are 
generally eligible to be counted and served by the program. 
Currently, this program serves approximately 624,000 migrant 
students; however, 720,000 are eligible to receive services and 
that number is increasing since states have been actively 
identifying and recruiting migrant children into educational 
programs.
    This appropriation also supports activities to improve 
interstate and intrastate coordination of migrant education 
programs.

Neglected and delinquent

    The Committee recommends $50,000,000 for the title I 
neglected and delinquent program, an increase of $8,000,000 
more than amount recommended by the administration and the 2000 
fiscal year level. The Committee recognizes this program as an 
essential component of the Youth Violence Prevention 
Initiative.
    This program provides financial assistance to State 
educational agencies for education services to neglected and 
delinquent children and youth in State-run institutions and for 
juveniles in adult correctional institutions.
    Funds are allocated to individual States through a formula 
based on the number of children in State-operated institutions 
and per-pupil education expenditures for the State.
    States are authorized to set aside up to 10 percent of 
their neglected and delinquent funds to help students in State-
operated institutions make the transition into locally operated 
programs. Transition activities are designed to address the 
high failure and dropout rate of institutionalized students and 
may include alternative classes, counseling and supervisory 
services, or educational activities in State-supported group 
homes.

Evaluation

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

Comprehensive school reform

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

High school equivalency program

    The Committee bill includes $20,000,000 for the high school 
equivalency program [HEP]. This amount is $5,000,000 more than 
the amount appropriated in fiscal year 2000 and the same as the 
amount requested by the administration.
    This program provides 5-year grants to institutions of 
higher education and other nonprofit organizations to recruit 
migrant students aged 16 and over and provide the academic and 
support services needed to help them obtain a high school 
equivalency certificate and subsequently gain employment, win 
admission to a postsecondary institution or a job-training 
program, or join the military. Projects provide counseling, 
health services, stipends, and placement assistance. HEP serves 
about 6,000 migrants.

College assistance migrant program

    For the college assistance migrant program [CAMP], the 
Committee recommends $10,000,000, an increase of $3,000,000 
over the fiscal year 2000 appropriation and the same as the 
amount requested by the administration.
    Funds provide 5-year grants to institutions of higher 
education and nonprofit organizations for projects that provide 
tutoring, counseling, and financial assistance to migrant 
students during their first year of postsecondary education. 
Projects also may use up to 10 percent of their grants for 
followup services after students have completed their first 
year of college, including assistance in obtaining student 
financial aid. CAMP serves about 1,000 students.

                               impact aid

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

    The Committee recommends an appropriation of $1,030,000,000 
for impact aid for the Department of Education. This amount is 
$123,548,000 above the 2000 appropriation and $260,000,000 
above the administration request.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities. 
Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education. During 
the current school year, approximately 1,400 school districts 
will receive payments on behalf of 1.2 million eligible 
children.
    The Committee recognizes that the Impact Aid program is 
under review as part of reauthorization of the Elementary and 
Secondary Education Act of 1965, as amended. The Committee 
defers actions on the Administration proposals for this program 
pending the outcome of the reauthorization of elementary and 
secondary education programs.
    Basic support payments.--The Committee recommends 
$818,000,000 for basic support payments, $80,800,000 more than 
the amount appropriated in fiscal year 2000 and $98,000,000 
above the amount recommended by the administration. Under 
statutory formula, payments are made on behalf of all 
categories of federally connected children.
    Payments for children with disabilities.--Under this 
program additional payments are made for certain federally 
connected children eligible for services under the Individuals 
with Disabilities Education Act. The Committee bill includes 
$50,000,000 for this purpose, the same as the 2000 level and 
$10,000,000 more than the administration request.
    Payments for heavily impacted districts.--These payments 
provide additional assistance to certain local educational 
agencies that enroll large numbers or proportions of federally 
connected children. The Committee recommends $82,000,000, an 
increase of $9,800,000 over the amount appropriated in fiscal 
year 2000. No funds were requested by the administration for 
this activity.
    Facilities maintenance.--This activity provides funding for 
maintaining certain school facilities owned by the Department 
of Education. The Committee recommends $8,000,000 for this 
purpose in fiscal year 2001, $3,000,000 more than the budget 
request and the amount appropriated in fiscal year 2000.
    Construction.--Payments are made to eligible LEA's to be 
used for construction and renovation of school facilities, or 
for debt service related to the construction of school 
facilities. The Committee recommends $25,000,000 for this 
program, $14,948,000 more than the amount appropriated in 
fiscal year 2000 and $20,000,000 more than requested by the 
administration.
    The Committee is aware of conditions at the Cannon Ball 
Elementary School, one of two schools that comprise the Solen, 
North Dakota school district. The school, which is located on 
the Standing Rock Sioux Reservation is more than 70 years old, 
with classrooms and other school facilities inadequate to 
support an environment conducive to learning. The Committee 
encourages the Department to provide assistance to the school 
district to remedy this situation.
    The Committee recognizes that the Harlem Elementary School 
in Harlem Public School District, Montana serves students in 
drastically deteriorating facilities and portable classrooms 
that are not conducive to student learning. The Committee 
encourages the Department to work with the school district to 
identify possible solutions to this situation.
    The Committee is aware that Brockton School in Montana is 
experiencing significant problems with its K-8 facility, 
including a leaking roof, faulty boilers, deteriorating pipes 
and plumbing, and asbestos removal. These conditions at 
Brockton School need to be remedied in order to promote the 
academic success of its students. The Committee encourages the 
Department to provide assistance to the Brockton School in 
identifying appropriate measures to improve the learning 
environment at the school.
    The Committee understands that schools of the Knob Noster 
and Waynesville Public School systems are in need of 
improvement given the increasing student population related to 
the military presence on the military bases of Whiteman Air 
Force Base and Fort Leonard Wood. The Committee urges the 
Department to work with the school districts to explore 
potential solutions that will provide an appropriate 
educational environment for students attending school in these 
districts.
    The Committee is aware of the critical construction needs 
for a new high school in the City of Craig, Alaska. The 
Committee requests that the Department work with this school 
district to address this issue and ensure that all possible 
solutions are explored.
    It has come to the Committee's attention that schools in 
the Eminence R-1 School District in Missouri are in urgent need 
of upgrade and expansion. The high school building that serves 
the district was constructed in 1910 and the cafeteria is 
capable of handling just one-third of the students at any one 
time. The Committee requests that the Department provide 
assistance to the School District in addressing this issue.
    Payments for Federal property.--These payments compensate 
local educational agencies in part for revenue lost due to the 
removal of Federal property from local tax rolls. Payments are 
made to LEA's that have a loss of tax base of at least 10 
percent of assessed value due to the acquisition since 1938 of 
real property by the U.S. Government. The Committee recommends 
$47,000,000 for this activity in 2001, $15,000,000 more than 
the fiscal year 2000 amount. No funds were requested by the 
administration for this activity.
    The Committee is aware of the unique circumstances that the 
Kadoka School District in Jackson County, South Dakota faces in 
proving eligibility for an appropriate level of funding for 
this program. Over time, the consolidation of two counties that 
form the current school district boundaries and the transfer of 
land ownership have made it difficult to produce the 
documentation required to prove eligibility for the all of the 
property within the school district's boundaries. The Committee 
encourages the Department to work with the school district and 
local officials to address this situation.

                      school improvement programs

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

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

Teaching to High Standards

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

School Leadership Initiative

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

National Activities for the Improvement of Teaching and School 
        Leadership

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

Hometown Teachers

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

Higher Standards, Higher Pay

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

Teacher Quality Incentives

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

Transition to Teaching: Troops to Teachers

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

Early Childhood Educator Professional Development

    The Committee defers action on this proposal pending 
reauthorization of elementary and secondary education programs. 
The administration requested $30,000,000 for the proposed Early 
Childhood Educator Professional Development program. This new 
initiative would award competitive grants to improve the 
knowledge and skills of early childhood educators and 
caregivers who work in communities with high concentrations of 
young children living in poverty.
    Innovative education program strategies State grants.--The 
Committee recommends $3,100,000,000, of which $2,585,000,000 
will become available on October 1, 2001 for innovative 
education program strategies State grants. This represents an 
increase of $1,434,250,000 over the 2000 level. The 
administration proposed to eliminate funding for this program. 
This program makes grants to State and local educational 
agencies for activities intended to help meet the national 
education goals and assist in their reform of elementary and 
secondary education. Funds are awarded to States by a formula 
based on school-aged population and then to local districts 
under a State-determined formula. State and local funds may be 
used for acquisition of instructional materials such as library 
books, curricular materials, and computer software and 
hardware; improving educational services to disadvantaged 
children and dropout prevention; combating illiteracy among 
children and adults; programs for gifted and talented children; 
and reform activities consistent with Goals 2000. Teacher 
training and other related activities in support of any of 
these purposes is also authorized.
    Within the Committee recommendation, $2,700,000,000 has 
been provided under the title VI block grant for purposes 
consistent with Title VI to be determined by the local 
education agency as part of a local strategy to help improve 
academic achievement of students. Funds may also be used to 
address the shortage of highly qualified teachers to reduce 
class sizes, particularly in early grades, using highly 
qualified teachers to improve educational achievement for 
regular and special needs children; to support efforts to 
recruit, train and retrain highly qualified teachers; or for 
renovating and constructing school facilities. It shall be the 
sole discretion of the LEA to determine how best to use these 
funds.

Safe and drug free schools and communities

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

Coordinator initiative

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

Project SERV

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

Inexpensive book distribution

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

Arts in education

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

Magnet schools assistance

    For the magnet schools assistance program, the Committee 
bill provides $110,000,000, the same as the amount recommended 
by the administration and the 2000 appropriation.
    This program supports grants to local educational agencies 
to establish and operate magnet schools that are part of an 
approved desegregation plan and are designed to attract 
substantial numbers of students of different social, economic, 
ethnic, and racial backgrounds. Grantees may use funds for 
teacher salaries, purchase of computers, and other educational 
materials and equipment.
    Within the amount provided, the Committee has included 
$5,000,000 for innovative programs, the same as the budget 
request and the fiscal year 2000 appropriation.
    Fiscal year 2001 marks the beginning of a new round of 
competition for Magnet School grant awards. The Committee is 
aware that the Yakima, Tacoma and Seattle School Districts will 
be applying for grant awards to continue the education reform 
that began with a previous Magnet School grant. The Committee 
urges that full and fair consideration be given to these grant 
requests.

Education for homeless children and youth

    For carrying out education activities authorized by part B, 
subtitle B of the Stewart B. McKinney Homeless Assistance Act, 
the Committee recommends $31,700,000, an increase of $2,900,000 
over the fiscal year 2000 amount and the same as the budget 
request.
    This program provides assistance to each State to support 
an office of the coordinator of education for homeless children 
and youth, to develop and implement State plans for educating 
homeless children, and to carry out other activities to ensure 
that all homeless children and youth in the State have access 
to the same free, appropriate public education, including a 
public preschool education, as provided to other children and 
youth. Grants are made to States based on the total that each 
State receives under the title I program.

Women's educational equity

    The Committee recommends $3,000,000 for the women's 
educational equity program, the same as the fiscal year 2000 
appropriation and the same as the amount requested by the 
administration. The program supports projects that assist in 
the local implementation of gender equity policies and 
practices.

Training and advisory services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $7,334,000, 
the same as the fiscal year 2000 appropriation and the 
administration's request.
    The funds provided will continue the 10 regional equity 
assistance centers [EACs] formerly known as regional 
desegregation assistance centers. Each EACs provides services 
to school districts upon request. Activities include 
disseminating information on successful practices and legal 
requirements related to nondiscrimination on the basis of race, 
color, sex, or national origin in education programs. No funds 
are included for civil rights units in State education 
agencies.

Ellender fellowships

    For Ellender fellowships, the Committee bill includes 
$1,500,000, the same as the 2000 appropriation. The 
administration recommended no funding for this program. The 
Ellender fellowship program makes an award to the Close Up 
Foundation of Washington, DC, to provide fellowships to 
students from low-income families and their teachers to enable 
them to participate with other students and teachers for 1 week 
of seminars on Government and meetings with representatives of 
the three branches of the Federal Government.

Education for native Hawaiians

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

Alaska Native educational equity

    The Committee recommends $15,000,000 for the Alaska Native 
educational equity assistance program, authorized under title 
IX, part C, of the Elementary and Secondary Education Act. This 
amount is $2,000,000 over the 2000 appropriation and the budget 
request. Additional funds in fiscal year 2001 will allow 
expansion of this program to include cultural education 
programs operated by the Alaska Native Heritage Center and for 
continued operation of the Rose program, including publication 
and distribution of literature, operated by the Alaska 
Humanities Forum to expose urban students to Native culture in 
rural Alaska. These funds address the severe educational 
handicaps of Alaska Native schoolchildren. Funds are used for 
development of supplemental educational programs to benefit 
Alaska Natives. The Committee directs the Department to consult 
with the Alaska Federation of Natives in developing criteria 
for grant proposals, in developing a simplified and streamlined 
application form, and in developing criteria for evaluating 
projects.
    It has been brought to the Committee's attention that in 
urban areas, 60 percent of Alaska Natives entering high school 
do not graduate, and that Alaska Natives test scores are on 
average 40 percent lower than those of other students. In some 
districts, none of the Alaska Native elementary students and 40 
percent of Native high school students are performing at their 
grade levels. The funds provided under the Alaska Native 
educational equity assistance program will help to address some 
of the barriers faced by Native Alaskan children and develop 
programs tailored to the unique needs of these children to 
improve performance levels.

Charter schools

    The Committee recommends $210,000,000 for support of 
charter schools, an increase of $65,000,000 over the 2000 
appropriation and $35,000,000 more than the budget request.
    This program, authorized under title X, part C of the 
Elementary and Secondary Act of 1965, as amended, provides 
funds to the Secretary to make awards to State educational 
agencies, which, in turn, make subgrants to partnerships of 
developers and local education agencies or other public 
entities that can authorize or approve a charter school. Grants 
are limited to 3 years in duration, of which not more than 18 
months may be used for planning and program design, not more 
than 2 years for the initial implementation of a charter 
school, and not more than 2 years to carry out dissemination 
activities.
    Unlike traditional public schools, charter schools operate 
under charters or contracts with school districts, State 
education agencies, or other public institutions. They are 
designed by groups of parents, teachers, school administrators, 
other members of the community, and private corporations and 
are held accountable for student performance under the terms of 
their contracts. Also, charter schools can operate with 
considerable autonomy from external controls such as district, 
State, and union requirements.

Opportunities to Improve Our Nation's Schools

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

Comprehensive regional assistance centers

    The Committee recommends $28,000,000 for the comprehensive 
regional technical assistance centers. This recommendation is 
the same as the fiscal year 2000 level and will continue to 
fund all current activities. The administration recommended no 
funding for this program. This program supports 15 regional 
centers that provide support, training, and technical 
assistance to Department of Education grantees. Of the amount 
recommended, up to $750,000 is for an evaluation to collect 
performance indicator data that would improve the delivery of 
technical assistance centers.

Strengthening Technical Capacity Grants

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

Advanced placement test fees

    The Committee recommends $20,000,000 for the advanced 
placement test fees program, the same as the amount requested 
by the administration and an increase of $5,000,000 more than 
the amount appropriated in fiscal year 2000. This program 
awards grants to States to enable them to cover part or all of 
the cost of advanced placement test fees of low-income 
individuals who are enrolled in an advanced placement class and 
plan to take an advanced placement test. The Committee is aware 
of the benefits of Internet-based AP pilot programs in rural 
parts of the country or other underserved districts where 
students would otherwise not have access to AP instruction and 
encourages the Department to consider proposals that meet the 
needs of students in these areas of the country.

                           reading excellence

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

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

                            indian education

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

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

Grants to local education agencies

    For grants to local education agencies, the Committee 
recommends $92,765,000, an increase of $30,765,000 over the 
fiscal year 2000 appropriation and the same as the budget 
request. These funds provide financial support to reform 
elementary and secondary school programs that serve Indian 
students, including pre-school children. Funds are awarded on a 
formula basis to local educational agencies, the Bureau of 
Indian Affairs [BIA]-supported schools and BIA operated 
schools.

Special programs for Indian children

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

National activities

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

                           School Renovation

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

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

                   bilingual and immigrant education

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

    The Committee recommends an appropriation of $443,000,000 
for bilingual and immigrant education. This is $37,000,000 
above the 2000 appropriation and $17,000,000 below the 
administration's request.
    The bilingual programs authorized by title VII of ESEA are 
designed to increase the capacity of States and school 
districts to provide special instruction to limited-English 
proficient students. The Committee defers action on all new 
programs and programmatic changes proposed by the 
Administration pending reauthorization of elementary and 
secondary education programs.

Instructional services

    The Committee bill includes $180,000,000 for bilingual 
instructional programs, $17,500,000 above the 2000 level and 
the same as the President's request.
    This activity provides competitive grants, primarily to 
school districts, to improve the quality of instructional 
programs for limited-English proficient students. Schools are 
permitted to select the instructional approach best suited to 
their students, except that no more than 25 percent of program 
funds may be used to support instruction that does not make use 
of the students' native language. Funds may also be used to 
provide services for preschool children and parents to assist 
in the education of their children.

Support services

    The Committee has included $14,000,000 for support 
services, the same as the fiscal year 2000 appropriation and 
$2,000,000 less than the administration's request. This program 
provides discretionary grants and contracts in four specific 
areas: research and evaluation; dissemination of effective 
instructional models; data collection and technical assistance; 
and a national clearinghouse to support the collection, 
analysis, and dissemination of information about programs for 
limited-English proficient students.

Professional development

    The Committee recommends $85,000,000 for professional 
development, an increase of $13,500,000 above the fiscal year 
2000 appropriation and $15,000,000 below the budget request.
    These funds support the training and retraining of 
bilingual education teachers and teacher aides, graduate 
fellowships related to the field of bilingual education, and 
grants to institutions of higher education to improve bilingual 
teacher training programs.

Immigrant education

    The Committee recommends $150,000,000 for immigrant 
education, the same as the administration request and the 
fiscal year 2000 appropriation.
    The Immigrant Education Program provides financial support 
to offset the additional costs of educating recently arrived 
immigrant students who often lack proficiency in English and 
need special services to make the transition to the American 
educational system. Federal dollars flow through State 
educational agencies to school districts enrolling a minimum of 
500 eligible immigrant students or where eligible immigrant 
children represent at least 3 percent of the enrollment. The 
Committee agrees with the administration and has included bill 
language to permit States to allocate all or any part of the 
funds to LEA's on a discretionary basis.

Foreign language assistance

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

                           Special education

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

    The Committee recommends a program level of $7,352,341,000 
for special education. This is $1,316,145,000 more than the 
2000 appropriation and $983,500,000 above the administration 
request. This amount includes $4,624,000,000 advance funded in 
fiscal year 2002.
    These programs, which are authorized by the Individuals 
with Disabilities Education Act [IDEA], provide assistance to 
ensure that all children with disabilities have access to a 
free, appropriate public education, and that all infants and 
toddlers with disabilities have access to early intervention 
services. This assistance is provided through State grants that 
offset a portion of the costs incurred by States and local 
educational agencies in educating children with disabilities 
and in developing and implementing statewide systems of early 
intervention services, and through six programs that provide a 
streamlined structure to help States improve educational and 
early intervention results for children with disabilities.

Grants to States

    The Committee bill provides $6,279,685,000, including 
$4,624,000,000 in advanced funding for fiscal year 2002 for 
special education grants to States. The amount recommended is 
$1,290,000,000 more than the fiscal year 2000 appropriation and 
$1,000,000,000 above the budget request. This program supports 
formula grants to States to finance a portion of the cost of 
providing special education and related services for children 
with disabilities.
    The Committee's recommended funding level represents 
approximately 15 percent of the estimated average per-pupil 
expenditure and 13 percent of excess costs, and would provide 
an estimated Federal share of $984 per child for the 6.4 
million children expected to receive special education 
services.

Preschool grants

    The Committee recommends $390,000,000 for preschool grants, 
the same as the fiscal year 2000 appropriation and the budget 
request. The preschool grants program provides formula grants 
to States based on the amount of funding received in fiscal 
year 1997, the number of preschool children aged 3 through 5 
years, and the number of preschool children aged 3 through 5 
living in poverty.
    The amount provided by the Committee is approximately $672 
per child for the 580,500 preschoolers expected to receive 
special education and related services in the next school year.
    States may retain an amount equal to 25 percent of their 
1997 allocation, cumulatively adjusted upward by the lesser of 
inflation or the percentage increase in the State's allocation, 
of which 20 percent may be used for administration. These funds 
may be used for direct and support services for 3- through 5-
year-olds; at a State's discretion, to serve 2-year-olds with 
disabilities who will turn age 3 during the school year; and, 
for other purposes. The remaining funds must be distributed to 
local educational agencies.

Grants for infants and families

    The Committee bill provides $383,567,000 for the part C 
grants for infants and families program, an increase of 
$8,567,000 above the fiscal year 2000 appropriation and the 
same as the budget request. This program provides formula 
grants to States to implement statewide systems of coordinated, 
comprehensive, multidisciplinary interagency programs to make 
available early intervention services to all children with 
disabilities, ages birth through 2, and their families.

State improvement

    For State improvement, the bill provides $35,200,000, the 
same as the fiscal year 2000 appropriation and $10,000,000 
below the budget request. This program supports competitive 
grants to State educational agencies to assist them, in 
partnership with parents, teachers, institutions of higher 
education, interest groups, and others, to improve results for 
children with disabilities by reforming and improving their 
educational systems.

Research and innovation

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

Technical assistance and dissemination

    The Committee bill provides $45,481,000, the same as the 
fiscal year 2000 level and $8,000,000 less than the budget 
request. These funds provide technical assistance and 
information through competitive awards that support institutes, 
regional resource centers, clearinghouses, and efforts to build 
State and local capacity to make systemic changes and improve 
results for children with disabilities.
    The Committee recognizes the efforts of the University of 
Northern Iowa, through its We Build Communications Access 
through Technology program, which seeks to provide technical 
information and support on accessing and using assistive 
technology for families of children and youth with 
disabilities.

Personnel preparation

    The Committee recommends $81,952,000 for the personnel 
preparation program. The amount recommended is the same as the 
fiscal year 2000 appropriation and the budget request. Funds 
support competitive awards to help address State-identified 
needs for qualified personnel to work with children with 
disabilities, and to ensure that these personnel have the 
skills and knowledge they need to serve these children.
    The appropriation includes funds to provide preparation for 
personnel to serve children with high incidence disabilities 
including grants for graduate support to ensure a proper 
balance among all authorized grant categories.

Parent information centers

    The Committee bill provides $26,000,000 for parent 
information centers, $7,465,000 more than the fiscal year 2000 
appropriation and the same as the budget request. This program 
makes awards to parent organizations to support parent training 
and information centers, including community parent resource 
centers. These centers provide training and information to meet 
the needs of parents of children with disabilities living in 
the areas served by the centers, particularly underserved 
parents, and parents of children who may be inappropriately 
identified.

Technology and media services

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

Readline

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

            rehabilitation services and disability research

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

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

Vocational rehabilitation State grants

    The Committee provides $2,399,790,000 for vocational 
rehabilitation grants to States, which is $60,813,000 more than 
the fiscal year 2000 appropriation and the same as the budget 
request.
    Basic State grant funds assist States in providing a range 
of services to help persons with physical and mental 
disabilities prepare for and engage in meaningful employment. 
Authorizing legislation requires States to give priority to 
persons with significant disabilities. Funds are allotted to 
States based on a formula that takes into account population 
and per capita income, and States must provide a 21.3-percent 
match of Federal funds, except the State's share is 50 percent 
for the cost of construction of a facility for community 
rehabilitation program purposes.
    The Rehabilitation Act requires that no less than 1.0 
percent and not more than 1.5 percent of the appropriation in 
fiscal year 2001 for vocational rehabilitation State grants be 
set aside for grants for Indians. Service grants are awarded to 
Indian tribes on a competitive basis to help tribes develop the 
capacity to provide vocational rehabilitation services to 
American Indians with disabilities living on or near 
reservations.
    The Committee is concerned that the agency may be 
considering a change in policy which would result in 
prohibiting State vocational rehabilitation agencies from 
counting blind or visually impaired persons as successfully 
rehabilitated if they are placed in a noncompetitive 
environment, even if the individual made an informed choice to 
accept employment in a noncompetitive environment, at the 
Federal minimum wage or higher. Such a decision by the agency 
would result in thousands of blind and visually impaired 
persons at risk of loss of services. However, the Committee 
believes that if the blind or visually impaired individual 
makes an informed choice to accept employment in a 
noncompetitive environment, at the Federal minimum wage or 
higher, the placement should be treated the same as any other 
successful Rehabilitation Employment Placement, and urges the 
agency not to change existing policy.

Client assistance

    The Committee bill recommends $11,147,000 for the client 
assistance program, an increase of $219,000 over the fiscal 
year 2000 appropriation and the same amount recommended by the 
administration request.
    The client assistance program funds State formula grants to 
assist vocational rehabilitation clients or client applicants 
in understanding benefits available to them and in their 
relationships with service providers. Funds are distributed to 
States according to a population-based formula, except that 
minimum grants of $100,000 are guaranteed to each of the 50 
States, the District of Columbia, and Puerto Rico and $45,000 
is guaranteed to each of the outlying areas, if the 
appropriation exceeds $7,500,000. States must operate client 
assistance programs in order to receive vocational 
rehabilitation State grant funds.

Training

    The Committee provides $39,629,000 for training 
rehabilitation personnel, the same as the 2000 appropriation 
and the administration request.
    The purpose of this program is to ensure that skilled 
personnel are available to serve the rehabilitation needs of 
individuals with disabilities. It supports training, 
traineeships, and related activities designed to increase the 
numbers of qualified personnel providing rehabilitation 
services. The program awards grants and contracts to States and 
public or nonprofit agencies and organizations, including 
institutions of higher education, to pay all or part of the 
cost of conducting training programs. Long-term, in-service, 
short-term, experimental and innovative, and continuing 
education programs are funded, as well as special training 
programs and programs to train interpreters for persons who are 
deaf, hard of hearing and deaf-blind.

Demonstration and training programs

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

Migrant and seasonal farmworkers

    The Committee recommends $2,850,000 for migrant and 
seasonal farmworkers, $500,000 more than the 2000 appropriation 
and the same level as the budget request.
    This program provides a 90-percent Federal match for 
comprehensive rehabilitation services to migrant and seasonal 
farm workers with disabilities and their families. Projects 
also develop innovative methods for reaching and serving this 
population. The program emphasizes outreach, specialized 
bilingual rehabilitation counseling, and coordination of 
vocational rehabilitation services with services from other 
sources.

Recreational programs

    The Committee provides $2,596,000 for recreational 
programs, $925,000 less than the 2000 appropriation and the 
same as the administration request.
    Recreational programs help finance activities such as 
sports, music, dancing, handicrafts, and art to aid in the 
employment, mobility, and socialization of individuals with 
disabilities. Grants are awarded to States, public agencies, 
and nonprofit private organizations, including institutions of 
higher education. Grants are awarded for a 3-year period with 
the Federal share at 100 percent for the first year, 75 percent 
for the second year, and 50 percent for the third year. 
Programs must maintain the same level of services over the 3-
year period.

Protection and advocacy of individual rights

    The Committee recommends $13,000,000 for protection and 
advocacy of individual rights, an increase of $1,106,000 over 
the 2000 appropriation and $868,000 more than the budget 
request.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities.

Projects with industry

    The Committee bill includes $22,071,000 for projects with 
industry, the same as the 2000 appropriation and the 
administration request.
    The projects with industry [PWI] program is the primary 
Federal vehicle for promoting greater participation of business 
and industry in the rehabilitation process. PWI provides 
training and experience in realistic work settings to prepare 
individuals with disabilities for employment in the competitive 
job market. Postemployment support services are also provided. 
The program makes grants to a variety of agencies and 
organizations, including corporations, community rehabilitation 
programs, labor and trade associations, and foundations.

Supported employment State grants

    The Committee's bill includes $38,152,000 for the supported 
employment State grant program, the same as the 2000 
appropriation and the budget request.
    This program assists persons who may have been considered 
too severely disabled to benefit from vocational rehabilitation 
services by providing the ongoing support needed to obtain 
competitive employment. Short-term vocational rehabilitation 
services are augmented with extended services provided by State 
and local organizations. Federal funds are distributed on the 
basis of population.

Independent living State grants

    The Committee recommends $22,296,000 for independent living 
State grants, which is the same as the amount appropriated in 
2000 and the budget request.
    The independent living State formula grants program 
provides funding to improve independent living services, 
support the operation of centers for independent living, 
conduct studies and analysis, and provide training and 
outreach.

Independent living centers

    For independent living centers, the Committee bill includes 
$58,000,000, which is $10,000,000 more than the 2000 
appropriation and the same as the budget request.
    These funds support consumer-controlled, cross-disability, 
nonresidential, community-based centers that are designed and 
operated within local communities by individuals with 
disabilities. These centers provide an array of independent 
living services.

Independent living services for older blind individuals

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

Program improvement activities

    For program improvement activities, the Committee provides 
$1,900,000, the same as the budget request and the 2000 
appropriation. In fiscal year 2001, funds for these activities 
will continue to support technical assistance efforts to 
improve the efficiency and effectiveness of the vocational 
rehabilitation program and improve accountability efforts. The 
funds provided are sufficient to support ongoing program 
improvement activities and to support a national conference on 
the findings of the longitudinal study of the vocational 
rehabilitation program.

Evaluation

    The Committee recommends $1,587,000 for evaluation 
activities, the same as the 2000 appropriation and the 
administration request.
    These funds support evaluations of the impact and 
effectiveness of programs authorized by the Rehabilitation Act. 
The Department awards competitive contracts for studies to be 
conducted by persons not directly involved with the 
administration of Rehabilitation Act programs.

Helen Keller National Center

    The Committee bill includes $8,717,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, $167,000 more 
than the 2000 appropriation and the same as the budget request.
    The Helen Keller National Center consists of a national 
headquarters in Sands Point, NY, with a residential training 
and rehabilitation facility where deaf-blind persons receive 
intensive specialized services; a network of 10 regional field 
offices which provide referral and counseling assistance to 
deaf-blind persons; and an affiliate network of 47 agencies. At 
the recommended level, the center would serve approximately 102 
persons with deaf-blindness at its headquarters facility and 
provide field services to approximately 1,825 individuals and 
families.

National Institute on Disability and Rehabilitation Research

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

Assistive technology

    The Committee bill provides $41,112,000 for assistive 
technology, the same as the budget request and $7,112,000 more 
than the fiscal year 2000 appropriation.
    The Assistive Technology Program is designed to improve 
occupational and educational opportunities and the quality of 
life for people of all ages with disabilities through increased 
access to assistive technology services and devices. It 
provides grants to States to develop comprehensive, consumer 
responsive statewide programs that increase access to, and the 
availability of, assistive technology devices and services. The 
National Institute on Disability and Rehabilitation Research 
administers the program.
    The Committee recommendation includes $7,000,000 to support 
grants to States and technical assistance activities, 
authorized under Title III of the Assistive Technology Act, to 
establish or maintain alternative loan financing programs, an 
increase of $2,972,225 over the fiscal year 2000 level. 
Currently, major service programs such as Medicaid, Medicare, 
special education, and vocational rehabilitation cannot meet 
the growing demand for assistive technology. Loan programs 
offer individuals with disabilities attractive options that 
significantly enhance their ability to purchase assistive 
technology devices and services.

           Special Institutions for Persons With Disabilities


                 American printing house for the blind

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

    The Committee recommends $12,500,000 for the American 
Printing House for the Blind [APH], $2,235,000 above the budget 
request and an increase of $2,400,000 above the 2000 
appropriation.
    This appropriation helps support the American Printing 
House for the Blind, which provides educational materials to 
students who are legally blind and enrolled in programs below 
the college level. The Federal subsidy provides about 49 
percent of APH's total sales income. Materials are distributed 
free of charge to schools and States through per capita 
allotments based on the total number of students who are blind. 
Materials provided include textbooks and other educational aids 
in braille, large type, and recorded form and microcomputer 
applications.

               national technical institute for the deaf

Appropriations, 2000....................................     $48,151,000
Budget estimate, 2001...................................      51,786,000
Committee recommendation................................      54,366,000

    The Committee recommends an appropriation of $54,366,000 
for the National Technical Institute for the Deaf [NTID], an 
increase of $6,215,000 over the 2000 appropriation and 
$2,580,000 above the budget request.
    The Institute, located on the campus of the Rochester 
Institute of Technology, was created by Congress in 1965 to 
provide a residential facility for postsecondary technical 
training and education for persons who are deaf. NTID also 
provides support services for students who are deaf, trains 
professionals in the field of deafness, and conducts applied 
research. Within the amount provided, $7,176,000 is for 
construction.
    It has come to the Committee's attention that the 
Administration request of $5,376,000 for the second of three 
installments towards NTID's $13,568,000 dormitory renovations 
project has been reduced by a total of $1,800,000 to reflect 
its expectation that NTID raise 15 percent of the funds 
necessary from private sources. It is NTID's professional 
judgment, based on extensive discussions with potential donors, 
that they are far better served using their very limited 
fundraising resources on raising funds for scholarships, 
classroom technology and new academic programs. The Committee 
notes that NTID has been very successful in raising nearly 
$12,000,000 for these purposes over the past 5 years.
    Given NTID's efforts in reducing its appropriation needs in 
these other areas through fundraising, the fact that it has 
already contributed $1,100,000 from its operating funds to 
supplement the dormitory project and the hardship placed upon 
the institution to raise private funds for this purpose, the 
Committee directs the Department of Education to waive the 15 
percent matching requirement imposed on this construction 
project.

                          gallaudet university

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

    The Committee recommends $87,650,000 for Gallaudet 
University, an increase of $1,670,000 above the amount 
appropriated in 2000 and the same as the administration 
request.
    Gallaudet University is a private, nonprofit institution 
offering undergraduate, and continuing education programs for 
students who are deaf, as well as graduate programs in fields 
related to deafness for students who are hearing-impaired. The 
university conducts basic and applied research related to 
hearing impairments and provides public service programs for 
the deaf community.
    The Model Secondary School for the Deaf serves as a 
laboratory for educational experimentation and development, 
disseminates models of instruction for students who are deaf, 
and prepares adolescents who are deaf for postsecondary 
academic or vocational education. The Kendall Demonstration 
Elementary School develops and provides instruction for 
children from infancy through age 15.

                     VOCATIONAL AND ADULT EDUCATION

Appropriations, 2000....................................  $1,672,750,000
Budget estimate, 2001...................................   1,751,250,000
Committee recommendation................................   1,726,600,000

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

                          Vocational education

    The Committee recommendation of $1,214,100,000 for 
vocational education is $30,350,000 more than the 
administration's request and $21,350,000 more than the fiscal 
year 2000 amount.
    Basic grants.--The Committee has included $1,071,000,000 
for basic grants, $15,350,000 more than the 2000 appropriation 
and $215,350,000 more than the administration request. Of the 
recommended amount, $791,000,000 will become available on 
October 1, 2001.
    Funds provided under the State grant program assist States, 
localities, and outlying areas to expand and improve their 
programs of vocational education and provide equal access to 
vocational education for populations with special needs. 
Persons assisted range from secondary students in prevocational 
courses through adults who need retraining to adapt to changing 
technological and labor market conditions. Funds are 
distributed according to a formula based on State population 
and State per capita income.
    Under the Indian and Hawaiian natives programs, competitive 
grants are awarded to federally recognized Indian tribes or 
tribal organizations and to organizations primarily serving and 
representing Hawaiian natives for services that are in addition 
to services such groups are eligible to receive under other 
provisions of the Perkins Act.
    Tech-prep education.--The Committee recommends $106,000,000 
for tech-prep programs. This is the same as the 2000 
appropriation and $200,000,000 less than the administration 
request. This program is designed to link academic and 
vocational learning and to provide a structured link between 
secondary schools and postsecondary education institutions. 
Funds are distributed to the States through the same formula as 
the basic State grant program. States then make planning and 
demonstration grants to consortia of local educational agencies 
and postsecondary institutions to develop and operate model 4-
year programs that begin in high school and provide students 
with the mathematical, science, communication, and 
technological skills needed to earn a 2-year associate degree 
or 2-year certificate in a given occupational field.
    Tribally controlled postsecondary vocational 
institutions.--The Committee has provided $5,600,000 on a 
current-funded basis for tribally controlled postsecondary 
vocational institutions. This is an increase of $1,000,000 over 
the fiscal year 2000 appropriation and the administration 
recommendation. This program provides grants for the operation 
and improvement of tribally controlled postsecondary vocational 
institutions to ensure continued and expanded educational 
opportunities for Indian students. Grantee institutions may use 
the funds for costs connected with training teachers, providing 
instructional services, purchasing equipment, administration, 
and operating and maintaining the institution.
    National programs, research.--The Committee recommends 
$26,500,000 for national research programs, an increase of 
$9,000,000 above the 2000 appropriation and the administration 
request.
    The amount of $9,000,000 has been provided to continue 
activities authorized by Section 118 of the Carl Perkins Act. 
The Act requires that at least 85 percent of the amount be 
provided directly to State Occupational Information 
Coordinating Committees (SOICC) to develop and deliver 
occupational and career information to students, job seekers, 
employers, education, employment and training programs. Of the 
total, up to $2,000,000 will support continuation of national 
and State career development and related capacity building 
programs that train personnel in assisting students and adults 
to understand themselves in the context of their career 
development and career transition, to be aware of the world of 
work, to understand the linkage between academic skills and 
work-related skills, to understand the linkages among related 
occupations and their skills requirements, and to make more 
informed and effective career decisions. The remaining funds 
may be used by a National entity to support the efforts of the 
SOICCs, including paying the costs of Federal salaries and 
expenses.
    The National Research Center for Career and Technical 
Education and the National Dissemination Center for Career and 
Technical Education is the only federally funded center charged 
with the responsibility to conduct research and provide 
technical assistance to vocational educators. The results of 
the applied research done by the Center are converted into 
technical assistance to reform and improve vocational education 
instruction in our schools and colleges. The Committee believes 
that the work of the Center is critically important to the 
provision of state-of-the-art job-related instruction that, in 
turn, will strengthen our Nation's economy.

Tech Prep Education Demonstration Program

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

                            Adult Education

    The Committee has included $490,500,000 for adult 
education, $65,000,000 less than the administration request and 
$20,500,000 above the 2000 appropriation.
    Adult education State programs.--For adult education State 
programs, the Committee recommends $470,000,000, an increase of 
$10,000,000 over the administration request and $20,000,000 
above the 2000 appropriation. These funds are used by States 
for programs to enable economically disadvantaged adults to 
acquire basic literacy skills, to enable those who so desire to 
complete a secondary education, and to make available to adults 
the means to become more employable, productive, and 
responsible citizens.
    National activities.--The Committee has included 
$14,000,000, the same as the 2000 appropriation and a decrease 
of $75,000,000 below the administration request.
    National Institute for Literacy.--The Committee recommends 
$6,500,000 for the National Institute for Literacy, authorized 
under section 242 of the Adult Education and Family Literacy 
Act, $500,000 more than the amount appropriated in 2000 and the 
same as the budget request. The Institute provides leadership 
and coordination for the national literacy effort by conducting 
research and demonstrations on literacy, providing technical 
assistance through a State capacity building grant program, 
establishing and maintaining a national center for adult 
literacy and learning disabilities, and awarding fellowships to 
outstanding individuals in the field to conduct research 
activities under the auspices of the Institute.

State grants for incarcerated youth offenders

    The Committee has included $22,000,000 for a program 
authorized by part D of title VIII of the Higher Education Act, 
$3,000,000 above the amount appropriated in fiscal year 2000 
and $10,000,000 more than the administration requested. This 
program provides grants to State correctional education 
agencies to assist and encourage incarcerated youth to acquire 
functional literacy, life and job skills, through the pursuit 
of a postsecondary education certificate or an associate of 
arts or bachelor's degree. Grants will also assist correction 
agencies in providing employment counseling and other related 
services that start during incarceration and continue through 
prerelease and while on parole. Each student is eligible for a 
grant of not more than $1,500 annually for tuition, books, and 
essential materials, and not more than $300 annually for 
related services such as career development, substance abuse 
counseling, parenting skills training, and health education. In 
order to participate in a program, a student must be no more 
than 25 years of age and be eligible to be released from prison 
within 5 years. Youth offender grants are for a period not to 
exceed 5 years, 1 year of which may be devoted to study in 
remedial or graduate education.
    The Committee also has included bill language providing 
$5,000,000 to continue the prisoner literacy initiative as part 
of the Youth Violence Prevention Initiative. The Committee 
notes that the extremely high rates of illiteracy or marginal 
reading skills among inmates is a national problem and 
therefore encourages the development of a uniform model to 
evaluate literacy programs across the country.

                      STUDENT FINANCIAL ASSISTANCE

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

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

Federal Pell Grant Program

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

Federal supplemental educational opportunity grants

    The Committee recommends $691,000,000 for Federal 
supplemental educational opportunity grants [SEOG], an increase 
of $70,000,000 above the 2000 appropriation level and the same 
as the budget request.
    This program provides funds to postsecondary institutions 
for need-based grants to undergraduate students. Institutions 
must contribute 25 percent of SEOG awards, which are subject to 
a maximum grant level of $4,000. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell grant recipients.

Federal work-study programs

    The Committee bill provides $1,011,000,000 for the Federal 
Work-Study Program, an increase of $77,000,000 above the 2000 
level and the same as the administration request. This program 
provides grants to approximately 3,400 institutions to help an 
estimated 1 million undergraduate, graduate, and professional 
students meet the costs of postsecondary education through 
part-time employment. Work-study jobs must pay at least the 
Federal minimum wage and institutions must provide at least 25 
percent of student earnings. Institutions also must use at 
least 7 percent of their grants for community-service jobs.
    The Committee supports continuing funding for the work 
colleges authorized in section 448 of the Higher Education Act. 
These funds help support comprehensive work-service-learning 
programs at qualifying institutions around the Nation. Of the 
funds provided, the Committee has included $3,000,000 to 
continue and expand the work colleges program.

Federal Perkins loans

    The Committee bill includes $100,000,000 for Federal 
Perkins loans capital contributions, which is the same as the 
2000 appropriation and the budget request. The amount 
recommended when combined with institutional revolving funds, 
would maintain the 2001 loan volume at the current estimated 
level of $1,058,000,000. At this funding level nearly 700,000 
loans would be made.
    The Federal Perkins Loan Program supports student loan 
revolving funds built up with capital contributions to about 
2,000 participating institutions. Institutions use these 
revolving funds, which also include Federal capital 
contributions (FCC), institutional contributions equal to one-
third of the FCC, and student repayments, to provide low-
interest (5 percent) loans that help financially needy students 
pay the costs of postsecondary education. The Committee has 
included the amount necessary to maintain the current loan 
volume level.
    The Committee bill also includes $60,000,000 for loan 
cancellations, an increase of $30,000,000 over the 2000 level 
and the same amount requested by the administration. These 
funds reimburse institutional revolving funds on behalf of 
borrowers whose loans are cancelled in exchange for 
statutorily-specified types of public or military service, such 
as working in a Head Start Program, serving in the Peace Corps 
or VISTA, or teaching in a qualified low-income school.

Leveraging educational assistance partnership program

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

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

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

    The Committee recommends $48,000,000 for discretionary 
Federal administrative expenses related to the Federal Family 
Education Loan [FFEL] Program, formerly known as the Guaranteed 
Student Loan Program. The amount recommended is the same as the 
budget request and the amount appropriated in fiscal year 2000.
    Funds appropriated for Federal administrative expenses will 
partially cover the fiscal year 2000 salaries and benefits, 
travel, printing, contracts, and other expenses associated with 
the program, including payment and claims processing, reducing 
loan default costs, and program monitoring. This discretionary 
administrative funding is included in the ``Federal family 
education loans'' appropriation account rather than under the 
Department's ``Salaries and expenses'' account pursuant to a 
requirement of the Federal Credit Reform Act of 1990.
    The FFEL Program is administered through State and private 
nonprofit guaranty agencies that insure loans directly, collect 
defaulted loans, and provide various services to lenders. The 
Federal Government supports the guaranty agencies by providing 
loan advances and reinsurance payments for borrower default, 
death, disability, and bankruptcy. The Federal Government also 
pays guaranty agencies loan processing and issuance fees out of 
the FFEL subsidy and account maintenance fees in the 
administrative funds under section 458 of the Higher Education 
Act.
    The Federal Government also pays an interest subsidy to 
lenders, based on the borrower's interest rate, on behalf of 
Stafford loan student borrowers while they are in school and 
during certain grace and deferment periods. To be eligible for 
this subsidy, students must demonstrate financial need, be 
enrolled at least half time, and not be incarcerated. Federal 
Stafford loans may be borrowed by eligible students, regardless 
of their school year or dependency status. Borrowing limits are 
tied to the extent of need, for the cost of attendance minus an 
expected family contribution, and other aid as determined by a 
statutory need analysis system.
    An unsubsidized Stafford Loan Program for middle-income 
borrowers provides federally reinsured loans to borrowers who 
do not qualify for Federal interest subsidy payments under the 
need-based Stafford Loan Program. Except for the interest 
benefit and certain loan limits, all other terms and conditions 
of the Federal Stafford Loan Program apply to the unsubsidized 
Stafford loans.
    Federal PLUS loans are made to parents of dependent 
undergraduate students. Interest rates for PLUS loans are 
usually higher than those for Federal Stafford loans, and the 
Federal Government does not pay the interest during in-school, 
grace, and deferment periods. No need analysis is required, but 
borrowing cannot exceed cost of attendance minus other aid.

                            HIGHER EDUCATION

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

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

Aid for institutional development

    The Committee recommends $352,500,000 for aid for 
institutional development authorized by titles III and V of the 
Higher Education Act, $59,250,000 above the 2000 appropriation 
and $36,000,000 below the budget request.
    The Committee encourages the Department to provide 
technical assistance and conduct research on issues germane to 
predominately and Historically Black Colleges and Universities 
(HBCUs) and other institutions of higher education that have 
large minority student populations, ranging from disseminating 
best practices information to the most efficient and cost-
effective use of title III funding, reducing student loan 
default rates, increasing graduation rates, and grant writing 
training.
    Strengthening institutions.--The Committee bill includes 
$65,000,000 for the part A strengthening institutions program, 
an increase of $4,750,000 over the 2000 level and $2,000,000 
more than the budget request. The part A program supports 
competitive, 5-year development grants for institutions with a 
significant percentage of financially needy students and low 
educational and general expenditures per student in comparison 
with similar institutions. Applicants may use part A funds to 
develop faculty, strengthen academic programs, improve 
institutional management, and expand student services.
    Hispanic-serving institutions [HSI].--The Committee 
recommends $62,500,000 for institutions at which Hispanic 
students make up at least 25 percent of enrollment, $20,250,000 
above the 2000 level and the same as the administration 
request. Institutions applying for title V funds must meet the 
regular part A requirements and show that at least one-half of 
their Hispanic students are low-income college students. Funds 
may be used for acquisition, rental or lease of scientific or 
laboratory equipment, renovation of instructional facilities, 
development of faculty, support for academic programs, 
strengthen institutional management, and purchase of 
educational materials. Title V recipients are not eligible for 
other awards provided under title III, parts A and B.

Dual Degree Programs for Minority-Serving Institutions

    The Administration requested $40,000,000 for the new Dual 
Degree Programs for Minority-Serving Institutions. This 
initiative intends to make grants available to consortia of 
minority-serving institutions and partner institutions that 
have or will establish 5-year dual-degree programs. The 
Committee defers action on this proposal pending 
reauthorization of elementary and secondary education programs.
    Strengthening historically black colleges and 
universities.--The Committee provides $169,000,000 for part B 
grants, $20,250,000 above the 2000 level and the same as the 
administration request. The part B strengthening historically 
black colleges and universities [HBCU] program makes formula 
grants to HBCU's that may be used to purchase equipment, 
construct and renovate facilities, develop faculty, support 
academic programs, strengthen institutional management, enhance 
fundraising activities, provide tutoring and counseling 
services to students, and conduct outreach to elementary and 
secondary school students. The minimum allotment is $500,000 
for each eligible institution. Part B recipients are not 
eligible for awards under part A.
    Strengthening historically black graduate institutions.--
The Committee bill includes $40,000,000 for the part B, section 
326 program, $9,000,000 above the 2000 level and the same 
amount as the administration request. The section 326 program 
provides 5-year grants to strengthen historically black 
graduate institutions [HBGI's]. The Higher Education Amendments 
of 1998 increased the number of recipients to 18 named 
institutions, but reserved the first $26,600,000 appropriated 
each year to the first 16 institutions included in the previous 
authorization. Grants may be used for any part B purpose and to 
establish an endowment.

Strengthening Alaska native and native Hawaiian-serving institutions

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

Strengthening tribal colleges and universities

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

Fund for the improvement of postsecondary education

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

Minority science and engineering improvement

    The Committee recommends $8,500,000 for the minority 
science and engineering improvement program [MSEIP], $1,000,000 
more than the 2000 level and the same as the administration 
request. This program provides discretionary grants to 
institutions with minority enrollments greater than 50 percent 
to purchase equipment, develop curricula, and support advanced 
faculty training. Grants are intended to improve science and 
engineering education programs and increase the number of 
minority students in the fields of science, mathematics, and 
engineering.

International education and foreign language studies

    The bill includes a total of $73,022,000 for international 
education programs, $3,320,000 above the 2000 level and the 
same as the budget request.
    Domestic programs.--The Committee recommends $62,000,000 
for domestic program activities related to international 
education and foreign language studies, including international 
business education, under title VI of the HEA, the same as the 
2000 appropriation and the administration request. Domestic 
programs include national resource centers, undergraduate 
international studies and foreign language programs, 
international research and studies projects, international 
business education projects and centers, American overseas 
research centers, language resource centers, foreign language 
and area studies fellowships, and technological innovation and 
cooperation for foreign information access.
    Overseas programs.--The bill includes $10,000,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This is $3,320,000 above the 2000 level and 
the same as the budget request. Under these overseas programs, 
grants are provided for group and faculty research projects 
abroad, doctoral dissertation research abroad, and special 
bilateral projects. Unlike other programs authorized by the 
Fulbright-Hays Act and administered by the U.S. Information 
Agency, these Department of Education programs focus on 
training American instructors and students in order to improve 
foreign language and area studies education in the United 
States. The Committee intends that most of the additional 
funding being provided be used to strengthen and expand 
programs in the emerging democracies of Central and Eastern 
Europe and the former Soviet Union, the purpose for which the 
original legislation was enacted.
    Institute for International Public Policy.--The Committee 
bill recommends $1,022,000 for the Institute for International 
Public Policy. This is the same amount as the 2000 level and 
the budget request. This program is designed to increase the 
number of minority individuals in foreign service and related 
careers by providing a grant to a consortium of institutions 
for undergraduate and graduate level foreign language and 
international studies. An institutional match of 50 percent is 
required.

Interest subsidy grants

    The Committee recommends $10,000,000 for interest subsidy 
grants, the same as the administration request and $2,000,000 
less than the 2000 level. This appropriation is required to 
meet the Federal commitment to pay interest subsidies on 
approximately 160 loans made in past years for constructing, 
renovating, and equipping postsecondary academic facilities. No 
new interest subsidy commitments have been entered into since 
1973 but subsidy payments on existing loans are expected to 
continue until the year 2013.

Federal TRIO programs

    The Committee bill includes $736,500,000 for Federal TRIO 
programs, an increase of $91,500,000 above the fiscal year 2000 
appropriation and $11,500,000 more than the administration 
request.
    TRIO programs provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students: Upward Bound 
offers disadvantaged high school students academic services to 
develop the skills and motivation needed to continue their 
education; student support services provides remedial 
instruction and counseling to disadvantaged college students to 
help them complete their postsecondary education; talent search 
identifies and counsels individuals between ages 11 and 27 
regarding opportunities for completing high school and 
enrolling in postsecondary education; educational opportunity 
centers provide information and counseling on available 
financial and academic assistance to adults who are low-income 
and first-generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in graduate 
programs.

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

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

Byrd honors scholarships

    The Committee recommends $41,001,000 for the Byrd honors 
scholarship program, $1,142,000 more than the 2000 
appropriation and the same as the budget request.
    The Byrd honors scholarship program is designed to promote 
student excellence and achievement and to recognize 
exceptionally able students who show promise of continued 
excellence. Funds are allocated to State education agencies 
based on each State's school-aged population. The State 
education agencies select the recipients of the scholarships in 
consultation with school administrators, teachers, counselors, 
and parents. The funds provided will support a new cohort of 
first-year students in 2001, and continue support for the 1998, 
1999, and 2000 cohorts of students in their fourth, third and 
second years of study, respectively. The amount recommended 
will provide scholarships of $1,500 to 27,334 students.

Javits Fellowships

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

Graduate assistance in areas of national need [GAANN]

    The Committee recommends $33,000,000 for graduate 
assistance in areas of national need, $2,000,000 more than the 
2000 level and $2,000,000 more than the request. This program 
awards competitive grants to graduate academic departments and 
programs for fellowship support in areas of national need as 
determined by the Secretary. The program is currently 
supporting study in mathematics, physics, biology, chemistry, 
engineering, geology and related sciences and computer and 
information sciences. Recipients must demonstrate financial 
need and academic excellence, and seek the highest degree in 
their fields.

Learning anytime anywhere partnerships

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

Teacher quality enhancement grants

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

Child care means parents in schools

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

Demonstration projects to ensure quality higher education for students 
        with disabilities

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

Underground railroad program

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

Community Scholarship Mobilization Program

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

GPRA/Higher Education Act Program Evaluation

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

                           howard university

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

    The Committee recommends an appropriation of $224,000,000 
for Howard University, which is the same as the budget request 
and an increase of $4,556,000 over the fiscal year 2000 
appropriation. Howard University is located in the District of 
Columbia and offers undergraduate, graduate, and professional 
degrees through 12 schools and colleges. The university also 
administers the Howard University Hospital, which provides both 
inpatient and outpatient care, as well as training in the 
health professions. Federal funds from this account support 
about 54 percent of the university's projected educational and 
general expenditures, excluding the hospital. The Committee 
agrees with the administration and recommends, within the funds 
provided, $3,530,000 for the endowment program.
    Howard University Hospital.--Within the funds provided, the 
Committee recommends $30,374,000 for the Howard University 
Hospital, the same as the budget request and the fiscal year 
2000 level. The hospital serves as a major acute and ambulatory 
care center for the District of Columbia and functions as a 
major teaching facility attached to the university that trains 
physicians in 17 specialty areas. The Federal appropriation 
provides partial funding for the hospital's operations.

             college housing and academic facilities loans

Appropriations, 2000....................................        $737,000
Budget estimate, 2001...................................         737,000
Committee recommendation................................         737,000

    Federal administration.--The Committee bill includes 
$737,000 for Federal administration of the CHAFL program, the 
same as the 2000 level and the same as the administration 
request.
    These funds will be used to reimburse the Department for 
expenses incurred in managing the existing CHAFL loan portfolio 
during fiscal year 2001. These expenses include salaries and 
benefits, travel, printing, contracts (including contracted 
loan servicing activities), and other expenses directly related 
to the administration of the CHAFL Program.

  historically black college and university capital financing program

Appropriations, 2000....................................        $207,000
Budget estimate, 2001...................................         208,000
Committee recommendation................................         208,000

    Federal administration.--The Committee recommends $208,000 
for Federal administration of the Historically Black College 
and University [HBCU] Capital Financing Program, the same as 
the administration request and an increase of $1,000 above the 
2000 level.
    The HBCU Capital Financing Program makes capital available 
to HBCU's for construction, renovation, and repair of academic 
facilities by providing a Federal guarantee for private sector 
construction bonds. Construction loans will be made from the 
proceeds of the sale of the bonds.

            education research, statistics, and improvement

Appropriations, 2000....................................    $591,081,000
Budget estimate, 2001...................................     517,567,000
Committee recommendation................................     496,519,000

    The bill includes $496,519,000 for educational research, 
statistics, assessment, and improvement programs. This amount 
is $94,562,000 less than the 2000 appropriation and $21,048,000 
below the administration request. This account supports 
education research, statistics, and assessment activities, as 
well as a variety of other discretionary programs for 
educational improvement.

Research, development, and dissemination

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

Statistics

    The Committee recommends $68,000,000 for data gathering and 
statistical analysis activities of the National Center for 
Education Statistics [NCES], the same as the fiscal year 2000 
appropriation and a decrease of $16,000,000 below the 
administration request.
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
Technical assistance to State and local education agencies and 
postsecondary institutions is also provided by the Center.

Assessment

    The Committee recommends $40,000,000 for assessment, the 
same as the amount appropriated in fiscal year 2000 and 
$2,500,000 below the administration request.
    The National Center for Education Statistics uses these 
funds to administer the national assessment of educational 
progress [NAEP], a 20-year-old congressionally mandated 
assessment created to measure the educational achievement of 
American students. The primary goal of NAEP is to determine and 
report the status and trends over time in educational 
achievement, subject by subject. NAEP has been expanded in 
recent years to include State representative assessments as 
well.
    Also included is $4,000,000 for the National Assessment 
Governing Board, $500,000 less than the administration request 
and the same as the fiscal year 2000 appropriation.

Fund for the improvement of education

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

International education exchange

    The Committee has provided $10,000,000 for the 
International Education Exchange Program authorized by section 
601(c) of Public Law 103-227. These funds are $2,000,000 more 
than the amount recommended by the administration and 
$3,000,000 more than the amount appropriated in fiscal year 
2000. The program provides funds to support democracy and free 
market economies in Eastern Europe, the Commonwealth of 
Independent States, and other countries that formerly were part 
of the Soviet Union, by providing educators and other leaders 
from those countries curricula and teacher training programs in 
civic and economic education, as well as the opportunity to 
exchange ideas and experiences with teachers in the United 
States and other participating countries.
    Included within this amount is $1,000,000 to continue a 
civic education program begun in fiscal year 1999 for the 
Republic of Ireland and Northern Ireland and civic education 
assistance to democracies in developing countries. The 
Committee also provides sufficient funds for the initiative 
underway in Bosnia-Herzegovina.

Civic education

    The Committee recommends $12,000,000 for the Center for 
Civic Education, $2,150,000 more than in fiscal year 2000 and 
$2,150,000 more than the administration request. The Committee 
intends that the authorized programs be funded at least at the 
fiscal year 2000 level. This program provides a course of 
instruction at the elementary and secondary level on the basic 
principles of our constitutional democracy and the history of 
the Constitution and the Bill of Rights. Funds also may be used 
to provide advanced training for teachers concerning the 
Constitution and the Bill of Rights.
    Within the amounts provided, the Committee has included 
$1,500,000 to continue the violence prevention initiative begun 
in fiscal year 1999. The Committee encourages that funds be 
used to conduct a five State violence prevention demonstration 
program on public and private elementary, middle, and secondary 
schools involving students, parents, community leaders, 
volunteers, and public and private sector agencies, such as law 
enforcement, courts, bar associations, and community based 
organizations.

Eisenhower professional development Federal activities

    The Committee recommends $23,300,000 for the Eisenhower 
Professional Development Federal Activities Program, the same 
as the 2000 appropriation and $1,700,000 below the 
administration request.
    This program supports activities of national significance 
contributing to the development and implementation of high-
quality professional development in the core academic subjects. 
Projects may include development of teacher training programs, 
or dissemination of information about exemplary programs of 
professional development.
    The Committee continues funding for the National Board for 
Professional Teaching Standards.
    The Committee has included $5,000,000 for the Eisenhower 
National Clearinghouse for Mathematics and Science Education, 
an increase of $200,000 over the fiscal year 2000 level. The 
clearinghouse maintains a permanent repository of mathematics 
and science education instructional materials and programs for 
elementary and secondary schools; disseminates information, 
programs, and instructional materials to the public, 
information networks, and regional consortiums; and coordinates 
with existing data bases containing mathematics and science 
curriculum and instructional materials.

Eisenhower regional mathematics and science education consortia

    The Committee has included $15,000,000 for the Eisenhower 
regional mathematics and science education consortia, the same 
amount appropriated in fiscal year 2000 and the amount 
recommended by the administration. This program supports grants 
to establish and operate regional consortia to disseminate 
exemplary mathematics and science instructional materials and 
provide technical assistance in the use of improved teaching 
methods and assessment tools to benefit elementary and 
secondary school students, teachers, and administrators.

Javits gifted and talented students education

    The Committee has included $7,500,000 for the Javits Gifted 
and Talented Students Education Program, the same amount 
recommended by the administration and $1,000,000 more than the 
fiscal year 2000 appropriation.
    This program authorizes awards to State and local education 
agencies, institutions of higher education, and public and 
private agencies for research, demonstration, and training 
activities designed to enhance the capability of elementary and 
secondary schools to meet the special educational needs of 
gifted and talented students. Priority is given to projects 
that identify and serve gifted and talented students who may 
not be identified and served through traditional assessment 
methods, including those who are economically disadvantaged or 
limited English proficient, or have disabilities. Some funds 
are set aside for a national center for research and 
development in the education of gifted and talented children 
and youth, which conducts research on methods and techniques 
for identifying and teaching gifted and talented students.

National writing project

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

                        Departmental Management


                         program administration

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

    The Committee recommends $396,672,000 for program 
administration, an increase of $13,738,000 above the 2000 
appropriation and $16,512,000 below the budget request.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing, and other services 
required to award, administer, and monitor approximately 170 
Federal education programs. Support for program evaluation and 
studies and advisory councils is also provided under this 
activity.

                        office for civil rights

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

    The Committee bill includes $73,224,000 for the Office for 
Civil Rights [OCR], $2,024,000 above the 2000 appropriation and 
$2,776,000 below the budget request.
    The Office for Civil Rights is responsible for the 
enforcement of laws that prohibit discrimination on the basis 
of race, color, national origin, sex, disability, and age in 
all programs and institutions funded by the Department of 
Education. To carry out this responsibility, OCR investigates 
and resolves discrimination complaints, monitors desegregation 
and equal educational opportunity plans, reviews possible 
discriminatory practices by recipients of Federal education 
funds, and provides technical assistance to recipients of funds 
to help them meet civil rights requirements.

                    office of the inspector general

Appropriations, 2000....................................     $34,000,000
Budget estimate, 2001...................................      36,500,000
Committee recommendation................................      35,456,000

    The Committee recommends $35,456,000 for the Office of the 
Inspector General, $1,456,000 above the 2000 appropriation and 
$1,044,000 less than the administration request.
    The Office of the Inspector General has the authority to 
investigate all departmental programs and administrative 
activities, including those under contract or grant, to prevent 
and detect fraud and abuse, and to ensure the quality and 
integrity of those programs. The Office investigates alleged 
misuse of Federal funds, and conducts audits to determine 
compliance with laws and regulations, efficiency of operations, 
and effectiveness in achieving program goals.

                           General Provisions

    The Committee bill contains language which has been 
included in the bill since 1974, prohibiting the use of funds 
for the transportation of students or teachers in order to 
overcome racial imbalance (sec. 301).
    The Committee bill contains language included in the bill 
since 1977, prohibiting the transportation of students other 
than to the school nearest to the student's home (sec. 302).
    The Committee bill contains language which has been 
included in the bill since 1980, prohibiting the use of funds 
to prevent the implementation of programs of voluntary prayer 
and meditation in public schools (sec. 303).
    The Committee bill includes a provision giving the 
Secretary of Education authority to transfer up to 1 percent of 
any discretionary funds between appropriations (sec. 304).

                       TITLE IV--RELATED AGENCIES

                   Armed Forces Retirement Home Board

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


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

             Corporation for National and Community Service


                  domestic volunteer service programs

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

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

VISTA

    The Committee bill provides $83,074,000 for the Volunteers 
in Service to America (VISTA) Program, $2,500,000 above the 
fiscal year 2000 level and $2,926,000 below the budget request.
    VISTA is a 30-year-old program which provides capacity 
building for small community-based organizations. VISTA 
volunteers raise resources for local projects, recruit and 
organize volunteers, and establish and expand local community-
based programs in housing, employment, health, and economic 
development activities.

National Senior Volunteer Corps

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

Foster Grandparent Program

    The Committee recommends $97,500,000 for the Foster 
Grandparent Program, $1,512,000 above the fiscal year 2000 
appropriations level and $282,000 less than the budget request.
    This program provides volunteer opportunities to seniors 
age 60 and over who serve at-risk youth. This program involves 
seniors in their communities and provides a host of services to 
children.
    The Committee notes that the southeastern portion of Iowa 
is without a Foster Grandparent program (FGP), and urges the 
Corporation to give full and fair consideration to a new FGP 
project in Ottumwa, Iowa.

Senior Companion Program

    For the Senior Companion Program, the Committee bill 
includes $40,219,000, an increase of $1,000,000 over the fiscal 
year 2000 appropriations level and $1,450,000 less than the 
budget request.
    This program enables senior citizens to provide personal 
assistance and companionship to adults with physical, mental, 
or emotional difficulties. Senior companions provide vital in-
home services to elderly Americans who would otherwise have to 
enter nursing homes. The volunteers also provide respite care 
to relieve care givers.
    The Committee recognizes the work of the Civic Venture's 
Experience Corps in developing a model program that mobilizes 
the time, talent, and experience of older adults in service to 
the younger generation. The Committee encourages the 
Corporation to give full and fair consideration to this project 
which is already operating in San Francisco, Kansas City, and 
Philadelphia among other areas, and will expand to sixteen 
other sites this year.

Retired and Senior Volunteer Program

    The Committee bill provides $48,117,000 for the Retired and 
Senior Volunteer Program (RSVP), $2,000,000 above the fiscal 
year 2000 level and $2,448,000 less than the budget request.
    This program involves persons age 55 and over in volunteer 
opportunities in their communities.

Program support

    The Committee bill includes $32,100,000 for program 
support, $971,000 above the fiscal year 2000 appropriation and 
$2,000,000 less than the budget request.

                  Corporation for Public Broadcasting

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

    The Committee recommends an appropriation of $365,000,000 
for the Corporation for Public Broadcasting (CPB), an advance 
appropriation for fiscal year 2003. This amount is $15,000,000 
more than the fiscal year 2002 appropriation and the same as 
the budget request.
    The Committee recommends $20,000,000 for the conversion to 
digital broadcasting. The recommendation is the same as the 
administration request for fiscal year 2001 and $10,000,000 
more than provided last year. These funds are contingent upon 
enactment of specific authorization.
    The Committee encourages CPB to explore new methodologies 
for distribution of Federal matching dollars which take into 
account measures such as per capita support and other factors 
that would serve to level the playing field between urban and 
rural stations in the distribution of matching funds.

               Federal Mediation and Conciliation Service

Appropriations, 2000....................................     $36,693,000
Budget estimate, 2001...................................      39,001,000
Committee recommendation................................      38,200,000

    The Committee recommends an appropriation of $38,200,000 
for the Federal Mediation and Conciliation Service (FMCS), 
$1,507,000 above the fiscal year 2000 appropriation and 
$801,000 less than the budget request.
    The FMCS was established by Congress in 1947 to provide 
mediation, conciliation, and arbitration services to labor and 
management. FMCS is authorized to provide dispute resolution 
consultation and training to all Federal agencies.

            Federal Mine Safety and Health Review Commission

Appropriations, 2000....................................      $6,136,000
Budget estimate, 2001...................................       6,320,000
Committee recommendation................................       6,320,000

    The Committee recommends an appropriation of $6,320,000 for 
the Federal Mine Safety and Health Review Commission, an 
increase of $184,000 over the fiscal year 2000 appropriation 
and the same as the budget request.
    The Federal Mine Safety and Health Review Commission 
provides administrative trial and appellate review of legal 
disputes under the Federal Mine Safety and Health Act of 1977. 
The five-member Commission provides administrative appellate 
review of the Commission's administrative law judge decisions.

         Office of Library Services: Grants and Administration

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

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

Office of Library Services State Grants

    The Committee recommends $143,118,000 for State grants. 
Funds are provided to States by formula to carry out 5-year 
State plans. These plans must set goals and priorities for the 
State consistent with the purpose of the act, describe 
activities to meet the goals and priorities and describe the 
methods by which progress toward the goals and priorities and 
the success of activities will be evaluated. States may 
apportion their funds between two activities, technology and 
targeted services. For technology, States may use funds for 
electronic linkages among libraries, linkages to educational, 
social and information services, accessing information through 
electronic networks, or link different types of libraries or 
share resources among libraries. For targeted services, States 
may direct library and information services to persons having 
difficulty using a library, underserved urban and rural 
communities, and children from low income families. Within the 
total recommended, $3,030,000 has been provided for library 
services to Native Americans and Native Hawaiians.

National leadership projects

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

Administration

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

                  Medicare Payment Advisory Commission

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

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

        National Commission on Libraries and Information Science

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

    The Committee recommends an appropriation of $1,495,000 for 
the National Commission on Libraries and Information Science, 
an increase of $200,000 over the fiscal year 2000 appropriation 
and the same as the budget request.
    The Commission determines the need for, and makes 
recommendations on, library and information services, and 
advises the President and Congress on the development and 
implementation of national policy in library and information 
sciences.

                     National Council on Disability

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

    The Committee recommends an appropriation of $2,615,000 for 
the National Council on Disability, $224,000 above the fiscal 
year 2000 appropriation and the same as the budget request.
    The Council is mandated to make recommendations to the 
President, the Congress, the Rehabilitation Services 
Administration, and the National Institute on Disability and 
Rehabilitation Research, on the public issues of concern to 
individuals with disabilities. The Council gathers information 
on the implementation, effectiveness, and impact of the 
Americans With Disabilities Act and looks at emerging policy 
issues as they affect persons with disabilities and their 
ability to enter or reenter the Nation's work force and to live 
independently.

                     National Education Goals Panel

Appropriations, 2000....................................      $2,241,000
Budget estimate, 2001...................................       2,350,000
Committee recommendation................................       2,350,000

    The Committee recommends $2,350,000 for the national 
education goals panel, $109,000 above the 2000 appropriation 
and the same as the budget request.
    Following the 1989 education summit in Charlottesville, the 
Governors and President Bush agreed on education goals for the 
Nation and created the National Education Goals Panel as an 
accountability mechanism to monitor and report on the Nation's 
progress toward reaching the goals. To date, the goals panel 
has issued eight annual reports delineating National and State 
progress toward the national education goals.

                     National Labor Relations Board

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

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

                        National Mediation Board

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

    The Committee recommends an appropriation of $10,400,000 
for the National Mediation Board, $838,000 more than the fiscal 
year 2000 appropriation and the same as the budget request.
    The National Mediation Board protects interstate commerce 
as it mediates labor-management relations in the railroad and 
airline industries under the Railway Labor Act. The Board 
mediates collective bargaining disputes, determines the choice 
of employee bargaining representatives through elections, and 
administers arbitration of employee grievances.

            Occupational Safety and Health Review Commission

Appropriations, 2000....................................      $8,470,000
Budget estimate, 2001...................................       8,720,000
Committee recommendation................................       8,720,000

    The Committee recommends an appropriation of $8,720,000 for 
the Occupational Safety and Health Review Commission, $250,000 
above the fiscal year 2000 appropriation and the same as the 
budget request.
    The Commission serves as a court to justly and 
expeditiously resolve disputes between the Occupational Safety 
and Health Administration (OSHA) and employers charged with 
violations of health and safety standards enforced by OSHA.

                       Railroad Retirement Board


                     dual benefits payments account

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

    The Committee has provided a total of $160,000,000 for dual 
benefits, including $10,000,000 in income tax receipts on dual 
benefits as authorized by law. The Committee recommendation is 
$13,339,000 less than the fiscal year 2000 level and the same 
as the budget request.
    This appropriation provides for vested dual benefit 
payments authorized by the Railroad Retirement Act of 1974, as 
amended by the Omnibus Reconciliation Act of 1981. This 
separate account, established for the payment of dual benefits, 
is funded by general fund appropriations and income tax 
receipts of vested dual benefits.

          Federal payments to the railroad retirement account

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

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

                      limitation on administration

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

    The Committee recommends an appropriation of $92,500,000 
for the administration of railroad retirement/survivor benefit 
programs. This amount is $1,845,000 more than the fiscal year 
2000 comparable level, and the same as the budget request.
    The Board administers comprehensive retirement-survivor and 
unemployment-sickness insurance benefit programs for the 
Nation's railroad workers and their families. This account 
limits the amount of funds in the railroad retirement and 
railroad unemployment insurance trust funds which may be used 
by the Board for administrative expenses.

           limitation on the office of the inspector general

Appropriations, 2000....................................      $5,380,000
Budget estimate, 2001...................................       5,700,000
Committee recommendation................................       5,700,000

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

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

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

    The Committee recommends an appropriation of $20,400,000 
for payments to Social Security trust funds, the same as the 
administration request. This amount reimburses the old age and 
survivors and disability insurance trust funds for special 
payments to certain uninsured persons, costs incurred 
administering pension reform activities, and the value of the 
interest for benefit checks issued but not negotiated. This 
appropriation restores the trust funds to the same financial 
position they would have been in had they not borne these 
costs, properly charged to the general funds.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

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

    The Committee recommends an appropriation of $365,748,000 
for special benefits for disabled coal miners. This is in 
addition to the $124,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 2000. The 
recommendation is the same as the administration request. These 
funds are used to provide monthly benefits to coal miners 
disabled by black lung disease and to their widows and certain 
other dependents, as well as to pay related administrative 
costs.
    The Social Security Administration holds primary 
responsibility for claims filed before July 1973, with the 
Department of Labor responsible for claims filed after that. By 
law, increases in black lung benefit payments are tied directly 
to Federal pay increases. The year-to-year decrease in this 
account reflects a declining beneficiary population.
    The Committee recommends an advance appropriation of 
$114,000,000 for the first quarter of fiscal year 2002, the 
same as the administration request. These funds will ensure 
uninterrupted benefit payments to coal miners, their widows, 
and dependents.

                      SUPPLEMENTAL SECURITY INCOME

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

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

Beneficiary services

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

Research and demonstration projects

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

Administration

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

Continuing disability reviews

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

                 LIMITATION ON ADMINISTRATIVE EXPENSES

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

    The Committee recommends a program funding level of 
$7,010,800,000 for the limitation on administrative expenses, 
which is $123,200,000 less than the administration request and 
$438,764,000 higher than the fiscal year 2000 level.
    This account provides resources from the Social Security 
trust funds to administer the Social Security retirement and 
survivors and disability insurance programs, and certain Social 
Security health insurance functions. As authorized by law, it 
also provides resources from the trust funds for certain 
nontrust fund administrative costs, which are reimbursed from 
the general funds. These include administration of the 
supplemental security income program for the aged, blind and 
disabled; work associated with the Pension Reform Act of 1984; 
and the portion of the annual wage reporting work done by the 
Social Security Administration for the benefit of the Internal 
Revenue Service. The dollars provided also support automated 
data processing activities and fund the State disability 
determination services which make initial and continuing 
disability determinations on behalf of the Social Security 
Administration. Additionally, the limitation provides funding 
for computer support, and other administrative costs.
    The limitation includes $6,469,800,000 for routine 
operating expenses of the agency, which is $123,200,000 less 
than the amount requested by the President and $362,764,000 
over the 2000 comparable amount. These funds, as well as those 
derived from an increase in the user fees which are discussed 
below, cover the mandatory costs of maintaining equipment and 
facilities, as well as staffing.
    The Committee recognizes the significant problems facing 
the Social Security Appeals Council, due to their overwhelming 
workload. Although the amount of appeals processed by the 
Council has almost doubled in the past four years, the number 
of pending cases has doubled as well. Since improvements have 
been made to other aspects of the hearings process of the 
Social Security Administration, the Committee understands that 
more resources could be directed towards the appeals council 
workload. By doing this, the Committee believes that many of 
the cases still pending will be processed in a more timely 
manner.

Social Security Advisory Board

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

User fees

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

                    OFFICE OF THE INSPECTOR GENERAL

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

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

                        U.S. Institute of Peace

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

    The Committee recommends an appropriation of $12,951,000 
for the U.S. Institute of Peace, the same as the fiscal year 
2000 appropriation and $1,499,000 less than the budget request.
    The Institute was established by the U.S. Institute of 
Peace Act (Public Law 98-525) in 1984. The Institute is an 
independent, nonprofit, national organization whose primary 
mission is to promote, through scholarship and education, 
international peace, and the resolution of conflicts without 
recourse to violence.

                      TITLE V--GENERAL PROVISIONS

    The Committee recommendation retains provisions which: 
authorize transfers of unexpended balances (sec. 501); limit 
funding to 1 year availability unless otherwise specified (sec. 
502); limit lobbying and related activities (sec. 503); limit 
official representation expenses (sec. 504); prohibit funding 
of any program to carry out distribution of sterile needles for 
the hypodermic injection of any illegal drug unless the 
Secretary of HHS determines such programs are effective in 
preventing the spread of HIV and do not encourage the use of 
illegal drugs (sec. 505); state the sense of Congress about 
purchase of American-made equipment and products (sec. 506); 
clarify Federal funding as a component of State and local grant 
funds (sec. 507); and limit use of funds for abortion (sec. 508 
and sec. 509).
    The Committee recommendation includes language on human 
embryo research (sec. 510).
    The Committee recommendation retains the limitation on use 
of funds for promotion of legalization of controlled substances 
included last year (sec. 511).
    The Committee recommendation retains the bill language 
limitation on use of funds to enter into or review contracts 
with entities subject to the requirement in section 4212(d) of 
title 38, United States Code, if the report required by that 
section has not been submitted (sec. 512).
    The Committee recommendation continues authority for 
agencies to use unobligated balances through the first quarter 
of fiscal year 2002 (sec. 513).
    The Committee bill includes language regarding the 
individual health identifier (sec. 514).
    The Committee has included bill language which repeals the 
provision in Public Law 105-33 which delays the October SSI 
payment until October 2, 2000. Consequently, the SSI benefit 
due October 1, 2000 (Sunday) will be paid September 29, 2000 
(Friday) consistent with the normal rules for making SSI 
payments which come due on a weekend or non-banking day and 
preventing a hardship on beneficiaries who may be depending on 
the regular payment date in order to meet their expenses for 
food and shelter (sec. 515).
    Current law provides that effective for months after 
September 2009, a State that has entered into an agreement with 
the Social Security Administration for Federal administration 
of State supplementary payments will be required to remit 
payments and fees no later than the business day preceding the 
SSI payment date. The Committee has included bill language 
which accelerates the effective date to the months after 
September 2001. SSI and State supplementary payment 
beneficiaries will not be affected by this proposal (sec. 516).


                                            BUDGETARY IMPACT OF BILL
  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays
                                                             ---------------------------------------------------
                                                               Committee    Amount  of   Committee    Amount  of
                                                               allocation      bill      allocation      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
 to its subcommittees of amounts in the First Concurrent
 Resolution for 2001: Subcommittee on Labor, Health and
 Human Services, Education, and Related Agencies:
    General purpose non-defense discretion-  ary............  ...........       97,820  ...........   \1\ 93,074
    Mandatory...............................................  ...........      237,067  ...........      236,568
Projections of outlays associated with the recommendation:
    2001....................................................  ...........  ...........  ...........  \2\ 221,717
    2002....................................................  ...........  ...........  ...........       39,666
    2003....................................................  ...........  ...........  ...........        9,286
    2004....................................................  ...........  ...........  ...........        1,421
    2005 and future year....................................  ...........  ...........  ...........          394
Financial assistance to State and local governments for 2001           NA      133,220  ...........      114,294
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.
\2\ Excludes outlays from prior-year budget authority.

NA: Not applicable.

Note.--Consistent with the funding recommended in the bill for continuing disability reviews and adoption
  assistance, and in accordance with section 314 of the Congressional Budget Act of 1974, the Committee
  anticipates that the Budget Committee will file a revised section 302(a) allocation for the Committee on
  Appropriations reflecting an upward adjustment of $470,000,000 in budget authority and $408,000,000 in
  outlays.

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

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

    The following items are identified pursuant to this 
requirement:
          Community service employment for older Americans, 
        $440,200,000;
          National Skills Standards Board, $3,500,000;
          Family Planning, $253,932,000;
          Preventive Health and Health Services Block Grant, 
        $130,899,000;
          Sexually transmitted diseases, $131,978,000;
          Injury Prevention and Control (Traumatic Brain Injury 
        Research), $68,000,000;
          Substance Abuse and Mental Health Services 
        Administration (except Program Management), 
        $2,680,814,000;
          Runaway and Homeless Youth; Homeless Youth 
        Transitional Living, $69,155,000;
          Developmental Disabilities, $127,347,000;
          Administration on Aging, $954,619,000;
          Adolescent Family Life, $19,327,000;
          Nursing Loan Payment, $2,279,000;
          Universal Newborn Hearing, $4,000,000;
          Organ Transplantation, $15,000,000;
          Prostate Cancer, $8,721,000;
          Research on Health Care Systems Cost and Access 
        Federal Funds, $24,326,000;
          Violent Crime Reduction Programs, $118,500,000.

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

    Pursuant to paragraph 7(c) of rule XXVI, the bill S. 2553 
was ordered reported from the Committee, subject to amendment 
and subject to the section 302(b) allocation, by recorded vote 
of 28-0, a quorum being present.
    The vote was as follows:
        Yeas                          Nays
Chairman Stevens
Mr. Cochran
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. Gorton
Mr. McConnell
Mr. Burns
Mr. Shelby
Mr. Gregg
Mr. Bennett
Mr. Campbell
Mr. Craig
Mrs. Hutchison
Mr. Kyl
Mr. Byrd
Mr. Inouye
Mr. Hollings
Mr. Leahy
Mr. Lautenberg
Mr. Harkin
Ms. Mikulski
Mr. Reid
Mr. Kohl
Mrs. Murray
Mr. Dorgan
Mrs. Feinstein
Mr. Durbin

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

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

TITLE 8--ALIENS AND NATIONALITY

           *       *       *       *       *       *       *



CHAPTER 12--IMMIGRATION AND NATIONALITY

           *       *       *       *       *       *       *



                       SUBCHAPTER II--IMMIGRATION


Part I--Selection System

           *       *       *       *       *       *       *



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

           *       *       *       *       *       *       *


       Establishing Categories of Aliens for Purposes of Refugee 
Determinations

           *       *       *       *       *       *       *


    ``(a) * * *

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


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

           *       *       *       *       *       *       *


    Adjustment of Status for Certain Soviet and Indochinese Parolees

    ``(a) * * *

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


Public Health Service Act

           *       *       *       *       *       *       *



TITLE XIX--BLOCK GRANTS

           *       *       *       *       *       *       *



SEC. 1918. DETERMINATION OF AMOUNT OF ALLOTMENT.

    (a) * * *

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


SEC. 1933. DETERMINATION OF AMOUNT OF ALLOTMENT.

    (a)  * * *

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


Social Security Act

           *       *       *       *       *       *       *



TITLE IV OF THE SOCIAL SECURITY ACT

           *       *       *       *       *       *       *



SEC. 403. GRANTS TO STATES.

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


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

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *


Balanced Budget Act of 1997, Public Law 105-33

           *       *       *       *       *       *       *



TITLE V--WELFARE AND RELATED PROVISIONS

           *       *       *       *       *       *       *



Subtitle F--Welfare Reform Technical Corrections

           *       *       *       *       *       *       *



CHAPTER 2--SUPPLEMENTAL SECURITY INCOME

           *       *       *       *       *       *       *



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

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

           *       *       *       *       *       *       *


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

           *       *       *       *       *       *       *



TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

           *       *       *       *       *       *       *



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

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

           *       *       *       *       *       *       *


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

                 TITLE I--DEPARTMENT OF LABOR

            EMPLOYMENT AND TRAINING ADMINISTRATION

               TRAINING AND EMPLOYMENT SERVICES

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

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

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

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

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

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

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

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

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

         FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

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

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

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

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

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

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

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

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

                    PROGRAM ADMINISTRATION

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

          PENSION AND WELFARE BENEFITS ADMINISTRATION

                     SALARIES AND EXPENSES

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

             PENSION BENEFIT GUARANTY CORPORATION

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

              EMPLOYMENT STANDARDS ADMINISTRATION

                     SALARIES AND EXPENSES

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

                       SPECIAL BENEFITS

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

               BLACK LUNG DISABILITY TRUST FUND

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

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

         OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

                     SALARIES AND EXPENSES

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

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

             MINE SAFETY AND HEALTH ADMINISTRATION

                     SALARIES AND EXPENSES

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

                  BUREAU OF LABOR STATISTICS

                     SALARIES AND EXPENSES

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

                    DEPARTMENTAL MANAGEMENT

                     SALARIES AND EXPENSES

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

               VETERANS EMPLOYMENT AND TRAINING

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

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

                OFFICE OF THE INSPECTOR GENERAL

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

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

       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

         HEALTH RESOURCES AND SERVICES ADMINISTRATION

                 HEALTH RESOURCES AND SERVICES

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

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

                      Health Professions

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

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

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

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

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

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

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

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

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

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

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

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

          CENTERS FOR DISEASE CONTROL AND PREVENTION

            DISEASE CONTROL, RESEARCH AND TRAINING

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

                 NATIONAL INSTITUTES OF HEALTH

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

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

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

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

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

          AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

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

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

             HEALTH CARE FINANCING ADMINISTRATION

                 GRANTS TO STATES FOR MEDICAID

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

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

                      PROGRAM MANAGEMENT

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

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

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

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

               FAMILY SUPPORT PAYMENTS TO STATES

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

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

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

                REFUGEE AND ENTRANT ASSISTANCE

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

               CHILD CARE AND DEVELOPMENT GRANT

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

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

            CHILDREN AND FAMILIES SERVICES PROGRAMS

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

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

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

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

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

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

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

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

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

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

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

  PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE

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

                    ADMINISTRATION ON AGING

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

                    OFFICE OF THE SECRETARY

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

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

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

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

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

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

        PUBLIC HEALTH AND SOCIAL SERVICE EMERGENCY FUND

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

              TITLE III--DEPARTMENT OF EDUCATION

                       EDUCATION REFORM

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

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

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

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

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

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

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

                EDUCATION FOR THE DISADVANTAGED

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

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

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

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

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

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

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

                  SCHOOL IMPROVEMENT PROGRAMS

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

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

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

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

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

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

                      READING EXCELLENCE

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

                       INDIAN EDUCATION

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

                       SCHOOL RENOVATION

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

               BILINGUAL AND IMMIGRANT EDUCATION

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

                       SPECIAL EDUCATION

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

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

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

        REHABILITATION SERVICES AND DISABILITY RESEARCH

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

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

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

      SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

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

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

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

                VOCATIONAL AND ADULT EDUCATION

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

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

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

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

                 STUDENT FINANCIAL ASSISTANCE

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

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

             FEDERAL FAMILY EDUCATION LOAN PROGRAM

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

                       HIGHER EDUCATION

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

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

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

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

                       HOWARD UNIVERSITY

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

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

 HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING,
                        PROGRAM ACCOUNT

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

        EDUCATION RESEARCH, STATISTICS, AND IMPROVEMENT

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

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

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

                    DEPARTMENTAL MANAGEMENT

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

                         STUDENT LOANS

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

                  TITLE IV--RELATED AGENCIES

                 ARMED FORCES RETIREMENT HOME

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

      CORPORATION FOR NATIONAL AND COMMUNITY SERVICE \5\

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

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

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

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

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

                   RAILROAD RETIREMENT BOARD

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

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

                SOCIAL SECURITY ADMINISTRATION

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

           SPECIAL BENEFITS FOR DISABLED COAL MINERS

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

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

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

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

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

                  OFFICE OF INSPECTOR GENERAL

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

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

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


                                  
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