[Senate Report 107-84]
[From the U.S. Government Publishing Office]




                                                       Calendar No. 193
107th Congress                                                   Report
                                 SENATE
 1st Session                                                     107-84

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2002
                                _______
                                

                October 11, 2001.--Ordered to be printed

                                _______
                                

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

                              R E P O R T

                         [To accompany S. 1536]

    The Committee on Appropriations reports the bill (S. 1536) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education and related agencies for the 
fiscal year ending September 30, 2002, and for other purposes, 
reports favorably thereon and recommends that the bill do pass.



Amount of budget authority

Total bill as reported to Senate........................$407,267,401,000
Amount of adjusted appropriations, 2001................. 364,816,166,000
Budget estimates, 2002.................................. 399,626,042,000
The bill as reported to the Senate:
    Over the adjusted appropriations for 2001...........  42,451,235,000
    Over the budget estimates for 2002..................   7,641,359,000


                            C O N T E N T S

                              ----------                              
                                                                   Page
Summary of Budget Estimates and Committee Recommendations........     4
Overview and Bill Highlights.....................................     4
Highlights of the Bill...........................................     4
Bioterrorism Initiative..........................................     6
Rural Health Initiative..........................................     7
Aging Initiative.................................................    11
Stem Cell Research...............................................    18
Youth Violence Prevention Initiative.............................    19
Reprogramming and Initiation of New Programs.....................    19
Transfer Authority...............................................    20
Title I--Department of Labor:
    Employment and Training Administration.......................    21
    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
    Office of Disability Policy..................................    46
    Veterans Employment and Training.............................    46
Title II--Department of Health and Human Services:
    Health Resources and Services Administration.................    49
    Centers for Disease Control and Prevention...................    82
    National Institutes of Health................................   119
    Substance Abuse and Mental Health Services Administration....   188
    Agency for Healthcare Research and Quality...................   201
    Centers for Medicare and Medicaid Services...................   205
    Administration for Children and Families.....................   217
    Administration on Aging......................................   235
    Office of the Secretary......................................   242
Title III--Department of Education:
    Education for the disadvantaged..............................   254
    Impact aid...................................................   258
    School improvement programs..................................   259
    Indian education.............................................   295
    Bilingual and immigrant education............................   296
    Special education............................................   297
    Rehabilitation services and disability research..............   301
    Special institutions for persons with disabilities:
        American Printing House for the Blind....................   308
        National Technical Institute for the Deaf................   308
        Gallaudet University.....................................   309
    Vocational and adult education...............................   309
    Vocational education.........................................   310
    Adult education..............................................   311
    State grants for incarcerated youth offenders................   312
    Student financial assistance.................................   313
    Federal family education loan program........................   315
    Higher education.............................................   316
    Howard University............................................   333
    College housing and academic facilities loans................   333
    Historically black college and university capital Financing 
      program....................................................   334
    Education research, statistics, and improvement..............   334
    Departmental management:
        Program administration...................................   336
        Office for Civil Rights..................................   337
        Office of the Inspector General..........................   337
    General provisions...........................................   337
Title IV--Related agencies:
    Armed Forces Retirement Home.................................   338
    Corporation for National and Community Service...............   338
    Corporation for Public Broadcasting..........................   340
    Federal Mediation and Conciliation Service...................   341
    Federal Mine Safety and Health Review Commission.............   341
    National Foundation of the Arts and the Humanities: Office of 
      Library Services: Grants and Administration................   341
    Medicare Payment Advisory Commission.........................   345
    National Commission on Libraries and Information Science.....   345
    National Council on Disability...............................   346
    National Education Goals Panel...............................   346
    National Labor Relations Board...............................   346
    National Mediation Board.....................................   347
    Occupational Safety and Health Review Commission.............   347
    Railroad Retirement Board....................................   347
    Social Security Administration...............................   348
    U.S. Institute of Peace......................................   353
Title V--General provisions......................................   354
Title VI--Mark-to-Market Extension Act of 2001...................   355
Budgetary impact of bill.........................................   356
Compliance with paragraph 7, rule XVI of the standing rules of 
  the Senate.....................................................   356
Compliance with paragraph 7(C), rule XXVI of the standing rules 
  of the Senate..................................................   357
Compliance with paragraph 12, rule XXVI of the standing rules of 
  the Sen- 
  ate............................................................   358
Comparative statement of new budget authority....................   376

       Summary of Budget Estimates and Committee Recommendations

    For fiscal year 2002, the Committee recommends total budget 
authority of $407,267,401,000 for the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies. 
Of this amount, $123,071,000,000 is current year discretionary 
funding.

                           ALLOCATION CEILING

    Consistent with Congressional Budget Office scorekeeping, 
the recommendations result in full use of the $123,071,000,000 
in discretionary budget authority pursuant to section 302(b) of 
the Congressional Budget Act of 1974, as amended.

                      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

    Youth violence prevention initiative.--Building on last 
year's efforts, the Committee bill includes $1,542,800,000 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.
    Job Training.--The Committee recommendation includes 
$5,533,281,000 for job training programs, an increase of 
$404,760,000 over the budget request.
    Worker protection.--The Committee bill includes 
$1,422,356,000 to ensure the health and safety of workers, 
including $450,262,000 for the Occupational Safety and Health 
Administration and $256,093,000 for the Mine Safety and Health 
Administration. The recommendation is an increase of 
$63,877,000 over the 2001 level.
    Persons With Disabilities.--In addition to programs 
highlighted individually and to promote independent living in 
home and community based settings, the Committee has included 
$1,275,976,000 for services to persons with disabilities. This 
includes $60,884,000 for programs authorized under the 
Assistive Technology Act, an increase of $19,772,000 over 2001. 
In addition, the recommendation includes $43,263,000 for the 
Office of Disability Policy at the Department of Labor, and 
$70,000,000 for Real Choice Systems Change Grants and Nursing 
Home Transition Grants through the Center for Medicaid and 
Medicare Services.
    National Institutes of Health.--A total of $23,695,260,000 
is recommended to fund biomedical research at the 25 Institutes 
and centers that comprise the NIH. This represents an increase 
of $3,400,000,000 over the fiscal year 2001 level.
    Embryo Adoption.--The Committee has included $1,000,000 for 
a public awareness Campaign to educate Americans about the 
existence of spare embryos and adoption options.
    AIDS.--The Committee bill includes $5,165,565,000 for AIDS 
research, prevention, and services. This includes 
$1,883,000,000 for Ryan White programs, an increase of 
$75,391,000 and $781,213,000 for AIDS prevention programs at 
the Centers for Disease Control and Prevention.
    Bioterrorism initiative.--The Committee bill includes 
$338,000,000 to fund efforts to address bioterrorism threats.
    Medical Error Reduction.--The Committee recommendation 
includes $60,000,000 for activities of the Agency for 
Healthcare Research and Quality to reduce medical errors, an 
increase of $10,000,000 over the administration's request.
    Health Centers.--The recommendation includes $1,343,723,000 
for health centers, an increase of $51,000,000 over the budget 
request, and $175,111,000 over the fiscal 2001 enacted level.
    Centers for Disease Control.--The Committee bill provides 
$331,518,000 within the Centers for Disease Control and 
Prevention to combat the growing threat of infectious disease. 
The amount recommended is an increase of $13,844,000 over the 
fiscal year 2001 amount.
    Community services block grant.--The Committee bill 
includes $675,000,000, an increase of $75,009,000 over the 2001 
enacted level. This program provides a wide range of services 
and activities to alleviate causes of poverty in communities 
and to assist low-income individuals in becoming self-
sufficient.
    Head Start.--The Committee recommendation includes 
$6,600,000,000 for the Head Start Program. This represents an 
increase of $400,188,000 over the 2001 enacted level.
    Low-income home energy assistance.--The Committee 
recommends $2,000,000,000 for heating and cooling assistance 
for low-income individuals and families. Of this amount, 
$300,000,000 supports additional energy assistance during 
emergencies.
    Education for the Disadvantaged.--The Committee has 
provided $11,879,900,000 in grants to enhance educational 
opportunities for disadvantaged children. This includes an 
increase of $1,437,279,000 over the fiscal year 2001 amount for 
grants to local education agencies, bringing the total to 
$10,200,000,000.
    Teacher Quality.--The Committee recommends $3,039,834,000 
for grants to improve teacher quality. This is an increase of 
$931,834,000 above the appropriation for fiscal year 2001 and 
$439,834,000 over the budget request.
    Educational Technology.--The Committee recommends 
$1,000,000,000 for educational technology, an increase of 
$182,904,000 over the budget request.
    After-School Programs.--The Committee recommends 
$1,000,000,000 for 21st Century Community Learning Centers, an 
increase of $154,385,000 over the fiscal year 2001 
appropriation and the budget request.
    Student financial aid.--The Committee recommends 
$12,284,100,000 for student financial assistance, an increase 
of $1,610,100,000 over last year. This recommendation includes 
$713,100,000 for the Federal Supplemental Educational 
Opportunity Grant Program, a $22,100,000 increase over last 
year. The amount provided for the Pell Grant Program will allow 
the maximum grant to be raised to $4,000, an increase of $250 
over the 2001 amount.
    Higher education initiatives.--The Committee bill provides 
$1,764,223,000 for initiatives to provide greater opportunities 
for higher education, including $805,000,000 for Federal TRIO 
programs.
    Education for individuals with disabilities.--The Committee 
bill provides $7,339,685,000 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 
$1,000,000,000 over the 2001 level. Included in this 
appropriation is an increase of $8,048,000 over last year's 
level for Personnel Preparation Services under Part D of IDEA.
    Rehabilitation services.--The bill recommends 
$2,481,383,000 for rehabilitation services, an increase of 
$81,593,000 above the amount provided in 2001. These funds are 
essential for families with disabilities seeking employment.
    Services for older Americans.--For programs serving older 
Americans, the Committee recommendation totals $2,786,477,000 
including $202,547,000 for senior volunteer programs, 
$450,000,000 for community service employment for older 
Americans, $366,500,000 for supportive services and centers, 
and $561,000,000 for senior nutrition programs. For the medical 
research activities of the National Institute on Aging, the 
Committee recommends $909,174,000. The Committee recommendation 
includes $15,000,000 for the Medicare insurance counseling 
program.
    Public broadcasting.--The Committee bill provides 
$375,000,000 to support public radio and television, an 
increase of $15,000,000 over the previous year's appropriation.

                        BIOTERRORISM INITIATIVE

    The terrorist attacks of September 11, 2001 proved the 
willingness of America's enemies to use new types of weapons of 
mass destruction to murder large numbers of civilians. Among 
these new weapons, the use of biological agents in acts of 
terrorism is considered a potential threat with extraordinarily 
grave consequences. An act of bioterrorism could be perpetrated 
directly against the health of Americans, or indirectly via an 
attack on the Nation's food supply. The Appropriations 
Subcommittee on Labor, Health and Human Services, Education and 
Related Agencies recognized the seriousness of this threat and 
held a series of hearings, beginning in 1998 and culminating on 
October 3, 2001, to assess the needs of the civilian agencies 
responsible for responding to acts of bioterrorism. In these 
hearings, the subcommittee heard testimony from Federal, State, 
and local officials that identified potential deficiencies in 
their response to an act of bioterrorism.
    This year's appropriation to the Department of Health and 
Human Services for responding to bioterrorism totals over 
$338,000,000, an increase of over $48,000,000 over last year 
which represents almost a doubling of that budget since 1999. 
The Committee recognizes that the urgency of the threat 
requires more funding, and will work with the administration to 
develop a supplemental appropriation bill that addresses the 
needs of Federal, State, and local agencies and health 
departments to coordinate a response, stockpile appropriate 
pharmaceuticals, and build our public health infrastructure so 
that it may more quickly detect and more effectively respond to 
an act of bioterrorism or any other event that threatens the 
health of our citizens.

                        RURAL HEALTH INITIATIVE

    There are more than 54 million Americans living in rural 
areas, roughly 20 percent of the country's population. Rural 
areas, however, face unique and longstanding problems in 
accessing and maintaining adequate health care services. 
According to HHS' Agency for Healthcare Research and Quality, 
almost one-third of the adults living in rural America is in 
poor to fair health--in fact, it is estimated that over 20 
million rural Americans have inadequate access to health care 
services.
    While there is great variability across rural areas, there 
are some common threads. Typically, rural communities have 
small populations spread out over large geographic areas. This 
causes many rural residents to have to travel great distances 
to receive care and in many communities the challenges are made 
even more difficult by bad weather, poor roads and/or 
mountainous terrain.
    Rural communities often face an aging infrastructure of 
older hospitals and clinics, problems accessing capital 
improvement funding and a limited and often depressed economic 
base.
    The serious lack of mental health and substance abuse 
professionals, community-based services, and infrastructure 
means that, in rural areas, individuals with a mental or 
substance abuse disorder go untreated at disproportionately 
greater rates than Americans with similar health problems 
living in urban communities.
    Rural Americans also are more likely to be poor, old, and 
experiencing poor health and disabilities than their urban 
counterparts. They are less likely than their urban 
counterparts to have access to an automobile or public 
transportation or to have a telephone.
    Thus, while there are significant barriers to primary 
health care for Americans living in all parts of the country, 
access to basic, yet essential, health care services is most 
problematic in rural communities.

Lack of health care clinicians
    Although 20 percent of the population lives in rural areas, 
only 9 percent of physicians practice there. In 2000, rural 
areas contained 67 percent of the country's primary care health 
professional shortage areas.
    While primary care providers are scarce in rural areas, 
specialized care is even more difficult to access. Internists, 
general surgeons, obstetrician-gynecologists and pediatricians 
and other medical specialists tend to be concentrated in bigger 
towns and cities.
    Studies show that physicians trained in rural areas are 
more likely to practice in those areas. Unfortunately, few 
rural training opportunities exist. There are currently only 21 
rural training tracks in which the residents spend the majority 
of their time training in rural areas under the 1+2 model (1 
year in a teaching hospital with 2 years in a rural practice 
site).
    Historically, the National Health Service Corps has been a 
key provider of rural health professionals. In fiscal year 
2000, 61.5 percent of the NHSC placements were in rural areas. 
Unfortunately, due to limited funding, only 12.5 percent of the 
communities eligible for a primary care provider placement 
receive assistance.

Limited local health care services
    Rural hospitals are the lifeblood of the rural health care 
delivery system. The bulk of the 2,187 rural hospitals are 
primary care hospitals. Specialized hospital care, however, is 
limited.
  --Of the 245 long-term care hospitals in the country, only 12 
        of them are in rural areas.
  --Of the 601 psychiatric hospitals in the country, only 81 of 
        them are in rural areas.
  --Of the 208 rehabilitation hospitals in the country, only 21 
        of them are in rural areas.
  --All of the country's 73 children's hospitals are in urban 
        areas.

Aging health care infrastructure
    Rural areas are reliant on an aging infrastructure. Twelve 
percent of rural hospitals located in counties adjacent to 
urban areas are using buildings and fixed equipment that is 
more than 20 years old, compared to just 7 percent for 
hospitals in urban areas. For those rural counties that are not 
adjacent to urban areas, the figure is even higher--15 percent 
are using aging building and equipment.
    There are few sources of capital for rural hospitals. The 
existing capital programs available through the U.S. Department 
of Housing and Urban Development are geared toward large urban 
facilities with substantial administrative requirements that 
are beyond the reach of most small rural providers. The USDA's 
Capital Facilities Loan program offers another opportunity for 
loans and grants but it has limited resources and is open to 
all rural providers and not targeted specifically to health 
care facilities.

Access
    Access problems for rural residents are most severe in the 
more isolated areas, due primarily to lack of providers and 
greater distances needed to travel to receive care.
    Forty-three percent of rural residents go without coverage 
of prescription drugs for the entire year compared to 27 
percent of urban residents. Fifty-two percent of rural elderly 
residents 85 and over have no prescription drug coverage 
compared to 33 percent of their urban counterparts.

Limited economic base
    Rural areas are often adversely affected by poor economic 
conditions. Many of these communities may have a weak economic 
base, which creates limited capacity to support modern health 
care delivery. The limited economic base also makes common 
capital improvements, such as air conditioning repairs, major 
obstacles or sometimes completely unaffordable.

Reliance on Medicare
    Medicare financing plays a critical role in supporting the 
rural health care delivery system and continues to be the 
dominant source of health care reimbursement in rural areas. 
Medicare patient expenses in 1998 accounted for 47 percent of 
total patient care expenses for rural hospitals, compared to 36 
percent of urban hospitals. That makes rural hospitals 
particularly vulnerable to Medicare payment policy changes.
    Also, rural Medicare beneficiaries are typically treated in 
a fee-for-service format and their provider base is heavily 
weighted toward primary care. Fifty-seven percent of the 
physicians in these areas are generalists compared to 27 
percent in urban areas. Therefore, rural populations are 
significantly less likely to receive specialized care, 
including timely EKGs for congestive heart failure and 
transient ischemic attack, follow-up care after 
hospitalizations for diabetes and gastrointestinal bleeding, 
timely gallbladder removal for symptomatic gallstones and 
screening mammography.
    To address these inequities and barriers to access in rural 
communities, the Committee has provided increased funding for 
programs for this rural health initiative.

Access to Providers
    National Health Service Corps.--To help train and retain 
primary care providers in rural areas, the Committee has 
provided $154,400,000, an increase of over $25,000,000 over 
fiscal year 2001 for both recruitment and placement under the 
National Health Service Corps. The Committee expects that a 
significant portion of the additional funding will be used to 
minimize the disparity in the supply of health care providers 
between rural and urban communities.
    Quentin N. Burdick Program for Rural Interdisciplinary 
Training.--The Committee has increased funding for the Quentin 
N. Burdick Program to ensure an appropriate increase in the 
distribution of health care professionals to rural areas by 
recruiting, training, and retaining teams of interdisciplinary 
professionals to work in rural underserved areas.

Access to health care facilities
    Community Health Centers.--The Committee has provided the 
largest single increase--over $175,000,000, for Community 
Health Centers. These centers play an integral role in 
providing critical health care services to underserved and 
uninsured people throughout America. The Committee expects that 
a portion of the additional funding provided in this bill will 
be used to expand access to health care services to rural 
communities.

Support for rural hospitals
    Rural Hospital Flexibility Grants.--The Committee has 
provided full funding for this program to assist States to 
stabilize and improve access to health care services in rural 
communities.
    Regulatory Relief for Rural Hospitals.--The Committee has 
provided $15,000,000 for the Rural Hospital Improvement Program 
to provide grants to small rural hospitals (those with fewer 
than 50 beds) and rural hospital networks to assist struggling 
rural facilities with the administrative burdens created by the 
Balanced Budget Restoration Act and the Health Insurance 
Portability and Accountability Act. While the Committee 
believes these regulatory changes will ultimately improve the 
health care system by improving quality and reducing medical 
errors, it believes rural facilities, because of their unique 
economic barriers, face unique hurdles and deserve some relief.

Reducing health disparities
    Rural Health Research.--The Committee has provided an 
increase for Rural Health Policy Development to improve and 
expand the capacity of Rural Health Research Centers to develop 
and identity appropriate recommendations for improving the 
delivery of health care services in rural communities.
    State Offices of Rural Health.--The Committee has doubled 
funding for the State Offices of Rural Health from $4,000,000 
to $8,000,000. The additional funding will enable States to 
improve rural health outreach and coordination and to better 
meet the specific rural health needs in each State. A portion 
of the new funding will be used to fund rural health quality 
improvement grants throughout America.
    Improving Medicare Reimbursement Levels for Rural 
Providers.--The per-beneficiary reimbursement rate for 
providers is typically much lower in rural States than in more 
heavily populated States. The Committee has directed the 
Secretary to develop a proposal that would increase the payment 
rates to Medicare providers who are currently reimbursed at a 
rate below 95 percent of the national average.
    Rural Health Outreach.--The Committee has provided 
$5,000,000 to improve access to automatic external 
defibrillators in rural communities.

Medical errors initiative
    Last year, the Committee provided funds to begin to address 
the problem of injuries and deaths resulting from preventable 
medical errors. The Institute of Medicine (IOM) estimates that 
medical errors are the fifth leading cause of death in the 
United States. With the $50,000,000 the Committee provided in 
fiscal year 2001, the Agency for Healthcare Research and 
Quality (AHRQ) was able to fund grants for 16 States to allow 
those States to begin collecting comparable data on medical 
errors so that national trends can be determined and analyzed. 
Also, AHRQ used a portion of the funds appropriated to support 
a number of projects to determine innovative ways of reducing 
medical errors.
    This year, the Committee is providing a total of 
$60,000,000 to continue and expand efforts to reduce medical 
errors. The Committee expects that AHRQ will use these funds to 
ensure that lessons learned and best practices will be shared 
among hospitals and healthcare providers. The Committee directs 
AHRQ to work with the Center for Medicare and Medicaid Services 
(CMS) to provide such information to participating hospitals 
and healthcare facilities so that they can begin implementing 
successful strategies. In an effort to reduce medical errors, 
the Committee also directs CMS to prepare a comprehensive 
report on how current State requirements are enforced. This 
report should include information detailing how well the State 
licensing boards are meeting their target patient safety goals.
    The Committee further directs AHRQ to provide a report 
detailing the results of its efforts to reduce medical errors. 
Among other things, the report should include how hospitals and 
other healthcare facilities are reducing medical errors; how 
these strategies are being shared among healthcare 
professionals; how many hospitals and other healthcare 
facilities record and track medical errors; how medical error 
information is used to improve patient safety; what types of 
incentives and/or disincentives have helped healthcare 
professionals to reduce medical errors; a list of the most 
common root causes of medical errors. The report should also 
provide data showing the effectiveness of State requirements in 
reducing medical errors. The report should also describe how 
AHRQ is responding to some of the findings in the IOM's report 
``To Err is Human: Building a Safer Health System.''
    The Committee reiterates its position that there should be 
zero tolerance for preventable medical mistakes and that the 
Congress, the Administration, State licensing boards, and 
private healthcare institutions and providers should work 
together to prevent further unnecessary deaths and injuries.

                            AGING INITIATIVE

    The decennial Census provides us with a snapshot of what 
our society looks like today, reminds us how we have changed 
over the years and offers a preview of the future composition 
of the United States population. Last year, almost 46,000,000 
Americans, or one of every six, were 60 years of age or older. 
While the total population for the United States increased by 
13 percent since 1990, those in the age category 75-84 
increased by twice that rate. Our Nation's most senior group--
the population 85 years and older--increased by three times the 
rate of the overall population, making it the second fastest 
growing age group. The largest increase occurred in the number 
of individuals age 45-54--members of the baby boom generation--
whose ranks increased by 50 percent since 1990. With 
improvements in health care supporting increasing life 
expectancy, it is this group that will add significant shades 
of grey to the picture of the population of the United States.
    These facts illustrate the trend of more people, living 
longer, but that alone does not tell the entire story. Many 
Americans know first hand that increases in age are accompanied 
often by the onset of a disabling condition. Census data show 
that more than half of the population 65 years of age and older 
report at least one disabling condition. Almost 25 percent of 
the Nation's elders will experience multiple, chronic, 
disabling conditions that make it necessary for them to rely on 
others for their care and help with meeting basic needs. And 
for those age 80 and older, approximately 3 out of 4 are likely 
to experience at least one disabling condition, and more than 
one in three will require some assistance with activities of 
daily living.
    In recognition of these facts and the many, significant 
contributions that our Nation's elderly have made and continue 
to make in our society, the Committee has developed an aging 
initiative designed to increase the capacity of home- and 
community-based services to support a high quality life for 
older Americans. The initiative is comprised of two components: 
guidance for the departments funded through the Labor, Health 
and Human Services, and Education and Related Agencies 
appropriations bill to follow in order to improve the 
administration of programs that serve seniors, and additional 
resources to increase the capacity of programs to meet their 
goals and objectives.
    The Committee recognizes that the national aging network, 
comprised of State units on aging, area agencies on aging, and 
service providers, is the foundation of supports and services 
for frail older people, their families and caregivers. Programs 
and services administered by the aging network make it possible 
for frail older people to live in their homes and receive care 
in the home or a community-based setting.
    The Committee notes that many of the aging services 
programs are administered at the Federal level by many 
different departments or agencies, which creates a number of 
barriers that make State and local administration more 
cumbersome. Removing some of these barriers and allowing more 
State and local flexibility will improve the ability of the 
aging network to be responsive to the needs of older people and 
their families and caregivers. The Committee believes that 
interagency cooperation and coordination across different 
programs will help leverage the resources available at the 
Federal level and establish a coordinated infrastructure of 
home- and community-based services for older adults, thereby 
improving the availability and accessibility of these services 
at the local level.
    Therefore, The Committee directs the Secretary of the 
Department of Health and Human Services to set up an 
Interagency Task Force on Aging Programs, comprised of the 
Departments of Health and Human Services, Housing and Urban 
Development, Agriculture, Labor and Transportation. The Task 
Force's efforts should focus on coordinating activities to 
maximize the impact of existing services, reducing and 
eliminating duplication in both service provision and the 
process for accessing such services, and minimizing regulatory 
burdens and costs at the local level. The Committee also 
strongly urges that HHS increase the visibility and prominence 
of elder issues within the Department and encourages the 
Department to provide the Administration on Aging with a more 
visible and stronger leadership role within HHS. The Committee 
expects to be briefed on a quarterly basis about the activities 
and accomplishments of the Task Force.

Strengthening the Aging Network
    The Older Americans Act is the only piece of Federal 
legislation that promotes comprehensive, coordinated systems of 
community care, but it falls short of its promise due to the 
challenges of limited resources. The Committee recognizes that 
insufficient resources available to the aging network makes it 
difficult to serve effectively the millions of Americans 
eligible for services. Therefore, the Committee has increased 
funding for Older Americans Act programs by 10 percent over the 
fiscal year 2001 level. These additional resources will provide 
critical investments in nutrition, caregiver support, 
transportation and other supportive services. The Committee 
believes that these investments in the aging network are 
essential to maintaining a high quality of life for our 
Nation's elderly--in their homes and communities--and a key to 
preparing for the needs associated with the aging of the baby 
boom generation.

Supportive Services and Senior Centers
    The Committee has provided $366,500,000 for the supportive 
services and senior centers program, an increase of $41,425,000 
over last year and the most significant investment in more than 
two decades. The Committee recognizes the critical role that 
this program plays in providing services to seniors that enable 
them to continue living independently at home or in their 
community. For example, transportation assistance provided to 
older Americans residing in rural areas allows them to make 
their doctor's appointment, get vital prescriptions filled or 
shop for groceries. The Committee also is aware that funding 
for elderly case management is essential to provide relief to 
community service providers and partners in the process who 
have historically provided support on a voluntary basis, but 
who now feel they are jeopardizing their ability to provide 
services to all clients by stretching their resources and 
organizations to the breaking point. Without adequate 
transportation assistance, adult day care, case management and 
in-home services that this program provides millions of older 
Americans could face avoidable hospital stays and unnecessary 
institutionalization.

Protection of Vulnerable Older Americans
    The Committee recommendation includes $18,181,000 to defend 
the basic rights of vulnerable older Americans and to help them 
protect themselves from abuse, neglect and exploitation, an 
increase of $4,000,000 over last year. The Committee is aware 
of the findings from the 1998 National Elder Abuse Incidence 
Study that almost 450,000 individuals 60 years of age and older 
in domestic settings experienced abuse, neglect, exploitation 
and/or self-neglect during 1996. Less than 1 in 5 individuals 
actually reported these incidents to the appropriate agencies. 
In addition, approximately 3 million elderly and disabled 
individuals receiving care in nursing homes, assistive living 
facilities and similar arrangements throughout the United 
States filed more than 200,000 complaints about their care. The 
Committee notes that the Institute of Medicine report on 
Improving the Quality of Long-Term Care identified the long-
term care ombudsman program as ``probably the best-known 
advocacy effort in long-term care'' and stated that ombudsmen 
and long-term care professionals argue that ``routine on-site 
presence of ombudsmen establishes resident confidence, allows 
resident problems to be detected before they become serious and 
promotes positive working relationships with facility 
administration and staff.'' The additional resources 
recommended by the Committee will support the hiring of 
additional ombudsmen and the publication and dissemination of 
educational materials.

Family Caregiver Support Program
    The Committee continues its investment in the critical 
long-term care assistance delivered by the family and informal 
caregiving support network by providing a $20,000,000 increase 
in the National Family Caregiver Support Program and an 
increase of $1,000,000 for the Native American Caregiver 
Support Program. The Committee recommends a total of 
$146,000,000 for caregiver support programs. As the population 
of the United States continues to age and average life spans 
continue to lengthen, more and more Americans face the 
challenges of providing care to those who need help because of 
chronic illness or disability. More than 12 million adults have 
a disability that may require assistance from others to carry 
out activities of daily living, such as bathing and feeding. 
The Committee notes that if the work of the more than 7 million 
unpaid caregivers had to be replaced by paid home care staff, 
the estimated cost would be $94,000,000,000 per year. The 
significant increase the Committee recommends is not based on 
cost savings to the Nation's health care system alone, but 
instead reflective of the important assistance and relief that 
caregiver support programs offer for those providing unpaid 
services to loved ones, friends and neighbors--our Nation's 
elderly--to help them continue to live independently in their 
community.
    The Committee strongly urges the Assistant Secretary of the 
Administration on Aging and the Chief Executive Officer of the 
Corporation for National Service to coordinate activities under 
the National Family Caregiver Support program of the Older 
Americans Act in a way that maximizes the ability of local 
communities to meet the burgeoning need for home- and 
community-based care for seniors and respite care for 
caregivers. The Committee notes that the Senior Companion 
Program authorized under the Domestic Volunteer Service Act has 
been providing in-home services to homebound seniors, respite 
services to their families, and more for three decades. 
Volunteers under the Retired and Senior Volunteer Program 
provide hundreds of thousands of hours annually to homebound 
seniors and their families. The Committee understands that 
coordination between area agencies on aging and these grantees, 
particularly those sponsored by groups other than senior 
organizations, can serve to strengthen the infrastructure of 
support available in communities throughout the country and in 
doing so, provide seniors and their families greater access to 
much-needed services.

Nutrition Programs
    The Committee has provided $561,000,000 for elderly 
nutrition programs, an increase of $30,588,000 over last year. 
This increase includes an additional $25,000,000 for the home 
delivered meals program. The Committee notes that nutrition 
programs are a critical component of the overall package of 
home- and community-based services for elderly people. For 
seniors, nutrition can be especially important, because of 
their vulnerability to health problems and physical and 
cognitive impairments. The last evaluation of the elderly 
nutrition programs indicated program participants are twice as 
likely to live alone and have physical impairments, but because 
of the services provided by the nutrition programs, experience 
higher daily intakes of key nutrients and more social contacts 
per month than similar nonparticipants. Expenditures under the 
nutrition program are highly leveraged by State, tribal, local, 
and other Federal monies and services and are also augmented by 
donations from participants--making the nutrition programs a 
great investment of Federal resources. Unfortunately, the 
evaluation noted that 41 percent of service providers have 
waiting lists for home-delivered meals. The increase provided 
by the Committee will help address the critical need for 
additional nutrition services.

Alzheimer's Disease Demonstrations
    The Committee recommendation includes $13,000,000 for this 
demonstration grant program, an increase of $4,038,000 over 
last year. The Committee notes that 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 
currently provides matching grants to 24 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. Given the 
programs proven record of success, the Committee has provided a 
significant investment in order to expand the program to 
additional States.

Enhancing Employment and Training Services for Mature and Older Workers
    Recent Census data show that among individuals age 65 years 
and older, 14 percent were in the civilian labor force. The 
Committee is aware that, prior to enactment of the Workforce 
Investment Act (WIA), the Federal job-training program targeted 
funds specifically to older workers. Currently, WIA funds are 
not targeted for training older workers, at a time when the 
number of older workers is increasing significantly. To remain 
competitive in the labor market, older workers must acquire or 
update their job skills. While WIA is designed to meet the 
needs of all workers, the Committee is concerned that the One-
Stop Career Centers, funded under WIA, may not be adequately 
meeting the training and educational needs of older workers. 
The Committee therefore requests that the Department of Labor 
(DOL) report within 180 days the measures it can undertake to 
ensure training and related services, appropriated under WIA, 
are available to older workers.
    The Committee is pleased that both Senior Community Service 
Employment Program (SCSEP) grantees and the DOL are interested 
in increasing unsubsidized placements of low-income older 
workers participating in the SCSEP program. However, given the 
decline in the national economy, the Committee is concerned 
that any significant increase in the SCSEP unsubsidized 
placement goal, absent the availability of national or local 
WIA occupational skills training resources for SCSEP 
participants, will not be achievable. The Committee, therefore, 
could support a modest increase in the SCSEP minimum 
unsubsidized placement goal only if it is implemented after the 
DOL has assured the Committee that the necessary WIA 
occupational skills training resources are available to all 
SCSEP participants.

Health Care Support Structure
    The Committee has provided $15,000,000 within the Centers 
for Medicare and Medicaid budget to support grants for State 
Health Insurance Counseling and Assistance programs (SHIPs), an 
increase of $5,000,000 over last year. SHIPs provide 
information, counseling and decision support to people with 
Medicare. The 53 State and territorial programs are 
administered either by the State unit on aging or the State 
department of insurance. The Committee is aware that these 
programs provide a valuable service to people with Medicare and 
require a stable source of funding. The CMS shall use these 
resources to provide grants to States for SHIPs to enable them 
to increase their capacity to serve Medicare beneficiaries, to 
operate a resource center and to administer special projects 
that will help SHIPs continuously improve the quality of 
service they provide. The Committee expects CMS to include, 
within its fiscal year 2003 congressional justification, a 
specific dollar request for SHIPs, or to indicate that no 
resources are being requested for this activity.
    The Committee is aware that many elderly individuals may be 
eligible for payment of the cost of medicare cost-sharing under 
the Medicaid program. The Committee notes that studies have 
estimated that 35 to 40 percent of the noninstitutionalized 
population eligible for the Qualified Medicare Beneficiary 
program and Specified Low-Income Medicare programs are not 
receiving the financial assistance available from these 
programs. Research has shown that individuals likely to be 
eligible for this assistance tend to be relatively old, have 
lower income and resources than other Medicare beneficiaries 
and are more likely to be in poor health and have functional 
limitations. In order to increase awareness of and 
participation in these programs, the Committee has provided 
$7,000,000 to the Social Security Administration (SSA) to 
enable SSA to conduct outreach efforts to identify individuals 
who may be eligible for payment of the cost of medicare cost-
sharing under the medicaid program.

Supporting Networks of Home and Community Based Care
    The Committee strongly supports efforts to reduce barriers 
to community living for all Americans. The Committee believes 
the Department of Health and Human Services (HHS) should 
continue to develop initiatives designed to reduce barriers to 
community living and ensure that the elderly disabled 
population is considered in all initiatives designed to address 
barriers to community living. The Committee notes that 
materials released by HHS since the Olmstead decision and in 
response to the New Freedom initiative have said little or 
nothing about the needs of the elderly disabled. The Committee 
believes that greater attention needs to be paid to the needs 
of older persons, to the role played by State Units on Aging 
(SUAs) both as administrators of Medicaid waiver and other home 
and community based services for the elderly and the unique 
issues involved in the delivery of HCBS to older people. The 
Committee also encourages the Centers for Medicare and Medicaid 
Services to focus increased attention on the issue of 
institutionalization, including the unique needs of the 
elderly.
    The Committee has included $50,000,000 within the Centers 
for Medicare and Medicaid Services budget for Real Choice 
Systems Change Grants to States to fund initiatives that 
establish specific actions steps and timetables to achieve 
enduring system improvements and to provide long-term services 
and supports, including community-based attendant care, to 
eligible individuals in the most integrated setting 
appropriate. Grant applications should be developed jointly by 
the State and Consumer Task Force. The Task Force should be 
composed of individuals with disabilities, including the 
elderly, consumers of long-term care services and supports, and 
those who advocate on behalf of such individuals. Grant funded 
activities should focus on areas of need as determined by the 
States and the Task Force such as needs assessment and data 
gathering, strategies to modify policies that unnecessarily 
bias the provision of long-term care to institutional settings 
or health care professionals, strategies to ensure the 
availability of a sufficient number of qualified personal 
attendants and training and technical assistance.
    The Committee notes that the purpose of the Assistive 
Technology Act is to enhance access to assistive technology to 
empower individuals with disabilities to have greater control 
over their lives and more fully participate in their home, 
school, and work environments, and their communities. The 
Committee recognizes the high priority of supporting 
individuals in their home or community-based settings. To that 
end, the Committee encourages the Secretary of Education to 
give priority in providing technical assistance and planning 
for assistive technology to support community living; provide 
States greater flexibility to set priorities under the 
assistive technology program; and facilitate States' ability to 
work directly with lending institutions to make available to 
consumers low cost loans to be used to purchase assistive 
technology that supports independent living. The Committee also 
has included bill language and sufficient resources within the 
Department of Education's Assistive technology program to 
continue all State projects funded under title I of the 
Assistive Technology Act and maintain the current program 
structure of the Alternative Loan Financing program authorized 
under title III of the Act.

Investments in Biomedical Research
    The Committee recommends a record $3,400,000,000 increase 
for the National Institutes of Health over the fiscal year 2001 
appropriation, for a total budget of $23,695,260,000. This 
investment in medical research can foster improved health, 
longer life expectancy, a better quality of life and lower 
health care costs. While the Committee does not earmark 
specific funding levels for individual diseases and conditions, 
a significant portion of this record increase will go toward 
research on aging-related matters. For example, funding for the 
National Institute of Aging will rise 15.7 percent, from 
$786,056,000 in fiscal year 2001 to $909,174,000 in fiscal year 
2002. Funding for the National Institute of Arthritis and 
Musculoskeletal and Skin Diseases will rise 16.5 percent, from 
$394,968,000 to $460,202,000, and funding for the National 
Institute of Neurological Disorders and Stroke will rise 15.4 
percent, from $1,172,132,000 to $1,352,055,000.

                           STEM CELL RESEARCH

    In November 1998, the world first learned that scientists 
had successfully cultured human embryonic stem cells. Those 
researchers found that these cells, in their earliest stages, 
have the ability to transform into any type of cell in the 
human body. In theory, a stem cell implanted into a diseased 
heart, for example, would become a healthy heart cell; the same 
procedure could restore new life to a damaged spinal cord, an 
insulin-deficient pancreas, or a liver riddled by hepatitis. 
That theory gained more credence when another team of 
researchers saw promising signs of movement after injecting 
human embryonic stem cells into the spinal cords of monkeys 
stricken with Lou Gehrig's disease.
    Since 1998, the Subcommittee on Labor, Health and Human 
Services, and Education has held nine hearings on stem cell 
research. The subcommittee has heard more than 20 hours of 
testimony from preeminent scientists who have described the 
potential of stem cells to cure the most common diseases 
afflicting Americans today. It has heard from ethicists who 
have discussed the moral and social implications of pursuing 
this line of research. It has listened to company executives 
recount their hopes for delivering therapies to patients and 
patent attorneys discuss intellectual property rights. But the 
most striking and most compelling testimony has come from 
patients who suffer from diseases and disabilities that could 
one day be treated or cured with the help of embryonic stem 
cells.
    The Committee urges the NIH to move quickly to support all 
types of stem cell research, including embryonic, adult, and 
cord blood, and to keep the Committee informed of the research 
progress.
    The Committee understands that it may take several years to 
translate research on these cells into therapies. Therefore, it 
directs the National Institutes of Health [NIH] to award grants 
for human embryonic stem cell research as quickly as possible, 
in strict compliance with ethical guidelines.

                  YOUTH VIOLENCE PREVENTION INITIATIVE

    An estimated 3 million crimes a year are committed in or 
near the Nation's 85,000 public schools. 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.
    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.
    The Committee is aware of the controversy regarding the 
media's role in influencing youth violence. 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.
    The Committee continues its commitment to provide adequate 
resources to address youth violence. Since fiscal year 1999, 
the Committee has devoted $2,900,000,000 for this prevention 
initiative. This year, the Committee recommends $1,542,800,000 
for this purpose. By reallocating funds from existing programs 
and coordinating efforts throughout the Departments of Health 
and Human Services, Labor, Education and the Department of 
Justice, the agencies have been able to target resources and 
address youth violence in a comprehensive fashion. This 
coordinated approach will improve research, prevention efforts, 
education and treatment strategies.

              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.

                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

Appropriations, 2001....................................  $5,452,453,000
Budget estimate, 2002...................................   5,128,521,000
Committee recommendation................................   5,533,281,000

    The Committee recommends $5,533,281,000 for this account in 
2002 which provides funding authorized primarily by the 
Workforce Investment Act [WIA]. This is $80,828,000 more than 
the 2001 level. This is $404,706,000 above the Administration 
request.
    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 2002 will support 
the program from July 1, 2002, through June 30, 2003.
    Beginning with the fiscal year 2000 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 was the first full year of operations 
under the new Workforce Investment Act, beginning July 1, 2000 
through June 30, 2001. The new legislation is significantly 
enhancing employment and training services, consolidating, 
coordinating, and improving programs utilizing a local level 
one-stop delivery system. However, transition to the new 
legislative requirements has resulted in higher levels of 
unexpended funds than historical averages, allowing for 
continued expansion of job training services in the budget year 
while maintaining formula grant funding at least at current 
levels. The Committee recommendation rejects the cutbacks 
proposed in the President's budget, recognizing the vital role 
of the workforce system at a time of economic slowdown.
    Adult employment and training activities.--For Adult 
Employment and Training Activities, the Committee recommends 
$950,000,000. This is the same as the 2001 comparable level and 
$50,000,000 more than the budget request. 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.
    Dislocated worker employment and training activities.--For 
Dislocated Worker Employment and Training Activities, the 
Committee recommends $1,549,000,000. This is an increase of 
$136,460,000 over the 2001 comparable level. Of this amount, 
$1,272,000,000 is designated for State formula grants, an 
increase of $109,968,000 over the 2001 enacted level. 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. The 
recommendation includes $277,000,000 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 commends the administration for moving 
expeditiously to release emergency dislocated worker funding in 
response to the recent terrorist attacks.
    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, multi-service projects and 
multi-State projects with regard to dislocated workers, and to 
waive certain other provisions in that Act.
    The Committee recommends continuation of the following 
fiscal year 2001 projects and activities in the fiscal year 
2001 conference agreement under the dislocated worker program:
  --Hawaii Department of Labor/Kauai Cooperative Extension
  --Maui Women in High Tech Training
  --JobLinks Program
  --Pennyslvania Training Consortium
  --Clayton College & State University GA-Virtual Ed & Training 
        Project
  --Bethel Native Corp.--Alaska
    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:
  --Good Faith Fund of the Arkansas Enterprise Group in 
        Arkadelphia, Arkansas
  --Opportunities Industrialization Centers, International, 
        services to those who had transitioned from welfare to 
        work but are now out of work
  --Cheiron Foundation, dislocated worker activities in rural, 
        underserved areas
  --Bloomington, Indiana job training program for dislocated 
        workers, using resources of Indiana University
  --Worker retraining for former tobacco workers, Idealliance 
        group in Winston-Salem, North Carolina
  --River Valley Growth Council, worker retraining for metal 
        products industry
  --Chicago Youth and Adult Training Center, careers in the 
        automobile industry
  --United Mineworkers of America career centers for retraining 
        of dislocated miners
  --Dexter Training Center to train and provide career 
        counseling to rural, dislocated workers
  --Training of dislocated and incumbent workers in plastics 
        and metals industries--Buncombe County Mountain Area 
        Workforce Development Board
  --Workforce and related service requirements of migrant and 
        seasonal agricultural workers facing employment 
        dislocation--La Cooperativa Compesina de California
  --Training services to both incumbent and dislocated 
        workers--the Labor Institute of Training in 
        Indianapolis, Indiana, and the Indiana Department of 
        Workforce Development
  --Workforce Training and Retraining for dislocated and 
        incumbent workers in real manufacturing environment--
        University of Albany, New York
  --Workforce Development project to retrain older incumbent 
        workers for Montana workforce--Montana State 
        University, Billings
  --Multi-State (Alabama, California, Connecticut, New 
        Hampshire, Michigan, Ohio, and Vermont) Pilot of 
        National Institute for Metal Working Skills to retrain 
        and certify dislocated workers and low wage workers as 
        metalworkers
  --State of New Mexico--telecommunications job training for 
        dislocated workers
  --Clemson University, retraining of tobacco farmers
  --Oregon technology training program for incumbent and 
        underemployed workers
  --Central Oregon Community College, manufacturing and applied 
        technology center
  --South Central Wisconsin Workforce Development Board
  --Recruiting for the Information Technology Age (RITA), to 
        increase the capacity of Women Work!
  --Opportunity Medical, Highland Park, Illinois, job training 
        for disabled persons
    The Committee recommendation includes, as it has in past 
years, funding for dislocated worker projects aimed at 
assisting the long-term unemployed.
    The Committee encourages efforts to make certain that 
dislocated workers in low pay, entry-level jobs can qualify for 
help under the Dislocated Worker Program and get a fair share 
of the funding.
    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 substantial worker 
dislocation brought on by the closure of all but two sugarcane 
plantations in Hawaii and the rapidly increasing demand for 
food safety training at all levels of food production. To meet 
these needs, the Committee urges funding for the Hawaii 
Department of Labor and Industrial Relations and the Hawaii 
Farm Bureau Federation to provide on-farm and off-farm food 
safety training for dislocated sugarcane workers employed in 
the agricultural and food sector.
    The Committee is aware of a collaborative effort between 
Kenosha County, Wisconsin, and Daimler Chrysler to retrain 
employees and create a regional technology center through the 
dislocated worker skills shortage demonstration program.
    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.
    Youth activities.--For Youth Activities, the Committee 
recommends $1,127,965,000, the same as the 2001 comparable 
level and $127,000,000 more than the budget request. 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 2001 
comparable level and the budget request. Youth Opportunity 
Grants are 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. 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 
$1,399,148,000. This is the same as the budget request and the 
2001 comparable level. The Committee applauds Job Corps for 
establishing partnerships with 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 continue its 
efforts to upgrade its vocational offerings and curricula to 
reflect industry standards and skill shortages. 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 strengthen 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 
continue its efforts to meet industry standards in its 
occupational offerings through a multi-year process to review, 
upgrade, and modernize its vocational curricula, equipment, and 
programs in order to create career opportunities for students 
in appropriate growth industries. The Committee 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.
    Responsible Reintegration for Young Offenders.--The 
Committee recommends $55,000,000 for Responsible Reintegration 
for Young Offenders, the same as the fiscal year 2001 level, to 
address youth offender issues. This large scale WIA Pilot and 
Demonstration initiative will link 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 reintegrate 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 
13,750 youth will be served, and it is expected that 65 percent 
of program graduates will get jobs, re-enroll in high school, 
or be enrolled in post-secondary education or training.
    The Committee recognizes the Home Builders Institute's 
Project CRAFT (Community Restitution and Apprenticeship Focused 
Training) program as a model intervention technique in the 
rehabilitation and reduced recidivism of accused and 
adjudicated juvenile offenders. The Committee also acknowledges 
the home building industry's shortage of skilled workers and 
the role that Project CRAFT plays in helping to address this 
need. As such, the Committee encourages the Department of Labor 
to work with the Justice Department to replicate such a project 
in order to offer at-risk and juvenile offenders pre-
apprenticeship training and job placement in the building 
industry.
    Native Americans.--For Native Americans, the Committee 
recommends $57,800,000. This is $2,800,000 more than the 2001 
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 
recommendation includes $1,711,000 for use under section 
166(j)(1) of the Act, relating to assistance to American 
Samoans. 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 $80,770,000. This is 
$4,000,000 more than the 2001 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. Enrollees and their families 
are provided with employment training and related services 
intended to prepare them for stable, year-round employment 
within and outside of the agriculture industry.
    The Committee recommendation includes bill language 
providing $74,751,000 for State service area formula grants, 
$5,000,000 for migrant and seasonal farmworker housing grants, 
and $1,019,000 for other discretionary purposes.
    In its fiscal year 2001 appropriations report the Committee 
provided an additional $4,253,000 to the Department because of 
the change in the formula used to allocate migrant and seasonal 
farmworker funds to grantees. These funds were used to restore 
grantees serving States with reduced allocations due to the 
formula change to the 1998 funding level for those States. For 
fiscal year 2002, in addition to the $73,643,000 recommended 
for State service area formula grants, the Committee is adding 
$1,108,000 to the $4,253,000 provided in fiscal year 2001 to 
fund grantees in those States impacted by the formula change at 
their comparable 1998 level.
    The Committee believes that the Association of Farmworkers 
Opportunity Programs provide valuable technical assistance and 
training to grantees and has distinguished itself as a 
tremendous resource. Its Children in the Fields Campaign 
provides information, education, and technical assistance 
related to child labor in agriculture. The Association also 
provides other assistance related to employment and training 
(including pesticide and other worker safety training for 
children and adults). The Department is encouraged to continue 
the services that the Association provides these areas.
    For migrant and seasonal farmworker housing, the Committee 
recommendation of $5,000,000 represents an increase of 
$1,000,000 over the fiscal year 2001 level. The Committee 
expects that these funds will be made available to housing 
grantees receiving grants in fiscal year 2000 to develop 
housing and related facilities.
    National programs.--This activity includes WIA-authorized 
programs in support of the workforce system including technical 
assistance and incentive grants, evaluations, pilots, 
demonstrations and research, the Women in Apprenticeship 
Program, as well as the National Skills Standards Advisory 
Board.
    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 $35,000,000 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 recommends continuation of the following 
fiscal year 2001 projects and activities under the pilot and 
demonstration program:
  --Job Corps Fellowship Training Program at Minot State 
        University
  --Training and Education Opportunities-University of Hawaii 
        at Maui
  --Remote Rural Hawaii Job Training project for low-income 
        youth and adults
  --Hawaii American Samoan Job Training
  --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
  --Peabody-Essex Museum in Salem, Massachusetts
  --University of Missouri-St. Louis Regional Center for Ed and 
        Work
  --Vermont Tech College-Tech Training Initiative
  --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
    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:
  --Expansion of Focus Hope Information Technology Center, 
        Detroit
  --Las Vegas Culinary Training Center
  --Intertribal Bison Cooperative expansion
  --Nevada Works demonstration projects
  --Alexandria/Arlington Workforce Investment Board
  --United Technologies Center--photonics curriculum for the 
        purpose of training students
  --Kennebec Valley Technical College--Precision Machining 
        Technology Program
  --New Hampshire Motor Transit Association Driver Training 
        School--public-private effort to recruit, train and 
        retain truck drivers
  --City of Indianapolis--trades training initiative
  --American Printing House for the Blind & Rehabilitation and 
        Research Training Center on Blindness at Mississippi 
        State University--national needs assessment of the 
        Workforce Investment Act's One-Stop Career Centers
  --Honest Day Labor, Nashville, Tennessee--provides homeless 
        and poor individuals with the transportation and tools
  --Total Action Against Poverty--Center for Employment 
        Training skill training program model
  --New Iowans Career Entry--address workforce needs
  --Salt Lake City--Youth City Empowerment program
  --Indiana Department of Workforce Development--Technology 
        Enhancement Certification for Hoosiers
  --Ivy Tech State College of Indiana--Machine Tool Technology 
        Training Initiative
  --Northeast Alabama Adult Education Program--adult education 
        program
  --Chemeketa Community College--educational and support 
        services to Woodburn
  --Koahnic Broadcasting
  --Yukon Kuskokwim Health Corporation
  --Northwest Regional Miner-Training and Research Facility 
        vocational training for miners, laborers, and 
        mechanics, research facilities for underground mining 
        and related safety and environmental problems
  --Altoona Blair County Development Corporation--highly 
        training workforce
  --Manufacturers Research Center & 3 Lehigh Valley community 
        colleges--workforce development system to train 
        dislocated disadvantaged, incumbent and emerging 
        workers
  --Ogontz Avenue Revitalization Corporation--community-
        targeted workforce development
  --Jobs for America's Graduates--school-to-work projects for 
        at-risk young people
  --National Court Reporters Association--recruit and train 
        individuals to perform real-time captioning services
  --Court Reporting Institute of Dallas and Alvin Community 
        College--train reporters and captioners
  --AIB College of Business--train reporters and captioners
  --Chattanooga State Community College--develop curriculum, 
        distance learning programs, job placements for training 
        closed captioners
  --Real Time Captioning at the University of Mississippi 
        School of Court Reporting
  --Lakeshore Technical College and Madison Area Technical 
        College, Wisconsin--train reporters and captioners
  --Green River Community College--train reporters and 
        captioners
  --Community College of Allegheny County--train reporters and 
        captioners
  --Cuyahoga Community College--train reporters and captioners
  --Clark State Community College--train reporters and 
        captioners
  --Alfred State College--train reporters and captioners
  --St. Louis Community College--train reporters and captioners
  --Southern Illinois University at Carbondale--train reporters 
        and captioners
  --Midstate College--train reporters and captioners
  --Sarasota County Technical Institute--train reporters and 
        captioners
  --Gadsen State Community College--train reporters and 
        captioners
  --Orleans Technical Institute in Pennsylvania--train 
        reporters and captioners
  --Chicago Area Workers' Rights Task Force, Center for Import 
        Research
  --Region of Manufacturing Excellence (ROME)--a project to 
        address the manufacturing workforce needs of northeast 
        Ohio
  --Northern Great Plains, Community eBusiness Service Center
  --State of Alaska Rural Veterans Job Search and Job 
        Preparation program
  --State of Alaska rural summer youth employment and academic 
        enrichment program
  --International Longevity Center, New York
  --Center for Employment Training in San Jose, California
  --Hood River Integrated Community/Community College 
        Technology Training and Education program
  --Vermont Telecommunications Application Center
  --Cyber Skills Vermont Workforce Development Initiative
  --Bay Area Workforce Development Board, Wisconsin
  --Great Cities' Universities Skills Enhancement Partnership, 
        Wisconsin
  --Wisconsin Indianhead Technical College
  --Douglas County Senior Center, Wisconsin
  --Northern Wisconsin Concentrated Employment Program, Inc.
  --Community Learning Center at Union County College, 
        Elizabeth, New Jersey
  --Nurse retention demonstration project, Washington Health 
        Foundation
  --Model data plan for Washington State health workforce 
        analysis and planning
  --San Diego State University, high-tech training program
  --Good Faith Fund, Arkansas Enterprise Group
  --University of Arkansas Medical Sciences BioVentures
  --University of Arkansas GENESIS Technology Incubator
  --Working Partners, demonstration programs to help reduce 
        substance abuse in the workplace
  --Tanana Chiefs Conference and the Alaska Laborers Union, on-
        the-job skills training and employment opportunities 
        for Alaska Natives
  --Alaska Department of Labor and Workforce Development to 
        develop a training program for firefighters in remote 
        villages in Alaska
  --Permian Basin Energy Education Project--petroleum 
        technology training
  --Lehigh University--developing innovative educational 
        methods
  --Collegiate Consortium--workforce training
  --Cox Family Enterprise Center--helping individuals meet 
        dramatic challenges of owning, operating, developing 
        family businesses
  --Good Shepherd Home in Lehigh County, the Re Place
  --Compton Youth Succeed Initiative, Los Angeles County
  --Federation of Southern Cooperatives
  --Ready, Willing and Able
  --Southern Arizona Institute of Advanced Technology, high-
        tech training
  --Mayville State University/Traill County Technology Center, 
        North Dakota
  --Bishop Museum
  --Pacific Basin Immigrant Job Training
  --Maui Women Future Employment Opportunities
  --School of the Building Arts to train students in the proper 
        restoration of historic sites, Charleston, SC
  --Retail Employee Link to Education, New Mexico Retailers 
        Association
  --Odyssey Maritime, school to work initiative in Washington 
        State
  --Training for at-risk young people in occupations related to 
        the use of biometric technology in the security 
        industry at Mississippi Valley State University
  --Alcorn Biotechnology Center, distance learning and business 
        training activities
  --Mississippi State University Nursery Assistance
  --University of Mississippi Engineering Coalition
  --Mississippi Delta Community College Business Services 
        Center
  --Harrisburg One-Stop project in Tupelo, Mississippi
  --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, New Jersey
  --Dream Center to provide job and training skills for new 
        labor market entrants or re-entrants--Los Angeles, 
        California
  --North Country Career Center model education and training 
        program--Newport, Vermont
  --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, Vermont
  --Institute for Health Care Workforce Development, South 
        Carolina
  --Lehigh University Job Training for hard to serve 
        disadvantaged youth in manufacturing sector--
        Pennsylvania
  --Workplace Acclimation Program for Ex-Offenders to provide 
        pre-employment training and job placement assistance to 
        former offenders--Safer Foundation, Chicago, Ill
  --Remote 21st Century Rural Hawaii Job Training Project
  --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
  --Nevada Works
  --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, South Carolina--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
  --California State Polytechnic University, technology 
        workforce training
  --San Diego State University, high-tech workforce development
  --Tlingit-Haida project--job training to unemployed natives 
        in southeast Alaska
  --Mott Community College Workforce Development Institute for 
        Manufacturing Simulation
  --Jefferson State Community College, Information Technology 
        workforce development
  --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
  --Covington Work Initiative Network, St Tammany Parish, 
        Louisiana
  --Job Challenge Pilot Program, Louisiana
  --Southeastern Louisiana Economic and Workforce Development 
        Initiative
  --Oregon Institute of Technology
  --Minority-Owned Business Development and Training Initiative 
        of the Minority Business Roundtable
  --Three Rivers Workforce Investment Board to train 
        individuals in information technology occupations to 
        take them from entry-level to mid-level skill positions 
        in Allegheny County
  --University Technology Park/Westchester University for the 
        establishment of a Computer and Internet Training 
        Center
  --Opportunities Industrialization Center of Philadelphia, 
        Inc. for the OIC Hospitality Training Institute of 
        Philadelphia to replicate the Philadelphia 
        Opportunities Inn: Hospitality Training Institute in 
        five cities
  --Southeastern Pennsylvania Chapter of the American Red Cross 
        to provide job counseling, training, and services for 
        disaster victims receiving extended care at the SEPA 
        Chapter Red Cross House
  --National Student Partnerships for the opening of National 
        Student Partnerships at Temple University, establishing 
        staffed offices at the University of Pennsylvania and 
        the University of Pittsburgh, and the continuation of 
        NSP's 18 current sites
  --Nueva Esperanza for the administration of the Nueva 
        Esperanza Telework Center in Philadelphia, to provide 
        technological jobs in a low-income area, provide 
        technical job training and aid in further career 
        development
  --Olde Kensington Redevelopment Corporation for the 
        establishment of the North Philadelphia Senior 
        Development Project by the Olde Kensington 
        Redevelopment Corporation
  --Community Loan Fund Southwestern Pennsylvanian to expand 
        CLF's ``Family-Wage Job Initiative,'' which will 
        provide resources and create family wage jobs in nine 
        Southwestern Pennsylvania Counties
  --The University of Louisville Center for Supply Chain 
        Workforce Development
    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.
    Women in Apprenticeship.--The Committee recommends 
$1,000,000 to continue the current level of the Women in 
Apprenticeship and Nontraditional Occupations program. This 
activity provides technical assistance to employers and unions 
to assist them in training, placing, and retraining women in 
nontraditional jobs and occupations.
    National Skills Standards Advisory Board.--The Committee 
recommends the budget request of $3,500,000 for the Board, the 
same amount provided in fiscal year 2001.
    The Committee understands that the Board helped the 
Manufacturing Skill Standards Council (MSSC) develop the 
comprehensive national manufacturing skill standards which were 
unveiled earlier this year and believes that it should now help 
the MSSC develop assessments and certifications to accompany 
these standards.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2001....................................    $440,200,000
Budget estimate, 2002...................................     440,200,000
Committee recommendation................................     450,000,000

    The Committee recommends $450,000,000, an increase of 
$9,800,000 over the budget request and the fiscal year 2001 
appropriation for community service employment for older 
Americans. 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 2002 
appropriation will support the program from July 1, 2002, 
through June 30, 2003. 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 aware that, prior to enactment of the 
Workforce Investment Act (WIA), the Federal job-training 
program targeted funds specifically to older workers. 
Currently, WIA funds are not targeted for training older 
workers, at a time when the number of older workers is 
increasing significantly. To remain competitive in the labor 
market, older workers must acquire or update their job skills. 
While WIA is designed to meet the needs of all workers, the 
Committee is concerned that the One-Stop Career Centers, funded 
under WIA, may not be adequately meeting the training and 
education needs of older workers. The Committee therefore 
requests that the Department report within 180 days the 
measures it can undertake to ensure training and related 
services, appropriated under WIA, are available to older 
workers.
    The Committee is pleased that both senior Community Service 
Employment Program grantees and the Department are interested 
in increasing unsubsidized placements of low-income older 
workers participating in the SCSEP program. However, given the 
decline in the national economy, the Committee is concerned 
that any significant increase in the SCSEP unsubsidized 
placement goal, absent the availability of national or local 
WIA occupational skills training resources for SCSEP 
participants, will not be achievable. The Committee, therefore, 
could support a modest increase in the SCSEP minimum 
unsubsidized placement goal only if it is implemented after the 
Department has assured the Committee that the necessary WIA 
occupational skills training resources are available to SCEP 
participants.

              Federal unemployment benefits and allowances

Appropriations, 2001....................................    $406,550,000
Budget estimate, 2002...................................     415,650,000
Committee recommendation................................     415,650,000

    The Committee recommends $415,650,000, the same as the 
budget request and an increase of $9,100,000 above the 2001 
enacted level for Federal unemployment benefits and allowances. 
These are entitlement funds.
    The trade adjustment line item has two activities totaling 
$349,500,000 in fiscal year 2002.
    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 $255,000,000. This is the 
same as the budget request and an increase of $7,000,000 above 
the 2001 comparable level. These funds will permit payment of 
benefits, averaging $239 per week, to 33,400 workers for 2002.
    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 $94,500,000 for this 
activity, the same as the budget request and an increase of 
$100,000 above the 2001 comparable level. These funds will 
provide services for an estimated 22,400 workers.
    For NAFTA activities, $66,150,000 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 $29,000,000 
for this activity. This is the same as the budget request and 
an increase of $2,000,000 over the 2001 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 2002 current services 
recommendation is $37,150,000, the same as the fiscal year 2001 
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, 2001....................................  $3,380,210,000
Budget estimate, 2002...................................   3,414,338,000
Committee recommendation................................   3,430,338,000

    The Committee recommends $3,430,338,000 for this account. 
This is $16,000,000 above the budget request and $50,128,000 
above the 2001 comparable level. Included in the total 
availability is $3,238,886,000 authorized to be drawn from the 
``Employment Security Administration'' account of the 
unemployment trust fund, and $191,452,000 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 
$2,413,923,000. This includes $2,403,923,000 for State 
Operations, which is the same as the President's request and 
$50,128,000 above the fiscal year 2001 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 2,622,000 average weekly insured unemployment 
(AWIU) claims. The Committee recommendation includes 
$10,000,000 for UI national activities, the same as the fiscal 
year 2001 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 2,622,000. 
This contingency amount would fund the administrative costs of 
unemployment insurance workload over the level of 2,622,000 
insured unemployed per week at a rate of $28,600,000 per 
100,000 insured unemployed, with a pro rata amount granted for 
amounts of less than 100,000 insured unemployed.
    The Committee recommendation includes bill language which 
addresses the settlement of litigation relating to the 
acquisition of an automated system for benefit payments under 
the unemployment compensation program.
    For the employment service, the Committee recommends 
$848,415,000 which includes $23,452,000 in general funds 
together with an authorization to spend $824,963,000 from the 
``Employment security administration'' account of the 
unemployment trust fund.
    Included in the recommendation for the employment service 
[ES] is $796,735,000 for Grants to States, available for the 
program year of July 1, 2002, through June 30, 2003. This is 
the same as the budget request and the 2001 comparable level. 
The recommendation includes $51,680,000 for national 
activities, an increase of $2,000,000 over the budget request.
    The recommendation also includes $148,000,000 for one-stop 
career centers. 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.
    The recommendation includes $20,000,000 for the 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 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 $22,000,000 for the 
administration of these initiatives, an increase of $2,000,000 
over the 2001 level.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2001....................................    $435,000,000
Budget estimate, 2002...................................     464,000,000
Committee recommendation................................     464,000,000

    The Committee recommends $464,000,000, an increase of 
$29,000,000 above the 2001 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 2002 
advances will be made to the black lung disability trust fund. 
The requested amount is required to provide for loan interest 
payments on Black Lung Trust Fund borrowed amounts.
    The separate appropriations provided by the Committee for 
all other accounts eligible to borrow from this account in 
fiscal year 2002 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, 2001....................................    $158,863,000
Budget estimate, 2002...................................     161,078,000
Committee recommendation................................     161,078,000

    The Committee recommendation includes $112,571,000 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 
$161,078,000. This is $2,215,000 greater than the 2001 
comparable level.
    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 
previous year's appropriations. 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 is aware that citizens of Alaska suffer from 
high unemployment rates due to a lack of available career and 
vocational job training, and that Alaska employers are often 
forced to import labor, while leaving many untrained Alaskans 
unemployed. The Committee encourages the Department to work 
with Alaska Department of Labor and Workforce Development on a 
project to conduct a comprehensive analysis of the State's 
labor requirements and the training facilities which would be 
required to meet those needs, and to provide technical 
assistance, professional development and capacity building for 
existing vocational and technical training, and to establish a 
statewide database of such programs.
    The Committee continues to be concerned over the economic 
plight of western Alaska, one of the poorest, most desolate 
areas in the United States with unemployment rates ranging 
upwards of 80 percent in many villages, due in large part to 
the collapse of the fishing industry there. The Committee urges 
the Department to continue its contribution to the University 
of Alaska and the State of Alaska's major economic development 
initiative in western Alaska, including establishment of talent 
banks for employers, needs assessments for employers, and 
training of unemployed workers for available jobs.
    The Committee supports the Vermont Department of 
Education's current efforts to assess the State's vocational/
technical education infrastructure.

              Pension and Welfare Benefits Administration


                         SALARIES AND EXPENSES

Appropriations, 2001....................................    $107,633,000
Budget estimate, 2002...................................     107,988,000
Committee recommendation................................     112,418,000

    The Committee recommendation provides $112,418,000 for this 
account, which is $4,785,000 above the 2001 comparable level.
    This recommendation provides sufficient funding to offset 
the impact of inflation, preventing the reduction in full-time 
equivalent staffing assumed in the budget request.
    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.

                  Pension Benefit Guaranty Corporation

    The Corporation's estimate for fiscal year 2002 includes 
benefit payments of $1,079,000,000, multiemployer financial 
assistance of $6,270,000, administrative expenses limitation of 
$11,690,000, and services related to terminations expenses of 
$178,924,000.
    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, 2001....................................    $362,716,000
Budget estimate, 2002...................................     284,434,000
Committee recommendation................................     377,145,000

    The Committee recommendation includes $377,145,000 for this 
account. This is $14,429,000 above the 2001 comparable level 
and $92,711,000 above the ubdget request. The bill contains 
authority to expend $1,981,000 from the special fund 
established by the Longshore and Harbor Workers' Compensation 
Act; the remainder are general funds. In addition, an amount of 
$31,443,000 is available by transfer from the black lung 
disability trust fund. This is the same as the request and 
$1,150,000 above the 2001 comparable level.
    This recommendation provides sufficient funding to offset 
the impact of inflation, preventing the reduction in full-time 
equivalent staffing assumed in the budget request. It rejects 
the administration's proposed legislation that would have 
established a surcharge on the amount billed to Federal 
agencies for workers' compensation benefits to finance Labor 
Department administrative expenses of $80,281,000.
    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 supports expansion of the equal pay 
initiative, which helps business improve the way they pay their 
employees, and assists in education about the importance of 
equal pay.

                            SPECIAL BENEFITS

Appropriations, 2001....................................     $56,000,000
Budget estimate, 2002...................................     121,000,000
Committee recommendation................................     121,000,000

    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 $121,000,000, the same as the 
budget request and an increase of $65,000,000 above the 2001 
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 2002 is 
$3,267,514,000, an increase of $25,044,000 above the 2001 
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 use fair share collections to fund capital 
investment projects and specific initiatives to strengthen 
compensation fund control and oversight.

       Energy Employees Occupational Illness Compensation Program

Appropriations, 2001....................................     $60,328,000
Budget estimate, 2002...................................     136,000,000
Committee recommendation................................     136,000,000

    The Committee recommends $136,000,000 for this account in 
2002. This is the same as the President's request and 
$75,672,000 above 2001.
    The mission of the Energy Employees Occupational Illness 
Compensation Program is to deliver benefits to eligible 
employees and former employees of the Department of Energy, its 
contractors and subcontractors or to certain survivors of such 
individuals, as provided in the Energy Employees Occupational 
Illness Compensation Program Act. The mission also includes 
delivering benefits to certain beneficiaries of the Radiation 
Exposure Compensation Act.
    The Energy Employees Occupational Illness Compensation 
Program provides benefits authorized by the Energy Employees 
Occupational Illness Compensation Program Act. The Program went 
into effect on July 31, 2001. The Department of Labor's Office 
of Workers' Compensation Programs within the Employment 
Standards Administration is responsible for adjudicating and 
administering claims filed by employees or former employees (or 
their survivors) under the Act.
    The Committee is concerned that the Secretary's planned 
implementation of the Energy Employees Occupational Illness 
Compensation Program will not result in sufficient services 
being provided to residents of West Texas who may qualify for 
benefits under the law. As the number of potential 
beneficiaries residing near the Pantex facility in Amarillo 
exceeds 12,000, a full-time resource center in that area is 
necessary to fully meet their needs. The Committee therefore 
expects the Secretary to establish a full-time resource center 
in West Texas and to provide the Committee with a report within 
90 days of enactment of the Act on the Department's progress in 
this regard.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2001 (Definite).........................  $1,027,900,000
Budget Estimate, 2002 (Definite)........................      54,717,000
Budget Estimate, 2002 (Indefinite)......................     981,283,000
Committee recommendation (Definite).....................      54,717,000
Committee recommendation (Indefinite)...................     981,283,000

    The Committee recommends $1,036,115,000 for this account in 
2002, of which $54,832,000 is definite budget authority and 
$981,283,000 is indefinite budget authority. In total, this is 
an increase of $8,215,000 over the 2001 comparable level and 
$115,000 more than the administration request. This represents 
a change in the appropriation language beginning in fiscal year 
2002 for the Black Lung Disability Trust Fund. This change will 
eliminate the need for drawdowns from the subsequent year 
appropriation in order to meet current year compensation, 
interest, and other benefit payments. The appropriation 
language will continue to provide definite budget authority for 
the payment of administrative expenses for the operation and 
administration of the Trust Fund.
    The total amount available for fiscal year 2002 will 
provide $388,283 000 for benefit payments, and $54,832,000 for 
administrative expenses for the Department of Labor. Also 
included is $407,343,000 for interest payments on advances. In 
fiscal year 2001, comparable obligations for benefit payments 
are estimated to be $407,393,000 while administrative expenses 
for the Departments of Labor and Treasury, respectively, are 
$52,201,000 and $356,000. In fiscal year 2001, the interest 
payments on advances is estimated to be $568,000,000.
    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 53,250 people will be receiving black 
lung benefits financed from the trust fund by the end of the 
fiscal year 2002. This compares with an estimated 57,000 
receiving benefits in fiscal year 2001.
    The basic financing for the trust fund comes from a coal 
excise tax for underground and surface-mined coal. Additional 
funds come from reimbursement payments from mine operators for 
benefit payments made by the trust fund before the mine 
operator is found liable, and advances. The advances to the 
fund assure availability of necessary funds when liabilities 
may exceed other income. The Omnibus Budget Reconciliation Act 
of 1987 continues the current tax structure until 2014.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

Appropriations, 2001....................................    $425,886,000
Budget estimate, 2002...................................     425,835,000
Committee recommendation................................     450,262,000

    The Committee recommendation includes $450,262,000 for this 
account. This is an increase of $24,427,000 over the budget 
request and an increase of $24,376,000 above the 2001 
comparable level. This agency is responsible for enforcing the 
Occupational Safety and Health Act of 1970 in the Nation's 
workplaces.
    This recommendation provides sufficient funding to offset 
the impact of inflation, preventing the reduction in full-time 
equivalent staffing assumed in the budget request.
    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 believes that OSHA's worker safety and health 
training and education programs, including the grant program 
that supports such training, are a critical part of a 
comprehensive approach to worker protection. The Committee is 
concerned that OSHA cut funding to help establish ongoing 
worker safety and health training programs and has indicated 
that due to funding cutbacks, such programs would be eliminated 
in fiscal year 2002. The committee has provided $3,000,000 in 
additional funds to restore the institutional competency 
building training grants.
    The Committee is concerned about the significant increase 
in workplace fatalities among Hispanic and immigrant workers 
that were reported in the 2000 BLS Census of Fatal Occupational 
Injuries. OSHA is urged to conduct an in-depth review of, and 
within 6 months, report to the Committee on the nature and 
causes of workplace fatalities and injuries among Hispanic and 
immigrant workers, the adequacy of existing standards, 
enforcement, compliance assistance, outreach and training 
programs that are directed towards these high risk workers, and 
specific initiatives OSHA plans to undertake to provide 
enhanced protection to these workers.
    The Committee has provided funding to maintain the State 
consultation grant program and expects that this program will 
continue to be targeted to provide compliance assistance to 
small businesses. The Committee understands that OSHA has 
conducted a study on the effectiveness of the State 
consultation program--the first such evaluation of the program 
since it was initiated in 1977--and that a draft report has 
been prepared. The agency is urged to finalize this report 
within the next 60 days and to provide a copy to the Committee 
upon its completion.
    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 2002 the Committee expects OSHA to 
continue to place high priority on the VPP. 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, 2001....................................    $246,306,000
Budget estimate, 2002...................................     246,306,000
Committee recommendation................................     256,093,000

    The Committee recommendation includes $256,093,000 for this 
account. This is $9,787,000 more than the 2001 comparable 
level.
    This recommendation provides sufficient funding to offset 
the impact of inflation, preventing the reduction in full-time 
equivalent staffing assumed in the budget request.
    This agency insures the safety and health of the Nation's 
miners by conducting inspections and special investigations of 
mine operations, promulgating mandatory safety and health 
standards, cooperating with the States in developing effective 
State programs, and improving training in conjunction with 
States and the mining industry.
    The Committee is concerned that miners working in 
vermiculite, talc, and taconite mines throughout the country 
are not being adequately protected from deposits of asbestos. 
The Committee is informed that in March of this year, the 
Inspector General of the Department of Labor issued an 
Evaluation of MSHA's Handling of Inspections at The W.R. Grace 
& Company Mine in Libby, Montana. The Committee urges MSHA to 
consider initiating rulemaking to implement recommendations 
contained within the Inspector General's evaluation as quickly 
as possible, and to provide an update on this progress to the 
Committee within 6 months.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

Appropriations, 2001....................................    $450,887,000
Budget estimate, 2002...................................     476,000,000
Committee recommendation................................     476,000,000

    The Committee includes $476,000,000 for this account, the 
same as the budget request and $25,113,000 more than the 2001 
comparable level. This includes $69,132,000 from the 
``Employment Security Administration'' account of the 
unemployment trust fund, and $406,868,000 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.
    The Committee has included bill language making $10,280,000 
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, 2001....................................    $357,387,000
Budget estimate, 2002...................................     329,765,000
Committee recommendation................................     361,834,000

    The Committee recommendation includes $361,834,000 for this 
account, which is $32,069,000 more than the budget request and 
$4,447,000 above the 2001 comparable level. In addition, an 
amount of $22,590,000 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.
    The Committee recommendation includes $25,177,000 for 
Executive Direction, a 5 percent reduction from the request.
    The Committee recommends $10,186,000 for the Women's 
Bureau, the same as the budget request and fiscal year 2001 
level. The Committee urges the Women's Bureau to provide 
increased support for effective programs such as ``Women 
Work!'', to provide technical assistance and training on 
programming for women in transition.
    The Committee recommends $147,982,000 for the Bureau of 
International Labor Affairs, the same level of funding as 
provided in fiscal year 2001.
    Of this amount, the Committee's recommendation includes 
$82,000,000 in recognition of the U.S. commitment, pursuant to 
adoption and ratification of ILO Convention #182, to provide 
additional resources on a sustained basis to assist developing 
countries in removing the worst forms of child labor. Of that 
sub-total, $45,000,000 constitutes the U.S. contribution to 
sustain and replicate the successful efforts of the ILO's 
International Program for the Elimination of Child Labor 
(IPEC). The remaining $37,000,000 is for assistance to expand 
the program initiated in fiscal year 2001 to afford access to 
basic education for children removed from the worst forms of 
child labor in impoverished nations where abusive and 
exploitative child labor is most acute. While the Committee is 
concerned by the slowness of the Department in obligating all 
of the funds previously appropriated for this purpose, 
affording access to basic education is the single most 
effective means to curb the worst forms of child labor. 
Therefore, the Committee reaffirms its support for this 
complementary work to international efforts and expects the 
Department to collaborate more effectively with our country's 
labor attaches and labor reporting officers abroad, as well as 
USAID and IPEC officials, in order to program these funds more 
promptly where they can do the most good.
    The Committee further recommends $20,000,000 for 
multilateral technical assistance and $17,000,000 for bilateral 
technical assistance. These funds help developing countries 
implement core labor standards, strengthen the capacities of 
Ministries of Labor to enforce national labor laws and protect 
internationally-recognized worker rights. The Committee expects 
ILAB to use these bilateral funds to further develop, improve, 
and expand its internal capacity and to post staff in the field 
to provide top quality, professional expertise on a continuing 
basis. The Committee further expects ILAB to provide a report 
to the Committee to explain the nature and scope of the 
technical assistance already provided with the increased 
funding appropriated to the Department in recent years. In this 
regard, the report should include efforts to improve the depth, 
quality, and regularity of reporting, as part of a strategic 
plan for ILAB activities, to be submitted to the Committee no 
later than September 1, 2002.
    The Committee recommendation includes $10,000,000 for 
global workplace-based HIV-AIDS education and prevention 
programs. The Committee expects the Department to work through 
the ILO to most effectively program the appropriated funds.
    The Committee recommendations further include $5,000,000 
for ILAB to build its own permanent capacity to monitor and 
report regularly and in-depth to the Congress on the extent to 
which foreign countries with trade and investment agreements 
with the United States respect internationally-recognized 
worker rights as currently required under various U.S. laws and 
effectively promote core labor standards as embodied in the ILO 
Declaration on Fundamental Principles and Rights at Work. In 
this regard, the Committee recognizes that it may be necessary, 
from time to time, for the Department to tap private sector 
expertise from knowledgeable employer, trade union, and non-
governmental organizations with their own presence or in-
country partners on the ground in foreign countries.
    For other ILAB programs, including 125 FTE for Federal 
Administration, the Committee recommends $13,982,000.
    Finally, the Committee requests that ILAB undertake and 
complete a study by October 1, 2002 to firmly establish, if 
feasible, amounts spent on military expenditures each year from 
1990-2001 compared to expenditures on basic education in each 
of the foreign countries with serious child labor problems as 
identified in the prior seven ILAB studies on child labor. This 
study should also determine the underlying trends and specific 
amounts that the World Bank and other international financial 
institutions have committed to specifically combat abusive 
child labor and to improve access to basic education in these 
problem countries every year since 1989.
    The Committee requested a study by the Department in fiscal 
year 1998 on the development of a methodology for the regular 
reporting of working conditions in the production of apparel 
imported into the United States. The Committee expects this 
report to be provided by December 31, 2001 along with 
corresponding recommendations for overcoming whatever 
deficiencies were identified.
    Acknowledging the need to upgrade the information 
technology capability in the Department of Labor, the Committee 
provides $37,000,000 for the information technology fund. The 
total provided includes support for cross-cutting investments 
such as common office automation suite implementation, and 
architecture requirements and web services.
    The Committee is aware of the important work the U.S. 
Department of Labor's Office of Policy is doing to encourage 
small businesses to develop alcohol-and drug-free workplace 
programs. The Labor Department established the Working Partners 
Program, an educational outreach initiative that has worked 
with numerous businesses in creating prevention programs to 
promote a safe, healthy and productive workforce. The Committee 
encourages the Department to continue the Working Partners 
Program.
    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.

                      Office of Disability Policy

Appropriations, 2001....................................     $22,969,000
Budget estimate, 2002...................................      43,263,000
Committee recommendation................................      43,263,000

    The Committee recommends $43,263,000 for this account in 
2002. This is the same as the President's request and 
$20,294,000 above 2001.
    Congress created the Office of Disability Employment Policy 
(ODEP) in the Department of Labor's fiscal year 2001 
appropriation. Programs and staff of the former President's 
Committee on Employment of People with Disabilities (PCEPD) 
have been integrated into this new office.
    The ODEP mission, under the leadership of an Assistant 
Secretary, is to bring a heightened and permanent long-term 
focus to the goal of increasing employment of persons with 
disabilities. This will be achieved through policy analysis, 
technical assistance, and development of best practices, as 
well as outreach, education, constituent services, and 
promoting ODEP's mission among employers.
    The increase includes: an expansion of one-stop 
accessability grants, to support the process of implementing 
the ``ticket to work'' through One-Stop Career Centers; 
expanding the provision of grants aimed at developing and 
implementing innovative programs for moving youth with 
disabilities from school to work; and funding an Olmstead grant 
program to assist persons with significant disabilities in 
making the transition from institutional settings to the 
community and employment.
    The Committee recommendation includes $1,000,000 to fund a 
minimum of three pilot programs to promote the employment of 
individuals with significant disabilities in Federal employment 
positions that can be performed from home-based work stations. 
Telecommunications technology makes it possible for properly 
equipped individuals employed in customer service/call contact 
centers, claims, loan or financial transaction processing 
operations to work from home-based work stations. Each pilot 
program should identify appropriate positions in a Federal 
agency, equip and train qualified individuals with significant 
disabilities for such positions and, at the end of 1 year, 
report to the Office of Disability Policy on the results of the 
telecommuting project, including number of individuals with 
disabilities employed in telecommuting jobs, attrition rates 
and performance of such individuals in comparison to the 
general workforce, and the feasibility of employing more 
individuals with disabilities in other agency positions.

                    Veterans Employment and Training

Appropriations, 2001....................................    $211,656,000
Budget estimate, 2002...................................     211,703,000
Committee recommendation................................     213,703,000

    The Committee recommendation includes $213,703,000 for this 
account, including $26,800,000 in general revenue funding and 
$186,903,000 to be expended from the ``Employment Security 
Administration'' account of the unemployment trust fund. This 
is $2,000,000 more than the budget request and $2,047,000 above 
the 2001 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. These amounts 
are the same as the budget request and the fiscal year 2001 
enacted level.
    For Federal administration, the Committee recommends 
$28,035,000, an increase of $47,000 over the fiscal year 2001 
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 2001 
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 urges funding for 
the Institute be maintained, to the extent possible, at the 
2001 level.
    The Committee recommendation includes $19,000,000 for the 
Homeless veterans program, an increase of $1,500,000 over the 
budget request and fiscal year 2001 level. Also included is 
$7,800,000 for the Veterans Workforce Investment Program, an 
increase of $500,000 above the budget request and fiscal year 
2001 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, 2001....................................     $54,683,000
Budget estimate, 2002...................................      57,133,000
Committee recommendation................................      57,133,000

    The bill includes $57,133,000 for this account, the same as 
the budget request and $2,450,000 above the 2001 comparable 
level. This funding will cover the agency's built in increases. 
The bill includes $52,182,000 in general funds and authority to 
transfer $4,951,000 from the ``Employment Security 
Administration'' account of the unemployment trust fund. In 
addition, an amount of $328,000 is available by transfer from 
the black lung disability trust fund.
    The Office of the Inspector General [OIG] was created by 
law to protect the integrity of departmental programs as well 
as the welfare of beneficiaries served by those programs. 
Through a comprehensive program of audits, investigations, 
inspections, and program evaluations, the OIG attempts to 
reduce the incidence of fraud, waste, abuse, and mismanagement, 
and to promote economy, efficiency, and effectiveness.

                           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).

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     HEALTH RESOURCES AND SERVICES

Appropriations, 2001....................................  $5,570,177,000
Budget estimate, 2002...................................   4,972,687,000
Committee recommendation................................   5,518,843,000

    The Committee recommends an appropriation of $5,518,843,000 
for health resources and services. This is $546,156,000 more 
than the administration request and $51,334,000 less than 
fiscal year 2001.
    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 $1,343,723,000 for the health 
centers, which is $175,111,000 above the fiscal year 2001 level 
and $51,000,000 above the administration request for this group 
of programs, which include community health centers, migrant 
health centers, health care for the homeless, and public 
housing health service grants.
    Community, migrant, public housing and homeless health 
centers will provide primary health care services to nearly 12 
million people this year. While the number of uninsured 
Americans decreased last year for the first time in a decade, 
the number of uninsured seeking care at health centers has 
increased dramatically. In addition, millions of people who 
have health insurance coverage encounter serious difficulties 
in getting access to health care. For many of these Americans, 
health centers are the only source of primary and preventive 
health care. Located in over 3,000 rural and urban medically-
underserved communities in all 50 States, health centers have 
proven to be a cost-effective and efficient source of care for 
the underserved. By providing access to basic health services, 
health centers annually save the health care system billions of 
dollars in reduced use of costly emergency room, specialty, and 
hospital inpatient care.
    The Committee does not set aside any additional 
appropriations for loan guarantee authority under Section 
330(d) of the Public Health Services Act. The Committee intends 
that unused loan guarantee authority made available in fiscal 
year 1997 and fiscal year 1998 continue to be available for 
guarantees of both loan principal and interest.
    As in previous years, the Committee limits the amount 
available for payment of claims under the Federal Tort Claims 
Act to $5,000,000.

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 67 percent have incomes below the poverty 
line.
    The Committee supports the administration request to 
eventually expand the program to double its service capacity. 
In addition, the Committee notes that HRSA should distribute 
additional resources provided in this bill to increase the 
number of new and expanded sites by 1,200 over the next 5 
years.
    As part of its rural health initiative the Committee 
expects HRSA to give priority consideration to creating new 
health centers in underserved communities, especially rural 
communities. In addition, the Committee supports providing 
assistance to struggling health centers to ensure their 
stability and quality of care and to existing health centers to 
expand the scope of medical services available to the 
community.
    The Committee remains concerned about the affordability of 
prescription drugs for all Americans. To help address this 
concern, the Committee encourages community health centers to 
utilize innovative approaches under their statutory Federal 
drug discount authority to reduce costs for those in greatest 
need, particularly the elderly and lower income Americans.
    The Committee continues to be concerned about how the 
Department distributes health center funds to States with large 
uninsured and underserved populations. The Committee requests 
the Secretary to review the program to ensure that funds are 
distributed in an equitable and appropriate manner, and provide 
a report to the Committee by June 30, 2002. The Department 
should explain how it intends to rectify any inequities in 
funds distribution or if there is some rationale for these 
inequities.
    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 applauds the agency for its initiative in 
Alaska, the ``Alaska Frontier Health Plan,'' and encourages the 
agency to continue and expand its efforts with this program.

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 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.

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.
    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 2002.
    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.

Other Native Hawaiian and Pacific Islander health issues

    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 
requests inclusion of the Samoan and other Pacific Island 
populations to partake in the traditional healing, prevention 
and disease management opportunities in the Waimanalo Health 
Center.
    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 encourages the development of a Center of 
Excellence for Indigenous Health and Healing at the University 
of Hawaii and in 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 and pharmacy. 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. The Committee also supports the creation 
of a Native Hawaiian Center of Nursing Excellence at the 
University of Hawaii at Hilo.
    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 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.
    Currently the State of Hawaii and Pacific Basin Region are 
experiencing an acute shortage of Doctorally prepared 
Pharmacists and there is no school of pharmacy in the State. 
Unique to Hawaii is the fact much its population comes from the 
pacific basin region and use health interventions that are 
unique to this part of the world. Therefore the Committee urges 
HRSA to develop a pharmacy program at the University of Hawaii/ 
Hilo that includes as part of the curriculum, strong clinical 
focus on pacific basin region culture and traditional 
interventions. The University of Hawaii/Hilo has a relationship 
with the National Tropical Botanical Gardens that would allow 
students in the school of pharmacy a rich study in ethnobiology 
helping them to provide a broader background and cultural 
understanding of the Hawaiian population.
    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 
provisions of health care in rural areas.

National Health Service Corps: Field placements

    The Committee provides $49,511,000 for field placement 
activities, which is $8,047,000 above the fiscal year 2001 
level and $7,000,000 more than 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 $104,916,000 for recruitment 
activities, which is $17,000,000 more than the fiscal year 2001 
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 multi-year, rather than single-
year, commitments.
    As part of its rural health initiative, the Committee is 
increasing funding for field placements and recruitment to 
address growing concerns about primary care provider shortages 
in rural and underserved areas. The Committee strongly supports 
these programs because of their success in recruiting, 
training, and retaining well trained providers in these areas. 
The Committee is aware that providers who train in rural and 
underserved areas are more likely to elect to practice in those 
areas.
    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 applauds the efforts of the National Health 
Service Corps (NHSC) to place psychologists and other mental 
and behavioral health professionals in designated underserved 
areas including community and migrant health centers. 
Nevertheless, the Committee believes greater emphasis should be 
placed on this priority to increase the number of these 
providers placed in Mental (and Behavioral) Health Professional 
Shortage Areas. In addition, the Committee is concerned that no 
psychologists are participating in the Scholarship Program. The 
Committee, therefore, directs the NHSC to take all necessary 
steps to increase the number of positions assigned to Mental 
Health Professional Shortage Areas (including for 
psychologists) and to begin including psychologists in the 
Scholarship Program.
    The Committee intends that $8,000,000 of the funds 
appropriated for this activity be used for State offices of 
rural health. As part of its rural health initiative, the 
Committee is significantly increasing funding for the offices 
of rural health to allow States to better coordinate care and 
improve support and outreach in rural areas.

                           HEALTH PROFESSIONS

    For all HRSA health professions programs, the bill includes 
$352,927,000, which is the same as fiscal year 2001 and 
$213,174,000 more than the administration request for these 
programs.
    The health professions and nursing education programs under 
Title VII and VIII of the Public Health Service Act provide 
support to students, programs, departments, and institutions to 
improve the accessibility, quality, and racial and ethnic 
diversity of the health care workforce. In addition to 
providing unique and essential training and education 
opportunities, these programs help meet the health care 
delivery needs of the over 2,800 Health Professions Shortage 
Areas in this country, at times serving as the only source of 
health care in many rural and disadvantaged communities. 
Providers who were trained under Title VII and VIII-funded 
programs are 3-5 times more likely to provide health care in 
rural and underserved areas. The organizations representing 
schools, programs, and institutions that benefit from this 
funding have determined that these programs needs strong 
funding to educate and train a health care workforce that meets 
the public's health care needs.
    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 is pleased that HRSA has re-focused the 
Minority Centers of Excellence program on providing support to 
historically minority health professions institutions. The 
Committee encourages the Centers of Excellence program to 
consider applications that are responsive to allied health 
professions which 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.
            Health careers opportunity program
    This program provides funds to medical and other health 
professions schools for recruitment of disadvantaged students 
and pre-professional 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 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.
    The Committee is pleased that HRSA has given priority 
consideration for H-COP grants to minority health professions 
institutions, and recommends that grant review committees have 
proportionate representation from these institutions. The 
Committee encourages the H-COP program to consider applications 
that are responsive to allied health professions which are 
experiencing shortages and high vacancy rates, such as 
laboratory personnel.
            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 intend that all health 
professions disciplines made eligible by statute be able to 
participate in the scholarship 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 Committee recognizes that these programs play a 
critical role in meeting the oral health care needs of 
Americans; especially those who require specialized or complex 
care and represent vulnerable populations in underserved areas. 
Additionally, the Committee realizes that several States have 
fewer than 10 pediatric dentists. The Committee notes that 
there is clearly a shortage of dentists needed to address the 
oral health requirements of America's children.
            Family medicine training
    Family medicine activities support grants for graduate 
training in family medicine, grants for pre-doctoral 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

    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

    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.
            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.
    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.
            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
    These programs seek to improve access, diversity, and 
distribution of allied health practitioners to areas of need. 
The program improves access to comprehensive and culturally 
competent health care services for underserved populations.
    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 professionals; and provide traineeships or 
fellowships to postbaccalaureate students who are participating 
in the program and who commit to teaching in the allied health 
profession involved. This program also provides funds to expand 
existing training programs or develop new ones, recruit 
individuals into allied professions with the most severe 
shortages or whose services are most needed by the elderly, and 
increase faculty recruitment and education, and research.
    The 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 is concerned 
about high vacancy rates for these critical laboratory 
personnel and encourages HRSA to redouble efforts to address 
these shortages.
            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. 
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. As part of its rural health initiative, the Committee 
expects to significantly increase funding for this program to 
help increase the number of health care providers in rural 
areas. The Committee continues to be concerned about the lack 
of providers in rural areas and expects the increased funding 
for this program will help alleviate this problem.
    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 expects the Bureau to expand its support 
for telecommunications and telehealth initiatives for providing 
distance education and training for nurses and allied health 
professionals serving rural areas.
            Podiatric primary care training
    This 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 continues to strongly support the 
chiropractic research and demonstration grant program, 
originally authorized under Section 782 of Public Law 102-408, 
and funded by the Committee in previous years. The Committee 
recommends that the chiropractic-medical school demonstration 
grant program be continued and funded at no less than current 
levels.

F. Nursing workforce development

    The Committee recognizes the current nursing shortage is 
creating a health care crisis in hospitals and skilled nursing 
facilities. The lack of young people in nursing has resulted in 
a steady and dramatic increase in the average age of U.S. 
nurses. Today, the average age of a working RN is 43 years old. 
According to recent surveys, one in five nurses plans to retire 
by 2006, exacerbating the shortage. Another factor contributing 
to the nursing shortage is the availability of nursing faculty. 
They, like nurses in healthcare delivery, are aging. Thus, for 
some schools, even if they could recruit more students, they 
may not have faculty to teach them. The Committee believes that 
this is an area that requires critical attention.
    Another reason for this shortage is the inability of 
nursing schools to educate more nursing students, which is in 
turn largely the result of a lack of qualified nursing faculty. 
Since the average age of nurse educators today is 55, this 
shortage of educators will continue to accelerate. The 
Committee is further aware of the success of the Troops-to-
Teachers program at the Departments of Defense and Education in 
placing qualified military veterans into teaching positions in 
America's public schools through an expedited certification 
process. The Committee therefore encourages HRSA to establish a 
pilot program similar to the Troops-to-Teachers program to 
encourage qualified, active duty military nurses to become 
nurse educators in certified nursing school programs. The 
program should include career and placement assistance, 
transitional stipends for those who commit to teach in nursing 
schools, and cooperation with nursing schools to expedite the 
transition from the military to civilian teaching.
    To address the well documented nursing shortage, the 
Committee expects funding for advanced education nursing, basic 
nurse education and practice, and nursing workforce diversity 
to be increased over the fiscal year 2001 funding level.
    The Committee directs the Secretaries of the Departments of 
Health and Human Services and Labor, in collaboration with the 
American Nurses Association and American Colleges of Nursing, 
to convene a national panel by March 1, 2002, to examine 
education and training requirements for all nursing 
occupations. The panel is encouraged to provide specific 
recommendations on education, training, continuing education, 
retention, and professional development for all levels of 
nursing care providers. The Committee directs the Department to 
fund this initiative and provide a report to the Committee with 
specific recommendations within 1 year of the panel's creation.
            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 Medical 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. There is 
also a severe shortage of trained nursing professionals in 
rural Alaska. The Committee encourages the agency to consider 
continuing and expanding the University's current program, 
including supportive services, stipends for needy students, and 
distance delivery of educational components.
    The Committee is aware of a need for more public health 
nurses, public health aides and child health consultants in 
remote areas of rural Alaska and encourages the agency to work 
with the Alaska Department of Health and Social Services to 
help meet these needs, particularly in early childhood 
education programs.
            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. The Committee 
urges the Division of Nursing to develop and increase cultural 
competence in nursing and to increase the number of 
underrepresented racial and ethnic minorities in all areas of 
nursing education and practice to enhance nursing's ability to 
provide quality health care services to the increasingly 
diverse community it serves.
            Children's hospital graduate medical education program
    The Committee recommends $243,442,000 for the Children's 
Hospital Graduate Medical Education (GME) program. This is 
$8,450,000 above the fiscal year 2001 level and $43,348,000 
more than the administration request.
    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.
    The Committee believes Federal support for GME for 
children's hospitals is a sound investment in children's 
health. Congress has enacted expansions in children's health 
coverage and increased support for health programs devoted to 
children and biomedical research. Equitable funding for 
children's hospitals GME is needed to sustain the pediatric 
workforce, including an adequate supply of future pediatric 
researchers, and our pediatric research enterprise.
    The Committee further recognizes that an inequity exists 
for GME funding for children's teaching hospitals because 
Medicare is the largest single payer of GME, and free-standing 
children's hospitals treat few Medicare patients. These funds 
provide essential, equitable support for the teaching 
contributions of these institutions.

                          OTHER HRSA PROGRAMS

Hansen's disease services

    The Committee has included $18,391,000 for the Hansen's 
Disease Program which is $501,000 more than fiscal year 2001 
and 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 $719,087,000 for the maternal and 
child health [MCH] block grant. This is $9,900,000 more than 
fiscal year 2001 and $15,000,000 more than the administration 
request.
    The Maternal and Child Health Block Grant program provides 
a flexible source of funding that allows States to target their 
most urgent maternal and child health needs through development 
of community-based networks of preventive and primary care that 
coordinate and integrate public and private sector resources 
and programs for pregnant women, mothers, infants, children, 
and adolescents. The program supports a broad range of 
activities including prenatal care, well child services and 
immunizations, reducing infant mortality, preventing injury and 
violence, expanding access to oral health care, addressing 
racial and ethnic disparities and providing comprehensive care 
for children, adolescents, and families through clinics, home 
visits and school-based health programs.
    The Committee is aware that each State MCH program has just 
completed a needs assessment that is conducted once every 5 
years. The assessment identified the need to expand programs in 
a variety of areas with the aim to assure access to quality 
health care; prevent disease, disability and death; provide 
family-centered, community-based services for women, children, 
adolescents and their families; and other priorities. The 
Committee has provided an increase in the MCH Block Grant to 
allow States to move forward to address the unmet needs that 
they have identified.
    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 expressed concerns in the past about MCH 
plans to eliminate SPRANS funding for three thalassemia centers 
that provide comprehensive services to patients and families. 
These centers, located in Boston, New York and Oakland and 
serving a broad geographical area, are the only source of 
support for many patients. For this reason, the Committee is 
pleased to learn that the Bureau has now agreed to continue 
funding all three centers well into 2003. The Committee urges 
MCH to continue to work closely with these centers and the 
Cooley's Anemia Foundation to assure that future changes in 
SPRANS funding will not have a negative impact on the centers' 
operations.
    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, and is pleased that the SIDS and Other Infant Death 
Support Center is collaborating with the National Institutes of 
Health to address the disproportionately high incidence of SIDS 
among African Americans.
    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 programs 
could be expanded to involve additional disciplines, including 
health care organizations such as the American College of 
Obstetricians and Gynecologists.
    The Committee recognizes that access to care through the 
hemophilia treatment center network is critical to the 
prevention and treatment of the complications of hemophilia and 
other bleeding disorders. The Committee believes that HRSA 
could strengthen support for these centers and requests a 
report by March 31, 2002 on the steps it has taken to improve 
its services to persons with hemophilia and other blood 
disorders, especially in underserved areas.

Healthy start initiative

    The Committee recommends $89,996,000 for the healthy start 
infant mortality initiative. This amount is the same as fiscal 
year 2001 and the administration request.
    The healthy start initiative was developed to respond to 
persistently high rates of infant mortality in this Nation. The 
initiative was expanded in fiscal year 1994 by a special 
projects program, which supported an additional seven urban and 
rural communities to implement infant mortality reduction 
strategies and interventions.
    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 MCH 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.
    The Committee is aware of the excellent services provided 
by the Northern Plains Healthy Start program to provide pre-
natal care to Native American women throughout South Dakota, 
Iowa, North Dakota, and Nebraska.
    The Committee is also aware of the high quality services 
provided to mothers and infants by Pee Dee Healthy Start in the 
Pee Dee region of South Carolina.

Universal newborn hearing screening and early intervention

    The Committee provides $10,000,000 for universal newborn 
hearing screening and early intervention activities, which is 
$2,001,000 above the fiscal year 2001 level and $3,419,000 more 
than the administration request. The Committee understands that 
screening technology has enabled health providers to conduct 
accurate, cost-efficient newborn hearing screening 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. Numerous studies have demonstrated that newborn 
hearing screening followed by early intervention services can 
greatly improve health and educational outcomes for children.
    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 $19,992,000 for organ transplant 
activities. This is the same as the administration request and 
$5,000,000 more than the fiscal year 2001 appropriation.
    These funds support a scientific registry of organ 
transplant recipients 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, 
through the establishment of donor registries.
    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 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.
    The Committee notes that in the last year while there were 
approximately 4,700 liver transplants performed, there were 
over 17,000 individuals on the list waiting for liver 
transplantations and about 1,700 people died due to the lack of 
a donor liver. In view of this continuing shortage of organ 
donors, the Committee is encouraged by the growing number of 
transplants using living donors who contribute a portion of 
their liver to a recipient. In order to increase the living 
donor liver transplantation, additional research is needed to 
study the outcome of both donors and recipients, define the 
optimal surgical procedure and identify eligibility criteria.

National bone marrow donor program

    The Committee has included $22,000,000 for the national 
bone marrow donor program. This is the same as the 
administration request and $42,000 more than the fiscal year 
2001 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 $57,921,000 for health outreach 
grants. This amount is $293,000 less than the fiscal year 2001 
level and $20,058,000 more than the administration request. 
This program supports projects that demonstrate new and 
innovative models of outreach in rural areas such as 
integration and coordination of health services. 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 is aware of the importance of having trained 
staff who have access to Automated External Defibrillators 
(AEDs), and that the survival rate for someone experiencing 
sudden cardiac arrest drops 7 percent to 10 percent as each 
minute passes. The Committee therefore includes $5,000,000 to 
implement the Rural AED Act of 2000 to provide grants to 
community partnerships to purchase equipment and provide 
training.
    The Committee is aware of the difficulties small rural 
hospitals have in complying with the new implementation 
requirements created by the Balanced Budget Act Refinement Act, 
the Health Insurance Portability and Accountability Act, and 
the Medicare, Medicaid, and S-CHIP Benefits Improvement and 
Protection Act. Therefore, as part of the its rural health 
initiative, the Committee includes $15,000,000 to assist rural 
hospitals through the Rural Hospital Performance Improvement 
Program. Under this program, grants would be provided to small 
rural hospitals (those with 50 beds or less), and networks of 
small rural hospitals (e.g., through State Hospital 
Associations), that are essential access points for Medicare 
and Medicaid beneficiaries. The program would target those key 
service areas in greatest need. The grants would be used to 
address the following critical areas of need:
  --Improved Financial Performance: Many small rural hospitals 
        face financial struggles in an increasingly complex 
        billing environment. These grants would assist these 
        providers in upgrading and improving their billing 
        practices, including technological upgrades (hardware 
        and software, as well as staff training), reducing 
        their accounts receivable, and ensuring a more 
        consistent financial foundation.
  --Reduced Medical Errors/Quality Improvement: Improving 
        health quality and reducing medical errors in a rural 
        environment requires an approach that recognizes the 
        special circumstances faced by small rural hospitals 
        that deal with low patient volumes within a clinical 
        focus that is dominated by primary care. Rural 
        communities are often heavily dependent on retaining 
        local health care dollars in order to remain 
        financially viable. A loss of confidence in locally 
        delivered care can quickly escalate into a self-
        fulfilling prophecy of reduced quality, as patients are 
        lost to distant urban providers. These grants would 
        allow small rural hospitals to develop locally based 
        and individualized quality improvement projects that 
        help retain local health care dollars in the community.
  --Increased Organizational Capacity: The health care system 
        is undergoing rapid change and small rural hospitals 
        are not immune to these changes. These grants would 
        assist small rural hospitals in their efforts to 
        improve their local health care delivery system by 
        improving clinical practices, re-organizing their 
        clinical pathways to better meet community needs and 
        modernizing their health technology infrastructure.
    The Committee continues to be concerned about the enormous 
chronic disease and public health burden faced by the 
Mississippi Delta region and expects that HRSA continue to 
provide support to the Delta Regional Authority (DRA) and that 
HRSA and DRA jointly administer this program. The Committee 
expects these resources to be used to provide targeted, 
innovative health education, access and research grants to 
existing Delta health-related educational institutions that 
have created comprehensive programs to improve health outcomes 
in the Delta.
    The Committee is aware of a number of rural health outreach 
programs that, if funded by the Department, would improve 
access to needed health care services in underserved rural 
areas. They include:
  --The Community Health Aide program, which is the only 
        provider of critical first-line health care in more 
        than 200 remote rural Alaska Native villages;
  --The Center for Sustainable Health Outreach in developing 
        model health access programs, health-related jobs and 
        the sustainability of community-based providers of 
        health services in rural and urban communities;
  --The Maui Community College and Hana Community Health Center 
        to facilitate the training of nurses for adequate 
        staffing at the Hana Community Health Center, which is 
        is one of the most remote areas in the State of Hawaii;
  --The Rural Family Diabetes and Mental Health Outreach 
        program in New Mexico;
  --Hispanic Community and Family Health programs in New 
        Mexico;
  --The University of South Alabama initiative to establish a 
        model diabetes foot treatment center;
  --LSU Health Science Center's Minority and Rural Health 
        Research and Outreach for the planning and development 
        of improved rural health outreach;
  --The Clakamas County, Oregon initiative to provide primary 
        health care to its chronically underserved population 
        of rural residents;
  --The Oregon Health Sciences University Institute for 
        Excellence in Nursing to enhance nurse training and 
        staff development for practicing nurses throughout 
        Oregon;
  --The Northwest Health Center in Pascoag, Rhode Island to 
        support health care services for 3,500 low income 
        individuals in rural Rhode Island;
  --The Oregon Community Health Information Network program to 
        allow health centers throughout Oregon to better 
        determine patient eligibility for Medicaid and other 
        health care programs;
  --The diabetes lower extremity amputation preventive program 
        at the University of South Alabama, the Louisiana State 
        University Medical School, the Roosevelt Institute for 
        Rehabilitation, and the Jackson Medical Mall;
  --The Littleton Regional Hospital in New Hampshire program to 
        allow the hospital to continue the paramedic services 
        program that is vital to that region's residents;
  --The Charles Cole Memorial Hospital proposal for Porter-
        Tioga Mckear Pain Clinic to be a model pain management 
        clinic for rural areas;
  --The Louisiana Public Health Institute Center for Community 
        Capacity Enhancement to promote community partnerships 
        to address health improvement priorities;
  --A demonstration project in the rural Mississippi Delta area 
        applying the Mississippi Medicaid disease State 
        management program to reduce the high prevalence and 
        improve management of chronic diseases such as 
        diabetes, asthma, hyperlipidemia, and cardiovascular 
        disease in rural areas;
  --The Children's Health Fund in Mississippi to provide mobile 
        comprehensive medical care to uninsured and medically 
        underserved children in the Mississippi Delta, 
        particularly in Mississippi and Arkansas, along with 
        the inner-city areas of New York City;
  --The comprehensive health initiative in the Mississippi 
        Delta and an initiative to promote basic and clinical 
        research on the prevention of the toxic effects of 
        agricultural chemicals and the prevention of 
        agricultural related injuries. The collaboration 
        between Delta State University, the University of 
        Mississippi Medical Center, and the Mississippi State 
        Department of Health could promote coordinated 
        consolidation of health and human services that will 
        positively impact the education, health, and economics 
        of this region;
  --The North Idaho Rural Health Consortium, to extend and 
        improve services to high-priority participants and 
        rural areas;
  --The Commun-I-Care program in South Carolina to provide 
        medications to the low-income, uninsured patients;
  --The University of Montana Drug Information Service to 
        provide health care professionals with access to 
        specialized health information in rural areas of 
        Montana;
  --The Bi-State Primary Care Association initiative to improve 
        the delivery of rural health care in Vermont;
  --The University of Maine program to build a statewide 
        database and access system that will allow more 
        efficient tracking and referral for intervention for 
        infants and children at risk in rural Maine settings;
  --The Hunstman Cancer Institute in South Dakota pilot project 
        to develop a medical outreach program utilizing mobile 
        clinics equipped with Positron Emission Tomography (PET 
        scan) to educate Native Americans in rural areas on 
        cancer risk, early detection, prevention and treatment.

Rural health research

    The Committee recommends $15,000,000 for the Office of 
Rural Health Policy. This is $1,563,000 above the fiscal year 
2001 level and $8,901,000 more than the administration request. 
The funds provide support for the Office as the focal point for 
the Department's efforts to improve the delivery of health 
services to rural communities and populations. Funds are used 
for rural health research centers, the National Advisory 
Committee on Rural Health, and a reference and information 
service. As part of its rural health initiative, the Committee 
is increasing funding for this program to improve the delivery 
of health care services to rural communities.
    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.
    The Committee is aware of rural health research programs 
that, if supported by the Department, could have a positive 
impact on the delivery of health care services to rural 
communities. They include:
  --The Educational Mall in Beckley, West Virginia, to serve as 
        a coordinating and research location for rural 
        initiative, especially in preventative medicine;
  --The Center for Rural Health and Medicine at the University 
        of North Dakota to study nation's the unique health 
        care needs of the rural elderly and special needs 
        populations;
  --The Secure Rural Imaging Network at Avera McKennan Hospital 
        in Sioux Falls, South Dakota;
  --The Center for Health Delivery at the University of Alaska 
        program to evaluate health care delivery and training 
        needs for health care workers to use this information 
        to improve the health status of Alaskans.
  --The Rural Primary Care and Health Service Research Center 
        at the University of South Dakota School of Medicine to 
        help define the status of health and health care 
        delivery in South Dakota;
  --The University of Texas Health Science Center at San 
        Antonio's Regional Academic Health Center program to 
        research and improve the diets of U.S. Hispanics, 
        particularly those living along the United States/
        Mexico Border.

Telehealth

    The Committee recommends $5,609,000 for telehealth 
activities. This amount is $30,369,000 less than fiscal year 
2001 and the same as the administration request.
    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 strongly supports HRSA's numerous rural 
telehealth initiatives and encourages the agency to work in 
partnership with medical librarians, the National Library of 
Medicine, and other health information specialists in the 
development and implementation of its telehealth projects.
    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. For example, 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 
region of Alaska with the highest poverty and unemployment 
rates, and encourages the agency to continue and expand a 
project to develop infrastructure to support a comprehensive 
health care delivery system in that region. The Committee 
supports this purpose, but also 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 is aware of a number of Telehealth programs 
that, with the support of the Department, could have positive 
health impacts on people living throughout America. They 
include:
  --The Mountaineer Doctor Television Program at West Virginia 
        University to allow health care providers at West 
        Virginia University to provide medical care through 
        telemedicine to rural West Virginia communities;
  --The Clarion University and the Primary Care Council of 
        Pennsylvania's State System of Higher Education 
        telecommunications network to help improve the health 
        status of Pennsylvanians through increased community 
        access and comprehensive care;
  --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 
        stations and will support bringing non-Federal partners 
        into the project and will fund operations of the Alaska 
        Telemedicine Advisory Council;
  --The University of Pittsburgh Medical Center is developing 
        and deploying its state-of-the-art health care 
        information technology system;
  --The Magee Womens Hospital in Pittsburgh is developing a 
        model to support coordinated and integrated care for 
        women with breast cancers by using new technologies for 
        mammography imaging, ultrasound imaging, and pathology 
        slides;
  --The Pennsylvania School of Optometry in Philadelphia is 
        establishing a network of urban community-based 
        satellite centers which give inner-city, underserved 
        persons access to eye care;
  --The Telehealth Education and Learning Center in Montana;
  --The Four County Library System program to provide 
        programming development and delivery to communities in 
        need of primary health care and reference resources;
  --The Pennsylvania Association of Home Health Agencies plan 
        to conduct a multi-facility examination of telehomecare 
        as a solution to the nursing shortage;
  --The Midwest Center for Rural Health telehealth project in 
        Indiana;
  --The Union Hospital in Terre Haute, Indiana, telehealth 
        demonstration project to improve accessibility to 
        quality health care for rural areas;
  --The South Alabama Telemedicine Project to allow this 
        project to continue to serve the health needs of rural, 
        poor, and medically underserved communities;
  --Continued support to implement Phase II of the Telehealth 
        Research Deployment Testbed (TRDT) program to increase 
        healthcare accessibility and quality in underserved 
        areas;
  --The Geisinger Stroke Care Partnership in rural Pennsylvania 
        to serve as an educational link for rural patients and 
        their providers by establishing informational resources 
        and outreach efforts;
  --The West Tennessee/North Mississippi Telemedicine Project 
        to bridge the gap between the resource-rich 
        metropolitan center of Shelby County, Tennessee, with 
        the medically underserved counties in Tennessee and 
        Mississippi;
  --The Telehealth Project at the University of Tennessee to 
        build upon its infrastructure, expand the scope of 
        clinical services provided, and incorporate the upper 
        region;
  --The New Mexico/Hawaii telehealth out reach for Unified 
        Community Health (TOUCH), which provided much needed 
        health services to rural patients;
  --Valley Children's Hospital E-Health and telehealth program 
        in California;
  --The Regional Telehealth Consortium's Network in Lake 
        Charles, Louisiana;
  --North Dakota State University, College of Pharmacy 
        Telepharmacy project;
  --The Healthy Mothers and Babies Technology Demonstration in 
        Minnesota to connect rural patients and their 
        communities to the specialty care available in 
        Minneapolis/St. Paul;
  --The Samuel Merritt College nurse anesthesia education 
        improvements through telehealth in California;
  --The University of Nevada Las Vegas ``e-Health'' initiative 
        to improve access to specialized and high quality 
        health care in rural Nevada;
  --Saint Vincent Hospital in Billings to establish a regional 
        video telecommunications network for healthcare 
        providers;
  --The Deaconess Billings Clinic (DBC) Northwest Area Center 
        for Studies on Aging in Billings, Montana to address 
        healthcare problems associated with rural aging, and 
        expand access to specialty healthcare via telemedicine 
        and video conferencing technology to a region where 
        specialty healthcare services are not currently 
        available;
  --The Central Michigan University Telehealth Project to 
        improve health care access and quality to migrant and 
        underserved rural populations;
  --The La Crosse Medical Health Science Consortium to support 
        the development of a telecommunications-based, 
        integrated network of Virtual Population Health Centers 
        in western Wisconsin;
  --Continued support for Phase II of a telemedicine system to 
        link the research capabilities of the American Health 
        Foundation with patients served by the Beaufort-Jasper-
        Hampton Comprehensive Health Services;
  --The Vermont Telemedicine Network to reduce disparities in 
        the clinical care and medical education of trauma in 
        Vermont;
  --The Susquehanna Health System plan to develop an electronic 
        medical information and physician access system for 
        rural areas;
  --Expansion of the Children's Hospital in Seattle, Washington 
        and University of Washington telemedicine program to 
        improve access to health care services;
  --Technology enhancements for federally Qualified Health 
        Centers in the state of Oregon;
  --Expansion of the Mississippi telemedicine network, which 
        includes Mississippi Blood Services, Mississippi 
        community colleges and universities, and local, State, 
        and Federal agencies in rural areas to eliminate health 
        care disparities in access for the underserved in rural 
        areas including the Mississippi Delta;
  --The Alcorn State University initiative to provide needed 
        medical care and health education to residents of the 
        lower Mississippi Delta;
  --The Idaho Telehealth Integrated Care Center at Idaho State 
        University;
  --The Rocky Mountain Technology Foundation (RMTF) in 
        Billings, Montana, telehealth program, which has 
        developed an approach to solving problems of rural and 
        frontier health providers; fragmentation of the health 
        care delivery system; slow diffusion of knowledge to 
        rural providers of standardized advancements in 
        diagnostic and therapeutic medical protocols; and lack 
        of strategic alliances and linkages between rural and 
        urban providers.

Native and rural Alaskan health care

    The Committee has provided $20,000,000 for the Denali 
Commission, which is $10,000,000 more than the fiscal year 2001 
level and $20,000,000 more than the administration request, to 
fund construction and renovation of health clinics, hospitals 
and social service facilities in rural Alaska as authorized by 
Public Law 106-113. Provision of this funding will help remote 
communities in Alaska develop critically needed health and 
social service infrastructure for which no other funding 
sources are available so that health and social services may be 
provided to Alaskans in remote rural communities as they are in 
other communities throughout the country.

Critical care programs

    The Committee has grouped the following ongoing and 
proposed activities: emergency medical services for children, 
the traumatic brain injury program, trauma care/emergency 
medical services, and poison control centers.
    The Committee provides $18,986,000 for emergency medical 
services for children. This is the same as the 2001 level and 
$3,412,000 more than 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, 
and supports the efforts and purpose of the EMSC program to 
continue to work with States to improve the training and 
availability of emergency medical services personnel who 
effectively treat children. The Committee also urges the 
Department to focus on the development of prevention and 
treatment programs and education of emergency personnel in 
remote and rural areas throughout the country, including Alaska 
and Hawaii, using telemedicine technology.
    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 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 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 provides $10,000,000 for the traumatic brain 
injury program, which is $5,000,000 more than the fiscal year 
2001 level and the administration request. The program supports 
implementation and planning grants to States for coordination 
and improvement of services to individuals and families with 
traumatic brain injuries as well as protection and advocacy. 
Such services can include: pre-hospital care, emergency 
department care, hospital care, rehabilitation, transitional 
services, education, employment, and long-term support. The 
Committee includes $3,000,000 for protection and advocacy 
services, as authorized under section 1305 of Public Law 106-
310.
    The Committee is extremely interested in the risk of head 
injury in youth soccer participants associated with their lack 
of protective head gear use. Therefore the Committee directs a 
study to determine the benefits of the use of protective head 
gear in decreasing the incidence of head injury among youth 
soccer participants. The Committee expects to receive the 
results of this survey by June 2002.
    The Committee is aware that Mississippi leads the Nation in 
both mortality and rates of incidences of traumatic brain 
injury. The Committee encourages HRSA to implement programs to 
reduce the mortality and rate of incidences of traumatic brain 
injury in Mississippi.
    The Committee provides $4,000,000 for trauma/emergency 
medical services. This is $1,000,000 more than fiscal year 2001 
and $1,533,000 more than the administration request. 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 provides $24,000,000 for poison control 
center activities, which is $4,004,000 more than fiscal year 
2001 and $7,579,000 above the administration request. 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.

Black lung clinics

    The Committee includes $7,000,000 for black lung clinics. 
This is $1,000,000 above both the fiscal year 2001 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 $15,000,000 for nurse loan payment 
for shortage area services. This is $12,721,000 more than 
fiscal year 2001 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. The Committee views this program as a 
critical component of the rural health initiative outlined in 
this report, and intends that the majority of the increased 
funding be provided to increase the supply of qualified health 
care professionals in rural areas.

Payment to Hawaii, Hansen's disease treatment

    The Committee includes $2,045,000 for Hansen's disease 
services. This is the same as fiscal year 2001 and the 
administration request.
    Within the amount provided for Hansen's disease services, 
the Committee urges funding for the fiscal year 2002 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 Gillis W. Long National Hansen's 
Disease Center. This amount is the same as the administration 
request and the 2001 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 $1,883,000,000 for Ryan White AIDS 
programs. This is $75,391,000 more than fiscal year 2001 and 
$75,236,000 more than the administration request.
    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 benefitted 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 develop 
strategies to address these problems in light of the changing 
medical needs of a patient population that is living longer 
with current therapies.
    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 encourages 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 $620,000,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic. This 
amount is $15,831,000 above the fiscal year 2001 and 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 encourages the Secretary, when awarding 
supplemental title I funds, to give priority as appropriate to 
EMA's whose applications increase services to women, 
adolescents, and children with AIDS/HIV infection.

Comprehensive care programs--title II

    The Committee has provided $950,000,000 for HIV health care 
and support services. This amount is $39,031,000 above the 
administration request and the 2001 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 
anti-retroviral 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 $610,000,000 for AIDS medications, compared to 
$589,000,000 provided for this purpose in fiscal year 2001. 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 about restrictions being placed 
on the type and scope of targeted outreach, as authorized under 
the Ryan White CARE Act, to identify underserved populations 
and provide them needed medical care. The Committee urges the 
Secretary to provide States flexibility, where appropriate, in 
conducting comprehensive, targeted outreach to underserved and 
minority populations to improve access to CARE Act programs for 
underserved communities.
    The Committee is concerned about the increasing prevalence 
of hepatitis C-HIV co-infection. Co-infection of the hepatitis 
C virus (HCV) in HIV infected patients has become the leading 
cause of AIDS mortality in some parts of the country. The death 
rate is higher and life expectancy shorter for co-infection 
patients than for patients who have only HIV.
    To address this growing problem, the Committee urges HRSA 
to encourage State ADAPs to offer co-infected patients access 
to approved hepatitis C treatments as their resources allow, to 
ensure that the Ryan White critical care funded programs 
(including Title III & IV clinics) provide opportunities for 
training care givers and clinicians to treat co-infected 
patients, and to ensure that AETCs address the need for 
physician education on HCV/HIV co-infection.
    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 $195,000,000 for early 
intervention grants. This is $9,121,000 above the 2001 level 
and 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.
    The Committee encourages HRSA to fairly allocate the 
increase for title III-B between existing grantees and new 
providers. 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 knowledgeable clinicians to improve 
access to quality HIV treatment based upon the evolving HIV 
treatment guidelines of DHHS.

Women, infants, children, and youth--title IV

    The Committee recommends $72,000,000 for title IV pediatric 
AIDS, which is $7,005,000 above the administration request and 
the 2001 amount. Funds are awarded to community health centers, 
family planning agencies, comprehensive hemophilia diagnostic 
and treatment centers, federally qualified health centers under 
section 1905(1)(2)(B) of the Social Security Act, county and 
municipal health departments and other nonprofit community-
based programs that provide comprehensive primary health care 
services to populations with or at risk for HIV disease.
    The Committee intends that at least 90 percent of total 
title IV funding be provided to grantees. The Committee expects 
the agency to provide at least 75 percent of the funding 
increase to existing grantees to reflect the increases in the 
costs of providing comprehensive care, including the 
implementation of quality management programs. HRSA should use 
a significant portion of the remaining funds to expand 
comprehensive services for youth, both through existing and new 
grantees. The Committee expects the agency to expand efforts to 
facilitate ongoing communication with grantees on the 
administration of the Title IV program. These expanded efforts 
should include collaboration with grantees on the forthcoming 
determinations by the Secretary mandated in the Ryan White CARE 
Act Amendments of 2000 on administrative expenses and HIV-
related research access. The Committee also expects HRSA to 
collaborate with CDC to identify and eliminate barriers between 
HIV prevention and care.
    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.

AIDS dental services

    The Committee provides $12,000,000 for AIDS dental 
services, which is $2,001,000 above the administration request 
and the 2001 level. This program provides grants to dental 
schools, dental hygiene 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 $34,000,000 for the AIDS education 
and training centers [AETC's]. This amount is $2,402,000 more 
than the 2001 level and 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 $266,000,000 for the title X 
family planning program. This is $12,090,000 above the fiscal 
year 2001 level and $11,830,000 more than the administration 
request. 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 provision of a 
broad range of acceptable and effective family planning methods 
and preventative health services. This includes FDA-approved 
methods of contraception.
    The Committee has increased funding for clinics receiving 
Title X funds to address increasing financial pressures in 
their effort to provide high-quality, subsidized family 
planning services to 4,400,000 each year, many of whom are 
uninsured. These pressures include rising costs of newer and 
longer lasting contraceptive methods, pharmaceuticals, and 
screening and diagnostic technologies, as well as a rising 
uninsured population.
    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 any remaining year-end funds in section 1001 activities.

Health care facilities

    The Committee provides $10,000,000 for health care 
facilities, which is $241,561,000 below the 2001 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.
    The Committee includes funding, as authorized in section 3 
of Public Law 107-21, for the Paul D. Coverdell Building at the 
Institute of the Biomedical and Health Sciences at the 
University of Georgia.

National Hansen's Disease Program buildings and facilities

    The Committee recommends $250,000 for buildings and 
facilities, which is the same as fiscal year 2001 level and the 
administration request.

Rural hospital flexibility grants

    The Committee includes $25,000,000 for rural hospital 
flexibility grants, which is $3,000 more than 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 recommends $17,200,000 for the national 
practitioner data bank, which is the same as last year and the 
administration request. The Committee and the administration 
assume that full funding will be provided entirely through the 
collection of user fees and will cover the full cost of 
operating the data bank. Traditional bill language is included 
to ensure that user fees are collected to cover all costs of 
processing requests and providing such information to data bank 
users.

Health care integrity and protection data bank

    The Committee recommends $8,000,000 for the health care 
integrity and protection data bank, which is $3,683,000 more 
than last year and the same as the administration request. The 
Committee and the administration assume that full funding will 
be provided entirely through the collection of user fees and 
will cover the full cost of operating the data bank. The data 
bank is intended to collect, maintain, and report on certain 
actions taken against health care providers, suppliers, and 
practitioners.

Healthcare access for the uninsured

    The Committee provides $15,041,000 for this activity, which 
is $124,950,000 less than fiscal year 2001 and the same as the 
administration's request. 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.

Program management

    The Committee recommends $135,991,000 for program 
management activities for fiscal year 2002. This is $3,000,000 
less than fiscal year 2001 and $11,058,000 less than the 
administration request.
    The Committee continues to recognize the important work of 
the American Foundation for Negro Affairs of Philadelphia.
    The Committee strongly urges, given its unique needs, 
filling of the Public Health Services Senior Programmatic 
position in Hawaii.

               Medical facilities guarantee and loan fund

    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 2002, 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 the 2001 appropriation.
    For administration of the HEAL Program including the Office 
of Default Reduction, the Committee recommends $3,792,000, 
which is $120,000 above the 2001 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, 2001....................................    $117,347,000
Budget estimate, 2002...................................     117,847,000
Committee recommendation................................     117,847,000

    The Committee recommends that $117,847,000 be released from 
the vaccine injury compensation trust fund in fiscal year 2002, 
of which $2,992,000 is for administrative costs. The total 
amount is $500,000 more than fiscal year 2001 and the same as 
the administration request budget request.
    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.

               Centers for Disease Control and Prevention


                Disease Control, Research, and Training

Appropriations, 2001....................................  $4,118,319,000
Budget estimate, 2002...................................   4,005,508,000
Committee recommendation................................   4,418,910,000

    For the Centers for Disease Control and Prevention [CDC], 
the Committee provides $4,418,910,000 which is $300,591,000 
above the fiscal year 2001 level and $413,402,000 above the 
budget request.
    The activities of the CDC focus on several major 
priorities: provide core public health functions; respond to 
urgent health threats; monitor the Nation's health using sound 
scientific methods; build the Nation's health infrastructure to 
insure our national security against bioterrorist 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 commends CDC for the agency's immediate 
response to the recent New York City and Washington, DC, 
tragedies. CDC sent a total of 71 staff, including 49 
epidemiologists, occupational health specialists, and other 
public health professionals to supplement local efforts and 
provide expertise and assistance to New York City hospitals as 
directed by State and local health officials. CDC's Health 
Alert Network distributed information to health officials in 
New York City and around the country regarding incident 
response and technical issues.
    It is also the Committee's understanding that CDC used the 
National Pharmaceutical Stockpile by deploying a ``push 
package'' of emergency materials that arrived in New York City 
within 7 hours of being requested. These materials included 
pharmaceuticals, intravenous supplies, airway supplies, 
emergency medication, bandages and dressings, which included 
84,000 bags of intravenous fluid and other intravenous 
supplies, as well as 350 portable ventilators and 250 
stationary ventilators and other materials to cover a spectrum 
of medical needs.

Birth Defects, Developmental Disabilities, Disability and Health

    The Committee recommends $88,748,000 for birth defects, 
developmental disabilities, disability and health which is 
$18,015,000 above the fiscal year 2001 level and $12,468,000 
above the administration request.
    Birth defects are the leading cause of infant death in the 
United States. More than 150,000 infants are born with birth 
defects each year in the United States. The Child Health Act of 
2000 created CDC's National Center on Birth Defects and 
Developmental Disabilities. This new center will expand 
existing surveillance, epidemiological research, prevention 
programs, and require support for a broad range of functions.
    The Committee recognizes CDC as the Nation's leader in 
assisting States in monitoring for birth defects and 
developmental disabilities and improving the health and 
wellness of people living with a disability. The birth defects 
and developmental disabilities monitoring programs collect, 
analyze, and make available data on the incidence and causes of 
birth defects and developmental disabilities.
    The Committee has included funding for further 
epidemiological research into Duchenne and Becker muscular 
dystrophy in the United States. More extensive data on this 
disease will inform research decisions, standards of care 
formation, prenatal and infant screening and medical education.
    The Committee is aware of the University of Louisville 
Health Science Center's work to improve the diagnosis, 
treatment, and prevention of birth defects. The Committee 
believes CDC could consider this center to be designated as a 
CDC National Center on Birth Defects Research.
    The Committee continues to be supportive of funding for the 
Alabama Birth Defects Monitoring and Prevention Center to be 
located at the University of South Alabama to implement the 
objectives outlined by the United States Birth Defects Act of 
1998.
    Attention Deficit/Hyperactivity Disorder.--The Committee is 
aware of the importance of early identification and proper 
treatment of Attention Deficit/Hyperactivity Disorder (AD/HD) 
in the prevention of serious consequences, including school and 
work failure, depression, conduct disorder, and substance 
abuse. The Committee supports the recommendations by CDC to 
establish a resource center for accurate and valid information 
about AD/HD for the public and professionals, including 
resource dissemination on evidence-based interventions for the 
disorder and has included sufficient funding to establish such 
a center.
    Autism.--The Committee is concerned about the lack of 
information available on the prevalence, cause or effective 
treatment of autism. Basic data collection and verification is 
integral to better understanding the incidence of autism, the 
factors that may be associated with a higher rate of incidence, 
and effective treatment. The Committee commends CDC's initial 
efforts to conduct epidemiological research on autism in select 
States and has included sufficient funds to expand those 
activities.
    Disabilities Prevention Programs.--The Committee continues 
to strongly support the CDC disabilities prevention program 
which provides support to States and academic centers to reduce 
the incidence and severity of disabilities, especially 
developmental and secondary disabilities.
    The Committee commends CDC for its work with the 
Christopher Reeve Paralysis Foundation to establish an 
information and support center and to reduce secondary 
disabilities among people with paralysis. Sufficient funds are 
provided to continue this important project which will do much 
to prevent secondary complications associated with paralysis, 
resulting in improved outcomes and quality of life for people 
living with paralysis.
    Fetal Alcohol Syndrome.--Fetal Alcohol Syndrome (FAS), the 
country's leading known cause of mental retardation and birth 
defects, devastates the lives of as many as 12,000 newborn 
children and their families each year. The Committee has 
included sufficient funds for CDC to: (1) develop guidelines 
for the diagnosis of FAS and other negative birth outcomes 
resulting from prenatal exposure to alcohol; (2) incorporate 
these guidelines into curricula for medical and allied health 
students and practitioners, and seek to have them fully 
recognized by professional organizations and accrediting 
boards; and (3) disseminate curricula to and provide training 
for medical and allied health students and practitioners 
regarding these guidelines. The Committee recommends that CDC 
coordinate its efforts with the National Task Force on Fetal 
Alcohol Syndrome, existing federally-funded FAS prevention 
programs, and appropriate non-governmental organizations.
    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.
    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 
research and demonstration 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 CDC 
to coordinate with HRSA in translating the results of these 
efforts into guidance for public health programs, including 
State newborn screening programs.
    Special Olympics Healthy Athletes Initiative.--The 
Committee is concerned regarding the unmet health needs among 
persons with mental retardation. On March 5, 2001, a field 
hearing was held in Anchorage Alaska, during the World Winter 
Special Olympics Games. At that hearing, numerous witnesses, 
including persons with mental retardation, expressed their 
frustration in securing needed health services and the severe 
consequences of not being able to obtain such services in a 
timely and appropriate way. Persons with mental retardation 
have more health challenges and poorer access to health care 
than the rest of the population. As a result, their lives are 
unnecessarily shortened and the quality of their lives is 
severely compromised.
    To address the unmet health needs among its athletes, 
Special Olympics has created the Healthy Athletes Program, 
which provides Special Olympics athletes access to an array of 
health assessment, education, preventive health services and 
supplies, and referral for follow-up care where needed. These 
services are provided to athletes without cost in conjunction 
with Games competitions at local, State, national, and 
international levels.
    The Committee strongly urges the CDC to establish a Special 
Olympics Healthy Athletes Initiative. The Committee further 
urges the CDC to have lead responsibility for this initiative, 
in collaboration with the Health Resources and Services 
Administration, National Institutes of Health, Agency for 
Healthcare Research and Quality, Center for Medicare and 
Medicaid Services. The agencies could examine existing programs 
and resources to determine appropriate actions that they may 
take, including studies and demonstration projects, to address 
the health challenges to persons with mental retardation. The 
initiative should help train health professionals and sensitize 
health care systems and institutions, as to the health needs of 
persons with mental retardation; establish clinical and program 
standards of care that meet the needs of individuals with 
mental retardation; expand systems to make them accessible to 
persons with mental retardation; help identify the nature and 
scope of health challenges and health access barriers to 
persons with mental retardation; and create and test models for 
athlete health promotion at the local level.

Chronic Disease Prevention and Health Promotion

    The Committee recommends $701,654,000 for chronic disease 
prevention and health promotion, which is $48,119,000 below the 
fiscal year 2001 level and $127,094,000 above the 
administration's request.
    The leading causes of death and disability (e.g., heart 
disease and stroke, cancer, diabetes, and arthritis) are among 
the most prevalent, costly, and preventable of all health 
problems. Seven of every 10 Americans who die each year, or 
more than 1.7 million people, die of these chronic diseases. 
Heart disease and stroke and cancer account for two-thirds of 
all deaths. The prolonged course of illness and disability from 
such chronic diseases as diabetes and arthritis results in 
extended pain and suffering as well as in decreased quality of 
life for millions of Americans. A relative few modifiable risk 
factors bring suffering and early death to millions of 
Americans. Three such factors--tobacco use, poor nutrition, and 
lack of physical activity are major contributors to our 
Nation's leading causes of death.
    The Committee recognizes that a greater effort is needed to 
control the leading causes of death and disability through the 
prevention of risk factors. Further, this Committee which 
consistently strives to insure that adequate resources are 
available for biomedical research is committed to insuring that 
applied research is adequately funded.
    Anemia.--The Committee notes that iron deficiency in 
children can result in delayed or stunted intellectual and 
physical development, and is disturbed to learn that Alaska 
Native children in rural areas have a high prevalence of iron 
deficiency anemia. Recent evidence suggests that treatment of 
H.pylori infection with antibiotics might lead to resolution of 
the anemia in some children. The Committee encourages the 
agency to give consideration to a proposal by the State of 
Alaska to reduce unacceptably high anemia rates among the 
Alaska Native children of southwestern Alaska, which includes a 
clinical trial to evaluate the ability of triple therapy with 
antibiotics to treat iron deficiency anemia among children 2 to 
5 years of age in western Alaska.
    Arthritis.--The Committee notes that Congress established 
the CDC arthritis program in 1999 following the development of 
the National Arthritis Action Plan (NAAP). The CDC activities 
form the backbone of a multi-pronged response to the Nation's 
leading cause of disability. Prior to this initiative, there 
was no coordinated public health strategy to prevent and 
appropriately treat the over 100 forms of this painful, 
debilitating disease. Grants to States are a core component of 
the CDC arthritis program. These partnerships promote the 
development of a State-based network of local activities to 
confront the burden of arthritis. This approach also encourages 
the formation of broadly-based coalitions with health care 
providers, community-based organizations, and other 
stakeholders to coordinate and leverage their resources. The 
Arthritis Foundation chapters across the country have led this 
external effort. The Committee has been supportive of increased 
funding for the arthritis program. The Committee recognizes 
that there is a rising demand among States for these programs 
and that CDC's desire to provide a minimum level of funding to 
each participating State has produced a shortfall of funds.
    Cancer Prevention and Control.--Cancer is the second 
leading cause of death in the United States. Since 1990, 13 
million new cancer cases have been diagnosed--including over 
1.2 million new cases in 2000 alone. Cancer costs the Nation 
$107,000,000,000 annually in direct and indirect costs. 
Screening tests for breast, cervical and colorectal cancer 
reduce the number of deaths from these diseases, and screening 
tests for cervical and colorectal cancer can actually prevent 
the development of cancer through the early detection and 
treatment of pre-cancerous conditions.
    The Committee commends CDC for its efforts to begin to 
build a coordinated focus for cancer efforts at the State 
level, CDC funds five States and an Indian health board to 
develop comprehensive cancer control programs. These States are 
building the foundation for a nationwide, comprehensive cancer 
control program. Comprehensive cancer programs integrate the 
full range of cancer prevention activities including research, 
evaluation, health education and communication, program 
development, public policy development, surveillance, and 
clinical services.
    The Committee has included increased funding for 
comprehensive cancer control programs. Particular attention 
should be paid to raising public awareness and enhancing 
professional education on cancers not currently addressed by a 
CDC program. For example, CDC is encouraged to develop an 
awareness campaign to educate patients and practitioners about 
the symptoms associated with lymphoma and the challenges of 
correctly diagnosing this complicated cancer.
    The Committee also urges CDC to plan and implement 
awareness programs for orphan cancers for patients and 
community oncologists. Patients diagnosed with these cancers, 
such as esophageal, kidney, liver, multiple myeloma, 
pancreatic, and stomach, currently have the lowest life 
expectancy rates of all diagnosed cancers, yet community 
oncologists generally lack specific knowledge about these 
malignancies. The Committee also encourages CDC to establish, 
with the States, high-risk registries for the digestive cancers 
and other cancers with significantly low survival rates 
following diagnosis.
    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 the 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.
    Chronic Fatigue Syndrome (CFS).--The Committee is pleased 
that CDC has restored funding for CFS research, and that these 
funds are being used in substantive areas of research and 
education. In particular, the Committee would like to commend 
CDC on its collaborations with prominent CFS clinicians, Emory 
University researchers, and CFS advocates. The Committee 
supports efforts to develop and test an empirically derived 
case definition and initiate a national CFS survey to estimate 
sex-, age-, race/eth-
nic-, and socioeconomic-specific prevalence of CFS.
    The Committee strongly encourages CDC to provide the funds 
and the infrastructure to support other aspects of its 
``reinvigorated'' CFS research plan, which includes 
surveillance projects on children, adolescents, and minorities 
with CFS; a national CFS patient registry; 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 expanded efforts to educate primary care 
providers about the detection, diagnosis, and treatment of CFS.
    The Committee recognizes CDC's support of the DHHS CFS 
Coordinating Committee (CFSCC) and expect that CDC will 
continue its support as the CFSCC transitions from a 
coordinating committee to an advisory committee.
    Community Health Centers.--The Committee strongly urges the 
utilization of Community Health Centers as an integral part for 
the provision of primary care in medically underserved 
populations. The Committee urges CDC to contract directly with 
the Hawaiian Community Health Centers to provide primary health 
care for its underserved populations, this includes an approval 
for expansion of the Community Health Centers to Kaui.
    Cooley's Anemia.--Patients with Cooley's anemia, or 
thalassemia, are the most frequently transfused of all patients 
receiving blood, often every 2 weeks. This makes them an 
effective ``early warning system'' for problems in the blood 
supply. The Committee is aware that CDC has created a program 
outline for establishing a blood safety surveillance program, 
modeled on the universal data collection program used in 
hemophilia. The Committee encourages CDC to provide sufficient 
funds to establish this program, which will make a major 
contribution to the safety of the blood supply for all 
Americans.
    Diabetes.--The Committee remains acutely concerned about 
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.
    The Committee is also aware of a proposal from the Standing 
Rock Sioux Tribe and Cheyenne River Sioux Tribe to establish 
the Dakota Plains Diabetes Center.
    The Committee acknowledges that the The Texas Tech 
Institute for Diabetes Prevention and Control has been very 
successful in addressing high incidence of diabetes in the 
Southwest, and supports its continued activities.
    The Committee continues to be supportive of the National 
Diabetes Prevention Center in Gallup, New Mexico.
    Dental decay.--The Committee urges CDC to further enhance 
its oral health activities to reduce the disparity in treatment 
of oral health diseases including dental decay, tooth loss, 
oral cancers, gum disease, and oral conditions associated with 
chronic diseases such as diabetes and heart disease. The 
Committee urges the CDC to work with eligible entities to 
implement the oral health prevention programs of the children's 
Health Act of 2000. The Committee has included sufficient 
funding to allow States to assist communities that are 
initiating water fluoridation projects to apply for appropriate 
assistance.
    Epilepsy.--Although the CDC has developed public health 
strategies to address epilepsy, additional investment is 
required to effectively implement these initiatives. The 
Committee has provided increased funding for 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 organization and 
other consumer groups in implementing this public health 
initiative.
    Glaucoma.--The Committee has included funds for CDC to 
develop a model project to test the efficacy of glaucoma 
screening using mobile units. The Committee further suggests 
the program establish protocols to conduct outreach, identify 
staffing needs, implement glaucoma screenings, as well as 
address other eye conditions, provide patient education 
regarding the management of glaucoma, and make appropriate 
referrals to eye care professionals. The program should also 
include a rigorous evaluation of the strategy to conduct 
glaucoma screening using mobile units including measuring the 
number of screenings conducted and outcome measures of the 
projects effectiveness. Alternate strategies to achieve similar 
goals should be explored to determine the most effective 
methods to deliver glaucoma screenings in various communities. 
Moreover, the evaluation component should address the 
effectiveness of mobile units as a method to address 
populations most in need of glaucoma screenings.
    Health Promotion.--The Committee has included sufficient 
funds to continue the pilot program, begun in fiscal year 2000, 
for an interdisciplinary approach to mind-body medicine and to 
assess the preventive health impact.
    Heart Disease and Stroke.--Heart disease and stroke are the 
leading causes of death in the United States among men and 
women and of all racial and ethnic groups. Challenges to 
combating these diseases include persistent geographic, racial 
and ethnic disparities; the increasing prevalence of sedentary 
lifestyles and obesity among all sectors of the American 
population, the growing number of people with these diseases as 
the population ages, and the under use of established effective 
treatments for those already afflicted by heart disease and 
stroke.
    The Committee commends CDC for publishing and distributing 
``Women and Heart Disease: An Atlas of Racial and Ethnic 
Disparities in Mortality'', the first publication to show heart 
disease death rates among women aged 35 years or older, county-
by-county, throughout the United States.
    The Committee has increased funding for the WISEWOMAN 
program to allow the program to expand to up to 20 States. The 
WISEWOMAN program builds on the CDC's National Breast and 
Cervical Cancer Early Detection Program to also screen women 
for heart disease, stroke and cardiovascular disease risk 
factors such as high blood pressure, elevated cholesterol, lack 
of physical activity and obesity. CDC also delivers dietary and 
physical activity counseling to these women to improve their 
health and to prevent cardiovascular diseases, the leading 
cause of death of American women. Currently in nine States, the 
program has screened more than 10,000 low-income and uninsured 
women ages 40-64 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.
    Stroke remains America's No. 3 killer, a major cause of 
permanent disability and a key contributor to late-life 
dementia. This year, nearly 600,000 Americans will suffer a 
stroke, costing Americans an estimated $45,000,000,000 in 
medical expenses and lost productivity. Nearly 4.5 million 
Americans live with the consequences of stroke; many are 
permanently disabled. Currently, the drug tPA, is the only 
approved emergency treatment for clot-based stroke, yet less 
than 5 percent of those eligible for tPA receive it.
    As a result, the Committee has included funding for the 
Paul Coverdell National Acute Stroke Registry, established by 
Congress last year and designed to track and improve the 
delivery of care to patients with acute stroke. The Committee 
encourages CDC to continue to work with the National Institute 
of Neurological Disorders and Stroke, and the National Heart, 
Lung, and Blood Institute at the National Institutes of Health, 
the Brain Attack Coalition, and other professional 
organizations, including hospitals, universities, State and 
local health departments, and other appropriate partners 
experienced in the treatment of stroke to further implement 
this registry.
    The Committee is impressed with the continued success of 
the Michael E. DeBakey Institute for the Integrated Study of 
Cardiovascular Disease and Biomedical Devices. This Institute 
has supported the development of life-saving heart pumps and 
other devices and combines the world-class expertise of Baylor 
College of Medicine with the engineering and veterinary 
medicine expertise of Texas A&M University.
    Hemophilia.--The Committee is appreciative of CDC's efforts 
last year to restore funding to meet the disease management, 
prevention, and outreach needs of persons with hemophilia and 
bleeding disorders, and in particular, women with bleeding 
disorders. The Committee expects CDC to continue working with 
the national hemophilia foundation to strengthen these programs 
and its blood safety surveillance. The Committee also 
understands that geno-typing of the hemophilia population is 
needed to speed identification of inhibitors and facilitate the 
rapid translation of gene therapy technologies into treatment 
and prevention efforts.
    Immunodeficiency Diseases.--The Committee has included 
sufficient funds to continue and expand the CDC's national 
education awareness campaign with regard to primary 
immunodeficiency diseases, in collaboration with NICHD, NIAID, 
NCI, and private entities, to serve as a model for other 
genetic diseases. At a minimum, the campaign should include 
development and distribution of educational materials to health 
care professionals and others likely to inter-act with 
undiagnosed patients, development and distribution of 
culturally competent materials for patients and their families, 
as well as physician and public education efforts. The Director 
of CDC should submit a report to the Committee prior to next 
year's appropriation hearings outlining the progress that has 
been made to date. The Committee is pleased that CDC is working 
to establish a competitively awarded primary immune deficiency 
diseases national surveillance program.
    Micronutrients.--Deficiencies of micronutrients such as 
iron, iodine, and vitamin A, affect nearly one-third of the 
world's population, and result in reduced mental and physical 
development of children, poor pregnancy outcomes, diminished 
work capacity of adults, and increased morbidity and premature 
mortality among populations. Effective and inexpensive 
interventions such as dietary diversification, food 
fortification and supplementation have eliminated most 
micronutrient deficiencies in developed countries.
    The Committee has provided sufficient funding for CDC to 
increase its efforts to eliminate micronutrient malnutrition. 
The focus of these efforts is to support a number of national 
and international efforts to assess mirconutrient status of 
populations and to monitor and strengthen implementation of 
interventions as well as to assess the impact of the 
interventions over time. CDC has extensive expertise in 
epidemiology, monitoring and assessment, and laboratory 
science; and these efforts reflect the unique contribution that 
CDC can make to eliminate micronutrient deficiencies.
    Multiple Sclerosis.--The Committee commends the University 
of Texas-Southwestern Medical Center for its preeminent 
Comprehensive Multiple Sclerosis Center of Excellence and its 
new National Multiple Sclerosis Training Center. This center is 
providing neurologists across the United States with intensive 
training on the management of MS.
    Nutrition, Physical Activity and Obesity.--Physical 
inactivity and unhealthy diet patterns account for at least 
300,000 preventable deaths each year among Americans and 
increase the risk for many chronic diseases. Most Americans do 
not engage in recommended behaviors for healthy eating and 
physical activity. More than 60 percent of adults do not engage 
in levels of physical activity necessary to provide health 
benefits, and daily participation in high school physical 
education has dropped from 42 percent to 27 percent in the last 
6 years. Obesity has reached epidemic proportions. In the past 
15 years, the prevalence of obesity has increased by over 50 
percent among adults and 100 percent in children and 
adolescents. The cost of diseases associated with obesity is 
almost $100,000,000,000 per year.
    The Committee is concerned about the alarming increase in 
childhood obesity and has provided $950,000 to CDC to fund a 
study by the Institute of Medicine to assess the nature of 
childhood obesity in the United States and develop an action 
plan to decrease its prevalence that focuses on prevention. The 
study should assess the primary factors responsible for the 
increasing prevalence of childhood obesity and identify the 
most promising methods for prevention.
    The Committee is aware of the report of the Evaluation 
Group on the national 5-A-Day for Better Health Program and the 
findings that eating fruits and vegetables reduces the risk of 
cancer, cardiovascular, and other diseases. Given these 
findings, the Committee urges the Centers for Disease Control 
and Prevention (CDC) and the National Cancer Institute (NCI) to 
jointly develop a comprehensive plan to strengthen and expand 
the 5-A-Day program. The plan should address the policy, 
environmental changes, communications, State and community 
programs, research and evaluation, and surveillance and program 
channels such as mass media, restaurants, supermarkets, 
schools, and faith organizations. The plan should also address 
how best to use already-developed technologies to promote 
healthy eating.
    The Committee is aware that Alaska ranks in the top five in 
the Nation in its proportion of people who are obese. The 
agency is encouraged to give consideration to a pilot program 
proposed by the State of Alaska to prevent and control obesity 
through the promotion of increased physical activity and 
improved nutrition.
    The Committee is aware of the Children's Health Life Skills 
Initiative at the University of North Carolina at Greensboro, 
which is a multi-university effort to address obesity and 
chronic disease among children.
    Pancreatic Cancer.--The Committee encourages the CDC to 
work with the National Cancer Institute to determine possible 
areas of collaboration in epidemiology, translational research, 
and awareness and registry programs for pancreatic cancer. A 
report to the Committee on initiatives in these areas should be 
submitted prior to next year's appropriations hearing.
    Prevention Centers.--The prevention centers form a 
nationwide network of academic institutions that conducts 
applied research designed to develop and test innovative 
strategies for health promotion and disease prevention. The 
primary goals of the program are to identify risk factors, and 
to identify barriers and facilitators to behavior change to 
demonstrate the effectiveness of prevention interventions, to 
increase collaboration among agencies and community partners, 
and to train public health professionals in creative ways for 
preventing chronic diseases and other health problems. The 
Committee has included sufficient funds to expand the number of 
prevention centers funded by CDC.
    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.
    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.
    For example, the West Virginia University Prevention 
Research Center (PRC) worked with the American Lung 
Association, schools, and communities in West Virginia and 
across the United States to develop and evaluate a smoking 
cessation program for teenagers. Controlled studies showed that 
20 to 30 percent of participants were smoke-free by the end of 
the year and young people who did not completely quit 
significantly reduced their cigarette smoking. This program is 
currently being used in many States, and the U.S. Army plans to 
use the program in military high schools across Europe.
    Compared to the Nation, Mississippi Delta residents 
disproportionately suffer from heart disease, cancer, diabetes, 
and other chronic illnesses. The Committee is aware that the 
University of Mississippi Medical Center and Delta State 
University have formed a partnership concentrating on improving 
the health, education, and economic opportunities of 
Mississippi Delta residents.
    Prostate Cancer.--The Committee is aware that prostate 
cancer is the second leading cause of cancer death among men in 
the United States, and that the CDC's prostate cancer awareness 
campaign plays a key role in screening, outreach, education, 
and treatment of men with this disease, especially those at 
high risk. The Committee is pleased with these efforts and 
encourages CDC to expand this program to include the broader 
at-risk male population.
    The Committee recognizes that early detection of prostate 
cancer by the prostate specific antigen (PSA) test is likely to 
reduce disease mortality and therefore believes it is important 
to accelerate programs that can benefit Americans at special 
risk of this disease. In particular, the Committee encourages 
CDC to improve outreach for early detection to populations at 
special risk. The Committee requests that CDC prepare a report 
describing how it plans to accelerate opportunities for early 
detection of prostate cancer as well as linkages to appropriate 
and accessible treatment for the medically underserved. It is 
further expected that CDC will consult closely with the 
research community, public health community, clinicians, 
patient advocacy groups, and the Congress in preparation of 
this report.
    Pulmonary Hypertension.--The Committee continues to be 
interested in pulmonary hypertension, a rare, progressive and 
fatal disease that predominantly affects women, regardless of 
age or race. Pulmonary hypertension causes deadly deterioration 
of the heart and lungs and is a secondary condition in many 
other serious disorders such as scleroderma and lupus. The 
Committee provided funding for public and professional 
awareness of pulmonary hypertension in the fiscal year 2001 
Conference Agreement, and expects CDC to report on the progress 
made to initiate this program by December 31, 2001.
    Safe Motherhood.--The Committee urges the National Center 
for Chronic Disease Prevention and Health Promotion and the 
National Center for Health Statistics to work together to 
review the Pregnancy Risk Assessment Monitoring Survey with the 
intent of expanding this survey, and to explore the possibility 
of a mandatory reporting requirement to track the medical care 
and interventions that women receive during pregnancy and 
delivery.
    School Health.--The Committee supports CDC's efforts to 
expand coordinated school health programs that reduce chronic 
disease risk factors including poor eating habits, physical 
inactivity, and tobacco use. The Committee recognizes that 
children are our most valuable resource and schools represent 
an opportunity to provide our children with valuable health 
skills. The Committee further recognizes that significant 
research has demonstrated that tobacco prevention programs in 
schools can lower smoking rates among teenagers.
    Sudden Infant Death Syndrome.--The Committee notes the work 
of CDC, the National Institute of Child Health and Human 
Development and HRSA in developing 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. The 
Committee expects CDC to be prepared to report on progress on 
this initiative during the fiscal year 2003 budget hearings.
    Tobacco Use.--Tobacco use is the single most preventable 
cause of death and disease in the United States; it is 
responsible for more than 430,000 deaths each year at an annual 
cost of nearly $100,000,000,000. Every day 3,000 young people 
become regular smokers, and it is anticipated that of today's 
children, 5 million will die prematurely if current smoking 
trends continue. In addition, the Committee recognizes the 
consequences of tobacco use have become an issue of global 
concern far beyond the confines of national boundaries. The 
global tobacco epidemic will become the leading cause of 
preventable and premature death worldwide.
    It has been brought to the Committee's attention that 
Alaska Native teens use tobacco at rates much higher than the 
national average and begin using tobacco as early as age 5. The 
Committee encourages the agency to consider the ``Challenge to 
Quit'' program operated by the Alaska Native Health Board which 
offers incentives for Alaska Native teenagers to quit using 
tobacco. The Committee is also disturbed to learn that tobacco 
use in the Yukon-Kuskokwim delta region of Alaska is among the 
highest in the Nation, including more than 40 percent of 
pregnant women, and also encourages the agency to work with the 
Alaska Native Health Board in partnership with the Yukon-
Kuskokwim Health Corporation, on a tobacco cessation program in 
the Yukon-Kuskokwim delta region of Alaska.
    Tourette Syndrome.--The Committee recognizes that Tourette 
Syndrome is a commonly misdiagnosed disease, and has learned of 
the Tourette Syndrome Association's efforts to educate health 
care professionals about this condition. The Committee supports 
these efforts, and urges CDC to support these activities with a 
focus on medically under served communities.
    Youth Media Campaign.--The Committee has not included any 
funding for the youth media campaign. The Committee is aware 
that CDC is implementing the first year of a youth media 
campaign that uses principles of marketing and communications 
strategies to influence America's children to develop habits 
that foster good health over a lifetime--including physical 
activity, good nutrition, and the avoidance of illicit drugs, 
tobacco, and alcohol. CDC is working with marketing and media 
experts to design and implement a media campaign for cable or 
broadcast television programs as well as on an interactive Web 
site.

Environmental Health

    The Committee recommends $171,683,000 for environmental 
health activities which is $34,584,000 above the fiscal year 
2001 level and $35,180,000 above the administration request.
    Many of the public health successes that were achieved in 
the 20th century can be traced to innovations in environmental 
health practices. However, emerging pathogens and environmental 
toxins continue to pose risks to our health and significant 
challenges to public health. Pfiesteria piscicida, an organism 
implicated in major fish kills at sites in the eastern United 
States, may cause a variety of health problems as well as 
impact local economies. Outbreaks of water-borne diseases such 
as cryptosporidium show the vulnerability of our water 
purification systems. The task of protecting people's health 
from hazards in their environment requires a broad set of 
tools. First among these tools are surveillance and data 
collection to determine which substances in the environment are 
getting into people and to what degree. It also must be 
determined whether or not these substances are harmful to 
humans, and at what level of exposure. Many scientists estimate 
that about two-thirds of all cancers result from environmental 
exposure, but much better data are needed to improve this 
estimate and determine which exposures cause cancer and other 
diseases.
    Asthma.--CDC's asthma activities focus on three areas: 
tracking the disease to improve the Nation's ability to 
determine asthma prevalence, severity, and management; assuring 
that interventions are based on science; and working to address 
this problem through partnerships including providing technical 
assistance to non-governmental organizations to carry out 
diverse community-based childhood asthma control programs.
    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 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 under served communities. The 
Committee also encourages CDC to work with other Public Health 
Service agencies at NIH, HRSA, and the Office of the Surgeon 
General to develop a PHS-wide plan to control asthma. The 
Committee has provided sufficient funds to allow CDC to 
increase the numbers of States covered by this program and to 
fund additional community-based interventions that apply 
effective approaches demonstrated in research projects within 
the public health community.
    As with the rest of the United States, there is an increase 
in the prevalence, incidence, and severity of asthma throughout 
Hawaii, especially in its medically underserved population. 
Because of this the Committee urges the CDC to contract with 
Hawaiian Community Health Centers in order to provide proper 
health care in the treatment of asthma throughout Hawaii.
    Childhood Lead Poisoning Prevention.--Since its inception 
in fiscal year 1990, the CDC program has expanded to 
approximately 40 project areas that encompass States, local 
areas, and numerous communities and screens an estimated 1.75 
million children annually. The program has developed its first 
Geographic Information System (GIS) website using U.S. Census 
data on income, race, and old housing to help State and local 
health departments identify high-risk geographic areas. The 
availability of such information will result in more efficient, 
targeted screening.
    The Committee is aware of the portable, easy to use lead 
screening device developed with the support and participation 
of the CDC. The Committee continues to believe that this device 
holds great promise for increasing childhood screening rates in 
under served communities and encourages CDC to support its 
further development for widespread application in community 
public health settings.
    The Committee notes the success that CLEARCorps/USA has had 
in helping communities and families protect their children from 
lead poisoning.
    Childhood Leukemia.--The Committee is aware of the integral 
role that CDC and ATSDR have played in helping the Nevada State 
Health Division's efforts to understand and address the 
outbreak of childhood acute lymphocytic leukemia (ALL) in 
Fallon, Nevada. CDC officials assisted the Health Division to 
develop a tool to survey the families of Fallon children with 
ALL for any information suggestive of features, experiences, or 
exposures in common among them. Officials from the centers also 
served on the Health Division's Expert Panel, a body that has 
provided the State with guidance on advancing the investigation 
into the ALL outbreak. More recently, CDC and ATSDR have been 
developing protocols for the study of contaminants in human 
tissue, soil, air, and dust in the Fallon community. It is 
anticipated that the study will be implemented later this 
summer. Given the limited resources available to Nevada State 
health officials to continue the investigation into the 
cause(s) of the Fallon childhood ALL outbreak, the Committee 
strongly urges the CDC and ATSDR to continue to support Nevada 
State health officials in their investigation.
    Environmental Health Activities.--CDC's environmental 
epidemiology activities include conducting national and 
international epidemiological studies on the association 
between health effects and groundwater contamination; 
collecting and analyzing data on the off-site migration of 
chemical contamination and resistant microbes from concentrated 
animal feeding operations; providing consultation on pesticide 
use in vector-control programs; conducting human pesticide 
exposure studies; developing sensitive biomarkers of pesticide 
exposure; and collaborating with EPA, academia, and State and 
local health departments in several pesticide-related 
activities.
    The genetics and disease prevention program is creating 
centers for genomics and public health within schools of public 
health to evaluate and disseminate information on gene-disease 
associations, gene-environment interaction, and genetic tests 
and to provide technical assistance and training for State and 
local public health programs. CDC will incorporate genetic 
discoveries about human disease into effective public health 
actions that identify ways to use this new knowledge in chronic 
and environmental disease prevention.
    The Committee recognizes the need for scientific 
investigation of the link between environmental contaminants 
and diseases in both humans and ecosystems. The Committee is 
aware the University of Mississippi Medical Center, in 
collaboration with University of Mississippi at Oxford, has a 
program focusing on the association between chemicals in the 
environment and the onset of disease among residents living in 
the Mississippi River basin.
    The Committee is supportive of the efforts of the 
University of Montana, Missoula's Center for Environmental 
Health Sciences. The University is studying the impact of 
environmental factors causing or exacerbating human health 
conditions in an effort to (1) discover new or better 
treatments, (2) better assess the actual risks caused by 
environmental agents, and (3) improve methods to reduce the 
adverse health impacts of these environmental agents.
    Environmental Health Laboratory.--The CDC environmental 
health laboratory performs assessments for State investigations 
of diseases (such as cancer and birth defects) and 
investigations of chemical exposures, such as dioxin, 
pesticides, mercury and cadmium. CDC is also working with 
States to improve public health laboratories that assess State 
level biomonitoring needs. CDC works closely with academic 
institutions, other Federal agencies, and other partners to 
measure human exposure to toxic substances and the adverse 
effects of that exposure.
    The Committee recognizes CDC for its commendable work in 
analyzing toxic exposures throughout the United States. The 
Committee further recognizes that CDC's environmental 
laboratory is unprecedented in the world for measuring toxic 
exposures to humans and further commends CDC for publishing the 
National Report on Human Exposure to Environmental Chemicals, 
which provides information about the U.S. population's exposure 
to 27 toxic substances, including heavy metals and certain 
pesticides.
    The Committee supports the CDC biomonitoring program and 
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. CDC should continue to pursue 
the development of a coordinated system among all the States to 
identify and track disease and conditions caused by exposure to 
environmental toxins.
    Health Tracking Network.--In fiscal year 2001, the 
Committee requested that the Centers for Disease Control and 
Prevention (CDC) develop a plan for a coordinated Nationwide 
Health Tracking Network among all States to identify and track 
chronic diseases and their related environmental factors. 
Across the Nation there is a serious lack of trained personnel 
and modern technology dedicated to responding to the very real 
health emergencies that face our communities. State and local 
health departments need epidemiologists, environmental health 
specialists, chronic disease investigators, technical resources 
and regional laboratories to track chronic disease and evaluate 
community exposures.
    The Committee has included funding to develop pilot 
programs in States as a first step in the development of a 
Nationwide Health Tracking Network. The pilot projects would 
include support for State health departments to develop and 
operate a comprehensive and coordinated State health tracking 
network, increased capacity at regional environmental 
laboratories and State environmental health investigators to 
lead rapid response teams when a disease cluster or other 
health emergency is detected. Finally, these funds would allow 
CDC, working in close coordination with State and local public 
health officers, environmental specialists and other relevant 
parties, to begin to develop national standards and protocols 
for tracking priority chronic disease as part of the Nationwide 
Health Tracking Network.
    Rural Health.--The Committee is greatly concerned about the 
health status of the residents of rural communities. The 
Committee encourages CDC to conduct an assessment of rural 
health problems, in particular, those that may be related to 
concentrated animal feeding operations. Potential health 
indicators should be identified and collected for selected 
areas that reflect the general health status or well-being of 
the community. Analyses of the data should be undertaken to 
identify potential causes of illnesses that may require further 
investigation. The Committee encourages the agency to conduct 
the assessment in Iowa where rural communities reflect many of 
the health problems suffered by rural residents nationwide.
    World Trade Center and Pentagon Emergency Workers.--The 
Committee has included funding for monitoring the health of 
workers directly involved in rescue and response efforts 
associated with the terrorist attacks of September 11, 2001, at 
the World Trade Center in New York City and the Pentagon, in 
Arlington, Virginia. CDC should coordinate its efforts with the 
Federal Emergency Management Agency, the Environmental 
Protection Agency, the Department of Labor, the State of New 
York, the City of New York, Arlington County and affected labor 
organizations. Such efforts shall include baseline and long-
term health monitoring of individuals directly involved in 
rescue and response efforts. The purpose of this demonstration 
is to study the long-term health impacts associated with rescue 
and response efforts at the World Trade Center and the 
Pentagon.
    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.

Epidemic Services and Response

    The Committee recommends $85,303,000 for epidemic services 
and response which is $7,506,000 above the fiscal year 2001 
level and $5,000,000 over the administration's request.
    CDC's epidemic services and response program provides 
resources and scientific expertise for operating and evaluating 
surveillance systems; developing and refining research methods 
and strategies to the benefit of public health practice; 
training public health professionals who are prepared to 
respond to public health emergencies, outbreaks and other 
assistance requests; and communicating with multi-faceted 
audiences accurate public health information and effective 
messages. The scientific basis of this program is applied 
epidemiology, in concert with other components of sound public 
health practice. Findings from these disciplines enable States, 
health organizations, foreign ministries of health, and others 
in the health field to make sound decisions and create 
effective policy. Information derived from epidemiologic data 
and scientific reasoning provide public health programs with an 
objective rationale to set priorities, apply interventions and 
policies, and evaluate public health programs. Within the 
epidemic services and response program, CDC carries out a 
variety of applied research and development activities. Areas 
of research include: social determinants of health; aberration 
detection; burden of disease; injury, and death; prevention 
effectiveness; and health care quality. The Committee 
recognizes that CDC maintains a keen appreciation for the fact 
that local outbreaks of illness can develop rapidly into 
epidemics, that previously unidentified health problems can 
appear at any time, that contaminated food or defective 
products may appear in the community without warning, and that 
the threat of bioterrorism is present in many areas of the 
world. When CDC participates in an investigation, all of the 
resources of the agency are at the disposal of the affected 
area, including its state-of-the-art laboratories.

Health Statistics

    The Committee recommends $126,978,000 which is $5,012,000 
above fiscal year 2001 and the same as the administration 
request.
    CDC's statistics give us context and perspective on which 
we can base important public health decisions. By aggregating 
the experience of individuals, we gain a collective 
understanding of our health, our collective experience with the 
health care system, and our problems and public health 
challenges. NCHS data are used to create a basis for 
comparisons between population groups or geographic areas, as 
well as an understanding of how trends in health change and 
develop over time.
    The Committee urges CDC to continue to prioritize current 
health information which is needed in all sectors of society as 
a prerequisite for planning, action, and evaluation, and can 
lead to improvements in health and quality of life. In this 
time of rapid change in health and welfare policy, medical 
practice, and biomedical knowledge, it is important to make the 
investments necessary to monitor trends so that we can assess 
the impact of these changes and guide policy.
    The Committee is pleased that NCHS continues working with 
the National Center for Infectious Diseases to implement a 
primary immune deficiency national surveillance program.

HIV, STD, and TB Prevention

    The Committee recommends $1,121,612,000 which is 
$77,463,000 above the fiscal year 2001 level and $53,160,000 
above the administration request.
    Recognizing the intersection among these diseases, and the 
need for a focal point for leadership and accountability, CDC 
combines HIV, STD, and TB activities to provide leadership in 
preventing and controlling human immunodeficiency virus 
infection, other sexually transmitted diseases (STDs), and 
tuberculosis. CDC works in collaboration with partners at 
community, State, national, and international levels, applying 
well-integrated, multi-disciplinary programs of research, 
surveillance, technical assistance and evaluation. These 
diseases are not vaccine preventable and must be controlled and 
prevented through identifying, diagnosing, and treating 
infected persons; through provision of confidential, culturally 
competent counseling to identify and reach those who have been 
exposed to infection and who may not know it; and through 
individual and population level health promotion to reduce high 
risk behaviors.
    HIV/AIDS Prevention.--CDC's HIV/AIDS prevention programs 
are working in every State and territory to prevent new 
infections, link people who are already infected to medical 
care and translate scientific research findings into practical 
prevention programs available to every person at risk. CDC will 
continue to adapt these prevention programs to meet new and 
different needs.
    The Committee urges that racial minorities be more fully 
targeted and included in HIV prevention efforts. The Committee 
urges CDC to consider allocating increased resources to address 
the HIV-related health disparities in ethnic and racial 
minority populations. In particular, CDC should continue to 
target support for minority community-based organizations and 
minority regional and national organizations including 
education, technical assistance, infrastructure, capacity 
building, community development, and public health initiatives.
    According to the CDC, between 4 million and 5 million 
people in the United States are at continued behavioral risk 
for HIV infection. The Committee recognizes that this is a low 
estimate due to under-reporting by participants and the lack of 
inclusion of schools, prisons, and the military. Communities 
must be better equipped with local data to identify and direct 
resources to those most at risk. They must have an array of 
effective interventions available and the capacity to implement 
and evaluate them at the local level. They must also be able 
not only to address barriers and deter risky behavior but also 
to encourage health promotion behavior through a variety of 
individual and group interventions, community-level supports, 
and structural level changes. Because those at risk for or 
living with HIV infection are often also at risk for other 
health problems, HIV prevention must be integrated with other 
services such as STD and TB screening and treatment, 
reproductive health services, mental health services, and drug 
use prevention and treatment. Therefore, the Committee urges 
CDC to give its HIV Strategic Plan high priority, especially 
with regard to behavioral research, development, 
implementation, and evaluation of prevention and intervention 
programs for at-risk subpopulations, such as racial and ethnic 
minorities, adolescents, women, sex workers, substance abusers, 
and incarcerated individuals.
    The Committee is concerned regarding the level funding 
received by the HIV school health program during the last 
decade compared to the increased funding for HIV activities. 
Significant increases in the HIV epidemic in the United States 
during the same period disproportionately affect adolescents 
and young adults who can benefit from school and university 
based HIV prevention programs. Of the increase provided for 
HIV/AIDS programs, the Committee directs CDC to increase school 
health HIV funding to a level that is consistent with the 
increased cost of living since 1991.
    Oral fluid testing is one of the newest and most 
revolutionary advances in diagnostic testing. Recent 
technological advances have resulted in a rapid oral fluid 
test, currently in FDA clinical trials, that will indicate HIV/
AIDS status within 20 minutes. The Committee is aware that, 
with some level of attention by the Centers of Disease Control, 
this test could be adapted to a variety of infectious diseases, 
including those resulting from biological warfare or 
bioterrorism.
    The Committee is aware of the growing incidence of HIV/AIDS 
along the United States-Mexico border and the greater 
difficulty health providers have in identifying and treating 
individuals in this region. The Committee understands that 
University of Texas Health Sciences Center-Houston could 
establish a Center for HIV Research and Education to better 
understand and respond to the unique demographic 
characteristics and needs of this population to help prevent 
the further spread of AIDS
    Global HIV/AIDS.--CDC's international work is conducted in 
collaboration with USAID and other Federal agencies. In fiscal 
year 2000 CDC began to implement prevention activities and 
programs in 15 countries, including India and 14 countries in 
Africa. In fiscal year 2002, CDC will expand activities to 
Latin America and other countries in Africa and Asia. The 
Committee has included bill language that will allow CDC to 
carry out international health activities, including HIV/AIDS.
    HIV/AIDS and other diseases such as hepatitis are spread in 
sub-Saharan Africa by blood transfusion. Testing sub-Saharan 
African blood using FDA approved blood transfusion testing 
technologies is important. Since testing will deteriorate the 
available blood supply in sub-Saharan Africa, funding for the 
development of donor and transfusion facilities with trained 
staff would ensure an adequate safe blood supply and safe 
transfusion practices. Funding initiatives vis-a-vis blood 
testing must include the comprehensive training of African 
nationals to staff testing laboratories and donor facilities.
    The Committee urges CDC to fund microbicide research and 
development within funds provided for global AIDS. These funds 
could support clinical trials of microbicides as set forth in 
CDC's HIV Prevention Strategic Plan and its topical 
microbicides 5-year research agenda.
    Sexually transmitted diseases.--CDC's strategy for STD 
prevention is to provide national and international leadership 
through research, surveillance, policy development, and 
assistance to States, territories and local health departments 
in the delivery of services to prevent and control the 
transmission of STDs and their complications. The Committee 
recognizes that this year, more than 15 million Americans will 
contract a STD. This epidemic will disproportionately affect 
adolescents, women, and people of color. The epidemic will 
tally $8,400,000,000 in direct costs, along with immeasurable 
human costs in pain and suffering. National surveillance of 
syphilis, chlamydia, and gonorrhea is supported, and sentinel 
surveillance strategies are being developed for new viral STDs, 
specifically, human papillomavirus. Prevention research is 
conducted to improve methods and delivery of prevention 
services and to develop and refine interventions.
    The Committee commends CDC in its work in this area and 
recognizes that STD prevention programs are highly effective. 
Two major foci of national STD prevention efforts are syphilis 
elimination and prevention of STD-related infertility. CDC has 
undertaken an initiative to eliminate syphilis in the United 
States by 2005 which builds upon existing STD programs and 
takes advantage of the opportunity afforded by historic lows in 
syphilis rates.
    Given the continuing high prevalence of chlamydia in the 
United States and the need to expand screening and treatment 
efforts, the Committee has included increased funding for this 
program and directs that this increase be used to provide 
services to all regions of the country, with each region 
receiving the same percentage increase.
    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.
    Tuberculosis Elimination.--CDC works with local, State, 
national, and international partners towards the goal of 
eliminating TB. In addition to promoting the more effective use 
of existing tools for combating TB, CDC is working with NIH and 
FDA to develop new diagnostic and treatment tools as well as 
better vaccines.
    The Committee commends CDC for its continued efforts to 
control tuberculosis (TB) in the United States, as demonstrated 
by the eighth year of declining TB trends reported for 2000. 
However, with the recent release of the Institute of Medicine's 
report ``Ending Neglect: the Elimination of Tuberculosis in the 
United States,'' the Committee remains concerned about the 
threat of TB and 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 
encourages 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 a new 
effective TB vaccine.
    The Committee is pleased with CDC's program to control TB 
along the United States-Mexico border. CDC is collaborating 
with the Mexican National Public Health Laboratory Program and 
the Association of State and Territorial Public Health 
Laboratory Directors to coordinate laboratory training between 
United States and Mexican laboratorians. CDC also provides 
funding to State and local health departments which supports 
several border health activities. The Texas-Mexico bi-national 
border projects are designed to reduce TB by co-managing TB 
cases and their contacts.
    The Committee is aware of the County of San Diego's program 
that provides treatment to multi-drug resistant TB patients 
along the northern Mexico border with California and encourages 
CDC to give full and fair consideration to this program.

Immunization

    The Committee recommends $637,145,000 for the program 
authorized under section 317 of the Public Health Service Act 
which is $84,540,000 above the fiscal year 2001 level and 
$62,500,000 above 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 2002 is 
$796,193,000 for the purchase and distribution of vaccines, 
which when combined with the section 317 discretionary funding 
totals $1,370,838,000.
    Despite great success in lowering disease levels and 
raising immunization coverage rates, much remains to be done to 
ensure the protection of children and adults worldwide. 
Approximately 1 million 2-year-old children in the United 
States have not received one or more of the more established, 
recommended vaccines. New vaccines, although greatly beneficial 
to public health, complicate an already complex immunization 
schedule and make it increasingly difficult to ensure complete 
immunization. One of our Nation's greatest challenges is 
extending our success in childhood immunization to the adult 
population. The burden due to the occurrence of vaccine-
preventable diseases in adults in the United States is 
staggering. As many as 50,000 U.S. adults die of influenza, 
pneumococcal infections and hepatitis B. CDC is addressing 
these obstacles to the greatest extent possible and continues 
to provide leadership to reduce disability and death resulting 
from diseases that can be prevented through vaccination.
    The Committee encourages 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, primarily by air. The Committee encourages the 
agency to give careful consideration to 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 deliver these vaccines at the community 
level, including development of a statewide immunization 
registry to ensure that all children in Alaska are immunized.
    The Committee notes that the Maine Immunization Registry 
Demonstration Project proposes a comprehensive, secure and 
detailed technological infrastructure to maintain databases 
that enroll children at birth and store information on each 
immunization; consolidate scattered immunization records; and 
transfer immunization records confidentially to patients' new 
providers to prevent the costly and clinically inappropriate 
duplication of vaccine administration.
    Global Immunization Activities.--Included in the amount for 
immunization are funds to continue CDC's global immunization 
activities, which include additional funds for polio vaccine 
and surveillance to augment support for the highly successful, 
yet unfinished polio eradication efforts; support for the 
purchase of measles vaccine for measles mortality reduction and 
regional measles elimination initiatives and to expand 
epidemiologic, laboratory, and programmatic/operational support 
to WHO and its member countries; and establishing CDC's program 
activities as a partner in the Global Alliance for Vaccines and 
Immunization (GAVI). Measles and GAVIactivities should build on 
the global disease control and surveillance infrastructure 
developed for polio eradication.

Infectious Disease Control

    The Committee recommends $331,518,000 for infectious 
disease control which is $13,844,000 above the fiscal year 2001 
level and the same as the administration request.
    These activities focus on: national surveillance of 
infectious disease; 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 disease prevention 
technologies; and strengthening the capability to respond to 
outbreaks of new or reemerging disease.
    Infectious diseases are a leading cause of death worldwide, 
accounting for 1/4 to 1/3 of the estimated 54 million deaths in 
1998. Disease outbreaks endanger U.S. citizens at home and 
abroad, threaten U.S. Armed Forces overseas, and exacerbate 
social and political instability. Outbreaks can interfere with 
the global marketplace, affecting tourism, trade, and foreign 
investment. CDC's strategies to combat infectious diseases 
invest in and build upon both the public health system that was 
established over a century ago to increase the preparedness to 
address the emergence of dangerous new threats.
    The Committee is aware that in 1995, in partnership with 
Federal, State, and local agencies, universities, private 
industry, foreign governments, the World Health Organization 
(WHO), and many non-governmental organizations, CDC launched 
the first phase of a nationwide program to revitalize national 
capacity to protect the public from infectious disease threats. 
The second phase of CDC's effort, ``Preventing Emerging 
Infectious Diseases: A Strategy for the 21st Century'', 
published in 1998, continues these partnerships to build 
domestic and global capacity for recognizing and responding to 
infectious diseases.
    Approximately 11 million people live along the 2,000-mile 
Southwest border between the United States and Mexico in the 
States of New Mexico, Texas, Arizona, and California. With 
rapid population growth, cross-border interchange, and low 
socio-economic status in many border areas, public health and 
safety is an ongoing concern. The Committee encourages CDC to 
expand its investment in the Border Infectious Diseases 
Surveillance (BIDS) program to provide increased personnel, 
equipment, training, and technical support to better monitor 
public health conditions and safety along the Southwest border.
    The Committee recognizes the excellent work being done at 
the University of Texas Medical Branch-Galveston and at the 
University of Texas Health Center-Tyler in the treatment and 
control of infectious disease, particularly along the United 
States/Mexico border.
    The Committee is aware of the Center for Emerging 
Infectious Diseases at the University of New Mexico and its 
work in biological detection and intervention against emerging 
infectious diseases.
    Antimicrobial Resistance Initiative.--The Committee is 
concerned about 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 communities and the 
health care system in the United States. To combat this 
national health threat, the Committee recognizes the need to 
discover and develop new pharmaceutical products to combat 
these drug resistant microbes. The Committee notes that the 
University of Mississippi, a leader in antimicrobial research 
and new compound discovery, has been working with CDC on this 
issue and urges CDC to give consideration to continuing this 
partnership.
    The Committee also recognizes the excellent work of 
Southern Methodist University in modifying antibiotics to make 
them more effective at combating human bacterial infection 
without causing antibiotic resistance.
    Bacterial Infections.--According to CDC, 65 percent of the 
bacterial infections treated by physicians in the developed 
world are caused by biofilms. The Committee understands that 
the Center for Biofilm Engineering at Montana State University 
is prepared to undertake research in the etiology and control 
of middle ear infections and encourages CDC to give full and 
fair consideration to this proposal.
    Food Safety.--CDC established PulseNet in 45 State health 
departments. PulseNet is a national network of public health 
laboratories that performs DNA ``fingerprinting'' on bacteria 
that may be foodborne. The PulseNet network has revolutionized 
foodborne disease surveillance by allowing near real-time 
comparison of these ``fingerprint'' patterns through an 
electronic database at CDC. Matching patterns can indicate 
possible nationwide outbreaks and provide an early warning for 
public health investigation and intervention. The Committee is 
pleased that CDC has developed and implemented a state-of the 
art diagnostic and communications system to improve parasitic 
disease diagnoses in the United States. This system, known as 
DPDx, uses Internet communication to rapidly exchange 
diagnostic images of parasites digitally captured from 
microscopic slides. Using DPDx, public health laboratories can 
obtain diagnostic assistance in real time, allowing for rapid 
identification of possible outbreaks.
    The Committee is aware of concerns raised within and 
outside Alaska about the safety of Alaskan wild foods. The 
Committee encourages the agency to give careful consideration 
to a State of Alaska program to monitor the safety of Alaskan 
wild foods, including field studies of the effects of 
environmental chemical contaminants and naturally occurring 
metals in Alaskan wild foods, measurement of PCB levels in 
remote arctic communities, documentation of mercury levels in 
ancient humans, documentation of incidence of childhood asthma, 
and development of public health recommendations on Alaskan 
wild food consumption by subsistence users and others.
    Global Malaria Initiative.--The Committee continues to 
recognize the tremendous impact of malaria in the developing 
world, and notes malaria's increasing resistance to 
antimalarial drugs designed to counter its pervasive effects. 
New drugs must be developed, and the Committee urges the CDC to 
continue its efforts to lead in new compound discovery. The 
Committee notes that the University of Mississippi has been 
working collaboratively with the CDC to address research in the 
area of malaria, along with TB and HIV/AIDS. The Committee 
encourages CDC to give full consideration of these projects and 
to continue its important research in this area.
    Hawaiian Patients with End Stage Renal Disease.--The 
Committee is aware that many Native Hawaiian in rural Hawaii 
afflicted with End Stage Renal Disease (ESRD) and on dialysis 
have a history of repeated infections that put them at greater 
risk for frequent hospitalization. The Committee encourages CDC 
to consider a demonstration project in Hawaii to reduce the 
incidence of infection in this patient population.
    Hepatitis C.--The Committee encourages funding for the 
National Hepatitis C Prevention Strategy, a public health 
initiative to control and reduce the incidence of Hepatitis C. 
This funding will begin to develop State-based programs by 
funding public health Hepatitis C coordinators in all 50 
States, plus 15 large metropolitan areas and demonstrations in 
15 States to learn the most feasible approach to integrating 
Hepatitis C and B screening, counseling and referral programs 
into the existing HIV-STD State programs. The Committee is 
pleased that the demonstrations include funding for screening, 
counseling, and referral services, but is concerned that no 
such services are funded in the remaining States and that even 
the demonstrations only provide the more comprehensive services 
in selected areas of the 15 demonstration States. The Committee 
therefore requests that the CDC submit by January 15, 2002 an 
implementation plan for a full response to the need for 
Hepatitis C prevention.
    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 on 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.
    Lyme Disease.--The Committee is deeply concerned about the 
safety of the Lyme disease vaccine (LymeRix). Over 1,000 
adverse event reports were filed with the Food and Drug 
Administration from December 1998 to October 2000. The 
Committee encourages CDC to work closely with the FDA to ensure 
that all adverse event reports are thoroughly and expeditiously 
investigated to ensure public safety as the vaccine is being 
distributed. Investigators should pay particular attention to 
patients' reports of arthritis when evaluating these reports.
    The Committee recognizes that the current state of 
laboratory testing for Lyme disease is very poor. The situation 
has led many people to be misdiagnosed and delayed proper 
treatment. The vaccine clinical trial has documented that more 
that one third (36 percent) of the people with Lyme disease did 
not test positive on the most sophisticated tests available. 
The ramifications of this deficit in terms of unnecessary pain, 
suffering and cost is staggering. The Committee directs CDC to 
work closely with the Food and Drug Administration to develop 
an unequivocal test for Lyme disease.
    The Committee is distressed in hearing of the widespread 
misuse of the current Lyme disease surveillance case 
definition. While the CDC does state that ``this surveillance 
case definition was developed for national reporting of Lyme 
disease: 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 aggressively pursue and correct the misuse of 
this definition. This includes issuing an alert to the public 
and physicians, as well as actively issuing letters to places 
misusing this definition.
    The Committee recommends that the CDC strongly support the 
re-examination and broadening of the Lyme disease surveillance 
case definition by the Council of State and Territorial 
Epidemiologists. Voluntary and patient groups should have input 
into this process. Currently there is just one definition 
(``confirmed case'') of seven possible categories. By 
developing other categories while leaving the current category 
intact, the true number of cases being diagnosed and treated 
will be more accurately counted, lending to improved public 
health planning for finding solutions to the infection.
    The CDC is encouraged to include a broad range of 
scientific viewpoints in the process of planning and executing 
their efforts. This means including 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.
    Mosquito surveillance and research.--The Committee urges 
the CDC and related State and local mosquito control agencies 
participating in CDC research into mosquito borne illnesses to 
utilize emerging technologies, including counterflow 
technology, in the collection, trapping or surveillance of 
mosquitos used in connection with such research. Emerging 
technologies developed for trapping mosquitos offer 
environmentally sound alternatives that have the potential to 
increase the productivity of personnel and enhance the quality 
of specimens collected for this research.
    Prevention Epicenter Program.--The Committee applauds CDC's 
support for the Prevention Epicenter Program and encourages CDC 
to continue and expand this program to address patient safety 
issues.
    Research and Development of Improved Vaccine Delivery 
Mechanisms.--Particularly in light of the recent terrorist 
attack, there is a pressing need to improve the availability of 
vaccines. The Committee is aware of exciting new work by the 
Oral Vaccine Institute to develop delivery mechanisms that 
allow vaccines currently only administered by injection to be 
given orally. These and other potential improvements would 
significantly reduce costs, and improve transportability and 
ease of storage. The Committee expects CDC to expand its 
efforts in this area.
    West Nile Virus.--The Committee is aware of CDC's effort to 
complete a national plan for West Nile virus response in the 
United States. That includes developing a computerized national 
surveillance system for West Nile virus and provides funds to 
53 health departments to build national capacity to develop and 
implement effective surveillance, prevention, and control of 
West Nile virus in the United States.

Injury Prevention and Control

    The Committee recommends $146,655,000 for injury prevention 
and control which is $3,805,000 above the 2001 level and 
$3,000,000 above the administration request.
    CDC 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 helmet use; lack of seatbelt and proper baby seat use; 
and other injuries. The national injury control program at CDC 
encompasses nonoccupational injury and applied research in 
acute care and rehabilitation of the injured. Funds are 
utilized for both intramural and extramural research as well as 
assisting State and local health agencies in implementing 
injury prevention programs. The Committee recognizes the vital 
role CDC serves as a focal point for all Federal injury control 
activities.
    The Committee is aware that accidental injury is the 
leading cause of death for Alaska children and teens. The 
injury fatality rate for Alaskan children exceeds the national 
average by 60 percent. The Committee encourages the agency to 
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.
    Injuries Among the Elderly.--By 2020, one in six Americans 
will be age 65 or older and every day, more than 100 older 
persons die from an injury. The three leading causes of injury 
deaths among older adults are falls (9,000 per year), motor 
vehicle collisions (7,000 per year), and suicide (6,000 per 
year). In addition, hundreds of thousands of older adults 
suffer non-fatal injuries every year (350,000 from falls; 
170,000 from motor vehicle crashes). Many if not most of these 
are preventable. The Committee is pleased that CDC and its 
public and private partners are making tremendous progress in 
injury prevention and control. CDC's strategy includes 
implementing successful safety programs into more States, 
communities, and businesses; communicating what works to safety 
organizations, health care providers, and the public; and 
conducting research to find out why people get injured, what 
works to prevent injuries, and how to get people to use 
interventions that are successful.
    Injury Control Research Centers.--The Committee recognizes 
the need for an additional Injury Control Research Center in 
Federal Region 7, and has included sufficient funds for an 
additional injury control center in Iowa. Preference should be 
given to applicants with proven injury center experience. The 
Committee is aware that injury ranks as one of the Nation's 
most pressing health problems accounting for 150,000 deaths and 
38 million emergency room visits per year. The Committee 
believes that rural populations have special and underserved 
needs in injury control. These funds would address the pressing 
needs to control morbidity, disability, death, and costs 
associated with injury in rural populations.
    National Violent Death Reporting System.--In fiscal year 
2001, Congress called for CDC to develop a system for more 
timely, complete, objective and accurate information about 
violent deaths and injuries to inform and evaluate policy and 
program efforts. The Committee is pleased that, during the past 
year, CDC has worked with the Department of Justice and a 
variety of interested groups to develop a model plan to 
implement a national violent death reporting system (NVDRS) 
that will enable State governments to understand more about the 
violence problem in their States. The Committee urges CDC to 
begin initial implementation of the Plan and has provided funds 
for that purpose.
    The Committee is aware of the progress made by the 
University of Pennsylvania, which sponsors injury reporting in 
Iowa and Ohio, and efforts being made by the University of 
Maryland in establishing reporting systems. The Medical College 
of Wisconsin and the Harvard School of Public Health are also 
developing injury reporting systems. The Committee urges the 
CDC to work with private health and education agencies as well 
as State agencies, when developing an injury reporting system.
    The Committee is pleased with the progress of the 
University of Northern Iowa (UNI) in implementing the action 
steps described in the National Action Plan for the Prevention 
of Playground Injuries and encourages continued support of this 
project.
    Residential Fire Deaths and Injuries.--Every 10 seconds in 
the United States, a residential fire occurs, and every 23 
minutes a residential fire injures a human being. In addition, 
445,000 burn victims miss more than half a day of work or 
school and residential fires cause $5,000,000,000 in direct 
property damage each year. Yet, deaths from fires are 
preventable and CDC's research indicates that installing smoke 
alarms and educating residents about fire safety can reduce 
deaths by as much as 50-80 percent. The Committee urges CDC to 
continue its efforts to increase the use of smoke alarms 
especially among under served and minority populations.
    Trauma Care.--The Trauma Information and Exchange Program 
(TIEP) stands to serve as the first-ever national clearinghouse 
on trauma statistics, enabling trauma physicians, emergency 
care coordinators and public health officials to determine and 
respond to trauma trends such as geographical variations among 
injuries, age-related injuries, and variations among rural 
versus urban/suburban environments. A fully operational TIEP 
will enhance prevention, amelioration, and treatment of injury 
and the reduction of injury-related disability and death across 
the Nation. The Committee continues to be supportive of the 
work of the American Trauma Society.
    The Committee recognizes that the scope of the ``National 
Study on Costs and Outcomes of Trauma Care'' has expanded since 
it was initially designed, and encourages CDC to expand and 
complete this effort. The expanded study would include greater 
analysis of trauma care, critical examination of patient care 
outcomes, and a broader range of patients analyzed, paying 
particular attention to elderly populations.
    The Committee is aware of the importance of the ongoing 
National Study on Costs and Outcomes of Trauma Care currently 
being conducted by Harborview Medical Center in Seattle, 
Washington and John Hopkins University.
    Youth Violence.--The Committee is acutely concerned about 
school shootings and similar violent acts among our youth. The 
Committee is also aware of 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 and the Substance Abuse and Mental Health 
Services Administration to develop a collaborative program in 
this regard. The Committee is pleased that the CDC focused a 
portion of their research efforts to discover approaches to 
intervene and prevent the complex behavior problems in children 
and youth which utilize molecular neuroscience, brain mapping, 
and behavioral analysis.

Occupational Safety and Health

    The Committee recommends $276,135,000 for occupational 
safety and health programs which is $16,001,000 above the 2001 
level and $10,000,000 above the administration budget.
    The CDC's National Institute for Occupational Safety and 
Health (NIOSH), is the only Federal agency responsible for 
conducting research and making recommendations for the 
prevention of work-related illness and injury. The NIOSH 
mission spans the spectrum of activities necessary for the 
prevention of work-related illness, injury, disability, and 
death by gathering information, conducting scientific 
biomedical research (both applied and basic), and translating 
the knowledge gained into products and services that impact 
workers in settings from corporate offices to constructions 
sites to coal mines.
    The Committee encourages NIOSH to give full consideration 
to establishing a center on environmental toxins at the 
University of Hawaii at Hilo.
    National Occupational Research Agenda.--The continuing need 
for occupational safety and health research, both public and 
private, led NIOSH to work with the occupational safety and 
health community to create the National Occupational Research 
Agenda (NORA) in 1996. Now in its 5th year, NORA has become the 
largest stakeholder-based research agenda in the United States, 
targeting 21 research priorities considered by the Nation's 
occupational safety and health community as most essential for 
improving the safety and health of the U.S. work force. 
Approximately 500 organizations and individuals outside of 
NIOSH provided input into the development of the agenda. These 
efforts have led to the evolution of more efficient and 
effective ways to conduct research within NIOSH, the growth of 
NIOSH's extramural programs, and the expansion of occupational 
safety and health research in other government agencies.
    The Committee is pleased that research conducted by NIOSH 
scientists is producing information of practical importance to 
millions of workers and their employers. For example, recent 
laboratory findings have confirmed the ability of common 
solvents to cause hearing damage, revealed the mechanisms by 
which inhaled metal dusts may be causing lung cancer, and 
determined the physical characteristics of inhaled fibers that 
cause occupational lung diseases. Engineering research 
identified effective technology for protecting workers from 
chemical emissions in automobile repair, lifting injuries in 
nursing homes and beverage delivery, and hazardous dusts in 
construction and mining.
    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. It 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.--The Committee once again 
is very pleased with the progress that NIOSH has made in its 
program directed at occupational illnesses and injuries in the 
building and construction industry. According to the Bureau of 
Labor Statistics, the rate of serious illnesses and injuries in 
construction has dropped 32 percent from 1992 to 1997. The 
Committee is also pleased by NIOSH's new focus on active 
intervention to prevent occupational injury and illness in the 
construction industry, and the National Occupational Research 
Agenda (NORA) for establishing research priorities. 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.
    The Committee is aware that the Construction Safety 
Alliance (CSA), a consortium of universities that include the 
University of Texas at Austin, the University of Florida at 
Gainesville, the University of Cincinnati in Ohio, and Purdue 
University in Indiana is conducting research to develop and 
implement a national program in construction safety and health. 
The Alliance will develop epidemiologic methods of studying 
injuries and illnesses and evaluating methods of prevention.
    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). The 
Committee has provided sufficient funding for the ERCs to 
expand research activities in support of implementation of the 
National Occupational Research Agenda (NORA).
    Emergency Workers.--The Committee believes that significant 
work must continue to protect emergency responders from 
biological and chemical terrorism exposures. Fire fighters, 
emergency medical personnel, and other on-site workers need 
reliable personal protective equipment, principally 
respirators, but also protective clothing and detection devices 
to be able to effectively help victims in case of exposure to 
biological and chemical terrorist agents. The Committee urges 
the NIOSH to carry out research and related activities aimed at 
protecting workers, who respond to public health needs in the 
event of a terrorist incident. The Committee further urges 
NIOSH to move forward quickly with a chemical and biological 
respirator certification standard. The Committee requests CDC 
to report to the Committee on its progress before next year's 
budget hearings.
    Farm Health and Safety.--The Committee has included funding 
to continue the farm health and safety initiative. 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.
    Maine Fishing Industry.--The Committee is aware of the loss 
of life in Maine's fishing industry in the last 18 months and 
urges NIOSH to work with the State of Maine to address 
occupational safety and health in the commercial fishing 
industry.
    Mine Safety Research.--The fatality rate for the mining 
industry continues to be excessive and is more than five times 
greater than the national average for all industry segments. 
The primary causes of mining fatalities are associated with 
ground falls, equipment operation and powered-haulage systems. 
The Committee recognizes that the mine safety and health 
research programs address these and other issues in the mining 
industry and continue as a high priority for NIOSH. The 
Committee is pleased with CDC's recent accomplishment to 
develop a load rate warning system for mobile roof supports. 
Retreat mining in underground coal mines is one of the more 
hazardous operations and the adoption of this mining strategy 
has increased significantly following the development of mobile 
roof supports. These supports replaced wooden timbers for roof 
support and have dramatically increased the productivity of the 
mining operation. The mobile roof supports may become 
overloaded depending upon the specific mining conditions and 
failure of the systems is often dramatic and catastrophic. The 
development of a warning system has been adopted by the 
industry and is now commercially available by the major 
manufacturer of the systems.
    Sleep Disorders.--The Committee is aware that sleepiness, 
as a result of either untreated sleep disorders or simple sleep 
deprivation, has been identified as a causal factor in many 
chronic diseases as well as a growing number of vehicular and 
on-the-job injuries. Sleep deprivation is also a growing 
problem for high school students, the largest at-risk group for 
fall-asleep car crashes, as well as police officers and medical 
residents.
    The Committee encourages CDC to develop and begin 
implementation of a 5-year sleep awareness action plan designed 
to develop public health programs regarding sleepiness and 
sleep disorders nationwide.
    Workplace Violence.--The Committee recognizes that 
workplace violence is a major national occupational priority 
and that it is the second leading cause of workplace deaths 
among women workers. The Committee further recognizes that 
several hundred workers die each year as victims of workplace 
violence, that at least 2 million workers suffer from injuries 
that result from workplace violence, and that the health care 
costs, lost productivity and countermeasure costs run into the 
billions of dollars. The Committee has included increased 
funding for NIOSH to develop an intramural and extramural 
prevention research program that will target all aspects of 
workplace violence and to coordinate its efforts with the 
Departments of Justice and Labor.

Preventive Health and Health Services Block Grant

    The Committee recommends $135,030,000 for the preventive 
health and health services block grant which is the same as the 
2001 level and the administration's request.
    The Preventive Health and Health Services Block Grant 
provides States with funds for services to reduce preventable 
morbidity and mortality to improve the quality of life. The 
Block Grant is the primary source of funding to States for 
health education and risk reduction activities; cholesterol, 
hypertension, and cancer screening; and programs to prevent sex 
offenses. The strategy of the Block Grant is to provide States 
with flexibility to tailor prevention and health promotion 
programs to their health priority needs. Block Grant funding 
enables States to provide money for developing new programs; 
fund essential services that would otherwise go unfunded; and 
address urgent, rapidly developing health hazards such as 
disease outbreaks or environmental disasters.

Public Health Improvement

    The Committee recommends $114,910,000 for public health 
improvement which is $4,021,000 above the fiscal year 2001 
level and $5,000,000 above the administration request.
    Our national public health system is the first line of 
defense against preventable disease and disability. Virtually 
every health problem in our communities--infectious disease 
outbreaks, chemical hazards, chronic diseases, and injuries--is 
first recognized by local public health professionals, who must 
work in concert with State and national officials to control 
these threats, prevent spread, and save lives. Despite steady 
increases and shifts in the U.S. population there has been a 
decline in the number of public health workers per capita in 
the past decade. Schools of Public Health and Preventive 
Medicine report that the majority of graduates do not seek 
employment in public health agencies. Only an estimated 44 
percent of the Nation's current 448,000 public health 
practitioners have had formal training in public health. One-
half of all public health nurses--the largest profession in 
public health--lack a baccalaureate nursing degree. The 
majority of public and private laboratory scientists lack 
access to continuing education and training essential to using 
the cascade of new, high-technology laboratory tests accurately 
and safely.
    Minority Health Disparities.--This program is intended to 
help racial and ethnic minority communities mobilize and 
organize their resources to support effective and sustainable 
programs that will contribute to the elimination of health 
disparities in the following six target health areas: infant 
mortality, breast and cervical cancer screening and management, 
cardiovascular disease, diabetes, HIV infection and AIDS, and 
child and adult immunizations. REACH 2010 is a 2-phased, 5-year 
demonstration project. Phase I is a 12-month planning phase to 
support planning and development of demonstration programs. 
Phase II is a 4-year implementation and evaluation phase. The 
Committee is pleased with CDC's commitment to the REACH 2010 
Program. The planning (Phase I) communities currently are 
establishing infrastructure to support community-level data 
collection, establishing collaborative partnerships, 
establishing linkages with other state and local agencies, and 
working with Federal agencies and other partners to identify 
promising prevention strategies that have the greatest 
potential for reducing the health disparities in the target 
populations.
    National Electronic Disease Surveillance System.--Accurate, 
timely health information is a critical component of all 
effective prevention and control efforts. Yet, only 55 percent 
of local health departments have high-speed, continuous 
Internet access for finding the most recent health guidelines 
and recommendations. Only 56 percent can successfully receive 
broadcast health alerts. Only 50 percent have access to 
community health information critical for setting priorities, 
taking effective actions, and tracking improvements in health 
status. The Committee is pleased with CDC's work to integrate 
disease detection and monitoring to ensure rapid reporting and 
follow-up.
    Phytomedicines.--Millions of U.S. citizens consume dietary 
supplements regularly. But there is no formal mechanism for 
reporting adverse events that may be associated with the use of 
such products, including events that may be linked to 
inappropriate use or interactions with drugs or foods. The 
Committee recognizes that development, implementation, and 
oversight of such a system must necessarily involve expertise 
in pharmaceutical care, disease management, monitoring and 
surveillance, and the chemistry and biology of natural 
products.
    Prevention Research.--The CDC Office of Extramural 
Prevention Research sponsors peer-reviewed research conducted 
by academic researchers who are linked with State and local 
health agencies to develop improved interventions and services. 
Extramural investigators are located in leading schools of 
public health, medical schools, State health departments, and 
other academic and practice-based organizations. Translation of 
research findings into information, guidelines, and tools for 
front-line public health practitioners are an integral part of 
the program and will be facilitated through existing and new 
partnerships between CDC's Public Health Practice Program 
Office and public health practice organizations. In addition to 
supporting high-priority prevention research projects, the 
Office of Extramural Prevention Research is a focal point for 
CDC's extramural research partners, aids development of 
practice-oriented CDC prevention research agendas, promotes use 
of rigorous peer-review processes for extramural research, and 
facilitates dissemination of research findings and translation 
of findings into action.
    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 more 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.
    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 with 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 complement efforts by this Center.
    The Committee has also included funds to research the 
antioxidant and anti-adhesion effects of Vaccinium 
proanthocyanidins from native North American fruit for possible 
prevention or treatment of cardiovascular disease and diseases 
or conditions caused by microbial pathogens such as ulcers, 
urinary tract infections and various diseases of the ear, nose 
and throat.
    Recognizing the importance of pediatric sleep disorders, 
last year the Committee included language encouraging CDC to 
allocate increased funding for research on these problems. The 
Committee is aware of Kosair Children's Hospital's Sleep 
Medicine Center and the University of Louisville's Multi-
Disciplinary Early Childhood Research Center's research to 
improve the prevention, diagnosis, and treatment of sleep 
disorders in children.
    The Committee is aware of the social, economic, and health 
disparities in Mississippi and that health-related 
interventions and programs should reflect the findings of 
individualized community assessments, and that measurements of 
resulting outcomes must evolve from a research design framed 
around the problem, the intervention, and the appropriate 
evaluation methodologies. The Committee recognizes that it is 
through research-based outcomes that health care planners and 
policy makers can best respond to the real needs of citizens. 
The Committee is aware of the development of the Research 
Center of Excellence located in Mississippi and recommends the 
utilization of the Mississippi Research Center of Excellence to 
offer its assessment and evaluation expertise to identify 
community health care needs and wants.
    The Committee is aware of the Tulane and Xavier 
Universities request for funding for research on environmental 
signals and work on biosensors and biomarkers which will 
identify hazards in the environment that may cause damage to 
humans.
    The Committee is aware of the Vermont Oxford Network, 
located in Burlington, Vermont, and it efforts to improve the 
quality of health care available to children born prematurely 
through the reduction of medical errors.
    The Committee urges CDC to give full and fair consideration 
to these proposals.

Buildings and Facilities

    The Committee recommendation includes $250,000,000 for the 
planning, design, and construction of new facilities as well as 
the repair and renovation of existing CDC facilities. This is 
$75,000,000 above the fiscal year 2001 level and $100,000,000 
above the administration request.
    While making progress on addressing the many problems 
caused by its buildings and facilities, CDC continues to carry 
out its mission with clearly inadequate laboratories, support 
facilities, and security infrastructure. As the Committee noted 
last year, CDC's buildings and facilities create serious 
problems regarding employee safety and interfere with the 
ability of the agency to carry out its mission in an efficient 
and effective manner. Some facilities are more than 40 years 
past their original life expectancy and should be replaced, 
while others are in great need of complete renovation.
    The Committee directs CDC to continue full implementation 
of the agency's 10 year buildings and facilities Master Plan. 
As provided by the Committee last year, CDC should use the 
enhanced contracting language provided in the bill to 
accelerate the start of new projects. This authority has 
acquired greater urgency in light of recent events impacting 
the security of Federal facilities. It is also the same 
authority that has allowed the National Institutes of Health to 
move forward quickly on the Clinical Center. The Committee is 
particularly interested in ensuring that the agency improves 
communications and distance training of local public health 
professionals in State and local health departments throughout 
the country. These institutions are the first line of defense 
in the event of bioterrorism and naturally occurring adverse 
health events, whether caused by infectious disease agents, 
chemical exposures, or changes in the population. CDC should 
focus efforts on constructing a Communications Center as soon 
as possible during fiscal year 2002 to address these 
challenges.
    Additionally, the Committee directs CDC to either start or 
continue the planning, design or construction of the following 
projects in the Master Plan: the Emerging Infectious Disease 
Laboratory and its required Central Utility Plant/
infrastructure; the Environmental Toxicology Laboratory and its 
required Central Utility Plant/infrastructure; the Scientific 
Communications Center; Phase I infrastructure, design, and 
construction of the East Campus Consolidated Laboratory 
Project; the Worker Safety and Injury Prevention facility at 
the Roybal Campus; the Environmental Health facility at the 
Chamblee Campus; the Transshipment facility and related 
infrastructure at the Roybal Campus; and repairs and 
improvements of CDC's nationwide inventory of facilities.

Office of the Director

    The Committee recommends $49,440,000 for the Office of the 
Director which is $7,919,000 above the fiscal year 2001 level 
and the same as the administration request.
    The Office of the Director (OD) manages and directs 
programs of the CDC. OD provides leadership, advises on policy 
matters, and develops and evaluates progress of goals and 
objectives related to disease prevention and control. OD 
provides direction and coordination to the epidemiologic 
activities of CDC and coordinates CDC's response to health 
emergencies. In addition, OD coordinates and manages programs 
on global health activities, minority health, and women's 
health relating to disease prevention and control.
    The Committee is pleased to learn that CDC has embarked on 
an aggressive Financial Management Excellence Initiative to 
improve fiscal management practices in four key areas that 
include: simplifying and streamlining the current fiscal 
structure, identifying new systems to share fiscal information 
throughout the agency, appointing senior level finance and 
accounting staff to provide leadership, and investing in 
education and training for financial management staff. The 
Committee recognizes that CDC's commitment to improving their 
financial management practices is consistent with the findings 
and recommendations of independent auditors who collaborated 
closely with the GAO in conducting a management review. The 
Committee recognizes that continuing improvement in CDC's 
financial management practices requires replacement of the 
agency's financial system with an enterprise-wide business 
solution. It is expected the new financial system will increase 
productivity and improve performance of the CDC's financial 
management practices. The Committee also recognizes and 
commends CDC for simplifying its budget structure at the 
recommendation of both an outside financial auditor and the 
Appropriations Subcommittee. The simplification includes 
changes in the presentation of the All Purpose Table and 
associated sub-budget activities. The change also adds 
transparency to CDC's very complex operating structure.
    The Committee notes that the Mississippi's Delta is a 
community with residents who disproportionately experience 
disease risk factors and have children who are significantly 
behind national averages for mental and physical development. 
The best hope for breaking the cycle of poor health in the 
Mississippi Delta is through a community health education 
program directed at individuals, families, and communities. The 
Committee believes that collaboration between Delta State 
University, the University of Mississippi Medical Center, 
University of Mississippi School of Nursing, and the 
Mississippi State Department of Health with CDC will promote 
coordinated consolidation of health and human services that 
will positively impact the education, health, and economics of 
this region.
    The Committee encourages the CDC to support the 
Environmental and Public Health Alliance to perform necessary 
public health service during the 2002 Winter Olympics.

Bioterrorism

    The Committee recommends $181,919,000 for preparation, 
infrastructure and public health response to the threat of 
bioterrorism which is $1,000,000 above the fiscal year 2001 
level and the same as the administration request.
    The events of September 11, 2001 have made it clear that we 
must begin to look at our public health system as part of our 
national defense system against biological attacks. The 
Committee plans to work with the administration to craft a 
supplemental appropriation bill that will address the needs of 
our State and local health departments as our first line of 
defense against bioterrorism and to provide CDC with the needed 
resources to coordinate a national plan. The Committee has 
included the President's request for bioterrorism but realizes 
that more funds are necessary and will address those needs in 
the supplemental appropriation.
    As scientific and technological advances increase the ease 
with which individuals are able to access and weaponize 
biological and chemical agents, the potential for bioterrorism 
continues to threaten the health of the U.S. public. 
Furthermore, factors such as genetic engineering, ambiguous 
relationships among certain foreign states, and decreasing 
biologic resistance to smallpox in the U.S. population 
contribute to this national concern. A strong public health 
infrastructure will result in a rapid, effective response, 
thereby, minimizing morbidity and mortality associated with 
such a bioterrorism event. An attack could result in a huge 
volume of patients and a corresponding need for large 
quantities of medical supplies and therapeutics, diagnostic 
tests, and hospital beds that could overwhelm public health 
capacity. Emergency responders, health care workers, and public 
health officials could be at special risk, and public fear of 
contagion could be high. U.S. capacity to respond quickly and 
effectively to biological or chemical terrorist threats depends 
on strong local capacity for public health surveillance, rapid 
laboratory diagnosis, and outbreak response.
    The Committee is aware of a proposal by the University of 
Louisville to develop a plan for the comprehensive integration 
of all essential activities in preparation for an attack that 
could serve as a template for medium-sized cities throughout 
the Nation. The Committee is encouraged that the surveillance 
and control capabilities generated under this proposal and 
other proposals would also produce helpful applications in the 
detection of other emerging pathogens, such as West Nile Virus, 
or the response to an outbreak of pandemic influenza.
    The Committee is pleased with the progress of the CDC and 
other public health agencies to prepare for the potential for a 
domestic biochemical terrorist attack, but remains concerned 
about the ability of many public health entities to accurately 
identify biochemical agents in human victims. The Committee is 
aware of a training and first responder training program 
utilizing human patient simulators being conducted by the 
National Emergency Response and Rescue Training Center.
    The Committee continues to support the work of the 
University of Texas, Medical Branch--Galveston National Rapid 
Response Bioterrorism Defense Center, which has been at the 
forefront of developing drugs to counter hazardous viruses that 
could be used by terrorists.
    National Pharmaceutical Stockpile.--The National 
Pharmaceutical Stockpile has been established to assure rapid 
availability of pharmaceuticals, supplies and medical equipment 
in the event of a bioterrorism or chemical incident. The 
Committee was pleased by the rapid deployment of materials from 
the stockpile to New York following the September 11, 2001 
terrorist attacks, and strongly supports the continued 
maintenance and expansion of the stockpile so that it will 
continue to be available and effective when requested.

                     National Institutes of Health

    The fruits of medical research have proved to be among this 
Nation's greatest achievements. Countless saved lives, new 
cures and treatments, and a thriving biomedical research 
industry are all the result of a long-standing Federal 
investment in improving people's health. Americans today are 
living longer than ever. Life expectancy at birth was less than 
50 years in 1900; it is 77 years today. Life expectancy at age 
65 was about 11 years in the first half of the 20th century; 
today, it is 17. Medical research has also improved the quality 
of those added years of life, as reflected by the steady 
decline of disabilities and other impairments among the elderly 
population. By another measure, basic research has stimulated 
immeasurable economic dividends in the form of new products, 
skilled jobs, and increased productivity. In sum, the Nation's 
investments in this area have directly benefited the lives of 
millions of Americans while reaffirming the central tenet of 
our democratic society: to protect the value and the sanctity 
of every individual.
    The unparalleled scientific advances of the past, however, 
are not self-sustaining--nor is the promise of future 
breakthroughs self-fulfilling. Despite remarkable progress, 
there are new and growing challenges to confront. Infectious 
diseases are now the second-leading cause of death worldwide. 
At least 20 well-known diseases--including tuberculosis, 
malaria, and cholera--have reemerged as major threats to 
health, while 30 previously unknown disease agents have been 
identified. On another front, while society's overall health 
status has improved, troubling disparities persist among 
African Americans, Hispanics, Native Americans, Alaskan 
natives, Asians, and Pacific Islanders. The graying of America 
is another area of concern. Ten years from now, 75 million baby 
boomers will begin to turn 65. By 2050, the number of Americans 
over 65 will more than double, and the number of individuals 
over 85 will grow five-fold. With that demographic explosion 
comes greater risk of disease and disability, as well as 
enormous strain on Medicare, Medicaid, and the Nation's health 
care infrastructure.
    But there is also good cause to hope for the future. The 
Human Genome Project has revolutionized our understanding of 
the fundamental mechanisms of life. As scientists learn more 
about how to decipher our DNA code, 95 percent of which has now 
been sequenced, we can look forward to a day when genetic tests 
will routinely predict a person's susceptibility to disease; 
diagnoses will be far more precise; treatments will attack 
diseases at the molecular level; and drugs will be matched to a 
patient's likely response.
    The Committee has a long tradition of support for the NIH, 
the single largest source for medical research funding. In 
1998, the Committee played a lead role in launching an effort 
to double funding for the NIH by fiscal year 2003. That 
decision was rooted in the firm belief that sustained and 
sufficient funding is essential to accelerate the pace of 
research advances, ensure the timely application of new 
discoveries into clinical practice, and maintain the Nation's 
research infrastructure. At the same time, the Committee notes 
that an investment of this magnitude demands accountability. 
The NIH must preserve a rigorous system for determining 
research priorities and for selecting those most qualified to 
pursue those priorities. And it must monitor research conducted 
with taxpayer dollars to ensure it is carried out ethically, 
responsibly and consistent with the research funding award.
    The Committee recommends $23,695,260,000 for the NIH, an 
increase of $3,400,000,000 over the fiscal year 2001 
appropriation and $748,358,000 more than the budget request. 
This amount maintains the goal of doubling funding for the NIH 
by fiscal year 2003.

                       NATIONAL CANCER INSTITUTE

Appropriations, 2001....................................  $3,716,064,000
Budget estimate, 2002...................................   4,153,398,000
Committee recommendation................................   4,258,516,000

    The Committee recommends an appropriation of $4,258,516,000 
for the National Cancer Institute [NCI]. This is $105,118,000 
more than the budget request and $542,452,000 more than the 
fiscal year 2001 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. The Institute 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.
    Blood cancers.--The Committee is interested in NCI's 
upcoming Progress Review Group report on leukemia, lymphoma, 
and multiple myeloma, and it is eager to know what research 
strategies NCI is pursuing to improve treatments for these 
blood cancers. In particular, the Committee urges NCI to expand 
its research on myelodysplasia, a serious blood disorder 
affecting primarily older adults and individuals who have 
previously undergone radiation or chemotherapy treatment for 
cancer.
    The Committee has listened to testimony about the 
devastating effects that multiple myeloma has on its victims 
and recognizes that, despite recent advances, median survival 
for patients responding to treatment is only 3 to 5 years. The 
Committee urges continued research and effort to seek new and 
better treatment for this disease. The Committee also requests 
that the NCI and NIEHS develop a joint report by April 1, 2002, 
on the progress of lymphoma and hematological cancer research. 
The report should address how the PRG has determined funds will 
be expended to expand the current base of lymphoma and 
hematological cancer research.
    Bone metastasis.--The Committee encourages NCI to conduct 
research to develop a better understanding of the unique role 
the bone microenvironment plays in metastatis of cancer to 
bone, in particular, breast cancer, prostate cancer and 
myeloma. The Committee also encourages NCI to support research 
on the development of animal models of bone metastasis and the 
identification of novel therapeutic targets and modalities to 
prevent and treat bone metastases.
    Brain tumors.--The Committee is concerned that insufficient 
attention is being given by NCI and the National Institute for 
Neurological Diseases and Stroke (NINDS) to brain tumor 
research. The recently issued report of the NCI/NINDS-sponsored 
Brain Tumor Progress Review Group has called for substantially 
greater effort into this little-understood area of tumor 
research and treatment. The Committee encourages NCI to fund at 
least three Specialized Program of Research Excellence in Brain 
Tumors (SPORE) grants in the upcoming fiscal year, with 
particular emphasis on those proposals which include both basic 
research and clinical treatment applications.
    Breast cancer.--The Committee continues to be concerned 
over the disparity in breast cancer mortality and morbidity 
among African-American women. The Committee therefore 
encourages the NCI to report to Congress by April 1, 2002, 
about existing efforts, as well as planned future efforts, to 
better understand and respond to this disturbing phenomenon.
    The Committee is aware of the importance of restoring 
sensitivity of tumor cells to standard chemotherapy drugs by 
reversing the effects of low oxygen stress on the cells. Cancer 
researchers have developed methods of achieving this important 
scientific tool, and the Committee encourages the NCI to 
consider this important research.
    Breast implants.--The Committee encourages the NCI to 
continue to collect and analyze data from the women in its 
three recent studies of the health risks of breast implants, to 
determine whether there is a link between breast implants and 
breast cancer, other cancers, or mortality from all causes.
    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.
    Cancer centers.--The Committee recognizes the high quality 
of care provided by NCI-designated Cancer Centers, but notes 
that many cancer patients must travel great distances to 
receive care from these centers. In addition, many other 
smaller institutions provide excellent patient care, perform 
high-caliber basic research, address unique cancer prevention 
and treatment issues, and lend great expertise to cancer 
treatment and control. The Committee encourages the NCI to 
further expand their Cancer Centers Program and give full 
consideration to applicants that care for a large number of 
underserved patients from rural and economically distressed 
areas.
    Cancer gene therapy.--With the sequencing of the human 
genome nearly complete, the challenge is no longer to identify 
genes but to understand the functions of these genes in order 
to find cures and treatments for cancer--especially prostate, 
breast and pancreatic cancer. As a result, the Committee and 
the NCI have previously supported cancer genomics projects that 
investigate the role of oncogenes in the CaSm, Ets 2 and ESF 
genes. The Committee expects the NCI to continue these projects 
with the goal of identifying potential cancer therapies.
    Chronic lymphocytic leukemia (CLL).--The Committee, during 
its fiscal year 2002 hearings, heard compelling testimony from 
patients regarding the devastating effects of chronic 
lymphocytic leukemia (CLL). This disease has evaded a 
satisfying cure, as only 50 percent of patients with CLL 
survive 6 years and only 25 percent survive 10 years. The 
Committee urges the NCI to increase research on CLL, its 
underlying cause, and improved therapies. The Committee is 
pleased to learn that the NCI awarded a program project grant 
last year to establish and lead a multidisciplinary national 
research consortium to study CLL at both the cellular and 
clinical levels. The Committee strongly encourages the NCI to 
give full and fair consideration to expanding the scope of 
research activities funded through the CLL Research Consortium 
and the participating partners involved.
    Complementary and alternative cancer therapies.--The 
Committee expects NCI to expand its work and its collaborative 
efforts with the National Center for Complementary and 
Alternative Medicine to support 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 a rigorous scientific review of them.
    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 urges NCI to continue its agreement 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.
    Gynecologic cancer.--Ovarian cancer remains one of the 
deadliest cancers for women, in part due to the lack of 
effective early screening methods. The Committee strongly urges 
NCI to expedite current research on screening methods to 
detect, diagnose, and identify staging of ovarian cancer. The 
Committee is pleased that NCI has fully funded four ovarian 
cancer SPOREs, and it encourages the Institute to consider 
issuing 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. NCI is strongly 
urged to accelerate research in this area.
    Healthy eating.--The Committee commends the NCI's national 
5-A-Day program. The Committee recognizes that a diet including 
a minimum of five servings of fruits and vegetables is a 
critical factor in reducing cancer risk. The Committee 
encourages NCI to fund behavioral research on how best to 
promote healthy eating, especially fruit and vegetable 
consumption. New research projects could include, but not be 
limited to (a) children and adolescents, the general adult 
population, policymakers, and low-income and disparate groups, 
especially African Americans and Latinos; (b) program channels 
such as the mass media, restaurants, supermarkets, schools, and 
faith organizations; and (c) transfer of already-developed 
technologies to other units and levels of government and to 
non-profit, civic, and other organizations.
    Hepatocellular carcinoma.--The Committee is aware that the 
incidence of hepatocellular carcinoma in the United States has 
increased by more than 70 percent in the last two decades. 
Given the limited treatment options available, most cases are 
fatal. Viral hepatitis is the leading predisposing factor 
contributing to this affliction. With 4 million Americans 
infected with hepatitis C virus, it is predicted that the 
incidence of hepatocellular carcinoma will continue to 
increase. The Committee is aware that too little is known about 
the mechanisms and natural history of this disease. The 
Committee, therefore, strongly encourages the NCI to work 
closely with the NIDDK to develop a comprehensive liver cancer 
research initiative to investigate prevention, diagnosis, and 
therapy.
    Imaging systems technologies.--The Committee is encouraged 
by progress made by NCI following its August 1999 conference on 
biomedical imaging, and it 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 that 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). 
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 quantify the 
increased diagnostic and staging capabilities of PET relative 
to conventional diagnostic and staging technologies, including 
mammography.
    Melanoma.--The Committee is aware of numerous epidemiologic 
accounts and personal stories of melanoma. The Committee 
believes that public knowledge of overexposure to sunlight and 
its connection with melanoma may be lacking. The Committee 
urges the NCI to continue seeking new therapies for melanoma as 
well as educate the public through campaigns that encourage 
appropriate protection from sunlight.
    National cancer registries.--The Committee encourages the 
Registries program to establish, with the States, high-risk 
registries for the digestive cancers (liver, pancreatic) and 
other cancers with significantly low survival rates following 
diagnosis.
    Neurofibromatosis (NF).--Neurofibromatosis research has 
significant potential for cancer patients since NF genes have 
been implicated in the signaling process that determines cell 
growth and cell differentiation. 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.
    Neurological cancer.--The Committee is pleased to learn of 
innovative research on the uniformly fatal brain cancer 
glioblastoma multiorme. Investigators have developed a 
transgenic mouse model in which tumor growth can be reduced by 
replacing a new gene that helps transport the brain chemical 
glutamate. The Committee is also aware of the importance of 
this research in the study of epilepsy. The Committee 
encourages the NCI to take note of these exciting developments.
    Pancreatic cancer.--The Committee commends NCI for its 
report on the Pancreatic Cancer Progress Review Group. The 
Committee urges the NCI to develop a professional judgment 
budget in line with the Progress Review Group for the period 
from fiscal year 2003 to fiscal year 2008. This budget should 
be presented to the Committee by April 1, 2002. In addition, 
the Committee encourages NCI to develop an initiative to raise 
the awareness of pancreatic cancer in the general public and 
the research community.
    Population health.--The Committee congratulates the NCI for 
building and nurturing an infrastructure to support rigorous 
community-based research. Community-based research makes it 
possible for interventions developed at taxpayer expense to 
reach the greatest number of people. The National Research 
Council has called attention to the need for additional 
research at multiple levels of analysis (individual, family, 
community) that integrates population health dynamics with 
behavioral, psychosocial, and environmental factors. One 
challenge is the development of methodologies that can enable 
such multilevel analyses. The Committee encourages NCI to 
continue its leadership in this area.
    Primary immunodeficiencies (PI).--The Committee notes that 
NCI held a symposium in March 2000 concerning the relationship 
between primary immunodeficiencies and cancer. The symposium 
showed, among other things, that PI patients have a 200 times 
greater risk of developing cancer (including lymphomas) than 
someone without PI. The Committee strongly encourages the 
Institute to develop a comprehensive research portfolio on the 
basis of the data generated at that conference and to supply 
the Committee with a report concerning its research plans not 
later than April 1, 2002. In addition, NCI is urged to greatly 
expand its role in the national education and awareness 
campaign sponsored by the Jeffrey Modell Foundation.
    Prostate cancer.--The Committee believes that prostate 
cancer research has not kept pace with the scientific 
opportunities and the proportion of the male population who are 
afflicted with the disease. This has resulted in significant 
gaps in scientific and clinical knowledge that contribute to 
the ongoing impact of prostate cancer on patients and their 
families. NIH has begun to address this shortcoming in the 5-
year prostate cancer research strategy presented to Congress in 
June 1999. The Committee strongly urges the NIH to renew its 
commitment to prostate cancer research with special emphasis on 
accelerating new avenues for basic research, drug development 
and clinical research. The Committee further requests that NIH 
submit a prostate research plan for fiscal year 2003 to fiscal 
year 2008 by April 1, 2002. In developing this plan, the 
Committee urges the NIH to consult and work closely with the 
research community, clinicians, patient advocacy groups and the 
Congress.
    The Committee is aware of a novel DNA-based tumor vaccine 
that has proven effective in pre-clinical, phase I and phase II 
studies for the treatment of advanced prostate cancer. The 
Committee is also aware of complementary research in prostate 
cancer treatment using Cox-2 inhibitors. The Committee 
encourages NCI to explore the use of these important research 
initiatives.
    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 in order to evaluate new models of 
nicotine addiction; heredity 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, 2001....................................  $2,287,015,000
Budget estimate, 2002...................................   2,554,319,000
Committee recommendation................................   2,618,966,000

    The Committee recommendation includes $2,618,966,000 for 
the National Heart, Lung, and Blood Institute [NHLBI]. This is 
$64,647,000 more than the budget request and $331,951,000 more 
than the fiscal year 2001 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.
    Alpha-1.--The Committee is aware that Alpha-1 Antitrypsin 
Deficiency is a genetic disorder that can result in devastating 
and fatal lung and or liver disease that is often misdiagnosed 
as asthma or Chronic Obstructive Pulmonary Disease (COPD). 
Alpha-1 is a major cause of lung transplantation in adults. The 
Committee encourages the NHLBI to expand its resources 
dedicated to researching and raising awareness of this 
devastating disorder.
    Bone formation and cardiovascular disease.--The Committee 
is aware that calcium is an early marker of atherosclerosis 
involving the arterial wall. Evidence suggests an association 
between bone formation, repair and breakdown (e.g. 
osteoporosis) and development of heart disease and other 
cardiovascular diseases. The Committee encourages the NHLBI to 
explore basic research in this area that may result in 
strategies to prevent osteoporosis and cardiovascular diseases.
    Cardiovascular diseases.--The Committee continues to regard 
research into the causes, cure, prevention and treatment of 
heart disease, stroke and other cardiovascular diseases as one 
of the Nation's top priorities. The Committee is alarmed that 
an expert panel, convened in 1999 at the request of this 
Committee, reports that progress in reducing the death rate 
from cardiovascular diseases has slowed and that there are 
striking differences in these death rates by race/ethnicity, 
socioeconomic status and geography, suggesting that new 
strategies are needed to control these diseases. The Committee 
continues to believe that an intensive research program on 
heart disease, stroke and other cardiovascular diseases should 
be a priority of the NHLBI and of the NIH.
    Children's heart defects.--Congenital heart defects are the 
most prevalent birth defect in the United States today. More 
than 32,000 babies--1 out of every 115 births--are born each 
year with congenital heart defects. The Committee encourages 
the NHLBI to research the issue of newborn screening for such 
defects in order to develop improved and cost-effective 
methodologies for heart screening and for the proper training 
of physicians.
    Cholesterol.--It has been brought to the Committee's 
attention that immunizing rabbits and mice against their own 
LDL (``bad'') cholesterol can significantly reduce arterial 
plaque build-up despite very high cholesterol levels in the 
blood. Further work is needed to bring this concept to human 
testing and application, and identify which part of the LDL-
cholesterol molecule provokes a protective immune response will 
be necessary. The Committee urges the Institute to facilitate 
research in this area.
    Cooley's anemia.--The Committee continues to be pleased 
with the outstanding progress being made by the Thalassemia 
Clinical Research Network, which is comprised of the leading 
research centers in North America on thalassemia, the medical 
term for Cooley's anemia, as well as with the leadership of 
NHLBI. The Committee understands that the Network is currently 
prioritizing the wide variety of potential research areas that 
are ripe for investigation. NHLBI and NIDDK should submit a 
joint report to the Committee on the work of the Network and, 
in general, the work they are doing that is of direct benefit 
to thalassemia patients by April 1, 2002.
    Cord blood.--The Committee recognizes the advances that are 
being made in the use of life-saving hematopoietic stem cells 
and the growing use of umbilical cord blood and placental blood 
as rich sources of these cells. The Committee is aware of the 
success of cord blood stem cell transplants in treating 
diseases such as leukemia, lymphoma, severe aplastic anemia and 
sickle cell disease. The Committee urges the NHLBI to support 
research on umbilical cord blood and cord blood stem cells to 
determine the nature of their capabilities, to identify their 
similarities and differences to stem cells from other sources, 
and to understand the mechanisms of differentiation.
    Heart disease, 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 
women than in men, and current diagnostic capabilities are less 
accurate in women than in men. Despite the seriousness of these 
diseases in women, they are largely unrecognized both by women 
and their doctors. The Committee urges the NHLBI to expand 
cardiovascular disease research in women, including studies to 
develop safe, efficient and cost-effective diagnostic 
approaches for women, and to create more informational and 
educational programs for women patients and health care 
providers on heart disease and stroke risk factors.
    Hemophilia.--The Committee commends NHLBI for the 
significant support it has provided for hemophilia gene therapy 
research, and it urges the Institute to continue this and other 
efforts to address the needs of persons with hemophilia and 
bleeding disorders, including blood and blood product safety, 
treatment of hepatitis C and other complications, and women's 
bleeding disorders. The Committee is concerned about the 
increasing shortage of trained hematology specialists to 
translate research discoveries into the treatment of hemophilia 
and prevention of its complications. The Committee urges NHLBI 
to work with the National Hemophilia Foundation to pursue 
strategies for addressing this critical issue.
    Juvenile diabetes.--Vascular complications including 
cardiovascular, peripheral vascular, and cerebrovascular are a 
major cause of mortality and morbidity in persons with 
diabetes--particular in those with juvenile diabetes. NHLBI is 
encouraged to launch major initiatives in diabetic-specific 
vascular complications, with emphasis on the accelerate 
pathways seen in juvenile diabetes, in order to develop 
effective treatments and prevention. NHLBI should consider 
newer therapeutic modalities, including gene therapy, and build 
upon the growing understanding of angiogenesis. The Institute 
should also consider collaborating with NIDDK to assess the 
genetics of complications of juvenile diabetes, understand gene 
function in individuals with diabetes who have serious and 
life-threatening complications, and help develop more effective 
therapeutic interventions.
    National Asthma Education and Prevention Program (NAEPP).--
The Committee commends the National Asthma Education and 
Prevention Program (NAEPP) for its leadership in helping to 
educate physicians, asthma patients, their families and the 
general public regarding asthma and asthma management. The 
Children's Health Act of 2000 authorized NAEPP to develop, in 
conjunction with other Federal agencies and voluntary and 
professional health organizations, a Federal plan to respond to 
asthma. The Committee urges NHLBI to move forward as 
expeditiously as possible.
    Pediatric Asthma Network.--The Committee recognizes that 
little is known about the optimal treatment for asthma in 
infants and young children. For example, it is still unknown 
what the most effective dose and type of medicine would be for 
different types of asthma and whether early therapy can prevent 
asthma. The Committee urges the NHLBI to consider the research 
amassed through the Pediatric Asthma Clinical Research Network 
to provide clearer choices for childhood asthma therapy, to 
encourage the development 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. PPH causes deadly 
deterioration of the heart and lungs and is a secondary 
condition in many other serious disorders, such as scleroderma 
and lupus. The Committee supports continued, high-quality 
research in this area and urges the Institute to increase 
funding for basic research, gene therapy, and clinical trials 
or promising pharmaceuticals.
    Sickle cell anemia.--Sickle cell anemia is an inherited 
condition that is particularly prevalent among African 
Americans. While there is no cure for sickle cell anemia, 
several promising developments have occurred to improve the 
quality of life of sickle cell patients, and the Committee 
encourages the Institute to carry out further research.
    Transfusion medicine.--The Committee supports the 
establishment of a clinical research network in transfusion 
medicine and hemostasis, which would attract and train much-
needed clinicians to hematology, while at the same time 
enabling patients with non-malignant blood disorders to 
participate in high-quality clinical protocols.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2001....................................    $304,606,000
Budget estimate, 2002...................................     340,158,000
Committee recommendation................................     348,767,000

    The Committee recommendation includes $348,767,000 for the 
National Institute of Dental and Craniofacial Research [NIDCR]. 
This is $8,609,000 more than the budget request and $44,161,000 
more than the fiscal year 2001 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.
    Dental caries.--The Committee is concerned about the 
exceptionally high rate of severe dental caries suffered by 
American Indian children. Within the funds provided, the 
Committee encourages the NIDCR to support long-term research of 
the etiology and pathogenesis of dental caries in these 
populations. The Committee also encourages NIDCR to conduct 
clinical research trials on effective ways to control severe 
caries in American Indian children.
    Fibrous dysplasia.--The Committee is aware that the NIDCR 
is playing a critical role in studies of fibrous dysplasia. In 
particular, the Committee is aware of NIDCR support for studies 
on drugs and surgical procedures to treat fibrous dysplasia. 
The Committee understands that one of the key problems faced by 
people with fibrous dysplasia is the lack of medical 
professionals who know and understand the disease. Therefore, 
the Committee encourages the NIDCR to work with other 
institutes to highlight and expand these activities in fibrous 
dysplasia and other bone research.
    Head and neck cancer.--Head and neck cancer has serious and 
debilitating effects on quality of life. Surgical treatment 
often leaves patients with impaired speech, eating 
difficulties, and severe disfigurement. The Institute is 
encouraged to support basic, clinical, and translational 
research to advance techniques for replacing bony structures of 
the head and face, and restoring sensory and motor functions of 
the reconstructed structures.
    Osteoporosis.--Given that osteoporosis and related bone 
diseases affect millions of Americans, the Committee encourages 
NIDCR to enhance its research efforts to compare bone loss in 
the oral cavity with bone loss elsewhere in the body. The 
Committee also encourages NIDCR to enhance research on 
dentinogenesis imperfecta and orthodontic manipulation in 
individuals with osteogenesis imperfecta.
    Temporomandibular joint disorders (TMJ).--The Committee is 
aware that the research portfolio on temporomandibular diseases 
and disorders includes extensive studies on the psychological 
and behavioral factors in the etiology or chronicity of TMJ 
diseases and disorders. The Committee urges the Institute to 
broaden its scientific base for TMJ research by putting greater 
emphasis on basic and clinical research on normal and abnormal 
structural and functional features of the joint and related 
structures, using the tools of cell and molecular biology as 
well as advanced imaging techniques. The Committee expects 
NIDCR to collaborate on this research with the National 
Institute of Arthritis and Musculoskeletal and Skin Diseases, 
the National Institute of Allergy and Infectious Diseases, and 
the National Institute of Biomedical Imaging and 
Bioengineering.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2001....................................  $1,302,798,000
Budget estimate, 2002...................................   1,456,996,000
Committee recommendation................................   1,501,476,000

    The Committee recommends an appropriation of $1,501,476,000 
for the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK]. This is $44,480,000 more than the 
administration's request and $198,678,000 more than the fiscal 
year 2001 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.
    Adult stem cell research.--The Committee is aware of the 
rapidly developing field of research in adult stem cell 
plasticity, and it encourages NIDDK to work with the American 
Society of Hematology in determining the next steps for 
realizing the full potential of adult stem cell biology in 
curing disease.
    The Committee encourages the National Institutes of Health 
to continue working with the Office of Naval Research to 
support research to develop curative therapies for patients 
with breast cancer, leukemia, lymphoma, and sickle cell 
disease, and for victims of radiation, chemical, and biological 
exposure.
    Benign prostatic hypertrophy.--The Committee is aware that 
benign prostatic hypertrophy affects more than 12 million men 
over age 50. Although new treatments have become available, 
there is still a poor understanding of the factors that affect 
prostate growth. The Committee encourages NIDDK to stimulate 
additional work and to capitalize on developments in other 
fields of science through additional funding. The Committee 
further encourages NIDDK to focus more attention on the bladder 
and urethral changes in response to the enlarged prostate.
    Bladder disease.--More than 1 of every 10 Americans suffers 
from bladder disease, 1 in 9 women will require bladder-related 
surgery, and patients continue to be added as the population 
ages. The Committee believes that these needs must be met with 
a strong commitment to fund research concerning bladder 
disease. The Committee is also pleased by NIDDK's issuance of 
an RFA related to urinary incontinence. While these steps are 
important, the Committee remains concerned about the funding 
level for research in bladder disease. The Committee urges the 
Institute to finalize a long-term research strategy based upon 
the recommendations of the Bladder Research Progress Review 
Group convened in 2001. The Committee supports increased 
bladder disease research by any available means, and encourages 
the Institute to consider initiating and maintaining a National 
Cell/Tissue Archive for Bladder Disease.
    Crohn's disease.--The Committee is concerned about the 
increasing frequency of regional enteritis (Crohn's disease) in 
the United States. The Committee is aware of the complicated 
etiology of this disease, which involves immunologic, 
infectious, and dietary factors. The Committee supports further 
research into Crohn's disease that may lead to better treatment 
of this chronic illness.
    Complementary and alternative medicine treatments.--
Complementary and alternative medicine treatments for liver 
diseases are becoming more common despite limited evidence of 
safety and efficacy. The Committee is aware that the NIDDK, 
working with the NCCAM, has begun funding studies of some of 
these treatments. The Committee urges the NIDDK to continue 
supporting this research and ensure that the public is aware of 
the results.
    Congenital urological disorders.--The Committee is aware 
that urology problems that are present at birth result in 
significant physical and psychological stress for both the 
parents and the child. The Committee urges NIDDK to collaborate 
with other interested institutes in developing a strategic 
research plan to address congenital urological disorders in the 
pediatric age group, and to initiate new, innovative research 
projects in areas such as ureteral reflux, fetal 
hydronephrosis, and bladder dysfunction of spina bifida.
    Cooley's anemia.--The Committee continues to support 
strongly the work being done in NIDDK to advance treatments for 
Cooley's anemia in the fields of iron measurement, fetal 
hemoglobin, iron chelation, and more. The April 2001 iron 
measurement workshop helped to set a direction for future 
research. In addition, the development of HBED, a more 
efficient iron chelator, under an NIDDK contract holds great 
promise to improve treatment and compliance. NIDDK and NHLBI 
should submit a joint report on the work they are conducting 
that is of direct benefit to thalassemia patients by April 1, 
2002. In addition, the Committee would like NIDDK to encourage 
greater investigator-initiated research in this area.
    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 NIDDK 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.
    Diabetic macular edema.--The Committee urges the Director 
of NIDDK to consider the National Eye Institute's new 
multicenter clinical trial initiative on diabetic macular 
edema, a major cause of visual loss in patients with diabetes, 
when allocating the special funds targeted for diabetes made 
available to the Department.
    Digestive cancers.--The Committee is pleased with the NCI 
Progress Review Group on Pancreatic Cancer and urges the NIDDK 
to collaborate with NCI on mutual research areas and awareness 
programs for the scientific and lay communities. The Committee 
urges NIDDK to establish translational research activities to 
understand the inter-relationships of pancreatitis, diabetes, 
and pancreatac cancer.
    Digestive diseases.--Diseases of the digestive system, such 
as colorectal cancer, inflammatory bowel disease, irritable 
bowel syndrome, and hepatitis, continue to affect more than 
one-half of all Americans at some time in their lives. The 
Committee continues to encourage NIDDK to strike an appropriate 
balance between conducting basic studies on digestive diseases 
and bringing those research findings to the bedside in the form 
of improved patient care. The Committee 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.
    Drug-induced liver disease.--The Committee is aware of the 
findings of a recent NIDDK-sponsored workshop that discussed 
the most appropriate response to the growing problem of drug-
induced liver injury. Liver injury due to over-the-counter and 
prescription drugs is an increasingly frequent cause of acute 
and chronic liver disease and is the single most common cause 
of acute liver failure in the United States. The Committee 
urges the NIDDK, in cooperation with other appropriate 
Institutes and the pharmaceutical industry, to establish a 
national surveillance system to further document hepatotoxicity 
of medications and to fund research to prevent and treat this 
serious cause of liver injury.
    Glomerular injury research.--The Committee urges NIDDK to 
expand its research efforts on glomerular injury, a group of 
diseases which affect the filtering mechanisms of the kidney. 
The Committee is pleased that in addition to basic research 
being conducted, NIDDK is working to initiate several clinical 
trials related to glomerular injury. Further, the Committee 
encourages NIDDK to consider initiating a consensus development 
conference on glomerular injury research, and to explore 
support for gathering prevalence data on glomerular injury.
    Hepatitis C.--The Committee is encouraged that the HALT-
Hepatitis C Clinical Trial should yield important information 
about the relatively low response rates to current hepatitis C 
treatments. The Committee is concerned, however, with the 
slower than expected progress to enroll patients in the 
clinical trial. The Committee has also learned that 10 
promising ancillary research projects have been developed, 
which is more than anticipated. The Committee therefore 
requests a report by April 1, 2002, on the timetable, new 
findings and additional resources that may be necessary to 
complete the HALT-Hepatitis C clinical trial.
    The Committee is also aware that the prevalence of 
hepatitis C in African Americans is more than two times greater 
than in Caucasians and that African Americans have a poor 
response rate to treatments. The Committee encourages the 
Institute to establish the appropriate number of clinical trial 
centers and a data-coordinating center to study the impact of 
the hepatitis C virus infection and the variable response to 
treatment in different human hosts. The Committee also urges 
the Institute to collaborate with the National Center on 
Minority Health and Health Disparities on this issue.
    Hereditary hemochromatosis.--Hereditary hemochromatosis, 
the most common genetic disease in human beings, is associated 
with identified genetic mutations in 70 to 90 percent of cases. 
The Committee urges the Institute, working with NHLBI, to 
expand research funding on this common disease with particular 
emphasis on screening, early diagnosis, and the still-unknown 
genetic mutations that cause 10 to 30 percent of cases.
    Inflammatory bowel disease.--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). The Committee commends NIDDK 
for its leadership in this area and encourages the Institute 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 
titled ``Challenges in Inflammatory Bowel Disease.'' The 
Committee believes that NIDDK should review the current 
intestinal transplantation procedures and make future 
recommendations on how they could be improved. It also 
encourages the Institute to implement a long-range research 
agenda to adequately fund research into the cause of and a cure 
for IBD and short bowel syndrome.
    Interstitial cystitis.--The Committee is aware that there 
is unprecedented momentum in interstitial cystitis research, 
particularly in the area of urinary markers. The Committee 
urges the NIDDK to aggressively support research that will 
enhance these recent advances. The Committee is pleased that 
the NIDDK convened a Bladder Research Review Group in 2001 to 
create a strategic plan and set research priorities for all 
aspects of bladder disease, including IC. The Committee urges 
that the strategic plan's recommendations regarding IC be 
implemented and fully funded as soon as possible. The Committee 
is pleased with the progress of the IC Clinical Trials group 
and it urges the NIDDK to re-compete the trials at the end of 
the current grant period. Since patients with IC frequently get 
multiple disorders, the Committee also encourages the NIDDK to 
support collaborative research on IC that includes urologists, 
neurologists, geneticists, and specialists in visceral pain, 
vulvodynia, irritable bowel syndrome, and irritable bowel 
disease
    Irritable bowel syndrome.--The Committee remains concerned 
about the increasing frequency of irritable bowel syndrome 
(IBS), a chronic complex of disorders that malign the digestive 
system. The Committee encourages NIDDK to provide adequate 
funding for irritable bowel syndrome/functional bowel disorders 
research and to give priority consideration to funding IBS 
education/scientific symposiums. Moreover, the Committee urges 
NIDDK to work with CDC and the private sector to initiate an 
IBS public awareness campaign.
    Juvenile diabetes.--The Committee wishes to commend NIDDK 
for its leadership in implementing the juvenile diabetes 
research funding approved by Congress last year. The Committee 
hopes that NIDDK's juvenile diabetes research portfolio will 
include such areas as vaccine development, the creation of 
genomics/bioinformatic capability, initiatives to enhance 
research training for juvenile diabetes, and the vigorous 
pursuit of the most promising scientific opportunities to 
develop alternative sources of insulin-producing beta cells for 
therapeutic replacement.
    Kidney disease clinical research.--It has been brought to 
the Committee's attention that the lack of a permanent 
infrastructure for clinical trials to study kidney disease is 
hampering the translation of basic research discoveries to the 
bedside. In order to provide an organizational framework, the 
Committee urges the NIDDK to make resources available to plan 
the development of a Cooperative Clinical Trials Group Program 
for Kidney Disease Research.
    Liver transplantation.--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.
    Mucopolysaccharidosis (MPS).--The Committee encourages the 
NIDDK to expand research efforts in the development of 
effective treatments for MPS disorders. The Committee 
encourages the Institute to pursue research addressing 
genotype-phenotype studies, the blood brain barrier, cell 
biology, pathophysiology of brain damage and substrate 
deprivation as they relate to MPS disorders. The Committee 
urges the NIDDK, NINDS, and NICHD to engage in collaborative 
research efforts and enhance grant support for current studies 
as well as new efforts to develop effective therapies for these 
deadly disorders.
    Neurological disorder-associated bladder dysfunction.--The 
Committee encourages NIDDK to increase funding into the 
effective treatment of bladder dysfunction associated with 
spinal cord injury and neurological diseases. The Committee 
urges NIDDK to investigate the most effective methods of 
treatment and new and innovative approaches to treatment.
    Non-alcoholic steatohepatitis.--Non-alcoholic 
steatohepatitis liver disease (NASH) is the second-most common 
cause of liver disease after hepatitis C. The disease is often 
unrecognized and undiagnosed, and it leads to cirrhosis and 
liver failure. The Committee urges the Institute to initiate a 
long-term epidemiological study including research focused on 
treatment options and outcomes for NASH.
    Obesity.--Obesity is a major health threat in the United 
States, with more than 49 million American adults considered 
clinically obese. The Committee urges the NIDDK to expand 
research in this area, particularly into the effects of obesity 
on gene expression, as well as excessive risk of 
gastrointestinal cancers, including colon cancer and liver 
disease. The Committee also encourages NIDDK to support 
research in the role of GI hormones, motility, and mucosal 
absorption in the complex balances of satiety, nutrient uptake 
and calorie and energy balance. Finally, the Committee urges 
NIDDK to support research into the effect of diet and nutrient 
intake on metabolism and gene function to provide further 
insight into how nutrients conversely affect gut function.
    Osteoporosis and related bone disorders.--The Committee 
urges NIDDK to enhance research on osteoporosis, primary 
hyperparathyroidism and other disorders of calcium metabolism, 
including renal osteodystrophy, a disorder affecting 
individuals suffering from chronic kidney disease. NIDDK is 
also encouraged to enhance its efforts in the areas of 
nutritional and hormonal influences on calcium and skeletal 
status and functional genomics in bone. The Committee urges 
NIDDK to work with NCI to focus on cancer that spreads to bone.
    Parity for kidney research.--The Committee is concerned 
that the resources available to conduct kidney research are not 
keeping pace with inflation. The Committee urges the NIDDK to 
review the current funding policy and provide increased funding 
for kidney disease research.
    Pediatric kidney disease.--The Committee remains concerned 
over the alarming number of children and adolescents suffering 
from kidney disease, a disproportionate number of whom are 
minorities. In calling for greater research emphasis on this 
vulnerable segment of our population, the Committee notes that 
chronic kidney failure among young people results in 
particularly severe consequences. Normal growth and development 
are impaired, and many scientists believe that chronic kidney 
failure has a profound effect on the developing brain, often 
resulting in learning disabilities and mental retardation. The 
Committee urges NIDDK to sharpen its research focus on both 
congenital and acquired chronic renal failure, including: the 
molecular mechanisms underlying growth failure in children with 
kidney failure; hypertension as a risk factor for 
cardiovascular and renal disease; and the development of a 
database of genetic renal diseases. Additionally, NIDDK is 
encouraged to launch new training initiatives to help ease the 
workforce shortage in this field.
    Pediatric liver disease.--The Committee is aware of the 
``Pediatric Liver Research Agenda 2000: A Blueprint for the 
Future'' developed by the Children's Liver Council of the 
American Liver Foundation, which defines research priorities 
for biliary atresia. Although rare, biliary atresia is the most 
common cause of liver transplantation in children. Since too 
few patients are seen annually at individual centers, a 
collaborative network of centers is needed to gather sufficient 
data and study specific hypotheses of the cause and treatment 
of biliary atresia. The Committee encourages the Institute to 
establish clinical centers and a data-coordinating center to 
address the scourge of biliary atresia.
    Phytotherapy.--The Committee is aware of the increasing use 
of patient self-administered phytotherapy (saw palmetto) to 
treat benign prostatic hypertrophy. However, there is little 
information available to clinicians or patients regarding the 
relative safety and effectiveness of this therapy. The 
Committee encourages NIDDK to move forward on clinical trials 
aimed at aiding the public and urologists better understanding 
whether or not there is a role for phytotherapy in treating 
benign prostatic hypertrophy.
    Polycystic kidney disease (PKD).--The Committee is 
encouraged that the number and significance of research 
discoveries leading to a treatment and cure for PKD are growing 
at a rapid pace and that notable breakthroughs are coming from 
the four P-50 PKD research centers established last year by 
NIDDK. The Committee is also pleased that the NIDDK is planning 
an International Scientific Workshop focusing on clinical 
aspects of PKD and an RFA for a PKD Interventional Trials 
Network, both in early fiscal year 2002. The Committee 
recommends that the NIDDK fund and execute the PKD Strategic 
Plan without delay.
    Training programs for physicians.--The Committee is aware 
of the need to encourage physicians who wish to pursue careers 
in the epidemiology of urologic disease and in the development 
and conduct of urological clinical trials. The Committee 
encourages NIDDK to initiate a training program to meet these 
needs.
    Urinary incontinence.--The Committee urges the NIDDK to 
significantly enhance its support of urinary incontinence 
research following the recommendations from the Bladder 
Progress Review Group. The Committee encourages the NIDDK to 
elevate its focus on urinary incontinence research by expanding 
its support to the Urinary Incontinence Treatment Network 
Initiative by increasing the number of clinical sites.
    Urinary tract obstruction.--The Committee is encouraged 
that the NIDDK will hold a workshop on obstructive uropathy and 
reflux in infancy and early childhood. Urinary tract 
obstruction, if left untreated, can result in progressive, 
irreversible loss of kidney function and end-stage renal 
disease.
    Urologic disorders and diabetes.--The Committee is aware of 
urological complications such as impotence and urinary 
retention associated with diabetes. The Committee encourages 
NIDDK to examine these aspects of diabetes and asks that NIDDK 
provide the Committee with its plan to address this problem.
    Urological disorders affecting women.--The Committee is 
aware that urological disorders affect millions of women of all 
ages. Urinary incontinence is a major cause of nursing home 
admissions for women. The Committee encourages NIDDK to support 
research targeted to these problems that may substantially 
prolong the ability of many elderly women to remain in their 
homes.
    Urology research.--The Committee is concerned that the 
urology research effort is not addressing the large public 
health impact of urological diseases and conditions. The 
Committee encourages NIDDK to increase funding for existing 
programs in urology research at a growth rate similar to that 
for the overall agency budget. The Committee is also aware of 
the significant progress made at the George M. O'Brien Kidney 
and Urology Research Centers of the NIDDK. The Committee urges 
continued and increased funding for their activities. In 
addition, the Committee encourages the creation of two new 
urologic centers, both of which should have a clinical 
component and a research training component.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2001....................................  $1,172,132,000
Budget estimate, 2002...................................   1,311,179,000
Committee recommendation................................   1,352,055,000

    The Committee recommends an appropriation of $1,352,055,000 
for the National Institute of Neurological Disorders and Stroke 
[NINDS]. This is $40,876,000 more than the budget request and 
$179,923,000 more than the fiscal year 2001 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 
role in advancing science's understanding of Alzheimer's, a 
progressive brain disorder that results in memory loss, 
behavior and personality changes, and a decline in thinking 
abilities. Working collaboratively with NIA, NINDS-supported 
researchers found that cortical degeneration, or brain atrophy, 
was 20 to 25 percent greater in patients with Alzheimer's, 
confirming this as the major basis for cognitive decline in 
Alzheimer's patients. The Committee encourages NINDS to treat 
Alzheimer's research as a high priority, and to continue to 
work closely with NIA and other research Institutes.
    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 that attacks specialized nerve cells that control the 
movement of voluntary muscles. 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 encourages the Institute to continue to expand and 
intensify its research efforts into ALS.
    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 is established. In recent years, 
funding for this disease has decreased. The Committee strongly 
urges that increased funding be provided to combat this 
devastating disease.
    Brachial plexus injuries.--The Committee understands that 
injury to the nerves of the brachial plexus, which control the 
muscles of the shoulder, arm, elbow, wrist, hand, and fingers, 
can result in full to partial paralysis. While these injuries 
most often occur during the birthing process at a rate of 2-3 
of every 1,000 births, traumatic injury is another cause. 
Although many affected individuals recover without 
intervention, and others can be helped with surgery, some 
experience permanent nerve damage. The Committee encourages 
NINDS to continue an aggressive program of nerve regeneration 
research, which should have benefits that can be applied to 
these injuries as well as to other forms of damage to the 
peripheral and central nervous systems.
    Brain tumors.--The Committee is concerned that not enough 
attention is being given by NINDS to identifying causes of and 
treatments for brain tumors, and it encourages NINDS to 
continue working with NCI to carry out the recommendations of 
the recently issued Report of the Brain Tumor Progress Review 
Group.
    Congenital muscular dystrophy (CMD).--The Committee urges 
the Institute to collaborate with the NIAMS to intensify 
research into CMD. The Committee is extremely concerned that, 
unlike nearly all other forms of muscular dystrophy, no 
specific gene defect or protein deficiency has even been 
identified to date for several types of CMD. The Committee 
requests that the NIH report to the Committee by April 1, 2002, 
on steps it will take to create a comprehensive research 
portfolio in CMD.
    Duchenne muscular dystrophy.--The Committee is aware that 
NIH has been directed to intensify and enhance muscle disease 
research, and it urges NINDS to aggressively support 
translational research where possible. To accomplish this, the 
Committee strongly urges NINDS to establish no fewer than three 
centers of excellence for basic and applied research in the 
muscular dystrophies and encourages the Institute to provide 
sufficient funds for this purpose. The Committee expects NINDS 
to coordinate with NIAMS and the Centers for Disease Control 
and Prevention on the planning and activities for the centers 
of excellence.
    Dystonia.--The Committee is concerned that NIH has 
traditionally underfunded research to develop treatments for 
the neurological movement disorder dystonia. In light of the 
fact that it ranks as the third most common movement disorder 
behind Parkinson's and tremor, the Committee encourages NIH to 
afford substantial increased funding for additional research on 
both focal and genetic dystonia as its sets its priorities for 
fiscal year 2002. The Committee also continues to be interested 
in the expansion of NINDS's extramural research portfolio with 
respect to dystonia, and it encourages NINDS to continue to 
expand the study of the DYT1 gene. In addition, the Committee 
encourages the Institute to increase its collaboration with the 
dystonia research community in supporting epidemiological 
studies on dystonia and in increasing public and professional 
awareness of this disorder.
    Epilepsy.--The Committee believes that NIH should make 
finding a cure and effective treatments for epilepsy a 
priority. The Committee is encouraged by the establishment of 
13 epilepsy research benchmarks resulting from the NINDS March 
2000 conference ``Curing Epilepsy: Focus on the Future.'' The 
Committee encourages NIH to develop a plan to implement the 
research benchmarks, as the Director deems appropriate, 
including the funding projections needed to carry out the plan. 
The Committee directs that the plan be submitted to Congress by 
April 1, 2002. Further, the Committee encourages the 
establishment of an Interagency Epilepsy Coordinating Committee 
comprised of agency scientists, industry, and patient 
representatives.
    Multiple sclerosis (MS).--Multiple sclerosis is a chronic, 
progressive disease of the central nervous system which is 
estimated to affect between 250,000 and 350,000 persons in the 
United States. While there is no known cure for MS, a number of 
therapies have been found helpful in slowing the disabling 
progression of the disease. The cause of MS remains equally 
elusive, although investigators are examining such factors as 
the role of viruses, genetics, and the environment. The 
Committee is aware that several scientific studies have not 
supported the role of trauma in causing MS or in triggering MS 
exacerbations. Nevertheless, the Committee is concerned over 
increasing reports of MS incidence caused by environmental 
triggers, be they allergic reactions, or more commonly, traumas 
such as automobile accidents. The Committee urges the Institute 
to devote additional resources toward study of the role of such 
traumas in causing multiple sclerosis.
    Neurofibromatosis.--Neurofibromatosis (NF) is a genetic 
disorder of the nervous system that causes tumors to grow along 
nerves anywhere on or in the body. The Committee is aware that 
recent advances in research have linked NF to cancer, brain 
tumors, learning disabilities and heart disease. It urges NINDS 
to expand its NF basic and clinical research portfolio through 
mechanisms such as requests for applications and program 
announcements.
    Prion disease.--Britain and several other countries in 
Europe have documented transmissible forms of spongiform 
encephalopathies (TSEs) and variant Creutzfeldt-Jakob Disease 
(vCJD), a type of TSE, caused by small infectious proteins 
called prions. It appears that the prions causing vCJD come 
from eating infected beef cattle. To date, NIH funding of 
prion-mediated diseases has been mainly for Creutzfeldt-Jakob 
disease (CJD--a separate but related disease to vCJD) but also 
has included funding for bovine (cow) spongiform 
encephalopathy, scrapie (sheep spongiform encephalopathy) and 
chronic wasting (human). The Committee urges NINDS to 
specifically fund research into prion disease and to work with 
other agencies to develop a diagnostic test to detect the 
presence of the disease.
    Stroke.--The Committee continues to regard research into 
the causes, cure, prevention, treatment and rehabilitation of 
stroke as a top priority of the NINDS and of the NIH. 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. The Committee commends the NINDS for its 
efforts in beginning to develop a 5-year strategic stroke 
research plan. Expected to be released in fall 2001, this plan 
will strongly stimulate novel ideas in stroke research. The 
Committee also 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.--Stroke in women is a major health 
problem, with women representing 61 percent of all deaths from 
stroke. Stroke kills twice as many women as breast cancer and 
AIDS combined. The Committee is concerned that very little 
research has been directed toward understanding gender 
differences in stroke and cerebrovascular disease. Since the 
physiology of women's bodies is different from men's, stroke 
prevention and treatments may affect women in dissimilar ways. 
The Committee is pleased to learn that NINDS is funding a trial 
looking at whether postmenopausal hormone replacement therapy 
alters stroke risk. The Committee urges the Institute to 
increase research specifically in the area of stroke-related 
care, risk factors, preventive strategies, acute stroke 
management, aspects of post-stroke recovery and long-term 
outcomes 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.
    Stroke research.--The Committee supports continued research 
and development efforts in the area of Polynitroxylated Albumin 
(PNA) as a neuroprotectant for ischemic stroke, hemorrhagic 
stroke and transient ischemic attack.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2001....................................  $2,062,089,000
Budget estimate, 2002...................................   2,329,643,000
Committee recommendation................................   2,375,836,000

    The Committee recommends an appropriation of $2,375,836,000 
for the National Institute of Allergy and Infectious Diseases 
[NIAID]. This is $46,193,000 more than the budget request and 
$313,747,000 more than the fiscal year 2001 appropriation. 
Included in these funds is $25,000,000 to be transferred to the 
Global Fund to fight HIV/AIDS, Malaria, and Tuberculosis. 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.
    Asthma research and management.--The Committee is pleased 
with NIAID's leadership regarding asthma research and 
management. The Committee recognizes the role that NIAID has 
played with the Inner City Asthma Study and the importance of 
this effort concerning morbidity and mortality among 
underserved populations, particularly children. The Committee 
urges NIAID to continue to improve its focus and efforts on 
asthma management, particularly as it relates to children.
    Chronic fatigue syndrome (CFS).--The Committee supports the 
development of a multidisciplinary, multidimensional Chronic 
Fatigue Syndrome Assessment and Treatment Center where people 
can be assessed and treated.
    Crohn's disease.--The Committee notes with interest and 
concern NIAID's report titled ``Crohn's Disease--Is There a 
Microbial Etiology?'' The report findings show that Crohn's 
disease may have an infectious etiology. The Committee shares 
NIAID's concern that if it is proven that Mycobacterium avium, 
subspecies paratuberculosis is the cause of Crohn's disease, 
the impact upon the public health could be enormous because of 
the prevalence of this mycobacteria on farms and in standing 
water. The Committee urges the NIH to consider designating 
Crohn's as an ``emerging infectious disease'' and encourages 
the NIAID to establish a formal Crohn's disease program 
specifically for research into an infectious cause of Crohn's 
disease.
    Hemophilia.--The Committee encourages NIAID to continue its 
efforts with the National Hemophilia Foundation leadership to 
ensure that persons with hemophilia have access to and 
opportunities to participate in research for improving 
treatment of HIV and complications of hemophilia, including 
hepatitis C.
    Gender-based research.--The Committee understands that the 
NIAID has partnered with the National Multiple Sclerosis 
Society and other groups to support research related to gender-
based differences in immune function and immunologic disease. 
The Committee commends the Institute for undertaking this 
important initiative.
    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 by a 
project titled Hepatitis C: Recovery Research Network. The 
Committee urges that adequate funding be made available to 
initiate this project. As part of that effort, the Committee 
urges the Institute to evaluate early treatment or treatment 
within the first year of infection.
    Inflammatory bowel disease (IBD).--The Committee is aware 
of NIAID's research partnerships with the IBD community, and it 
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.
    Pediatric kidney disease.--Studies have shown that 
improvements seen in transplant survival among adults with 
kidney disease have not been completely realized in children, 
who have not fully benefited from improvements in 
immunosuppressive medications tested largely in the adult 
population. NIAID is encouraged to step up its efforts to 
maintain transplants over a longer period, thereby improving 
kidney transplant outcomes in children and adolescents.
    Population mixing.--The Committee urges the NIAID, in 
cooperation with the Department of Defense, to develop a plan 
for studying population mixing, which is an unusual mixing of 
people in relatively isolated rural areas. In such situations, 
a variety of infectious viruses and bacteria may trigger an 
unusual and rare reaction that affects children in susceptible 
populations. The Committee hopes that this study will 
contribute to a greater understanding of this important 
possible cause of childhood cancers. This will benefit 
communities around the Nation such as Fallon, Nevada, which has 
experienced an outbreak of childhood acute lymphocytic leukemia 
(ALL).
    Primary immunodeficiencies (PI).--The Committee continues 
to be pleased with NIAID's strong commitment to addressing the 
medical and other problems caused by primary 
immunodeficiencies. In particular, the Committee looks forward 
to learning the results of the NIAID-sponsored research 
concerning the impact of PI among urban minority populations 
and seeing the research replicated on a larger scale throughout 
the country. Building on past collaborations with nonprofit 
groups, the Committee encourages NIAID to move aggressively in 
all research areas, including cutting-edge research related to 
gene therapy, bone marrow transplantation, and cord blood 
transplantation. The Committee also continues to be pleased 
with NIAID's PI clinical registries program, and urges the 
NIAID to continue to support this important initiative. The 
Committee also encourages the Institute to work with the PI 
community and the Centers for Disease Control and Prevention on 
a national surveillance program. Finally, the Committee urges 
NIAID to continue to remain actively and meaningfully involved 
in the national education and awareness campaign for PI 
sponsored by the Jeffrey Modell Foundation and to expand its 
role in fiscal year 2002.
    Prostatitis research.--The Committee strongly urges the 
formation of prostatitis research centers under the direction 
of infectious disease specialists as separate and distinct 
entities from the urological centers.
    Rhinosinusitis.--Chronic rhinosinusitis affects 
approximately 33,000,000 Americans, yet its cause remains 
unclear. Recent studies have suggested that the trigger is 
fungus or fungi that circulate in the environment. Many 
healthy, normal people may be exposed to the same fungi, yet do 
not develop rhinosinusitis or sinus polyps. The Institute is 
urged to support studies to determine the factors that 
sensitize an individual to fungus or which generate a fungus-
specific immune response.
    Temporomandibular joint disorders (TMJ).--The Committee 
urges NIAID to put a greater focus in its research portfolio on 
TMJ patients and autoimmune and inflammatory processes. The 
collection of tissue samples from TMJ patients and people 
without TMJ disease has been suggested (as part of a patient 
registry) to determine whether inflammatory mediators, growth 
factors, cytokines and other cell and molecular factors 
affecting immunity may differ between people with and without 
TMJ disease.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2001....................................  $1,530,988,000
Budget estimate, 2002...................................   1,710,182,000
Committee recommendation................................   1,753,465,000

    The Committee recommendation includes $1,753,465,000 for 
the National Institute of General Medical Sciences [NIGMS]. 
This is $43,283,000 more than the budget request and 
$222,477,000 more than the fiscal year 2001 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.
    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. 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 physician behavior and practices.
    Training.--The Committee continues to be pleased with the 
quality of NIGMS's 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 expects NIGMS to continue to support 
these important initiatives, and is particularly pleased that 
NIGMS has supported biomedical research career opportunity 
programs for high school and undergraduate college students in 
conjunction with minority institutions. The Committee urges 
continued, long-term support of this program.

        NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

Appropriations, 2001....................................    $978,136,000
Budget estimate, 2002...................................   1,095,954,000
Committee recommendation................................   1,123,692,000

    The Committee recommends an appropriation of $1,123,692,000 
for the National Institute of Child Health and Human 
Development [NICHD]. This is $27,738,000 more than the budget 
request and $145,556,000 more than the fiscal year 2001 
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 and 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.
    Adolescent health and disparities.--The Committee strongly 
encourages the collaboration of NICHD, the National Cancer 
Institute, the NIH Office of Behavioral and Social Science 
Research, and the Centers for Disease Control and Prevention 
(CDC) in efforts to support CDC's Healthy Passages Program, 
which studies the developmental paths of health risk behaviors 
and adverse health outcomes in white, African-American, and 
Hispanic youth. The Committee commends the involvement of NIH 
Institutes in supporting this CDC study on adolescent health 
and health disparities.
    Autism.--The Committee is aware that NIH, under the 
auspices of its Autism Coordinating Committee, has established 
a plan to implement the autism provisions of recent legislation 
dealing with children's health. The Committee notes that 
current plans include an expedited implementation of the full-
scale program of Centers for Research in Autism. Despite the 
expedited nature of this plan for centers, the Committee 
expects that peer review will be a primary factor in funding 
decisions regarding these grants. The Committee also commends 
NIH efforts in a program under which samples of tissues and 
genetic materials are donated, collected, preserved, and made 
available for autism research.
    The Committee also urges the NICHD to continue its support 
of the Collaborative Programs of Excellence in Autism (CPEA), a 
program that has encouraged collaboration in research efforts 
among leading institutions in the field of autism research.
    Behavioral and social sciences research.--The Committee is 
pleased to learn that NICHD is undertaking a strategic planning 
process strongly emphasizing a collaborative process between 
the biomedical and behavioral sciences to successfully 
accomplish the goals of the Institute.
    Bone disease in adolescents.--Given the high incidence of 
teen pregnancies, more research is needed to understand the 
relationship between pregnancy, lactation, and bone mass in 
adolescents. In particular, NICHD is urged to support research 
on 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 adolescence, and the 
impact on bone status of chronic under-nutrition of young 
women. The Committee supports the continuing efforts of the 
Institute to provide a database of bone density across a decade 
for white and minority children and adolescents. Furthermore, 
the Committee encourages NICHD to expand research on 
osteogenesis imperfecta, with special emphasis on further 
research into genetic therapies, animal models, drug treatment 
and rehabilitation techniques.
    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.
    Child development and literacy.--The Committee recognizes 
NICHD's leading role in identifying factors affecting how 
children learn generally, both with and without formal 
instruction, and for normal children as well as children for 
whom learning is a challenge. NICHD research on early child 
development, reading development and disorders has contributed 
to converging evidence about how children must be taught in 
order to read and how children who are likely to have 
difficulty learning may be identified early in their education. 
The Committee strongly supports NICHD's efforts to translate 
this research to improve literacy and academic performance.
    Chromosome 18.--The Committee is aware of efforts to 
encourage new scientific work into the molecular genetic, 
clinical and therapeutic aspects for chromosome abnormalities. 
NIH has supported little research into the abnormalities of 
Chromosome 18, despite repeated urging by this Committee. The 
Committee believes that the NIH must ensure that this research 
be performed. It requests that a strategic plan and report 
addressing initiatives to fund Chromosome 18 research be 
provided to the Committee by no later than April 1, 2002.
    Demographic research.--The Committee strongly endorses 
demographic and behavioral research supported by NICHD, which 
includes studies of poor families and neighborhoods, adolescent 
health, fertility patterns and their relationship to education 
and labor, risky sexual behavior and HIV, infant mortality, and 
particularly health disparities. The Committee is pleased that 
NICHD plans to expand its examination of health disparities 
through research on the social and behavioral factors leading 
to pre-term births and low birth weight, as well as research to 
develop more effective means of preventing and treating HIV 
among minority youth. The Committee strongly supports planned 
research linking social and cultural understandings of gender 
dynamics to account for how these factors may influence HIV 
risk among different racial, ethnic and socioeconomic groups. 
The Committee also supports research identifying the barriers 
to school readiness and academic success for minority and low-
income children.
    Duchenne muscular dystrophy.--The Committee is aware that 
NICHD has done little in the field of muscular dystrophy 
research, even though Duchenne muscular dystrophy is the single 
most common lethal genetic disorder of children in America. The 
Committee urges NICHD to develop collaborative partnerships 
with NINDS and NIAMS to advance basic, clinical, and 
translational research into treatment for Duchenne muscular 
dystrophy.
    Environmental effects on child health and development.--The 
Committee applauds NICHD for its efforts to work with the 
Environmental Protection Agency and the Centers for Disease 
Control and Prevention on developing a major national 
longitudinal study quantifying the effects of environmental 
exposures and biological and social factors on child health and 
development. The Committee places a high priority on 
investigating the relationship between behavior and exposure to 
harmful environmental influences, such as the extent to which 
behavior drives exposure to low-level contaminants during key 
developmental phases of a child's life.
    Fatherhood and family stability.--The Committee applauds 
NICHD's demographic, behavioral and social science-based 
surveys on fatherhood, marriage and other issues affecting the 
stability of families. NICHD's leading efforts to understand 
the impact of fatherhood and other factors affecting the 
integrity of families will provide critical information to 
enhance our understanding of family formation, family structure 
and parent roles, and the impact of these factors on the 
development and well-being of children.
    Fragile X.--Fragile X, the most common inherited cause of 
mental retardation, results from the failure of a single gene 
to produce a specific protein. Researchers at the NICHD have 
made great strides in understanding the mechanism by which this 
genetic defect causes mental retardation, seizures, aggressive 
outbursts and severe anxiety. Fragile X has the potential to be 
a powerful research model for other forms of X-linked mental 
retardation, as well as neuropsychiatric disorders, including 
autism, schizophrenia, mood disorders, and pervasive 
developmental disorder. The Committee is gratified that the 
NICHD has enhanced its research efforts on fragile X both 
internally and by partnering with the FRAXA Research Foundation 
in the issuance and funding of a Request for Applications to 
research scientists.
    The Committee notes that Title II of the Children's Health 
Act of 2000 calls for the establishment of at least three 
fragile X research centers. The Committee strongly urges the 
NICHD to allocate sufficient funds for that purpose, to 
expedite that objective, and to ensure the discrete 
accountability of the Centers.
    Health behaviors of youth.--The Committee is increasingly 
concerned about youth and health behaviors and their impact on 
society as a whole. 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, and it 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, and 
behavioral analysis.
    Infertility and contraceptive research.--The Committee 
continues to place a high priority on research to combat 
infertility and speed the development of improved 
contraceptives. NICHD is urged to continue aggressive 
activities in this area, including individual research grants 
and those of the infertility and contraceptive research 
centers.
    Juvenile diabetes.--The Committee is concerned about 
reports of a severe shortage of pediatric endocrinologists, and 
it urges NICHD to develop a strategy to ameliorate this 
problem. The Committee also wishes to reiterate its interest in 
NICHD collaborating with NIAID and NIDDK in leading a project 
that will develop a vaccine for juvenile diabetes. The 
Committee understands that CDC is funding a pediatric diabetes 
registry project and urges NICHD to collaborate in this 
project.
    Maternal-fetal medicine.--The Committee urges the NICHD to 
sponsor a planning workshop for the purpose of defining 
research questions regarding the causes of pre-term delivery, 
building on previous research surrounding the role of infection 
and the immune response, and the role of genetics. The outcome 
should provide the basis for the development of appropriate 
funding mechanisms and increased collaboration with academic 
centers not currently participating in cooperative agreements 
with the NICHD. The Director is urged to report to the 
Committee on activities in this area by June 30, 2002.
    Medical rehabilitation.--The Committee is pleased with the 
Center's progress in addressing rehabilitation and disability 
research issues. The Committee encourages the Center to focus 
on a number of priority areas including: advanced orthotics and 
prosthetics; increased research into engineered biomaterials 
and tissue reengineering as strategies for rehabilitation with 
a focus on incorporating nanotechnology and robotics into 
orthotics and prosthetics; and additional research in traumatic 
brain injury through the clinical trials network. The Committee 
is also pleased with the progress on clinical trials in the 
areas of hip fracture and stroke, and it requests progress 
reports on the results of these trials.
    National longitudinal cohort study.--The Committee 
understands that the NICHD is leading a consortium of 
representatives from appropriate Federal agencies, including 
other NIH Institutes, CDC and EPA, in planning and developing a 
national longitudinal cohort study of environmental influences 
on children's health. The Committee is pleased that an 
interagency workgroup has begun preliminary work in developing 
an innovative structure for the study and initiating necessary 
pilot studies. The Committee urges the Institute to provide 
sufficient funds to support increased planning and piloting 
activities over the next 2 fiscal years, so that the full study 
is underway by the end of 2003.
    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. We also 
encourage NICHD 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 children and adolescents. NICHD is encouraged to 
strengthen support for 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 
cognitive and physical development in children.
    Pelvic floor dysfunction.--The Committee is encouraged by 
the NICHD's accomplishments to date on establishing a research 
portfolio into pelvic floor disorders. The Committee urges 
NICHD make resources available to fund additional grant 
applications for epidemiological research and for the newly 
created clinical trials network. The Committee also encourages 
NICHD to foster research interest by sponsoring a 
grantsmanship's technical assistance workshop for gynecologic 
and obstetrics researchers.
    Policy-relevant demographic research.--The Committee urges 
the NICHD to continue its strong support for objective, policy-
relevant demographic research on vital issues such as marriage, 
family structure, teen childbearing, fatherhood, immigration, 
child and adolescent health, and the impact of changing age 
structures on children and adults. It endorses the expansion of 
interdisciplinary research which bridges biomedical, 
demographic, social and spatial sciences. The Committee 
continues to strongly support NICHD's partnerships with Federal 
statistical agencies that help to produce the data so critical 
to demographic research.
    Primary immunodeficiencies (PI).--The Committee continues 
to be impressed by the comprehensive commitment that NICHD has 
shown in addressing PI, particularly with regard to the 
national education and awareness campaign sponsored by the 
Jeffrey Modell Foundation in partnership with the Institute, as 
well as NIAID, NCI, CDC, and other private entities. The 
Committee encourages NICHD to expand its commitment in fiscal 
year 2002 through such steps as additional Clinical Center 
Grand Rounds, distribution of appropriate materials to 
pediatricians and others, trans-institute cooperation on 
research issues, and replication of successful programs to 
determine the nature of under-diagnosis in minority 
communities.
    Reproductive health.--The Committee commends NICHD on its 
strategic plan to translate research on reproductive health to 
reduce the incidence of unwanted pregnancy and to identify 
usable strategies to increase knowledge about healthy adult 
sexuality and improved reproductive health. The Committee is 
pleased that such translation will draw from the research 
advances of the last 10 years including improved identification 
of behavioral factors affecting both fertility and infertility. 
The Committee supports NICHD's perspective that research 
relating to reproductive health should integrate economic, 
political, sociocultural and psychological factors while 
considering other factors that affect reproductive function. 
The Committee additionally encourages efforts to understand and 
better address the barriers to appropriate contraceptive 
services in minority communities.
    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 your investigators.
    Sudden Infant Death Syndrome (SIDS).--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 Nation. The Committee is particularly pleased that NICHD is 
collaborating with HRSA's Maternal and Child Health Bureau and 
the NIH Director's Office to improve public awareness about 
SIDS to the African-American community.
    Uterine fibroids.--Uterine fibroids (leiomyomata) are one 
of the most prevalent diseases impacting women today, with over 
70 percent of all women having fibroids present in/on their 
uterus. African-American women have the highest prevalence 
rates and are two to three times more likely to acquire 
symptoms related to uterine fibroids. The majority of all women 
with symptomatic uterine fibroids undergo a hysterectomy. The 
Committee urges NICHD to aggressively increase efforts that 
will lead to an understanding of the physiological endocrine 
mechanisms that allow uterine fibroids to grow and become 
symptomatic. The Conferees also encourage research leading to 
new treatments, new preventives, and new interventions (beyond 
the hysterectomy) in the care and treatment of women with 
uterine fibroids.
    Vulvodynia.--Preliminary new research indicates that 
millions of American 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. 
Since fiscal year 1998, the Committee has called on the NICHD 
to support research on the prevalence, causes and treatment of 
vulvodynia. While some initial steps have been taken, the 
Committee continues to be very concerned about the lack of 
research progress made in this important area and the low 
priority placed on it by NICHD. The Committee urges NICHD to 
significantly expand research on vulvodynia.

                         NATIONAL EYE INSTITUTE

Appropriations, 2001....................................    $507,842,000
Budget estimate, 2002...................................     568,103,000
Committee recommendation................................     614,000,000

    The Committee recommends an appropriation of $614,000,000 
for the National Eye Institute [NEI]. This is $45,897,000 more 
than the budget request and $106,158,000 more than the fiscal 
year 2001 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 laboratory and clinical research, 
research training, and other programs with respect to blinding 
eye diseases, visual disorders, mechanisms of visual function, 
preservation of sight, and the special health problems and 
needs of individuals who are visually impaired or blind. In 
addition, the NEI is responsible for the dissemination of 
information, specifically public and professional education 
programs aimed at the prevention of blindness.
    The Committee is pleased that vision impairment is a 
priority area in the national Healthy People 2010 initiative. 
The Institute is urged to develop the data on the extent of the 
problem of eye disease, especially among the aging population, 
and the economic consequences of eye disease so progress in 
these areas can be measured.
    Diabetic retinopathy.--Diabetic retinopathy is the leading 
cause of new cases of blindness in working-age adults. The 
Committee recognizes the collaborative efforts of the NEI with 
other Institutes and Centers to study ways to control the 
proliferation of abnormal vessels that give rise to diabetic 
complications within the eye and in other organs and systems of 
the body. The Committee encourages the NEI to continue this 
important research that may lead to the development of methods 
to inhibit this proliferation before sight-threatening damage 
has occurred.
    Genomic research.--The Committee recognizes the outstanding 
success of the NEI's Functional Genomics Workshop and the 
implementation of its recommendations to create a national eye 
genome resource. Not only has the NEI significantly increased 
its support of research to identify and sequence genes that are 
expressed in the visual system, work is now underway to make 
this information publicly available through a NEI-supported Web 
site. This will assist researchers in gaining a better 
understanding of genetic diseases that affect the eye and 
visual system and will speed development and testing of new 
gene-based therapies. The Committee encourages the Institute to 
emphasize the development of these gene-based therapies 
especially for retinal degenerative diseases.
    Glaucoma.--Glaucoma is a significant cause of blindness in 
older Americans and is the number one cause of blindness in 
African Americans, who are disproportionally at greater risk 
for developing the disease and being blinded by it. NEI-
supported clinical trials have demonstrated the effectiveness 
of a variety of treatments, as well as the importance of early 
detection and appropriate treatment in preventing or delaying 
vision loss. The Committee looks forward to the results of the 
Ocular Hypertension Treatment Study, which will determine the 
benefit of treating people with ocular hypertension with 
pressure-lowering drugs to prevent or delay sight-threatening 
eye damage. The Committee also encourages the NEI to continue 
its research on the genetics of the development of glaucoma and 
on the discovery of ways to protect against nerve damage from 
glaucoma.
    Health education.--The Committee is pleased with the NEI's 
efforts to communicate the results of its research efforts into 
meaningful health education messages to the public and to 
professionals through its National Eye Health Education 
Program. The Committee is particularly pleased with the NEI's 
efforts to increase awareness of low vision and its impact on 
quality of life. Through a mobile exhibit that travels to 
shopping malls and centers around the country, information on 
low-vision services and resources are made directly available 
to those with low vision and their families. The Institute 
should continue its emphasis on this important outreach 
program.
    Macular degeneration.--The Committee commends the NEI for 
the prioritization of its research on macular degenerative 
diseases, which account for nearly 30 percent of the bilateral 
blindness in this country and are particularly devastating to 
the independence and quality of life of our older citizens. 
NEI-supported research has demonstrated that two potentially 
modifiable risk factors, smoking and hypertension, are 
associated with the most severe form of the disease. The 
Committee eagerly awaits the results of a clinical trial that 
will determine whether low-intensity laser treatment can 
prevent the development of advanced complications in the age-
related form of the disease.
    Retinitis pigmentosa.--Retinitis pigmentosa is a chronic, 
progressive, degenerative disease that causes the deterioration 
of the photoreceptor cells in adolescence and leads to 
substantial visual loss in adulthood. Retinitis pigmentosa, 
Usher's Syndrome, and other related degenerative disorders can 
have a dramatic effect on the quality of life of those affected 
and their families. The Committee recognizes the technical 
difficulties associated with rescue and regeneration of 
deteriorating neurons but is encouraged by the Institute's 
exploration of the use of growth factors, transplantation, and 
gene-based techniques to combat this destructive disease.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2001....................................    $502,987,000
Budget estimate, 2002...................................     561,729,000
Committee recommendation................................     585,946,000

    The Committee recommends an appropriation of $585,946,000 
for the National Institute of Environmental Health Sciences 
[NIEHS]. This is $24,217,000 more than the budget request and 
$82,959,000 more than the fiscal year 2001 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.
    Agent Orange.--The Committee urges the NIEHS to continue 
its work with scientists in the United States and Southeast 
Asia on the health and environmental effects of the use of 
Agent Orange and dioxin. Scientists representing the United 
States and Vietnamese Governments have recently negotiated a 
landmark commitment to proceed with this program, and this 
Committee recognizes the importance of demonstrating sustained, 
timely interest and engagement on the part of the U.S. 
Government. NIEHS is encouraged to continue these efforts and 
expand them when feasible into a broader-based effort, 
including a grants program that funds both independent and 
collaborative research. NIEHS should provide a report on these 
activities to the Congress by April 1, 2002.
    Animal manure management.--The Committee urges NIEHS to 
study the issue of animal manure management and storage by 
agricultural producers, and to explore the public health 
implications of this issue.
    Breast cancer.--The Committee recognizes the serious lack 
of research on the relationship between the environment and 
breast cancer, and believes that it is essential for the 
Institute to support such research. The Committee understands 
that the Institute will establish a Breast Cancer and 
Environmental Research Advisory Board to make recommendations 
to the Director with regard to the development of Breast Cancer 
and Environmental Research Centers. The Committee is aware of 
the tremendous success of the DOD Breast Cancer Research 
Program and its grant process. The Committee expects the 
Advisory Board to integrate a peer review and planning process 
along the lines of the DOD integration panel. The Committee is 
pleased that the Advisory Board will include representatives 
from the breast cancer community who have had breast cancer. 
The Committee further strongly urges the NIEHS to establish 
centers to conduct multi-disciplinary and multi-institution 
research on environmental factors that may be related to breast 
cancer.
    Environmental factors and liver disease.--The impact of 
environmental factors on liver disease is an important area 
that needs 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.
    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.
    Lymphoma.--The Committee encourages NIEHS to expand its 
research on investigating the potential of environmental, 
bacterial, and viral factors that are associated with the 
development of lymphoma and other hematological cancers. The 
Committee also encourages NIEHS to collaborate with NCI and CDC 
to conduct research that will lead to a better understanding on 
how environmental factors contribute to the development of 
lymphoid malignancies. The Committee requests that NIEHS and 
NCI submit a joint report to the Committee by April 1, 2002, on 
their current research portfolios on lymphoma and the direction 
of future research.
    Test methods.--The Committee supports the assessment of 
scientific validation of new, revised and alternative 
toxicological test methods by ICCVAM. The Committee encourages 
NIEHS to use the expertise and credibility of ICCVAM for these 
assessments to streamline their individual consideration of 
new, revised and alternative toxicological test methods.
    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, 2001....................................    $786,056,000
Budget estimate, 2002...................................     879,651,000
Committee recommendation................................     909,174,000

    The Committee recommendation includes $909,174,000 for the 
National Institute on Aging [NIA]. This is $29,523,000 more 
than the budget request and $123,118,000 more than the fiscal 
year 2001 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.
    Advanced imaging technology for Alzheimer's.--The Committee 
continues to urge NIA to focus on early detection of 
Alzheimer's disease so 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 it 
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 disease.--Few diseases affect more Americans, 
require more prolonged treatment, cause more suffering for the 
families of the afflicted, and waste more precious human and 
financial resources than Alzheimer's disease. An estimated 4 
million persons suffer from Alzheimer's, or about one in 10 
Americans over age 65 and nearly half of those over age 85. As 
the baby boom generation shoulders its way into old age, few 
diseases represent a greater threat to the health and financial 
well being of society as a whole. Within the next few decades, 
14 million individuals will be stricken with Alzheimer's, 
raising the annual cost of caring for its victims to 
$375,000,000. Because of its critical size and tragic impact, 
Alzheimer's disease represents one of the nation's most 
critical health problems. After two decades of intensive 
research, scientists have begun to understand the basic 
mechanisms of Alzheimer's as well as the complex interplay of 
genetic and environmental risk factors. Past investments have 
opened the doors to exciting new opportunities, including 
clinical trials of a vaccine that may prevent amyloid deposits 
in the brain, a hallmark of Alzheimer's; evidence that 
cholesterol-lowering drugs may delay or prevent the onset of 
the disease; and FDA approval of a fourth drug for the 
treatment of the disease's cognitive symptoms. But if society 
hopes to avert widespread suffering and enormous strain on its 
health care system, science must act now because researchers 
believe that Azheimer's actually begins 10 to 20 years before 
its first symptoms appear. While investigator-initiated 
research continues, concurrent large-scale clinical trials 
offer the best hope for finding ways to treat, delay or prevent 
Alzheimer's disease. The Committee urges NIA to expand its 
investment in Alzheimer's disease research, particularly for 
clinical trials, and has provided additional funds for that 
purpose. It is the Committee's goal to increase the NIH 
commitment to Alzheimer's research to $1,000,000,000 as soon as 
possible, a goal made even more compelling by the growing 
number of Americans who will soon be at greatest risk.
    Alzheimer's research.--NIA is commended for its innovative 
research on effective management of Alzheimer's disease 
patients (special care units) and the needs of Alzheimer's 
caregivers. 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.
    Behavioral and Social Research.--The Committee commends 
NIA's Behavioral and Social Research (BSR) program for its 
demographic and economic research portfolio on health dynamics 
in older populations and the early life determinants of the 
late life health disparities. The Health and Retirement Study 
and the National Long Term Care Survey, the Office of 
Demography and the 11 demographic research centers are 
important national resources for advancing research on the 
Medicare and Social Security systems. The Committee is very 
pleased with the BSR's efforts to link demography and biology, 
and to develop a more integrated social and behavioral science.
    Bone disease and aging.--The Committee encourages NIA to 
coordinate its research on osteoporosis and Paget's disease 
with NIAMS. NIA is also encouraged to study the effects of 
aging on individuals with osteogenesis imperfecta. The 
Committee urges the Institute to renew its commitment to 
funding studies related to the aging skeleton.
    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. The Committee encourages the 
Institute to make cardiovascular research a priority, and urges 
it to expand into innovative extramural and intramural 
cardiovascular research programs.
    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. The Committee again urges NIA to expand 
these centers to include a school of nursing.
    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 
is portfolio in this area, and the Committee encourages those 
efforts. 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. The 
Committee urges NIA to use the IOM recommendations as a guide 
for expanding its portfolio in this critical area of research.

  NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2001....................................    $394,968,000
Budget estimate, 2002...................................     441,803,000
Committee recommendation................................     460,202,000

    The Committee recommends an appropriation of $460,202,000 
for the National Institute of Arthritis and Musculoskeletal and 
Skin Diseases [NIAMS]. This is $18,399,000 more than the budget 
request and $65,234,000 more than the fiscal year 2001 
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.
    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.
    Drug research.--The Committee supports research in the area 
of TOPS-ester therapeutics, a type of drug being developed that 
is compartmentalized inside skin cells and expresses 
antioxidant actions that limit oxidant mediated pathologies 
including psoriasis, sunburn, skin aging and cancer.
    Duchenne muscular dystrophy.--The Committee is aware of 
past collaboration between NIAMS and NINDS to intensify and 
enhance muscle disease research. The Committee urges NIAMS to 
continue working closely with NINDS to identify collaborative 
opportunities to advance basic, clinical, and translational 
research into treatment for Duchenne muscular dystrophy. The 
Committee has urged NINDS to establish centers of excellence 
for basic and applied research in the muscular dystrophies. The 
Committee urges NIAMS to coordinate with NINDS and the Centers 
for Disease Control and Prevention on the planning and 
activities for these centers.
    Economic burden of skin diseases.--The Committee is aware 
of the lack of information regarding the overall economic 
burden of skin diseases for the nation, as well as the lack of 
reliable data on how many individuals in the United States are 
affected by these diseases. The Committee, therefore, 
encourages the NIAMS, in conjunction with other PHS components, 
including NCHA, CDC, AHRQ, and HRSA, to sponsor a workshop to 
identify existing information sources on the costs and scope of 
skin diseases, and to recommend strategies for developing new 
information sources. The Institute is encouraged to work with 
skin diseases researchers and voluntary health organizations to 
plan the workshop.
    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. 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 greater funding for continued research of 
this disease.
    Fibrous dysplasia.--Fibrous dysplasia is a chronic disorder 
of the skeleton that predominantly afflicts young children and 
adolescents, resulting in uneven growth, severe pain, and 
deformed extremities. Given the long-term implications of this 
disorder on both children and adults, the Committee sees the 
need for a targeted research effort to evaluate promising drug 
therapies. NIAMS is encouraged to support such research at an 
institution with a large population of both pediatric and 
adolescent fibrous dysplasia patients, as well as a staff of 
orthopedic and endocrinology specialists qualified to conduct 
this research.
    Osteogenesis imperfecta.--Osteogenesis imperfecta (OI) is a 
genetic disorder characterized by frequent fractures from 
little or no trauma. The Committee commends the effort NIAMS 
has made to encourage and fund osteogenesis imperfecta research 
and recommends that osteogenesis imperfecta continue to be an 
area of special emphasis in the Institute. NIAMS and NHLBI are 
urged to investigate respiratory and cardiovascular problems 
associated with OI. The Committee also encourages NIAMS to 
continue its strong support of research into gene therapies and 
drug treatment for OI, and to continue its active follow-up of 
new research opportunities arising out of the 2001 NIH workshop 
on OI.
    Osteoporosis and related bone diseases.--The Committee 
recognizes that osteoporosis and related bone diseases are a 
major public health problem that exacts an enormous human and 
economic toll. The Committee commends the National Resource 
Center for its role in providing patients, health professionals 
and the public with access to resources, and encourages the 
Center to increase prevention and treatment efforts. The 
Committee encourages NIAMS to devote additional resources to 
studying osteoporosis in non-white women, as well as 
understanding the genetic predisposition of osteoporosis in 
certain populations. Moreover, given the large number of 
individuals affected by this disease, NIAMS is urged to focus 
on therapies to improve quality of life and to reduce the 
subsequent risk of fractures. The Committee encourages NIAMS to 
continue to work with NHLBI to investigate the basic and 
clinical relationship between cardiovascular diseases and 
osteoporosis.
    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 it encourages NIAMS to enhance efforts in 
this area as well as research to develop animal models for 
Paget's disease.
    Pediatric rheumatoid arthritis.--The Committee commends the 
NIAMS for its growing support of research and training 
activities to better understand childhood rheumatic diseases, 
including pediatric rheumatoid arthritis. The Committee is 
especially pleased with the continued operation of the 
Pediatric Rheumatology Clinic, which opened on the NIH campus 
in the fall of 2000. The Committee is also pleased to learn 
that, through research at an NIAMS-supported Multipurpose 
Arthritis and Musculoskeletal Diseases Center, the drug 
Etanercept has recently been shown to be a safe and effective 
drug in the treatment of children and teenagers with pediatric 
rheumatoid arthritis. The Committee appreciates the Institute's 
emphasis on pediatric rheumatic diseases in recent research 
solicitations. The Committee understands that the Institute's 
pediatric rheumatoid arthritis registry has been expanded to 
include a major emphasis on a genome-wide search for 
susceptibility genes and strongly urges the Institute to 
continue its research into the genetic factors as well as 
infectious triggers of the disease.
    Psoriasis.--Psoriasis is a genetically acquired immune-
mediated disease of the skin and joints that affects over 7 
million Americans. The Committee encourages NIAMS to conduct a 
scientific workshop to assess basic and clinical research in 
psoriasis, especially prospects for innovative therapeutic 
approaches for moderate to severe forms of the disease. The 
Committee urges the Institute to collaborate with patient 
organizations, medical specialty societies, and other 
interested parties in the development of this workshop. NIAMS 
is further urged to work with these partners through all 
available mechanisms to support a public awareness and 
education program on the best available treatments for moderate 
and severe psoriasis.
    Sjogren's syndrome.--The Committee is pleased that the 
NIAMS has published a booklet on Sjogren's syndrome, providing 
an important means of educating people about this common 
autoimmune disease. The Committee encourages the Institute to 
do more for this disease, including holding scientific 
workshops, providing grant monies, and including Sjogren's in 
autoimmune databases.
    Temporomandibular joint disorders (TMJ).--The Institute is 
urged to increase research on unique features of the 
temporomandibular joint as well as exploring to what extent TM 
disorders share common pathogenic mechanisms with fibromyalgia 
and osteoarthritis.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2001....................................    $301,069,000
Budget estimate, 2002...................................     336,744,000
Committee recommendation................................     349,983,000

    The Committee recommends an appropriation of $349,983,000 
for the National Institute on Deafness and Other Communication 
Disorders [NIDCD]. This is $13,239,000 more than the budget 
request and $48,914,000 more than the fiscal year 2001 
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; contributes to health promotion and disease 
prevention; and supports efforts to create devices that 
substitute for lost and impaired sensory and communication 
functions.
    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, and for collaboration with other NIH Institutes on 
this important disorder.
    Health survey.--The Committee encourages the Institute to 
create and administer a national deaf and hard of hearing 
health survey, conducted annually, to assess the health status 
of this population and monitor changes as a result of 
intervention efforts.
    Noise-induced hearing loss.--The Committee continues to be 
concerned by the number of Americans who 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 urges the Institute to provide sufficient funds 
to expand this promising new initiative.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2001....................................    $105,158,000
Budget estimate, 2002...................................     117,681,000
Committee recommendation................................     125,659,000

    The Committee recommends an appropriation of $125,659,000 
for the National Institute of Nursing Research [NINR]. This is 
$7,978,000 more than the budget request and $20,501,000 more 
than the fiscal year 2001 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.
    Cancer screenings.--The Committee continues to be concerned 
about disparities in the incidence and prevalence of cancer 
among minorities. The Committee believes that the NINR is 
positioned well to address prevention strategies, particularly 
screening for minority populations. Therefore, the Committee 
urges increased promotion of regular cancer screenings and 
positive behavioral modifications that will help prevent 
cancers.
    Caregivers.--Informal caregivers in the home need help as 
they administer to the needs of patients with chronic 
illnesses. One in four U.S. families is involved in caregiving. 
The Committee is troubled that caregivers themselves are at 
risk for poor physical and emotional health as they devote 
themselves to tending to others. The NINR is urged to devote 
greater attention to caregiver needs regarding improved 
strategies, skills, and support.
    Chronic conditions.--The NINR is to be commended for its 
increased focus on chronic illnesses, which affect growing 
numbers of people in this country as patients live longer with 
severe but enduring diseases. The Committee urges the Institute 
to continue its emphasis on pain management and other 
conditions such as cachexia, which involves muscle wasting and 
weight loss.
    End-of-life care.--The Committee is pleased with the NINR's 
efforts to stimulate research on palliative care. Research 
supported by the NINR and collaborative organizations is 
critical to addressing key issues such as how to manage pain 
and help patients and their families make difficult choices 
about treatment and care.
    Mentorship program.--The Committee is greatly encouraged by 
the progress made by the NINR and the NIMH in implementing a 
technical assistance workshop on grant writing and navigating a 
research career trajectory in the area of behavioral change 
related to psychiatric populations--a program that will build 
the research capacity of our Nation's psychiatric mental health 
nurse researchers. The Committee urges the NINR and NIMH to 
implement a a mentorship program that will enable participants 
to develop formal grant proposals for ultimate submission to 
the Institutes.
    New research opportunities.--The Committee encourages the 
Institute to take advantage of increased funding by supporting 
new research opportunities in several areas, including: 
research on health disparities in diseases such as diabetes and 
cardiovascular disease, self-management of chronic pain, end-
of-life research to address weight loss, muscle wasting, 
fatigue, and caregiver issues. Most critical to enhancing 
research within the nursing profession is infrastructure 
development that increases the pool of nurse investigators, 
expands programs to develop partnerships between research-
intensive environments and small colleges and universities, and 
promotes career development for minority researchers.
    Nurse researchers.--The Committee is concerned about the 
effects of the nursing shortage on evidence-based practice. The 
NINR has the Committee's strong support for its emphasis on 
protecting and expanding the infrastructure of nursing 
research. Recruiting minority researchers and enhancing career 
development for all nurses interested in research is essential 
to addressing the Nation's pressing health issues. Expanding 
technological skills for the nursing discipline, through 
efforts such as the NINR's training program in genetics, is 
another laudable goal for the Institute.
    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 very 
concerned about the public health aspects of volcanic emissions 
in Hawaii, and it urges the Institute to collaborate with the 
National Institute of Environmental Health Sciences to develop 
a multidisciplinary approach to this problem.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2001....................................    $340,537,000
Budget estimate, 2002...................................     381,951,000
Committee recommendation................................     390,761,000

    The Committee recommends an appropriation of $390,761,000 
for the National Institute on Alcohol Abuse and Alcoholism 
[NIAAA]. This is $8,810,000 more than the budget request and 
$50,224,000 more than the fiscal year 2001 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, 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.
    Alcoholic liver disease.--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 it encourages NIAAA to 
consider sponsoring additional research on treatment.
    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 treatment services. The Committee acknowledges NIAAA's 
progress in implementing this recommendation and encourages the 
Institute to consider supporting additional research in this 
area.
    Behavioral research to identify high-risk youth.--Studies 
show that people who begin drinking early in life have a 
dramatically higher risk of later becoming alcoholic than do 
those who begin later. Other studies show that personality 
characteristics that are evident as early as age 3 predict 
alcoholism in adulthood. Given these data, developing effective 
methods for identifying high-risk youth, as well as appropriate 
prevention strategies, is particularly important. The Committee 
urges NIAAA to expand efforts on this promising line of 
research.
    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 appreciates the progress made by NIAAA in building 
community partnerships to help expand the research on college 
drinking and in developing research-based interventions for 
preventing the harm caused by misuse of alcohol. Further, the 
Committee understands that NIAAA will soon begin the first 
national, longitudinal survey to assess alcohol consumption and 
contributing characteristics of adolescents and college-age 
youth. The Committee encourages NIAAA to continue and expand 
these activities.
    Health disparities.--The Committee encourages the NIAAA to 
place a priority on studying the disparities in risk of 
alcoholism and treatment availability and accessibility among 
various ethnic and racial groups. Additionally, the Committee 
urges the Institute to consider establishing a mentoring 
program with the specific objective of providing quality 
research training for all racial groups.
    Multidisciplinary approaches.--The examination of alcohol 
misuse and alcohol use disorders must include the effective 
integration of multiple disciplines and strong 
interdisciplinary coordination. Thus, the Committee urges that 
sufficient funding be directed toward those endeavors which 
seek to apply multidisciplinary approaches to relevant 
questions of etiology, consequences and recovery. Specifically, 
the Committee urges support for efforts directed toward 
integrating animal and human data as well as the multiple 
sources of human data.
    Prevention and treatment of violence.--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 the NIAAA to consider supporting 
additional research on the prevention and treatment of violence 
by persons with alcohol problems.
    Risk and resiliency.--The Committee sees a critical need to 
identify adequate resources regarding risk and resiliency, 
including both genetic and psychosocial factors, and age-
appropriate education and prevention materials which can be 
empirically evaluated.
    Technology advances.--Advances in a range of technologies, 
such as genetic applications and brain imaging, may benefit the 
study of alcoholism. The Committee encourages the NIAAA to 
allocate adequate funding not only for the application of these 
technologies, but also for providing training to current and 
new investigators in these technologies.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2001....................................    $779,510,000
Budget estimate, 2002...................................     905,810,000
Committee recommendation................................     902,000,000

    The Committee recommends an appropriation of $902,000,000 
for the National Institute on Drug Abuse [NIDA]. This is 
$3,810,000 less than the budget request and $122,490,000 more 
than the fiscal year 2001 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 
that 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. The Committee is 
especially pleased that NIDA is planning to launch a drug abuse 
prevention model to more systematically test prevention 
programs in a wide variety of diverse settings and populations.
    Clinical trials network.--The Committee applauds NIDA's 
success in launching and expanding the new National Drug Abuse 
Treatment Clinical Trials Network, a much-needed infrastructure 
to test science-based drug addiction treatments in real-life 
community-based treatment settings. The Committee believes this 
is an extraordinary step forward in improving the quality of 
drug addiction treatment in this country, especially for 
minority populations and disadvantaged groups in both rural and 
urban settings. The Committee commends NIDA's leadership in 
forging strong partnerships with treatment researchers and 
community-based treatment providers to ensure that new 
treatments are tested and incorporated into ongoing drug 
treatment programs. The Committee encourages NIDA to continue 
to make this network, and research of new behavioral and 
pharmacological treatments, a top priority.
    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 it 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.
    Genes and drug abuse.--The Committee recognizes that 
treating drug abuse effectively requires understanding what 
makes individuals more or less vulnerable to addiction. The 
Committee urges further research in the Human Genome Project, 
which will provide the information and technology to identify 
genes that may play a role in addiction.
    International efforts.--The Committee commends NIDA for 
expanding its international efforts to more globally address 
drug addiction and the health consequences such as HIV/AIDS 
that it brings in its wake. These international efforts will 
better equip the United States to effectively prevent and treat 
addiction and infectious diseases.
    Medications development.--The Committee encourages NIDA to 
study the development of anti-addiction medications, 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 continues to be concerned 
about 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 it 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 and behavioral research provides a foundation for 
NIDA's research portfolio. The Committee urges NIDA to continue 
its efforts to develop new areas of neuroscience research, 
including the role that genetics plays in vulnerability to 
addiction.
    Nicotine research.--The Committee recognizes that the 
consequences of nicotine addiction are substantial to adults, 
children, and adolescents, and it 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.
    Prescription drug abuse.--Certain segments of the 
population, including adolescents, women, and the elderly, 
appear to be particularly vulnerable to the problem of 
prescription drug abuse. The Committee is particularly pleased 
that NIDA has taken a proactive leadership role in informing 
the public, health care professionals and others about the 
misuse and abuse of certain medications, particularly opiates. 
The Committee recognizes the importance of both behavioral and 
pharmacological interventions in treating prescription drug 
abuse and the critical role that primary care providers and 
mental health specialists play in identifying abuse and 
addiction.
    Prevention.--As our Nation continues to look for effective 
and cost-effective ways to reduce drug abuse, the Committee is 
pleased to hear that NIDA will launch a new initiative to 
develop a National Drug Abuse Prevention Trials System. The 
system will test proven research-based efforts in a wide 
variety of populations and settings. The Committee recognizes 
that different racial and ethnic groups have different patterns 
of drug use and abuse. NIDA is encouraged to expand research 
aimed at developing effective, culturally specific drug abuse 
prevention strategies for minority populations who are at 
increased risk for drug abuse.
    The Committee also applauds NIDA's efforts to launch a 
major new National Prevention Research Initiative. This 
initiative will establish the Prevention Research System, which 
is intended to ensure that communities across the country have 
effective ways to prevent drug abuse, particularly among 
adolescents.
    Stress.--NIDA is to be commended for its work on 
determining the role that stress plays in drug abuse and 
relapse to addiction and for developing science-based 
approaches to help individuals cope with stress and drug 
craving. The recent terrorist attacks and the fact that Post-
Traumatic Stress Disorder is a known risk factor for substance 
abuse and addiction warrants that NIDA expand its research in 
this important area.
    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 to new strategies for treating nicotine 
addiction and preventing tobacco use, particularly by teens and 
younger children.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2001....................................  $1,103,062,000
Budget estimate, 2002...................................   1,234,389,000
Committee recommendation................................   1,279,383,000

    The Committee recommends an appropriation of $1,279,383,000 
for the National Institute of Mental Health [NIMH]. This is 
$44,994,000 more than the budget request and $176,321,000 more 
than the fiscal year 2001 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 to the Nation's well-being.
    Aging.--Studies show that elderly people are at greater 
risk of mental disorders and their complications than younger 
people; major life changes, such as the loss of friends and 
loved ones, and physical illnesses, which often co-occur with 
depression, are often contributing factors. The Committee is 
pleased that NIMH has renewed and strengthened its emphasis on 
mental disorders among the elderly, and it commends the 
increased resources being directed to this critical area. The 
Committee also notes the launch of an intra-NIMH consortium of 
scientists concerned with mental disorders in the aging 
population, with a goal of increasing coordinated research 
efforts, expanding recognition of disorders in the elderly, 
developing new treatments, and reducing stigma.
    Alzheimer's disease.--NIMH continues to play an important 
role in research on the causes of Alzheimer's disease, its 
clinical course, and treatment and services for patients. For 
example, the Institute is providing extensive support to 
scientists to investigate aspects of depression, an important 
problem that affects both Alzheimer's patients and family 
caregivers. A clinical study already underway has documented a 
strong link between depression and physical aggression in 
Alzheimer's patients, suggesting that depression treatment may 
reduce aggression in patients. The Committee encourages NIMH to 
assign a high priority to Alzheimer's research and to continue 
to collaborate with NIA and other institutes.
    Children's mental health.--The Committee is aware that 
NIMH's National Advisory Mental Health Council established a 
Workgroup on Child and Adolescent Mental Health that is charged 
with charting a new, more rational course for the future of 
child and adolescent mental health research. The Committee 
supports this effort in light of the continuing evidence of 
high prevalence of mental illnesses in children and 
adolescents, and the difficulty many children encounter in 
accessing effective treatments, preventive strategies, and 
services. The Committee endorses the further direction of 
targeted research programs specifically for children and 
adolescents.
    Clinical trials.--The Committee commends NIMH on its launch 
of four large clinical trials to investigate real-world 
effectiveness of mental health research. The Committee 
recognizes the efforts of NIMH to study treatments in everyday 
settings by enrolling a representative sample of typical clinic 
patients who may have co-occurring diseases and come from 
diverse backgrounds. The Committee urges a balanced approach in 
this endeavor, integrating clinical approaches to disease and 
intervention efforts that address social and behavioral 
determinants of disease.
    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.
    Extramural aging research.--The Committee is concerned 
that, despite substantial funding increases for NIMH in recent 
years, the Institute's sponsorship of extramural research on 
the mental health of the elderly has not kept pace with its 
funding of research for other populations. The Committee 
strongly encourages NIMH to devote additional resources to 
extramural aging research and urges the Director of NIMH to 
designate an individual within the Office of the Director to 
oversee the Institute's aging research agenda and initiatives. 
The Committee also encourages the Director to ensure that 
reviewers of research proposals include members with 
specialized expertise in geriatrics.
    Families and School Together Track program.--The Committee 
commends NIMH for building science-based programs, such as the 
Families and School Together (FAST) 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.
    Fragile X.--Fragile X is the most common single-gene 
neuropsychiatric disease known, affecting 1 in 2,000 males and 
1 in 4,000 females with cognitive impairment and mental 
disorders such as obsessive-compulsive disorder and extreme 
anxiety. The Committee urges NIMH to conduct research on the 
neurobiological basis of fragile X, including studies on 
specific neural circuits and molecules. The Committee encourage 
NIMH to use its unique expertise to characterize the mental 
health symptoms of fragile X and to investigate effective 
treatments and promising new psychopharmacologic interventions 
that target those symptoms. The Committee also urges NIMH to 
include fragile X in its studies of related neuropsychiatric 
disorders and to work with other Institutes such as NICHD and 
NINDS to develop cooperative research support mechanisms in 
this area.
    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.
    Health disparities.--The Committee commends NIMH's efforts 
to investigate the causes for the disproportionate impact of 
mental disorders on racial and ethnic minority groups, as well 
as methods of addressing and alleviating these health 
disparities. The Committee is concerned that within and among 
minority populations of Hawaii, access to health services and 
treatment is uneven and at times nonexistent, and that 
prevention of illness, recovery and treatment have often been 
poorer in minority populations. The Committee strongly supports 
NIMH's strategic plan to address problems and develop solutions 
in the area of health disparities, and particularly supports 
the following strategic goals: to achieve a more ethnic and 
racially diverse pool of mental health investigators; to ensure 
inclusion of minority groups in clinical trials funded by NIMH; 
to obtain an accurate measurement of the extent of mental 
health disparities; and to use basic behavioral science to 
determine cultural differences in stress, coping and 
resilience. The Committee also notes that NIMH has established 
a Workgroup on Initiatives on Racial/Ethnic Diversity in 
Training and Health Disparities Research. The Committee 
endorses such efforts to increase racial/ethnic diversity among 
research scientists as a means to reduce the severe disparities 
that exist in the burden that mental illnesses place on 
minority groups.
    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, women of color, youth, and rural populations) 
where the epidemic is spreading most rapidly. NIMH should 
continue to support studies seeking to develop more effective 
ways to prevent infections and strategies to deliver cost-
effective services.
    Joint workshop between NINR and 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 in infants and children.--The 
Committee commends NIMH for the work conducted to explore the 
neurological and behavioral aspects of learning disabilities. 
The Committee encourages the Institute to continue to 
coordinate with other Institutes to work on related activities.
    Native Hawaiian center of excellence.--The Committee 
remains very supportive of NIMH's efforts to develop a cadre of 
native Hawaiian mental health researchers. 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.
    New neuroscience center.--The NIMH, the NINDS, and other 
Institutes have begun to design the John Edward Porter National 
Neuroscience Research Center (NNRC), which will house 
outstanding trans-NIH research programs. Intramural 
neuroscience researchers from nine Institutes will perform 
cutting-edge projects and form better collaborations due to 
proximity in the same facility. This is critically important to 
increasing the effectiveness, efficiency and pace of progress 
in overall neuroscience being conducted at the NIH. The 
Committee hopes that by fostering interaction among scientists 
in different organizational settings, and among diverse 
disciplines, the NNRC will serve to break down artificial 
barriers that can keep scientists who are studying 
complementary areas of science from communicating and 
collaborating. Additionally, this will hasten the translation 
of new knowledge into clinical applications.
    Review of mood disorders research.--NIMH recently conducted 
a major review of its research portfolio on mood disorders, 
such as major depression and bipolar disorder. To do this, NIMH 
brought together almost 100 of the country's leading 
researchers in this area to evaluate the state of the field of 
research and to make recommendations for future directions for 
research. Participants were also asked to offer their views and 
ideas for shaping the Institute's research agenda, as well as 
informing educational and communication efforts for improving 
health care. The Committee looks forward to hearing more from 
NIMH about how this process is succeeding, and how it has 
influenced the conduct of research in this area.
    Social work research.--The Committee commends NIMH for its 
continued recognition of the importance of social work research 
in the delivery of disease prevention and treatment services. 
The Committee urges NIH to explore ways to further involve 
social workers in research efforts and to report back to 
Congress on the involvement of social work in promoting 
effective prevention and treatment outcomes throughout all NIH 
Institutes and programs. The Committee continues to support the 
NIMH's efforts to expand the number of social work research 
development centers in light of the important work the centers 
do to inform the delivery of mental health services by social 
workers and other providers.
    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. The NIMH should 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 2003 
budget proposal.
    Tourette syndrome.--The Committee recognizes that public 
misunderstanding of the neurobiological disorder Tourette 
syndrome frequently results in ridicule, denied learning 
accommodations and lost employment opportunities for children 
and adults who have this disorder. The Committee is concerned 
that lack of knowledge about and treatment for this disorder 
may be particularly onerous in traditionally under-served 
communities. The Committee is pleased that NIH has initiated 
research into the genetic basis of this little-known disorder. 
Consistent with the Children's health Act of 2000, the NIMH is 
urged to develop a public education program that would reach 
parents, educators, pediatricians, family physicians, and other 
health care workers.
    Translational behavioral research.--The Committee strongly 
supports NIMH's efforts to investigate methods of building on 
the Institute's portfolio of basic behavioral science in order 
to address major public health issues including mental health 
disorders. The Committee strongly supports translational 
research in the behavioral and social sciences in order to 
inform the diagnosis, treatment and delivery of services for 
mental illness, particularly for young people. The Committee 
commends NIMH for convening conferences bringing together 
experts in basic behavioral research, clinical research and 
services research, and others, to share information and 
identify specific areas of promise for translational research 
in addressing public health problems. The Committee also 
promotes the establishment of translational behavioral research 
as a priority funding area for NIMH.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2001....................................    $381,101,000
Budget estimate, 2002...................................     425,674,000
Committee recommendation................................     440,448,000

    The Committee recommendation includes $440,448,000 for the 
National Human Genome Research Institute [NHGRI]. This is 
$14,774,000 more than the budget request and $59,347,000 more 
than the fiscal year 2001 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 3.1 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 3.1 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 the 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 the 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 
that can provide information to health professionals and the 
public about such disorders. In previous years, the Committee 
has encouraged the NHGRI, in collaboration with the Office of 
Rare Diseases (ORD), to create an information center to 
disseminate information, knowledge, and understanding of rare 
and genetic disorders. The Committee is pleased to learn that 
the NHGRI and the ORD plan to establish such a center this 
fiscal year.
    Epilepsy.--The Committee encourages the Institute to 
intensify its efforts to identify epilepsy genes for the more 
than 40 different types of epilepsy, and to assist the NINDS in 
the search for a genetic fingerprint diagnostic test aimed at 
improving drug therapy for epilepsy. The Committee suggests 
that the Institute coordinate efforts with the NINDS to create 
a national consortium to identify new epilepsy susceptibility 
genes through a large-scale genotype:phenotype screen. The 
Committee urges the Institute to make research in epilepsy a 
priority and to coordinate research efforts with other 
Institutes through the Interagency Epilepsy Coordinating 
Committee comprised of agency scientists and industry and 
patient representatives.
    Human Genome Project.--The Committee commends the 
international Human Genome Project, led by the NHGRI, for 
sequencing 95 percent of the 3.1 billion bases of the human 
genome years ahead of schedule. This was a remarkable 
achievement that could not have occurred without Federal 
support. At the same time, the Committee recognizes that 
substantial effort will be required to produce the final, 
highly accurate sequence by 2003. The Committee encourages 
NHGRI to pursue the development of the next generation of 
genomic tools and technologies needed to study the human genome 
and understand its role in human health and disease.
    The Committee is pleased that the NHGRI has made it a 
policy to provide the sequence information immediately and 
freely to the world via the World Wide Web, with no 
restrictions on its use or redistribution. The information is 
scanned daily by scientists in academia and industry, as well 
as by commercial database companies, providing key information 
services to biotechnologists. Already, tens of thousands of 
genes have been identified from the genome sequence, including 
more than 30 in just the last 2 years that play a direct role 
in human disease. The Committee encourages the NIH to continue 
this policy of free and unfettered access to genomic data.
    The Committee also commends the NHGRI for its leadership in 
research and policy development related to the ethical, legal 
and social implications of the Human Genome Project. The early 
commitment to devote 5 percent of the Institute's research 
budget to study the ethical, legal, and social implications of 
genome research has generated important information and 
recommendations regarding research and public policy. The 
Committee is particularly pleased with the Institute's 
attention to protecting the genetic information of individuals 
from misuse in health insurance and employment and its 
development of policy recommendations in both areas. The 
Committee supports and encourages the NHGRI's ongoing efforts 
to examine the privacy and fair use of genetic information in 
these settings and the many other important issues related to 
human genetics research and its consequences, including: the 
appropriate use of genetic tests; the protection of human 
subjects who participate in genetic research; the development 
of policies to guide research into genetic variation; and the 
attention to complex social issues, such as how genetics 
informs concepts of race and ethnicity.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2001....................................     $68,823,000
Budget estimate, 2002...................................     115,425,000
Committee recommendation................................     140,000,000

    The Committee recommends an appropriation of $140,000,000 
for the National Institute of Biomedical Imaging and 
Bioengineering [NIBIB]. This is $24,575,000 more than the 
budget request and $71,177,000 more than the fiscal year 2001 
appropriation. The comparable amounts for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The NIBIB improves health by promoting 
fundamental discoveries, design and development, and 
translation and assessment of technological capabilities in 
biomedical imaging and bioengineering, enabled by relevant 
areas of information science, physics, chemistry, mathematics, 
materials science, and computer sciences. The Institute plans, 
conducts, fosters, and supports an integrated and coordinated 
program of research and research training that can be applied 
to a broad spectrum of biological processes, disorders and 
diseases and across organ systems. The Institute coordinates 
with the biomedical imaging and bioengineering programs of 
other agencies and NIH Institutes to support imaging and 
engineering research with potential medical applications and 
facilitates the transfer of such technologies to medical 
applications.
    The Committee recognizes the contribution bioengineering 
brings to medicine. Bioengineering improves the quality of life 
through its contribution to advances in science and technology 
related to health. The Committee understands that this newly 
created Institute must have adequate resources to begin its 
important task of high-quality research.
    Imaging technologies.--The Committee encourages this new 
Institute to devote significant resources to molecular imaging 
technologies such as positron emission tomography (PET) and 
microPET to take advantage of the capacities of molecular 
imaging to detect disease process at the molecular level and to 
monitor the effectiveness of targeted gene therapies now under 
development. The Committee also encourages the new Institute to 
develop its research agenda in close collaboration with other, 
disease-specific Institutes at NIH, so that new imaging 
technologies are closely tied to the research projects being 
undertaken by the various other Institutes of NIH.
    Joint replacement wear.--Average life expectancy has at 
least doubled over the past century, presenting new challenges 
in our efforts to reduce disability. For example, an estimated 
500,000 joint replacements are performed in the United States 
each year, many of which fail and require additional surgery. 
Because the patients are typically elderly and frail, the 
failed implant is often difficult to remove. The required 
surgery is much more complex, dangerous, and expensive than the 
original procedure, and the failure rate is several times 
greater. It is widely recognized that the majority of failures 
of artificial joints are caused by wear of the weight-bearing 
surfaces. In light of demographic projections of a rapid 
increase in the elderly population, the Committee expects the 
Institute to assign a high priority to research identifying the 
causes of wear in prosthetic joints as well as to finding 
solutions to the problem, such as new materials.
    Non-destructive evaluation.--The Committee is encouraged by 
the possible use of non-destructive evaluation research for the 
improvement of diagnostic capabilities in medicine. It also 
recognizes that the initial parts of many clinical studies will 
proceed more quickly on living animals. Research on developing 
quantitative measurement techniques in the areas of 
radiography, CT, ultrasound and magnetic resonance, and others 
should be investigated, with experiments on animals being a 
vehicle for early clinical studies.
    Temporomandibular joint disorders (TMJ).--The Committee is 
aware that the research portfolio on temporomandibular diseases 
and disorders has extensively studied psychological and 
behavioral factors in the etiology or chronicity of TMJ 
diseases and disorders. The Committee urges the Institute to 
broaden its scientific base for TMJ research by putting greater 
emphasis on basic and clinical research on normal and abnormal 
structural and functional features of the joint and related 
structures, using the tools of cell and molecular biology as 
well as advanced imaging techniques.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 2001....................................    $811,237,000
Budget estimate, 2002...................................     967,025,000
Committee recommendation................................   1,014,044,000

    The Committee recommends an appropriation of $1,014,044,000 
for the National Center for Research Resources [NCRR]. This is 
$47,019,000 more than the budget request and $202,807,000 more 
than the fiscal year 2001 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.
    Crystallography.--The Committee is aware of the important 
role that X-ray diffractometers and crystallography 
laboratories play in allowing researchers to study the 
interaction between possible drugs and receptor proteins. The 
Committee encourages NCRR to consider supporting these systems, 
which could benefit the development of new cancer treatments.
    Extramural construction.--The Committee has included bill 
language identifying $125,000,000 for extramural biomedical 
facility renovation and construction. This is an increase of 
$50,000,000 over the fiscal year 2001 appropriation. These 
funds are to be awarded competitively, consistent with the 
requirements of section 481A of the Public Health Service Act, 
which allocates 25 percent of the total funding to institutions 
of emerging excellence. The Committee commends NCRR for taking 
a more proactive role in fulfilling this requirement.
    General Clinical Research Centers.--Over three decades ago, 
NIH established the General Clinical Research Centers (GCRCs) 
program to support regional patient-oriented research centers. 
Today, the NCRR supports about 80 GCRCs, which provide citizens 
across the country with local access to clinical research 
programs focused on a wide range of diseases and disorders. In 
recent years, the Committee has expressed concern regarding the 
inadequate funding provided to the GCRCs. Last year, the 
Congress recognized the need to expand the GCRCs by authorizing 
them in law as part of the Clinical Research Enhancement Act. 
To achieve this goal and ensure that the GCRCs are equipped to 
support clinical research aimed at preventing and curing 
disease, the Committee has provided $275,000,000 for the GCRC 
program as authorized by Section 481C of the Public Health Act. 
This increase should be used to address the funding shortfall 
of recent years; upgrade GCRC facilities with the sophisticated 
technologies needed to apply information from the mapping of 
the human genome to the pursuit of cures for diseases with a 
genetic component; expand staffing as recently mandated by NCRR 
to ensure patient safety and maximum compliance with new 
regulatory requirements; and support local GCRC pilot projects 
as approved by the NCRR Advisory Council in May of last year.
    Human tissue supply.--The Committee continues to be very 
interested in matching the increased needs of researchers, 
particularly NIH grantees, as well as intramural and 
university-based researchers, who rely upon human tissues and 
organs to study human diseases and to search for cures. The 
Committee is aware that the leader in this competitive field, 
the National Disease Research Interchange [NDRI], is uniquely 
positioned to serve NIH grantees, as well as the intramural and 
university-based researchers who are finding it increasingly 
difficult to obtain this valuable and effective alternative 
research resource. More than 400 peer-reviewed research 
advances made by NDRI-dependent researchers have been published 
during the past 3 years contributing to the research 
community's fund of knowledge. The Committee is greatly 
encouraged by NDRI's role in these research advances and 
applauds the Director's initial efforts to expand support for 
NDRI by bringing NEI, NIDDK, NIAID, and the Office of Rare 
Diseases into the multi-institute initiative. While this is 
promising, more needs to be done to match the expanding and 
unmet demand for the use of human tissue in research. The 
Committee, therefore, expects the Director to advise the 
Director of NCRR to substantially increase its core support for 
NDRI, and to continue to encourage the Institute Directors NIH-
wide to identify and implement program-specific initiatives to 
expand support for NDRI. The NIH should submit a written 
progress report to the Committee no later than April 1, 2002, 
outlining its plan and action steps to accomplish these goals 
in fiscal year 2002.
    IDeA grants.--The Committee has provided $200,000,000 for 
the Institutional Development Award [IDeA] Program authorized 
by section 402(g) of the Public Health Service Act. This is a 
$100,000,000 increase over fiscal year 2001.
    The Committee urges the NCRR to continue the successful 
Centers of Biomedical Research Excellence program, as well as 
the Biomedical Research Infrastructure Network program. The 
focus of IDeA should continue to be on improving the necessary 
infrastructure and strengthening the biomedical research 
capacity and capability of research institutions within the 
IDeA States.
    Imaging technology.--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.
    Science Education Partnership Awards.--The Committee 
applauds NCRR's demonstrated commitment to the Science 
Education Partnership Awards (SEPA) program and the full 
participation of the Nation's science centers and museums in 
enhancing public awareness of health related research. The 
Committee expects that a portion of NCRR's overall increase 
will be used for a new competition of SEPA grants.

   NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE [CCAM]

Appropriations, 2001....................................     $89,121,000
Budget estimate, 2002...................................     100,059,000
Committee recommendation................................     110,000,000

    The Committee has included $110,000,000 for the National 
Center for Complementary and Alternative Medicine, an increase 
of $9,941,000 above the budget request and $20,879,000 over the 
fiscal year 2001 appropriation. The comparable amounts for the 
budget estimate include funds to be transferred from the Office 
of AIDS Research.
    The Committee strongly supports the work of the National 
Center for Complementary and Alternative Medicine. The Center 
is charged with ensuring that complementary and alternative 
therapies be rigorously reviewed to provide consumers with 
reliable information.
    The Committee expects that funding for existing and new 
Centers supported by NCCAM will be maintained and directs the 
Center to undertake field investigations and a program for the 
collection and evaluation of outcome data on promising 
alternative therapies. The Committee expects NCCAM to expand 
its support of CDC's field investigations program and of AHRQ 
literature reviews and data-analysis efforts. The Committee 
also expects the Center to allocate sufficient funds to develop 
and disseminate a comprehensive set of fact sheets on CAM 
therapies to inform the public and health professionals of the 
state of scientific knowledge about these therapies.
    The Committee also expects the Center to transfer 
sufficient funds 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.
    Plant-based medicinal products.--The Committee supports the 
need to accelerate the development and commercialization of 
plant-based medicinal products, and encourages the NCCAM to 
consider collaborating with plant scientists and companies in 
Hawaii to responsibly use that State's unprecedented 
biodiversity in developing new, health-enhancing products.
    Traditional and indigenous medicine.--The Committee is 
aware that knowledge of traditional and folk medicine is 
rapidly disappearing from areas such as the Appalachian region 
of the eastern United States, and it encourages NCCAM to fund 
studies that preserve indigenous knowledge of the uses of 
medicinal plants and investigate possible scientific bases for 
their efficacy. The Committee further recognizes that the 
moderated harvest of wild medicinal plants is important to 
their availability for future use and recommends that funding 
preference be afforded to those studies that incorporate a 
holistic approach of scientific investigation and resource 
management.

       NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2001....................................    $132,044,000
Budget estimate, 2002...................................     158,421,000
Committee recommendation................................     158,421,000

    The Committee has included $158,421,000 for the National 
Center on Minority Health and Health Disparities, the same as 
the budget request and $26,377,000 over the fiscal year 2001 
appropriation. The comparable amounts for the budget estimate 
include funds to be transferred from the Office of AIDS 
Research.
    Mission.--The NCMHD advises the NIH Director and Institute 
and Center (IC) directors on the development of NIH-wide policy 
issues related to minority health disparities research, 
research on other health disparities, and related research 
training. Among other activities, the NCMHD develops, in 
consultation with the NIH Director, IC directors, and the 
advisory council, a comprehensive strategic plan that 
identifies and establishes objectives, priorities, budgets, and 
policy statements governing the conduct and support of all NIH 
minority health disparities research, research on other health 
disparities, and related research training activities. It also 
administers funds for the support of minority health 
disparities research and other health disparities research, by 
awarding grants and leveraging the programs of the ICs.
    Glomerular injury.--The Committee understands that 
glomerular injury, a group of diseases that affect the 
filtering mechanisms of the kidney, are more prevalent among 
African Americans than the general population. The Committee 
urges NCMHD to explore collaborations with NIDDK to conduct and 
support research activities related to glomerular injury.
    Osteoporosis.--The Committee urges the Center to support 
research that furthers the understanding of the risk factors, 
causes and consequences of osteoporosis among African-American, 
Hispanic, Asian-American and Native American women and men. 
Furthermore, the Center is encouraged to undertake 
epidemiological studies to establish the prevalence of 
osteoporosis among these populations and to determine whether 
FDA-approved drug therapies are as efficacious among these 
populations as in white postmenopausal women and men.

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

Appropriations, 2001....................................     $50,472,000
Budget estimate, 2002...................................      56,446,000
Committee recommendation................................      57,874,000

    The Committee recommends an appropriation of $57,874,000 
for the Fogarty International Center [FIC]. This is $1,428,000 
more than the budget request and $7,402,000 more than the 
fiscal year 2001 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; and third, to help 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.
    Global tuberculosis threat.--The Committee recognizes the 
growing importance of international research and surveillance 
programs with respect to infectious diseases such as 
tuberculosis (TB). The Committee is pleased by the Center's 
research collaboration with international organizations and 
governments on multi-drug-resistant TB, and it encourages the 
Center to continue these important studies. The Committee is 
aware that FIC offers TB supplemental training grants to 
recipients of the AIDS International Training and Research 
Program (AITRP) or the International Training and Research 
Program in Emerging Infectious Diseases (ERID). The Committee 
encourages FIC to develop a specific free-standing TB training 
program.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2001....................................    $245,338,000
Budget estimate, 2002...................................     274,633,000
Committee recommendation................................     281,584,000

    The Committee recommends an appropriation of $281,584,000 
for the National Library of Medicine [NLM]. This is $6,951,000 
more than the budget request and $36,246,000 more than the 
fiscal year 2001 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.
    Bioethical issues.--Since 1985, the NLM has undertaken 
important work in support of information retrieval in bioethics 
and has established an effective and cooperative relationship 
with the National Reference Center for Bioethics Literature at 
the Georgetown University-based Kennedy Institute of Ethics. As 
public policy debates today increasingly include in-depth 
discussion of the bioethical aspects of topics such as the 
oversight of human experimentation, stem cell research, cloning 
and privacy issues surrounding health and genetic records, the 
Committee is particulary aware of the importance of the work 
begun through this partnership. The Committee encourages the 
NLM and the Kennedy Institute of Ethics to maintain and build 
upon this important work.
    Facility expansion.--The Committee is pleased to actively 
support the allocation of the needed funds to complete the full 
design of the NLM facilities expansion. It hopes the design 
will be completed expeditiously so that the burgeoning programs 
of the National Center for Biotechnology Information and the 
growing limits of available space for the world's greatest 
medical collection can be satisfied through new facility 
construction.
    Home medical consultations.--The Committee expects NLM to 
provide sufficient funds for a demonstration to test the use of 
state-of-the-art telemedicine technology for home medical 
consultations. This innovative approach holds 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 and MEDLINEplus databases. 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. 
The Committee continues to be concerned about challenges 
related to access to health information in the rural and other 
medically underserved areas, and it particularly supports NLM's 
efforts to address this through its Internet Connection Grant 
program.
    PubMed Central.--The Committee commends NLM for its 
leadership in developing PubMed Central, an electronic online 
repository for life sciences articles. PubMed Central holds 
great promise for increasing access to health care literature 
by health professionals, students, educators, researchers and 
the general public. 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 it therefore expects NIH to provide 
sufficient funds for a demonstration of a different means to 
that end, such as including Internet access at senior centers 
and congregate meal sites. The Committee expects to be briefed 
on NLM's progress in this area.

                         OFFICE OF THE DIRECTOR

Appropriations, 2001....................................    $188,346,000
Budget estimate, 2002...................................     232,929,000
Committee recommendation................................     236,408,000

    The Committee recommends an appropriation of $236,408,000 
for the Office of the Director [OD]. This is $3,479,000 more 
than the budget request and $48,062,000 more than the fiscal 
year 2001 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 any 
reprogramming of $1,000,000 or more, 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.
    Aphasia.--It has come to the Committee's attention that the 
scientific knowledge of this common and devastating acquired 
speech and language disorder has gone virtually unchanged for 
decades. The Committee, therefore, urges the appropriate 
Institutes and Centers to expand and better coordinate their 
support of research into the cause, incidence, treatment and 
prevention of aphasia. Furthermore, the Committee urges the 
Director to initiate a trans-NIH aphasia research planning and 
coordinating function, charged initially with developing an 
aggressive Aphasia Research Agenda that involves a 
comprehensive state-of-the-science review and a delineation of 
those areas with the most potential for yielding significant 
advances in near-term treatments and rehabilitation 
methodology.
    Asian Indians.--The Committee recognizes that Asian Indians 
worldwide have one of the highest rates of coronary artery 
disease (CAD) and diabetes mellitus (DM) of any community 
around the world, ranging from 2 to 10 times higher in any 
given age range. The Committee understands that while there are 
data in other countries regarding the prevalence of and risk 
factors for CAD and DM of Asian Indians, there is a lack of 
such data in the U.S. The Committee recommends that the 
Director gather and analyze data from Indian-American 
communities to study the prevalence of DM and CAD within this 
population, and to create a registry for a longitudinal study 
to gain insight into effective intervention strategies.
    Asthma and allergic diseases.--Given the widespread 
incidence of asthma and allergies and their high economic toll 
on society, the Committee urges the NIH to consider a 
cooperative effort by the appropriate Institutes and Centers, 
including the NHLBI and NIAID, to encourage and promote 
increased research in these areas.
    Autism.--The Committee urges the Director, in coordination 
with NIAID, NIDCD, NIEHS, NIMH, and NINDS, to continue to fund 
and aggressively encourage researchers to engage in research 
related to the potential causes, treatments, prevention, and 
cure of autism spectrum disorders. In particular, the Committee 
wishes to see the meaningful implementation of the new Centers 
of Excellence in Autism Research, mandated in the Children's 
Health Act of 2000. To that end, the Committee urges the 
Director to allocate sufficient resources to advance the 
scientific and research agenda related to autism spectrum 
disorders.
    Autoimmune diseases.--Autoimmunity is at the root of a 
family of over 80 genetically and clinically interrelated major 
diseases affecting some 50 million Americans. The Committee 
encourages NIH and its Autoimmune Disease Coordinating 
Committee to expand research aimed at improving awareness, 
diagnosis and treatment for the entire family of autoimmune 
diseases. Interrelated disease research will accelerate the 
application of important findings among the many medical 
specialties dealing with autoimmune diseases. The Committee 
encourages NIH to study the overlapping genetics of autoimmune 
diseases in order to improve diagnostic procedures and 
effective treatments.
    Behavioral science.--There is growing public awareness of 
the behavioral underpinnings of disease. Heart disease, lung 
cancer, liver disease, AIDS, suicide, developmental 
disabilities, and many neurological and cognitive disorders in 
some cases 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 its 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.
    Biotechnology.--Over the last decade, there has been an 
enormous growth in development of products from biotechnology. 
With the nearing completion of the Human Genome Project and the 
development of many new biological techniques, there are still 
a large number of untapped areas of research that may produce 
cures for many debilitating diseases. The Committee encourages 
the Director to explore new projects that link government, 
academia and industry, and involve public-private partnerships 
across traditionally separated disciplines including genetics, 
nano-technology, material sciences, physics, biology and 
chemistry.
    Child abuse and neglect.--The Committee recognizes the 
significance of child abuse and neglect as a serious public 
health problem claiming an estimated 826,000 victims in 1999, 
according to the most recent data reported by the Department of 
Health and Human Services. In 1996, the Committee called upon 
NIH to develop a research agenda designed to address the 
problems and gaps that currently exist in the State of research 
in child abuse and neglect. The Committee encourages NIH to 
proceed at a high level of attention with addressing the 
research agenda with which it began in examining the National 
Research Council report entitled Understanding Child Abuse and 
Neglect, and requests that the working group be prepared to 
report on current NIH research efforts in this area, the 
accomplishments of that research, and on plans for future 
coordination efforts at NIH at the fiscal year 2003 hearings.
    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, aural atresia, and 
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 
develop a comprehensive action plan targeting these conditions.
    Chronic fatigue syndrome (CFS).--Despite the Committee's 
supportive report language for CFS research and generous 
funding increases to NIH overall, CFS funding has not 
increased. The Committee is pleased by NIH's efforts toward 
elevating the prominence of CFS, such as moving the CFS program 
to the Office of the Director, revitalizing the internal NIH 
CFS Working Group, and holding two ``State of the Science'' 
conferences on CFS. In fiscal year 2001, the NIH developed a 
program announcement to solicit applications in the priority 
areas identified by the 2000 CFS State of the Science meetings, 
and its next priority task will be to work on building a 
multifaceted intramural research project.
    Clinical research loan repayment.--The Committee is 
concerned about the declining numbers of physician-scientists 
pursuing careers in clinical research. In 1994, the Institute 
of Medicine recommended the creation of an NIH extramural loan 
repayment program. Last year, the Congress authorized the 
program in the Clinical Research Enhancement Act. The Committee 
believes that this program is critically important and that 
tuition loan repayment should be made available to the largest 
possible number of health professionals who are pursuing 
structured training experience in clinical research; actively 
engaged in clinical research career development activities with 
the guidance of a mentor; or conducting clinical research with 
independent support from NIH.
    Collaboration with the CDC.--The Committee urges the Office 
of Behavioral and Social Sciences Research (OBSSR) to develop a 
working group or groups in collaboration with the Centers for 
Disease Control in order to speed translation of behavioral 
research to practice. The Committee recognizes that without 
dedicated resources it is difficult for staff in different 
agencies to collaborate as closely as may be needed. NIH is 
urged to use its increased funding to intensify collaboration, 
as well as facilitate communication and the transfer of 
information.
    Epilepsy.--The Committee recognizes that while the NINDS is 
the primary Institute for addressing epilepsy, several other 
Institutes are also involved in related research. As 75 percent 
of epilepsy cases begin in childhood, the NICHD has an 
important role to play in studying this disease. So, too, does 
the NHGRI, which is urged to assist the NINDS in the search for 
a genetic fingerprint diagnostic test aimed at improving drug 
therapy for epilepsy, and the NIMH, which is urged to explore 
the link between epilepsy and mood disorders, both of which are 
often treated with anticonvulsant medications. Finally, the NIA 
is encouraged to examine epilepsy in patients over age 65. The 
Committee urges the Director to coordinate research efforts 
among all these Institutes through an Interagency Epilepsy 
Coordinating Committee that includes agency scientists and 
industry and patient representatives.
    Graduate Training in Clinical Investigation Awards.--The 
Committee is pleased that the NIH has initiated the Clinical 
Research Curriculum Awards to improve the quality of training 
in clinical research. However, it is clear that a shortcoming 
of this program is the absence of support for tuition and 
stipends for the individual students. Last year, the Congress 
addressed this by authorizing the Graduate Training in Clinical 
Investigation Awards in the Clinical Research Enhancement Act. 
The Committee believes that these grants are necessary if the 
Curriculum Awards are to fulfill their enormous potential to 
replenish the supply of well-trained clinical investigators.
    Information technology.--Advances in information technology 
make it possible to build powerful software-based simulations 
that integrate the information emanating from medical and 
biological science in ways that greatly enhance research, 
education and training and medical practice. The Committee 
urges the Director to facilitate the development and use of 
these new tools by leading a national effort to ensure that 
software components for simulations developed by NIH 
contractors and by other Federal agencies can interoperate and 
easily be improved and reused. The Director should also 
encourage researchers to form an open-source community that 
would facilitate sharing of software components and ensure 
thorough peer review and testing of simulations against 
empirical data. The Committee also urges the Director to 
coordinate NIH's activities with other Federal agencies 
including the National Science Foundation, the Department of 
Defense and DARPA, and NASA.
    Juvenile arthritis.--The Committee urges the Director, in 
collaboration with the NIAMS, NICHD, and NIAID, to strengthen 
its investment in and commit additional resources to basic, 
clinical, and translational research efforts and related 
activities specific to juvenile arthritis as authorized by the 
Children's Health Act.
    Lyme disease.--The Committee recommends that the NIH 
improve its communication across Institutes in order to better 
coordinate Lyme disease research and outreach to public and 
private scientists with the goal of stimulating research 
interest in this field. The Committee encourages the Office of 
the Director to involve NIAID, NHLBI, NINDS, NEI, NIMH, and 
NCCAM in promising areas of research. The Committee urges NIH 
officials to identify appropriate NIH advisory committees for 
Lyme disease representation and ensure the appointment of 
qualified persons. The NIH is encouraged to include a broad 
range of scientific viewpoints in the process of planning and 
executing these efforts, including community-based clinicians 
with extensive experience in treating these patients, voluntary 
agencies who have advocacy in their mission, and patient 
advocates.
    Microbicides research.--The Committee is supportive of 
increased funding for microbicide research and product 
development through the OAR, NIAID, NICHD, NIMH, NIDA, and 
ORWH. The Committee urges NIH to begin implementation of the 5-
year strategic plan for microbicide research, development and 
evaluation in coordination with other Federal agencies. To 
accelerate that implementation, the Committee encourages NIH to 
increase the number of full-time employees dedicated to work 
encompassed by the plan. The Committee requests a report by 
March 31, 2002, on the status of its new microbicides program, 
including research efforts, funding and staffing levels, and 
implementation of the strategic plan.
    Mississippi Delta.--The Committee urges the NIH to pursue a 
comprehensive medical research agenda with academic 
institutions in the Mississippi Delta that have partnered 
together to develop initiatives and research projects focusing 
on the disproportionate disease-risk factors and high rates of 
morbidity in this health-challenged region. Though this area 
leads the Nation in several chronic disease categories, the NIH 
has not conducted any systematic study of the region. The 
Committee requests that the Director report to the Committee by 
March 1, 2002, on what comprehensive study should be 
undertaken, when the research will begin, and with what 
institutions the NIH will partner.
    Neurofibromatosis.--The Committee recognizes that 
neurofibromatosis (NF) research involves many Institutes and 
Centers, including NCI, NINDS, NHLBI, NEI, NIDCD, and NIAMS. 
The Committee urges the Director to develop a plan to identify 
new research opportunities regarding NF that cuts across 
Institutes and Centers. The Committee encourages the Director 
to intensify and expand its NF research portfolio, and to work 
with NF advocacy groups when identifying and pursuing new 
scientific opportunities that will ultimately allow for the 
development of effective treatments of NF.
    NIH/DOE Medical Technology Partnership.--The Committee 
urges the 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 use of dietary 
supplements has increased significantly among Americans who 
want to improve their health and prevent disease, and there is 
a great need for additional research to better inform consumers 
of the benefits of these supplements. The Committee expects the 
Office to allocate sufficient funds to expand the number of 
botanical research centers, and it urges that hypericum and 
echinacea be studied at one of these new centers.
    The Committee has included sufficient funds to speed up 
ongoing collaborative efforts to develop, validate, and 
disseminate analytical methods, and reference materials for the 
most commonly used botanicals and other dietary supplements.
    The Committee is pleased that the ODS has followed through 
on its recommendation to begin a major research initiative on 
the safety and efficacy of products containing ephedra, and it 
urges the Office to continue and expand this important effort. 
The results of this expanded research should be evaluated by 
the FDA to ensure that any final action on the proposed rule on 
products containing ephedrine alkaloids is based on sound 
science. The Committee believes the Department should 
immediately take necessary interim action that addresses 
scientifically supportable safety activities (such as adopting 
appropriate warning labels that include contraindications and 
warn against sales to minors) while this research is being 
completed.
    Office of Research on Women's Health.--The Office of 
Research on Women's Health (ORWH) works in collaboration with 
the Institutes and Centers (ICs) of the NIH to promote and 
foster efforts to address gaps in knowledge related to women's 
health through the enhancement and expansion of funded research 
and the initiation of new investigative studies. The ORWH is 
responsible for ensuring the inclusion of women in clinical 
research funded by the NIH, including the development and 
implementation of a computerized tracking system and the 
implementation of guidelines on such inclusion. The Office is 
also involved in promoting programs to increase the number of 
women in biomedical science careers, and in developing women's 
health and sex and gender factors in biology as a focus of 
medical/scientific research. The Committee urges the Director 
to use the increased funds provided to ORWH for new research 
activities in a variety of health issues and new and expanded 
career development programs for women scientists, such as 
Building Indisciplinary Research Careers in Women's Health. In 
addition, the Committee strongly supports the creation of new 
interdisciplinary research centers to focus on multi-systemic 
diseases in women, and urges ORWH, in conjunction with the NIH 
ICs, to move forward with this proposal without delay. The 
Director is asked to present a progress report to the Committee 
by April 1, 2002.
    Omega-3 fatty acids.--The Committee is aware of promising 
research showing significant positive heart health effects 
related to the consumption of omega-3 fatty acids through foods 
or supplements. Given the significant human and financial costs 
associated with coronary heart disease, the Committee urges the 
Office to begin preliminary work on a major assessment of the 
health benefits of omega-3 fatty acid consumption.
    Parkinson's disease.--In consultation with the extramural 
research community, the NIH has developed a Parkinson's Disease 
Research Agenda that would require an estimated $1,000,000,000 
increase in funding over 5 years to carry out. It is the clear 
intent of the Committee that the NIH seek to implement this 
research agenda, and that the Office of the Director assume an 
aggressive leadership role in this effort.
    Last year, the Congress strongly urged the NIH to work 
toward implementing Year 1 of the research agenda, which cited 
the need for a $71,400,000 increase in Parkinson's research 
funding. The Committee is concerned that the NIH did not meet 
that goal. As a consequence, much of the agenda remains to be 
undertaken, and this highly promising field of research is not 
moving ahead as speedily as the Congress intended.
    An estimated $143,500,000 increase over the baseline year 
would be needed to implement Year 2 of the research agenda, and 
the Committee has provided additional funds for that purpose. 
In order to ensure full implementation and funding, the 
Committee directs the NIH to host a series of consortia in 
collaboration with the Parkinson's research-related Institutes 
and the extramural research community by February 15, 2002. The 
consortia shall identify, to the full extent of available 
scientific opportunity, the research needed to implement the 
Research Agenda and the funding mechanism and dollars necessary 
for each area. The Committee requests the Director to report by 
March 15, 2002, that the consortia have been held, and on the 
specific steps the NIH will take to implement the Research 
Agenda.
    The Committee commends the NIH for encouraging and 
supporting workshops and other collaboration between sectors of 
the Parkinson's research community, including the NIEHS-
supported consortia and the NINDS-supported workshop on gene 
therapy, and encourages similar collaborative models. The 
Committee also urges the NIH to continue support of the Udall 
Centers program and to continue expansion thereof.
    Pediatric research initiative.--The Committee is aware that 
the Children's Health Act of 2000 authorized the establishment 
of the Pediatric Research Initiative within the Office of the 
NIH Director, for the purpose of encouraging an increased 
emphasis on research addressing children's illnesses and 
conditions across the various Institutes and Centers. The 
Committee urges the Office of the NIH Director to carry out the 
Initiative, including supporting training for pediatric 
researchers, as authorized by Title X of the Children's Health 
Act. The Committee requests NIH to provide a report to the 
Committee by April 1, 2002, on the pediatric research 
activities supported with these Initiative funds.
    Pediatric Research Loan Repayment.--The Children's Health 
Act of 2000 established the Pediatric Research Loan Repayment 
Program to ensure the future supply of researchers dedicated to 
the care and research needs of children. The Committee urges 
NIH to use this program to encourage promising investigators to 
enter various areas of pediatric research, particularly in the 
areas of Duchenne muscular dystrophy and fragile X. The 
Committee requests that the Director prepare a report, by April 
1, 2002, detailing the progress of this program.
    Population-based prevention research.--The Committee urges 
NIH to significantly expand its support for studies that 
examine the biological, behavioral and environmental risks for 
disease. The Committee is especially interested in the 
assessment of prevention-focused interventions designed to 
enhance health status, the exploration of heath disparities 
across population subgroups, the examination of strategies 
designed to move the findings of laboratory-based research from 
individuals to population-wide applications, and the 
exploration of the potential uses of communication technologies 
to enhance human health. The Committee urges NIH to submit a 
report to the Committee by April 1, 2002, that indicates total 
dollars spent on population-based prevention research by 
Institute and relevant disease areas where possible.
    Resuscitation research.--Some 600 Americans die each day 
from cardiac arrest. The Committee understands that 
cardiopulmonary and trauma resuscitation techniques have only 
about a 10 to 15 percent success rate, and the average survival 
rate has not improved significantly over the last four decades. 
The Committee is pleased that the NHLBI, the NINDS, the NICHD, 
the NIGMS, the Department of Defense, and the Food and Drug 
Administration supported a forum to set a broad research agenda 
on novel life-saving therapies and to identify promising new 
directions in CPR and trauma resuscitation research. The 
Committee encourages these agencies to pursue these new areas 
of investigation.
    Sjogren's syndrome.--Sjogren's syndrome is an autoimmune 
disease with significant impact, and the Committee recommends 
that the NIH Autoimmune Diseases Coordinating Committee include 
Sjogren's syndrome as a priority in its strategic plan. 
Sjogren's crosses many specialties and falls under the auspices 
of many NIH institutes, including the National Institute of 
Arthritis and Musculoskeletal and Skin Diseases, the National 
Institute of Allergy and Infectious Diseases, the National 
Institute of Dental and Craniofacial Research, and the National 
Eye Institute. The Committee recognizes the need for NIH to 
develop an integrated plan to cover Sjogren's syndrome that 
cuts across the Institutes and meets the diverse needs of 
Sjogren's patients.
    Summer Student Research Program.--The Committee is aware of 
the highly successful ``Summer Student Research Program,'' 
administered through Children's Research Institute at 
Children's Hospital in Columbus, Ohio, that addresses the 
critical shortage of physician-scientists in pediatrics--a 
shortage that is far more acute in pediatrics than in adult 
medicine. This program should be made permanent due to its 
success in placing highly-qualified medical students in summer 
research experiences in pediatrics and due to its outstanding 
track record of including under-represented minorities and 
women. Since 1991 there have been 1,183 applications to the 
program, and 370 students from more than 80 different medical 
schools have been successfully placed in nearly 140 
laboratories throughout the United States and Canada. One-
fourth of awardees have been from under-represented minorities, 
and women awardees have outnumbered men by more than 1.5 to 1.
    Systems and integrated biology.--The Committee recommends 
increased support for research and training in whole-systems 
pharmacology, physiology, toxicology, and other integrative 
biological disciplines that help to define the effects of 
therapy on disease and the overall function of the human body. 
Over the past two decades, there has been an emphasis on 
supporting research and training at the cellular and molecular 
levels, but diminished support for training and research in 
systems and integrated biology. The erosion of support in the 
area of integrated systems threatens to slow the rate at which 
fundamental discoveries made at the cellular and subcellular 
levels are translated into useful therapies. The Committee 
understands that the Center for Scientific Review (CSR) is 
currently reorganizing its peer review panels. It hopes that 
the CSR will ensure that scientists with whole-systems 
expertise will be represented on those panels.
    Tobacco products.--The Committee urges that the NIH, 
including NCI, NIDA, NHLBI, and NIMH, increase its commitment 
to tobacco-related research, especially regarding cigarette 
design, including ingredients and constituents. There is a 
growing concensus in the scientific community that cigarettes 
could be made less toxic and that changes in tobacco products 
could reduce the risk of the disease and death in people who 
continue to use them. However, there are major gaps in the 
science base necessary for guiding such efforts. For example, 
research is needed to understand the impact of tobacco product 
variations on the development of cancer, heart disease, brain 
diseases, fetal growth and nicotine addition itself. A specific 
request for research applications, along with support for 
intramural researchers to conduct such research, would 
accelerate the process of discovery and cultivation of 
expertise on this critical subject.
    Temporomandibular joint disorders (TMJ).--The Committee 
recognizes that the problems associated with temporomandibular 
diseases and disorders involve many Institutes and Centers, 
including the National Institute of Dental and Craniofacial 
Research, the National Institute of Arthritis and 
Muscoloskeletal and Skin Diseases, the National Institute of 
Allergy and Infectious Diseases, and the National Institute of 
Biomedical Imaging and Bioengineering. The Committee calls on 
the Office of the Director to coordinate cross-cutting research 
by the various Institutes and Centers and provide a report 
directly to the Committee by April 1, 2002, on TMJ initiatives 
begun in fiscal year 2001 or scheduled to begin in fiscal year 
2002. In addition, a Special Emphasis Panel should be 
established to review applications in the multiple disciplines 
applied to studies of the causes, manifestations and treatments 
of temporomandibular diseases and disorders.
    Veterans affairs cooperation.--The VA system of 173 
hospitals and 771 clinics provides medical care for the full 
array of diseases and medical conditions to 4.1 million 
veterans. The Committee, therefore, believes that the VA system 
is an ideal setting for large multi-center studies and clinical 
trials and that NIH should more aggressively utilize this 
resource to facilitate and accelerate research. The Committee 
requests that NIH explore with the VA ways to increase 
cooperative research efforts and develop an interagency 
Memorandum of Understanding to accomplish this purpose and 
report to the Committee by April 1, 2002, on the projects 
initiated under this move.

                        BUILDINGS AND FACILITIES

Appropriations, 2001....................................    $153,761,000
Budget estimate, 2002...................................     236,600,000
Committee recommendation................................     306,600,000

    The Committee recommends an appropriation of $306,600,000 
for buildings and facilities [B&F]. The amount recommended is 
$70,000,000 more than the budget request and $152,839,000 more 
than the fiscal year 2001 appropriation. Included in these 
funds is $70,000,000 to be transferred to the Global Fund to 
fight HIV/AIDS, Malaria, and Tuberculosis.
    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, 2001....................................................
Budget estimate, 2002...................................................
Committee recommendation................................................

    The Committee recommendation does not include a direct 
appropriation for the Office of AIDS Research [OAR]. 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.

       Substance Abuse and Mental Health Services Administration

Appropriations, 2001....................................  $2,963,856,000
Budget estimate, 2002...................................   3,029,456,000
Committee recommendation................................   3,073,456,000

    The Committee recommends $3,073,456,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 2002, an increase of $109,600,000 over the fiscal 
year 2001 level and $44,000,000 more than the administration 
request. SAMHSA is responsible for supporting mental health 
programs and alcohol and other drug abuse prevention and 
treatment services throughout the country, primarily through 
categorical grants and block grants to 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 
Hawaiian 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 within 
CSAP and CSAT to continue supporting projects that increase 
knowledge about effective ways to deliver services to rural and 
native communities. The Committee believes that Community 
Health Centers should be utilized in this effort.
    The Children's Health Act of 2000 reauthorized programs 
administered by the SAMHSA and created new program authorities 
designed to address emerging mental health, alcohol and other 
drug abuse issues. The Committee has provided funding for 
programs of regional and national significance under each of 
the three SAMHSA centers: mental health services, substance 
abuse treatment and substance abuse prevention. Separate 
funding is available for the children's mental health services 
program, projects for assistance in transition from 
homelessness, the protection and advocacy program, data 
collection activities undertaken by the Office of Applied 
Studies and the two block grant programs: the community mental 
health services block grant and the substance abuse prevention 
and treatment block grant.

                   CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2001....................................    $782,048,000
Budget estimate, 2002...................................     766,148,000
Committee recommendation................................     787,148,000

    The Committee recommends $787,148,000 for mental health 
services, $5,100,000 more than last year's level and 
$21,000,000 more than the budget request. Included in this 
amount is funding for programs of regional and national 
significance, the mental health performance partnership block 
grant to the States, children's mental health services, 
projects for assistance in transition from homelessness, and 
protection and advocacy services for individuals with mental 
illnesses. The Committee continues to support funding for 
mental health counselors for school-age children, as part of an 
effort to reduce the incidence of youth violence. The Committee 
intends that $90,000,000 be used for counseling services for 
school-age youth.

Programs of regional and national significance

    The Committee recommends $203,599,000 for programs of 
regional and national significance, $5,100,000 more than the 
fiscal year 2001 amount and $21,000,000 more than the 
administration's request. Programs of regional and national 
significance address priority mental health needs through 
developing and applying best practices, offering training and 
technical assistance, providing targeted capacity expansion 
grants, and changing the delivery system through family, 
client-oriented and consumer run activities.
    The Committee has again included resources to continue and 
expand mental health services for schoolchildren that are at 
risk of exhibiting violent behavior. Among other things, the 
Committee believes that mental health counseling for troubled 
youth can help prevent violent acts, and therefore is providing 
additional resources to help schools in that effort. It is 
again expected that SAMHSA will collaborate with the 
Departments of Education and Justice to continue a coordinated 
approach.
    The Committee is concerned that the Agency's funding of 
health services knowledge development for the mental health of 
the elderly has not kept pace with its funding for other 
populations. For example, CMHS does not have any projects 
planned to assess how health care systems impact access to 
quality mental health for the elderly population. The Committee 
strongly encourages CMHS to devote additional resources in 
fiscal year 2002 and subsequent fiscal years to this issue, and 
urges the Director of CMHS to designate an individual within 
the Office of the Director to oversee the Center's aging 
knowledge development agenda and initiatives. Special priority 
should be given to funding dissemination and implementation of 
evidence based practices in real world health care settings.
    The Committee is aware of the need for additional suicide 
prevention activities and is impressed with the Surgeon 
General's report, ``A National Strategy for Suicide Prevention: 
Goals and Objectives for Action'', which was released in May 
2001. The passage of S. Res. 84 and H. Res. 212 in the 105th 
Congress recognized suicide as a national problem and declared 
suicide prevention to be a national priority. Since then, the 
Committee is encouraged by the progress being made through the 
collaborative efforts of both the public and private sectors to 
raise national awareness on suicide prevention, to develop a 
national suicide prevention strategy, and to involve States in 
the development of State plans for grassroots implementation to 
continue reducing the rate of suicide in America. Preliminary 
data from the National Center for Health Statistics for 1999 
suggest that these collective efforts have had a positive 
impact. The number of suicides in the United States decreased 
more than 5 percent from 30,575 in 1998 to 29,041 in 1999. 
Nevertheless, suicide remains a serious public health challenge 
and more needs to be done.
    The Committee commends the joint efforts of the SAMHSA/
CMHS, NIH/NIMH, CDC, and HRSA to launch a website resource 
which provides a wide array of suicide prevention related 
information and resources for mental and public health 
professionals, health care providers, community coalitions, 
policymakers, survivors, and advocates. Significant activity is 
now ongoing at the State, community, and non-profit levels in 
developing and implementing plans, programs and services. This 
follows the guidance outlined in the National Strategy for 
Suicide Prevention: Goals and Objectives for Action (NSSP). 
Further, the NSSP recommends the development of one or more 
training and technical resource centers to build capacity for 
States and communities to implement and evaluate suicide 
prevention programs. The Committee has included $3,000,000 to 
build upon the work of the Agencies identified above by 
establishing a National Suicide Prevention Resource Center to 
provide technical assistance in developing, implementing and 
evaluating effective suicide prevention programs. The Resource 
Center will provide training and field support and serve as a 
clearinghouse for all pertinent best practices information 
regarding suicide prevention. The Center should promote 
evaluation of suicide prevention programs to ensure that 
effective techniques, strategies, and recommended best 
practices are made available to users.
    Hawaii has a large refugee immigrant population that has 
been found to be suffering from a disproportionately high 
amount of post-traumatic stress disorder. Because of the 
multiple diverse cultures that these future citizens come from 
and the fact many speak no English, it is very difficult to 
meet their mental health needs. The Committee urges attention 
be given to effectively resolving the mental health problems of 
these future citizens.
    The Committee recommendation includes funding for the Safe 
Schools/Healthy Students Program, which supports the 
Departments of Health and Human Services, Justice, and 
Education, 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 urges the use of community health 
centers as part of this effort.
    The Committee commends CMHS for its efforts to reduce 
stigma and other barriers that discourage Americans from 
seeking mental health services. The Committee is aware that 
fewer than one-third of Americans with a diagnosable mental 
disorder seek out services and notes the recent Surgeon General 
finding that stigma is a barrier that both discourages people 
from obtaining treatment and promotes discrimination against 
the mentally ill. The Committee understands that the National 
Mental Health Awareness Campaign has launched a very successful 
youth initiative designed to reduce the fear and shame 
associated with childhood mental disorders. The Committee 
believes that a nationwide public service advertising campaign 
combating stigma among adults and senior citizens could have a 
positive effect on public attitudes and behaviors.
    The Committee is aware of the significant steps CMHS has 
taken to improve services to those living with and suffering 
from HIV/AIDS and has included sufficient funding to continue 
these efforts. The Committee recognizes the need for more 
trained health providers, including allied health professionals 
and social workers, to work with people suffering from HIV/AIDS 
and commends the collaborative effort of CMHS, HRSA, NIMH, 
NIAAA and NIDA to address this issue. The Committee also notes 
the support CMHS has provided to community-based initiatives to 
deliver direct mental health services for people living with 
HIV/AIDS. These HIV/AIDS activities should continue to develop 
and apply new knowledge that improves the quality of services 
available.
    The Committee recommendation includes resources for 
Targeted Capacity Expansion (TCE) activities to develop and 
implement empirically based models for prevention and early 
intervention for children's mental health problems. The 
Committee recognizes that the increased number of young 
children diagnosed with mental disorders, the rising teen 
suicide rate, and the recent incidents of school violence are 
all indicators that our Nation's children and youth have 
serious unmet mental health needs.
    The Committee appreciates CMHS's commitment to improving 
the quality, effectiveness and availability of therapeutic 
services delivered to traumatized children and adolescents; 
furthering the understanding of the individual, familial, and 
community impact of child and adolescent traumatic stress and 
the methods used to prevent its consequences; and reducing the 
frequency and consequences of traumatic events on children and 
adolescents. The Committee recommendation includes sufficient 
funding to expand activities of the Child Traumatic Stress 
Program.
    The Committee notes that the Minority Fellowship Program 
(MFP) plays a crucial role in reducing the racial and ethnic 
disparities in mental health status in Native Hawaiian and 
Samoan communities. The MFP plays a significant role in 
training minority mental health professionals to provide 
services, through community health centers and other clinics, 
to individuals who would otherwise go untreated.
    The Committee is pleased that the Center for Mental Health 
Services funds state-of-the-art, peer-run programs that help 
people with mental illnesses live successfully in the 
community. These low-cost services have an impressive record of 
assisting people with mental disorders to decrease their 
dependence on expensive social services and avoid 
hospitalization. The Committee is supportive of CMHS's funding 
of five national technical assistance centers that provide 
training and information to help these programs serve their 
clients.
    The Committee is aware of the following projects and 
programs, and encourages SAMHSA to give each full and fair 
consideration for awards available in new grant competitions.
    Expansion of Phase II of the HIV/AIDS High Risk Behavior 
Prevention Program will help reduce the behavioral transmission 
of the virus and support mental health services to those 
persons already infected with the disease.
    The Comprehensive Community Mental Health Services for 
Children and their Families program will continue the 
development and evaluation of mental health services for 
children and youth in States and localities using community 
health centers.
    Life Quest Community Mental Health Center, which serves the 
second largest population center in Alaska, is seeking to fill 
the previously unmet need for treatment of co-occurring 
disorders for severely and persistently mentally ill, severely 
emotionally disturbed adults and children in the Mat-Su Valley 
region of Alaska.
    Ventura County, California has developed its capacity to 
effectively transition mentally ill prisoners out of detention 
facilities and into a community treatment environment.
    The Pennington County Detention Center in Rapid City, South 
Dakota has experienced significant growth in the number of 
detainees in need of mental health and substance abuse 
treatment services.
    The Weingart Center in Los Angeles, California will develop 
and expand mental health support and long-term case management 
within transitional housing and clinical programs to help end 
poverty and break the cycle of homelessness.
    Washoe County, Nevada will develop a suicide prevention 
program designed to investigate the effect of an Intensive 
Depression Recognition and Treatment Training Program for 
primary care physicians and their nurses, psychiatrists, and 
corporate and student health personnel on the recognition of 
mood disorder, suicide mortality and morbidity.
    The Texas Medication Algorithm Project (T-MAP) has 
developed a disease management program that synthesizes 
scientific and practitioner consensus into a practical 
guideline for physicians, and also has demonstrated 
improvements in the quality of care for individuals receiving 
psychotropic medications.
    The Mental Health Connection of Tarrant County, Texas, is 
planning a collaborative initiative to provide families and 
individuals with a seamless, accessible ``wraparound'' system 
of community mental health services.
    The Fairbanks Native Association, Tanana Chiefs Conference, 
and the University of Alaska Fairbanks' ``Ch'eghutsen'' 
comprehensive mental health services program for children in 
interior Alaska is addressing the critical shortage of 
culturally relevant mental health services for children, 
especially those who are seriously emotionally disturbed, in 
the vast area which comprises interior Alaska. Ch'eghutsen is 
guided by Alaska Native principles which view the child as 
inseparable from family and community, and is addressing 
suicide attempts, substance abuse, fetal alcohol syndrome and 
fetal alcohol effect, sexual abuse, violence, and individual 
and collective trauma for the more than 600 Alaska Native 
children who are estimated to suffer from serious emotional 
disturbances in this region.
    The Alaska Psychiatric Institute and the State of Alaska 
will continue designing programs to treat co-occurring 
disorders and focus efforts on developing treatments for 
victims and witnesses of domestic violence and child abuse, a 
considerable problem in Alaska, which has the highest rates of 
child abuse and domestic violence in the Nation.
    The Alaska Federation of Natives, in consultation with the 
State of Alaska, continues to develop integrated systems of 
community care for Alaska Native children who commit suicide at 
the highest rate in the Nation and suffer disproportionately 
from behavioral and mental disorders, some caused by fetal 
alcohol syndrome.
    The Alaska Federation of Natives, in consultation with the 
State of Alaska, will develop a plan for outreach, screening 
and diagnostic treatment services, rehabilitation, mental 
health services, alcohol and drug treatment, training, and case 
management to help reduce the large numbers of individuals, 
particularly Alaska Natives, suffering from severe mental 
illness and substance abuse disorders who are also homeless. 
This problem is especially acute in Anchorage, Alaska.
    Family Communications and its pilot project, ``What Do You 
Do with the Mad that You Feel?'' has provided encouraging 
evidence of success in preventing youth violence. Family 
Communications proposes to expand this initiative beyond the 
original pilot States and plans to introduce a follow-up 
program, ``The Challenging Child.''
    The 2nd Trauma project, an initiative designed to help over 
7 million families each year who receive the news of the 
sudden, unexpected violent death or critical injury of their 
child, spouse, parent or other loved one, has developed a 
program to train trauma center and emergency room personnel to 
develop the skills needed to tell a family member that a loved 
one has suffered a traumatic injury or death, prepare personnel 
to provide immediate and sensitive counseling on critical 
decisions, and engage long-term community support networks when 
appropriate.
    Safe Havens, an award-winning training program for care 
givers and teachers, aims to help adults counsel children who 
have witnessed violence and plans to expand its training beyond 
the pilot States of Pennsylvania, Iowa, Massachusetts, 
Maryland, and New York.
    The Alaska Federation of Natives, in consultation with the 
State of Alaska, will identify the most effective service 
delivery practices and develop model programs for 
implementation in the Alaska Native community that help reduce 
the rates of suicide, child abuse, and alcohol dependency, 
especially in Native communities. Alaska has the highest rates 
of alcohol dependency in the Nation, the highest rate of 
suicide, and the highest rate of child abuse, especially in 
Native communities in Alaska.

Mental health performance partnership block grant

    The Committee recommends $420,000,000 for the mental health 
performance partnership block grant, the same amount as the 
fiscal year 2001 appropriation and the budget 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 and 
territories by formula.

Children's mental health services

    The Committee recommends $91,694,000 for the children's 
mental health services program, the same amount as the fiscal 
year 2001 level and 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. Grantees must 
provide matching funds, and services must involve the 
educational, juvenile justice, and health systems.
    The Committee has provided sufficient resources to expand 
the child mental health services program over the past several 
years. However, staff resources dedicated to administering this 
program have not grown. The Committee recognizes the benefit of 
providing sufficient staff support to ensure that local 
grantees have the technical capacity to operate this program 
effectively.

Projects for assistance in transition from homelessness [PATH]

    The Committee recommends $39,855,000 for the PATH Program, 
an increase of $3,000,000 over the fiscal year 2001 amount and 
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 $32,000,000 for the protection and 
advocacy program, an increase of $2,000,000 over the fiscal 
year 2001 amount and the administration's request. This program 
helps ensure that the rights of mentally ill individuals are 
protected while they are patients in treatment facilities, or 
while they are living in the community, including their own 
homes. Funds are allocated to States according to a formula 
based on population and relative per capita income.
    The Committee notes the Children's Health Act of 2000 
provided additional authorities to State P&A systems in their 
efforts to protect the rights of individuals with mental 
illness and severe emotional impairment. This includes the 
specific authority to monitor all public and private 
residential care and treatment facilities and non-medical 
community-based facilities for children and youth to ensure 
that they are not at risk for inappropriate use of seclusion 
and restraint and to investigate all incidents involving 
serious injuries and deaths related to incidents of seclusion 
and restraint used by staff at these facilities. State P&A 
systems also have a significant role in addressing the 
community integration needs of individuals identified in the 
Olmstead decision. The Committee recommendation includes 
$2,000,000 more than last year's appropriation to support State 
P&A systems in their effort to address these critical issues.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2001....................................  $1,921,122,000
Budget estimate, 2002...................................   2,021,122,000
Committee recommendation................................   2,001,122,000

    The Committee recommends $2,001,122,000 for substance abuse 
treatment programs, an increase of $80,000,000 over last year's 
funding and $20,000,000 less than the budget request. This 
amount funds substance abuse treatment programs of regional and 
national significance and the substance abuse prevention and 
treatment block grant to the States.
    The Committee is concerned about the treatment gap that 
continues to exist for those Americans in need of substance 
abuse treatment services, for whom treatment is not available. 
The latest estimates indicate that millions of Americans with 
serious substance abuse treatment go untreated each year, 
adding billions in monetary costs to our society each year and 
immeasurable emotional pain and suffering for millions of 
families. Studies have shown that substance abuse treatment is 
effective at reducing primary drug use by nearly 50 percent, 
criminal activity by 80 percent and alcohol- and drug-related 
medical visits by 50 percent while increasing individual 
financial self-sufficiency. The Committee commends CSAT for 
initiating its National Treatment Plan Initiative (NTP), and 
believes that additional resources need to be devoted to the 
NTP and to reducing, and eventually eliminating, the treatment 
gap.

Programs of regional and national significance

    The Committee recommends $276,122,000 for programs of 
regional and national significance [PRNS]. This amount is 
$20,000,000 above the fiscal year 2001 amount and $20,000,000 
less than the budget request.
    Programs of regional and national significance, as 
reauthorized by the Children's Health Act of 2000, include 
three primary activities: knowledge development and application 
projects are used to develop more information on how best to 
serve those most in need; training and technical assistance 
supports dissemination of information through knowledge 
development; and targeted capacity expansion programs enable 
the agency to respond to service needs in local communities.
    The Committee recommendation includes $10,000,000 to expand 
CSAT's support of clinically based treatment and related 
services for adult, juvenile and family drug courts and 
individuals returning from the community who are on probation, 
parole, or unsupervised release. The Committee is aware of the 
rapid increases in the use of drug courts throughout the 
country as an alternative to the traditional court system. 
These courts make substance abuse treatment available, when 
appropriate, as an alternative to incarceration, and are 
considered a cost-effective approach to helping drug users 
regain control of their lives. While the fiscal year 2002 
appropriation for CSAT includes additional resources for 
treatment, the Committee notes that support for treatment 
services has not kept pace with the increase in the use of drug 
courts, thereby limiting the cost-effectiveness of this 
approach. The Committee also believes SAMHSA should work with 
the Department of Justice (DOJ) to ensure that administrative 
and drug testing costs associated with sanctions-based 
treatment for individuals under DOJ supervision are distributed 
fairly.
    Programs of regional and national significance include 
critical support for substance abuse treatment services for the 
Nation's homeless population. The homeless have unique needs 
and life circumstances that have received inadequate attention 
in terms of substance abuse treatment. Therefore, the Committee 
continues to advocate coordinated and seamless service delivery 
for the homeless that includes mental health, primary care, and 
other social services that will support positive treatment 
outcomes. The Committee recommendation includes additional 
resources to continue to make progress in this area.
    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, as well as other emerging drug issues. The Committee 
recommendation includes sufficient funding to support 
prevention and treatment demonstration projects in Iowa and 
other parts of the Midwest and South. School-based prevention 
demonstration projects would teach the dangers of 
methamphetamine abuse and addiction as well as other emerging 
drug issues, 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 treatment programs that are designed to assist 
individuals to quit their use of methamphetamine or other 
emerging drugs and remain drug-free.
    The Committee recognizes the importance of the residential 
treatment program for pregnant and postpartum women, which was 
authorized as part of the Children's Health Act of 2000 (Public 
Law 106-310). This program has helped significantly increase 
the percentage of children born free of illicit substances. 
Continued funding of this program will contribute to the health 
and well being of pregnant women with addictions and their 
children.
    The Committee is aware of the following projects and 
programs, and encourages SAMHSA to give each full and fair 
consideration for awards available in new grant competitions.
    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.
    Center Point, Inc. will demonstrate and evaluate the 
effectiveness of its Adolescent Residential and Aftercare 
Treatment Program, which is widely recognized throughout 
Northern California as an effective option for troubled youth 
because it provides a continuum of care, involves the family 
and provides critical aftercare support.
    The City of New Orleans Seamless Accountability System for 
Substance Involved Offenders is a pre-sentencing program that 
focuses on anti-violence behaviors and treatment therapies. The 
program targets offenders 17 to 24 years of age.
    The City of San Francisco's Treatment on Demand program 
provides services that advance individuals' recovery through 
abstinence and harm reduction, including the reduction of 
delays in gaining access to substance abuse.
    Haymarket West in Schaumburg, Illinois will expand its 
comprehensive substance abuse treatment and related services in 
the northwest suburbs.
    The city of Baltimore is employing innovative techniques to 
enhance drug treatment services for area residents, 
particularly for those in need of intermediate residential 
treatment.
    Spectrum Youth and Family Services proposes to expand 
services provided through its Youth Health Clinic located in 
Burlington, Vermont.
    Recovery House, Inc., in Wallingford, Vermont is developing 
a day treatment program for women with dependent children and 
pregnant women.
    The Vermont Division of Alcohol and Drug Abuse Program and 
the Vermont Department of Social and Rehabilitative Services 
will improve access to residential treatment for adolescents in 
custody in Rutland County.
    The Navajo-Farmington Alcohol Crisis Response Program is 
addressing the substance abuse problems in the City of 
Farmington, San Juan County, and also working with affiliated 
partners by establishing and operating an alcohol crisis 
response network of services to address serious alcohol 
problems.
    The United Community Center/Centro de la Comunidad Unida's 
demonstration project to address domestic violence in 
Milwaukee's Hispanic community represents an innovative 
integration of domestic violence intervention with the Center's 
Latinas Unidas treatment program for substance-abusing women 
and their families.
    Lutheran Social Services of Wisconsin and Upper Michigan, 
Inc. is developing a unique alcohol and other drug abuse 
treatment program to address the specific needs of the older 
adult population by locating certified alcohol treatment in the 
community-based settings of three senior centers in northeast 
Wisconsin.
    The Corporation for Supportive Housing will help combat 
chronic homelessness in communities by supporting the provision 
of health-related assistance to this vulnerable population.
    The National Center on Addiction and Substance Abuse at 
Columbia University is partnering with the New Jersey 
Department of HHS and the Department of Health and Senior 
Services to evaluate strategies to assist women who have 
substance abuse problems and are approaching Federal welfare 
time limits.
    The Southcentral Foundation in Anchorage has developed an 
innovative program designed to provide substance abuse 
treatment for Alaska Native adolescents.
    The inpatient treatment program for adult Alaska Native 
substance abusers at the Ernie Turner Center operated by the 
Cook Inlet Tribal Council continues to provide inpatient and 
outpatient services.
    The Allegheny County Department of Human Services continues 
to provide for both inpatient and outpatient drug and alcohol 
services for its citizens as it faces increasing costs for 
inpatient services that severely strain its ability to meet the 
demand for treatment.

Substance abuse prevention and treatment block grant

    The Committee recommends $1,725,000,000 for the substance 
abuse prevention and treatment block grant, $60,000,000 more 
than the fiscal year 2001 level and the same as the 
administration's request.
    The 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.
    The Children's Health Act of 2000 made several changes to 
the authority for the substance abuse prevention and treatment 
block grant, including the development of a performance 
partnership framework in which States are granted program 
flexibility for achieving a common set of performance measures; 
extending the period of time States have to obligate block 
grant funds; and prohibiting discrimination against religious 
organizations in receiving Federal assistance for providing 
substance abuse services. The Committee expects SAMHSA to be 
prepared to provide detailed information about implementation 
of these and other modified and new program authorities during 
the fiscal year 2003 budget process.
    The Committee supports efforts currently underway in SAMHSA 
to create a strategic plan around homelessness. The Committee 
commends SAMSHA on this initiative, and encourages the Agency 
to tie this plan in with planning requirements in the recent 
SAMSHA reauthorization bill. Specifically, the Committee 
encourages SAMSHA to build housing status into the common set 
of performance measures required from States reporting on block 
grant programs. The Committee is concerned about the lack of 
data from the mental health and substance abuse block grant 
programs on the housing status of persons entering and exiting 
programs. A set of consistent performance measures is needed 
across programs serving homeless and precariously housed people 
in SAMHSA and other Operating Divisions, including HRSA, ACF 
and CMS, to understand the impact HHS programs are having. 
Further, the Committee requests reports on the status of plans 
for performance partnerships, including the outcomes to be 
measured, from the Substance Abuse Prevention and Treatment 
Block Grants and Mental Health Block Grants within 6 months of 
the enactment of this Act.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2001....................................    $175,013,000
Budget estimate, 2002...................................     175,013,000
Committee recommendation................................     189,013,000

    The Committee recommends $189,013,000 for programs to 
prevent substance abuse, an increase of $14,000,000 above last 
year's level and $14,000,000 more than the budget request. This 
amount funds substance abuse prevention programs of regional 
and national significance.

Programs of regional and national significance

    The Committee has provided $189,013,000 for programs of 
regional and national significance [PRNS], $14,000,000 more 
than the fiscal year 2001 amount and $14,000,000 more than the 
administration's request. The Center for Substance Abuse 
Prevention is the sole Federal organization with responsibility 
for improving accessability and quality of substance abuse 
prevention services. Through the programs of regional and 
national significance activity, CSAP supports: development of 
new practice knowledge on substance abuse prevention; 
identification of proven effective models; dissemination of 
science-based intervention information; State and community 
capacity-building for implementation of proven effective 
substance abuse prevention programs; and programs addressing 
new needs in the prevention system.
    The Committee notes the alarming increase in use and 
availability of ecstasy and other club drugs among our Nation's 
youth. For 2 consecutive years, ecstasy use reported by 10th 
and 12th grade students has increased. According to SAMHSA's 
Drug Abuse Warning Network, ecstasy-related emergency room 
admissions in the United States increased significantly from 
253 in 1994 to 4,511 in 2000. The Committee urges SAMHSA to pay 
close attention to this and other emerging drug use issues.
    The Committee is aware of the need to strengthen fetal 
alcohol syndrome (FAS) prevention efforts and improve service 
delivery by ensuring that professionals in key fields are 
knowledgeable about FAS and related birth defects, particularly 
in high-prevalence regions. The Committee has therefore 
included sufficient funding to allow the Four-State FAS 
Consortium in Minnesota, Montana, North Dakota, and South 
Dakota to develop programs to provide training on FAS and 
related birth defects for professionals and students in health 
care, education, social work, foster care, criminal justice, 
and other relevant fields.
    The Committee notes the insufficient number of effective 
fetal alcohol syndrome and fetal alcohol effects (FAS/FAE) 
programs in communities affected by this problem. The Committee 
has provided an additional $1,300,000 to expand efforts to 
identify, disseminate and implement effective FAS/FAE 
prevention and treatment programs.
    The Committee is aware of the following projects and 
programs, and encourages SAMHSA to give each full and fair 
consideration for awards available in new grant competitions.
    The Fairbanks Native Association's LifeGivers residential 
treatment program continues to achieve successes in helping 
pregnant women with substance abuse problems and their 
children.
    The Vermont Department of Health, Division of Alcohol and 
Drug Abuse Programs proposes a pilot project of support for 
community-based programs in Rutland, Burlington, and Barre to 
explore best practices for combating the growing drug abuse 
problem.
    The Ai Ki Ruti Center is developing outreach initiatives to 
underserved Native American populations in Northeast Nebraska 
to increase their access to needed prevention and treatment 
services.
    The Start SMART Foundation in Bethlehem, Pennsylvania is 
developing a pilot project to reduce underage drinking 
utilizing QED, a new saliva alcohol test which returns an 
accurate measurement of blood alcohol levels in 2 to 5 minutes.
    The National Center on Addiction and Substance Abuse at 
Columbia University has developed CASEWORKS for Families, an 
innovative program to help women at risk of substance abuse.
    The Institute for Research, Education, and Training in 
Addictions in Pittsburgh will facilitate the coordination of 
approaches to research, treatment and health policy 
development.
    The Municipality of Anchorage, home to almost 50 percent of 
Alaska's population, plans to initiate a prevention program 
based on research into best practices and culturally relevant 
programs to reduce the incidence of drug and alcohol abuse 
among Anchorage residents.
    The City of Providence's Southeast Asian Youth and Family 
Development (SEAYFD) project has helped address the increase in 
drug and alcohol abuse, and the alarming gang activity among 
the Southeast Asian community.
    The Bridgebuilders program in Ohio will create and evaluate 
the effectiveness of a multi-tiered blueprint for reducing 
youth alcohol and drug use that uses a systematic, statewide 
approach to bridge the divide between youth, parents, community 
systems, and related State systems.
    The Alaska Department of Health and Social Services will 
assess and screen Alaska youth for alcohol abuse and dependency 
and develop a statewide plan to address youth alcohol abuse and 
dependency in Alaska. The plan is a response to concerns that 
50.8 percent of Alaska high school youth report current alcohol 
use and 33.4 percent report binge drinking at least once a 
month.

                           PROGRAM MANAGEMENT

    The Committee recommends $96,173,000 for program management 
activities of the agency, $10,500,000 more than the fiscal year 
2001 level and $29,000,000 more than the President's request.
    The additional $29,000,000 provided by the Committee 
support national data collection activities, including the 
Household Survey on Drug Abuse. The increase will be used to 
add to the survey two new components: The Longitudial Survey of 
Youth and Survey of the Elderly, as well as augment the Drug 
Abuse Warning System. The budget requested the $29,000,000 for 
these activities under the Department's evaluation authority.
    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 SAMHSA's programs.
    The Committee commends SAMHSA for its prompt, effective 
response to the terrorist attacks that occurred on September 
11, 2001. The Committee is aware that the agency promptly 
mobilized personnel, resources and other supportive services to 
help address the needs of individuals in affected areas. Mental 
health experts were provided promptly to help address immediate 
needs as well as to assist with longer-term planning for future 
mental health and substance abuse services in affected States 
and communities. The Committee is supportive of additional 
resources being made available to SAMHSA to ensure that 
individuals affected by the events of that day have access to 
appropriate mental health and substance abuse prevention and 
treatment services.

               Agency For Healthcare Research and Quality

Appropriations, 2001....................................    $269,796,000
Budget estimate, 2002...................................     306,245,000
Committee recommendation................................     291,245,000

    The Committee recommends $291,245,000 for the Agency for 
Healthcare Research and Quality [AHRQ]. This is $15,000,000 
less than the administration request and $21,449,000 more than 
the fiscal year 2001 level. The administration proposed to fund 
AHRQ through transfers available under section 241 of the 
Public Health Service Act. The Committee did not approve this 
request.
    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 to reduce the costs of 
health care.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    The Committee provides $240,145,000 for research on health 
costs, quality and outcomes [HCQO], which is $15,000,000 less 
than the administration request and $13,699,000 above the 
fiscal year 2001 level. 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

    The Committee continues to be very concerned about the 
enormous personal and economic cost of medical errors. 
According to the Institute of Medicine (IOM), an estimated 
44,000 to 98,000 people each year die from medical errors. Even 
using the lower estimate, this would make medical errors the 
eighth leading cause of death in this country--higher than car 
accidents, breast cancer or AIDS. The IOM also suggests that 
medical errors may cost up to $29,000,000,000 in excess health 
care expenditures and lost productivity each year.
    Last year the Committee provided $50,000,000 for initiating 
research into the causes of medical errors in the hope of 
dramatically improving the safety of health care services in 
this country. The Committee commends the Agency for planning 
and instituting an impressive patient safety initiative, which 
includes demonstrations to test best practices for reducing 
errors, development and testing the use of appropriate 
technologies to reduce medical errors, such as hand-held 
electronic medication systems, and research in geographically 
diverse locations to determine the causes of medical errors.
    Of the total amount provided for HCQO, the Committee 
directs AHRQ to devote $60,000,000 to determining ways to 
reduce medical errors, an increase of $10,000,000 over the 
amount provided in fiscal year 2001. The Committee expects that 
AHRQ will use these funds to share lessons learned and best 
practices among hospitals and healthcare providers. The 
Committee directs AHRQ to work with the Center for Medicare and 
Medicaid Services (CMS) to provide this information to 
participating hospitals and healthcare facilities so that they 
can begin implementing successful strategies.
    The Committee further directs AHRQ to provide a report 
detailing the results of its efforts to reduce medical errors. 
The report should include how hospitals and other healthcare 
facilities are reducing medical errors; how these strategies 
are being shared among healthcare professionals; how many 
hospitals and other healthcare facilities record and track 
medical errors; how medical error information is used to 
improve patient safety; what types of incentives and/or 
disincentives have helped healthcare professionals reduce 
medical errors and; a list of the most common root causes of 
medical errors. The report should provide data showing the 
effectiveness of State requirements in reducing medical errors. 
The report should also describe how AHRQ is responding to some 
of the findings in the IOM's report ``To Err is Human: Building 
a Safer Health System.''
    The Committee reiterates its position that there should be 
zero tolerance for preventable medical mistakes and that the 
Congress, the Administration, State licensing boards, and 
private healthcare institutions and providers should work 
together to prevent further unnecessary deaths and injuries.
    The Committee encourages the Agency to fund research on 
health costs, quality, and outcomes, especially in the chronic 
illness and disability population.
    The Committee notes that the University of Louisville, in 
conjunction with experts in computers, medical informatics, 
nosology, and related fields, is developing and implementing a 
new system of electronic medical record transfer that would 
facilitate the selected transfer of medical information. The 
University is also working with health care facilities to 
capture data from all available electronic sources and provide 
access to the data from multiple perspectives and groupings, 
which will enable uses from the research, community health and 
consumer health communities. The University would be eligible 
to receive funding under AHRQ's patient safety initiative for 
both these efforts.
    The Committee supports the Vermont Oxford Network in 
Burlington, Vermont and its efforts to improve the quality of 
health care available to children born prematurely through the 
reduction of medical errors.
    The Committee is aware of the Medical Error Reduction 
project at Valley Hospital in Ridgewood, New Jersey. Valley 
Hospital has found that the complete standardization of 
processes and use of hand-held technology help guarantee the 
correct dispensation of medications and collection of 
specimens.
    The Committee is aware that Cedars-Sinai Hospital will 
design and implement a computer-based integrated health 
information system to track patient care resulting in a 
reduction of preventable medical errors.
    Cerebral Autosomal Dominant Arteriopathy with Subcortical 
Infarcts and Leukoencephalopathy (CADASIL).--The Committee 
encourages AHRQ to consider an evidence-based review for the 
care of CADASIL carriers, including Native Hawaiians. AHRQ is 
encouraged to work closely with the Native Hawaiian Health Care 
System to translate the evidence on the care of CADISIL into 
clinical practice strategies.
    Chronic fatigue syndrome.--The Committee understands that 
AHRQ is nearing completion of its evidence report on chronic 
fatigue syndrome and encourages the Agency to make databases 
used in the writing of this report readily available to 
researchers and the public on the Internet.
    End of life care.--In order to address the lack of adequate 
information to tailor programs and match needs in end of life 
care, the Committee encourages the Agency to develop methods of 
measurement, translation of findings into usual practice and 
guidelines to improve the reliability of care of the seriously, 
chronically ill individual.
    Geographical distribution.--In order to broaden the 
geographic distribution of health services research funding by 
enhancing the competitiveness for research funding among 
institutions, the Committee encourages the Agency for 
Healthcare Research and Quality to continue the peer reviewed 
and merit-based program, ``Building Research Infrastructure and 
Capacity (BRIC).''
    Pharmaceutical pricing.--The Committee recognizes the high 
prevalence of chronic 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 in 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 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.
    Practice guidelines.--The Committee is concerned that a 
study published in the Journal of the American Medical 
Association found that three-quarters of the practice 
guidelines developed by AHRQ for treating illnesses were 
outdated. While AHRQ has removed these out-of-date guidelines 
from its web site and no longer produces guidelines, the 
Committee encourages AHRQ to devote more resources to ensuring 
that the National Guideline Clearinghouse contains updated and 
timely information.

                   MEDICAL EXPENDITURES PANEL SURVEYS

    The Committee provides $48,500,000 for health insurance and 
medical expenditures panel surveys [MEPS], which is the same as 
the administration request and $7,650,000 above the fiscal year 
2001 level. 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 $2,600,000 for program support. 
This amount is the same as the administration request and is 
$100,000 more than the fiscal year 2001 level. This activity 
supports the overall management of the Agency.

               Centers for Medicare and Medicaid Services


                     Grants to States for Medicaid

Appropriations, 2001.................................... $99,613,130,000
Budget estimate, 2002................................... 106,821,882,000
Committee recommendation................................ 106,821,882,000

    The Committee recommends $106,821,882,000 for Grants to 
States for Medicaid. This amount is $7,208,752,000 more than 
the fiscal year 2001 appropriation and the same as the 
administration's request. This amount excludes $36,207,551,000 
in fiscal year 2001 advance appropriations for fiscal year 
2002. In addition, $46,601,937,000 is provided for the first 
quarter of fiscal year 2003, 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 understands that a General Accounting Office 
report estimated that two-thirds of children on Medicaid have 
never been screened for lead, despite Federal laws requiring 
such screening. The Committee urges CMS to more closely monitor 
screening rates and take every appropriate step to ensure that 
screening rates among children enrolled in Medicaid are 
substantially increased, reporting the national results to 
Congress within 18 months, including lead screening rates for 
children age 2 and under.

                  Payments to Health Care Trust Funds

Appropriations, 2001.................................... $70,381,600,000
Budget estimate, 2002...................................  81,924,200,000
Committee recommendation................................  81,994,200,000

    The Committee recommends $81,994,200,000 for Federal 
payments to health care trust funds. This amount is $70,000,000 
more than the administration's request and is an increase of 
$11,612,600,000 from the fiscal year 2001 appropriation. The 
committee recommendation includes $70,000,000 to reimburse the 
Hospital Insurance Trust Fund for funds advanced on behalf of 
the general fund for Real Choice Systems Change Grants to 
States and Medicaid community-based attendant care 
demonstrations in the research and demonstration activity of 
program management.
    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.
    A shortfall of $832,000,000 is anticipated in fiscal year 
2001 for the Federal contribution of the Supplementary Medical 
Insurance Trust Fund. This shortfall is a result of the current 
estimate being slightly higher than when Congress enacted the 
appropriation. The fiscal year 2002 request includes an 
estimated payback of $844,000,000 including the fiscal year 
2001 shortfall plus interest. The Committee has provided 
$81,332,000,000 for 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's request, and is 
$11,555,000,000 more than the fiscal year 2001 amount.
    The recommendation also includes $292,000,000 for hospital 
insurance for the uninsured. This amount is the same as the 
administration's request and is $29,000,000 less than the 2001 
amount. The Committee also recommends $150,000,000 for 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 $18,000,000 
more than the fiscal year 2001 appropriation. The Committee 
recommendation includes $220,200,000 to be transferred to the 
Hospital Insurance Trust Fund as the general fund share of 
CMS's program management administrative expenses. This amount 
is $70,000,000 more than the administration's request and is 
$68,600,000 more than the fiscal year 2001 level.

                           Program Management

Appropriations, 2001....................................  $2,242,162,000
Budget estimate, 2002...................................   2,351,158,000
Committee recommendation................................   2,464,658,000

    The Committee recommends $2,464,658,000 for CMS program 
management. This is $113,500,000 more than the administration 
request and $222,496,000 more than the fiscal year 2001 enacted 
level.

Research, demonstrations, and evaluations

    The Committee recommends $125,311,000 for research, 
demonstration, and evaluation activities. This amount is 
$70,000,000 more than the budget request and $13,000,000 less 
than the amount provided in fiscal year 2001.
    CMS 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 CMS research include access to 
high-quality health care, health service delivery systems, and 
provider payment systems.
    The Committee has included funds to continue at $20,000,000 
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, 
including the provision of support and technical assistance 
from CMS to assure effective implementation of these 
demonstrations.
    The Committee has included $50,000,000 for Real Choice 
Systems Change Grants to States to fund initiatives that 
establish specific actions steps and timetables to achieve 
enduring system improvements and to provide long term services 
and supports, including community-based attendant care, to 
eligible individuals in the most integrated setting 
appropriate. Grant applications should be developed jointly by 
the State and Consumer Task Force. The Task Force should be 
composed of individuals with disabilities, consumers of long-
term care services and supports, and those who advocate on 
behalf of such individuals. Grant funded activities should 
focus on areas of need as determined by the States and the Task 
Force such as needs assessment and data gathering, strategies 
to modify policies that unnecessarily bias the provision of 
long-term care to institutional settings or health care 
professionals, strategies to ensure the availability of a 
sufficient number of qualified personal attendants and training 
and technical assistance.
    The Committee encourages CMS 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 supportive of the continuation of CMS's 
demonstration program to develop a comprehensive and reliable 
paramedic services program.
    The Committee reiterates its continued support for a 
lifestyle modification demonstration, begun in fiscal year 
2000, at the Mind-Body Institute of Boston, Massachusetts. The 
Committee encourages CMS to expand the eligibility criteria by 
increasing the number of enrollees and including in the 
demonstration ischemia-free patients with recent acute 
myocardial infarctions, coronary artery bypass graft surgery, 
angioplasty and stents.
    The Committee is pleased with the progress of the Western 
Governors' Association Health Passport project and commends HHS 
in the awarding of discretionary funding in 2001 allowing 
continuation of this pilot project that demonstrates an 
important new public-private, multi-agency, integrated model of 
health care and benefit delivery using smart cards, magnetic 
stripe, and public key infrastructure secure certificate 
technologies. The Committee reiterates its support for this 
demonstration project which serves as a model for complying 
with the Health Insurance Portability and Accountability Act.
    The Committee recognizes that persons with uncontrolled 
diabetes account for about 50 percent of all leg amputations, 
25 percent of all kidney failure, and are the leading source of 
preventable blindness and a major cost to the Medicare program. 
Diabetes mullitus is clearly a major health problem in the 
country and is particularly acute among Hispanics and Native 
Americans. Funds for this project would be used to establish 
six rural regional programs to improve the access to care for 
some of our elderly citizens. The programs would provide 
monitoring and diet assistance for rural elderly with diabetes, 
as well as assessment and referral related to depression of 
rural elderly. This demonstration will provide much needed 
nutrition and social services to our most vulnerable elderly 
populations and potentially decrease the effects of diabetes 
and depression. Funding would be targeted to low-income elderly 
in geographic regions with high incidence of diabetes mullitus.
    The Committee is aware of the need for a mobile asthma care 
program at Valley Children's Hospital in California. The poor 
air quality in California makes those children who suffer from 
asthma particularly vulnerable to asthma attacks. These mobile 
asthma care teams would work with patients and families 
throughout the Central Valley to reduce the cost of asthma 
care.
    The Committee is aware of the California State University 
Hayward's Health and Wellness Program. This program produces 
graduates that are well prepared to be health care 
professionals in the region. With additional funding, the 
Institute would create a model program for students to enter a 
mental health career.
    The Committee is aware of the University of Kentucky's 
Cooperative Extension Service and School of Public Health's 
partnership to identify and target the most frequent and 
expensive medication use issues in the State. This center would 
improve medication use in Kentucky's highest need counties with 
additional Federal funds.
    The Committee is concerned about the confidentiality of 
patient medical records. The University of Louisville is 
currently constructing an electronic medical record that could 
serve as a prototype for proper transmission of medical 
records. Additional Federal funding would further this effort 
significantly.
    Providing health care professionals access to patient data 
both in the community and the university setting is a complex 
task but necessary to provide uniform quality. A demonstration 
project between the University of Louisville and the 
surrounding community hospitals would be important to further 
this goal.
    With additional Federal funding, the Center for Healthcare 
Systems Standards in South Carolina would conduct a 
demonstration project to examine reducing medical errors 
through standards-based Quality Management Systems.
    The Committee encourages CMS 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.
    As a follow-up to the Committee's recommendation in fiscal 
year 2001, and in order to determine the effectiveness of the 
nurse-managed clinic model, the Committee encourages CMS 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 CMS 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 CMS 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 is aware of the proposed modification by CMS 
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, CMS should continue its negotiations with the 
appropriate State authorities and inform the Committee of its 
deliberations, prior to making any modifications.
    The Committee remains concerned about the extraordinary 
adverse health status of Native Hawaiians and encourages CMS 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 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 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 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 is creating 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 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 CMS's 
telemedicine demonstration projects. The Committee has provided 
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 the pilot 
waiver program.
    With additional Federal funding, the Children's Hospital 
Los Angeles would purchase and develop programming for a 
Magnetic Resonance Microscope.
    The Committee is supportive of the continuation of CMS's 
demonstration program to develop a comprehensive and reliable 
paramedic services program.
    The Committee is pleased with the progress of the 
Mississippi Medicaid Disease State Management plan approved in 
1998 that allows reimbursement of pharmacists working under 
protocol of physicians to manage patients with certain chronic 
diseases. The Committee urges CMS to consider extension of a 
demonstration project for the Mississippi Medicare population. 
The Committee expects CMS 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 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 CMS to utilize the expertise of the 
center in policy making.
    The Committee understands that terminally ill patients 
desire to receive outpatient end-of-life care in their homes. 
Hospice care is an effort to meet these needs. Currently, no 
reimbursement is allowed for inpatient hospice, but there are 
individuals in rural areas in every State who are denied 
hospice care because they lack homes or have no able care 
giver. The Committee recognizes the need for freestanding 
inpatient hospice residence homes in rural areas. The Committee 
is aware that the Sanctuary Hospice House, located in Tupelo, 
Mississippi, has developed a demonstration model to care for 
the short-term needs of terminally ill patients requiring pain 
management and palliative care.
    The Committee is supportive of Health Link of Idaho, to 
establish private-public partnerships with employers, State 
governments, and health insurance providers, to provide health 
coverage for very small businesses (employing fewer than 10 
people) with low-wage employees. The project will test the 
efficacy of the model in both urban and rural areas for its 
ability to increase access, foster appropriate use of health 
care services and reduce public expenditures.
    The Committee is aware of a proposal that would enable a 
multilingual, mulitmedia screening tool for citizens to better 
determine their potential eligibility for Medicare Medicaid, 
and QMB, and urges CMS to fully assess the concept.
    The Committee encourages CMS to consider a proposal to 
provide a pilot project for Arizona to provide reimbursement to 
Arizona hospitals and localities for cost associated with 
providing federally-defined emergency medical care to 
undocumented immigrants.
    The Committee encourages CMS to consider expansion of the 
California State University expansion of the Health and 
Wellness program. The program is designed to meet increasing 
demand for well prepared health care professionals in the 
region.
    The Committee encourages CMS to consider a 2-year 
demonstration model for establishing private-public 
partnerships with employers, State governments, and health 
insurance providers, to provide health coverage for very small 
businesses (employing fewer than 10 people) with low-wage 
employees (average of less than $10 per hour). The project 
would test the efficacy of the model in both urban and rural 
areas for its ability to increase access, foster appropriate 
use of health care services and reduce public expenditures. 
Results would be evaluated and disseminated nationally.
    The Committee is pleased with CMS's proposal to provide 
demonstration grants to States to test innovative asthma 
disease management techniques for children enrolled in 
Medicaid. The Committee encourages CMS to provide this program 
with the necessary funding to carry out this initiative.
    The Committee encourages CMS to consider a demonstration 
project in Cook County, Illinois to reduce morbidity and 
mortality from asthma in the community areas in Cook County 
with the highest prevalence and inadequate service.
    The Committee encourages CMS to consider a project for the 
Illinois Primary Health Care Association to implement the 
Shared Integrated Management Information System and provide 
centralized case management, reimbursement, and administrative 
support services to a number of Consolidated Health Centers in 
Illinois.
    The Committee encourages CMS to continue an outreach 
program designed to provide Chicago public school students with 
vision care.
    The Committee encourages CMS to consider a proposal from 
the Madonna Rehabilitation Center Institute for Rehabilitation 
Science and Engineering in Lincoln, Nebraska.
    The Committee encourages CMS to conduct a Medicare Medical 
Nutrition Therapy Education Campaign, to inform both Medicare 
beneficiaries and physicians about the new Medicare benefit of 
Medicare Nutrition Therapy for patients with diabetes and renal 
disease, available January 2002.
    The Balanced Budget Refinement Act of 1999 required the 
Medicare Payment Advisory Commission (MEDPAC) study to 
determine whether skilled nursing facilities in Alaska and 
Hawaii should receive additional payment to accommodate their 
unique circumstances. The Committee recommends CMS conduct a 
detailed study to determine if there are enough differences in 
these States non-labor costs to justify a payment adjustment 
for the skilled nursing facilities in Alaska and Hawaii, the 
Committee further suggests consideration of a temporary 
adjustment to the non-labor share of the per diem payment for 
skilled nursing facilities in Alaska and Hawaii at this time.
    The Committee understands that the Montana Comprehensive 
Health Care Association in Helena, Montana has expressed a need 
for a demonstration project to subsidize coverage to 
individuals under 150 percent of the Federal poverty level who 
have significant health conditions and are therefore 
uninsurable.

Medicare contractors

    The Committee recommends $1,547,000,000 for Medicare 
contractors, which is $25,000,000 more than the budget request 
and $190,000,000 more than the comparable fiscal year 2001 
appropriation. In addition, $700,000,000 is available for the 
Medicare Integrity Program within the mandatory budget as part 
of the health insurance reform legislation.
    Medicare contractors, which 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 recommendation includes $15,000,000 to 
support grants for State Health Insurance Counseling and 
Assistance programs (SHIPs), an increase of $5,000,000 over 
last year and $15,000,000 more than the budget request. SHIPs 
provide information, counseling and decision support to people 
with Medicare. The 53 State and territorial programs are 
administered either by the State unit on aging or the State 
department of insurance. The Committee is aware that these 
programs provide a valuable service to people with Medicare and 
require a stable source of funding. The Centers for Medicare 
and Medicaid Services (CMS) shall use these resources to 
provide grants to States for SHIPs to enable them to increase 
their capacity, to operate a resource center and to administer 
special projects that will help SHIPs continuously improve the 
quality of service they provide. The Committee expects CMS to 
include, within its fiscal year 2003 congressional 
justification, a specific dollar request for SHIPs, or to 
indicate that no resources are being requested for this 
activity.

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. On-site surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys.
    The Committee recommends $260,647,000 for Medicare State 
survey and certification activities, which is an increase of 
$18,500,000 over the fiscal year 2001 level.

Federal administration

    The Committee recommends $531,700,000 for Federal 
administration costs. This recommendation is $26,996,000 more 
than the fiscal year 2001 level, and the same as the budget 
request. This will support 4,632 full-time equivalent 
positions, an increase of 22 over fiscal year 2001. Most of the 
increase is for fixed expenses of personnel compensation and 
benefits.
    The Committee understands that HIV drug resistance testing 
is a critical component of the Nation's fight against AIDS. HIV 
drug resistance testing lengthens life expectancy, enhances 
life functions and retards emergence of a more resistant virus. 
Because of the life-saving aspect of these tests and because 
their reliability has historically been so variable, the FDA 
has determined that HIV drug resistance tests should be subject 
to FDA approval to insure a high degree of reliability. One 
such test has already been approved and others are in progress. 
The Committee understands that the differential in cost between 
FDA approved and non-approved tests may be significant, 
therefore urges CMS to review its reimbursement policies to 
assure that Medicare beneficiaries have access to the highest 
quality most medically beneficial HIV drug resistance tests.
    Medicaid and the SCHIP program are the sole source of most 
dental care provided to the Nation's poor children. However, 
according to the U.S. Surgeon General's report, ``Oral Health 
in America'', fewer than one in five Medicaid-covered children 
received a single preventive dental visit in a year. Left 
untreated, dental disease is inevitable and will not abate. 
Therefore, the Committee believes that it is important that CMS 
maintain a distinct focus on oral health by retaining a 
position of Chief Dental Officer.
    The Committee remains extremely concerned over CMS's 
continuing failure to articulate clear guidelines and to set 
expeditious timetables for consideration of new technologies, 
procedures and products for Medicare coverage. A particularly 
troubling example is CMS's lengthy delays and failure to 
articulate clear standards regarding Medicare coverage of 
positron emission tomography (PET). The effect of these delays 
in instituting Medicare coverage is to continue to deny the 
benefits to these technologies and procedures to Medicare 
patients. The Committee also remains concerned that CMS 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 
clinical trials and which serve as signals to private insurers 
to cover new technologies. The Committee is also concerned that 
CMS 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 asks that the 
Secretary take a leadership role in resolving this matter 
expeditiously. The Committee also urges the Secretary to 
investigate the recent proposal by CMS to reduce hospital 
outpatient payment for PET scans from $2,200 to $841 in light 
of the fact that each PET scan uses a unit of the radioisotope 
FDG which generally costs from $500 to $600 per dose.
    In the Balanced Budget Act of 1997, Congress urged the 
Secretary to provide GME reimbursement for clinical 
psychological programs. To date CMMS has not issued the 
necessary rule. The Committee expects the agency to release the 
rule immediately.
    A provision was included in the Health Insurance 
Portability and Accountability Act (HIPAA) to redesign the 
specialty provider code system to an alphanumeric system; 
however, implementation of this new system seems to be in 
doubt. In the interim, to ensure that pregnant women receive 
risk-appropriate care, the Committee urges CMS to create an 
interim two-digit specialty code under the current system, 
recognizing maternal-fetal medicine.
    The Committee is concerned that many severely disabled 
Medicare recipients are being denied access to specialized 
equipment that can improve their health and quality of life. 
Through administrative ruling 96-1 Medicare changed its 
coverage policy and classified certain highly specialized sets 
of braces individually fit for the patient as non-covered 
wheelchairs. Congress has since mandated that the GAO review 
this change in policy. While the Congress awaits GAO's report, 
the Committee calls on CMS to withhold enforcement of 96-1 and 
to develop a proper ``L'' code and carrier instructions that 
would provide permanent and clear parameters for this type of 
reimbursement while safeguarding program integrity.
    The Omnibus Consolidated & Emergency Supplemental 
Appropriations Act for Fiscal Year 2001, which included ``the 
Medicare, Medicaid & S-CHIP Benefits Improvement & Protection 
Act of 2000,'' incorporated provisions relating to States' 
Medicaid upper payment limit programs. These provisions, which 
included reasonable transition periods for States to adopt a 
revised standard for treatment of their programs, were adopted 
after intense bipartisan negotiations among the House, Senate, 
and administration.
    The Committee is pleased that the administration, in 
January and September 2001, supported this Medicaid upper 
payment limit agreement in the promulgation of Medicaid upper 
payment limit regulations. Further, the Committee reiterates 
its commitment to both the letter and spirit of this agreement, 
and directs the administration to maintain its course in 
complying with congressional intent. Any subsequent 
modifications should be done only after the administration has 
had an opportunity to assess the implementation of the new 
regulations and only in consultation with the States and their 
Medicaid programs, as well as the other stakeholders. The 
Committee is extremely concerned that eliminating the higher 
payment limit category compromise struck last year would be 
disastrous for all safety net hospitals, both public and 
private, that participate in the Medicaid program.
    The Committee is aware of the progress made in translating 
selected CMS 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 is aware of efforts by the Center for 
Healthcare Systems Standards to help hospitals implement the 
``Guidelines for Process Improvements in Healthcare 
Organizations,'' developed as international standards under ISO 
9001:2000 and ISO 9004:2000. These new standards focus 
attention on reducing medical errors through process 
improvement including identifying systemic root causes of 
medical errors, improving the documentation process, and 
changing organizations towards a culture of systemic review, 
continuous error reduction, and overall quality improvement. 
The Committee encourages CMS to pursue efforts like this to 
help hospitals reduce errors.
    The Committee is pleased with 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 continues to urge CMS to utilize 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 continues to strongly urge use of the Secretary's 
enhanced inherent reasonableness authority on a national basis.
    The Committee is aware that CMS 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 CMS to undertake testing of other similar 
commercial software and to incorporate edits found to achieve 
savings within current Medicare regulations and without harming 
quality of care.
    The Committee is pleased that CMS has moved ahead to 
establish program integrity contracts. These contractors have 
significant potential to reduce losses to the Medicare program. 
The Committee encourages CMS 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.
    The Committee is pleased with the progress that the CMS has 
made in meeting the Congressional mandates for a Medicare 
prospective payment system for long-term care hospitals. It 
remains important that this payment system be based on data 
from long-term care hospital patients and be designed expressly 
for patients treated in long-term care hospitals. It is also 
important that this improved payment system be based on patient 
medical diagnoses, reflect the level of acuity for long-term 
care hospital patients, recognize that these patients often 
have multiple medical problems, and include appropriate 
adjustments for outlier patients and other typical payment 
factors. CMS should maintain these efforts and continue to 
coordinate with Congress and all affected parties.
    The Committee has held hearings documenting the need to 
reform Medicare's payments for ambulance services. It is this 
Committee's understanding that CMS will implement this year a 
comprehensive regulation establishing a new fee schedule for 
ambulance payments as required by the Balanced Budget Act of 
1997. The Committee is concerned that CMS is considering 
implementing the new fee schedule without fully implementing 
the required condition codes and believes such a decision would 
be adverse to beneficiaries, quality health care and program 
integrity. Therefore, the Committee directs CMS to implement 
the full set of condition codes simultaneously with the 
implementation of the fee schedule.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2001....................................  $2,441,800,000
Budget estimate, 2002...................................   2,447,800,000
Committee recommendation................................   2,447,800,000

    The Committee recommends that $2,447,800,000 be made 
available in fiscal year 2002 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 appropriation, when combined with 
the $1,000,000,000 in advance funding provided in last year's 
bill and an estimated $460,000,000 from offsetting collections, 
makes $3,907,800,000 available for this program.
    The Committee also has provided $1,100,000,000 in advance 
funding for the first quarter of fiscal year 2003 for the child 
support enforcement program, the same as the budget request. 
These funds support efforts to locate noncustodial parents, 
determine paternity when necessary, and establish and enforce 
orders of support.

               low-income home energy assistance program

Appropriations, 2001....................................  $2,000,000,000
Budget estimate, 2002...................................   1,700,000,000
Committee recommendation................................   2,000,000,000

    The Committee recommendation for LIHEAP is $2,000,000,000. 
This amount, when combined with the $300,000,000 available from 
the Supplemental Appropriations Act, 2001, provides a total of 
$2,300,000,000 for the LIHEAP program. This level of funding is 
$300,000,000 more than last year and $600,000,000 more than the 
budget request.
    LIHEAP grants are awarded to States, territories, Indian 
tribes and tribal organizations 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.
    The Committee recommendation includes $1,700,000,000 for 
the State grant program, $300,000,000 more than last year's 
funding level and the amount requested by the administration. 
These resources are distributed by formula to States, 
territories, Indian tribes and tribal organizations defined by 
statute, based in part on each State's share of home energy 
expenditures by low-income households nationwide.
    The Committee recommendation includes $300,000,000 for the 
contingency fund, the same as the amount requested by the 
Administration and $300,000,000 less than the fiscal year 2001 
appropriation. These resources are available until expended and 
can be released 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. The 
Administration did not request resources for the contingency 
fund subject to this emergency requirement. The contingency 
fund may be used to provide assistance to one or more States 
adversely affected by extreme heat or cold, significant price 
increases or other causes of energy-related emergencies.
    The Committee intends that up to $27,500,000 of the amounts 
appropriated for LIHEAP for fiscal year 2002 be used for the 
leveraging incentive fund. The fund will provide a percentage 
match to States for private or non-Federal public resources 
allocated to low-income home energy benefits.

                     refugee and entrant assistance

Appropriations, 2001....................................    $433,103,000
Budget estimate, 2002...................................     445,224,000
Committee recommendation................................     445,224,000

    The Committee recommends $445,224,000 for refugee and 
entrant assistance, $12,121,000 more than the fiscal year 2001 
level and the same amount as the budget request.
    Based on an estimated refugee admission ceiling of 121,000, 
this appropriation, together with prior-year funds available 
for fiscal year 2002 expenses, will enable States to continue 
to provide at least 8 months of cash and medical assistance to 
eligible refugees and entrants, a variety of social and 
educational services, as well as foster care for refugee and 
entrant unaccompanied minors.
    The Refugee and Entrant Assistance Program is designed to 
assist States in their efforts to assimilate refugees, asylees, 
Cuban and Haitian entrants, and adults and minors who are 
trafficking victims, into American society as quickly and 
effectively as possible. The program funds State-administered 
transitional and medical assistance, the voluntary agency 
matching grant program, programs for victims of trafficking and 
torture, employment and social services, targeted assistance, 
and preventive health.
    In order to carry out the refugee and entrant assistance 
program, the Committee recommends $227,291,000 for transitional 
and medical assistance, including State administration and the 
voluntary agency program; $10,000,000 for victims of 
trafficking; $143,621,000 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 $10,000,000 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 
acknowledges that well-established treatment centers, such as 
the Center for Victims of Torture, have developed the knowledge 
base that has fostered growth of treatment facilities around 
the country and strengthened treatment services generally. This 
positive trend may continue if leading centers are able to 
expand their staffs to create more trainers and improve 
evaluation and research needed to guide and develop new 
programs.

                 CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2001....................................  $1,999,987,000
Budget estimate, 2002...................................   2,199,987,000
Committee recommendation................................   2,000,000,000

    The Committee recommendation provides $2,000,000,000 for 
the child care and development block grant, $199,987,000 less 
than the budget request and $13,000 more than fiscal year 2001.
    The child care and development block grant supports 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 Committee rejects the administration proposal to set 
aside $400,000,000 within the block grant for States to provide 
certificates for low-income parents to help defray the costs of 
after-school programs with an education focus. The Committee 
notes that the 21st century community learning centers program 
administered by the Department of Education currently operates 
an education-based extended learning program for school-aged 
students. Fiscal year funding for this program was sufficient 
to fund just one in five high quality applications and 
approximately $800,000,000 was needed to provide grants to all 
applicants considered worthy of funding. Any fundamental change 
in the way the program operates is an issue that should be 
considered during the reauthorization of the child care and 
development block grant program.
    The Committee recommendation provides $19,120,000 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 $272,672,000 for 
child care quality activities, and sets aside $100,000,000 
specifically for an infant care quality initiative. The 
Committee recommendation also provides $10,000,000 for child 
care research, demonstration and evaluation activities.
    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.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2001....................................  $1,725,000,000
Budget estimate, 2002...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

    The Committee recommends an appropriation of $1,700,000,000 
for the social services block grant. The recommendation is the 
same amount as the budget request and $25,000,000 below the 
2001 enacted level.
    The Committee has included bill language that will allow 
States to transfer up to 5.9 percent from their fiscal year 
2002 allocations under the Temporary Assistance for Needy 
Families program to the Social Services Block Grant program. 
Under the budget request, States would be limited to transfers 
of up to 4.25 percent for fiscal year 2002. The Committee 
recognizes that the block grant is a vital source of support 
for many vulnerable children and families, the elderly and 
single adults.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2001....................................  $7,965,739,000
Budget estimate, 2002...................................   8,191,398,000
Committee recommendation................................   8,592,496,000

    The Committee recommends an appropriation of $8,592,496,000 
for children and families services programs. This is 
$626,757,000 more than the fiscal year 2001 appropriation and 
$401,098,000 more than the budget request.
    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 $6,600,000,000 for the Head Start 
Program, an increase of $400,188,000 above the 2001 level and 
$275,188,000 more than the budget request. The Committee 
recommendations includes $1,400,000,000 in advance funding that 
will become available on October 1, 2002.
    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 aware that, in fiscal year 2001, 
approximately $180,000,000 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 Head Start Act contemplates services to low-income 
children and their families. The law does not, however, 
prescribe age requirements for Head Start participation, short 
of limiting enrollment to children ``who have not yet reached 
the age of compulsory school attendance.'' Despite this fact, 
Head Start has traditionally served children in their years 
immediately prior to their entering into kindergarten. With 
States and localities increasing their investments in preschool 
services, local Head Start programs have been presented with 
not only an opportunity, but a need to serve infants and 
toddlers--in their years proven to be the most formative in 
recently publicized brain research developmental studies.
    Accordingly, the Committee encourages the Department of 
Health and Human Services to support efforts by local Head 
Start programs to use grant funds to deliver quality services 
to the infant and toddler population where a community 
assessment evidences a need for such services and the local 
program has the capacity to meet that need. The Committee 
supports this expansion in response to changing local community 
needs, separate and apart from the new grant process under the 
Early Head Start program created as part of the 1994 Head Start 
reauthorization. When combined with the new grant authority for 
Early Head Start which flows from increased appropriations 
annually, expansion of existing preschool programs to serve 
infants and toddlers is particularly responsive to research 
emphasizing the developmental needs of our youngest children--
needs which can be ably addressed through the Head Start model 
of comprehensive services.
    During the 107th Congress, the House and Senate will 
consider reauthorization of the Personal Responsibility and 
Work Opportunities Act, in order to assist individuals to 
secure gainful employment and help families to gain self-
sufficiency in the new economy. As a result of the 1996 
enactment of welfare reform, families previously eligible for 
Head Start services based on their low-income status have found 
themselves marginally exceeding those income limitations and, 
therefore, losing access to Head Start services for their 
children.
    The Committee recognizes that Head Start does not serve all 
income-eligible children and their families in the country. 
Nonetheless, while eligibility for other programs is sensitive 
to regional disparities in income, Head Start eligibility is 
not. It is clear that an inner-city family's expenses with 
respect to food, housing and medical needs are different from 
those of a rural family, while a rural family's transportation 
needs, for one, may well outpace similar needs for their urban 
neighbors. Eligibility requirements should reflect this 
difference. Current law gives the Secretary of Health and Human 
Services authority to permit the enrollment of a ``reasonable 
number'' of over-income families in Head Start. In a welfare-
reformed era, families may find their income marginally 
exceeding national poverty guidelines, while their need for 
quality early childhood programming is even more pronounced. 
The Committee encourages the Secretary to permit local programs 
to best address local community needs in these changing times, 
but encourages flexibility which does not deny services to the 
neediest of the needy.
    Accordingly, the Committee encourages the Secretary to 
exercise his authority to permit the enrollment of over-income 
children and their families in up to 25 percent of program 
placements, so long as services are not denied to income-
eligible children and families as a result of this flexibility.
    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 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 expects the Department to provide adequate 
direction and decisional support to regional offices 
responsible for assessing the need for bus purchases and 
requests that the Department provide the Committee with a 
report of steps taken to ensure that vehicles are purchased 
only when the local program demonstrates that this approach is 
safest and most cost effective. The Committee believes that the 
level of bus purchases in fiscal year 2002 should not exceed 
the fiscal year 2001 level. Further, the Committee directs the 
Head Start Bureau to provide the Committee with a list of all 
bus purchases made by local programs, the number of vehicle 
lease agreements entered into and the number of contracts for 
services with local transportation providers for fiscal year 
2002.
    The Committee understands that there are serious concerns 
that the bus safety rule promulgated at the beginning of 2001 
contains elements that make it difficult to use the same buses 
for children and adults throughout the day in ways that have 
little or no effective safety benefits to Head Start 
participants, significantly increasing the program's 
transportation costs. The Department is urged to carefully 
examine that issue.
    The Committee understands the serious need for additional 
and expanded Head Start facilities among native American 
populations and in rural areas. The Committee believes that the 
Department could help serve these needy communities by 
providing minor construction funding for facilities in the 
Alaskan communities served by the Tanana Chiefs Conference and 
the Central Council of Tlingit-Haida of Alaska.
    The Committee encourages the agency to continue and expand 
its support of the Alaska SEED initiative to expand early 
childhood services for at risk children in Alaska ages 0-6 and 
to train Early Head Start teachers with AAS degrees through 
distance delivery for positions in rural Alaskan communities.

Consolidated runaway and homeless youth program

    The Committee recommends $105,133,000 for this program, an 
increase of $36,000,000 above the fiscal year 2001 level and 
$3,000,000 more than the Administration request.
    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 not less than 90 percent of 
the funds be allocated to States for the purpose of 
establishing and operating community-based runaway and homeless 
youth centers, as authorized under Parts A and B of the Act. 
Funds are distributed 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.
    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 basic centers program, authorized under Part A of the 
Act, supports grants to community-based public and private 
agencies for the provision of outreach, crisis intervention, 
temporary shelter, counseling, family unification and aftercare 
services to runaway and homeless youth and their families.
    The transitional living grant 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.
    Maternity group homes.--Within the Committee recommendation 
for the consolidated runaway and homeless youth program, 
$33,000,000 is available for the maternity group home program, 
the same as the budget request. This is a new program proposed 
by the administration as part of its Faith Based Initiative. 
Under this program, the ACF will provide targeted funding for 
community-based, adult-supervised group homes for young mothers 
and their children. These homes will provide safe, stable, 
nurturing environments for mothers who cannot live safely with 
their own families and assist them in moving forward with their 
lives by providing support so they can finish school, acquire 
job skills, and learn to be good parents.

Child abuse prevention programs

    The Committee has included $54,743,000 for child abuse and 
neglect prevention and treatment activities, including 
$21,026,000 for State grants and $33,717,000 for discretionary 
activities. This is the same as the fiscal year 2001 level and 
$15,739,000 more than 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 is aware of the following projects and 
programs, and encourages ACF to give each full and fair 
consideration for awards available in new grant competitions.
    Parents Anonymous, Inc. will establish and maintain a 
national network of mutual support and parent leadership 
programs as a means of strengthening families in partnership 
with their communities.
    A significant number of abused or neglected children in 
foster care programs have serious emotional, psychological and 
developmental problems which cannot be adequately addressed in 
regular foster care. Ohel Family Services in Brooklyn, New York 
plans to provide specialized services to aid these children, 
including intensive psychiatric and psychological treatment and 
crisis intervention, in-home support for foster parents, and 
rehabilitation activities for biological families.
    Babyland Family Services, Inc. will integrate its family 
violence and child abuse prevention and crisis intervention 
services in order to develop a comprehensive program for 
children and families.
    The University of Notre Dame has proposed a collaborative 
intervention and research project to prevent child neglect and 
delinquency among teenage mothers and their children.
    Casa Myrna Vazquez is the largest provider of comprehensive 
services to battered women and children in New England.
    Klamath Tribes Children's Protective Services and Family 
Preservation program will provide child abuse and prevention 
services.
    The Alaska Native Health Board and Alaska Department of 
Health and Social Services will support the development and 
implementation of 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.
    The innovative Connecticut Healthy Families Initiative will 
expand to additional sites and help prevent child abuse and 
neglect in families at risk for such behavior.
    ``STOP IT NOW!'', a national non-profit organization 
dedicated to preventing the sexual abuse of children, will 
continue to increase public awareness about child sexual abuse, 
educate adults about the ways to stop it, and call on abusers 
and potential abusers to stop and seek help.
    Healthy Families Home Visiting program in Alaska continues 
to achieve success especially in the area of preventing child 
abuse, in part due to the one-on-one interaction represented by 
this program. The State of Alaska will work with Alaska Native 
regional nonprofit corporations to continue and expand the 
Healthy Families Home Visiting Program in Alaska.
    The Alaska Department of Health and Social Services 
proposes to develop a training program for social service and 
health providers in Alaska designed to help these providers 
identify cases of child abuse and document them appropriately.

Abandoned infants assistance

    The Committee concurs with the budget request in 
recommending an appropriation of $12,205,000 for abandoned 
infants assistance, the same as the 2001 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 services

    The Committee recommends an appropriation of $291,986,000 
for child welfare services, the same as the fiscal year 2001 
level and the administration request. This program helps State 
public welfare agencies improve their child welfare services 
with the goal of keeping families together. State services 
include: preventive intervention, so that, if possible, 
children will not have to be removed from their homes; 
reunification so that children can return home and development 
of alternative placements like foster care or adoption if 
children cannot remain at home.

Child welfare training

    The Committee recommends $7,998,000, an increase of 
$1,000,000 over the fiscal year 2001 level and 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.

Adoption opportunities

    The Committee recommends $27,405,000 for adoption 
opportunities, the same as the fiscal year 2001 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.

Adoption incentives

    The Committee recommends $43,000,000 for adoption 
incentives, the same amount as the fiscal year 2001 
appropriation and the budget request. The purpose of this 
program is to provide incentive funds to States to encourage an 
increase in the number of adoptions of children from the public 
foster care system. These funds are used to pay States bonuses 
for increasing their number of adoptions. The appropriation 
allows incentive payments to be made for adoptions completed in 
fiscal years 2000 and 2001.

Adoption awareness

    The Committee recommendation includes $12,906,000 for the 
adoption awareness program, an increase of $3,006,000 over the 
fiscal year 2001 level and $3,000,000 more than the 
administration request. This program was authorized in the 
Children's Health Act of 2000. The program consists of two 
activities: the Infant Adoption Awareness Training Program and 
the Special Needs Awareness Campaign. The Committee has 
provided resources above the request to implement the Special 
Needs Awareness Campaign in fiscal year 2002.

Compassion capital fund

    The Committee recommendation includes $89,000,000 for the 
compassion capital fund, the same as the budget request. This 
new program is part of the Administration's Faith Based 
Initiative. Funds available for this program will be used for 
grants to public/private partnerships that help small faith-and 
community-based organizations replicate or expand model social 
services programs. Partnerships will provide technical 
assistance to these entities to increase their capacity to 
deliver high quality social services and provide financial 
assistance to support start up and operational costs of their 
social service programs.
    The Committee expects funds made available through this 
program to supplement and not supplant private resources and 
encourages the Secretary to require private resources to match 
grant funding provided to public/private partnerships.

Responsible fatherhood initiative

    The Committee recommendation does not include resources for 
this proposed program. As part of its Faith Based Initiative, 
the administration proposed creating a new program to make 
responsible fatherhood a national priority and requested 
$64,000,000 for this new effort. The Committee has deferred 
action on this program pending the enactment of authorizing 
language. The proposed program would support competitive grants 
to faith- and community-based organizations to support 
initiatives that promote responsible fatherhood.

Social services research

    The Committee recommends $27,426,000 for social services 
and income maintenance research, $10,175,000 less than the 
fiscal year 2001 level and $21,000,000 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.
    The Committee is concerned about the current status and 
future prospects for hard-to-employ welfare recipients who are 
close to meeting the 60-month time limit on benefits 
established by the Personal Responsibility and Work Opportunity 
Reconciliation Act (PRWORA). A March, 2001 report by the 
General Accounting Office entitled ``Moving Hard-to-Employ 
Recipients Into the Workforce'', found that many current 
welfare recipients have two or more characteristics that make 
it difficult for them to find and hold a job. The report also 
observed that some States are unclear about the kinds of 
activities they are allowed to provide to welfare recipients, 
and as a result, are hesitant to allow recipients to 
participate in the full range of activities that might help 
them find and keep jobs. The Committee strongly urges the 
Department to undertake research to identify the types of 
barriers hard-to-employ welfare recipients face, the 
pervasiveness of these barriers among the current population of 
recipients and to estimate the number of such recipients who 
will reach their 60-month limit on benefits. The Committee also 
encourages the Department to expand its efforts to help States 
better understand how to use the flexibility they have under 
the PRWORA to provide appropriate services to hard-to-employ 
welfare recipients.
    At the Committee's request, ACF 3 years ago launched a 
concerted effort to assist States in meeting the complex 
information and systems reporting requirements of TANF. ACF 
turned to the State information technology consortium, out of 
which emerged a knowledge base that is enabling each State to 
tailor the best practices developed by others to meet their own 
unique needs. In order to further streamline service delivery 
and reduce overall costs, an effort is now underway to apply 
web-based technology to help each State integrate their loosely 
connected stand-alone systems under a single information 
technology network. The Committee supports this common-sense 
approach to systems coordination and encourages ACF to continue 
this effort at the current level of support.
    The Committee continues to be supportive of the National 
Center for Appropriate Technology's information technology 
clearinghouse in Butte, Montana.
    The Committee is aware of the following projects and 
programs, and encourages the Department to give each full and 
fair consideration when making awards in new grant 
competitions.
    The Toni Jennings Exceptional Education Institute located 
within the University of Central Florida's Academy for 
Teaching, Learning and Leadership has developed programs to 
enhance parenting skills; develop new approaches for 
interaction between fathers and their special needs children; 
and facilitate the development of knowledge and skills 
necessary to provide educational and clinical services for 
children and adults.
    The Montana Child Care Financing Demonstration Project 
proposes to establish an ongoing child care financing fund to 
create meaningful support for the many low income working 
families who earn just above the eligibility guidelines for 
child care financial assistance.
    The City of Newark will develop and evaluate a coordinated 
approach for the delivery of a full spectrum of social services 
to underinsured and uninsured women and youth ages 0-5 to 
improve the health status of this target population.
    CONTACT project provides health and human services 
information and referrals, as well as Elder Reassurance and 
volunteer referrals in support of the needs of community 
residents.
    The family resiliency initiative of the University of 
Hawaii Center on the Family will include the development of a 
comprehensive data system for a wide range of end users.

Community-based resource centers

    The Committee recommends $32,834,000 for community-based 
resource centers, the same level as provided in fiscal year 
2001. 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 $140,534,000 for developmental 
disabilities programs, an increase of $7,000,000 over last year 
and $7,200,000 more 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.

State councils

    For State councils, the Committee recommends $69,800,000. 
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 $35,000,000. 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.
    The Committee supports the continuation of an interagency 
approach to providing training and technical assistance to the 
Protection and Advocacy System. This collaboration has worked 
well in coordinating the provision of critical information to 
the system. The Committee intends that training and technical 
assistance should be delivered through a multiyear cooperative 
agreement with an agency that has demonstrated the capacity to 
provide this service and is supported by the P&A agencies in 
the States. The Committee recommends that ADD involve other 
agencies which administer P&A programs such as Social Security 
Administration and HRSA in determining the entity to receive 
the interagency grant.

Projects of national significance

    The Committee recommends $11,734,000 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.

University-affiliated programs

    For university-affiliated programs, the Committee 
recommends $24,000,000. 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 recommends $45,996,000 for Native American 
programs, the same amount as the 2001 level and $1,600,000 more 
than the budget request. 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 continues to be concerned that Native 
American children may be placed in homes without foster care 
maintenance payments to support the cost of food, shelter, 
clothing, daily supervision, school supplies, or liability 
insurance for the child. For children adopted through tribal 
placements, there may be no administrative payments for 
expenses associated with adoption and training of professional 
staff or parents involved in the adoption. In the past, the 
Committee has supported a demonstration project to provide 
funding to two Alaska Native regional non-profit organizations, 
Cook Inlet Tribal Council, Inc. in Anchorage, and Kawerak, Inc. 
in Nome. Also, the Tanana Chiefs Conference in Interior Alaska 
is developing a State/Alaska Native information system so that 
Alaska Native children have the same support as other American 
children.
    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 initiated 
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.
    The Committee is aware that the Tate Ota (Many Winds) 
Corporation on the Rosebud Indian Reservation in Mission, South 
Dakota, will research historical efforts to educate Native 
American youth and apply what is learned to improve the 
educational process in tribal schools.
    The Committee is concerned about the allocation of 
resources for Native Hawaiian groups, and urges equal 
consideration for future government-funded programs that affect 
Native Hawaiians. The Committee recommends equitable funding 
from the Administration for Native Americans for the provision 
of assistance to support educational activities associated with 
the exercise of self-determination by Native Hawaiian people 
and the identification of self-government.

Community services

    The Committee recommends an appropriation of $765,304,000 
for the community services programs. This is $82,654,000 more 
than the fiscal year 2001 level and $110,289,000 higher than 
the administration request.
    Within the funds provided, the Committee recommends 
$675,000,000 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 continues to recognize the importance of the 
Community Services Block Grant and the Community Action 
Agencies it funds. An appropriation of $675,000,000 has been 
provided for CSBG for fiscal year 2002, a sizable increase of 
$75,009,000 over the fiscal year 2001 level.
    It is the intent of the Committee that all eligible 
entities in good standing receive a proportionate share of the 
increase provided for fiscal year 2002. Congress has provided 
significant investment in the Community Services Block Grant in 
recent years, and expects all eligible entities, particularly 
Community Action Agencies, to benefit. The Committee is aware 
that report language in the statement of the managers 
accompanying the fiscal year 2001 conference report to this 
effect (H. Rept. 106-1033) was not universally implemented in 
all States; therefore the Committee has adopted legislative 
language to make its intentions unambiguously clear. The 
Committee expects that the Office of Community Services will 
enforce this bill language.
    The Committee expects the Office of Community Services to 
release funding to the States in the most timely manner. The 
Committee also expects the States to makes funds available 
promptly. The Committee is aware that the Office of Community 
Services and some States have been extraordinarily delinquent 
in providing funds to local eligible entities.
    The Committee is aware that Community Action Agencies have 
well-established partnerships with the private sector, the 
public sector, other community-based organizations, and faith-
based organizations. The Committee expects fiscal year 2002 
funding to help provide stronger partnerships of eligible 
entities of the Community Services Block Grant, which are 
predominantly Community Action Agencies.
    The Committee is also aware that Community Action Agencies 
are developing model programs in the areas of fatherhood 
initiatives, mentoring, literacy, and family development. For 
example, CAP of Lancaster County, of Lancaster, Pennsylvania, 
and Metropolitan Development Council of Tacoma, Washington, 
have excellent fatherhood programs. CHANGE, Inc. of Weirton, 
West Virginia and the Rural Alaska Community Action Program, 
Inc., which serves the entire State of Alaska, have developed 
exemplary mentoring programs. CAP Services, Inc. of Stevens 
Point, Wisconsin and the Community Action Council of Lexington, 
Kentucky, have implemented nationally recognized literacy 
programs. Community Action Agencies across Iowa and Wisconsin 
have developed exemplary family development programs. The 
Committee expects that the money going to Community Action 
Agencies through the Community Services Block Grant will 
continue to provide services that innovate and create model 
programs such as these.
     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 2002: community economic 
development, $35,000,000; individual development accounts, 
$24,990,000; rural community facilities, $7,000,000; national 
youth sports, $16,000,000; and community food and nutrition, 
$7,314,000.
    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. The Committee has 
included bill language clarifying that Federal funds made 
available through this program may be used for financing for 
construction and rehabilitation and loans or investments in 
private business enterprises owned by Community Development 
Corporations. Of the total provided, the Committee has included 
$5,000,000 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 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.
    The Committee is aware that Yellowstone County, Montana is 
home to a growing number of low income, high-risk, preschool 
children and families with escalating needs. The County is 
developing innovative solutions that coordinate employment 
training, health services and school readiness programs for 
these disadvantaged families. The Committee encourages ACF to 
give consideration to such a proposal.

Family violence prevention and services

    The Committee recommends $139,156,000 for family violence 
prevention and services programs, an increase of $5,082,000 
over the fiscal year 2001 appropriation and the budget request.
    For the runaway youth prevention program, the Committee 
recommends $14,999,000, which is the same as the fiscal year 
2001 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 amount as the fiscal 
year 2001 appropriation and the administration request. This is 
a cooperative agreement which funds the operation of a 
national, toll-free, 24-hours-a-day telephone hotline to 
provide information and assistance to victims of domestic 
violence.
    The Committee recommends $122,000,000 for the grants for 
battered women's shelters program, $5,082,000 above the fiscal 
year 2001 program level and the administration request. This is 
a formula grant program to support community-based projects 
which operate shelters for victims of domestic violence. 
Emphasis is given to projects which provide counseling, 
advocacy, and self-help services to victims and their children.

Early learning opportunities program

    The Committee recommendation includes $25,000,000 for the 
early learning opportunities program, $5,002,000 more than the 
fiscal year 2001 funding level. The administration proposed 
eliminating this program. This program supports grants to local 
community councils comprised of representatives from agencies 
involved in early learning programs, parent organizations and 
key community leaders. Funds are used to increase the capacity 
of local organizations to facilitate development of cognitive 
skills, language comprehension and learning readiness; enhance 
childhood literacy; improve the quality of early learning 
programs through professional development and training; and 
remove barriers to early learning programs.

Faith-based center

    The Committee recommendation does not include $3,000,000 
requested for staff to support operation of a Center for Faith-
Based and Community Initiatives. The staff resources required 
for the Center can be absorbed within the general departmental 
management account.

Program administration

    The Committee recommends $171,870,000 for program 
administration, $8,000,000 above the fiscal year 2001 
appropriation and the same as the administration request.
    The Committee appreciates the contributions made by ACF in 
responding to the tragedy that occurred on September 11, 2001. 
The Committee notes that ACF promptly released resources to 
support the social service needs of individuals in affected 
communities and provide for child care and related services 
required to sustain the heroic efforts of relief workers. These 
resources, as well as the additional support provided to ACF's 
programs that serve children in affected communities, will help 
individuals and families access the services and information 
they need to cope with and heal from the tragic events of that 
day.
    The Committee is aware of the Department's new rule 
regarding outcome-based reviews. These reviews are an effective 
method for monitoring the progress States are making in 
assuring the safety, health and permanency for children in 
child welfare and foster care as required in the Adoption and 
Safe Families Act. The Committee encourages the Department to 
make available sufficient resources to ensure full 
implementation of the new collaborative monitoring system.

                   PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2001....................................    $305,000,000
Budget estimate, 2002...................................     572,000,000
Committee recommendation................................     305,000,000

    The Committee recommends $305,000,000 for fiscal year 2002, 
$267,000,000 less than the amount requested by the 
administration and the same amount as the fiscal year 2001 
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.
    The promoting safe and stable families program is under 
consideration for reauthorization this year. The administration 
proposed increasing the authorization level of this 
appropriated entitlement program by $200,000,000 and also 
requested $67,000,000 for a new mentoring children of prisoners 
program. The Committee defers action on these requests pending 
enactment of authorizing legislation.

                    Mentoring children of prisoners

    The Committee defers action on this request pending 
enactment of authorizing legislation. As part of its Faith 
Based Initiative, the administration proposed a new program 
designed to mentor children of prisoners and requested 
$67,000,000 for this purpose. Funds would be used to award 
competitive grants to local governments for the establishment 
or operation of programs providing mentoring for children of 
prisoners and probationers through networks of community 
organizations, including faith based organizations.

       payments to states for foster care and adoption assistance

Appropriations, 2001....................................  $4,863,100,000
Budget estimate, 2002...................................   4,945,200,000
Committee recommendation................................   4,885,200,000

    The Committee recommends $4,885,200,000 for this account, 
which is $22,100,000 more than the 2001 comparable level and 
$60,000,000 less than the budget request. In addition, the 
Committee recommendation concurs with the administration's 
request of $1,754,000,000 for an advance appropriation for the 
first quarter of fiscal year 2003. 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.
    The Independent Living Program provides services to foster 
children under 18 and foster youth ages 18-21 to help them make 
the transition to independent living by engaging in a variety 
of services including educational assistance, life skills 
training, health services and room and board. States are 
awarded grants from the annual appropriation proportionate to 
their share of the number of children in foster care, subject 
to a matching requirement.
    The administration proposed amending the Independent Living 
program by increasing the cap on entitlement spending to 
$200,000,000. The additional $60,000,000 made available through 
this proposal would support vouchers for children who age out 
of the foster care system so they can pursue vocational 
training or college and be better prepared to live 
independently and contribute productively to society. The 
Committee defers action on this proposal pending enactment of 
authorizing legislation.

                        Administration on Aging

Appropriations, 2001....................................  $1,103,093,000
Budget estimate, 2002...................................   1,097,718,000
Committee recommendation................................   1,209,756,000

    The Committee recommends an appropriation of $1,209,756,000 
for aging programs, $106,663,000 above the 2001 appropriation 
and $112,038,000 more than the budget request.

Supportive services and senior centers

    The Committee recommends an appropriation of $366,000,000 
for supportive services and senior centers, $41,425,000 more 
than the amount appropriated in fiscal year 2001 and 
$39,425,000 more than the administration request. The increased 
funding will provide additional transportation, in-house 
services, chore services, case management and other support for 
frail older individuals. This State formula grant program funds 
a wide range of social services for the elderly, including 
multipurpose senior centers, adult day care 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 and those residing in rural areas. Under the basic 
law, States have the option to transfer up to 30 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.

Preventive health services

    The Committee recommends $22,000,000 for preventive health 
services, an increase of $877,000 more than the amount 
appropriated in fiscal year 2001 and the budget request. 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. Within the 
appropriation for this program, $5,000,000 is provided to 
continue medication management, screening and education 
activities to prevent incorrect medication and adverse drug 
reactions. These activities will help older adults learn more 
about managing medications safely and help reduce unnecessary 
hospitalizations and illnesses.

Protection of vulnerable older Americans

    The Committee recommends $18,181,000 for grants to States 
for protection of vulnerable older Americans. Within the 
Committee recommendation, $12,949,000 is for the ombudsman 
services program and $5,232,000 is for the prevention of elder 
abuse program. The amount recommended for the ombudsman 
services program is $3,500,000 more than the fiscal year 2001 
level and the administration request. The amount recommended 
for the elder abuse prevention program is $500,000 more than 
the fiscal year 2001 level and budget request. 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 recognizes the importance of the Long-Term 
Care Ombudsman Program in assisting residents of nursing homes 
and board and care facilities resolve abuse and neglect 
complaints. The Committee is aware of the Institute of 
Medicine's 1995 study which recommended a ratio of 1 Ombudsman 
for every 2,000 nursing home beds to meet the needs of long-
term care residents, as well as DHHS Office of Inspector 
General's 1999 report recommending additional funding for the 
program. Therefore, the Committee has provided an increase of 
$3,500,000 for the Long-Term Ombudsman Program, which will 
allow the program to hire additional Ombudsman staff, expand 
public information and education campaigns, and upgrade 
technology.
    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.

National family caregiver support program

    The Committee recommends $140,000,000 for the national 
family caregiver support program, an increase of $20,000,000 
over the amount appropriated in fiscal year 2001 and 
$18,000,000 more than the budget request. Funds appropriated 
for this activity established a multifaceted support system in 
each State for family caregivers. All States are expected to 
implement the following five components into their program: 
individualized referral information services; assistance to 
caregivers in locating services from a variety of private and 
voluntary agencies; caregiver counseling, training and peer 
support; respite care provided in the home, an adult day care 
center or other residential setting located in an assisted 
living facility; and limited supplemental services that fill 
remaining service gaps.

Native American Caregiver Support Program

    The Committee recommendation includes $6,000,000 to carry 
out the Native American Caregiver Support Program, an increase 
of $1,000,000 over last year. The program will assist Tribes in 
providing multifaceted systems of support services for family 
caregivers and for grandparents or older individuals who are 
relative caregivers. In fiscal year 2001, funds were used to 
provide both discretionary and formula grants to support the 
purpose of this program.

Congregate and home-delivered nutrition services

    For congregate nutrition services, the Committee recommends 
an appropriation of $384,000,000, an increase of $5,588,000 
over the amount appropriated in fiscal year 2001 and the budget 
request. For home-delivered meals, the Committee recommends 
$177,000,000, an increase of $25,000,000 over the amount 
appropriated in fiscal year 2001 and $19,000,000 more than the 
administration request. 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 40 percent of funds between these programs.

Aging grants to Indian tribes and native Hawaiian organizations

    The Committee recommends $26,000,000 for grants to native 
Americans, $2,543,000 more than the amount appropriated in 
fiscal year 2001 and $543,000 more than the administration 
request. 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 supportive services and assure that 
nutrition services and information and assistance are 
available.

Training, research and discretionary projects

    The Committee recommends $36,574,000 for training, 
research, and discretionary projects, $722,000 more than the 
fiscal year 2001 enacted level and $19,000,000 more than the 
budget request. These funds support activities designed to 
expand public understanding of aging and the aging process, 
apply social research and analysis to improve access to and 
delivery of services for older individuals, test innovative 
ideas and programs to serve older individuals, and provide 
technical assistance to agencies who administer the Older 
Americans Act.
    The Committee has provided support at last year's level to 
continue the pilot project to test the best ways of using the 
skills of retired nurses, doctors, accountants and other 
professionals to train other 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 CMS and the OIG 
to track cases referred by this initiative.
    The following programs and projects have been brought to 
the Committee's attention. The Committee expects the 
Administration on Aging to give each full and fair 
consideration for awards available under new grant 
competitions.
    The National Indian Council on Aging continues to initiate 
programs designed to improve access to social services at the 
Federal, State, and tribal levels for elders in Indian Country 
through the nation's 235 Title VI programs.
    Recent studies have forecasted significant changes in the 
size and economic well being of the elderly population in 
Missoula, Montana. The Missoula Aging Services will continue to 
develop new and innovative programs such as a resource center 
and other support systems to serve the needs of community 
residents.
    The SPRY Foundation will continue its efforts to improve 
the quality of life for seniors throughout the United States by 
developing web-based resources and related training programs to 
help seniors and their families access high-quality information 
and caregiver support services.
    The West Virginia University National Rural Aging Project 
proposes to support State efforts to implement and evaluate 
best practices in improving service delivery to the elderly in 
rural areas.
    The National Council on the Aging proposes to establish the 
National Center on Senior Benefit Outreach to provide seniors 
and caregivers with timely information and assistance about 
State and Federal programs that address important health, 
financial and social needs.
    The Motion Picture and Television Fund, in partnership with 
the University of Southern California's Andrus School of 
Gerontology has developed the Eden Alternative demonstration 
project, which seeks to improve quality of care and life for 
seniors residing in nursing homes and assisted living 
facilities.
    Sonoma State University has developed the Lifelong Learning 
Institute which encompasses a university-community partnership 
designed to promote a wide range of intellectually stimulating 
learning opportunities in support of the creative growth of 
retired individuals.
    Naturally Occurring Retirement Communities (NORCs) provide 
seniors with the supportive services that they need to continue 
living independently and avoid early and unnecessary 
institutionalization. A multi-state demonstration project 
targeting NORC communities in Baltimore, Cleveland, Detroit, 
St. Louis, and Pittsburgh could promote the testing and 
development of improved integrated systems providing supportive 
services to large concentration of seniors, the results of 
which could be used to formulate national models.
    Access Community Health Network in Chicago has developed a 
Senior Outreach Program to provide direct links to primary 
health care for the isolated elderly.
    The Florida State University System has developed a major 
research initiative consisting of an integrated set of 
research, policy analysis and development projects designed to 
address long-term care in Florida and the nation, in particular 
focusing on community-based long-term care services with the 
integration of housing, assistive technology, transportation, 
caregiver, mental health and acute-care services.
    The Gerontological Studies Center at Northern Michigan 
University will combine research and educational programming 
with community services to benefit the elderly population of 
Michigan's upper peninsula.
    Oregon Health Sciences University will expand its Healthy 
Aging project by helping the elderly and their family maintain 
self-determination, dignity and optimal quality of life as they 
deal with inevitable declines in physical independence.
    Texas Tech University's Center for Healthy Aging, a state-
of-the art geriatric care, training, and research center, will 
serve as a national model for the treatment and understanding 
of long-term health care for older Americans.
    The Coalition of Wisconsin Aging Groups proposes to expand 
the Elder Law Center to provide legal backup to benefit 
specialists and to educate members of the legal community and 
the public on growing concerns about financial elder abuse and 
possible remedies to that problem.
    The La Crosse Hmong Mutual Assistance Association is 
developing programs to provide employment, social, economic and 
educational assistance to elderly Hmong refugees.
    Champlain Senior Center in Burlington, Vermont proposes to 
utilize technology in its efforts to help more low income 
senior remain independent and active for as long as possible.
    The University of Indianapolis, through its new Center for 
Aging and Community Health, is developing an integrated 
complement of clinical, educational, and research programs in 
order to improve services to the community.
    The Center to Enhance Quality of Life in Chronic Illness at 
Indiana University proposes to undertake research on preventing 
falls among the elderly, home support of patients with 
congestive heart failure and interventions to family care 
givers of Alzheimer patients.
    The National Asian Pacific Center for Aging's efforts have 
helped increase access for American Asian and Pacific Islander 
seniors to social services and other support programs.
    The Franciscan Health System's program ``Improving Care 
through the End of Life'' has demonstrated cost savings 
achieved by programs that integrate palliative care into a 
comprehensive, interdisciplinary service geared toward patients 
with terminal illnesses.
    The Hana Community Health Center provides traditional 
nutrition services to the area's elderly population, and also 
provides additional wellness programs, home health care and 
transportation assistance, enabling the elderly to remain in 
the Hana Community.
    The Allegheny County Homestead Apartments LIFE Center will 
provide quality primary health care, physical and occupational 
therapy, and limited social services to the senior citizens at 
the Homestead Apartments and in the surrounding area, allowing 
seniors to remain at home.
    The International Longevity Center proposes to establish a 
Visiting Scholars Program, expand research focused on the daily 
life experiences of older persons and disseminate research 
findings widely.
    The Family Friends Project continues to pursue new 
replication approaches and support technical assistance and 
training for local sites through the Family Friends national 
office.

Aging network support activities

    The Committee recommends $2,379,000 for aging network 
support activities, $567,000 more than the fiscal year 2001 
level and the budget request. The Committee recommendation 
includes $1,198,607 for Eldercare Locator, $337,557 more than 
the fiscal year 2001 appropriation. The Committee 
recommendation provides $1,180,393 for the pension information 
and counseling projects, $229,000 more than last year. These 
program were funded as demonstration activities through the 
fiscal year 2001 appropriation. Last year's reauthorization of 
the Older Americans Act authorized both of these activities 
under section 201 of the Act.
    The Eldercare Locator, a toll-free, nationwide directory 
assistance service for older Americans and their caregivers, is 
operated by the National Association of Area Agencies on Aging. 
Since 1991, the service has linked nearly 500,000 callers to an 
extensive network of resources for aging Americans and their 
caregivers. Pension counseling projects provide information, 
advice, and assistance to workers and retirees about pension 
plans, benefits, and pursuing claims when pension problems 
arise.

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 $13,000,000, an increase of $4,038,000 over 
the fiscal year 2001 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 currently 
provides matching grants to 24 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. Given the programs proven 
record of success, the Committee recommends an increase of 
$4,038,000 over the comparable 2001 appropriation to expand the 
program to additional States.

Program administration

    The Committee recommends $18,122,000 to support Federal 
staff that administer the programs in the Administration on 
Aging, $903,000 above the 2001 level and the same amount as the 
budget request. These funds provide administrative and 
management support for programs administered by the agency.
    The Committee applauds the efforts of the AoA and the 
national aging network in helping address the needs of the 
elderly and their caregivers arising from the tragedy that 
occurred on September 11, 2001. The Committee recognizes that 
AoA and many State and local organizations serving the elderly 
and caregivers focused resources and increased attention on 
helping support the local aging network in responding to the 
needs of elderly individuals residing in communities affected 
by that day's tragedy. These events underscore both the 
vulnerability of the elderly, and especially homebound elderly, 
in times of both natural and man-made disasters. However, these 
events also underscore the fact that the national aging 
network, comprising 56 State units on aging, 655 area agencies 
on aging, 235 Tribes and Tribal organizations, and 29,000 local 
services providers, represents a tremendous resource for 
assisting the community at large during emergency situations. 
The Committee commends and supports the continued efforts of 
AOA and the aging network in providing for the needs of the 
elderly and their caregivers, including mental health needs, in 
affected communities. The Committee also urges the Secretary to 
continue efforts to plan for emergencies, to ensure that the 
elderly and their caregivers receive the help they need and to 
facilitate making the resources of the national aging network 
available to the community at large in emergency situations.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2001....................................    $378,019,000
Budget estimate, 2002...................................     442,751,000
Committee recommendation................................     422,212,000

    The Committee recommends $422,212,000 for general 
departmental management [GDM]. This is $20,539,000 less than 
the administration request and $44,193,000 above the fiscal 
year 2001 level. Within this amount, the Committee includes the 
transfer of $5,851,000 from Medicare trust funds, which is the 
same as the administration request and the fiscal year 2001 
level. Included in these funds is $5,000,000 to be transferred 
to the Global Fund to Fight HIV/AIDS, Malaria, and 
Tuberculosis.
    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.
    The Committee is aware that, in response to the September 
11th terrorist attacks, the Department activated the National 
Disaster Medical System (NDMS) to provide emergency medical 
assistance to local officials in New York City and at the 
Pentagon. The Office of Emergency Preparedness deployed 328 
medical personnel as part of Disaster Medical Assistance Teams 
(DMATS), which consisted of physicians, nurses and emergency 
medical technicians trained to deal with traumatic injuries. In 
addition, four Disaster Mortuary Operation Response Teams 
(DMORTS) were dispatched to New York City, and three to the 
Washington area. The Committee commends the Department for its 
quick response and for providing needed resources to local 
emergency personnel.
    The Committee has provided $4,000,000 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 directs that specific information requests 
from the Chairman and Ranking Members of the Subcommittee on 
Labor, Health and Human Services, and Education, and Related 
Agencies, on scientific research or any other matter, shall be 
transmitted to the Committee on Appropriations in a prompt 
professional manner and within the time frame specified in the 
request. The Committee further directs that scientific 
information requested by the Committees on Appropriations and 
prepared by government researchers and scientists be 
transmitted to the Committee on Appropriations, uncensored and 
without delay.
    The Committee is aware that the Department is undertaking 
an overhaul of its internal computer systems, specifically a 
Unified Financial Management System. The Committee is further 
aware that there are concerns about the process by which the 
Department has solicited bids for fulfilling its software 
needs. Therefore, the Committee urges the Department to ensure 
that the procurement process for any and all service and 
software purchases is conducted in the most open, fair, and 
appropriate manner in compliance with current Federal 
guidelines.
    The Committee has included funding for the Human Services 
Transportation Technical Assistance Program. These funds shall 
be used to provide assistance to human service transportation 
providers on management, coordination and meeting the 
requirements of the Americans with Disabilities Act. Funding is 
also included for a Medicare Transportation Demonstration 
Program in Iowa. Under this demonstration, residents of an 
urban and rural community shall receive non-emergency 
transportation assistance for visits to hospitals, clinics, and 
physicians and for related services. The purpose of this 
demonstration is to ascertain the obstacles, including costs, 
that senior citizens encounter in securing non-emergency 
transportation to health care providers. The Committee notes 
that the technical assistance provided by the Community 
Transportation Association of America is vital to the success 
of these demonstrations.
    The Committee understands that Mercy Housing, Inc., a 
national non-profit faith-based organization focused on 
improving the health care and housing opportunities available 
to low-income families, elderly households and individuals, 
would benefit from technical assistance to develop linkages 
between health care services and affordable housing 
developments.
    Children's eye exams.--As 80 percent of what children learn 
is acquired through vision processing information, the 
Committee recognizes that ensuring that all children start 
school ready to learn is essential to their academic 
achievement and our Nation's economic success and urges that 
all children have access to comprehensive eye examinations 
prior to school matriculation. The Committee believes that 
comprehensive eye exams in children prior to entering school 
are an important step to assure they start their academic 
careers ready to learn and that the full range of visual 
impairments are identified and diagnosed. The Committee 
therefore urges the Secretary to explore and develop ways in 
which to assure that more children receive comprehensive eye 
examinations.
    Chronic fatigue.--The Committee is pleased that the 
Department has announced that it will establish a chronic 
fatigue syndrome advisory committee to build upon progress made 
by the DHHS CFS Coordinating Committee within the limits of its 
charter. It is this Committee's expectation that this 
transition to an advisory committee will not diminish the full 
partnership of involved agencies or the collaborative 
relationships among Federal agencies, scientists, and CFS 
advocates that have developed over recent years through the CFS 
Coordinating Committee. The Committee is disappointed that, 
despite 2 years of report language, the Department has not yet 
undertaken a prominent educational campaign to inform health 
care professionals and the general public about CFS. The 
Committee urges the Secretary and the Surgeon General to take a 
leadership role in this effort and to report back to the 
Committee within 90 days on plans to inform the public that CFS 
is a serious, prevalent, and disabling illness.
    Coordination of child support enforcement activities.--The 
flow of information between Federal and State agencies and the 
court system continues to be a critical factor in the success 
of the Child Support Enforcement program. While some States 
have succeeded in implementing seamless, cost-effective 
processes for information-sharing among their human service 
agencies and the courts, others have not. The Committee has 
been impressed with the results of ACF's efforts using the 
State information technology consortium to improve the 
information and systems reporting requirements of TANF. That 
success underscores the notion that States are in the best 
position to solve their own problems. The Committee therefore 
encourages the Secretary to utilize this consortium of States 
to identify and widely disseminate methods for improving the 
flow of information between agencies and the court system.
    Dietary supplements.--The Committee recognizes the 
substantial role that dietary supplements can play in improving 
the health status of Americans. Indeed, improved nutrition and 
healthful diets may mitigate the need for expensive medical 
procedures and reduce health care expenditures. In 1994, the 
Congress passed the Dietary Supplement Health and Education Act 
(DSHEA), which provides the regulatory framework necessary to 
ensure that consumers have access to safe, accurately labeled 
dietary supplements and information about those products. 
However, while the Food and Drug Administration (FDA) has spent 
resources to take action against a number of important 
healthful products, the Committee believes it has failed to 
take action against a number of clearly violative claims and 
inaccurate ingredient labels. The Committee is aware that 
funding for the Food and Drug Administration is in the 
Department of Agriculture appropriations bill. However, the 
Committee directs the Secretary to work with the FDA to 
undertake appropriate enforcement of DSHEA in areas relating to 
the accuracy of claims about dietary supplement ingredients, 
and prohibiting any dietary supplement claim that is false or 
misleading.
    Embryo adoption awareness.--During hearings devoted to Stem 
Cell research, the Committee became aware of approximately 
100,000 spare frozen embryos stored in in vitro fertilization 
(IVF) clinics throughout the United States. The Committee is 
also aware of many infertile couples who, if educated about the 
possibility, may choose to implant such embryos into the woman 
and, potentially, bear children. The Committee therefore 
directs the Department to launch a public awareness campaign to 
educate Americans about the existence of these spare embryos 
and adoption options. The Committee has provided $1,000,000 for 
this purpose.
    Homelessness.--The Committee supports the ongoing efforts 
of the Department in its initiative to end chronic 
homelessness. The Committee encourages the collaboration 
between HHS and the Department of Housing and Urban Development 
(HUD) and supports the goal of ending homelessness for the 
estimated 150,000 chronically homeless. The Department should 
continue to identify funds for supportive services to 
supplement permanent supportive housing projects being funded 
by HUD.
    Long-term care.--The Committee notes that long-term care 
settings (nursing homes, assisted living, home health care, 
etc.) nationwide are facing a shortage of frontline caregivers 
including registered and licensed practical nurses, certified 
nurse aids (CNAs) and other direct care workers. The Committee 
notes that the General Accounting Office estimates that the 
U.S. health care system will need an additional 800,000 nurse 
aides by the year 2008. The Committee expects the Secretary to 
coordinate a study with the Administrators of HRSA and CMS to 
identify the causes of the shortage of frontline caregivers in 
long-term care settings and make comprehensive recommendations 
to the Committee to address the increasing demand of an aging 
baby-boomer generation, and report findings and recommendations 
to the Committee by June 1, 2002.
    Medical devices.--The Secretary is urged to submit a report 
to the Committee on medical devices developed or improved by 
the Federal Government or in conjunction with Federal funds. 
The report should specifically address medical devices used in 
the treatment of chronic illness, including diabetes. To the 
extent possible, the report should address how medical devices 
developed or used by the Federal Government are introduced into 
the mainstream health care delivery system; how the use of a 
medical device by a chronically ill person is evaluated for 
efficacy; how the Federal Government can improve efforts to 
introduce medical device technology developed by its agencies 
and programs into the mainstream health care delivery system; 
and how the Department can improve its consideration of the 
needs of chronically ill patients when evaluating the efficacy 
of medical devices. The Secretary is urged to report to the 
Committee no later than May 30, 2002.
    Nurse anesthetists.--The Committee understands that 
concerns have been raised about the administration's proposed 
rules to address the issue of physician supervision of 
certified registered nurse anesthetists. The Committee urges 
the Secretary to take the differing views of the interested 
parties, including the nurse anesthetists and 
anesthesiologists, into consideration before issuing a final 
rule.
    Report on osteoporosis and related bone diseases.--More 
than 30 million Americans suffer from some form of bone 
disease, including osteoporosis, Paget's disease and 
osteogenesis imperfecta. The Committee therefore recommends 
that the Department commission a Surgeon General's report on 
osteoporosis and related bone diseases, detailing the burden 
bone diseases places on society, and highlighting preventive 
measures to improve and maintain bone health throughout life. 
The report should also identify best practices for collecting 
data about the prevalence, morbidity and disability associated 
with bone diseases among minority populations.
    Runaway youth.--The Committee is concerned with reports 
that runaway, throwaway, homeless, and street experiences among 
youth are increasing. The Committee is also troubled that the 
exact nature of these problems is not well defined because 
national statistics on the number, characteristics, and 
circumstances of this population are not tabulated. The 
Committee instructs the Secretary, acting through the Assistant 
Secretary of Planning and Evaluation, to prepare and submit by 
September 30, 2002 a plan for developing estimates of the 
incidences of runaway, throwaway, homeless, and street 
experiences among youth, as well as a plan for regularly 
monitoring incidence trends.
    Underage drinking prevention.--The Committee recommendation 
includes $1,000,000 for the National Academy of Sciences 
Institute of Medicine to conduct a comprehensive review of all 
existing Federal, State and non-governmental programs designed 
specifically to reduce the illegal purchase and consumption of 
alcohol, as well as media-based programs with the purpose of 
changing the attitudes and behaviors of youth. The Committee 
directs the NAS to review, evaluate and report on the 
effectiveness of all such programs, the results of which shall 
identify those programs which have been the most successful at 
accomplishing the goals of reducing underage drinking or 
successfully altering the attitudes and behaviors of youth. The 
NAS shall, based on its review, make recommendations on a 
comprehensive strategy for reducing and preventing underage 
drinking in the United States. The review and recommendations 
of the NAS shall be reported to the United States Senate 
Committee on Appropriations, the United States Secretary of 
Health and Human Services, the United States Secretary of 
Education and the United States Attorney General no later than 
12 months after the date of enactment of this Act.

Adolescent family life

    The Committee has provided $30,000,000 for the Adolescent 
Family Life Program [AFL]. This is $5,673,000 more than the 
fiscal year 2001 appropriation and $2,138,000 over the 
administration request.
    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 $1,139,000 for the Federal staff 
which supports the President's Council on Physical Fitness and 
Sports. This is the same as the budget request and $48,000 more 
than the fiscal year 2001 appropriation.
    The President's Council on Physical Fitness and Sports 
serves as a catalyst for promoting increased physical activity/
fitness and sports participation for Americans of all ages and 
abilities, in accordance with Executive Order 12345, as 
amended. The programs sponsored by PCPFS are supported largely 
through private sector partnerships.

Minority health

    The Committee recommends $43,084,000 for the Office of 
Minority Health. This is the same as the budget request and 
$5,935,000 less than the fiscal year 2001 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.
    The Committee has provided $1,000,000, the same as the 
budget request, to support a national program to assess and 
reduce health disparities affecting minority males. The 
Committee urges the Department, when launching the new National 
Minority Male Health Project, to do so through a consortium of 
historically black colleges and universities with a 
demonstrated relationship that will contribute to educating 
minority males about their health. The Committee further urges 
the Department to directly involve historically black colleges 
and universities in the community-based health strategies 
affecting minority males.
    The Committee encourages the Office of Minority Health to 
provide support to historically black serving institutions and 
other minority-serving institutions to enhance their efforts in 
HIV/AIDS and other disease prevention.
    The Committee recommends continuation of the following 
fiscal year 2001 projects and activities referenced in the 
fiscal year 2001 conference agreement:
  --Trinity Health in Detroit, Michigan for its primary care 
        clinic that serves underserved, low-income and minority 
        individuals
  --the Community Lead Education and Reduction Corps 
        (CLEARCorps) at the University of Maryland Baltimore 
        County to prevent lead poisoning among low-income and 
        minority children.
    The Committee is aware of the following projects and urges 
the Department to give them full and fair consideration:
  --the American Association of Physicians of Indian Origin 
        (AAPI) efforts to study bone mineral density (BMD) in 
        the Indian American community
  --the AIDS Foundation of Chicago's efforts to expand current 
        prevention programs
  --the Center for Hispanic Community and Family Health at the 
        University of North Carolina at Greensboro
  --Padres Contra El Cancer, a non-profit organization that 
        serves Latino children with cancer in Los Angeles, CA
  --the Institute for the Elimination of Health Disparities at 
        the University of Medicine and Dentistry of New Jersey 
        (UMDNJ) for focusing on minority health issues
  --the California Teratogen Information Service in San Diego, 
        CA for its outreach and education program directed at 
        Hispanic women of reproductive age
  --the Chronic Disease Prevention for Hispanic Children 
        Project being sponsored through the Texas Agricultural 
        Extension Service, Baylor Children's Hospital and the 
        Texas A&M Health Sciences Center
  --the Baltimore City Health Department for HIV/AIDS testing 
        for high-risk individuals.
  --the Thomas Jefferson University Hospital for providing 
        linguistically competent and culturally sensitive 
        health care services to the Chinese community.

Office on Women's Health

    The Committee recommends $27,396,000 for the Office on 
Women's Health. This is the same as the administration request 
and $10,126,000 more than the fiscal year 2001 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 remains strongly supportive of the various 
women's health-related offices in NIH, CDC, HRSA, FDA, SAMHSA, 
AHRQ, and HCFA. These offices are essential to the mission of 
the Department and must be adequately supported to accomplish 
their goals in line with the expanded role planned for OWH. The 
Secretary should notify the Committee in advance of any 
significant changes in the status of any of these offices.
    The Committee is supportive of the efforts of Wishard 
Health Services in Indianapolis, Indiana to establish a 
National Center of Excellence in Women's Health. The Center of 
Excellence would offer a comprehensive array of programs 
designed to help women take important steps toward leading 
positive, productive lives.
    National Bone Health Campaign.--The Committee commends the 
Office on Women's Health for their commitment to the National 
Bone Health Campaign aimed at girls aged 9 to 18. The Committee 
encourages the Office on Women's Health to increase their 
support of the Campaign.

Office of Emergency Preparedness

    The Committee has provided $14,200,000, which is the same 
as the budget request and $2,532,000 more than last year, 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 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.

Bioterrorism

    The Committee recommendation includes $68,700,000 for 
bioterrorism activities, which is the same as the 
administration request and $8,670,000 above the fiscal year 
2001 level. In fiscal year 2001 funds for bioterrorism were 
appropriated in the Public Health and Social Services Emergency 
Fund. The fiscal year 2002 budget request funds bioterrorism 
programs in the OEP and the Office of the Secretary. Additional 
funds for bioterrorism have been provided by the Committee 
within the CDC and NIH.
    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 is aware that the administration is 
submitting a supplemental budget request for additional fiscal 
year 2002 bioterrorism funding. The Committee looks forward to 
working with the administration on this request to insure that 
substantially increased investments are made in our public 
health infrastructure, and that our first-responders at the 
State and local level are sufficiently prepared in the event of 
a bioterrorist attack.
    The Committee recommends continuation of the following 
fiscal year 2001 projects and activities in the fiscal year 
2001 conference agreement:
  --the West Virginia University Virtual Medical Campus to 
        address medical community needs for weapons of mass 
        destruction readiness and preparedness.
  --University of Findlay's National Center for Terrorism 
        Preparedness for an ALERT (Actual Learning Environment 
        Response Training) Center.
  --the Center for the Study of Bioterrorism and Emerging 
        Infections at the St. Louis University School of Public 
        Health.
    The Committee is aware of the following projects that it 
encourages the Department to consider supporting:
  --The Center for BioDefense at the University of Medicine and 
        Dentistry in New Brunswick, New Jersey
  --The Detroit Medical Center for an urban disaster and 
        emergency medical response initiative
  --The Center for Civilian Biodefense Studies at Johns Hopkins 
        University
  --St. Michael's Medical Center in Newark, New Jersey, for its 
        work on bioterrorism as part of the practice and study 
        of high risk infectious disease
  --The Centers for Biopreparedness and Infectious Disease at 
        the University of North Carolina.

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.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2001....................................     $33,786,000
Budget estimate, 2002...................................      35,786,000
Committee recommendation................................      35,786,000

    The Committee recommends an appropriation of $35,786,000 
for the Office of Inspector General. This is the same as the 
administration request and $2,000,000 higher than the fiscal 
year 2001 level. In addition to discretionary funds, the Health 
Insurance Portability and Accountability Act of 1996 provides 
$150,000,000 in mandatory funds for the Office of the Inspector 
General in fiscal year 2002; the total funds provided to the 
Office by this bill and the authorizing bill would be 
$185,786,000 in fiscal year 2002.
    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 also wants to assure that seniors calling into the 
toll-free telephone line to report Medicare mispayments get a 
prompt and complete response.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2001....................................     $28,005,000
Budget estimate, 2002...................................      32,005,000
Committee recommendation................................      32,005,000

    The Committee recommends $32,005,000 for the Office for 
Civil Rights. This is the same as the administration request 
and $4,000,000 more than the fiscal year 2001 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 2001 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.
    The Committee supports the efforts of OCR to properly 
enforce the final medical privacy regulation that went into 
effect earlier this year. The Committee urges OCR to ensure 
that the necessary resources are not taken away from the 
Office's other enforcement areas of responsibilities.

                            POLICY RESEARCH

Appropriations, 2001....................................     $16,715,000
Budget estimate, 2002...................................      20,500,000
Committee recommendation................................      20,500,000

    The Committee recommends $20,500,000 for policy research, 
which is the same as the administration request and $3,785,000 
more than the fiscal year 2001 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, 2001....................................    $219,772,000
Budget estimate, 2002...................................     242,577,000
Committee recommendation................................     242,577,000

    The Committee provides an estimated $242,577,000 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 $22,805,000 over the estimated 
payments for fiscal year 2001.
    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.

      General Provisions, Department of Health and Human Services

    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 2001 which limits assignment of certain public 
health personnel (sec. 202).
    The Committee recommendation retains language carried in 
fiscal year 2001 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 2001 to limit use of grant funds to pay individuals 
more than an annual rate of Executive level I (sec. 204).
    The Committee recommendation retains language from fiscal 
year 2001 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.
    The Committee recommendation (sec. 206) authorized transfer 
of up to 2 percent of Public Health Service funds for 
evaluation activities.
    The Committee recommendation retains language included in 
fiscal year 2001 restricting transfers of appropriated funds 
among accounts and requiring a 15-day notification of both 
Appropriations Committees prior to any transfer (sec. 207).
    The Committee recommendation includes language included in 
fiscal year 2001 permitting the transfer of up to 3 percent of 
AIDS funds among Institutes and Centers (sec. 208) by the 
Director of NIH and the Director of the Office of AIDS Research 
of NIH.
    The recommendation also includes language included in 
fiscal year 2001 which directs that the funding for AIDS 
research as determined by the Directors of the National 
Institutes of Health and the Office of AIDS Research be 
allocated directly to the OAR for distribution to the 
Institutes and Centers consistent with the AIDS research plan 
(sec. 209).
    The Committee recommendation includes a provision (sec. 
210) 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 2001 which restricts the use of funds to carry 
out the MedicareChoice Program if the Secretary denies 
participation to an otherwise eligible entity (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 continues to include a provision prohibiting 
the Secretary from withholding substance abuse treatment funds 
(sec. 214).
    The Committee recommendation includes a provision (sec. 
215) that facilities expenditure of funds for international 
AIDS activities.
    The Committee recommendation includes a provision allowing 
the Acting Director of NIH to remain in that position until a 
new Director is confirmed (sec. 216).
    The Committee has included a provision (sec. 217) 
transferring $100,000,000 to International Assistance Programs 
for the Global Fund to Fight HIV/AIDS, Malaria and 
Tuberculosis.

                   TITLE III--DEPARTMENT OF EDUCATION

    The Committee understands that programs authorized by the 
Elementary and Secondary Education Act (ESEA) of 1965, as 
amended, currently are under consideration for reauthorization. 
Therefore, the Committee has allocated funds for these programs 
in accordance with H.R. 1, the ESEA reauthorization bill, as 
passed by the Senate on June 14, 2001.

                    education for the disadvantaged

Appropriations, 2001.................................... $10,014,621,000
Budget estimate, 2002...................................  11,045,621,000
Committee recommendation................................  11,879,900,000

    The Committee recommends an appropriation of 
$11,879,900,000 for education for the disadvantaged. This is 
$1,865,279,000 more than the fiscal year 2001 appropriation and 
$834,279,000 more than the budget request. In fiscal year 2001, 
$6,953,300,000 was made available for this account in fiscal 
year 2002 funds. The Committee recommends the same amount in 
fiscal year 2003 funds for fiscal year 2002.
    Programs financed under this account are authorized under 
Title I of the ESEA as amended by H.R. 1 as passed by the 
Senate 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, homeless children, 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.

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 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 and high-quality 
educational 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.
    The Committee is aware that the distribution formula for 
Title I grants to LEAs is the subject of ongoing negotiations 
by House and Senate conferees on the ESEA reauthorization bill. 
Given the uncertain outcome of that process, the Committee 
recommends distributing the funds under the formula used in 
fiscal year 2001 and will revisit this issue at conference for 
this bill.
    For Title I basic grants, including the amount transferred 
to the Census Bureau for poverty updates, the Committee 
recommends an appropriation of $8,568,000,000, which is 
$1,169,279,000 more than appropriated in fiscal year 2001 and 
$1,330,279,000 more than the budget request.
    The Committee recommends $1,632,000,000 for concentration 
grants. This amount is $268,000,000 more than the amount 
appropriated in fiscal year 2001 and the budget request. Funds 
under this program are distributed according to the basic 
grants formula, except that they go only to LEAs where the 
number of poor children equals at least 6,500, or 15 percent, 
of the total school-aged population.
    The Committee recommends that each State and LEA should 
receive the greater of either the amount it would receive at 
specified levels under a 100 percent hold-harmless provision or 
what it would receive using the statutory formulas. This 
applies for both basic and concentration grants. Also, the 
Department should make 100 percent hold-harmless awards to LEAs 
that were eligible for concentration grants in fiscal year 
2001, but are not eligible to receive grants in fiscal year 
2002.

William F. Goodling Even Start Family Literacy Program

    For the Even Start program, the Committee recommends 
$200,000,000, which is $50,000,000 less than the budget request 
and the fiscal year 2001 appropriation.
    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. The local share of 
program costs must increase from 10 percent in the first year 
to 40 percent in the 4th year, 50 percent in years 5 through 8, 
and 65 percent after 8 years.
    The Committee is aware that the National Even Start 
Association, in conjunction with the National Center for Family 
Literacy, the National Institute for Child Health and Human 
Development, the National Institute for Literacy and the 
William F. Goodling Institute for Research in Family Literacy, 
will provide training and technical assistance to local Even 
Start programs in need of such support (as identified by the 
States). Activities shall include, but are not limited to, 
assistance to personnel to help them meet the qualifications 
for instructional personnel set forth in the Even Start law, 
and training and materials to ensure instructional programs are 
based on scientifically based reading research.

Reading First State Grants

    The Committee recommends $900,000,000, the same as the 
budget request, for the Reading First State Grants program. 
This program will build on and replace the Reading and Literacy 
Grants program, which was authorized under the Reading 
Excellence Act program and funded at $286,000,000 in fiscal 
year 2001.
    Reading First is a comprehensive effort, authorized by the 
Senate-passed version of H.R. 1, to provide States and LEAs 
with funds to implement comprehensive reading instruction for 
children in grades K-3. The purpose of the program is to help 
ensure that every child can read by third grade. LEAs and 
schools that receive funds under this program should use the 
money to provide professional development in reading 
instruction for teachers and administrators, adopt and use 
reading diagnostics for students in grades K-3 to determine 
where they need help, implement reading curricula that are 
based on scientific research, and provide reading interventions 
for children who are not reading at grade level.

Early Reading First

    The Committee recommends $75,000,000, the same as the 
budget request, for Early Reading First, a new program 
authorized by the Senate-passed version of H.R. 1. Early 
Reading First will complement Reading First State Grants by 
providing competitive grants to school districts and nonprofit 
groups to support activities in existing preschool programs 
that are designed to enhance the verbal skills, phonological 
awareness, letter knowledge, pre-reading skills, and early 
language development of children ages 3 through 5. Funds will 
be targeted to communities with high numbers of low-income 
families.

Migrant

    For the State agency migrant program, the Committee 
recommends $380,000,000, the same as the budget request and the 
fiscal year 2001 appropriation.
    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 ages 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.
    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. This amount is $4,000,000 
more than the budget request and the fiscal year 2001 
appropriation.
    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 $8,900,000, the same as the 
budget request and the fiscal year 2001 appropriation, for 
Title I evaluation activities. Evaluation funds are used to 
support large-scale national surveys that examine how the Title 
I program is contributing to student performance.

High school equivalency program

    The Committee bill includes $20,000,000 for the high school 
equivalency program (HEP). This amount is the same as the 
budget request and the fiscal year 2001 appropriation.
    This program provides 5-year grants to institutions of 
higher education and other nonprofit organizations to recruit 
migrant students ages 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, the same as the budget 
request and the fiscal year 2001 appropriation.
    Funds provide 5-year grants to institutions of higher 
education and nonprofit organizations for projects that provide 
tutoring, counseling, and financial assistance to migrant 
students during their first year of postsecondary education. 
Projects also may use up to 10 percent of their grants for 
follow-up services after students have completed their first 
year of college, including assistance in obtaining student 
financial aid.

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 $36,000,000, which is $1,000,000 more 
than the budget request and the fiscal year 2001 appropriation.
    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.

                               IMPACT AID

Appropriations, 2001....................................    $993,302,000
Budget estimate, 2002...................................   1,130,500,000
Committee recommendation................................   1,130,500,000

    The Committee recommends an appropriation of $1,130,500,000 
for impact aid for the Department of Education. This amount is 
the same as the budget request and $137,198,000 more than the 
fiscal year 2001 appropriation.
    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.
    Basic support payments.--The Committee recommends 
$954,000,000 for basic support payments, $72,000,000 more than 
the budget request and the fiscal year 2001 appropriation. 
Under statutory formula, payments are made on behalf of all 
categories of federally connected children.
    The Committee is aware that the Frazer School District in 
Montana must repay over $350,000 in impact aid funding because 
of errors made by former school district administrators, and 
that the district does not qualify for the forgiveness criteria 
as currently encoded. The Committee urges the Department to 
work with the district to identify possible solutions to this 
problem.
    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 fiscal year 2001 
level and the budget request.
    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, the same as the budget request and the fiscal year 
2001 level.
    Construction.--Payments are made to eligible LEAs to be 
used for construction and renovation of school facilities, or 
for debt service related to the construction of school 
facilities. The Committee recommends $68,000,000 for this 
program. This amount is $82,000,000 less than the budget 
request and $55,198,000 more than the fiscal year 2001 
appropriation.
    The Committee is aware that Blair Elementary School, which 
operates on Fairfield Air Force Base in Washington State, has 
inadequate electrical, heating, ventilation, and air 
conditioning systems. The Committee urges the Department to 
work with the Medical Lake School District to identify possible 
solutions to this situation.
    The Committee is aware that the Ronan School District in 
Montana was forced to close its middle school because of sewer 
contamination and poor indoor air quality, and that the 
students are now attending the already crowded elementary and 
high schools. The Committee encourages the Department to work 
with the school district to remedy this situation.
    The Committee understands that Harlem Elementary School, at 
the edge of the Fort Belknap Indian Reservation in Montana, 
requires major reconstruction because of damage caused by an 
underground stream. The Committee urges the Department to work 
with the Harlem School District to rectify this situation.
    The Committee understands that San Juan School District in 
Utah serves children in extremely rural areas, including many 
residing on Indian reservations. The Committee is aware of the 
need for a new elementary school in Monument Valley, and it 
urges the Department to work with the District to rectify this 
situation.
    The Committee is aware of the critical construction needs 
for a new regional vocational school in the Yukon-Kuskokwim 
delta area of Alaska, the poorest region in the State. The 
Committee requests that the Department work with the Lower 
Kuskokwim School District in Alaska and its partners to address 
this issue and ensure that all possible solutions are explored.
    The Committee is aware that Brockton School in Montana is 
experiencing significant problems with the K-8 facility, 
including a leaky roof, faulty boilers, deteriorating pipes and 
plumbing, and asbestos removal. The Committee urges the 
Department to provide assistance to the Brockton School in 
identifying appropriate measures to improve the learning 
environment.
    The Committee recognizes the need for further construction 
monies for Hays/Lodgepole Elementary School in Montana and 
encourages the Department of Education to give every 
consideration to its construction needs.
    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 LEAs 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 
$50,500,000 for this activity, $10,000,000 more than the budget 
request and the fiscal year 2001 appropriation.

                      SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2001....................................  $7,053,575,000
Budget estimate, 2002...................................   6,353,794,000
Committee recommendation................................   8,717,014,000

    The Committee recommends an appropriation of $8,717,014,000 
for school improvement programs. This is $2,363,220,000 more 
than the budget request and $1,663,439,000 more than comparable 
programs in the fiscal year 2001 appropriation. Unless 
otherwise noted, programs under this account are authorized by 
the Senate-passed version of H.R. 1.

State grants for improving teacher quality

    The Committee recommends an appropriation of $3,039,834,000 
for State grants for improving teacher quality, a new program. 
This amount is $439,834,000 more than the budget request and 
$931,834,000 more than comparable programs in the fiscal year 
2001 appropriation.
    This program replaces the Eisenhower professional 
development State grants program, Eisenhower professional 
development Federal activities, Eisenhower regional math and 
science education consortia, and the class size reduction 
program. Reducing class sizes will remain an allowable use of 
teacher quality State grants.
    States and LEAs that receive grants for improving teacher 
quality will be required to ensure that program funds are used 
for professional development that is based on the best 
available research on training and learning, tied to State or 
local standards, of sufficient intensity and duration to affect 
teaching performance, and designed to improve teachers' 
knowledge concerning the subjects they teach. In addition, 
States will be held accountable for ensuring that all children 
are taught by highly qualified teachers and for improving 
student achievement.
    States and LEAs may use funds for a range of activities 
related to the certification, recruitment, professional 
development and support of teachers. Activities may include 
reforming teacher certification and licensure requirements, 
addressing alternative routes to State certification of 
teachers, recruiting teachers and principals, and implementing 
teacher mentoring systems, teacher testing, merit pay and 
merit-based performance systems.
    The Committee recognizes that smaller classes in the early 
grades can have a positive impact on students for years to come 
by improving classroom discipline, providing students with more 
individualized attention, and allowing parents and teachers to 
work more closely together. Some research has shown that 
reducing class sizes in kindergarten through third grade to no 
more than 18 students improves student achievement, especially 
among our most disadvantaged students. Congress has 
appropriated funds specifically for reducing class sizes for 
the past 3 years, with the goal of enabling schools to hire an 
additional 100,000 fully qualified teachers. Although the 
fiscal year 2002 bill does not include a guaranteed funding 
stream for class-size reduction, funds within the teacher 
quality State grants program may be used to continue this 
commitment to our Nation's students, parents and teachers, 
without taking away from other efforts to invest in 
professional development.
    The first year of Federal class-size-reduction funds 
enabled schools to hire 29,000 teachers who are already 
teaching in smaller classes across the country. As a result, 
approximately 1.7 million students are learning in smaller 
classrooms. Another 8,000 teachers will be hired with the funds 
provided by the fiscal year 2001 appropriations bill, creating 
smaller learning environments for hundreds of thousands of 
additional students. The Committee encourages districts to 
continue that progress.
    The Committee directs the Department to submit a report as 
soon as possible at the end of the program year on how much 
money was spent to reduce class sizes and how many new teachers 
were hired through the program.

Mathematics and science partnerships

    In January 2001, the U.S. Commission on National Security/
21st Century issued a report titled ``Road Map for National 
Security: Imperative for Change.'' This Commission, co-chaired 
by former Senators Warren Rudman and Gary Hart, concluded that 
``America faces distinctly new dangers, particularly to the 
homeland and to our scientific and educational base.'' One of 
the many recommendations outlined in the report was the need to 
produce more science and engineering professionals as well as 
qualified teachers in science and math.
    In responding to this need, the Committee recommends 
$25,000,000 for mathematics and science partnerships, a new 
program authorized by the Senate-passed version of the ESEA 
reauthorization bill. The administration requested no funds for 
this purpose. These funds will be used to improve the 
performance of students in the areas of math and science by 
bringing math and science teachers in elementary and secondary 
schools together with scientists, mathematicians, and engineers 
to increase the teachers' subject-matter knowledge and improve 
their teaching skills. The Secretary is authorized to award 
grants, on a competitive basis, to eligible partnerships to 
enable the entities to pay the Federal share of the costs of 
developing or redesigning more rigorous mathematics and science 
curricula that are aligned with State and local standards; 
creating opportunities for enhanced professional development 
that improves the subject-matter knowledge of math and science 
teachers; recruiting math and science majors; and improving and 
expanding training of math and science teachers, including the 
effective integration of technology into curricula and 
instruction.

National activities/Transition to Teaching

    The Committee recommends $95,000,000 for professional 
development national activities. This amount is $54,000,000 
more than the fiscal year 2001 appropriation and $65,000,000 
more than the budget request. Within those funds, $15,000,000 
is included for professional development activities for early 
childhood educators and caregivers in high-poverty communities. 
This amount is $5,000,000 more than the fiscal year 2001 
appropriation and $15,000,000 more than the budget request. In 
addition, $5,000,000 is included for the Eisenhower National 
Clearinghouse for Mathematics and Science Education, and 
$10,000,000 for the National Board for Professional Teaching 
Standards.
    Funds are also included for the Transition to Teaching 
program requested by the administration. The purpose of 
Transition to Teaching is to support the Defense Department's 
Troops to Teachers program, which helps prepare retiring 
military personnel to teach in high-poverty school districts, 
as well as other recruitment efforts involving non-military 
teacher candidates. The budget request for Transition to 
Teaching is $30,000,000. The remaining funds may be used for 
other efforts to recruit teachers and principals, subject to 
ongoing conference negotiations over the Elementary and 
Secondary Education Act.

Innovative education program strategies State grants

    The Committee recommends $410,000,000 for innovative 
education program strategies State grants. This amount is 
$25,000,000 more than the fiscal year 2001 appropriation and 
$61,500,000 less than the amount requested by the 
administration for the proposed Choice and Innovation State 
Grants program, which has a similar purpose.
    The innovative education program provides support to States 
and LEAs in developing education reform initiatives that will 
improve the performance of students, schools and teachers.

School renovation

    The Committee recommends $925,000,000 for grants to local 
educational agencies for emergency school renovation and repair 
activities, as authorized in section 321 of this Act. This 
amount is $250,000,000 less than the fiscal year 2001 
appropriation. The administration requested no funds for this 
program.
    The funds should be distributed to State educational 
agencies based on the Title I, part A allocations under the 
Elementary and Secondary Education Act. The State educational 
agency or other entity with jurisdiction over school facilities 
financing, as the case may be, would distribute the State funds 
to local educational agencies through competitive grants for 
emergency school repair and renovation activities.
    These funds may be used by local educational agencies to 
meet the requirements of Federal mandates such as the Americans 
with Disabilities Act, Section 504 of the Rehabilitation Act, 
asbestos-abatement requirements and security upgrades. Funds 
may also be used for emergency health and safety of students 
and staff (repairing, replacing, or installing roofs, 
electrical wiring, plumbing systems, or sewage systems; 
repairing, replacing, or installing heating, ventilation, or 
air conditioning systems, including insulation; and bringing 
schools into compliance with fire and safety codes.)
    If a State holds a grant competition among LEAs that 
attracts school renovation applications that are of 
insufficient quality and quantity, it must use 100 percent of 
its excess allocation to provide all LEAs in the State an award 
under section 5312 of H.R. 1 as passed by the Senate on June 
14, 2001. This reallocation can take place only after the State 
has held a period of public notice and comment about the 
availability of funds for emergency repairs and the 
insufficient response, consistent with State and local laws 
governing how the comments may be received and reviewed by the 
public. Funds received by LEAs under this reallocation may be 
used for any purpose under section 5331 of H.R. 1, including 
professional development, acquisition of instructional 
materials, and school improvement activities.

Educational technology state grants

    The Committee recommends $712,146,000 for educational 
technology State grants, as authorized under the Senate-passed 
version of H.R. 1. This is $40,000,000 less than the budget 
request.
    This program consolidates four current educational 
technology programs, five fewer than the budget request. Funds 
will flow by formula to States and may be used for the purchase 
of hardware and software, and teacher training on integrating 
technology into the curriculum.

Community technology centers

    The Committee recommends $64,950,000, the same amount as 
the fiscal year 2001 appropriation, for community technology 
centers. The administration proposed eliminating this program 
by consolidating it into the educational technology State 
grants program. This community technology centers program 
supports grants, contracts, or cooperative agreements to local 
and State educational agencies, institutions of higher 
education, libraries, museums, foundations, or other public, 
private, non-profit and for-profit entities or consortia of 
such organizations to create or expand community technology 
centers. Although the number of Americans connected to the 
Internet is soaring, there remains a digital divide between 
those who have access to technology and use it effectively, and 
those who don't. In many cases, the divide is actually 
widening. Minorities, low-income persons, the less-educated, 
and children of single-parent households, particularly when 
they reside in rural areas or central cities, are among the 
groups that lack access to information resources. Community 
technology centers provide disadvantaged residents of 
economically distressed urban and rural communities with access 
to information technology and related training. They can 
provide, among other things, preschool and after-school 
programs, adult education and literacy, and workforce 
development and training.

Preparing Tomorrow's Teachers to Use Technology

    The Committee recommends $125,000,000, the same amount as 
the fiscal year 2001 appropriation, for the Preparing 
Tomorrow's Teachers to Use Technology program. The 
administration proposed consolidating this program into the 
educational technology States grants program. Funds will be 
used to assist consortia of private and public entities to 
prepare prospective teachers to use advanced technology in the 
classroom.

Ready to Learn Television

    The Committee recommends an appropriation of $24,000,000 
for the Ready to Learn Television program. This is $8,000,000 
more than the fiscal year 2001 level. The administration 
proposed consolidating this program into the educational 
technology State grants program.
    Ready to Learn Television supports the development and 
distribution of educational television programming designed to 
improve the readiness of preschool children to enter 
kindergarten and elementary school, consistent with the first 
national education goal that all children should start school 
ready to learn. The program supports the development, 
production, and dissemination of educational materials designed 
to help parents, children, and caregivers obtain the maximum 
advantage from educational programming. Funding will support 
the growth in demand for related local educational activities, 
improve training for professional caregivers, provide new 
foreign language translations of children's programs, enhance 
the online components of the program, reach additional 
underserved populations, and demonstrate the use of digital 
broadcasting to provide programming and training to underserved 
populations.

Ready to Teach/Teacherline

    The Committee recommends $15,000,000 for the continuation 
of the Public Broadcasting Service initiative called 
Teacherline, formerly known as Mathline. This amount is 
$6,500,000 more than the fiscal year 2001 appropriation. The 
administration proposed consolidating this program into the 
educational technology State grants program.
    Within this amount, the Committee provides $6,000,000 for 
digital educational content (DEC) development grants, a 
demonstration project authorized by the Senate-passed version 
of the ESEA reauthorization bill. DEC grants will allow 
community partnerships among local public television stations, 
State and local educational agencies, institutions of higher 
education, and businesses to develop, produce, and distribute 
innovative educational instructional video programming that is 
designed for use by K-12 schools based on State and local 
standards and capable of distribution through digital 
broadcasting and school digital networks. The Committee 
strongly encourages the Secretary to award DEC grants that 
assure the delivery of integrated data to schools serving high 
concentrations of disadvantaged children.
    The remaining funds should be used to provide high-quality, 
accessible and continuous professional development to school 
teachers. The increase from the fiscal year 2001 level will 
allow the Teacherline Program to link the digitized public 
broadcasting infrastructure beyond its current partnership with 
29 local public television stations and LEAs to provide 
training services to institutions of higher education for pre-
service teacher training as well as in-service professional 
development for K-12 teachers.

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. The Committee recommends a total of $644,250,000 for 
activities to promote safe and drug-free schools and 
communities. This amount is the same as the budget request and 
the fiscal year 2001 appropriation.
    State grant program.--The Committee bill provides 
$444,250,000 for the safe and drug-free schools and communities 
State grant program. This amount is $5,000,000 more than the 
fiscal year 2001 appropriation and $103,362,000 less than the 
budget request.
    National programs.--The Committee has included $150,000,000 
for the national programs portion of the safe and drug-free 
schools program. This amount is $5,000,000 less than the fiscal 
year 2001 appropriation and $53,362,000 more than the budget 
request. The Committee intends that $117,000,000 of these 
funds, the same amount as last year, be used for the Safe 
Schools/Healthy Students program, which the Department funds in 
conjunction with the Departments of Justice and Health and 
Human Services. Safe Schools/Healthy Students supports LEAs and 
communities in developing and implementing comprehensive 
programs that create safe, disciplined, and drug-free learning 
environments and promote healthy childhood development. Funds 
for national programs are also used for a variety of other 
activities designed to improve the field of drug and violence 
prevention.
    The Committee is aware of the increasing problem of alcohol 
and drug abuse on college campuses. Therefore, it 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 fiscal year 2001 
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 2002 awards to institutions of higher education 
that did not receive an award in the fiscal year 2001 
competition.

Coordinator initiative

    The Committee has included $50,000,000 for the coordinator 
initiative, the same amount as the fiscal year 2001 
appropriation. The administration requested no funds for this 
program. 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.

21st Century Community Learning Centers

    The Committee recommends an appropriation of $1,000,000,000 
for the 21st Century Community Learning Centers program. This 
amount is $154,386,000 more than the budget request and the 
fiscal year 2001 appropriation.
    The purpose of the program is to support public elementary 
and secondary schools, especially low-performing 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 States 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 has listed relevant projects of interest 
under the Local Innovations for Education program in this 
year's Committee report.

State assessments

    A key accountability measure in the Senate-passed version 
of the ESEA reauthorization calls for annual State assessments 
in reading and mathematics for all students in grades 3-8. 
States will be permitted to select and design their own new 
assessments, as long as they are aligned with State standards 
and student achievement results are comparable from year to 
year. Funds under this new program would pay the Federal share 
of developing and implementing these new assessments. The 
Committee recommends $320,000,000 for this purpose, the same 
amount as the budget request.

Inexpensive book distribution

    For the inexpensive book distribution program, the 
Committee provides $25,000,000, which is $2,000,000 more than 
the fiscal year 2001 appropriation. The administration proposed 
consolidating this program into the Choice and Innovation State 
Grants program.
    The inexpensive book distribution program is operated by 
Reading Is Fundamental (RIF), a private nonprofit organization 
associated with the Smithsonian Institution. 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.

Enhanced assessment instruments

    The Committee recommends $32,000,000 for enhanced 
assessment instruments, a new program authorized by the Senate-
passed version of the ESEA reauthorization bill. The 
administration did not request funds for this program.
    Grants under this program will be awarded to States and 
LEAs to help them collaborate with institutions of higher 
education, other research institutions, and other organizations 
on ways to improve the quality and fairness of State assessment 
systems required under Title I of the ESEA. Grant recipients 
should strive to design enhanced assessments that better 
measure higher-order thinking skills, analytical abilities, and 
learning over time.

Magnet schools assistance

    For the magnet schools assistance program, the Committee 
bill provides $110,000,000, the same as the budget request and 
the fiscal year 2001 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 fiscal year 
2001 appropriation.

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 budget request and the fiscal year 2001 
appropriation.
    The funds provided will continue the 10 regional equity 
assistance centers (EACs) formerly known as regional 
desegregation assistance centers. Each EAC 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 fiscal year 2001 appropriation. The 
administration proposed consolidating this program into the 
Choice and Innovation State Grants program. The Ellender 
fellowship program makes an award to the Close Up Foundation of 
Washington, D.C., to provide fellowships to students from low-
income families and their teachers to enable them to 
participate with other students and teachers for 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 $33,000,000, which is $5,000,000 more 
than the budget request and the fiscal year 2001 appropriation. 
When allocating these funds, the Committee urges the Department 
to provide $7,500,000 for curricula development, teacher 
training, and recruitment programs, including native language 
revitalization. Priority should 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. The Committee 
also recommends $2,600,000 for the community-based learning 
centers; $3,700,000 for the Hawaii higher education program; 
$1,500,000 for the gifted and talented programs; $2,200,000 for 
construction of schools with high enrollments of Native 
Hawaiian children, pursuant to ESEA reauthorization language; 
$3,100,000 for the special education programs; $500,000 for the 
Native Hawaiian education councils; and $11,900,000 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 it 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 literacy.
    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. The Committee 
recommends full funding be made available by grant or otherwise 
to the Hawaii Farm Bureau to carry out this program.
    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 full funding be made available in fiscal year 2002 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 and traditional medicine education.--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'omomi 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 to teach Hawaiian children these 
traditional marine management practices and recognizes the 
expertise that Hui Malama o Mo'omomi and their consortium 
partners have in this area.
    Hawaiian development of culturally appropriate curricula.--
Because Hawaiian and part-Hawaiian children have fallen behind 
in this area during the past decade, the Committee strongly 
recommends that the Department fund an initiative to develop 
culturally appropriate curricula and programs that would meet 
the National Council of Teachers of Mathematics' 2000 
standards. Such a curricula must successfully equip students 
with tools to present, organize and interpret numerical 
information while reflecting the traditional culture's reliance 
on observation and practical use of statistical processes. The 
Committee urges the Department to develop these materials with 
nonprofit, community organizations such as the Pacific American 
Foundation and/or the foundation Partners in Development.
    Curricula workshops for teachers in Hawaii.--Hawaiian and 
part-Hawaiian families suffer from elevated levels of health 
problems, alcoholism, drug use, and domestic violence. These 
form significant barriers to the successful education of 
Hawaiian and part-Hawaiian children. Public and private schools 
and their staffs are not sufficiently prepared to identify, 
treat, or refer students and their families to appropriate 
public or private agencies providing help in these areas of 
need. The Committee urges the Department to fund the 
development and implementation of curricula and workshops for 
teachers and staff in culturally appropriate ways to identify 
and refer students and their families in need of counseling and 
assistance and to provide teachers and staff with information 
and resources on the most current and effective referral 
agencies available. The Committee urges the Department to use 
nonprofit, community development agencies and organizations 
such as the Pacific American Foundation and/or Partners in 
Development to develop and implement such needed programs.
    Curricula teaching environmental stewardship.--A strong 
understanding of environmental stewardship and the responsible 
use of the environment are anchor values in the traditional 
Hawaiian culture. Environmental stewardship needs to be taught 
to all students, particularly Hawaiian and part-Hawaiian 
students. The Committee urges the Department to fund the 
development and implementation of curricula teaching 
environmental stewardship based on the traditional ecological 
knowledge (TEK) of the Hawaiian culture. Given the oral 
tradition of the Hawaiian culture, this development program 
should include the identification, translation, and analysis of 
appropriate traditional chants and stories related to the 
management and responsible use of Hawaii's resources and the 
integration of these perspectives into an effective curriculum 
that addresses Hawaii State Educational Standards in social and 
natural sciences. The Committee recommends that nonprofit 
organizations with experience in these areas, such as the 
Pacific American Foundation and/or Partners in Development, be 
used to develop these curricula units.
    Native Hawaiian Mid-level Practitioners Training Program.--
The Committee urges the Department of Education to develop a 
focused program to recruit, train, and place nurse 
practitioners, physician assistants, clinical psychologists, 
and clinical pharmacists to work in Hawaiian communities. The 
Committee also recommends that nongovernmental agencies, such 
as health care providers, insurers, and nonprofit foundations 
like Partners in Development, be integrated into the effort.
    Adjudicated and High-Risk Native Hawaiian Youth Education 
Program.--The Committee is concerned about the high proportion 
of Native Hawaiian Youth on legal status with Family Court 
statewide and in Hawaii youth correctional facilities. 
Therefore, the Committee recommends that the Adjudicated and 
High-Risk Native Hawaiian Youth Education Program, which is 
intended to prevent recidivism and strengthen Hawaiian 
families, should be considered a priority to receive funding.
    Postsecondary computer and technology training for Native 
Hawaiians.--The Committee recognizes the lack of computer and 
technology skills possessed by the Native Hawaiian community 
and its resultant impact on their employability. The Committee 
requests culturally sensitive educational centers be 
established to provide training in career skills, technology 
readiness, technology management, and advanced technology 
certification. The Committee recommends this program should be 
considered a priority to receive funding.
    Native Hawaiian Financial Literacy Program.--The Committee 
is concerned of the inability of many Native Hawaiians to 
understand money management and financial planning. The 
Committee recommends the development of culturally sensitive 
training on money management, financial literacy, family 
budgeting, and debt avoidance. The Committee recommends this 
program should be considered a priority to receive funding.

Alaska Native educational equity

    The Committee recommends $33,000,000 for the Alaska Native 
educational equity assistance program. This amount is 
$18,000,000 more than the budget request and the fiscal year 
2001 appropriation. The Committee recommends expanding this 
program to include cultural education programs operated by the 
Alaska Native Heritage Center and continuing operation of the 
Rose program operated by the Alaska Humanities Forum to expose 
urban students to Native culture in rural Alaska.
    Funds from this program address the severe educational 
handicaps of Alaska Native schoolchildren. 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 level. The funds 
provided under the Alaska Native education equity assistance 
program will help to address some of the barriers faced by 
Native Alaskan schoolchildren and develop programs tailored to 
the unique needs of these children to improve performance 
levels.

Charter Schools Homestead Fund

    The Committee recommends $50,000,000 for the Charter 
Schools Homestead Fund, a new program authorized in the Senate-
passed version of H.R. 1. This amount is $125,000,000 less than 
the budget request.
    A major obstacle to the creation of charter schools in many 
communities is the limited availability of suitable academic 
facilities. The Charter Schools Homestead Fund would build on 
and replace the Charter School Facility Demonstration Grants 
program by providing grants to public and nonpublic entities to 
leverage funds to help charter schools purchase, construct, 
renovate, or lease academic buildings or obtain donated 
buildings. The demonstration grants program, currently funded 
through the school renovation program, received $25,000,000 in 
fiscal year 2001.

Charter schools

    The Committee recommends $200,000,000 for the support of 
charter schools. This amount is the same as the budget request 
and $10,000,000 more than the fiscal year 2001 appropriation.
    This program 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.

Comprehensive regional assistance centers

    The Committee has included bill language to provide 
$28,000,000 to continue the operation of the current 
comprehensive regional technical assistance centers. This 
recommendation is the same as the budget request and the fiscal 
year 2001 level. This program supports 15 regional centers that 
provide support, training, and technical assistance to 
Department of Education grantees.

Advanced Placement test fees

    The Committee recommends $22,000,000 for the Advanced 
Placement test fees program. This amount is the same as the 
budget request and the fiscal year 2001 appropriation. 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 
it encourages the Department to consider proposals that meet 
the needs of students in these areas of the country.

Parental assistance

    The Committee recommends $45,000,000 for parental 
assistance services. This amount is $7,000,000 more than the 
fiscal year 2001 appropriation. The administration proposed 
eliminating this program by consolidating it into the teacher 
quality State grants program. This title 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 ages 5 and under.
    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.
    The Committee strongly urges the Department of Education to 
stipulate that at least 50 percent of each grant award shall be 
used for Parents as Teachers Programs.

Small, Safe and Successful High Schools

    The Committee recommends an appropriation of $100,000,000 
for the Small, Safe and Successful High Schools program. This 
amount is $25,000,000 less than the fiscal year 2001 
appropriation. The administration recommended eliminating this 
program by consolidating it into its proposed Choice and 
Innovation State Grants program.
    These funds shall be used for activities related to the 
redesign of large high schools enrolling 1,000 or more 
students.

Local Innovations for Education

    The Committee recommends an appropriation of $300,000,000 
for the Local Innovations for Education (LIFE) program, a new 
program authorized by the Senate-passed version of H.R. 1 that 
consolidates eight existing activities or programs, including 
five in the Fund for the Improvement of Education. This amount 
is $124,099,000 less than comparable activities and programs in 
the fiscal year 2001 appropriation. The administration proposed 
eliminating most of these programs through consolidations.
    LIFE 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.
    Within the amount recommended, the Committee includes 
$35,000,000 for the Elementary School Counseling Demonstration 
Program to establish or expand counseling programs in 
elementary schools, and $10,000,000 to make awards under part H 
of Title I of the Senate-passed version of H.R. 1 for a dropout 
prevention demonstration project. These levels are each 
$5,000,000 higher than the fiscal year 2001 appropriations.
    The Committee also includes $100,000,000 for a 
demonstration program focusing on the instruction of American 
history in elementary and secondary education. This amount is 
$50,000,000 more than the fiscal year 2001 level. Under this 
program, the Secretary of Education will award grants to local 
educational agencies, and, in turn, the LEAs will make awards 
to schools that are teaching American history as a separate 
subject within a school curriculum, not as a part of a social 
studies course. Grant awards are designed to augment the 
quality of American history instruction and to provide 
professional development activities and teacher education in 
the area of American history.
    The LIFE appropriation also includes $59,318,000 for the 
Star Schools program. This amount is the same as the fiscal 
year 2001 appropriation. The Star Schools 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 recommends $10,000,000 for a new program to 
provide educational, cultural, apprenticeship, and exchange 
programs for Alaska Natives, Native Hawaiians and their 
historical whaling and trading partners in Massachusetts. This 
is a new program authorized by the Senate-passed version of the 
ESEA reauthorization bill; it was not requested by the 
administration.
    Funds will be used to develop and implement innovative 
culturally-based educational programs and cultural exchanges to 
assist Alaska Natives, Native Hawaiians and children and 
families of Massachusetts linked by history and tradition to 
Alaska and Hawaii to learn about shared culture and traditions, 
and to develop internship and apprenticeship programs to assist 
these groups prepare for professional careers in cultural 
institutions and related fields. The Committee expects that 
funds will be equally divided by the Department among the 
Alaska Native Heritage Center, the Inupiat Heritage Center in 
Barrow, AK, the Bishop Museum in Hawaii, the Peabody-Essex 
Museum in Salem, MA, and the New Bedford Whaling Museum/New 
Bedford Historical Site in MA.
    The Committee also includes $30,000,000 for the arts in 
education program. This amount is the same as the fiscal year 
2001 appropriation. It includes $6,650,000 for a grant to VSA 
arts, which supports the development of programs to integrate 
the arts into the lives of children and adults with 
disabilities, and $5,600,000 for a grant to the John F. Kennedy 
Center for the Performing Arts, which supports a variety of 
activities throughout the Nation. Funds provided in this 
account also support youth violence prevention activities and 
model professional development activities to support the 
increasing demand for arts and music teachers.
    The Committee is supportive of the upcoming Very Special 
Arts International Festival. Held every 5 years in locations 
throughout the world, the June 2004 festival will take place in 
Washington, D.C. Approximately 2,000 children and adults with 
disabilities will participate in this 5-day exploration and 
celebration of the role of the arts in learning at home, in the 
workplace and in the community. The Committee recommends 
$1,650,000 for this purpose.
    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 pre-service and in-service professional development 
programs for arts educators and other instructional staff; 
specific instruction in music, art, theater, 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 LIFE appropriation also includes $3,000,000 for the 
women's educational equity program. This amount is the same as 
the fiscal year 2001 appropriation. The program supports 
projects that assist in the local implementation of gender 
equity policies and practices.
    The Committee also recommends $25,000,000 for character 
education grants to States and LEAs. The administration 
requested the same amount as part of its proposed Reform and 
Innovation Fund. The money may be used for developing character 
education curricula, implementing model character education 
programs that involve parents and community members, and 
training teachers to incorporate character-building lessons and 
activities into the classroom.
    The LIFE appropriation includes sufficient funds for the 
Reach Out and Read program, which promotes literacy by 
providing children's books to pediatricians and arranging for 
trained volunteers to read to children while they wait for 
their appointments in doctors' waiting rooms.
    The appropriation also includes sufficient funds for 
Project GRAD, a school-community program designed to improve 
the instructional quality and school environment of at-risk 
children. The core program focuses on improving student 
achievement in math, reading and language arts. Another 
component of the program addresses student behavior and 
discipline problems. Students participating in Project GRAD 
have a 24 percent increase in graduation rates, an 18 percent 
increase in their reading skills, a 34 percent increase in 
their math scores and a 25 percent increase in college 
enrollment. Project GRAD is currently operating in Houston; Los 
Angeles; Atlanta; Columbus, Ohio; Nashville; Newark, N.J.; 
Cincinnati; Knoxville, Tenn.; and Laredo and Brownsville, 
Texas. Projects will soon be operating in Philadelphia and 
three other Ohio communities.
    The Committee notes that there is considerable evidence 
that lack of appropriate nutrition, and in particular 
deficiencies in basic vitamins and minerals, can reduce 
students' academic performance. The Committee is aware of a 
pilot project by the Healthy Foundation to distribute a daily 
multi-vitamin to impoverished school children. The Committee 
commends this program and urges the Department to fund an 
expansion of this promising initiative and to rigorously 
evaluate its impact on school performance.
    The Committee is aware of the following projects and 
encourages the Department to give them full and fair 
consideration:
    The University of Montana, working with law enforcement, 
education, and community organizations, will develop a 
statewide community-based curriculum that promotes responsible 
behavior and prevents violence in schools and communities.
    Montana State University-Bozeman will coordinate an 
Educational Technology Leadership Institute that will train 
school administrators in rural areas how to encourage their 
teachers and students to use technology effectively.
    The Montana TREK Center at Flathead Valley Community 
College will provide rural educators with professional and 
educational growth opportunities through access to technology 
and training.
    The Indiana Academy for Science, Mathematics and Humanities 
develops distance education programs to bring enhanced science 
education into classrooms across the Nation.
    The ProEquity Advancement Placement teacher training 
project will increase the availability of AP coursework, expand 
the number of schools participating in the AP program, and 
train teachers at urban and rural schools serving disadvantaged 
students in five States.
    The Riverside School for the Arts in California trains 
students for performing and technical careers in the 
entertainment industry while providing a strong liberal arts 
and sciences education.
    Columbia Teachers College plans to expand its successful 
teacher training pilot program to Mississippi, Pennsylvania, 
New York, and Dallas, Texas. This program has been proven 
effective at increasing teacher retention.
    The Wheeling Jesuit University NASA Center for Educational 
Technologies will provide technology training to all elementary 
and secondary West Virginia mathematics and science teachers.
    Steps to Success, an ongoing initiative which plans on 
attracting significant non-Federal funding, plans to expand its 
efforts to provide parents of children from birth to 3 years of 
age with the information and support necessary for their 
development.
    The Missoula Family YMCA in Missoula, Montana is developing 
the ``Give Me Five'' after school program.
    The After School Recreation Program works in cooperation 
with Pasadena Unified School District in California to provide 
a recreation program for elementary-school-age children.
    The San Francisco Unified School District Child 
Development/Pre-School Program provides early childcare and 
educational services for young children. It promotes cognitive 
development and ensures that children are ready and eager to 
learn.
    The Fresno Unified School District in California will 
expand the Keep Kids in School program, which the district runs 
in collaboration with the Fresno County District Attorney's 
Office, the Fresno County Superior Court and the Fresno County 
Interagency.
    California State University, San Bernardino will create a 
Math/Science Demonstration Center that will house a wide 
variety of university and collaborative school district 
programs revolving around an advanced math/science lab school.
    The County of San Bernardino, Calif., will expand a program 
that provides family-centered case management and special 
school-based, grade-appropriate education for the children of 
homeless families.
    Fresno Pacific University in California will expand its 
math and science program to more effectively deliver quality 
math and science education to teachers, and to encourage more 
underrepresented students to teach those subjects.
    California State University San Marcos runs the Barahona 
Center for the Study of Books in Spanish for Children and 
Adolescents, which collects, catalogues and reviews the world's 
only complete collection of Spanish-language books published 
since 1989 for children and adolescents.
    The Los Angeles Center Theatre Group will develop a 
national model K-12 curriculum for the integration of the 
dramatic arts into general reading and language arts skills.
    The American Film Institute will establish a Screen 
Education Center within the Los Angeles Unified School District 
that will develop curricular modules for teachers and students.
    THINK Together provides after-school tutoring and homework 
assistance for low-income and low-achieving students in Orange 
County, Calif.
    The city of Twentynine Palms in California will expand its 
education and after-school care program, which serves many low-
income families and helps ensure that students are academically 
ready to enter kindergarten.
    The California Department of Education's Technology 
Information Center for Administrative Leadership (TICAL) 
Project, administered through the Santa Cruz County Office of 
Education, is a Web site where school administrators can access 
resources on using technology to improve teaching, learning, 
and school management.
    Audubon After School plans to expand its two existing 
after-school programs, and add a third program, for at-risk 
students in kindergarten through 8th grade in New Orleans.
    The University of New Orleans' Millennium School Project 
will establish a charter school district and redesign teacher 
education to support school restructuring.
    Nicholls State University's Center for the Study of 
Dyslexia will train faculty, reading specialists and families 
to identify the reading disabilities of children and adults in 
the Southern Gulf Coast region of Louisiana.
    Southeastern Louisiana University's Alternate Teacher 
Certification Program offers all its professional education 
courses via the Internet.
    Prevent Child Abuse Louisiana and the Task Force on Child 
Sexual Abuse plan to train 10,500 teachers in the greater New 
Orleans area on how to recognize and report child abuse cases 
among their students.
    Southern University plans to study the use and 
effectiveness of an interactive Web-based learning program.
    Prime Time Family Reading Time, a family literacy program, 
plans to expand into 20 States.
    The city of Shreveport's Sci-Port Discovery Center plans to 
develop space science educational programs.
    Louisiana Tech University's CATALYST program will be a 
regional center for math and science education serving rural 
populations in Louisiana, Arkansas, Texas, and Mississippi.
    Southern University will conduct research on the influence 
of nutrition and access to health care on elementary school 
student performance.
    Virtual school classroom demonstration programs have been 
proposed for the Washington State Office of Public Instruction, 
New Mexico, the Iowa Department of Education, and the U.S. 
Secretary of Education.
    The Olympic National Institute Hands-on Environmental 
Education Access Project in Washington State seeks to improve 
student competencies in science and math through hands-on 
educational training.
    The Pacific Science Center in Seattle is developing a 
hands-on genetic exhibit to explain basic concepts of genetics 
and the Human Genome Project to children.
    The Washington Department of Public Instruction is 
designing a project to use the Web to link together schools, 
districts, and the Office of Public Instruction to provide an 
accessible central database for student information.
    The Pacific Northwest Aquarium in Seattle will develop 
exhibits designed to educate students about marine ecosystems.
    The NASA Educator Resource Center at Southeast Missouri 
State University will make available to K-12 schools, teachers, 
and students throughout Missouri a wide array of educational 
materials related to science and math.
    Finance CIRCLE is a new demonstration initiative that will 
set up financial-aid systems to help families send their 
children to early learning and after-school programs in five 
sites: greater Kansas City, Mo.; Seattle/King County; greater 
Minneapolis; the lakes region of New Hampshire; and Fairfax 
County, Va.
    The Georgia Project, a nonprofit consortium of business and 
community leaders in Dalton, continues to support the academic 
and social needs of Hispanic children and their families in 
northern Georgia.
    The Great Cities' Universities coalition plans to expand 
its Urban Educator Corps Partnership Initiative, which seeks to 
meet the urgent demand for classroom teachers in the Nation's 
urban schools.
    The Ellijay Wildlife Rehabilitation Sanctuary seeks to 
expand its ecological science education programs to make them 
available to more students in Georgia.
    The city of Macon, Ga., plans to develop and implement a 
character-building education program.
    Spelman College's Teacher as Leader Educational Initiative 
seeks to provide early intervention and academic support for 
at-risk, disadvantaged children and their families.
    The Challenger Learning Center at SciTrek in Atlanta will 
use a simulated mission control station and space laboratory to 
create a dynamic learning environment for students in the areas 
of science and technology.
    The Institute for Student Achievement in New York plans to 
expand its programs, which are designed to support school 
districts' strategies for helping students overcome academic 
and social challenges adversely affecting performance.
    The Long Island Works Coalition is consolidating and 
building upon school-to-career partnerships educating students 
in Long Island.
    Life and Industry for Education (LIFE) provides vocational 
and computer training, family workshops, after-school and 
weekend initiatives for at-risk youth, and English language 
instruction in New York. LIFE's proposed Recreational, 
Educational, and Counseling Center would centralize the group's 
efforts in Hewlett, N.Y.
    The ExplorNet Technology Learning Project provides 
technology education and workforce development programs to K-12 
students and helps schools and communities implement their 
technology plans.
    The Center for Math, Science, and Teaching Excellence at 
New Jersey Institute of Technology will develop and deploy 
technology to provide interactive learning experiences for 
teachers who want to improve their math, science, and 
technology skills.
    RUNet 2000 at Rutgers University will continue to expand 
its innovative voice-video-data communications system to bring 
the resources of the university to more K-12 teachers and 
students throughout the State.
    Babyland Family Services, Inc. will launch the Newark 
Project, a technology initiative that will provide minority 
inner-city children and families with access to educational 
institutions and other community resources.
    The New York University Child Study Center will expand the 
ParentCorps project into urban New Jersey areas and evaluate 
its impact. ParentCorps trains parents to improve parenting 
skills and promote the academic, social, and emotional 
readiness of their children.
    Project REACH will provide before-school, after-school, and 
summer programming for K-12 students at six schools in 
Mitchell, S.D.
    Marty Indian School in South Dakota will provide students 
with after-school and summer educational opportunities.
    The East Dakota Educational Cooperative in Sioux Falls, 
S.D., will provide before-and after-school programs, as well as 
summer activities, in eleven communities.
    The HOPE Consortium, which consists of seven schools in 
South Dakota, will address educational, health, social 
services, cultural, and recreational needs of students and 
their communities through school-based learning centers.
    Crazy Horse School in Wanblee, S.D., plans to provide 
after-school and summer programs on the Pine Ridge Indian 
Reservation.
    The Brookings School District in South Dakota will provide 
students with after-school and summer educational opportunities 
in a wide variety of subjects and interest areas.
    The Huron School District in South Dakota, in conjunction 
with the local YWCA and Career Learning Center, will expand its 
after-school programming.
    The Howard and Carthage School Districts in Miner County, 
S.D., will expand an after-school program to make it available 
to more students and begin a summer program.
    The Consortium Community Education Project will provide 
out-of-school activities to students in the Redfield, Lower 
Brule, and Beresford School Districts in South Dakota.
    The Foundation for School Safety runs a Safe and Disaster-
Resistant Schools Initiative to help school facilities address 
disaster risks through the help of disaster-mitigation 
professionals.
    The Digital Dakota Network wires South Dakota classrooms to 
the Internet, trains teachers and administrators on how to use 
technology in schools, and facilitates distance education.
    The Dial Corporation will develop, implement, and evaluate 
three K-12 courses in biology, health sciences, and earth 
sciences, to be delivered over South Dakota's distance learning 
network.
    Kids Voting USA is a nonprofit, nonpartisan, grassroots 
organization that works with schools and communities to enhance 
civics education and encourage voter participation.
    The Bushnell Center for the Performing Arts in Hartford, 
Conn., will expand its Partners in Arts and Education 
Revitalizing Schools Program, which strengthens language arts 
instruction and multicultural understanding for students.
    Amistad America, Inc., a foundation that built and operates 
a full-size, working replica of the slave ship Amistad, will 
coordinate with local schools to provide students free 
admission, tours, and history lessons on the schooner when it 
visits various ports in the United States.
    Minot State University in North Dakota 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.
    Millikin University in Decatur, Ill., runs an initiative to 
assist inner-city and rural high school students in preparing 
for college.
    The Chicago Public Schools plan to expand tutoring and 
mentoring programs.
    Columbia College--Chicago will establish a mentoring 
program designed to improve minority student educational 
success and retention.
    The Virginia Frank Child Development Center in Chicago will 
provide youth scholarships to support inner-city children.
    Southern Illinois University will undertake a teacher 
preparation and placement initiative.
    The Northwest Community Center in Rockford, Ill., will 
develop technology-based educational outreach programs.
    The Illinois Institute of Technology's Digital Media Center 
will use digital technology to help elementary and high school 
students and their teachers improve learning in math and 
science.
    Chicago State University's Urban Campus/Community 
Technology Initiative is designed to support teacher training 
and expand teachers' technology skills.
    College Summit is a national program that assists low-
income students prepare for and enroll in college. College 
Summit Chicago is the hub of the program.
    The Teen Reach Community Youth Program in Illinois is a 
comprehensive initiative to teach Temporary Assistance for 
Needy Families populations and at-risk youth practical skills 
while encouraging tutoring and mentoring.
    The North Carolina Electronics and Information Technologies 
Association will help bridge the digital divide in the State's 
rural and under-served school districts through a school 
technology demonstration program.
    Fresno At-Risk Youth Services in California will attack the 
problem of at-risk youths by coordinating the city's efforts 
through an education program coordinator, working with targeted 
groups, and making peer counselors available to students.
    The Foundation for the Improvement of Mathematics and 
Education seeks to improve math and science testing scores 
through the advancement of curriculum and improvement in 
teacher/administrator education.
    Yosemite National Institutes will develop more outreach 
programs targeted on Native American and minority communities, 
support training programs for educators from disadvantaged 
areas, and purchase advanced technology.
    The Los Angeles Unified School District will provide a 
pilot pre-kindergarten program to 1,000 students.
    The California Institute for the Arts teaches college-level 
arts programs for high school-age students with the goal of 
providing young people with job skills needed for the arts and 
entertainment industry.
    The Florida Department of Education is continuing its 
Comprehensive Plan for Teacher Recruitment and Retention 
(formerly known as ``SchoolNet'').
    The YMCAs of Sarasota, St. Petersburg, and Clearwater, 
Fla., will launch additional YMCA Character Development 
Schools, also known as ``Second Chance Schools.'' The schools, 
conducted in cooperation with local school districts, are 
designed to address behavior problems.
    The Technology Research and Development Authority of 
Florida will continue implementation of a program for math, 
science and technology teacher education for grades 9 through 
12.
    One-to-one ``e-learning'' pilot programs are planned at one 
school in each of these four States: South Carolina, Montana, 
Massachusetts, and Washington. The programs will provide 
students with their own wireless laptop computer, teacher and 
administrator training, and progress reports on student 
achievement.
    The South Carolina Association of School Administrators 
continues to develop a clearinghouse to facilitate the 
distribution and implementation of the methodology and pedagogy 
used by Blue Ribbon Schools.
    Clemson University has developed the Call Me Mister 
collaborative effort with Morris College, Benedict College, and 
Claflin College to recruit, train, certify, and secure 
employment for 200 minority male teachers in public schools.
    The University of South Carolina continues to develop the 
Partners for Literacy model to promote the literacy growth of 
children from birth through age 8.
    Everybody Wins! is a mentoring program that promotes 
children's literacy and love of learning through shared reading 
experiences with caring adults.
    YMCA centers in Texas will continue and expand their youth 
assistance and teen intervention programs, in conjunction with 
the YMCA of the USA.
    The Houston Independent School District will expand and 
improve the computer and telecommunications technology of its 
schools through its Technology Infrastructure Plan.
    The Early Childhood Development Center at Texas A&M, Corpus 
Christi, serves as a childhood development center for at-risk 
children, a professional development center for area public 
school teachers, and a clinical research facility in the study 
of childhood development.
    The Novice and Student Teacher Support Project of West 
Texas A&M University and Texas A&M University, College Station, 
will continue its efforts to recruit and retain more qualified 
teachers to America's public schools.
    The National Association of Partners in Education 
establishes mentoring programs for students across the country 
and encourages business-education partnerships.
    Building Trust in Representative Democracy, a joint effort 
of the National Conference of State Legislatures, the Center 
for Civic Education, and the Center on Congress at Indiana 
University, will work to improve public understanding and trust 
in our Nation's democratic institutions through multimedia 
classroom materials.
    The Reading Evaluation and Assessment Demonstration (READ) 
project, supported by the Today Foundation of Dallas, Texas, 
uses educational software to help students learn to read.
    Help One Student to Succeed (HOSTS) programs encourage 
volunteers to provide effective one-on-one academic mentoring 
to students in districts across the Nation, including Texas.
    The Institute for Engineering at Southern Methodist 
University brings together engineering and science professors 
with high school educators, in conjunction with private 
industry, to increase the interest and quality of math and 
science programs in Dallas-area high schools.
    The National Center for School Improvement, formed by a 
consortium of universities and led by Southwest Texas State 
University, sends teams of educators into struggling schools to 
help turn them around.
    Sam Houston State University will continue its efforts to 
establish a technical assistance learning center to facilitate 
the development of after-school programs for at-risk youth.
    The California School of Professional Psychology, in 
cooperation with school districts in the San Diego, Los 
Angeles, San Francisco and Fresno metropolitan areas, plans to 
develop and implement model teacher training programs regarding 
using technology in the classroom, violence prevention, and 
brain functioning.
    The Pacific Islands Center for Educational Development 
develops and implements training and educational programs aimed 
at assisting Samoan and other Pacific Islander students who 
aspire college education.
    The Vermont Higher Education Consortium will support 
universal, early learning programs through the development, 
coordination and delivery of academic and experiential training 
programs for early childhood educators.
    Watertown Public Schools in South Dakota will integrate 
technology in the classroom by expanding Macintosh iBook 
Wireless Labs and computers to five elementary schools.
    Jobs for Youth uses technology to provide basic literacy 
and job-skill training to youths and adults.
    WGBH, the Nation's largest producer of public television 
programming, will develop the earth sciences portion of a Web 
site called TeachersDomain.org, an Internet portal that will 
benefit teachers and children nationwide.
    The Milwaukee Teacher Education Center will expand programs 
to recruit, prepare and retain a diverse, effective, innovative 
teaching force for the Milwaukee Public Schools.
    The University of Wisconsin--Extension's School Readiness 
Project will provide training and technical assistance to its 
partners in preparing children for learning in school.
    St. Norbert College in DePere, Wis., runs a field-based 
teacher training program that partners with K-12 area schools 
to better prepare teachers to address obstacles in the 
classroom.
    The Green Bay Area Public Schools will establish a project-
oriented model for technology integration by introducing 
teachers and students to effective and appropriate use of 
untethered (wireless, battery-powered) network-connected 
computers.
    The YMCA of Metropolitan Milwaukee is expanding its Teen 
Agenda to serve at-risk teenage youth.
    The Grand Valley State University Teacher Academy in 
Michigan will train a cadre of master teachers who will develop 
a curriculum and mentor pre-service and novice science and math 
teachers.
    The University of Arkansas Little Rock will offer high 
school students a Web-based math course with the goal of 
reducing the number of entering freshmen who need math 
remediation.
    The Early Childhood Compact between Arkansas, Louisiana, 
Mississippi, and Alabama is a plan to develop and implement a 
high-quality, early childhood educational pilot program for at-
risk 4-year-olds that will form the basis of a comprehensive, 
cohesive, universally accessible preschool education program.
    The Yell County schools in Arkansas will expand their 
bilingual programs to address the needs of a growing Hispanic 
population.
    The Maryland Institute for Minority Achievement and Urban 
Education, which is run by the University of Maryland's College 
of Education in partnership with the Maryland Department of 
Education, will serve State school districts by enhancing urban 
education and closing the minority achievement gap.
    The Boys & Girls Clubs of Greater Washington is one of the 
region's largest service organizations helping at-risk youths 
develop the skills necessary for their growth into adulthood.
    The Northeast and Islands Regional Educational Laboratory 
at Brown University has created a Web site called Knowledge 
Loom that provides enrichment resources for educators.
    The Professional Partnership Laboratory School at Roger 
Williams University in Bristol, R.I., will provide an 
innovative learning environment for approximately 500 K-12 
students in the Bristol Warren Regional School District.
    The Institute for International Sport, a nonprofit group 
located on the campus of the University of Rhode Island, plans 
to expand the reach of its Center for Sports Parenting. The 
center addresses the difficult questions related to 
sportsmanship between young athletes and their parents, 
coaches, and teachers.
    The Charter School Development Foundation will operate a 
charter school that is intended to improve the dropout rate in 
Las Vegas schools by offering academic programs designed to 
enhance students' character, self-esteem, and career 
possibilities.
    The Humboldt County School District in Winnemuca, Nev., 
will operate an English as a Second Language program for each 
of its schools.
    Project STARS will provide literacy interventions for 
Nevada students in grades 3 to 5.
    Pahranagat Valley Elementary School, Hawthorne Elementary 
and Junior High School, and Schurz Elementary School in Nevada 
will provide each of their students with a laptop computer.
    The Baltimore City Public School system is continuing its 
efforts to provide each of its classrooms with the technology 
needed to bridge the digital divide.
    The Kennedy Krieger Institute's Career and Technology High 
School in Baltimore provides a school-to-work transition for 
youths with serious learning, emotional, neurological, and 
development disabilities and adolescents who have suffered 
traumatic brain injury.
    The University of Maryland College Park and Morgan State 
University will create a Center for Minority Achievement and 
Urban Education Research.
    The Baltimore Symphony Orchestra's Distance Learning at 
Home and Abroad initiative will extend the reach of BSO's 
programming to students in Maryland public schools and to 
students across the Nation via the Internet.
    New York City's Museum of Modern Art will use a distance 
learning program to maintain education-outreach opportunities 
while the museum embarks on a major expansion and renovation 
project.
    The 24 Challenge/Jumping Levels Math Program supplements 
basic math curriculum in grades 1-8.
    Bloomsburg University in Pennsylvania is providing 
computers, computer wiring, and training for teachers in 25 
surrounding school districts.
    The Boys and Girls Clubs of Philadelphia are developing a 
school-based mentoring program.
    Cabrini College in Pennsylvania is developing a new Center 
for Science, Education, and Technology that will provide a 
model elementary education classroom to facilitate and enhance 
the educational experience of Cabrini undergraduate students 
majoring in education.
    CAPE/PETE Net is continuing to develop its national 
demonstration program for distance learning with 105 
Pennsylvania universities and colleges.
    Cheyney University in Pennsylvania is creating a pilot 
Collaborative Center for Teacher Preparation program by 
partnering with area school districts.
    The city of Philadelphia is continuing to modernize its 
community recreational centers with new computer terminals and 
other technological improvements. The City is also developing 
an anti-truancy initiative and establishing after-school 
programs for its students.
    The College of Physicians of Philadelphia is expanding its 
educational outreach to all students in the Philadelphia School 
District through a medical science museum-based experimental 
learning program.
    Communities in Schools of Lehigh Valley is developing in-
school and after-school programs for at-risk middle school and 
high school students.
    Drug-Free Pennsylvania is implementing a demonstration 
project in which it would partner with local school districts 
and media outlets in an effort to provide at-risk students with 
an opportunity to develop and produce public service 
announcements targeting drug use prevention.
    The Eisenhower Foundation is replicating a full community 
school program that emphasizes the school as the central point 
of the community.
    Freedom Theatre, the Nation's largest African-American 
theater and performing arts training program, trains over 900 
youth annually by promoting artistic and personal development. 
It plans to provide greater access to its training programs for 
talented youth.
    HUBS is providing tools for teacher training tools and 
classroom management, including school-to-home communication.
    Indiana University of Pennsylvania is establishing a K-12 
computer services center for area school districts.
    Jazz in the Schools is continuing to expand its program to 
engage inner city high school students in a hands-on program 
that uses jazz as a means to maintain student interest in 
academic subjects in the core curriculum.
    MICROSOCIETY has developed and will continue to disseminate 
a comprehensive school reform model.
    The National Foundation for Teaching Entrepreneurship plans 
to expand to Philadelphia. The program partners with high 
schools and community-based organizations to teach topics such 
as sales, marketing, venture capital, and business ethics 
classes.
    The Opera Company of Philadelphia is developing the Sounds 
of Learning, which uses opera as the base for integrating all 
aspects of a child's formal education. The program targets low-
income households living in urban school districts.
    The Pennsylvania Ballet is developing the Accent on Dance 
program for elementary and secondary school students for in-
school and after-school programs.
    The Philadelphia Orchestra is expanding its five 
educational programs to reach a broader and more diverse 
audience.
    The Philadelphia Zoo is seeking to develop and create 
programs and interpretive media for the Avian Conservation 
Center.
    Pittsburgh Technology Council is providing computer 
training to teachers in school districts in a 13-county area.
    Project 2000 is planning to expand its existing academic 
support and mentoring programs for inner-city African-American 
youth to an adjoining housing project.
    SEPCHE is developing a ``global curriculum'' to challenge 
students to develop their knowledge of foreign languages and 
cultures, and recognize relationships between history and 
current issues.
    Tesoro High School in California is developing a Knowledge 
Center which will be a customized facility consisting of a 
technology lab, seminar lab, communications center, and 
library.
    Washington and Jefferson College is conducting quality 
education initiatives and professional development in the 
southwest region of Pennsylvania. A key focus of the program is 
to integrate technology into teacher preparation and 
performance.
    Walnut Street Theatre's Educational Outreach Program for K-
12 schools in the Philadelphia area includes an apprenticeship 
program, an adopt-a-school program, and a summer camp.
    Widener University in Pennsylvania is seeking to provide 
computer networking management services to 12 area school 
districts and other educational entities.
    The Pittsburgh YWCA is continuing to expand its after-
school activities.
    Big Brothers/Big Sisters is hoping to double the number of 
children served in school-based mentoring.
    The Detroit Science Center will develop and implement an 
educational series of new Urban Intervention Science Programs 
that will correlate with Michigan Educational Assessment 
Program measures. Students will be introduced to careers in 
science, technology, and engineering.
    The Detroit Public Schools will provide professional 
development for its site-based management teams.
    The Principals Academy in Detroit will serve as the primary 
entity for ensuring that the school system's principals are 
trained to run high-quality schools.
    The Detroit Public Schools will create an alternative 
teacher certification program to attract working professionals 
who want to teach but are not currently certified.
    The Michigan Association of School Administrators (Region 
I) will expand its telecommunications infrastructure in the 
upper peninsula to allow schools to communicate with 
individuals more effectively.
    The Eastern Upper Peninsula Intermediate School District in 
Michigan will offer services and activities for youths and 
adults during after-school hours and, during the summer, all 
day.
    The Eastern Upper Peninsula Intermediate School District in 
Michigan will provide cost-effective curriculum and student 
enrichment programs to 12 communities through distance 
learning.
    The Flint Area Chamber of Commerce in Michigan will 
establish an ``e-mentoring'' program designed to create a 
partnership between employers and students, with the goal of 
improving academic performance and workforce readiness.
    The YWCA of Anchorage offers after-school and enrichment 
programs to at-risk schoolchildren and their mothers that 
stress building self-esteem and strong value systems.
    The United Way of Anchorage supports a number of high-
quality after-school programs designed to help students stay 
out of trouble and do well in school.
    Alaska's Right Start program provides extended-day programs 
for kindergarten-age schoolchildren who are behind expected 
developmental levels and makes use of academic program 
coordinators.
    The Alaska Initiative for Community Engagement (Alaska ICE) 
program uses community resources to help schoolchildren 
increase academic performance and involve them in their own 
communities.
    Alyeska Central School in Alaska plans to use online 
distance education to help students in small, rural schools 
prepare for the State's high school graduation qualifying 
examination.
    The Qualified Teachers for Alaska program recruits and 
prepares teachers to work in the State.
    The Alaska Department of Education runs an intense remedial 
summer reading program for high school students that is 
designed to help them graduate on time and with their 
classmates.
    Big Brothers Big Sisters agencies in Alaska plan to extend 
their after-school mentoring programs across the State to 
include rural and remote villages and communities.
    The Anchorage School District will develop a Summer Reading 
Lab to increase reading comprehension skills for Anchorage area 
high school students.
    The Sheldon Jackson College Center for Life Long Learning 
trains teachers, especially Alaska Natives, to teach in remote 
Alaskan villages.
    Alaska Geographic Alliance plans to work with Library of 
Congress to incorporate its Meeting of the Frontiers project 
into the Alaska school history and geography curriculum.
    The Galena School District and several partners are 
assisting Alaska Native students who attend boarding schools 
and colleges make the transition from rural village life to 
educational residence facilities.
    The University of Alaska Anchorage's LitSite project will 
help bridge the rural/urban literacy gap in Alaska, especially 
for schoolchildren in grades K-12.
    The Anchorage Community Theater School is initiating an 
after-school performing arts program for Anchorage-area 
schoolchildren in grades K-12.
    The Rowan Center for the Advancement of Learning at Rowan 
University in New Jersey has developed a process called Let Me 
Learn that enables students to understand what types of 
learners they are so they can learn more effectively. The 
center plans to implement its programs in eight sites 
throughout the State.
    Schools Plus is a safe, neighborhood-based, after-school 
program designed to provide academic assistance and one-on-one 
mentoring for students.
    The Northwest Regional Education Laboratory in Portland, 
Ore., is training senior citizens to serve as reading tutors in 
K-12 school settings in Oregon, Alaska and Washington.
    Oregon State University's Lifelong Learning Alliance will 
use distance learning to create a new statewide system for 
providing a variety of education-related services, including 
professional development for teachers and school counselors.
    The Schools Uniting Neighborhoods (SUN) program in 
Portland, Ore., is creating and supporting school/neighborhood 
partnerships in an effort to increase student achievement and 
family involvement with children.
    Portland State University in Oregon is establishing the 
Portland Metropolitan Partnership for School Leadership, a 
program that will recruit, prepare, and offer professional 
development for school leaders in the region's secondary 
schools.
    Self-Enhancement, Inc. in Portland, Ore., provides after-
school services for at-risk students.
    The Native American Performing Arts Project will add a 3-
day performing arts workshop to the Konaway Nika Tillicum, 
Southern Oregon University's summer youth academic camp for 
middle school students. It will also create a Native American 
Theater production that would travel the State.
    The Multnomah Outdoor School project in Oregon is a 
residential program that allows students to experience hands-on 
science learning over an extended weekend.
    Friends of the Children, a national nonprofit group based 
in Portland, Ore., provides adult mentors to children who are 
most in danger of school failure, abuse, gang and drug 
involvement, and other serious problems.
    The Integrated Performance Benchmarking System, tested by 
Oregon and Nebraska the past 2 years, is a proposed initiative 
to eliminate cumbersome paperwork currently required by the 
Department by allowing States to electronically store, share, 
and even compare State education data.
    Several school districts in Utah plan to conduct a 
demonstration project in which they would administer their 
annual assessments using computers.
    Under the Utah Reading Excellence Act, school districts in 
the State are working to improve literacy among their students, 
especially those in grades K-3.
    The University of Montana's Safe Schools Project is 
facilitating a statewide community-based curriculum development 
initiative that promotes responsible youth behavior.
    Fisher's Peak YMCA in Trinidad, Colo., has established a 
teen center and is sustaining a conflict resolution center.
    The YMCA of Metropolitan Denver is developing a teen 
initiative program targeting at-risk African-American and 
Hispanic teens at the East Denver Family YMCA.
    The Pikes Peak YMCA is expanding the Youth Connection 
Program in Colorado Springs, which connects at-risk teens with 
business leaders to learn job skills and model other healthy 
behavior.
    The Pueblo YMCA in Colorado is developing teen programs and 
a new teen center that will focus on leadership development, 
outdoor adventure skills and intramural sports programs.
    Longmont YMCA is trying to double the number of teens 
served in Longmont and the St. Vrain Valley in Colorado. 
Additional funds will allow the programs to mentor youths, 
provide employment and training skills, and offer community 
service activities, reading skills, fitness activities, and 
summer camping.
    The Boulder Valley YMCA in LaFayette, Colo., is expanding 
its After School and Active Peer (ASAP) program, which works in 
conjunction with local universities to provide mentoring and 
tutoring to high school students.
    The Pathway Partners rural education program, developed in 
the mountains of Maine, plans to expand to more rural 
communities.
    The Lewiston-Auburn College/University of Southern Maine 
TEAMS Program is preparing future and current teachers to meet 
the demands of Maine's 21st century elementary and middle 
schools.
    The University of Maine Foreign Language Education 
Initiative aims to increase the competitiveness of the U.S. 
workforce in the global economy by enhancing foreign language 
education.
    I-SAFE America, an Internet-safety education foundation, 
plans to expand a current pilot project in Utah to encompass 
school districts and police departments nationwide.
    The University of Nebraska at Omaha's P-12 Urban Education 
Program plans to implement an innovative program to improve 
mathematics and science education in urban public schools. This 
project will be a collaborative effort between the College of 
Education at UNO, Omaha Public Schools, and other partners.
    The University of Nebraska at Kearney is working with pre-
service and in-service teachers to assist them in dealing with 
an increasingly diverse student population.
    Stillman College, in conjunction with Zelpha Wells Cultural 
Education Center, is providing music education and music 
instruction to minority and disadvantaged youth.
    The Pendleton, Pilot Rock, and Athena-Weston school 
districts in Oregon have partnered with the Confederated Tribes 
of the Umatilla Indian Reservation (CTUIR) to establish a 
formal cooperative dropout-prevention program.
    Fayette County High School in Tennessee is continuing its 
efforts to support technology enhancements and improve after-
school programs.
    Classika Theatre of Arlington, Va., plans to expand its 
successful ARTsmarts and SS VETA (Social Studies: Virginia 
Education Through Arts) programs, which are intended to improve 
students' overall academic performance, enhance reading and 
comprehension skills, and strengthen concentration and 
memorization ability.
    Junior Achievement of Delaware Valley educates students 
about free enterprise, business, and economics through its 
Exchange City program.
    The Regional Performing Arts Center in Philadelphia will 
include a state-of-the-art concert hall, a recital theater, and 
an arts education center that will offer distance learning 
programs, with instant access for schools in the region.
    The Tupelo Public School District plans to expand its 
C*R*E*A*T*E* for Mississippi project, which joins teachers in 
several districts into a network to model successful, 
replicable technology application and use in classrooms.
    The Electronic Learning Marketplace uses technology in 
support of educators' efforts to improve the learning of all 
Maine students toward the rigorous standards defined by the 
Maine Learning Results.
    The Maine Center for Educational Services' Discover ME Web 
site will create an on-line resource center that will allow 
students and teachers to access curriculum materials, 
participate in panel discussions with experts, share resources, 
and build an online community.
    The Schools and Technology for Assessment and Reflection 
(STAR) project in Maine uses telecommunications technology with 
the goal of significantly increasing the number of students who 
demonstrate proficiency on State mathematics, science, reading 
and writing educational standards.
    The University of Alabama plans to upgrade its science 
lecture halls to incorporate state-of-the-art, multimedia 
rooms, instant response devices, and distance learning 
technology to provide instruction to K-12 classes.
    Spring Hill College in Mobile, Ala., is developing 
technology enhancements and technology training of their 
teachers for distance learning.
    Three Rivers Connect of Allegheny County, Pennsylvania, 
plans to acquire and upgrade nearly 3,000 Federal surplus 
computers to be used by Pittsburgh Public Schools to provide an 
Internet-based learning curriculum.
    Educational Service District 117 in Wenatchee, Wash., will 
equip a community technology center to expand technology-based 
training.
    KCTS, a PBS affiliate in Seattle, will develop a database 
of primary-source research materials.
    The Washington Association of Career and Technical 
Education will update its training technology to ensure that it 
meets industry standards.
    The Community Education and Lifelong Learning Center at 
Satsop Development Park in Washington State will equip its 
classrooms and conference facilities.
    The Temple University Center for Research in Human 
Development and Education is developing innovative models to 
address teacher recruitment, training, and mentoring that will 
enhance student achievement and raise the capabilities of low-
performing schools.
    Lock Haven University and the Keystone Central School 
District in Pennsylvania will collaborate to form a model 
alternative school that will provide educational opportunities 
for students who are not able to succeed in the conventional 
classroom.
    The First Freedom Center in Richmond, Va., will prepare and 
design educational exhibits to show the history of religious 
freedom and its role in U.S. democracy.
    Great Films Project Co., Inc. of New York produces 
documentary films to provide objective assessments of the 
impact of Federal education programs on the education of our 
Nation's youth.
    The Pennsylvania Department of Education's Division of 
Migrant Education, in a consortium with the Migrant Education 
Division of Arkansas, Colorado, Texas, Florida, Illinois, 
Montana and Kansas, will create an educational technology 
system geared toward improving K-8 migrant student achievement 
in reading, language proficiency and mathematics.
    The New Mexico Department of Education will continue to 
expand use of the Individual Services Model to help reduce the 
dropout rate for high school students in the State.
    The New Mexico Department of Education is developing a 
``virtual school'' technology plan that would ensure that all 
students, regardless of circumstance or geographic location, 
have equal opportunity to develop a strong academic foundation, 
by creating dynamic, student-centered learning environment 
delivered via the World Wide Web, two-way interactive video 
conferencing, and satellite downlink technologies in 
collaboration with the State's major education partners.
    The Children and Family Development Education Center in 
Albuquerque, N.M., will expand access to comprehensive, 
community-based continuum of services to preschoolers and their 
families, including comprehensive child and family development 
services.
    The Mid-Rio Grande Collaborative for Educational in 
Albuquerque is developing innovative strategies for working 
with at-risk students, aligning curriculum and standards, and 
improving literacy, math and science studies.
    Albuquerque Public Schools will continue to develop an 
innovative schoolwide program at one of its high schools. The 
program will focus on the teaching and learning of mathematics, 
science and technologies, and serve as a resource for all of 
New Mexico's school districts through research, teacher 
training, and distance learning.
    The Integrated TechCenter program in Roswell, N.M., is an 
innovative program designed to provide secondary students with 
technology skills that will prepare them for employment.
    St. Joseph's Indian School in South Dakota plans to expand 
and improve education outcomes of at-risk Native American youth 
by providing services that help reduce the high school drop-out 
rate, improve academic standing, and provide rehabilitative 
counseling.
    The Alameda County Social Services Agency in California 
will support an education and training program for high school 
students.
    The California School of Professional Psychology runs an 
initiative to help ensure that elementary and secondary school 
students have adequate access to counseling and mental health 
services in their schools.
    The Enterprise Center, in West Philadelphia, will expand 
its revitalization program in distressed urban neighborhoods to 
educate its residents with entrepreneurial skills, resources, 
and opportunities.
    The Louisiana State University Health Science Center will 
establish the National Center for Special Education 
Accountability and Monitoring, which will be devoted to 
improving education for children with disabilities.
    School boards in Orleans Parish and Jefferson Parish, La., 
will implement a universal literacy system at competitively 
selected schools.
    The District Attorney's Office in Orleans Parish, La., will 
run a school-based, drug-awareness education and prevention 
program.
    The North Carolina Electronics and Information Technologies 
Association will improve workforce development in underserved 
areas to increase technology tools, including teacher training, 
hardware, software, connectivity.
    The Holy Redeemer Health System in Philadelphia will expand 
and enhance afterschool programs for at-risk youth.
    The Department of Education of the Commonwealth of 
Pennsylvania will provide assistance to low-performing school 
districts that are deemed distressed and slated for potential 
takeover by the Commonwealth as prescribed by Pennsylvania law. 
The initiative is intended to improve the management and 
operations of the school districts; assist with curriculum 
development; provide after-school, summer and weekend programs; 
offer teacher and principal professional development; and 
promote the acquisition and effective use of instructional 
technology and equipment.
    Do Something America instills self-confidence and 
leadership skills in K-12 students by encouraging them to 
participate in community projects.
    American Theater Arts for Youth, Inc. is developing an Arts 
in Education Program.
    The Children's Literacy Initiative is planning to 
supplement Head Start's distance learning programs and provide 
a teacher education program.
    Friends of the Children is providing full-time, paid adult 
mentors to at-risk children in Chester, Pennsylvania.
    Music Education and Technology Advancement (MENC) is 
planning to establish a standard music education and creativity 
instructional technology and professional development program 
for approximately 4,000 K-12 public schools.
    Lincoln University plans to purchase laboratory and 
computer equipment to provide a 6-week summer workshop for 
Philadelphia teachers, and also to conduct a 1-day annual 
workshop for approximately 200 high school students to expose 
them to scientific disciplines.
    Champions of Caring programs encourage young people to take 
an active role in their communities.
    A consortium of nine school districts in Washington State 
will establish interconnectivity in rural schools to expand 
learning opportunities.
    The YMCA of Greater Seattle will expand teen activities 
offering academic support and leadership development.
    First Book will expand to serve an additional 80 
communities nationwide.
    The Odyssey Maritime Discovery Center in Seattle will 
develop educational programs.
    The I Can Learn program assists teachers in algebra 
instruction.
    The Correction Education Association, in partnership with 
the Pennsylvania Department of Education, Juvenile Corrections 
Education, and Lock Haven University, will design and develop 
curricula and student assessments.
    Delta State University will run an initiative to address to 
address teacher recruitment and retention, technology 
development, and administrator training in the Mississippi 
Delta.
    The Madison County, Mississippi, school district will 
conduct an impact study of the sudden influx of new students in 
the district.
    Protecting You, Protecting Me is an educational curriculum 
for grades 1-5 developed by Mother's Against Drunk Driving.
    Futures for Children of Albuquerque will expands its 
educational services to American Indian children to prepare 
them for high school.
    New Mexico public broadcasters are implementing a digital 
translator project to deliver educational programming to two 
demonstration sites in rural New Mexico.
    The Spring Arbor University-based consortium of higher 
education institutions is using high voluntary standards in 
technology integration to improve teacher preparation and 
classroom practice.
    Reading Together USA is a demonstration program working to 
improve reading comprehension and fluency among second grade 
children.
    The Clark County (Nevada) School-to-Work Program provides 
students who do not plan to attend college with instruction in 
nursing and home health aid.
    The Lynn Meadows Discovery Center for Arts Education in 
Gulfport, Mississippi will continue and enhance its Shooting 
Stars program for students ages 12-17.
    The University of Southern Mississippi Frances Karnes 
Gifted Center will continue its summer programs and make 
participation available to an increased number of students.
    The Mississippi Humanities Council will provide programs in 
local libraries to support Prime Time Family Reading Time.
    The Fort Lewis College Child Development Center is designed 
to serve young children, their families, students, faculty and 
community members in Southwest Colorado and the Four Corners 
Region.
    A Rural Distance Learning Coalition comprising three 
States--Montana, Alaska, and Hawaii--will address the issues 
and challenges surrounding distance learning opportunities for 
rural and remote populations.
    The Committee is aware of the need for an up-to-date 
comprehensive management information system for the Alaska 
Department of Education and Early Development's early childhood 
activities, including all of the programs it administers and 
central eligibility and payment components to reduce 
duplication and provide better access to needed services.
    The Committee is concerned that Alaska Native students in 
high schools and middle schools in Anchorage have achievement 
scores well below those of their non-Native counterparts and 
that the dropout rate for Alaska Native students is more than 
twice that of non-Native students. The Committee encourages the 
Department to consider the ``Partners for Success'' program of 
the Cook Inlet Tribal Council, Inc. and the Anchorage School 
District to provide additional resources to increase graduation 
rates and achievement scores of Alaska Native schoolchildren in 
the Anchorage area.
    The Committee encourages the Department to continue its 
support of the Galena School District's innovative distance 
education program, which benefits thousands of children across 
Alaska, especially in remote areas, by allowing students access 
to more courses and subject-qualified teachers.
    The Committee encourages the Department to continue its 
support of the Partnerships 2000 project of the National 
Association of Partners in Education, and to consider a study 
by the organization of the effectiveness of business/community/
school partnerships on student performance and to explore 
additional strategies to expand these partnerships at the State 
and local levels.
    The Committee encourages the Department to consider a 
proposal from Alaska Digital Video to document important 
segments of Alaska's history from 18,000 B.C. to the present to 
help Alaskan schoolchildren learn the history of an important 
part of their State.
    The Committee is concerned that students and teachers in 
rural, remote communities of Alaska do not have access to 
coursework, teaching materials and teacher training in science 
and mathematics, and it encourages the Department to consider a 
proposal from the Imaginarium in Anchorage to develop new 
courses in math and science for students and teachers in rural 
communities in Alaska using distance delivery.
    The Committee is concerned that in the first round of 
Alaska's High School Qualifying Exam, more than two-thirds of 
students failed the math portion and over half of students 
failed the writing portion. The Committee urges the Department 
to work with the University of Alaska and the Alaska Department 
of Education and Early Development to establish the Alaska 
Center for Excellence in Schools at the University of Alaska to 
assist Alaska's low-performing schools meet requirements of new 
State educational standards.
    The Committee is aware of the Tanana School District's need 
for technology to help its students bridge the digital divide 
in this remote rural Alaskan community.

Mentoring

    The Committee recommends $5,000,000 for mentoring programs. 
This is a new program authorized by the Senate-passed version 
of the ESEA reauthorization bill; it was not requested by the 
administration.
    Funds will be used to promote mentoring programs for 
children who lack strong, positive adult role models or who are 
at risk of educational failure or involvement in criminal or 
delinquent activities. Such programs must seek to help these 
children receive support and guidance from a caring adult, 
improve their academic performance, and avoid involvement with 
gangs. The Department may award grants through this program to 
LEAs; nonprofit, community-based groups; or partnerships 
between the two.

Community service for expelled or suspended students

    The Committee recommends $50,000,000 for a new program to 
encourage community service by students who have been expelled 
or suspended from school. This program was authorized by the 
Senate-passed version of H.R. 1; it was not requested by the 
administration.
    The program will provide grants to States to help make it 
possible for students who have been expelled or suspended from 
school to participate in a community service activity during 
the period of expulsion or suspension. While the Committee 
recognizes that most LEAs require expelled or suspended 
students to attend an alternative school during the period of 
expulsion or suspension, the hours for such schools often 
differ from those of regular schools. The Committee also 
recognizes that primary caretakers in many households work 
outside of their homes, giving students the opportunity to 
engage in inappropriate behavior during non-school hours.
    This program is intended to demonstrate to students who are 
apathetic about their expulsion or suspension that there are 
repercussions to their bad behavior, as well as give them the 
opportunity to give back to their community in a positive way.

Public school choice

    The Committee recommends $50,000,000 for public school 
choice, a new program authorized by the Senate-passed version 
of the ESEA reauthorization bill. This program was not 
requested by the administration.
    Funds will be used to assist school districts implement 
public school choice programs that permit disadvantaged 
students to transfer from a failing public school to a high-
performing public school. School districts may use funds for a 
variety of purposes associated with implementing a public 
school choice program including: informing parents and students 
about the choice program, covering the costs of transportation, 
and capacity-enhancing activities that enable high-demand 
schools to accommodate transfer requests. Grants will be made 
on a competitive basis to local educational agencies to plan 
and implement programs of intradistrict-wide or interdistrict-
wide public school choice. In awarding the grants, the 
Secretary is directed to give the highest priority to school 
districts with low-performing schools.

Youth Alcohol Abuse Prevention Initiative

    The Committee recommends $25,000,000 for the Youth Alcohol 
Abuse Prevention Initiative, a new program authorized by the 
Senate-passed version of H.R. 1; it was not requested by the 
administration.
    This program authorizes competitive grants to LEAs to 
implement proven strategies for reducing underage drinking in 
secondary schools. The Committee directs the Department and the 
Substance Abuse and Mental Health Services Administration 
(SAMHSA) to work together on this effort. According to SAMHSA, 
by the time students are high school seniors, more than 80 
percent have used alcohol and 64 percent have gotten drunk. 
When adolescents move on to college, they bring their drinking 
habits with them. Members of the Committee are deeply concerned 
about the prevalence of underage drinking, and this program 
addresses the need for this issue to be an educational 
priority.
    The Committee directs that $20,000,000 should be used to 
provide the grants and $5,000,000 should be used by SAMHSA to 
provide alcohol abuse resources to assist in implementing the 
anti-alcohol programs.

Rural education

    The Committee recommends $125,000,000 for rural education 
programs. The funding should be equally divided between the 
Small Rural Schools Achievement Program and the Low-Income and 
Rural Schools Program. The administration did not request 
funding for these new programs, which were authorized by the 
Senate-passed version of H.R. 1.
    The Small Rural School Achievement Program permits rural 
school districts to combine certain Federal education funds and 
apply them toward local initiatives, such as professional 
development to improve student achievement. The Low-Income and 
Rural Schools Program is designed to meet the needs of school 
districts serving large numbers of economically disadvantaged 
students. Participating local education agencies are eligible 
to receive supplemental grant funds that will enable the rural 
schools to offer activities of sufficient size, scope, and 
quality to have a significant impact on student achievement.

Physical Education for Progress

    The Committee recommends $50,000,000 for the Physical 
Education for Progress program, which received $5,000,000 in 
fiscal year 2001 as part of the Fund for the Improvement of 
Education. The administration did not request any funding for 
this program.
    Under this program, the Secretary is authorized to award 
grants to, and enter into contracts with, LEAs to pay the 
Federal share of the costs of initiating, expanding and 
improving physical education programs in grades K-12 by: (1) 
providing equipment and support to enable students to actively 
participate in physical education activities; and (2) providing 
funds for staff and teacher training and education. Each LEA 
desiring a grant or contract shall submit to the Secretary an 
application outlining its plan to initiate, expand or improve 
its physical education program. The Secretary shall ensure that 
grants and contracts that are awarded shall be equitably 
distributed between LEAs serving urban and rural areas, and 
areas with both large and small student enrollments. Not more 
than 5 percent of any grant or contract may be used for 
administrative costs.

Improving Literacy Through School Libraries

    Recognizing the strong, research-based connection between 
well-equipped and well-staffed school libraries and the 
literacy skills of students, the Committee recommends 
$25,000,000 for the Improving Literacy Through School Libraries 
program, which was authorized in the Senate-passed version of 
H.R. 1. This is a new program that was not requested by the 
administration.
    Improving Literacy Through School Libraries will provide 
funds for urgently needed, up-to-date school library books and 
training for school library media specialists in order to 
support the scientifically based reading programs authorized by 
the new Reading First initiative. States and local educational 
agencies will receive funds on the basis of their proportion of 
Title I allocations. Funds should be targeted by LEAs to high-
poverty schools and schools with the greatest need for school 
library improvement. Funds may be used to acquire up-to-date 
school library media resources, including books and advanced 
technology; facilitate resource-sharing networks among schools 
and school libraries; provide professional development for 
school library media specialists; and provide students with 
access to school libraries during non-school hours.

                            INDIAN EDUCATION

Appropriations, 2001....................................    $115,500,000
Budget estimate, 2002...................................     116,000,000
Committee recommendation................................     117,000,000

    The Committee recommends $117,000,000 for Indian education 
programs. This amount is $1,500,000 more than the fiscal year 
2001 appropriation and $1,000,000 more than the budget request.

Grants to local education agencies

    For grants to local education agencies, the Committee 
recommends $94,265,000, which is $1,500,000 more than the 
budget request and the fiscal year 2001 appropriation. These 
funds provide financial support to reform elementary and 
secondary school programs that serve Indian students, including 
preschool children. Funds are awarded on a formula basis to 
local educational agencies and schools supported and operated 
by the Bureau of Indian Affairs.

Special programs for Indian children

    The Committee recommends $20,000,000 for special programs 
for Indian children, the same as the budget request and the 
fiscal year 2001 appropriation. 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 fiscal year 2001 appropriation and 
$500,000 less than the budget request. 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.

                   BILINGUAL AND IMMIGRANT EDUCATION

Appropriations, 2001....................................    $460,000,000
Budget estimate, 2002...................................     460,000,000
Committee recommendation................................     516,000,000

    The Committee recommends an appropriation of $516,000,000 
for bilingual and immigrant education, $56,000,000 more than 
the budget request and the fiscal year 2001 appropriation. The 
bilingual programs authorized by the Senate-passed version of 
H.R. 1 are designed to increase the capacity of States and 
school districts to provide special instruction to limited-
English-proficient students.

Bilingual and immigrant education State grants

    The Committee recommends $500,000,000 for bilingual and 
immigrant education State grants, a new program that 
consolidates the three bilingual activities with the immigrant 
education program. This amount is $40,000,000 more than the 
budget request. The program is intended to help States address 
the needs of limited-English-proficient and immigrant students 
statewide, instead of dealing with these problems on a 
piecemeal basis.

Foreign language assistance

    The Committee recommends $16,000,000, which is $2,000,000 
more than the fiscal year 2001 appropriation, for competitive 
foreign language assistance grants. The administration proposed 
consolidating this program into the State block grant program.
    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. Further, the 
Committee is distressed that the only Federal program designed 
to help schools meet this need is unavailable to the poorest 
schools. The Committee encourages the Secretary to use 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, 2001....................................  $7,439,948,000
Budget estimate, 2002...................................   8,425,595,000
Committee recommendation................................   8,439,643,000

    The Committee is aware that the Senate-passed version of 
the ESEA reauthorization bill would fully fund the Federal 
Government's share of special education costs within 7 years. 
If Senate and House conferees agree to that measure, special 
education grants to States will become a mandatory spending 
program.
    In the meantime, the Committee recommends a program level 
of $8,439,643,000 for special education. This amount is 
$999,695,000 more than the fiscal year 2001 appropriation and 
$14,048,000 more than the budget request. It includes 
$5,072,000,000 in fiscal year 2003 advanced funding.
    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.
    The Committee is aware of the greater difficulties faced by 
special needs students and their parents in remote rural 
communities in Alaska, and it urges the Department to continue 
and expand its work with Alaska's PARENTS, Inc., which trains 
teachers, specialists and parents in the use of technology to 
assist students with disabilities. PARENTS, Inc. also plans to 
create a matching, mentoring and home-visit system to support 
rural Alaskan parents of children with disabilities, and to 
partner with community faith-based organizations to develop a 
mentoring program for youth with disabilities at risk for 
entering the juvenile justice system in Alaska.
    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. 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 Committee is 
impressed with the Center's progress and responsiveness in 
meeting the expectations set out in fiscal year 2000 and fiscal 
year 2001. It is especially encouraged that the Center is using 
the recommendations of the National Reading Panel in its 
research dissemination, teacher and parent training, 
development of replicable models for reading assessment and 
intervention.
    The Committee also urges the Department to provide funds 
required to support operations for the 2002 Paralympic Games in 
Salt Lake City.

Grants to States

    The Committee bill provides $7,339,685,000, including 
$5,072,000,000 in fiscal year 2003 advanced funding, for 
special education grants to States. The amount recommended is 
$1,000,000,000 more than the fiscal year 2001 appropriation and 
the same as 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 17 percent of the estimated average per-pupil 
expenditure and 14 percent of excess costs, and would provide 
an estimated Federal share of $1,133 per child for the 6.5 
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 2001 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, 
and the number of preschool children aged 3 through 5 living in 
poverty.
    The amount provided by the Committee is approximately $637 
per child for the 612,700 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 grants for the 
infants and families program under part C of the IDEA. This is 
the same amount as the fiscal year 2001 appropriation and 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 2 
and under, and their families.

State improvement

    For State improvement grants, the bill provides 
$49,200,000, the same as the fiscal year 2001 appropriation and 
the budget request. This program provides 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 $70,000,000, the same as the 
budget request, for research and innovation. This amount is 
$7,353,000 less than the fiscal year 2001 appropriation. This 
program supports competitive awards to produce and advance the 
use of knowledge to improve services and results for children 
with disabilities.
    The Committee urges the Secretary to emphasize research 
that contributes to the development and evaluation of 
empirically based practices designed to address the needs of 
children in special education, and enhance our knowledge of 
best practices, as well as research on programs that provide 
early intervention for children and youth with behavioral 
disorders at risk of requiring more intensive special education 
services.
    The Committee is aware of the following project and 
encourages the Department to give it full and fair 
consideration:
    Oregon State University will research and pilot a program 
to expand the scope of special education training to include 
cultural influences on special needs, and to address the 
shortage of special education teachers with a bilingual 
background.

Technical assistance and dissemination

    The Committee bill provides $53,481,000, the same as the 
fiscal year 2001 level and 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.

Personnel preparation

    The Committee recommends $90,000,000 for the personnel 
preparation program. This amount is $8,048,000 more than the 
fiscal year 2001 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.
    The Committee has increased funds for personnel preparation 
in response to the alarming shortage of special education 
personnel, including special education teachers and faculty. 
The increase should help institutions of higher learning 
address this shortage so that students with disabilities will 
be appropriately served.

Parent information centers

    The Committee bill provides $26,000,000 for parent 
information centers, the same as the fiscal year 2001 
appropriation and 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 $36,210,000 for technology and 
media services, $1,000,000 less than the fiscal year 2001 
appropriation and $4,500,000 more than 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 $9,500,000 for 
Recording for the Blind and Dyslexic, Inc. This is the same 
amount as the fiscal year 2001 level and $3,500,000 more than 
the budget request. These funds support the 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 notes that video description is important for 
the full inclusion of blind and visually impaired children in 
the education process, and it directs the Department to fund 
this service at a level of $2,500,000, an increase of 
$1,000,000 over the budget request and the fiscal year 2001 
appropriation.

Readline

    The Committee recommends $1,500,000 for the Readline 
Program. The amount recommended is the same as the fiscal year 
2001 appropriation for this activity. The administration 
proposed eliminating this program.
    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 Web site, 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, 2001....................................  $2,805,339,000
Budget estimate, 2002...................................   2,930,117,000
Committee recommendation................................   2,932,617,000

    The Committee recommends $2,932,617,000 for rehabilitation 
services and disability research, $127,278,000 more than the 
2001 appropriation and $2,500,000 more than the administration 
request.

Vocational rehabilitation State grants

    The Committee provides $2,481,383,000 for vocational 
rehabilitation grants to States, which is $81,593,000 more than 
the fiscal year 2001 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. 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 percent 
and not more than 1.5 percent of the appropriation in fiscal 
year 2002 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 strongly supports individual States' efforts 
to provide vocational services to the disabled and recognizes 
that the Vocational Rehabilitation program has helped put 
millions of people back to work. The Committee is aware that 
the cost of critical care and counseling services is rising, 
while per capita income and population in most States is 
increasing at a slower rate. The Committee notes that the 
authorizing statute determines the annual increase in this 
mandatory appropriation, and also specifies the allotment for 
each State. The Committee recognizes that if formula 
allocations for each State increased by the annual cost of 
living, States would be better prepared to ensure that services 
continue to be successfully rendered.

Client assistance

    The Committee bill recommends $12,147,000 for the client 
assistance program, $500,000 more than the fiscal year 2001 
appropriation and the administration request.
    The client assistance program funds State formula grants to 
assist vocational rehabilitation clients or client applicants 
in understanding the 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 2001 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 $16,492,000 for demonstration 
and training programs for persons with disabilities, $4,600,000 
less than the fiscal year 2001 appropriation and the same as 
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 Committee is aware of the following projects and 
encourages the Department to give them full and fair 
consideration:
    The University of New Orleans will provide support services 
to meet the needs of entrepreneurs with disabilities through 
its Training Research and Assistive Technology Center.
    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 Virtual Reality-Based Education and Training for Deaf 
and Hearing Impaired Children and Adults Project at Orange 
County (FL) Public Schools 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 
support teacher training and professional development.
    The member institutions of the Consortium for Orthotic and 
Prosthetic Education and Research will develop programs 
designed to improve the quality of applied orthotic and 
prosthetic research and help meet the increasing demand for 
provider services.
    The National Literacy Center for the Visually Impaired in 
Atlanta, Georgia is well suited to address the growing need to 
upgrade and keep current the skills of the cadre of teachers 
across the country that teach blind or visually impaired 
children and adults.
    The Hot Springs Rehabilitation Center continues to help 
individuals with disabilities gain the vocational skills they 
need to lead productive and independent lives.
    The Seattle Lighthouse for the Blind will offer support-
service providers to deaf-blind citizens, improve outreach and 
enhance support programs for eligible individuals.

Migrant and seasonal farmworkers

    The Committee recommends $2,350,000 for migrant and 
seasonal farmworkers, the same as the fiscal year 2001 
appropriation and the budget request.
    This program provide grants limited to 90 percent of the 
costs of the projects providing comprehensive rehabilitation 
services to migrant and seasonal farm workers with disabilities 
and their families. Projects also develop innovative methods 
for reaching and serving this population. The program 
emphasizes outreach, specialized bilingual rehabilitation 
counseling, and coordination of vocational rehabilitation 
services with services from other sources.

Recreational programs

    The Committee provides $2,596,000 for recreational 
programs, the same amount as the fiscal year 2001 appropriation 
and the administration request.
    Recreational programs help finance activities such as 
sports, music, dancing, handicrafts, and art to aid in the 
employment, mobility, and socialization of individuals with 
disabilities. Grants are awarded to States, public agencies, 
and nonprofit private organizations, including institutions of 
higher education. Grants are awarded for a 3-year period with 
the Federal share at 100 percent for the first year, 75 percent 
for the second year, and 50 percent for the third year. 
Programs must maintain the same level of services over the 3-
year period.

Protection and advocacy of individual rights

    The Committee recommends $14,000,000 for protection and 
advocacy of individual rights, the same as the 2001 
appropriation and the budget request.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities.
    The Committee understands that the issue of program income 
is treated differently among protection and advocacy systems 
established under various Federal laws. The Committee 
recommends that RSA review its policies on program income and 
develop a policy that is consistent with the other Federal 
agencies that administer P&A programs.

Projects with industry

    The Committee bill includes $22,071,000 for projects with 
industry, the same as the 2001 appropriation and the 
administration request.
    The projects with industry [PWI] program promotes 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 2001 
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 
2001 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 
$60,000,000, an increase of $2,000,000 over the 2001 
appropriation and 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, the same as the 2001 
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 10 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 
$900,000, a decrease of $1,000,000 from the 2001 appropriation 
and the same as the budget request. In fiscal year 2002, 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 
ongoing dissemination and performance measurement activities.

Evaluation

    The Committee recommends $1,000,000 for evaluation 
activities, $587,000 less than the 2001 appropriation and the 
same amount as 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, the same as 
the 2001 appropriation and 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 1,950 individuals and 
families.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $110,000,000 for the National 
Institute on Disability and Rehabilitation Research [NIDRR], 
$9,600,000 more than the amount appropriated in 2001 and the 
same as the budget request.
    NIDRR develops and implements a comprehensive and 
coordinated approach to the conduct of research, demonstration 
projects, and related activities 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 urges the NIDRR to focus on activities to 
enhance access to assistive technology for people with 
disabilities, including technology-based activities, such as 
technology transfer.
    The Committee strongly encourages NIDDR to give priority in 
awarding grants for the establishment of new rehabilitation and 
research engineering centers which will aid in the 
implementation of the Executive Order to implement the Supreme 
Court Decision in L.C. vs. Olmstead.
    The Committee recommendation supports increased funding for 
the Interagency Committee on Disability Research (ICDR) and 
notes that the primary purpose of the ICDR is to promote 
cooperation across various government agencies in the 
development and execution of disability and rehabilitation and 
research activities. The Committee strongly encourages the ICDR 
to enter into cooperative agreements with other ICDR members to 
identify federally funded technological and scientific research 
that could be applied to promote the independence of people 
with disabilities and the elderly. The same Federal agencies 
shall work in partnership with the private sector to develop a 
plan to bring the applied technologies to the private 
marketplace. The Committee also encourages ICDR to expand its 
website/database for the coordination of research by various 
agencies.
    The Committee strongly urges NIDRR to use resource 
appropriated for the Assistive Technology Development Fund to 
develop new assistive technology, bring technology that has 
already been developed to market and expand the availability of 
existing assistive technology to people with disabilities. The 
Committee believes that priority for grants should be given to 
the development of technology that has a limited number of 
users, or orphan technology. In addition, a portion of these 
funds should be used to further the development of assistive 
technology for children and students and reach the goals of 
projects that were previously funded through the small business 
innovation research activity of OSER's technology and media 
services program.

Assistive technology

    The Committee bill provides $60,884,000 for assistive 
technology, an increase of $19,772,000 over the fiscal year 
2001 appropriation and the same as the budget request.
    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 $34,000,000 for 
activities authorized under title I of the Assistive Technology 
Act (AT Act). The Committee has included bill language which 
allows all State projects funded currently under title I of the 
AT Act to receive minimum grants of $500,000. The bill language 
also provides outlying areas minimum grants of $150,000 and 
State protection and advocacy systems minimum grants of 
$100,000. In fiscal year 2002, the AT Act would require 9 
States to lose Federal financial support provided by title I, 
at a time when States are operating in a new policy landscape 
that includes the Olmstead decision, final section 508 
guidelines and the Ticket to Work and Work Incentives 
Improvement Act. The Committee notes that all of the grants 
awarded in fiscal year 2000 for the alternative financing 
program were provided to State entities receiving Federal 
support under title I of the AT Act.
    The Committee recommendation includes $26,884,000 to 
support grants to States and technical assistance activities, 
authorized under title III of the AT Act, to establish or 
maintain alternative loan financing programs, an increase of 
$11,884,000 over the fiscal year 2001 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.
    The Committee recommendation concurs with the 
administration request to make technical changes to the 
alternative financing program authorized under title III of the 
AT Act. The changes will eliminate the minimum grant amount and 
formula allocation requirements, allow States to receive more 
than 1 year of funding and enable States to be awarded more 
than one grant. These changes will ensure that States are able 
to take full advantage of the opportunities presented by this 
program and are the same as enacted in the Department of 
Education Appropriations Act, 2001. The Committee believes that 
States should be allowed to utilize non-Federal resources from 
any source in order to meet the match required to receive an 
award to operate alternative loan programs.

Access to telework fund

    The Committee bill provides $20,000,000 for the access to 
telework fund, the same as the budget request. This fund is a 
new program requested by the administration.
    The access to telework fund is designed to increase 
employment opportunities for individuals with disabilities by 
providing greater access to computers and other equipment 
individuals need if they decide to work from home. The fund 
would provide matching funds to States to enable them to 
provide loans for individuals with disabilities to purchase 
computers and other equipment so that they can telework from 
home. Funds appropriated are available until September 30, 
2003.
    The Committee encourages the Department of Education to 
design the access to telework loan program in a manner which 
creates the maximum incentives for people with disabilities to 
participate. The Committee recognizes that the decision to 
attempt to work involves a high level of risk for a person with 
a disability, including the potential loss of health care 
coverage and income subsidies, and that the design of the 
program should take this fact into account (including the 
possibility of loan forgiveness should the person's attempt to 
work fail). Finally, the Committee encourages the Department to 
allow States flexibility in implementation of the program to 
encourage participation, including the use of any non-Federal 
resources to meet the match requirement.

           Special Institutions for Persons With Disabilities


                 American printing house for the blind

Appropriations, 2001....................................     $12,000,000
Budget estimate, 2002...................................      12,000,000
Committee recommendation................................      14,000,000

    The Committee recommends $14,000,000 for the American 
Printing House for the Blind [APH], $2,000,000 above the 2001 
appropriation and the budget request.
    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. The Committee recommendation includes sufficient 
funds to continue the Accessible Textbook Initiative and 
Collaborative Project.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2001....................................     $53,376,000
Budget estimate, 2002...................................      52,570,000
Committee recommendation................................      54,976,000

    The Committee recommends an appropriation of $54,976,000 
for the National Technical Institute for the Deaf [NTID], an 
increase of $1,600,000 over the 2001 appropriation and 
$2,406,000 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, $5,376,000 is for 
construction.
    It has come to the Committee's attention that the 
administration request for the third installment towards NTID's 
$14,900,000 dormitory renovations project has been reduced by a 
total of $806,000 to $4,570,000. This reduction reflects the 
Department's expectation that NTID raise 15 percent of the 
funds required to complete the project 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 funds 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 $1,000,000 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 not to impose a 
matching requirement on this construction project.

                          GALLAUDET UNIVERSITY

Appropriations, 2001....................................     $89,400,000
Budget estimate, 2002...................................      89,400,000
Committee recommendation................................      97,000,000

    The Committee recommends $97,000,000 for Gallaudet 
University, an increase of $7,600,000 above the amount 
appropriated in 2001 and the budget 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.
    The Committee recommendation includes funding to enable 
Gallaudet University to maintain and enhance its technological 
base, continue investments in faculty and staff, and support 
improvements in physical facilities, including campus security.

                     VOCATIONAL AND ADULT EDUCATION

Appropriations, 2001....................................  $1,825,600,000
Budget estimate, 2002...................................   1,801,660,000
Committee recommendation................................   1,818,060,000

    The Committee recommendation includes a total of 
$1,818,060,000 for vocational and adult education, consisting 
of $1,240,000,000 for vocational education and $556,060,000 for 
adult education, and $22,000,000 for State grants for 
incarcerated youth offenders. Of the total, $791,000,000 is 
advanced funded for fiscal year 2003.

                          Vocational education

    The Committee recommendation of $1,240,000,000 for 
vocational education is $3,100,000 less than the fiscal year 
2001 amount and $16,400,000 more than the administration's 
request.
    Basic grants.--The Committee has included $1,100,000,000 
for basic grants, the same as the fiscal year 2001 
appropriation and the administration request. Of the 
recommended amount, $791,000,000 will become available on 
October 1, 2002.
    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.
    The Committee has included bill language allowing the 
Secretary to establish the set aside available for incentive 
grants. Incentive grants are provided to States that exceed 
their adjusted level of performance required in title I of WIA, 
the Adult Education and Family Literacy Act and the Perkins 
Act. The Committee requests that the Department provide a 
report detailing how the incentive grant set aside is 
determined for fiscal year 2002 incentive grant awards.
    Tech-prep education.--The Committee recommends $106,000,000 
for tech-prep programs. This is the same as the 2001 
appropriation and 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 $7,000,000 on a 
current-funded basis for tribally controlled postsecondary 
vocational institutions, an increase of $1,400,000 over the 
fiscal year 2001 level and the budget request. This program 
provides grants for the operation and improvement of two 
tribally controlled postsecondary vocational institutions to 
ensure continued and expanded opportunities for Indian 
students: United Tribes Technical College in Bismarck, North 
Dakota, and Crownpoint Institute of Technology in Crownpoint, 
New Mexico. Grantee institutions may use the funds for costs 
connected with training teachers, providing instructional 
services, purchasing equipment, administering programs, and 
operating and maintaining the institution.
    National programs, research.--The Committee recommends 
$12,000,000 for national research programs and other national 
activities, $5,500,000 less than the 2001 appropriation and the 
same amount as the administration request. The National 
Research Center for Career and Technical Education and the 
National Dissemination Center for Career and Technical 
Education are the only federally funded centers charged with 
the responsibility to conduct research and provide technical 
assistance to vocational educators. The results of the applied 
research done by the Center inform technical assistance to 
reform and improve vocational education instruction in schools 
and colleges. Resources made available through this program 
also are used to support a variety of activities to identify 
and promote effective research-based programs and practice in 
vocational education.
    Tech-prep education demonstration program.--The Committee 
recommendation includes $5,000,000 for this program, the same 
amount as provided in fiscal year 2001. The administration did 
not request funding for this program. Under this demonstration 
authority, the Secretary awards grants competitively to 
consortia that involve a business as a member, locate a 
secondary school on the site of a community college, and seek 
voluntary participation of secondary school students enrolled 
such a high school. The purpose of the demonstration program is 
to support development of the ``middle college'' model of high 
school, which promotes higher student achievement and 
postsecondary enrollment. Funds may be used for curriculum, 
professional development, equipment, and other start-up and 
operational costs.
    Occupational and employment information program.--The 
amount of $10,000,000 has been provided to continue activities 
authorized by Section 118 of the Carl Perkins Act, $1,000,000 
more than last year. The administration proposed to eliminate 
this program. The Act requires that at least 85 percent of the 
amount be provided directly to State entities to develop and 
deliver occupational and career information to students, job 
seekers, employers, education, employment and training 
programs; make available and improve access to career 
information and planning resources; equip teachers, 
administrators and counselors with the skills and knowledge to 
assist students and parents; and improve coordination and 
communication among workforce development administrators and 
planners. The remaining funds may be used for national 
activities to support the efforts of the State entities, 
including technical assistance, dissemination of information 
promoting replication of high-quality practices, and the 
development and distribution of products and related services.

                            Adult Education

    The Committee has included $556,060,000 for adult 
education, $4,440,000 less than the 2001 appropriation and the 
same as the administration request.
    Adult education State programs.--For adult education State 
programs, the Committee recommends $540,000,000, the same 
amount as the fiscal year 2001 appropriation and the 
administration request. 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.
    The Committee recommendation continues the English literacy 
and civics education State grants set aside within the Adult 
Education State grant appropriation. Within the total, 
$70,000,000 is available to help States or localities affected 
significantly by immigration and large limited-English 
populations to implement programs that help immigrants acquire 
English literacy skills, gain knowledge about the rights and 
responsibilities of citizenship and develop skills that will 
enable them to navigate key institutions of American life. The 
amount recommended is the same as the fiscal year 2001 level 
and the budget request.
    The Committee has included bill language allowing the 
Secretary to establish the set aside available for incentive 
grants. Incentive grants are provided to States that exceed 
their adjusted level of performance required in title I of WIA, 
the Adult Education and Family Literacy Act and the Perkins 
Act. The Committee requests that the Department provide a 
report detailing how the incentive grant set aside is 
determined for fiscal year 2002 incentive grant awards.
    National activities.--The Committee has included 
$9,500,000, a decrease of $4,500,000 from the 2001 
appropriation and the same as the administration request.
    National Institute for Literacy.--The Committee recommends 
$6,560,000 for the National Institute for Literacy, authorized 
under section 242 of the Adult Education and Family Literacy 
Act, $60,000 more than the amount appropriated in 2001 and the 
same as the budget request. The Institute provides leadership 
and coordination for national literacy efforts 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, 
the same as the amount appropriated in fiscal year 2001 and the 
administration request. 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 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.
    Within the appropriation for State grants for incarcerated 
youth offenders, the Committee includes $5,000,000 to continue 
the prisoner literacy 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, 2001.................................... $10,674,000,000
Budget estimate, 2002...................................  11,674,000,000
Committee recommendation................................  12,284,100,000

    The Committee recommends an appropriation of 
$12,284,100,000 for student financial assistance, an increase 
of $1,610,100,000 over the fiscal year 2001 appropriation and 
$610,100,000 over the administration request.

Federal Pell Grant Program

    For Pell grant awards in the 2002-2003 academic year, the 
Committee recommends $10,314,000,000.
    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 $4,000, the highest level in the program's 
history and an increase of $250 over the maximum grant for the 
2001-2002 academic year.

Federal supplemental educational opportunity grants

    The Committee recommends $713,100,000 for Federal 
supplemental educational opportunity grants [SEOG], an increase 
of $22,100,000 above the 2001 appropriation level and the 
budget request.
    This program provides funds to postsecondary institutions 
for need-based grants to undergraduate students. Institutions 
must contribute 25 percent of SEOG awards, which are subject to 
a maximum grant level of $4,000. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell grant recipients.

Federal work-study programs

    The Committee bill provides $1,011,000,000 for the Federal 
Work-Study Program, the same as the 2001 level and the 
administration request. This program provides grants to more 
than 3,300 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 strongly supports continued funding for the 
work colleges program authorized in section 448 of the Higher 
Education Act of 1965. These funds help support comprehensive 
work-service learning programs at seven work colleges, and 
cooperative efforts among the work colleges to expose other 
institutions of higher education to the work college concept.

Federal Perkins loans

    The Committee bill includes $100,000,000 for Federal 
Perkins loans capital contributions, which is the same as the 
2001 appropriation and the budget request. The amount 
recommended, when combined with institutional revolving funds, 
would maintain the 2002 loan volume at the current estimated 
level of $1,112,692,000. 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 $70,000,000 for loan 
cancellations, an increase of $15,000,000 over the 2001 level 
and 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 teaching in a 
qualified low-income school, working in a Head Start Program, 
serving in the Peace Corps or VISTA, or nurses and medical 
technicians providing health care services.

Leveraging educational assistance partnership program

    For the Leveraging educational assistance partnership 
[LEAP] program, the Committee includes $70,000,000, an increase 
of $15,000,000 over the 2001 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 postsecondary students. 
Federally supported grants and job earnings are limited to 
$5,000 per award year for full-time students.

Loan forgiveness for child care providers

    The Committee recommends $1,000,000 for this demonstration 
program, the same as the fiscal year 2001 appropriation and the 
budget request. Under this demonstration program, Stafford and 
Unsubsidized Stafford Loan borrowers under the Federal Family 
Education Loan Program and the William D. Ford Direct Loan 
program who have earned a degree in early childhood education 
and work for 2 full years as a child care provider in a low-
income community may have a portion of their loan obligation 
forgiven.

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

Appropriations, 2001....................................     $48,000,000
Budget estimate, 2002...................................      49,636,000
Committee recommendation................................      49,636,000

    The Committee recommends $49,636,000 for discretionary 
Federal administrative expenses related to the Federal Family 
Education Loan [FFEL] Program, formerly known as the Guaranteed 
Student Loan Program. The amount recommended is $1,636,000 more 
than the amount appropriated in fiscal year 2001 and the same 
as the budget request.
    Funds appropriated for Federal administrative expenses will 
partially cover the fiscal year 2002 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, 2001....................................  $1,911,710,000
Budget estimate, 2002...................................   1,723,223,000
Committee recommendation................................   1,764,223,000

    The Committee recommends an appropriation of $1,764,223,000 
for higher education programs, $147,487,000 less than the 
fiscal year 2001 amount and $41,000,000 more than the budget 
request.

Aid for institutional development

    The Committee recommends $418,000,000 for aid for 
institutional development authorized by titles III and V of the 
Higher Education Act, $25,500,000 above the 2001 appropriation 
and $6,500,000 more than 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, including disseminating 
best practices information on the most efficient and cost-
effective uses of title III funding, reducing student loan 
default rates, increasing graduation rates, and grant writing 
training.
    Strengthening institutions.--The Committee bill includes 
$74,250,000 for the part A strengthening institutions program, 
an increase of $1,250,000 over the fiscal year 2001 level and 
the budget request. The part A program supports competitive, 1-
year planning and 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. 
Institutions awarded funding under this program are not 
eligible to receive grants under other sections of part A or 
part B.
    Hispanic-serving institutions [HSI].--The Committee 
recommends $73,750,000 for institutions at which Hispanic 
students make up at least 25 percent of enrollment, $5,250,000 
more than the fiscal year 2001 level and $1,250,000 more than 
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, institutional management, and purchase of 
educational materials. Title V recipients are not eligible for 
other awards provided under title III, parts A and B.
    Strengthening historically black colleges and 
universities.--The Committee provides $197,000,000 for part B 
grants, $12,000,000 more than the fiscal year 2001 level and 
the same as the administration request. The part B 
strengthening historically black colleges and universities 
[HBCU] program makes formula grants to HBCUs 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.
    The Committee encourages Historically Black Colleges and 
Universities to use funds, as suggested by the Hart-Rudman 
Report of 2001, to train students in the fields of math, 
science, and engineering as well as to be teachers in those 
fields.
    Strengthening historically black graduate institutions.--
The Committee bill includes $48,000,000 for the part B, section 
326 program, $3,000,000 more than the fiscal year 2001 level 
and the same amount as the administration request. The section 
326 program provides 5-year grants to strengthen historically 
black graduate institutions [HBGIs]. 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 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 $7,000,000 for this program, an 
increase of $1,000,000 over the fiscal year 2001 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 tribally controlled colleges and universities

    The Committee recommends $18,000,000 to support the Title 
III program for strengthening the Nation's tribal colleges and 
universities (TCUs), an increase of $3,000,000 over the fiscal 
year 2001 level and the budget request. While sufficient funds 
are not available to adequately address all of the needs of 
these important institutions, the Committee believes that the 
funds provided represent an important step in that direction. 
The recommendation includes $6,000,000 for grants for 
renovation and construction of facilities. The additional funds 
provided for facilities grants, a program launched by the 
Committee last year, will enable TCUs to begin remedying 
serious structural and safety issues at these institutions. 
Over the past three decades, tribally controlled colleges and 
universities (TCCUs) 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, TCCUs have demonstrated their ability to educate 
students who might not otherwise be served by mainstream 
postsecondary institutions. However, TCCUs are among the most 
poorly funded institutions in America. Unlike non-Indian 
institutions, TCCUs cannot rely on endowments, State 
appropriations or wealthy alumni to defray costs.

Fund for the improvement of postsecondary education

    The Committee recommends $51,200,000 for the fund for the 
improvement of postsecondary education [FIPSE], which is 
$95,487,000 less than the 2001 appropriation and the same 
amount as 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 recommendation includes sufficient funding 
for the Shriver Peace Worker Program, Inc. to support the 
establishment of the Sargent Shriver Peace Center and graduate 
research fellowships, professorships, and grants and 
scholarships for students related to peace studies and social 
change.
    The Committee recommendation for FIPSE is consistent with 
the Administration request to consolidate the Learning Anytime 
Anywhere program (LAAP) within the FIPSE program. The Committee 
recommendation includes $22,680,000 to continue support for 63 
current LAAP grantees. The Committee notes that the 
administration's rationale for this action is that new projects 
focused on the development and improvement of distance learning 
technologies can be funded under FIPSE.
    The Committee is aware of the following projects and 
encourages the Department to give them full and fair 
consideration:
    The National Center for Health Care Informatics at Montana 
Tech University will link the disciplines of information 
technology and health care administration through internships 
and specialized degree programs to support the job skill needs 
of workers in the health care industry.
    The University of Great Falls will utilize state-of-the-art 
computer, video and audio equipment to provide distance 
students the opportunity to access and fully participate in 
university courses.
    The University of New Mexico, through its nonprofit Science 
and Technology Corporation, is developing an innovative core 
cluster of courses at their Anderson Business School for a High 
Technology Executive Training Program.
    A 3-year service learning program at Eastern New Mexico 
University will be designed to integrate volunteer community 
service and pre-professional experiential learning with active 
guided reflection into the curriculum to enhance and enrich 
student learning of course material.
    The California School of Professional Psychology has 
developed an initiative to train doctorate level counseling 
personnel and masters level school psychologists to help 
participating school districts in California meet the 
recommended 250 to 1 student to counselor ratio.
    The Ruby Gerontology Center at California State University, 
Fullerton proposes to utilize technology in delivering high-
quality training and education programs.
    CADERA connects rural Americans to the new distance 
education and on-line career training mainstream by 
incorporating best educational methods and technologies in a 
model program.
    Occidental College will improve access to higher education 
for non-native English speakers through the Northeast Los 
Angeles College Resource Center.
    California State University-Northridge will develop 
specialized applications for a new entertainment engineering 
curriculum.
    California State University-Chico continues to develop its 
polymer engineering program.
    The Lifelong Learning and Technology Complex at Grambling 
State University will improve academic programs offered at the 
University.
    Dillard University's Center for Technology, Learning and 
Culture will improve preparation of minority students entering 
graduate business programs.
    Louisiana State University and Southern University will 
establish the Center for Analytical Chemistry to focus on 
developing solutions to environmental and medical research 
problems.
    City University plans to expand its distance learning 
program in Slovakia by enhancing its technology infrastructure 
and course offerings, which will enable the University to 
increase student exchange programs in Eastern Europe.
    The University of Washington-Tacoma is developing the 
Washington Institute for Technology to address the gap between 
the number of technology jobs being created within the region 
and the number of college graduates with sufficient education 
and training to meet this increasing employment.
    Westminster College will support programs to improve 
leadership among high school and college students and faculty 
through innovative services provided by its Center for 
Leadership Service and Churchill Summer Leadership Academy.
    Logan College of Chiropractic will alter significantly the 
college's instructional framework, through the use of 
technology, to make college education more accessible.
    Southeast Missouri State University will utilize advanced 
communication and computer technology to improve curricula and 
programs offered by its integrated School of Visual and 
Performing Arts.
    The Advanced Distributed Learning project at Middle Georgia 
College has been developed to provide technology-based training 
and access to educational programs to America's servicemen and 
women throughout the world.
    Albany Technical College in Georgia has developed an 
Interactive Distance Learning Project to provide high-quality 
educational opportunities in rural communities.
    The Coles College of Business at Kennesaw State University 
in Georgia will utilize technology to link universities across 
the country to facilitate the sharing of programs, information 
and materials to enhance the ongoing educational training and 
development opportunities for family businesses.
    The C.W. Post Campus of Long Island University has proposed 
to augment its efforts in education in the arts and sciences 
programs, and improve outreach to students.
    The North Dakota State University will continue to address 
the need for technically trained personnel through its Tech 
Based Industry Traineeship program by expanding and enhancing a 
program which provides post-secondary students with carefully 
constructed and monitored traineeship operations in companies 
in North Dakota, South Dakota and Minnesota.
    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.
    Fairfield University will develop instructional technology 
to improve access to and enhance the quality of its graduate 
and undergraduate programs.
    Darton College will establish and operate an information 
and technology network that will provide underserved and 
disadvantaged populations access to education opportunities and 
career services in the health care and information technology 
fields.
    The Federation of Independent Illinois Colleges and 
Universities will utilize a high bandwidth network, distance 
learning technologies and innovative training programs to link 
Illinois institutions and improve access to and quality of 
postsecondary education.
    California State University at Dominquez Hill plans to 
improve academic support services for students by utilizing 
digital media and advanced technologies.
    The University of San Francisco has launched programs to 
train adult learners for positions in the new economy and will 
incorporate advanced technologies and related training in 
expanded programs throughout northern California.
    St. Mary's College of Maryland has developed an initiative 
to enhance the technology skills of K-16 students and adult 
learners through its proposed Center for Teaching and Learning 
Systems.
    The University of Maryland Baltimore County and Georgetown 
University have proposed the shared development of advanced 
degree programs to accelerated the training period of students 
entering the field of biotechnology.
    The Grand Valley State University Teacher Academy will 
provide training and support for math and science teachers.
    Lake Superior State University will develop and implement a 
new degree program and utilize distance learning to increase 
the number of skilled trade workers trained in new 
technologies.
    The Gerald R. Ford School of Public Policy at the 
University of Michigan will continue to increase understanding 
of public policy problems and contribute to the development of 
solutions.
    Finlandia University plans to improve educational programs 
for nursing and teaching and other specialties that meet the 
needs of rural areas.
    Michigan Technological University will increase student 
exposure to high-tech instructional practices and advanced 
learning technologies through its Center for Microsystems 
Technology.
    The Lifelong Learning Center at Northwestern Michigan 
College will support innovative educational partnerships 
between the public and private sectors.
    The Center for Teacher Preparation and Learning 
Technologies at Montclair State University will provide 
teachers with the most recent skills, techniques and training 
for use of technology in the classroom.
    Brookdale Community College has developed an innovative 
approach for establishing higher education and business 
training solutions in Central New Jersey.
    The Plangere Center for Communication and Instructional 
Technology at Monmouth University will utilize state-of-the-art 
instructional technology to improve the technical skills of 
communication students.
    The Oregon Graduate Institute at Oregon Health Sciences 
University seeks to increase student participation and 
retention, particularly for those from diverse and disadvantage 
backgrounds, in certificate and degree programs in 
Environmental Information Technology.
    New Mexico State University Cooperative Extension Service 
in Las Cruces is developing a training program utilizing a 
national E-commerce model to assist experienced business and 
community leaders with making strategic electronic business and 
community planning decisions, and establishing a network of 
youth with advanced computer training to provide rural 
community and rural business leaders with fundamental computer 
and Internet access skills.
    Salve Regina University will expand and update its distance 
education efforts to serve a larger potential student market 
via web links and interactive communication to courses, 
services, and information.
    The African Technology for Education and Workforce 
Development Initiative will employ new information technologies 
to deliver education and training from American universities to 
Africa.
    The University of Alaska and the State of Alaska propose to 
establish the Alaska Digital Archives and Digital Library to 
help students and others in rural and remote parts of Alaska 
access historical materials and research tools relating to 
Alaska's history.
    The partnership of the Galena School District and the 
University of Alaska-Southeast continues to develop and 
implement occupation-based curriculum for students in Alaska.
    The Alaska Distance Education Corsortium will serve 
students throughout the entire State, regardless of how remote 
the area.
    The collaborative technology transfer program of the 
College of Rural Alaska-Interior Aleutians and the Galena 
School District continues to improve access and quality of 
education.
    The Barahona Center for the Study of Books in Spanish at 
California State University, San Marcos' will continue its 
effort to improve access to Spanish-language literature.
    California State University, Northridge will implement a 
new entertainment engineering curriculum.
    The Oregon Institute of Technology has established a 
Technology Training Program designed to integrate technology 
into the lives of disadvantaged students and improve student 
success.
    The Early Childhood Leadership initiative of Oregon State 
University will pioneer new strategies to develop 
collaboration, administration and evaluation skills among early 
childhood personnel.
    Oregon State University will design and implement a model 
program for placement of graduate students and interns within 
positions of government and nonprofit agencies.
    The Center for Distance Learning and Accessibility Research 
at Oregon State University will develop programs that support 
an integrated strategy of linking accessibility research and 
distance learning technologies.
    The Tides Foundation plans to support an existing 
charitable program of the McKelvey Foundation which provide 
entrepreneurial college scholarships to rural, low-income 
Pennsylvania high school graduates who demonstrate spirit and 
excellence.
    Western Governors University, an online university created 
by the governors of 19 western States, continues the 
development of innovative distance learning programs.
    The University of Idaho continues to test, evaluate, and 
develop Internet-based interactive learning environments for 
physically handicapped, at-risk, isolated, rural, and other 
populations.
    The Burns Telecommunications Center (BTC) at Montana State 
University-Bozeman plans to launch a Coalition for Establishing 
a National Teacher Enhancement Network, which will improve 
professional development opportunities for science teachers.
    The University of Idaho will continue to develop its 
Advanced Computing and Modelling Laboratory in Boise, to 
educate students in using new tools for research and practical 
applications.
    The Maine Technical College System ``Careers for ME'' 
project will develop a multimedia, Internet-based career 
information site for careers in Maine related to programs of 
the Technical Colleges.
    Southern New Hampshire University in Manchester plans to 
expand its high tech infrastructure and professional 
development, as part of its distance learning program.
    Colorado State University proposes to use an existing 
network of universities to assess the software and the 
technical health of solutions to common technical problems and 
a research laboratory based on collaborative projects in 
response to business needs disseminate the concept throughout 
Colorado.
    The University of Nebraska Medical Center is developing 
distance education programs in Medical Technology, Radiation 
Science Technology, Physical Therapy and Nursing.
    Utah State University (USU) will advance science education 
for all USU students through innovative applications of 
distance learning.
    The University of Colorado, Boulder Alliance for 
Technology, Learning, and Society (ATLAS) program is developing 
new curricula and teaching methods that employ leading 
technologies in classrooms and through distance learning.
    Montana State University in Billings is developing a pilot 
project to initiate a 2-year computer science program within 
the College of Technology.
    University of Southern Colorado, the only comprehensive 
regional university in Southern Colorado, has developed a plan 
to make significant improvements to its information technology 
infrastructure.
    Oklahoma State University (OSU), through its School of 
International Studies, is organizing OSU's intellectual capital 
around international regional bureaus, a world-region focused 
structure similar to that utilized by the U.S. State 
Department.
    ``Peirce Online'', an Internet Mediated Delivered Learning 
(IMDL) degree program at Peirce College in Philadelphia, helps 
students reach their educational goals and earn a degree via 
the flexibility of online learning.
    The University of Maine offers associate and baccalaureate 
programs at its three campus locations in Augusta, Bangor, and 
Lewiston, Maine. UMA has developed plans for a technological 
extension of existing academic courses and programs from one or 
more UMA campus locations to its other locations, focusing 
specifically on UMA, Lewiston-Auburn.
    Lehigh University, through its Integrated Product, Project 
and Process (IP3) Program involve students in all phases of the 
industrial design discipline.
    The Coalition for Ultrasound Education and Training is 
developing a comprehensive multi-institution model distance 
training network for the training of ultrasound technologists 
and medical sonographers.
    The Mark Hatfield School of Government at Portland State 
University will enhance academic programs that support 
professional development of elected officials and other 
individuals associated with public and nonprofit management.
    The Native American Tribal Government Center at Portland 
State University will improve recruitment and retention of 
Native American students and provide professional development 
opportunities for Tribal governments.
    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 for arts and science 
education and outreach.
    The Concord College Technology Center will better equip new 
teachers with the technical skills essential for the 
utilization of informational technologies in the classroom.
    Maryland Community College Information Technology 
Initiative will support collaborative efforts designed to 
improve the quality and quantity of programs that train 
information technology workers.
    The Consortium on the Advancement of Women, Minorities and 
Persons with Disabilities in Science, Engineering and 
Technology will develop programs to encourage and support 
women, minorities and persons with disabilities to enter and 
complete programs in science, engineering and technology.
    The Single Parents Support System Program at Texas College 
in Tyler, Texas will provide assistance that addresses the 
support needs of single parent students.
    College Summit will expand programs designed to help 
promising, low-income students access, persist in and complete 
postsecondary education.
    The University of Hawaii's efforts continue to support 
development of a Globalization Research Consortium.
    The Flandrau Santee Sioux Tribe will improve postsecondary 
education opportunities through expansion of the higher 
education assistance program.
    The Standing Rock Sioux Tribe will help improve access to 
opportunities in higher education for tribal members.
    Lake Area Technical College proposes to integrate 
interactive learning in its technical education programs.
    South Dakota State University, Brookings will enhance the 
programs offered by the Polytechnic Center of Excellence in the 
College of Engineering.
    Waukesha County Technical College and Marquette University 
are developing joint curricula to train minority students in 
the fields of engineering and nursing.
    The Community-Based Services Training Partnership for 
Adults proposes to develop curriculum to support professional 
development opportunities for those social workers whose client 
populations are primarily rural, impoverished, and vulnerable 
adults.
    Norwalk Community College will develop new information 
technology courses and service learning opportunities through 
its new center for excellence in information technology.
    California State University at Stanislaus has developed a 
proposal to address the acute regional and statewide nursing 
shortage.
    The University of South Dakota and Good Samaritan Society 
Nursing Education/Service Partnership will support remote 
learning for those interested in entering the nursing 
profession.
    The Connecticut State University System continues to 
develop innovative initiatives for its nursing program.
    The University of San Diego Institute for Advancement of 
Health Policy is expanding its programs to develop more 
professionally trained nurses.
    Wayne State University and the University of Detroit-Mercy 
Nurse will expand programs designed to prepare nurse 
anesthetists.
    The Nursing Center of Excellence at the University of 
Vermont proposes programs designed to address rural nursing 
workforce issues.
    The Washington Health Foundation initiative will improve 
nurse retention in the State of Washington.
    The Creighton University Accelerated Nursing Program will 
increase the number of well-qualified nurses in Nebraska and 
Iowa.
    The Ryan-Matura Library and Jandrisevits Learning Center at 
Sacred Heart University will utilize new technology to improve 
access to University resources for students and faculty.
    Project Access, an initiative of the University of 
Indianapolis, will employ advanced technologies to enable 
Indiana's first generation higher education students to pursue 
a degree.
    The Indiana Higher Education Commission, in collaboration 
with Intelenet, Indiana's telecommunication commission, will 
support small Indiana colleges and universities as they develop 
applications for higher-performance computer networks.
    Ivy Tech State College of Indiana, through its campuses in 
East Chicago and South Bend, is developing an education and 
training program in machine tool technology.
    The East Chicago campus of Ivy Tech State College is 
developing a mortuary science degree program.
    Indiana University proposes to expand the successful 
Project TEAM initiative to additional campuses in the Indiana 
University system.
    Indiana State University, in collaboration with Bowling 
Green State University, East Carolina University, University of 
Wisconsin-Stout, North Carolina A&T State University and 
Central Missouri State University, will create a shared 
doctoral program for technology management.
    The Columbia River Estuary Research Program will establish 
certificate and degree programs.
    The Native American Law Center at the University of 
Washington School of Law provides a tremendous opportunity for 
students interested in Native American issues to gain academic 
and practical experience in the field.
    Green River Community College is developing a program in 
Communications Access Realtime Translation Services Training.
    The Center for Families at Edmonds Community College is 
developing curriculum for training and certificate programs in 
early childhood education.
    The Technology Training Center at Seminole State College 
will provide a high-quality environment for dynamic and 
interactive training.
    Emmanuel College will continue to improve access to higher 
education programs for all students.
    The University of Massachusetts School of Marine Science 
and Technology proposes to enhance research programs in 
fisheries management, aquaculture and ocean communications and 
control.
    Emerson College will develop educational programs through 
its Performance and Production Center.
    The Assumption College Lt. Joseph P. Kennedy Jr. Science 
and Technology Center will improve research and instructional 
opportunities for students and faculty.
    The University of Arkansas Little Rock will utilize 
advanced and simulation technology to improve teaching and 
learning in medical, engineering and other sciences.
    The University of Arkansas Mountain Home will utilize 
distance learning technology to develop and offer a new degree 
program for hearing healthcare practitioners.
    The Environmental Biotechnology Initiative at the 
University of Rhode Island will enhance teaching, research and 
outreach through programs in genomics, transgenics, imaging and 
bioinformatics.
    Cabrini College is developing a new Center for Science, 
Education, and Technology which will provide a model elementary 
education classroom to facilitate and enhance the educational 
experience of Cabrini undergraduate students majoring in 
education.
    The Army War College is developing a major educational 
center to provide research and educational programs in military 
and social history.
    East Stroudsburg University is planning to purchase 
laboratory equipment for its degree programs in biotechnology 
and chemical biotechnology at its Science and Technology 
Center.
    Eastern College plans to hire additional faculty and 
purchase computers, printers, telecommunications equipment, and 
laboratory equipment for the Center for Information, Science 
and Learning Resources.
    Keystone Virtual University is establishing an ``online'' 
Pennsylvania University.
    Lehigh University is developing a Center for Promoting 
Healthy Development for Individuals with Disabilities.
    Temple University's Center for Research in Human 
Development and Education is developing innovative models to 
address teacher recruitment, training, and mentoring which will 
enhance student achievement.
    The George Mitchell Scholarships program is providing 
scholarships to allow Americans to pursue a year of post-
graduate study at universities in Ireland.
    The Benjamin L. Hooks Institute for Social Change at the 
University of Memphis will pursue a broad agenda that 
emphasizes the continued importance of the civil rights 
movement and encourage academic research and community 
outreach.
    The Clinical Skills Training and Assessment Center at 
Thomas Jefferson University will supplement the clinical 
learning and evaluation skills of healthcare professionals.
    ``Project Promotion'' for Paraprofessional Educators, a 
cooperative project of the Southern Penobscot Regional Program 
for Children with Exceptionalities and Eastern Maine Technical 
College, aims to improve the education and support for 
currently employed educational technicians.
    The University of Hartford-Hartt Performing Arts Education 
Center will enhance educational opportunities for its students, 
and improve theater and music instruction and educational 
programs for area teachers and students.
    The Center for Science and Technology at Dominican 
University of California will improve access to and delivery of 
nurse and teacher development programs, as well as other 
educational opportunities at the university.
    The United Negro College Fund will conduct a project for 
curriculum development at historically black colleges and 
universities and other institutions to develop the capacity of 
these entities to prepare minority students for careers in 
international affairs and business and the global employment 
market.
    Urban College will continue its efforts to provide 
affordable continuing education for nontraditional students 
through tutoring and other supportive services.
    The University of Detroit Mercy will improve its 
information technology infrastructure to provide students and 
faculty with an enhanced learning environment.
    The Center for International Education and Entrepreneurship 
at Ramapo College would expand the offerings of international, 
intercultural and global courses and related services.
    The Technology Center at Mountain State University will 
improve its information technology infrastructure and establish 
interactive classrooms for students to improve training and 
education programs for students to create their own electronic 
business opportunities.
    Pittsburgh Digital Greenhouse is continuing to develop a 
state-of-the-art, high-tech curriculum in a collaborative 
effort with three member universities--Penn State, University 
of Pittsburgh and Carnegie Mellon Contact--to train university 
students. This initiative will further enhance the high tech 
talent pool (which is in short supply) in the Allegheny County 
area.
    Shippensburg University is wiring its computers for the 
Performing Arts Center.
    Wilson College is expanding and developing the ``Women with 
Children Program,'' which assists single women with children in 
earning a degree, becoming financially independent, and raising 
the children's aspirations for educational accomplishment.
    Westchester University plans to develop curriculum for the 
University's Business and Information Technology Center.
    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.
    Jackson State University will establish electronics-based 
program to advance the Central Mississippi Communications and 
Information Technology Cluster at the Mississippi e-Center.
    East Central Community College, Ellisville, Mississippi 
will establish a Wireless Computer Lab to enhance learning on 
that campus and in that community.
    The La Roche College plans to develop its Integrated 
Transcultural Technology Center with information technology 
features critical to 21st Century educational institutions, 
including state-of-the-art ``smart'' classrooms.

Minority science and engineering improvement

    The Committee recommends $8,500,000 for the minority 
science and engineering improvement program [MSEIP], the same 
as the fiscal year 2001 level and the administration request. 
This program provides discretionary grants to institutions with 
minority enrollments greater than 50 percent to purchase 
equipment, develop curricula, and support advanced faculty 
training. Grants are intended to improve science 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 $78,022,000 for international 
education programs, the same as the fiscal year 2001 level and 
the budget request.
    Domestic programs.--The Committee recommends $67,000,000 
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 
fiscal year 2001 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. The recommendation is the same amount as 
the fiscal year 2001 level and 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 
Department of State, 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.
    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 fiscal year 2001 
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 $5,000,000 for interest subsidy 
grants, $5,000,000 less than the fiscal year 2001 level and the 
same as the administration request. This appropriation is 
required to meet the Federal commitment to pay interest 
subsidies on 124 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 $805,000,000 for Federal TRIO 
programs, an increase of $75,000,000 above the fiscal year 2001 
appropriation and $25,000,000 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, counseling, summer programs and grant aid 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 low-income adults who are first-generation college students; 
and the Ronald E. McNair Postbaccalaureate Achievement Program 
supports research internships, seminars, tutoring, and other 
activities to encourage disadvantaged college students to 
enroll in graduate programs.
    The Committee notes that, at the budget request level, 
$3,070,000 has not been allocated to any particular TRIO 
program. To the extent that the Department receives highly 
rated applications for funding under the Talent Search and 
Educational Opportunity Centers grant competitions, the 
Committee encourages the Secretary to allocate these 
undistributed funds, as well as the increase provided by the 
Committee, to additional or increased grants for these 
programs.

Gaining early awareness and readiness for undergraduate programs [GEAR 
        UP]

    The Committee recommends $227,000,000, a decrease of 
$68,000,000 from the amount provided in fiscal year 2001 and 
the same as the budget request. Under this program funds are 
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 help students prepare for and pursue a 
postsecondary education. The Committee notes that at the 
funding level requested by the administration, all continuing 
GEAR UP cohorts of low-income middle and high school students 
would be fully funded.
    The Committee is very concerned that the Department decided 
to alter significantly its plans for awarding new grants under 
the GEAR UP program. The Committee notes that the number of new 
partnership grants the Department planned to award according to 
the fiscal year 2001 congressional justification was 127, for 
total new award funding of $58,457. The actual number of new 
partnership awards made with the fiscal year 2001 appropriation 
for this program was six, for total new award funding of 
$42,502. The Committee's ability to respond to and act on the 
budget request for a given fiscal year depends on credible and 
reliable information about the rationale supporting the 
request, as well as the plan for implementing the program. The 
Committee strongly urges the Department to notify the Committee 
not less than 3 business days prior to any grant opportunities 
or notices inviting applications that include funding 
priorities, competitive preferences or stated funding 
availability different from what is contained in the 
congressional justification.

Byrd honors scholarships

    The Committee recommends $41,001,000 for the Byrd Honors 
Scholarship program, the same amount as the fiscal year 2001 
appropriation and 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 2002, and continue support for the 1999, 
2000, and 2001 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 $10,000,000 for the Javits 
Fellowships program, the same as the fiscal year 2001 amount 
and the budget request.
    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 2002 appropriation support 
fellowships for the 2003-2004 academic year.

Graduate assistance in areas of national need [GAANN]

    The Committee recommends $31,000,000 for graduate 
assistance in areas of national need, the same as the fiscal 
year 2001 level and the budget 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. In fiscal year 2001, the Secretary 
designated the following areas of national need: biology, 
chemistry, computer and information sciences, engineering, 
geological and related sciences, mathematics and physics. 
Recipients must demonstrate financial need and academic 
excellence, and seek the highest degree in their fields.

Learning anytime anywhere partnerships

    The Committee does not recommend an appropriation for the 
learning anytime anywhere partnerships program (LAAP) in fiscal 
year 2002. Consistent with the administration's request, the 
Committee has included sufficient resources under the fund for 
the improvement of postsecondary education to continue all 
grants funded under this program. In fiscal year 2001, 
$30,000,000 was made available for the LAAP program. Funds 
support projects using technology and other innovations to 
enhance the delivery of postsecondary education and lifelong 
learning opportunities, especially for underserved populations 
in underserved geographic areas.
    The Committee notes that the administration's rationale for 
not requesting funds for the LAAP program is that all of the 
activities carried out under its authority can be supported 
under FIPSE. The Committee expects the Department to provide 
the Committee with a report documenting FIPSE grant support in 
fiscal years 2001 and 2002 of projects that support the use of 
technology and other innovations to enhance the delivery of 
postsecondary education and lifelong learning, especially for 
underserved populations in underserved geographic areas.

Teacher quality enhancement grants

    The Committee recommends $54,000,000 for the teacher 
quality enhancement grants program, $44,000,000 less than the 
fiscal year 2001 level and the same as 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 are designated for a 
recruitment grant program.
    The adminis