[Senate Report 109-103]
[From the U.S. Government Publishing Office]
Calendar No. 163
109th Congress Report
SENATE
1st Session 109-103
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2006
_______
July 14, 2005.--Ordered to be printed
_______
Mr. Specter, from the Committee on Appropriations,
submitted the following
R E P O R T
[To accompany H.R. 3010]
The Committee on Appropriations, to which was referred the
bill (H.R. 3010) making appropriations for the Departments of
Labor, Health and Human Services, and Education and related
agencies for the fiscal year ending September 30, 2006, and for
other purposes, reports the same to the Senate with an
amendment and recommends that the bill as amended do
pass.
The Committee on Appropriations reports the bill (S. 2810)
making appropriations for Departments of Labor, Health and
Human Services, and Education and related agencies for the
fiscal year ending September 30, 2005, and for other purposes,
reports favorably thereon and recommends that the bill do
pass. deg.
Amount of budget authority
Total of bill as reported to the Senate............. $604,436,313,000
Amount of 2005 appropriations....................... 501,344,991,000
Amount of 2006 budget estimate...................... 600,212,625,000
Amount of House allowance........................... 601,592,573,000
Bill as recommended to Senate compared to--
2005 appropriations............................. +103,091,322,000
2006 budget estimate............................ +4,223,688,000
House allowance................................. +2,843,740,000
C O N T E N T S
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Page
Summary of Budget Estimates and Committee Recommendations........ 4
Overview and Bill Highlights..................................... 4
Highlights of the Bill........................................... 4
Title I--Department of Labor:
Employment and Training Administration....................... 7
Employee Benefits Security Administration.................... 19
Pension Benefit Guaranty Corporation......................... 19
Employment Standards Administration.......................... 20
Occupational Safety and Health Administration................ 23
Mine Safety and Health Administration........................ 24
Bureau of Labor Statistics................................... 25
Office of Disability Employment Policy....................... 25
Departmental Management...................................... 26
Veterans Employment and Training............................. 29
Office of the Inspector General.............................. 30
General Provisions........................................... 30
Title II--Department of Health and Human Services:
Health Resources and Services Administration................. 32
Centers for Disease Control and Prevention................... 57
NIH Preamble................................................. 88
Substance Abuse and Mental Health Services Administration.... 176
Agency for Healthcare Research and Quality................... 186
Centers for Medicare and Medicaid Services................... 188
Administration for Children and Families..................... 196
Administration on Aging...................................... 214
Office of the Secretary...................................... 218
Office of the Inspector General.............................. 224
General Provisions, Department of Health and Human Services.. 225
Title III--Department of Education:
Education for the Disadvantaged.............................. 228
Impact Aid................................................... 235
School Improvement Programs.................................. 236
Indian Education............................................. 243
Innovation and Improvement................................... 244
Safe Schools and Citizenship Education....................... 253
English Language Acquisiton.................................. 256
Special Education............................................ 257
Rehabilitation Services and Disability Research.............. 261
Special Institutions for Persons With Disabilities:
American Printing House for the Blind.................... 267
National Technical Institute for the Deaf................ 267
Gallaudet University..................................... 268
Vocational and Adult Education............................... 268
Student Financial Assistance................................. 273
Student Aid Administration................................... 275
Higher Education............................................. 276
Howard University............................................ 284
College Housing and Academic Facilities Loans................ 284
Historically Black College and University Capital Financing
Program.................................................... 284
Institute of Education Science............................... 285
Departmental Management:
Program Administration................................... 288
Office for Civil Rights.................................. 289
Office of the Inspector General.......................... 290
General Provisions........................................... 291
Title IV--Related Agencies:
Committee for Purchase from People who are Blind or Severely
Dis-
abled...................................................... 292
Corporation for National and Community Service............... 292
Corporation for Public Broadcasting.......................... 297
Federal Mediation and Conciliation Service................... 298
Federal Mine Safety and Health Review Commission............. 299
Institute of Museum and Library Services..................... 299
Medicare Payment Advisory Commission......................... 301
National Commission on Libraries and Information Science..... 301
National Council on Disability............................... 301
National Labor Relations Board............................... 301
National Mediation Board..................................... 302
Occupational Safety and Health Review Commission............. 303
Railroad Retirement Board.................................... 303
Social Security Administration............................... 304
Title V--General Provisions...................................... 308
Budgetary Impact of Bill......................................... 309
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the Sen-
ate............................................................ 309
Compliance With Paragraph 7(C), Rule XXVI of the Standing Rules
of the Senate.................................................. 310
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 310
Comparative Statement of New Budget Authority.................... 313
SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS
For fiscal year 2006, the Committee recommends total budget
authority of $604,436,313,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
Of this amount, $141,653,000,000 is current year discretionary
funding, including offsets.
OVERVIEW AND BILL HIGHLIGHTS
The Labor, HHS, and Education and Related Agencies bill
constitutes the largest of the non-defense 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 the right to a basic
education and job skills training; protection from illness and
want; 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
Job Training.--The Committee recommendation includes
$5,250,806,000 for job training programs, an increase of
$195,293,000 over the budget request, but $86,966,000 below the
enacted 2005 level.
Worker Protection.--The Committee bill includes
$1,557,000,000 to ensure the health and safety of workers,
including $252,268,000 for the National Labor Relations Board,
$477,491,000 for the Occupational Safety and Health
Administration and $280,490,000 for the Mine Safety and Health
Administration. The recommendation is an increase of
$32,000,000 over the 2005 level.
Child Labor.--The Committee bill includes $93,248,000 for
activities designed to end abusive child labor. This is
$80,829,000 above the budget request, but the same as the 2005
level.
National Institutes of Health.--A total of $29,414,515,000
is recommended to fund biomedical research at the 27 Institutes
and Centers that comprise the NIH. This represents an increase
of $1,050,000,000 over the fiscal year 2005 level and
$904,731,000 over the budget request.
Health Centers.--The recommendation includes $1,839,311,000
for health centers, $105,000,000 over the fiscal 2005 level.
Medicare Modernization Act [MMA].--The Committee
recommendation included $880,000,000, the full amount of the
budget request, for MMA activities, consisting of $560,000,000
in the Program Administration account of the Centers for
Medicare and Medicaid Services, and $320,000,000 for the Social
Security Administration.
Substance Abuse.--The Committee bill provides
$3,260,783,000 for substance abuse prevention and treatment
programs. Included in this amount is $2,186,646,000 for
substance abuse treatment, $202,289,000 for substance abuse
prevention and $901,334,000 for mental health programs.
Low-income Home Energy Assistance State Grants.--The
Committee recommends $2,183,000,000 for heating and cooling
assistance for low-income individuals and families,
$183,000,000 above the budget request and $601,000 more than
the 2005 level.
Head Start.--The Committee recommendation includes
$6,874,314,000 for the Head Start Program. This represents an
increase of $31,200,000 over the 2005 level.
Persons With Disabilities.--To promote independent living
in home and community-based settings. This includes $47,164,000
for the Office of Disability Policy at the Department of Labor,
$14,879,000 for Disabled Voter Services and $40,000,000 for
Real Choice Systems Change Grants through the Center for
Medicaid and Medicare Services.
Education for the Disadvantaged.--The Committee has
provided $12,839,571,000 in grants to enhance educational
opportunities for disadvantaged children, an increase of
$100,000,000 over the fiscal year 2005 level.
Educator Professional Development.--The Committee
recommends $2,916,605,000 for State grants to improve teacher
quality and almost $3,600,000,000 in various programs
administered by the Department of Education.
English Language Acquisition.--The Committee recommends
$675,765,000 for bilingual education.
Student Financial Aid.--The Committee recommends
$15,103,795,000 for student financial assistance, an increase
of $838,046,000 over the fiscal year 2005 level. The amount
provided for the Pell Grant Program will allow for a maximum
grant award of $4,050.
Higher Education Initiatives.--The Committee bill provides
$2,104,508,000 for initiatives to provide greater opportunities
for higher education, including $836,543,000 for Federal TRIO
programs and $306,488,000 for GEAR UP.
Education for Individuals With Disabilities.--The Committee
bill provides $11,515,151,000 to help 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
$103,500,000 over the 2005 level.
Rehabilitation Services.--The bill recommends
$3,133,638,000 for rehabilitation services, an increase of
$59,064,000 above the amount provided in 2005. These funds are
essential for families with disabilities seeking employment.
The Committee restored funding for several important programs
proposed for elimination, such as Supported Employment State
Grants, Projects with Industry, Recreational programs and
programs for migrant and seasonal farmworkers.
Services for Older Americans.--For programs serving older
Americans, the Committee recommendation includes
$3,170,461,000. This recommendation includes $219,784,000 for
senior volunteer programs, $436,678,000 for community service
employment for older Americans, $354,136,000 for supportive
services and centers, $160,744,000 for family caregiver support
programs and $718,697,000 for senior nutrition programs. For
the medical research activities of the National Institute on
Aging, the Committee recommends $1,090,600,000. The Committee
recommendation also includes not less than $31,700,000 for the
Medicare insurance counseling program.
Corporation for Public Broadcasting.--The Committee bill
recommends an advance appropriation for fiscal year 2008 of
$400,000,000 for the Corporation for Public Broadcasting. In
addition, the Committee bill includes $35,000,000 for
conversion to digital broadcasting and $40,000,000 for the
replacement project of the interconnection system in fiscal
year 2006 funding.
REPROGRAMMING AND TRANSFER AUTHORITY
The Committee has included bill language delineating
permissible transfer authority in general provisions for each
of the Departments of Labor, Health and Human Services, and
Education, as well as specifying reprogramming authority in a
general provision applying to all funds provided under this
Act.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
(INCLUDING RESCISSIONS)
Appropriations, 2005.................................... $5,337,772,000
Budget estimate, 2006................................... 5,055,513,000
House allowance......................................... 5,121,792,000
Committee recommendation................................ 5,250,806,000
The Committee recommends $5,250,806,000 for this account in
2006 which provides funding primarily for activities under the
Workforce Investment Act [WIA]. This is $86,966,000 less than
the 2005 level, $129,014,000 more than the House allowance, and
$195,293,000 over 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 2006 will support
the program from July 1, 2006 through June 30, 2007.
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.
Pending reauthorization of the Workforce Investment Act the
Committee is acting on a current law request, deferring without
prejudice proposed legislative language under the jurisdiction
of the authorizing committees.
The Committee is aware of the High Growth Job Training
Initiative created in 2002 to prepare workers for job
opportunities in high growth and high demand sectors of the
American economy. The Committee supports efforts to take a
proactive approach to job training, tracking workforce trends
and anticipating industry needs in communities hard-hit by
recent economic downturns. The Committee has included
$55,000,000 for this initiative, which shall be awarded based
on a competitive process.
The Committee notes that the budget request does not
include funding for the personal re-employment account
initiative, and expects that none of the funds provided for
fiscal year 2006 will be utilized for this initiative unless
specifically authorized by law.
The Committee recommendation concurs with the House in
retaining language from last year's bill requiring that the
Department take no action to amend, through regulatory or other
administrative action, the definition established in 20 CFR
677.220 for functions and activities under title I of the
Workforce Investment Act until such time as legislation
reauthorizing the Act is enacted. The Committee expects that,
while the Workforce Investment Act is in the process of being
altered and renewed, the Administration will refrain from
unilateral changes to the administration, operation and
financing of employment and training programs.
Adult Employment and Training.--For Adult Employment and
Training Activities, the Committee recommends $893,618,000,
which is $27,882,000 more than the budget request and House
allowance, and $3,000,000 less than the program year 2005
level. This program 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 Assistance.--For Dislocated Worker
Assistance, the Committee recommends $1,476,064,000 the same as
the program year 2005 level, $132,480,000 more than the budget
request, and $70,800,000 more than the House allowance. Of the
total, $1,193,264,000 is designated for State formula grants.
This program 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
$282,800,000 available to the Secretary for activities such as
responding 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, including
community college initiatives.
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, as well as to provide assistance where there
have been dislocations across multiple sectors or local areas
of a State.
The Committee recommendation includes, as it has in past
years, funding for dislocated worker projects aimed at
assisting the long-term unemployed.
The Committee was pleased to learn from the Secretary that
the administration has established an interagency effort to
address our Nation's nursing shortage. The shortage is
especially critical in rural America and within various ethnic
minority populations, such as native Hawaiians. The Department
is accordingly strongly urged to work with nursing programs
serving such populations, and in particular, to ensure that
summer employment opportunities exist for nursing students.
The Committee is aware of the ever changing agricultural
worker training needs in Hawaii and recommends continued
funding for a collaborative and adaptive effort involving the
Hawaiian Department of Labor and Industrial Relations and the
Hawaiian Cooperative Extension Service to provide
multiculturally-sensitive on-farm food safety training,
agribusiness training, and production training in support of a
rapidly expanding landscaping and grounds keeping industry.
Community Based Job Training Initiative.--The Committee
recommendation includes $125,000,000 to carry out the Community
College/Community Based Job Training Grant initiative, compared
to the $250,000,000 request. The House recommendation includes
a rescission of $125,000,000 in funds provided in fiscal year
2005 for this program, as well as a total of $125,000,000 for
2006. The Committee recommendation allocates $125,000,000 from
National Emergency Grant funds available under section
132(a)(2)(A) of the Workforce Investment Act, and does not
rescind funds provided in the fiscal year 2005 bill for this
initiative. The Secretary is directed to initially use
resources from the National Emergency Grants account for these
awards that are designated for non-emergencies under sections
171(d) and 170(b) of the Workforce Investment Act. Community
Based Job Training Grant awards will also be subject to the
limitations of sections 171(c)(4)(A) through 171(c)(4)(C) of
the Workforce Investment Act to ensure that these grants are
awarded competitively. Funds used for this initiative should
strengthen partnerships between workforce investment boards,
community colleges, and employers, to train workers for high
growth, high demand industries in the new economy.
The Committee encourages the Employment and Training
Administration to consider, in future solicitations for grant
applications for the Community Based Job Training Initiative,
including One Stop Career Centers, and in rural areas and other
communities without community colleges, eligibility of
alternative education and training providers to apply for these
grants.
Youth Training.--For Youth Training, the Committee
recommends $986,288,000, which is $36,288,000 more than the
budget request and House allowance, and the same as the program
year 2005. The Committee recommendation does not address the
administration's legislative proposals for these activities.
The purpose of Youth Training 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.
Job Corps.--For Job Corps, the Committee recommends
$1,582,000,000. This is $64,981,000 more than the budget
request, and $30,140,000 more than the 2005 comparable level.
The Committee concurs with the House in not including the
proposed $25,000,000 rescission of funds previously
appropriated for construction and renovation activities. 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 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.
As a national training program, Job Corps is particularly
well suited to help meet the needs of large, multi-state
employers for skilled entry-level workers. The Committee
commends Job Corps for establishing partnerships with national
employers, and encourages Job Corps to continue to work with
both larger employers and small businesses to ensure that
student training meets current labor market needs. The
Committee urges Job Corps to also strengthen and expand the
program in order to help meet our Nation's needs for trained,
entry level workers in three high growth industry sectors:
health care, homeland security, and national defense. In
addition, Job Corps should intensify its efforts to upgrade its
vocational offerings and curricula to reflect industry
standards and required certifications recognized by employers.
The Committee commends the Job Corps program for developing
mutually beneficial partnerships with community colleges across
the country. Community college partners including the
Mississippi Gulf Coast Community College and the Cincinnati
State and Technical Community College find that it is efficient
to work with Job Corps because they share the same basic goals
of providing access and opportunity for disadvantaged Americans
and they have the ability to partner with employers looking for
high-skilled workers. The Committee encourages the Department
of Labor's Community College Initiative to collaborate with the
Job Corps program to offer advanced co-enrollment programs,
increase opportunities for disadvantaged youth pursuing a
career in high growth areas, and maximize access to industry-
recognized certification programs. The Committee also
recommends a minimum of $10,000,000 of the program year 2005
Community College Initiative funding be dedicated to community
colleges partnerships with Job Corps centers. The Committee
expects this portion be designated to: (1) develop strategic
partnerships with community colleges, business and industry
leaders, and Job Corps centers to train students in high,
growth, high demand industries; and (2) design ``dual
enrollment'' programs based on reciprocal agreements between
Job Corps and adjacent community colleges.
The Committee commends the work of the NJCA Foundation for
Youth Opportunities [FYO] in its charitable and educational
activities and programs that benefit youth, especially those
at-risk. The FYO seeks to provide resources and research that
helps non-profit, for-profit, and Government agencies further
education and training opportunities for disadvantaged youth.
The Committee recognizes the shortage of health care
professionals and the need to provide access to health care
vocational opportunities for many disadvantaged young people.
The Committee is also aware that the Job Corps is uniquely
qualified to utilize the Department of Health and Human
Services [HHS] Health Resources and Services Administration
[HRSA] grant programs to train students to pursue health
careers while generating more health care professionals to
serve economically disadvantaged communities.
The Committee commends the common mission of the Job Corps
and HRSA in exposing under-represented minorities and
disadvantaged students to seek strategically important careers.
Nearly three quarters of the Nation's 122 Job Corps Centers
offer health occupations training as well as training in health
care related fields. The Committee recognizes and commends the
Job Corps success in training students with the skills they
need to fill critical shortages through major national employer
partners. Through preferred access to HRSA grant funds, Job
Corps' training can generate even more qualified and prepared
allied health professionals in the coming decade.
The Committee is committed to promoting and expanding cost-
effective Federal programs that have a proven record of success
provide consistent and positive results and help address
national labor shortages. Therefore, the Committee recommends
$10,000,000 for second year funding for the incremental
expansion of Job Corps. This in addition to the $10,000,000
provided in previously appropriated funds to begin the process
of establishing additional Job Corps centers. In the selection
process, priority should go to: States that currently do not
have a Job Corps Center or who work in conjunction with an
existing center serving the entire State or region; Sites that
can be started in the short term as satellite Job Corps centers
(residential or non-residential) and later be converted to
stand alone facilities.
The Committee recognizes Project CRAFT (Community,
Restitution, and Apprenticeship-Focused Training), a program of
the Home Builders Institute, the workforce development arm of
the National Association of Home Builders, as a modern
intervention technique in the rehabilitation and reduced
recidivism of adjudicated youth. The Committee also
acknowledges the importance of housing to our Nation's economy
and the role Project CRAFT plays in preparing young people to
join the residential construction industry's workforce. The
Committee therefore encourages the Department to replicate
Project CRAFT to bring its outcomes-oriented approach to
adjudicated juveniles throughout the country in order to help
them become members of this industry's workforce and spur the
Nation's economy.
The Committee recognizes that the Weber Basin and
Clearfield, Utah Job Corps centers are among the highest ranked
in the Nation. The Committee recognizes the State of Utah for
its impressive contribution to the Job Corps program.
Responsible Reintegration of Youthful Offenders.--The
Committee recommendation includes $50,000,000, to continue
funding for the current Reintegration of Youthful Offenders
Program. Neither the budget request in House allowance included
funding for this program, which was funded at $49,600,000 in
program year 2005. The Reintegration of Youthful Offenders
Program targets critical funding to help prepare and assist
young offenders to return to their communities. The program
also provides support, opportunities, education and training to
youth who are court-involved and on probation, in aftercare, on
parole, or who would benefit from alternatives to incarceration
or diversion from formal judicial proceedings.
Prisoner Re-entry.--The recommendation includes the
$19,840,000 for the prisoner re-entry initiative, to extend
assistance to a broader population of ex-offenders. This is the
same as the enacted 2005 level and the House allowance, and
$15,160,000 below the request.
Native Americans.--For Native Americans, the Committee
recommends $54,238,000. This is the same as the budget request,
the House allowance, and the enacted program year 2005 level.
This program 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.
Migrant and Seasonal Farmworkers.--For Migrant and Seasonal
Farmworkers, the Committee recommends $80,557,000, compared to
the 2005 enacted level of $75,759,000. Authorized by WIA, this
program 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.
There are at least 3 million hard-working migrant and
seasonal farmworkers in America whose annual incomes are below
$10,000. At a time when most State budgets are shrinking and
many of the basic services provided by State and local
governments are being cut back, the Committee recognizes the
importance of sustaining a national commitment, dating from
1964, to help alleviate the chronic seasonal unemployment and
underemployment that traps many farmworker families in a cycle
of poverty across generations and that deprives many farmworker
children of educational opportunities and real prospects for
better jobs at higher wages. The Committee also recognizes that
many State and local government officials will be reluctant to
fund this training and related assistance for this vulnerable
portion of our Nation's workforce who migrate through many
States every year, even though the work they perform is
essential to the economic well-being of our Nation's farmers,
growers, and small businesses.
The Committee recommendation of $80,557,000 for program
year 2006 activities authorized under Section 167 of the
Workforce Investment Act is reflected in two separate line
items on the table accompanying the Committee Report: ``Migrant
and Seasonal Farmworkers'' and ``National Activities/Other.''
Under the Migrant and Seasonal Farmworkers line item, the
Committee recommends $80,053,000. The Committee recommendation
includes bill language directing that $5,000,000 of this amount
be used for migrant and seasonal farmworker housing grants, of
which not less than 70 percent shall be for permanent housing.
The principal purpose of these funds is to continue the network
of local farmworker housing organizations working on permanent
housing solutions for migrant and seasonal farmworkers. The
Committee encourages greater emphasis on the southeast region
for farmworker housing grants. The recommendation also provides
that the remaining amount of $75,053,000 be used for State
service area grants, including funding grantees in those States
impacted by formula reductions to at least the amount they were
alloted in program year 2004, requiring $3,840,000. Within the
National Activities/Other line item, the Committee
recommendation includes $504,000 to be used for Section 167
training, technical assistance and related activities,
including funds for migrant rest center activities. The
Committee urges the Department to continue valuable technical
assistance services provided by the Association of Farmworker
Opportunity Programs. Finally, the Committee wishes to again
advise the Department regarding the requirements of the
Workforce Investment Act in selecting an eligible entity to
receive a State service area grant under Section 167. Such an
entity must have already demonstrated a capacity to administer
effectively a diversified program of workforce training and
related assistance for eligible migrant and seasonal
farmworkers.
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, and the Women in Apprenticeship
Program.
Technical Assistance.--The Committee recommends $3,458,000
for the provision of technical assistance and staff
development, an increase of $1,458,000 over the budget request
and House allowance, but the same as the program year 2005
level. This includes $982,000 for technical assistance to
employers and unions to assist them in training, placing, and
retraining women in nontraditional jobs and occupations, as
authorized under the Women in Apprenticeship and Non-
Traditional Occupations Act of 1992, Public Law 102-530; this
amount is specified in bill language, to prevent its being
diverted to other purposes. As described in the Migrant and
Seasonal Farmworker section of this report, the recommendation
also includes $504,000 for WIA Section 167 activities.
Pilots, Demonstrations, and Research.--The Committee
recommends $90,367,000, an increase of $60,367,000 over the
budget request, and $16,367,000 over the House allowance for
grants or contracts to conduct research, pilots or
demonstrations that improve techniques or demonstrate the
effectiveness of programs.
In addition, the Committee recommends $6,944,000 to
maintain the current level of for the Denali Commission as
authorized in Public Law 108-7, for job training in connection
with infrastructure building projects it funds in rural Alaska.
Funding will allow unemployed and underemployed rural Alaskans
to train for high paying jobs in their villages.
The Committee is deeply concerned about the ability of the
28 million Americans who are deaf or hard-of-hearing to be
informed of critical news and information in the post-9/11/01
environment. The Committee is aware that court reporting
schools may not be able to meet the ``unfunded mandate'' set by
the Telecommunications Act of 1996 to provide closed captioning
of 100 percent of broadcast programming by January 2006. These
compelling concerns justify continued Federal support to those
schools to increase their capability to attract and train more
real time writers and to work closely with the broadcasting
industry to significantly increase the amount of programming
that is closed captioned, that 100 million Americans utilize
closed captioning in some form and the shortage of providers
need to be addressed immediately.
The University of Hawaii Center on the Family is dedicated
to understanding and promoting the factors that foster
resiliency in families facing personal, social, and financial
crises. The uniqueness of this program is the emphasis on the
psychological and behavioral processes, family resilience and
vulnerability, and includes Asian, Pacific Islander, and
Caucasian families. The State's diverse multicultural
population adds to the reliability of the research conclusions.
Evaluation.--The Committee recommends $7,936,000 to provide
for the continuing evaluation of programs conducted under the
Workforce Investment Act, as well as of federally-funded
employment-related activities under other provisions of law.
Rescission.--The Committee concurs with the House in
recommending rescission of $20,000,000 in unobligated Health
Care Tax Credit Funds and $5,000,000 in unobligated funds
provided for emergency response activities, as requested by the
administration.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriations, 2005.................................... $436,678,000
Budget estimate, 2006................................... 436,678,000
House allowance......................................... 436,678,000
Committee recommendation................................ 436,678,000
The Committee recommends $436,678,000, the same as the
budget request, the House allowance, and the program year 2005
comparable level 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 2006
appropriation will support the program from July 1, 2006,
through June 30, 2007. 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 program provides a direct, efficient, and quick means
to assist economically disadvantaged older workers because it
has a proven effective network in every State and in
practically every county. Administrative costs for the program
are low, and the vast majority of the money goes directly to
low-income seniors as wages and fringe benefits.
The program provides a wide range of vital community
services that would not otherwise be available, particularly in
low-income areas and in minority neighborhoods. Senior
enrollees provide necessary and valuable services at Head Start
centers, schools, hospitals, libraries, elderly nutrition
sites, senior center, and elsewhere in the community. These
services would not be available without the program.
A large proportion of senior enrollees use their work
experience and training to obtain employment in the private
sector. This not only increases our Nation's tax base, but it
also enables more low-income seniors to participate in the
program.
The Committee believes that the program should pay special
attention 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.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriations, 2005.................................... $1,057,300,000
Budget estimate, 2006................................... 966,400,000
House allowance......................................... 966,400,000
Committee recommendation................................ 966,400,000
The Committee recommends $966,400,000 the same as the
budget estimate and House allowance for fiscal year 2006, and a
decrease of $90,900,000 below the fiscal year 2005
appropriation for Federal Unemployment Benefits and Allowances.
Trade adjustment benefit payments are expected to decline from
$750,000,000 in fiscal year 2005 to $655,000,000 in fiscal year
2006, while trade training in fiscal year 2006 will remain at
the 2005 level of $259,400,000 with an estimated 80,000
participants. Wage insurance costs are expected to increase
form $48,000,000 in fiscal year 2005 to $52,000,000 in fiscal
year 2006.
The Committee expects the Department to provide funds to
the State of Alaska to mitigate negative effects on Alaskan
fishermen and other Alaskan displaced workers stemming from
passage of trade legislation in 2002. Funds should be provided
on a flexible basis to cover costs of job training and
placement programs, among other uses.
The Trade Adjustment Assistance Reform Act of 2002 that
amended the Trade Act of 1974 was signed into law on August 6,
2002 (Public Law 107-210). This Act consolidated the previous
Trade Adjustment Assistance [TAA] and NAFTA Transitional
Adjustment Assistance [NAFTA-TAA] programs, into a single,
enhanced TAA program with expanded eligibility, services, and
benefits. Additionally, the Act provides a program of
Alternative Trade Adjustment Assistance for Older Workers.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriations, 2005.................................... $3,636,709,000
Budget estimate, 2006................................... 3,470,366,000
House allowance......................................... 3,470,366,000
Committee recommendation................................ 3,499,779,000
The Committee recommends $3,499,779,000 for this account.
This is $29,413,000 above the budget request as well as the
House allowance and $136,930,000 above the 2005 comparable
level. Included in the total availability is $3,366,954,000
authorized to be drawn from the ``Employment Security
Administration'' account of the unemployment trust fund, and
$132,825,000 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
$2,610,000,000. This includes $2,600,000,000 for State
Operations, and $10,000,000 for UI national activities, which
is directed to activities that benefit the State/Federal
unemployment insurance program. The bill provides for a
contingency reserve amount should the unemployment workload
exceed an average weekly insured claims volume of 2.8 million.
This contingency amount would fund the administrative costs of
unemployment insurance workload over the level of 2.8 million
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 has provided funds requested by the
administration from the Unemployment Insurance Trust Fund for
conducting in person reemployment and eligibility assessments
of UI beneficiaries and preventing and detecting fraudulent
claims. The Committee notes that the Social Security Act
requires the use of merit based staff in the administration of
the UI program and expects that States will use State merit
staffed UI personnel to perform these functions.
For the Employment Service allotments to States, the
Committee recommends $746,302,000 which includes $23,114,000 in
general funds together with an authorization to spend
$723,188,000 from the ``Employment Security Administration''
account of the unemployment trust fund. This compares to the
budget request and House allowance of $696,000,000 and the
enacted level of $780,592,000 for allotments to States. Due to
tight budget constraints, the Committee recommendation does not
include Reemployment Services Grants, funded in 2005 at
$34,291,000, but restores the additional $50,302,000 reduction
proposed by the administration for Employment Service Grants to
States. These funds are available for the program year of July
1, 2006 through June 30, 2007.
The recommendation also includes $33,766,000 for Employment
Service national activities, a decrease of $31,210,000 from the
fiscal year 2005 level. This recommendation reflects the
transfer of the foreign labor certification program to the
Employment and Training Administration Program Administration
account, as requested by the administration. The recommendation
maintains the 2005 enacted level of $17,856,000 for the work
opportunity tax credit program.
The recommendation also includes $90,000,000 for One-Stop
Career Centers, compared to the budget request and House
allowance of $87,974,000 and 2005 enacted level of $97,974,000.
The 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 the budget request level of
$19,711,000 for the Work Incentives Grants program, 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.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
Appropriations, 2005.................................... $517,000,000
Budget estimate, 2006................................... 465,000,000
House allowance......................................... 465,000,000
Committee recommendation................................ 465,000,000
The Committee recommends $465,000,000, the same as the
budget estimate and House allowance for fiscal year 2006, and
$52,000,000 less than the fiscal year 2005 level. 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 2006
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 2006 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 appropriate 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, 2005.................................... $170,101,000
Budget estimate, 2006................................... 206,111,000
House allowance......................................... 206,111,000
Committee recommendation................................ 200,000,000
The Committee recommendation includes $117,123,000 in
general funds for this account, as well as authority to expend
$82,877,000 from the ``Employment Security Administration''
account of the unemployment trust fund, for a total of
$200,000,000. This level provides sufficient resources to cover
built-in cost increases.
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,
the Denali Commission Act, the Women in Apprenticeship and Non-
Traditional Occupations Act of 1992, 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 believes that the public workforce system is
strengthened by the effective participation of all of the
stakeholders in the system and urges that the Department use a
portion of its discretionary funds to support that
participation through grants and contracts to
intergovernmental, business, labor, and community-based
organizations dedicated to training and technical assistance in
support of Workforce Investment Boards and their members.
The Committee is concerned that there are limited
opportunities for Native Hawaiian administrators in health care
organizations and encourages effective training programs to
prepare Native Hawaiians with the expertise to excel in these
areas.
The Committee instructs that, for the purposes of the
temporary visa programs, the Department of Labor shall treat
loggers as agricultural workers and not as non-agricultural
workers. Presently, the Department classifies loggers as non-
agricultural; however, since June 1987, it has imposed upon
them the same worker protections and labor standards as H-2A
agricultural workers. Employers wishing to hire logger aliens
must already provide transportation, housing, and meals, and
must make the same benefits available to U.S. workers based on
Department policy that predates the 1986 immigration reforms.
The provision applies strictly to loggers, and shall not affect
any other H-2B workers.
WORKERS COMPENSATION PROGRAMS
(RESCISSION)
Appropriations, 2002.................................... $175,000,000
Appropriations, 2005....................................................
Budget estimate, 2005................................... -120,000,000
House allowance......................................... -120,000,000
Committee recommendation................................ -120,000,000
The Committee concurs with the budget request and House
allowance in rescinding $120,000,000 in unobligated emergency
response funds.
The Committee is aware of the long-term health concerns of
first responders in the wake of the September 11 tragedy. The
Nation owes a debt to these workers, who reacted with courage
and bravery in a moment of chaos. The Committee is concerned
that the needs of the first responders be well documented and
funds be dispersed in a manner that quickly and efficiently
serves the needs of these brave men and women. For that reason,
the Committee has included bill language which retroactively
authorizes $44,000,000 in spending on behalf of victims and
first responders.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriations, 2005.................................... $131,213,000
Budget estimate, 2006................................... 137,000,000
House allowance......................................... 137,000,000
Committee recommendation................................ 134,900,000
The Committee recommendation provides $134,900,000 for this
account which is $3,687,000 above the 2005 comparable level.
This provides sufficient resources to cover built-in cost
increases.
The Employee Benefits Security Administration [EBSA] is
responsible for the enforcement of title I of the Employee
Retirement Income Security Act of 1974 [ERISA] in both civil
and criminal areas. ESBA is also responsible for enforcement of
sections 8477 and 8478 of the Federal Employees' Retirement
Security Act of 1986 [FERSA]. In accordance with the
requirements of FERSA, the Secretary of Labor has promulgated
regulations and prohibited transactions class exemptions under
the fiduciary responsibility and fiduciary bonding provisions
of the law governing the Thrift Savings Plan for Federal
employees. In addition, the Secretary of Labor has, pursuant to
the requirement of section 8477(g)(1) of FERSA, established a
program to carry out audits to determine the level of
compliance with the fiduciary responsibility provisions of
FERSA applicable to Thrift Savings Plan fiduciaries. ESBA
provides funding for the enforcement and compliance; policy,
regulation, and public services; and program oversight
activities.
PENSION BENEFIT GUARANTY CORPORATION
The Corporation's estimated obligations for fiscal year
2006 include single employer benefit payments of
$5,102,000,000, multiemployer financial assistance of
$90,000,000 and administrative expenses of $296,978,000.
Administrative expenses are comprised of three activities: (1)
pension insurance activities, $41,599,000; (2) operational
support, $93,749,000; and (3) pension plan termination
expenses, $161,630,000. Such expenditures will be financed by
permanent authority.
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, assets of terminated pension plans, collection
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 defined benefit plans fail or go out of existence.
The 2006 budget does not recommend a discretionary limit on
administrative expenditures [LAE] for PBGC. The PBGC's budget
reflects--in a way that is more accountable to the Committee--
the level of administrative expenditures that the Committee
believes is appropriate to PBGC's changing responsibilities to
protect the pensions it insures. PBGC's dollar benefit levels
and workload change from year to year as specific pension plans
fail. Most of its workload involves terminating failed pension
plans, so that pension benefits can be paid. The workload of
plan termination especially fluctuates from year to year as
large plans (or a spate of small ones) terminate, and then as
the terminations are completed. The language provides the PBGC
the flexibility to respond when dictated by increased workload
and increased benefit payments, while increasing accountability
to the Committee by requiring approval by the Office of
Management and Budget and the Committees on Appropriations.
The single-employer program protects about 34.6 million
participants in about 29,600 defined benefit pension plans. The
multi-employer insurance program protects about 9.8 million
participants in more than 1,600 plans.
Employment Standards Administration
SALARIES AND EXPENSES
Appropriations, 2005.................................... $400,847,000
Budget estimate, 2006................................... 416,332,000
House allowance......................................... 416,332,000
Committee recommendation................................ 412,616,000
The Committee recommendation includes $412,616,000 for this
account. The bill contains authority to expend $2,048,000 from
the special fund established by the Longshore and Harbor
Workers' Compensation Act; the remainder of $410,568,000 are
general funds. In addition, an amount of $33,050,000 is
available by transfer from the black lung disability trust
fund.
This recommendation provides sufficient funding to offset
The impact of inflation, and includes resources for a portion
of requested program increases, to implement a program of union
advisory services. The $15,891,000 request for Program
Direction has been reduced to $15,375,000, an increase of
$123,000 over the 2005 level to cover built-in costs; an
addition of $2,000,000 is described in the following paragraph.
The recommendation includes $2,000,000 to make available
personnel and other resources to facilitate the expeditious
startup of a system to resolve claims of victims for bodily
injury caused by asbestos exposure. This may include contracts
with individuals or entities having relevant experience to
assist in jump starting the program, as described in S. 852,
the Fair Act of 2005. Activities to shorten the lead-time for
implementation of asbestos activities encompass procedures for
the processing of claims, including procedures for the
expediting of exigent health claims, and planning for
promulgation of regulations.
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).
SPECIAL BENEFITS
Appropriations, 2005.................................... $233,000,000
Budget estimate, 2006................................... 237,000,000
House allowance......................................... 237,000,000
Committee recommendation................................ 237,000,000
The Committee recommends $237,000,000, the same as the
budget estimate for fiscal year 2006, and $4,000,000 more than
fiscal year 2005. This appropriation primarily provides
benefits under the Federal Employees' Compensation Act [FECA].
The payments are prescribed by law. In fiscal year 2006, an
estimated 155,000 injured Federal workers or their survivors
will file claims; 55,000 will receive long-term wage
replacement benefits for job-related injuries, diseases, or
deaths.
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 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.
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 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 of fair share collections to fund capital
investment projects and specific initiatives to strengthen
compensation fund control and oversight.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriations, 2005.................................... $275,997,000
Budget estimate, 2006................................... 232,250,000
House allowance......................................... 232,250,000
Committee recommendation................................ 232,250,000
The Black Lung Consolidation of Administrative
Responsibility Act was enacted on November 2, 2002. The Act
amends the Black Lung Benefits Act to transfer part B black
lung benefits responsibility from the Commissioner of Social
Security to the Secretary of Labor, thus consolidating all
black lung benefit responsibility under the Secretary. Part B
benefits are based on claims filed on or before December 31,
1973. The Secretary of Labor already responsible for the part C
claims filed after December 31, 1973. In fiscal year 2006, an
estimated 46,100 beneficiaries (5,100 miners and 41,000
survivors) will receive benefits.
The Committee recommends an appropriation of $232,250,000
in fiscal year 2006 for special benefits for disabled coal
miners. This is in addition to the $81,000,000 appropriated
last year as an advance for the first quarter of fiscal year
2006. The recommendation is the same as the administration
request and House allowance. These funds are used to provide
monthly benefits to coal miners disabled by black lung disease
and to their widows and certain other dependents, as well as to
pay related administrative costs.
By law, increases in black lung benefit payments are tied
directly to Federal pay increases. The year-to-year decrease in
this account reflects a declining beneficiary population.
The Committee recommends an advance appropriation of
$74,000,000 for the first quarter of fiscal year 2007, the same
as the administration request. These funds will ensure
uninterrupted benefit payments to coal miners, their widows,
and dependents.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM
Appropriations, 2005.................................... $40,321,000
Budget estimate, 2006................................... 96,081,000
House allowance......................................... 96,081,000
Committee recommendation................................ 96,081,000
The Committee recommends $96,081,000, the same as the
budget estimate for fiscal year 2005, and $55,760,000 more than
2005.
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. Benefit costs of $760,515,000 are
anticipated in fiscal year 2006.
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 program went into effect on July 31, 2001.
In 2006, the volume of incoming claims under Part B of the
Energy Employees Occupational Illness Compensation Program is
estimated to remain stable at about 16,500 claims from
Department of Energy [DOE] employees or survivors, and private
companies under contract with DOE, who suffer from a radiation-
related cancer, beryllium-related disease, or chronic silicosis
as a result of their work in producing or testing nuclear
weapons.
BLACK LUNG DISABILITY TRUST FUND
Appropriations, 2005.................................... $1,061,969,000
Budget estimate, 2006................................... 1,068,000,000
House allowance......................................... 1,068,000,000
Committee recommendation................................ 1,068,000,000
The Committee recommends $1,068,000,000 for this account in
2006, an increase of $6,031,000 above the fiscal year 2005
level, and the same as the budget request and House allowance.
The appropriation language changed beginning in fiscal year
2003 for the Black Lung Disability Trust Fund to provide such
sums as may be necessary to pay for benefits. This change
eliminated the need for drawdowns from the subsequent year
appropriation in order to meet current year compensation,
interest, and other benefit payments.
The total amount available for fiscal year 2006 will
provide $314,011,000 for benefits payments, and $57,989,000 for
administrative expenses for the Department of Labor. Also,
included is $696,000,000 for interest payments on advances.
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 41,400 people will be receiving black
lung benefits financed through the end of the fiscal year 2006,
compared to an estimated 44,500 receiving benefits in fiscal
year 2005.
The basic financing for the trust fund comes from a coal
excise tax for underground and surface-mined coal. Additional
funds come from reimbursement from the Advances to the
Unemployment Trust Fund and Other Funds as well as payments
from mine operators for benefit payments made by the trust fund
before the mine operator is found liable. 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, 2005.................................... $464,158,000
Budget estimate, 2006................................... 466,981,000
House allowance......................................... 477,199,000
Committee recommendation................................ 477,491,000
The Committee recommendation includes $477,491,000 for this
account. This is an increase of $10,510,000 over the budget
request and an increase of $13,333,000 above the 2005
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, as well as additional resources to
expand outreach to non-English speaking workers and small
businesses.
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 has again cut funding to help establish
ongoing worker safety and health training programs and has
therefore restored the Susan Harwood training grant program to
$10,510,000. Bill language specifies that no less than
$3,200,000 shall be used to maintain the existing institutional
competency building training grants, provided that grantees
demonstrate satisfactory performance.
The Committee has provided $53,896,000, the budget request
level, for the State consultation grant program and expects
that this program will continue to be targeted to provide
compliance assistance to small businesses.
The Committee continues to be pleased with OSHA's efforts
in placing high priority on the voluntary protection programs
[VPP] and other voluntary cooperative programs. 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 continue to be funded as close as possible to its
present level.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2005.................................... $279,136,000
Budget estimate, 2006................................... 280,490,000
House allowance......................................... 280,490,000
Committee recommendation................................ 280,490,000
The Committee recommendation includes $280,490,000 for this
account, an increase of $1,354,000 over the 2005 enacted level,
and the same as the budget request and House allowance.
This recommendation provides sufficient funding to offset
the impact of inflation, as well as additional resources for
enforcement and compliance assistance. It deletes one-time
funding of projects contained in the 2005 enacted level.
The Committee recommendation also includes bill language
providing up to $2,000,000 for mine rescue and recovery
activities, the same as the fiscal year 2005 comparable level.
It also retains the provision allowing the Secretary of Labor
to use any funds available to the Department to provide for the
costs of mine rescue and survival operations in the event of a
major disaster.
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.
In addition, bill language is included to allow the
National Mine Health and Safety Academy to collect not to
exceed $750,000 for room, board, tuition, and the sale of
training materials to be available for mine safety and health
education and training activities. Bill language also allows
MSHA to retain up to $1,000,000 from fees collected for the
approval and certification of equipment, materials, and
explosives for use in mines, and may utilize such sums for such
activities.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriations, 2005.................................... $529,003,000
Budget estimate, 2006................................... 542,523,000
House allowance......................................... 542,523,000
Committee recommendation................................ 542,523,000
The Committee includes $542,523,000 for this account,
$13,520,000 more than the 2005 comparable level. This includes
$77,845,000 from the ``Employment Security Administration''
account of the unemployment trust fund, and $464,678,000 in
Federal funds. This funding level will cover the Agency's
built-in increases, and includes funds to continue the Mass
Layoff Statistics Program.
The Bureau of Labor Statistics is the principal fact
finding Agency in the Federal Government in the broad field of
labor economics.
The Committee urges the Bureau of Labor Statistics to
revamp its website to make it more user friendly.
Office of Disability Employment Policy
Appropriations, 2005.................................... $47,164,000
Budget estimate, 2006................................... 27,934,000
House allowance......................................... 27,934,000
Committee recommendation................................ 47,164,000
The Committee recommends $47,164,000 for this account in
2006. This is $19,230,000 more than the President's request and
the same as 2005. The Committee intends that at least 80
percent of these funds shall be used for demonstration and
technical assistance grants to develop innovative and effective
practices to increase the employment of youth and adults with
disabilities.
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 office.
The Committee is aware of the outstanding success of
national non-profits working to increase self-employment among
people with disabilities. Self-employment can provide income,
assets and other elements of self-sufficiency to people with
disabilities that are hard to place in traditional work
environments because of the flexibility inherent in self-
employment. In addition to the direct benefit to the business
owner and the savings to the Social Security Disability Income
program resulting from self-employment, preliminary data
suggests that business owners with disabilities are far more
likely to hire other people with disabilities as the business
expands.
Within the funds provided for the Office of Disability
Employment Policy, the Committee has included $5,000,000 for a
national initiative focusing on self-employment as an option
for persons with disabilities. As the centerpiece of this new
initiative, the Committee has included $3,000,000 to assist
State Job Training Institutions, WIA One Stops, SBA Small
Business Development Centers, the Vocational Rehabilitation and
Employment Services of the Department of Veterans Affairs,
State, and Tribal Vocational Rehabilitation Agencies, and other
related programs in implementing effective and accessible
practices for achieving sustainable self employment outcomes
for individuals with disabilities. Practices should include but
not be limited to providing public education, training,
technical assistance and accessible online and print resources
with the purpose of advancing self employment opportunities for
Americans with disabilities. The Committee directs that, in
making the national technical assistance grant, priority be
given to national non-profits with experience in delivering
direct consumer services as well as training to public and
private agencies. The remainder of the funds in the initiative
should be used to undertake a thorough analysis of the
structures currently in place that either promote or impede the
expansion of business ownership in the disability community.
The Committee recommends that the Office of Disability
Employment Policy continue the existing, structured, internship
program for undergraduate college students with disabilities,
at no less than current appropriation levels. The Committee
continues to believe that this innovative, structured
internship program will provide important opportunities for
undergraduate students with disabilities to pursue academic and
career development opportunities within the Department of Labor
and other Federal agencies.
Departmental Management
SALARIES AND EXPENSES
Appropriations, 2005.................................... $320,688,000
Budget estimate, 2006................................... 244,423,000
House allowance......................................... 239,783,000
Committee recommendation................................ 320,561,000
The Committee recommendation includes $320,561,000 for this
account, which is $76,138,000 more than the budget request and
$127,000 less than the 2005 comparable level. In addition, an
amount of $24,239,000 is available by transfer from the black
lung disability trust fund, which is the same as the budget
request and the House allowance.
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 includes $26,720,000 for
Executive Direction, the same as the fiscal year 2005
comparable level.
The Committee recommendation includes $9,764,000 for the
Women's Bureau. The Committee encourages the Women's Bureau to
support effective programs such as ``Women Work!'', to provide
technical assistance and training on programming for women in
transition to reenter the workforce.
The Committee is pleased with efforts to investigate the
impact of the nursing shortage on the overall health care labor
market across the country, particularly in rural areas, such as
Hawaii. The Committee urges the Department to work with HRSA in
creating solutions to remedy the ongoing shortage and report on
these efforts.
The University of Hawaii Center on the Family is dedicated
to understanding and promoting the factors that foster
resiliency in families facing personal, social, and financial
crises. The uniqueness of this program is the emphasis on the
psychological and behavioral processes, family resilience and
vulnerability, and includes Asians, Pacific Islanders and
Caucasians families. The State's diverse multicultural
population adds to the reliability of the research conclusions.
The Committee is disappointed that the Department of Labor
has once again put forward a budget for the coming year that
drastically reduces funding for International Labor Affairs
Bureau [ILAB], in particular, those initiatives working with
the International Labor Organization [ILO] to combat abusive
and exploitative child labor.
The Committee is aware that the administration is
aggressively pursing multiple trade agreements that will depend
upon the United States' ability to provide technical assistance
on labor standards, including but not limited to the
eradication of child labor. ILAB is the division of the U.S.
Government with the mission and authority to provide that
assistance. A budget request that eliminates all funding for
multilateral and bilateral technical assistance, elimination of
child labor, permanent reporting capacity and HIV/AIDS in the
Workplace promotes a lack of confidence in the United States'
trade efforts.
The Committee commends the Department of Labor on its
report ``Investing In Every Child'' which found that the
average economic benefit of eliminating child labor around the
world exceeds the cost of those efforts by a ratio of 6.7 to 1.
The study also found that each year of additional education
beyond the age of 14 yields an 11 percent increase in that
individual's earning power resulting in just over
$5,000,000,000,000 in global benefits. The Committee views the
investment made by the United States and the programs run by
the Department of Labor to eliminate child labor as a proven
method for improving the economic infrastructure of developing
nations and providing a market for U.S. goods.
Given the aggressive trade agenda and the recent commitment
to capacity building in developing nations as a form of aid,
the Committee is mystified by the Department's now annual
effort to eliminate these programs, this year proposing an
astounding 86 percent reduction.
Therefore, the Committee recommendation includes
$93,248,000 for the Bureau of International Labor Affairs. Of
this amount, the Committee's recommendation includes
$45,000,000 for the U.S. contribution to sustain and to extend
to more countries in waiting the successful efforts of the
ILO's International Program for the Elimination of Child Labor
[IPEC]. Also included is $37,000,000 for bilateral assistance
to expand upon the program initiated by the Department in
fiscal year 2001 to help ensure access to basic education for
the growing number of children removed from the worst forms of
child labor in impoverished nations where abusive and
exploitative child labor is most acute. The Committee expects
the Department of Labor to work with the governments of host
countries to eliminate school fees that create a barrier to
education.
The Committee notes and welcomes ILAB's technical
assistance programs that promote the goals of the Harkin-Engel
protocol, as well as ILAB's ongoing efforts to implement
Executive Order 13126 and its reporting under the Trade and
Development Act of 2000. To complement these efforts, the
Committee directs that $4,500,000 of the basic education funds
be used to provide critical oversight of both the public and
private investment in the protocol. The Committee expects that
at a minimum, this will include an annual public report to both
the Congress and the Department. The report should cite
progress made on key points of the Protocol and Joint Statement
including: development of a child labor monitoring system by
industry, the effective elimination of the worst forms of child
labor and forced labor in the supply chain, and the development
of an industry-wide, public, transparent certification system.
The Committee directs that funds be awarded with priority given
to academic institutions with expertise in agriculture and the
U.N. Norms on Business and Human Rights.
The Committee deems it very important that ILAB deepen and
improve its permanent capacity to compile and report to the
Congress annually on the extent to which each foreign country
that has trade and investment agreements with the United States
enforces internationally-recognized worker rights. This report
is required under multiple U.S. laws and promotes core labor
standards as embodied in the ILO Declaration on Fundamental
Principles and Rights at Work as adopted and reaffirmed in
1998. The Committee is aware that currently this report only
tracks the progress of countries that are designated as
beneficiaries under the U.S. Generalized System of Preferences
[GSP]. The GSP program grants duty-free treatment to specified
products imported from developing countries and territories. As
the United States' negotiates separate Free Trade Agreements
with GSP beneficiaries, the DOL stops tracking their progress
in the elimination of abusive and exploitative child labor.
Therefore, the Committee directs the Secretary to include in
the 2006 report, all former GSP recipients that have achieved a
Free Trade Agreement with the United States over the preceding
2 years. The Committee has provided $1,000,000 for the
compilation of this report, which shall be transmitted to the
Congress no later than September 1, 2006.
The Committee is disturbed by recent reports that the
Department is treating commodities that were purchased with
grant funds as a sub-grant and requiring re-payment in ways
that undermine the original purpose of the grants. The
Committee notes that the U.S. Government has sensible
procedures in place for the distribution of commodities that
retain value after the end of the grant. Therefore, the
Committee directs that the Department adhere to the OMB
standards for grant-making, including those standards that
pertain to the disbursement of goods. These standards should be
applied to all ongoing grants, as well as any new grants.
For other ILAB programs, including 125 FTE for Federal
Administration, the Committee recommends $10,248,000.
Acknowledging the need to upgrade the information
technology capability in the Department of Labor, the Committee
recommends $29,760,000 for the information technology fund, and
$1,700,000 for management cross cut activities. The total
provided includes support for cross-cutting investments such as
common office automation suite implementation, architecture
requirements, equipment, software, and related needs, as well
as human resource management. In addition, $6,230,000 is
recommended for a separate Working Capital Fund appropriation,
for implementation of a new core accounting system for the
Department of Labor.
The Committee retains bill language intended to ensure that
decisions on appeals of Longshore and Harborworker Compensation
Act claims are reached in a timely manner.
VETERANS EMPLOYMENT AND TRAINING
Appropriations, 2005.................................... $222,833,000
Budget estimate, 2006................................... 224,334,000
House allowance......................................... 229,334,000
Committee recommendation................................ 224,334,000
The Committee recommendation includes $224,334,000 for this
account, including $194,834,000 in general revenue funding and
$29,500,000 to be expended from the ``Employment Security
Administration'' account of the unemployment trust fund. This
is $1,315,000 more than the 2005 comparable level.
For State grants the bill provides $162,415,000, which
includes funding for the Disabled Veterans Outreach Program and
the Local Veterans Employment Representative Program.
For Federal administration, the Committee recommends
$30,435,000, the same as the budget request and the House
allowance. 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 this effective program.
Individuals leaving the military may be at high risk of
homelessness due to a lack of job skills transferable to the
civilian sector, disrupted or dissolved family and social
support networks, and other risk factors that preceded their
military service. The Committee expects the Secretary of Labor
to ensure that a module on homelessness prevention is added to
the Transition Assistance Program curriculum. The module should
include a presentation on risk factors for homelessness, a
self-assessment of risk factors, and contact information for
preventative assistance associated with homelessness.
The Committee recommendation includes $1,984,000, the same
as the budget request, 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 recommendation includes $22,000,000 for the
Homeless Veterans Program, the same as the budget request. Also
included is $7,500,000 for the Veterans Workforce Investment
Program, the same as the budget request.
The Committee is interested in ensuring that qualified job
training programs of the Department of Labor fully extend
priority of service for veterans as required by the Jobs for
Veterans Act. Toward this effort, the Committee urges the
Secretary to develop a guide for veterans in accessing
workforce investment planning processes; and a guide to inform
workforce systems on the employment services needs of veterans
and the responsibility of such systems to prioritize veterans
for services and to collaborate with veterans organizations and
providers. The Committee urges the Secretary to instruct State
workforce agencies to increase their outstationing of disabled
veterans outreach program specialists and local veterans
employment representatives in locations where homeless veterans
congregate, including grantees under the homeless provider
grant and per diem program and the homeless veterans
reintegration program.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2005.................................... $68,995,000
Budget estimate, 2006................................... 70,819,000
House allowance......................................... 70,819,000
Committee recommendation................................ 72,819,000
The bill includes $72,819,000 for this account, $3,824,000
above the 2005 comparable level. The bill includes $67,211,000
in general funds and authority to transfer $5,608,000 from the
``Employment Security Administration'' account of the
unemployment trust fund. In addition, an amount of $344,000 is
available by transfer from the black lung disability trust
fund. This level provides sufficient resources to cover built-
in cost increases, as well as augmenting program accountability
activities and expanding the labor racketeering program.
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:
Provide for modified general transfer authority (sec. 101).
Prohibit funding for the procurement of goods and services
utilizing forced or indentured child labor in industries and
host countries already identified by the Labor Department in
accordance with Executive Order 13126 (sec. 102).
Authorize funds to be appropriated for job training for
workers involved in construction projects funded through the
Denali Commission (sec. 103).
Provide that certain payments made by the New York Workers'
Compensation Board in response to terrorist attacks shall be
deemed to have been made for workers compensation programs
(sec. 104).
Require the Department of Labor to submit its fiscal year
2007 congressional budget justifications in the same format and
level of detail used by the Department of Education in its
fiscal year 2006 congressional budget justification (sec. 105).
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
HEALTH RESOURCES AND SERVICES
Appropriations, 2005.................................... $6,828,012,000
Budget estimate, 2006................................... 5,991,144,000
House allowance......................................... 6,468,437,000
Committee recommendation................................ 7,423,434,000
The Committee provides a program level of $7,423,434,000
for the Health Resources and Services Administration [HRSA].
The Committee recommendation includes $7,398,434,000 in budget
authority and an additional $25,000,000 via transfers available
under section 241 of the Public Health Services Act. The fiscal
year 2005 comparable program level was $6,828,012,000, the
administration request program level was $5,991,144,000, and
the House provided $6,468,437,000.
Health Resources and Services Administration 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.
The Committee recognizes the unique needs of frontier and
rural populations and applauds the Department for establishing
competitive grants specifically aimed at programs with those
designations. The Committee likewise recognizes the limited
accessibility of island communities, whether rural or urban,
and urges the Department to include an island designation to
promote programs in areas geographically isolated from the
mainland and neighbor islands. Criteria for island designation
includes a clinic, federally qualified health center, or
hospital located on a land mass surrounded by water and greater
than 2,000 miles from the United States mainland.
BUREAU OF PRIMARY HEALTH CARE
COMMUNITY HEALTH CENTERS
The Committee provides $1,839,311,000 for the community
health centers. The fiscal year 2005 comparable program level
was $1,734,311,000, the administration request program level
was $2,037,871,000, and the House provided $1,834,311,000. This
group of programs includes community health centers, migrant
health centers, health care for the homeless, and public
housing health service grants.
Within the amount provided, $20,000,000 has been allocated
to offset the rising cost of health care at existing centers,
and $5,000,000 has been allocated to resolve specific financial
situations beyond the control of the local health center, such
as unusual increases in the number of uninsured patients
seeking care.
The Committee includes bill language limiting the amount of
funds available for the payment of claims under the Federal
Tort Claims Act to $45,000,000, which is the same as the
administration request and in fiscal year 2005. Bill language
has also been included clarifying that these funds are
available until expended. The Committee has included bill
language allowing costs associated with the health centers tort
liability relief to be paid from the fund. The Committee
intends that the fund be used to pay judgments and settlements,
occasional witness fees and expenses, and the administrative
costs of the program, which includes the cost of evaluating
claims, defending claims, and conducting settlement activities.
The Committee is aware of legislation that would extend FTCA
coverage to volunteer physicians and non-grantee health centers
(commonly referred to as ``look-alikes''). While both proposals
would extend FTCA coverage to additional providers, the
Committee expects the amount provided to be adequate to cover
any increased costs in fiscal year 2006.
The Committee does not provide additional funds for loan
guarantee authority under section 330(d) of the Public Health
Service Act. The Committee notes that $105,000,000 in loan
guarantee authority from the $160,000,000 appropriated in
fiscal years 1997 and 1998 continues to remain available for
guarantees of both loan principal and interest.
The Committee is concerned by the small number of health
centers that have been able to utilize the loan guarantee
program despite sufficient funding being available since fiscal
year 1997. The Committee urges HRSA to increase the percentages
at which loan guarantees are provided for managed care plans,
networks, and facilities to the highest authorized levels in
order to enhance the number of health centers participating in
the program.
The Committee supports the long-standing HRSA policy of
approving specific qualified applications for future funding.
This process enables high-quality applicants to take steps to
develop and implement care delivery systems in their
communities instead of wasting scarce resources to reapply for
funding. However, HRSA should limit the use of this mechanism
in a manner consistent with expected budget requests.
The Committee is concerned that HHS requires health centers
and other facilities to have a HPSA priority score of 14 or
above in order to obtain a J-1 Visa physician placement and
that this additional criterion has severely limited access to
J-1 physicians in underserved communities. The Committee
encourages HRSA to consider using an alternative methodology
for entities eligible for Federal J-1 Visa physician
placements.
The Committee recognizes an important role of the
consolidated health centers is caring for people living with or
at risk of hepatitis C. The committee encourages the Bureau of
Primary Care to provide leadership and training to its grantees
on hepatitis C prevention, medical management and treatment.
The Committee recognizes the cultural differences inherent
in addressing family violence prevention among minority
populations, such as Native Hawaiians. Additionally, many
victims of domestic violence seek care through safety net
providers in community health centers rather than present to
costly emergency departments. The Committee encourages the
Department to fund demonstration projects that combine
integrated family violence prevention models focused on
minority populations with primary care delivery.
The Committee commends the efforts of health centers to
deliver culturally and linguistically appropriate care and
encourages the Secretary to work with health centers to better
enable them to provide, to the maximum extent feasible,
culturally competent and linguistically appropriate services.
The Committee also urges that attention be given to strategies
to increase the numbers and diversity of health professionals
at community health centers.
The Committee recognizes that Nurse-Managed Health Centers
[NMHCs] serve a dual function in strengthening the health care
safety net by providing health care to populations in
underserved areas and by providing the clinical experiences to
nursing students that are mandatory for professional
development. Recognizing that NMHCs are frequently the only
source of health care to their patients and that a lack of
clinical education sites for nurses is a contributing factor to
the nationwide nursing shortage, the Committee encourages HRSA
to provide alternative means to secure cost-based reimbursement
for NMHCs, by providing that reimbursement or by granting
university-based CHCs. In addition, the Committee encourages
HRSA to research the effectiveness of nurse-managed health
centers as a national model to reduce health disparities.
The Committee encourages the Bureau of Primary Health Care
to consider establishing a grant program within its community
health center program that would support the establishment and/
or expansion of nurse practice arrangements commonly referred
to as nurse-managed health centers that provide the medically
underserved with access to primary care services and promote
career advancement among nursing personnel in a variety of
training settings.
The Committee is concerned that Federal community health
center funds are often not available to small, remote
communities in Alaska, Hawaii, and other similar States because
the population base is too small. Many of these communities
have no health service providers and are forced to travel long
distances by boat or plane even in emergency situations. The
Committee supports efforts now underway to increase community
health center funding to address the growing number of
uninsured persons in this country. The Committee recommends
that HRSA examine its regulations and applications procedures
to ensure they do not unduly burden small communities and are
appropriately flexible to meet the needs of these communities.
The Committee applauds the agency for its initiatives such as
the ``Alaska Frontier Health Plan'' and encourages the Agency
to continue and expand its efforts with this program.
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 $14,100,000 be provided
for these activities in fiscal year 2006.
Free Clinics Medical Malpractice Coverage
The Committee provides $99,000 in funding for payments of
claims under the Federal Tort Claims Act to be made available
for free clinic health professionals as authorized by U.S.C.
Title 42, Section 233(o) of the Public Health Service Act. The
fiscal year 2005 comparable level was $99,000 and neither the
administration nor the House provided any funding for this
program. This appropriation continues to extend Federal Tort
Claims Act coverage to medical volunteers in free clinics in
order to expand access to health care services to low-income
individuals in medically underserved areas.
Radiation and Exposure Screening and Education Program
The Committee provides $1,958,000 for the Radiation
Exposure Compensation Act. The fiscal year 2005 comparable
level was $1,958,000, the administration request was $1,936,000
and the House provided $1,900,000. This program provides grants
for the education, prevention, and early detection of
radiogenic cancers and diseases resulting from exposure to
uranium during its mining and milling at nuclear test sites.
Health Care Access for the Uninsured/Community Access Program
The Committee provides $60,000,000 for the Community Access
Program. The fiscal year 2005 comparable level was $82,993,000
and the administration did not request fund for this program in
fiscal year 2006. 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.
Community Health Centers have the potential to serve as a
valuable resource in biomedical and behavioral research aimed
at reducing health status disparities among minority and
medically underserved populations. The Committee is pleased
that HRSA, through the H-CAP program, has prioritized the
establishment of demonstration projects between Community
Health Centers and minority health professions schools for the
purpose of health status disparities research and data
collection. Such demonstration projects were authorized in the
``Health Care Safety Net Amendments of 2002.''
National Hansen's Disease Program
The Committee has included $17,066,000 for the National
Hansen's Disease Program. The fiscal year 2005 comparable level
was $17,251,000 and the administration request was $16,066,000
in fiscal year 2006. 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.
National Hansen's Disease Program Buildings and Facilities
The Committee provides $222,000 for buildings and
facilities. The fiscal year 2005 comparable level was $247,000
and the administration request was $222,000. This funding
provides for the repair and maintenance of buildings at the
Gillis W. Long Hansen's Disease Center.
Payment to Hawaii for Hansen's Disease Treatment
The Committee provides $2,017,000 for Hansen's disease
services. The fiscal year 2005 comparable level was $2,017,000
and the administration requested $2,016,000.
Black Lung Clinics
The Committee provides $5,975,000 for black lung clinics.
The fiscal year 2005 comparable level was $5,951,000 and the
administration requested $5,912,000. This program funds clinics
that treat respiratory and pulmonary diseases of active and
retired coal miners. These clinics reduce the incidence of
high-cost inpatient treatment for these conditions.
BUREAU OF HEALTH PROFESSIONS
National Health Service Corps: Field Placements
The Committee provides $40,705,000 for field placement
activities. The fiscal year 2005 comparable level was
$45,068,000 and the administration request was $40,705,000. The
funds provided for this program are used to support the
activities of National Health Service Corps obligors and
volunteers in the field, including travel and transportation
costs of assignees, training and education, recruitment of
volunteers, and retention activities. Salary costs of most new
assignees are paid by the employing entity.
The Committee is pleased by the increasing proportion of
NHSC assignees being placed at Community, Migrant, Homeless,
and Public Housing Health Centers. The Committee encourages
HRSA to further expand this effort to ensure that the health
center expansion effort has access to a sufficient level of
health professionals through the NHSC.
The Committee is concerned by reports that the current HPSA
scoring process used by HRSA to place physicians disadvantages
many health centers located in medically underserved areas of
the country. The Committee urges HRSA to reconsider the
decision to score FQHCs under the newly authorized automatic
designation process based on data and criteria that virtually
eliminate all such FQHCs from eligibility for the placement of
NHSC scholars, Ready Responders, and HHS' J-1 Visa waiver
program.
National Health Service Corps: Recruitment
The Committee provides $86,091,000 for recruitment
activities. The fiscal year 2005 comparable level was
$86,380,000 and the administration request was $86,091,000.
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. These funds should support multi-year, rather than
single-year, commitments.
The Committee believes that the inclusion of Optometrists
in the National Health Service Corps' [NHSC] Student Loan
Repayment Program will result in the expanded accessibility of
eye care in communities where it is most needed. Accordingly,
the Committee urges the Health Resources and Services
Administration to take immediate steps to fully utilize Doctors
of Optometry in the NHSC Student Loan Repayment Program as part
of an effort to make preventive eye care services more
accessible in community health centers within rural and urban
primary care health professional shortage areas.
HEALTH PROFESSIONS
The Committee provides $454,393,000 for all HRSA health
professions programs. The fiscal year 2005 comparable level was
$450,213,000 and the administration requested $160,534,000 in
fiscal year 2006.
The Committee recognizes that physicians trained in
combined Internal Medicine-Pediatrics [Med-Peds] residency
training programs are particularly well suited to care for
patients with chronic medical illnesses who transition from
pediatric to adult-centered care. These physicians receive
intensive training in the care of children with chronic
illnesses as well as primary care for adults. The Committee
believes that Med-Peds physicians may fill the emerging need of
caring for these patients. The Committee encourages HRSA to
consider developing model demonstration projects on transition
care. The goal would be to address the healthcare needs of this
underserved population and to train future physicians to
provide care for them.
The Committee understands that nearly three quarters of the
Nation's 122 Job Corps Centers offer health occupations
training as well as training in health care related fields. The
Committee recognizes the Job Corps success in training students
with the skills they need to fill critical shortages through
major national employer partners. The Committee encourages HRSA
to consider making Job Corps Centers eligible for HRSA funding
for allied health training programs.
The Committee commends HRSA for its continuing efforts to
address the growing gap between the size of the Nation's aging
baby boom population and the number of pulmonary/critical care
physicians. The Committee is aware that HRSA has prepared a
report on the healthcare workforce shortage issue, and that the
portion of the report that will attempt to identify the causes
of, and potential responses to, the critical care workforce
shortage will be informed, in part, by The Critical Care
Medicine Crisis: A Call for Federal Action prepared by the
American College of Chest Physicians and the members of the
Critical Care Workforce Partnership. The Committee requests
HRSA provide a copy of this report to the Committee by July 1,
2006. The Committee continues to encourage HRSA to address the
critical care workforce shortage issue and use the pulmonary/
critical care specialty as a model for developing and testing
policy approaches to address workforce shortage issues.
Training for Diversity
Centers of Excellence
The Committee provides $33,609,000 for the Centers of
Excellence program. The fiscal year 2005 comparable level was
$33,609,000 and the administration did not request any funds
for this program in fiscal year 2006. 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 HRSA has re-focused the
Minority Centers of Excellence program on providing support to
historically minority health professions institutions. The
Committee recognizes the important role of this program in
supporting faculty and other academic programs at minority
institutions.
Health Careers Opportunity Program
The Committee provides $35,647,000 for the Health Careers
Opportunity Program. The fiscal year 2005 comparable level was
$35,647,000 and the administration did not request any funds
for this program in fiscal year 2006. This program provides
funds to medical and other health professions schools for
recruitment of disadvantaged students and pre-professional
school preparations.
The Committee is concerned about the reduced level of
support provided to minority health professions schools through
the H-COP program in recent fiscal years. For fiscal year 2006,
the Committee urges HRSA to give priority consideration to
awarding grants to those institutions with a historic mission
of training minorities in the health professions. HRSA should
report to the Committee within 6 weeks of enactment of this Act
with the steps it has taken to address this issue.
Faculty Loan Repayment
The Committee provides $1,302,000 for the Faculty Loan
Repayment program. The fiscal year 2005 comparable level was
$1,302,000 and the administration did not request any funds for
this program in fiscal year 2006. 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
The Committee provides $47,128,000 for the Scholarships for
Disadvantaged Students program. The fiscal year 2005 comparable
level was $47,128,000 and the administration requested
$9,381,000 for this program in fiscal year 2006. 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.
Training in Primary Care Medicine and Dentistry
The Committee provides $90,000,000 for Training in Primary
Care Medicine and Dentistry programs. The fiscal year 2005
comparable level was $88,816,000 and the administration did not
request funding for this program in fiscal year 2006.
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.
Interdisciplinary, Community-based Linkages
Area Health Education Centers
The Committee provides $28,971,000 for the Area Health
Education Centers program. The fiscal year 2005 comparable
level was $28,971,000 and the administration did not request
any funds for this program in fiscal year 2006. 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.
Health Education and Training Centers
The Committee provides $3,819,000 for the Health Education
and Training Centers program. The fiscal year 2005 comparable
level was $3,819,000 and the administration did not request any
funds for this program in fiscal year 2006. These centers
provide training to improve the supply, distribution, and
quality of personnel providing health services in the State of
Florida or along the border between the United States and
Mexico and in other urban and rural areas with populations with
serious unmet health care needs.
Allied Health and Other Disciplines
The Committee provides $11,753,000 for the Allied Health
and Other Disciplines programs. The fiscal year 2005 comparable
level was $11,753,000 and the administration did not request
any funds for this program in fiscal year 2006. The Committee
intends that these funds be used to support existing programs
at not less than last year's level. 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 is concerned about the emerging shortage of
occupational therapists needed to work with baby boom retirees
and encourages HRSA to give priority consideration to projects
for schools that address these manpower shortages by both
training faculty and students for entry level service.
The Committee is aware that dental disease
disproportionately affects our Nation's most vulnerable
populations, including many in rural America. New ways of
bringing oral health care to rural and underserved populations
are needed. The Committee encourages HRSA to explore
alternative methods of delivering preventive and restorative
oral health services in rural America. Specifically, the
Committee encourages HRSA to explore development of an advanced
dental hygiene practitioner who would be a graduate of an
accredited dental hygiene program and complete an advanced
educational curriculum, which prepares the dental hygienist to
provide diagnostic, preventive, restorative and therapeutic
services directly to the public in rural and underserved areas.
The Committee notes that since 1999 HRSA has not provided a
focus, through a request for proposals or other program
initiatives, on pediatric occupational therapy. In view of the
importance of this health profession to children with
disabilities, the Committee encourages HRSA to identify a
competitive category specifically for pediatric occupational
therapy training grants in 2006.
Geriatric Education Centers and Training
The Committee provides $29,548,000 for the Geriatrics
Education Centers and Training programs. The fiscal year 2005
comparable level was $31,548,000 and the administration did not
request any funds for this program in fiscal year 2006. This
program supports 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.
Quentin N. Burdick Program for Rural Health
Interdisciplinary Training
The Committee provides $6,076,000 for these programs. The
fiscal year 2005 comparable level was $6,076,000 and the
administration did not request any funds for this program in
fiscal year 2006. 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.
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
This 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 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.
Workforce Information and Analysis
The Committee provides $712,000 for these programs. The
fiscal year 2005 comparable level was $716,000 and the
administration requested $712,000.
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
workforce 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.
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 Programs
The Committee provides $9,097,000 for these programs. The
fiscal year 2005 comparable level was $9,097,000 and the
administration did not request any funds for this program in
fiscal year 2006. 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.
Health Administration Programs
The Committee provides $1,070,000 for the Health
Administration programs. The fiscal year 2005 comparable level
was $1,070,000 and the administration did not request any funds
for this program in fiscal year 2006. These programs provide
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.
Although the majority of Native Hawaiians receive services
in federally qualified community health centers, there is only
one Native Hawaiian health care administrator working in these
centers. The Committee is concerned that limited mentoring and
training opportunities exist for Native Hawaiian administrators
in health care organizations. The Committee urges that a
portion of money appropriated for Native Hawaiian Health Care
Act programs be used to prepare Native Hawaiians with the
expertise to excel in administrative health care positions.
Nursing Workforce Development Programs
The Committee provides $155,661,000 for the Nursing
Workforce Development programs. The fiscal year 2005 comparable
level was $150,661,000 and the administration requested
$149,991,000 for these programs in fiscal year 2005. The
Committee recognizes that the current nursing shortage has
reached a crisis state across America. The situation only
promises to worsen due to a lack of young nurses in the
profession, an aging existing workforce, and inadequate
availability of nursing faculty to prepare future nurses. The
Committee urges HRSA to support programs aimed at increasing
nursing faculty and encouraging a diverse population's entry
into nursing.
Advanced Education Nursing
The Committee provides $58,160,000 for the Advanced
Education Nursing programs. The fiscal year 2005 comparable
level was $58,160,000 and the administration requested
$42,806,000 for this program in fiscal year 2006. This program
funds nursing schools to prepare nurses at the master's degree
or higher level for teaching, administration, or service in
other professional nursing specialties.
The Committee understands that advanced practice nurses
provide high quality, cost-effective care in whatever
geographic locations they practice and that often they are a
patient's only option for care. The Committee requests the
Administrator to report to the Committee within 6 weeks of
enactment of this Act on the number of advanced practice nurse
candidates that receive traineeships and the number that then
work in rural, isolated or underserved areas across the United
States.
Nurse Education, Practice, and Retention
The Committee provides $40,468,000 for the Nurse Education,
Practice, and Retention Programs. The fiscal year 2005
comparable level was $36,468,000 and the administration
requested $46,325,000 for this program in fiscal year 2006. 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 nursing
workforce and empower the workforce to meet the demands of the
current health care system.
Nursing Workforce Diversity
The Committee provides $17,270,000 for the Nursing
Workforce Diversity program. The fiscal year 2005 comparable
level was $16,270,000 and the administration requested
$21,244,000 for this program in fiscal year 2006. 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 nurses' ability to
provide quality health care services to the increasingly
diverse community it serves.
Nurse Loan Repayment and Scholarship Program
The Committee provides $31,482,000 for the Nurse Loan
Repayment and Scholarship programs. The fiscal year 2005
comparable level was $31,482,000 and the administration
requested $31,369,000 for this program in fiscal year 2006.
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.
Nurse Faculty Loan Program
The Committee provides $4,831,000 for the Nursing Faculty
Loan program. The fiscal year 2005 comparable level was
$4,831,000 and the administration requested $4,821,000 for this
program in fiscal year 2006. This program supports the
development of a student loan fund in schools of nursing to
increase the number of qualified nursing faculty.
Comprehensive Geriatric Education
The Committee provides $3,450,000 for Comprehensive
Geriatric Education grants. The fiscal year 2005 comparable
level was $3,450,000 and the administration requested
$3,426,000 for this program in fiscal year 2006. These grants
prepare nursing personnel to care for the aging population.
Children's Hospitals Graduate Medical Education Program
The Committee has provided $300,000,000 for the Children's
Hospitals Graduate Medical Education [GME] program. The fiscal
year 2005 comparable level was $300,730,000 and the
administration requested $200,000,000 for this program in
fiscal year 2006.
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.
National Practitioner Data Bank
The Committee provides $15,700,000 for the national
practitioner data bank. The fiscal year 2005 comparable level
was $15,700,000 and the administration request was $15,700,000.
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. 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 provides $4,000,000 for the health care
integrity and protection data bank. The fiscal year 2005
comparable level was $4,000,000 and the administration request
was $4,000,000. 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.
MATERNAL AND CHILD HEALTH BUREAU
Maternal and Child Health Block Grant
The Committee provides $710,000,000 for the maternal and
child health [MCH] block grant. The fiscal year 2005 comparable
level was $723,928,000 and the administration request was
$723,928,000.
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 MCH block grant funds are provided to States to support
health care for mothers and children. According to statute, 85
percent of appropriated funds up to $600,000,000 are
distributed to States and 15 percent are set aside for special
projects of regional and national significance [SPRANS]. Also
according to statute, 12.75 percent of funds over $600,000,000
are to be used for community-integrated service systems [CISS]
programs. The remaining funds over $600,000,000 are distributed
on the same 85/15 percent split as the basic block grant.
The Committee has included bill language identifying
$121,396,250 for the SPRANS set-aside. Within that total, the
Committee intends that $4,000,000 be used to continue the
sickle cell newborn screening program and its locally based
outreach and counseling efforts; $5,000,000 be used to continue
the oral health demonstration programs and activities in the
States; $2,000,000 be used for mental health programs and
activities in the States; $3,000,000 be used for epilepsy
demonstration projects; $1,000,000 be used for a fetal alcohol
syndrome demonstration program; and $2,000,000 be used for
newborn and child screening for heritable disorders as
authorized in title XXVI of the Children's Health Act of 2000.
The Committee has provided $5,000,000 for the continuation
of oral health programs in the States. Through grants,
cooperative agreements or contracts, these funds may be used to
increase access to dental care for the most vulnerable low-
income children, such as Medicaid, SCHIP, and Head Start
eligible children and to implement State identified objectives
for improving oral health. Anticipated activities include those
targeting the reduction of early childhood caries, and
strengthening school-linked dental sealant programs.
The Committee also provides $2,000,000 for mental health
programs and activities in the States. The Committee expects
that the programs will include mental health grants for
prevention and early intervention services for children and
youth ages 0 to 24 years and for women's mental health as it
relates to their role in the family, particularly for women
diagnosed with postpartum depression [PPD]. One out of every
ten new mothers suffers from PPD, a treatable condition that
presents a range of emotional and physical changes.
Unfortunately, half of these women never get help. The
Committee encourages the Bureau to utilize this funding to
focus on low-income women and mothers of children with low
birth weight. The Committee recommends that funding be used on
science-based programs or models such as the Starting Early
Starting Smart Program that was funded by the Substance Abuse
and Mental Health Service Administration [SAMHSA] and the Casey
Family Programs to specifically target early intervention and
prevention.
The Committee has provided $3,000,000 for the continuation
of epilepsy demonstration programs to improve access to health
and other services regarding seizures and to encourage early
detection and treatment in children and others residing in
medically underserved and rural areas. Of the amount provided,
the Committee recommends 30 percent be used to continue to fund
the development and testing of a national public health
awareness campaign to increase seizure recognition and improve
access to care among minorities and underserved populations. In
implementing this program, the Committee encourages HRSA to
partner with a national organization whose mission is to
improve the lives of children and adults affected by seizure
through research, education, advocacy and service.
The Committee has included $1,000,000 to continue the
demonstration program on fetal alcohol syndrome begun in last
year's appropriation. Each year, 40,000 children are born with
fetal alcohol spectrum disorders [FASD], the leading known
cause of mental retardation and birth defects. The
demonstration program should continue to coordinate services
between the National Organization on Fetal Alcohol Syndrome and
community health centers to improve the prevention,
identification, and support of individuals with fetal alcohol
syndrome. In addition, funds have been included to engage and
include maternal child health sites in this successful
demonstration.
Newborn screening is a public health activity used for
early identification of infants affected by certain genetic,
metabolic, hormonal and or functional conditions for which
there are effective treatments or interventions. Screening
detects disorders in newborns that, left untreated, can cause
death, disability, mental retardation and other serious
illnesses.
The Committee again provides $2,000,000 within the SPRANS
amount for the heritable disorders program authorized in title
XXVI of the Children's Health Act. This program is designed to
strengthen States' newborn screening programs and improve
States' ability to develop, evaluate, and acquire innovative
testing technologies, and establish and improve programs to
provide screening, counseling, testing and special services for
newborns and children at risk for heritable disorders. The
Committee urges HRSA to include additional conditions, such as
biliary atresia, Fragile X, and abnormally elevated levels of
bilirubin, in this evaluation of testing programs with the goal
of implementing cost-effective public health screening programs
for these and other disorders. The Committee requests a report
by July 15, 2006 on the steps taken to validate a screening
tool for Fragile X and to launch a screening program across the
country. Given the potential of Fragile X screening as a viable
prototype for newborn and infant screening, the Committee
encourages HRSA to allocate funding from the heritable
disorders screening program toward screening and
epidemiological research activities related to Fragile X.
The Committee is aware of the extreme disparities that
exist among State newborn screening programs for metabolic and
genetic disorders. Parents and healthcare providers responsible
for the care of newborns should be able to provide the best
chance at a healthy start on life. For this reason, the
Committee strongly urges HRSA to include as a requirement for
funding a provision that parents be informed in writing of the
availability of additional tests that may not be required under
State law.
The Committee reiterates its long-standing support for the
continuation of funding that the Maternal and Child Health
Block Grant has provided to comprehensive thalassemia treatment
centers under the SPRANS program. The Committee strongly
encourages MCHB to continue this program, expand it to include
additional centers around the country, and to coordinate
closely its activities with the Cooley's Anemia Foundation.
The most crucial need for individuals suffering from
Chronic Fatigue Syndrome is for effective, compassionate
medical care. Through its demonstration grants program, HRSA
has piloted effective ways of delivering health care services
to those with emerging illnesses. The Committee encourages HRSA
to provide demonstration grants to develop model CFS clinical
centers with the goal of delivering effective,
multidisciplinary clinical care to persons with CFS.
The Committee recognizes the critical role of hemophilia
treatment centers in providing needed comprehensive care for
persons with bleeding disorders and the expanded role of these
centers in addressing the needs of women with bleeding
disorders and persons with clotting disorders such as
thrombophilia. The Committee urges HRSA to continue its support
of this model disease management network.
The Committee is aware that many school-age children with
vision problems significant enough to affect their learning are
not screened for vision problems prior to entering school. In
an effort to stimulate a national effort to reduce the
occurrence of vision loss and its accompanying disabilities,
the Committee encourages HRSA to consider developing a National
Core Performance Measure for children's vision.
Sickle Cell Anemia Demonstration Program
The Committee provides $500,000 for the sickle cell anemia
demonstration program. The fiscal year 2005 comparable level
was $198,000 and the administration did not request funding for
this program in fiscal year 2006.
Traumatic Brain Injury Program
The Committee provides $9,297,000 for the traumatic brain
injury program. The fiscal year 2005 comparable level was
$9,297,000 and the administration did not request funding for
this program in fiscal year 2006. 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.
Healthy Start Initiative
The Committee provides $104,000,000 for the healthy start
infant mortality initiative. The fiscal year 2005 comparable
level was $102,543,000 and the administration request was
$97,747,000.
The healthy start initiative was developed to respond to
persistently high rates of infant mortality in this Nation. The
initiative was expanded in fiscal year 1994 by a special
projects program, which supported an additional seven urban and
rural communities to implement infant mortality reduction
strategies and interventions. The Children's Health Act of 2000
fully authorized this initiative as an independent program.
The Committee urges HRSA to give preference to current and
former grantees with expiring or recently expired project
periods. This should include grantees whose grant applications
were approved but not funded during fiscal year 2005.
Universal Newborn Hearing Screening and Early Intervention
The Committee provides $9,792,000 for universal newborn
hearing screening and early intervention activities. The fiscal
year 2005 comparable level was $9,792,000 and the
administration did not request funds for this program in fiscal
year 2006.
The Committee has included sufficient funding to continue
the initiative begun several years ago to provide grants to
States to establish universal newborn hearing screening and
early intervention programs. The Committee is pleased by the
success of the initiative and the substantial response from
States.
The Committee expects HRSA to coordinate projects funded
with this appropriation with projects related to early hearing
detection and intervention by the National Center on Birth
Defects and Developmental Disabilities, the National Institute
on Deafness and Other Communication Disorders, the National
Institute on Disability and Rehabilitation Research, and the
Office of Special Education and Rehabilitative Services.
Emergency Medical Services for Children
The Committee provides $20,000,000 for emergency medical
services for children. The fiscal year 2005 comparable level
was $19,830,000 and the administration did not request funding
for this program in fiscal year 2006. The program supports
demonstration grants for the delivery of emergency medical
services to acutely ill and seriously injured children.
The Committee notes that this program is the only Federal
source of funding and expertise for improving EMS systems for
children. The Committee commends the EMSC program for its 20
years of achievement and applauds its commitment to improving
the delivery of emergency medical services to ill and injured
children.
Poison Control Centers
The Committee provides $23,301,000 for poison control
center activities. The fiscal year 2005 comparable level was
$23,499,000 and the administration requested $23,301,000 for
this program in fiscal year 2006. The funds provided support
activities authorized in the Poison Control Center Enforcement
and Enhancement Act as well as the development and assessment
of uniform patient management guidelines.
HIV/AIDS BUREAU
ACQUIRED IMMUNE DEFICIENCY SYNDROME
Ryan White AIDS Programs
The Committee provides $2,083,296,000 for Ryan White AIDS
programs. The recommendation includes $25,000,000 in transfers
available under section 241 of the Public Health Service Act.
The fiscal year 2005 comparable level was $2,073,296,000 and
the administration request was $2,083,296,000.
Next to the Medicaid program, the Ryan White CARE Act (the
CARE Act) is the largest Federal investment in the care and
treatment of people living with HIV/AIDS in the United States.
The CARE Act provides a wide range of community-based services,
including primary and home health care, case management,
substance abuse treatment, mental health services, and
nutritional services.
Within the total provided, the Committee intends that Ryan
White AIDS activities that are targeted to address the growing
HIV/AIDS epidemic and its disproportionate impact upon
communities of color, including African-Americans, Latinos,
Native Americans, Asian Americans, Native Hawaiians, and
Pacific Islanders continue with at least the level of funding
provided in fiscal year 2005.
The Committee is concerned that at least 30 percent of
persons living with HIV are co-infected with hepatitis C, and
that hepatitis C related complications are emerging as the
leading cause of death among persons living with HIV/AIDS. The
Committee requests that HRSA provide both more guidance to
grantees on providing services to co-infected individuals, and
more education and training to medical providers on treating
persons co-infected with HIV and HCV.
Emergency Assistance--Title I
The Committee provides $610,094,000 for emergency
assistance grants to eligible metropolitan areas
disproportionately affected by the HIV/AIDS epidemic. These
funds are provided to metropolitan areas meeting certain
criteria. Half of the funds are awarded by formula and the
other half are awarded through supplemental competitive grants.
Comprehensive Care Programs--Title II
The Committee provides $1,131,836,000 for HIV health care
and support services. 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 $797,521,000 for AIDS medications.
The Committee is concerned that Title II base award amounts
have been reduced by $14,000,000 over the past 2 fiscal years,
thereby reducing the ability of State and territory health
departments to provide comprehensive health care services to
all those living with HIV/AIDS in need. The Committee
recognizes the unique role that State health departments play
in coordinating HIV/AIDS care and treatment programs within
their State, regardless of funding source. The Committee
encourages HRSA, in collaboration with state health
departments, to seek meaningful measures by which coordination
between all Ryan White CARE Act grantees and other Federal HIV/
AIDS programs can occur within States and territories, with
inclusion of State representatives in HRSA's monitoring visits
of Title III and IV grantees, as well as notification to states
of new grantees within their jurisdictions.
The Committee recognizes the importance of ADAP in making
it possible for low-income Americans to access and afford the
drugs to treat HIV/AIDS. Today, more than 150,000 Americans
depend on ADAP to preserve and extend their lives.
Unfortunately, dozens of States find themselves unable to keep
up with the demand for patients in need of coverage under ADAP,
and many states have been forced to take drastic action to
offset funding shortfalls. The Committee encourages HRSA to
explore methods of redistributing unobligated funds to help
address the ADAP crisis.
Early Intervention Program--Title III-B
The Committee provides $195,578,000 for early intervention
grants. 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.
Women, Infants, Children, and Youth--Title IV
The Committee provides $72,519,000 for title IV pediatric
AIDS. 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.
Title IV of the CARE Act provides a program of grants for
coordinated services and access to research for women, infants,
children and youth. Title IV grantees may engage in a broad
range of activities to reduce mother-to-child transmission,
including voluntary testing of pregnant women and treatment to
reduce mother-to-child transmission. In addition, title IV
grantees are required to provide individuals with information
and education on opportunities to participate in HIV/AIDS
clinical research.
The Committee expects HRSA to maximize available funds
under this part to existing grantees. The Committee is
concerned that instructions to HRSA regarding the analysis of
data pertaining to administrative costs in title IV have still
not been followed, making it almost impossible for HRSA to
impose a cap in fiscal year 2006. The Committee strongly urges
HRSA to collaborate with grantees under this title to produce
necessary tools for the accurate collection of expense data.
Unless HRSA can produce data regarding administrative expenses
with a precise definition to ensure accuracy and comparability,
the Agency will be unable to impose a limitation on such
expenses without harming the ability of grantees to provide
services for women, children, youth and families infected with
HIV.
The Committee is aware of the efforts of title IV grantees
to care for youth infected with HIV and urges HRSA to
disseminate the effective practices and models of care
developed by title IV grantees across all Ryan White CARE Act
providers.
Technical assistance may be provided to title IV grantees
using up to 2 percent of the funds appropriated under this
section. Within this amount sufficient funds exist to maintain
agreements to provide technical assistance to title IV grantees
and to conduct policy analysis and research.
AIDS Education and Training Centers
The Committee provides $35,051,000 for the AIDS education
and training centers [AETC's]. 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.
AIDS Dental Services
The Committee provides $13,218,000 for AIDS Dental
Services. 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.
Telehealth
The Committee provides $3,888,000 for telehealth
activities. The fiscal year 2005 comparable level was
$3,916,000 and the administration request was $3,888,000. The
telehealth program funded through the Office for the
Advancement of Telehealth promotes the effective use of
technologies to improve access to health services for people
who are isolated from healthcare and distance education for
health professionals.
SPECIAL PROGRAMS BUREAU
Organ Donation and Transplantation
The Committee provides $24,413,000 for organ transplant
activities. The fiscal year 2005 comparable level was
$24,413,000 and the administration request was $23,282,000.
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 notes that Public Law 108-216, the Organ
Donation Recovery and Improvement Act of 2004 has provided new
program authorizations and urges efforts to implement the new
law. Funding provided by the Committee may be used to implement
the provisions of the new law and the Committee notes that the
new provisions may have a direct impact on increasing the rate
of successful transplantations.
The Committee is concerned that pregnant women and their
families are unaware of the benefits of umbilical cord blood in
treating many congenital and genetic diseases. The Committee
encourages HRSA to consider adding umbilical cord blood to
organ and tissue donation education programs operated by HRSA
to provide education on all options for umbilical cord blood
storage including public donation and private banking.
The Committee is encouraged by the continuing success of
the Organ Donation Collaborative Project and has included funds
for its continuation. This project is focused on the Nation's
largest hospitals and has adopted the goal of helping these
hospitals achieve organ donation rates of 75 percent or higher,
which will result in at least 6,000 additional organs available
for transplantation. The Committee notes that this project has
made important progress toward this goal over the last year and
urges its continuation. The Committee also urges the agency to
facilitate the adoption of a national system of simultaneous
referrals of available organs as opposed to the current system
of sequential or serial referrals.
National Cord Blood Stem Cell Bank Program
The Committee has provided $9,859,000 for the National Cord
Blood Stem Cell Bank Network. The fiscal year 2005 comparable
level was $9,859,000 and the administration did not request
funds for this activity in fiscal year 2006.
The Committee continues to be supportive of the effort to
build the Nation's supply of cord blood stem cells available
for therapy and research. The Committee notes that the
Institute of Medicine study required by House Report 108-401
has been completed and submitted to the Committee and HRSA. The
Committee expects HRSA to begin implementation of this program
as soon as possible.
National Bone Marrow Donor Program
The Committee provides $22,916,000 for the National Bone
Marrow Donor Registry. The fiscal year 2005 comparable level
was $25,416,000 and the administration request was $22,916,000.
The National Bone Marrow Donor Registry is a network, operated
under contract, which 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.
Trauma Care
The Committee provides $3,418,000 for trauma/emergency
medical services. The fiscal year 2005 comparable level was
$3,418,000 and the administration did not request funds for
this program in fiscal year 2006. This program is intended to
improve the Nation's overall emergency medical systems, which
are constantly activated to respond to a wide range of natural
and man-made disasters.
State Planning Grants for Health Care Access
The Committee has not provided funding for State Planning
Grants for Health Care Access in fiscal year 2006. The fiscal
year 2005 comparable level was $10,910,000 and the
administration did not request funding for this activity in
fiscal year 2006.
RURAL HEALTH PROGRAMS
Rural Health Policy Development Program
The Committee provides $8,825,000 for the Rural Health
Policy Development Program. The fiscal year 2005 comparable
level was $8,825,000 and the administration request was
$8,528,000. The funds provide support for the Office of Rural
Health Policy to be 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.
Rural Health Care Services Outreach Grants
The Committee provides $39,278,000 for health outreach
grants. The fiscal year 2005 comparable level was $39,278,000
and the administration request was $10,767,000. This program
supports projects that demonstrate new and innovative models of
outreach in rural areas such as integration and coordination of
health services.
The Committee understands that many primary care clinics in
isolated, remote locations are providing extended stay services
and are not staffed or receiving appropriate compensation to
provide this service. The Committee encourages HRSA to continue
its support for a demonstration project authorized in the
Medicare Modernization Act to evaluate the effectiveness of a
new type of provider, the ``Frontier Extended Stay Clinic,'' to
provide expanded services in remote and isolated primary care
clinics to meet the needs of seriously ill or injured patients
who cannot be transferred quickly to acute care referral
centers, and patients who require monitoring and observation
for a limited time.
Mississippi's Delta is a community in which residents
disproportionately experience disease risk factors and children
are significantly mentally and physically developmentally
behind. The Committee recognizes that communities such as this
show positive behavioral change when community-based programs
and infrastructure are in place. The Committee believes that
collaborative programs offering health education, coordination
of health services and health-related research offer the best
hope for breaking the cycle of poor health in underprivileged
areas such as the Mississippi Delta. Therefore, the Committee
recommends the continued funding of these activities as already
initiated and undertaken by the coordinated efforts of the
Mississippi Delta Health Alliance, which is a collaboration
involving Delta State University, Mississippi State University,
the University of Mississippi Medical Center, and the
Mississippi State Department of Health.
Rural and Community Access to Emergency Devices
The Committee provides $8,927,000 for rural and community
access to emergency devices. The fiscal year 2005 comparable
level was $8,927,000 and the administration request was
$1,960,000. This provides funding for both the rural program
under section 413 of the Public Health Service Act and the
community access demonstration under section 313. These
programs provide grants to expand placement of automatic
external defibrillators [AEDs] and to ensure that first
responders and emergency medical personnel are appropriately
trained.
Rural Hospital Flexibility Grants
The Committee provides $64,180,000 for rural hospital
flexibility grants. The fiscal year 2005 comparable level was
$39,180,000 and the administration did not request funds for
this program in fiscal year 2006.
Under this program, eligible rural hospitals may convert
themselves into limited service facilities termed Critical
Access 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.
Of the amount provided, the Committee includes $15,000,000
to continue the Small Rural Hospital Improvement Grant Program,
as authorized by section 1820(g)(3) of the Social Security Act
and Public Law 107-116 and outlined in House Report 107-342.
The Committee has included $25,000,000 for a Rural Health,
Education, and Workforce Infrastructure Demonstration Program
which shall solicit and fund proposals from local governments,
hospitals, universities, and rural public health-related
entities and organizations for research development,
educational programs, job training, and construction of public
health-related facilities.
State Offices of Rural Health
The Committee provides $8,321,000 for the State Offices of
Rural Health. The fiscal year 2005 comparable level was
$8,321,000 and the administration request was $8,223,000. The
State Office of Rural Health program helps the States
strengthen rural heath care delivery systems by allowing them
to better coordinate care and improve support and outreach in
rural areas. The Committee believes that continued funds for
this purpose are critical to improving access and quality
health care services throughout rural communities.
Rural Emergency Medical Services
The Committee has provided $500,000 for the Rural EMS
Training and Assistance Grants program. The comparable fiscal
year 2005 level was $496,000 and the administration did not
request funding for this program in fiscal year 2006.
Native and Rural Alaskan Health Care
The Committee provides $39,680,000 for the Denali
Commission. The fiscal year 2005 comparable level was
$39,680,000 and the administration did not request funding for
this program in fiscal year 2006. These funds support
construction and renovation of health clinics, hospitals and
social service facilities in rural Alaska, as authorized by
Public Law 106-113, to help remote communities in Alaska
develop critically needed health and social service
infrastructure for which no other funding sources are
available, thereby providing health and social services to
Alaskans in remote rural communities as they are in other
communities throughout the country. The Committee expects the
Denali Commission to allocate funds to a mix of rural hospital,
clinic, long-term care and social service facilities, rather
than focusing exclusively on clinic funding.
Terrorism Preparedness
The Committee provides $510,500,000 for bioterrorism
preparedness related activities at HRSA. Within this total,
$483,000,000 is provided for hospital preparedness grants and
$27,500,000 is provided for education and curriculum
development.
The Committee intends that, at the discretion of the
Secretary of Health and Human Services, funds provided for the
hospital preparedness grants may be used for deployable mass
casualty units (as requested in the Strategic National
Stockpile), credentialing integration (as requested in the
Office of the Secretary), and training a medical reserve corps
(as requested in the Office of the Secretary). These deployable
mass casualty units could provide key hospital surge capacity
in the event of a terrorist attack or natural disaster. HRSA
should continue to work with the Department and other HHS
agencies to coordinate their terrorism preparedness activities.
Within the total provided for hospital preparedness grants,
the Committee approves the request for $25,000,000 to create a
medical surge capacity national demonstration at Washington
Hospital Center. The funding will increase emergency care
capacity for the Nation's Capital, and serve as a national
demonstration center for advanced mass casualty emergency
facility design, training, and care.
The Committee is concerned about the current HRSA strategy
for providing training to health care professionals on
bioterrorism preparedness. Many expert analyses, including
several presented at the Secretary's Council on Public Health
Preparedness, have stressed the need for a consistent, national
curriculum for bioterrorism preparedness training. The
Committee is troubled that, instead of adopting a consistent,
national approach to training, HRSA has instead chosen to issue
19 separate grants for continuing education on bioterrorism
training, and a further 12 grants for curriculum development.
The Committee believes that this approach risks producing a
fragmented and uncoordinated bioterrorism preparedness training
program instead of the integrated and coordinated program that
is needed. The Committee instructs HRSA to seek ways to improve
the coordination and consistency of its bioterrorism training
program, and to report to the Committee on recommendations for
achieving a consistent, national strategy for bioterrorism
preparedness training no later than 6 weeks after the date of
enactment of this Act.
Family Planning
The Committee provides $285,963,000 for the title X family
planning program. The fiscal year 2005 comparable level was
$285,963,000 and the administration request was $285,963,000.
Title X grants support primary health care services at more
than 4,600 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 preventive health services. This includes
FDA-approved methods of contraception. The Committee believes
that the authority for making grants under title X must remain
unchanged.
The Committee is aware of the findings of a recent HHS
Inspector General's report, which documents efforts by the
Office of Population Affairs to inform and periodically remind
title X grantees of their responsibilities regarding State
child abuse and sexual abuse reporting requirements. The report
notes that OPA includes State reporting requirements in its
reviews and site visits of grantees, and cites an extensive
amount of effort and training that goes on within the program
to ensure that clinicians are conversant with State reporting
requirements, and trained to both recognize signs of sexual
coercion and sexual violence and follow appropriate procedures
when dealing with such cases.
Health Care-related Facilities and Activities
The Committee provides $480,751,000 for the construction
and renovation (including equipment) of health care-related
facilities and other health care-related activities. The fiscal
year 2005 comparable level was $482,729,000 and the
administration did not request funds for this program in fiscal
year 2006. This account makes funds available to public and
private entities for the construction and renovation of health
care-related facilities and other health care-related
activities.
Program Management
The Committee provides $143,992,000 for program management
activities for fiscal year 2006. The fiscal year 2005
comparable level was $147,080,000 and the administration
request was $145,992,000.
Section 340B of the Public Health Service Act created the
340B Drug Discount Program to lower drug prices for over 10,000
public health grantees including community health centers and
public hospitals. The Committee notes that the program is
growing rapidly due the growth in the number of Community
Health Centers and an expansion of the number of rural and
small hospitals eligible to be recognized as disproportionate
share hospitals, contained in the Medicare Modernization Act.
The Committee is deeply concerned that the Department lacks the
oversight capability to ensure that safety-net organizations
participating in the program receive the full statutory
discounts. The Committee agrees with the Inspector General that
participating entities must have the ability to independently
verify that they are receiving the mandated discounts, and
strongly urges HRSA to develop a mechanism by which this
verification can take place.
HEALTH EDUCATION ASSISTANCE LOANS
The Committee provides $4,000,000 to liquidate obligations
from loans guaranteed before 1992. The fiscal year 2005
comparable level was $4,000,000 and the administration request
was $4,000,000. For administration of the HEAL Program
including the Office of Default Reduction, the Committee
provides $2,916,000. The fiscal year 2004 comparable level was
$3,244,000 and the administration request was $2,916,000.
The HEAL Program insures loans to students in the health
professions. 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.
NATIONAL VACCINE INJURY COMPENSATION PROGRAM
The Committee provides that $74,484,000 be released from
the vaccine injury compensation trust fund in fiscal year 2006,
of which $3,600,000 is for administrative costs. The total
fiscal year 2005 comparable level was $69,151,000 and the total
administration request was $73,716,000.
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, 2005.................................... $4,775,810,000
Budget estimate, 2006................................... 4,306,063,000
House allowance......................................... 6,105,586,000
Committee recommendation................................ 6,254,215,000
The Committee provides a program level of $6,254,215,000
for the Centers for Disease Control and Prevention [CDC]. The
Committee recommendation includes $5,989,115,000 in budget
authority and an additional $265,100,000 via transfers
available under section 241 of the Public Health Services Act.
The fiscal year 2005 comparable program level was
$4,775,810,000 and the administration requested program level
was $4,306,063,000.
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.
INFECTIOUS DISEASES
The Committee recommends $1,709,361,000 for infectious
disease related programs at the CDC. The fiscal year 2005
comparable level was $1,679,889,000 and the administration
requested a comparable level of $1,709,758,000 for fiscal year
2006. The Committee recommendation includes $12,794,000 in
transfers available under section 241 of the Public Health
Services Act.
The Coordinating Center for Infectious Diseases includes
the National Center for Infectious Diseases, the National
Center for STD, TB, and HIV Prevention, and the National
Immunization Program.
Infectious Diseases Control
The Committee has provided $3,848,000 above the comparable
amount for fiscal year 2005 to expand infectious diseases
control activities. The Committee intends that all infectious
diseases control activities be funded at least at the level of
the administration's request and that the additional funds be
used to address emerging issues as determined by CDC.
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.
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.
Chronic Fatigue.--With near-completion of the restoration
of $12,900,000 to the Chronic Fatigue Syndrome [CFS] research
program in response to a report from the Inspector General
dated May 12, 1999, the Committee commends CDC for developing a
comprehensive CFS program. The Committee encourages CDC to
provide sufficient resources to sustain efforts to identify
biomarkers for CFS, educate health care providers about the
diagnosis and treatment of CFS, and better inform the public
about it to aid early detection and improve patient care. The
Committee requests a report by May 1, 2006 providing a detailed
accounting of how the $12,900,000 in restored funding has been
used.
Collaboration With Asia.--The Committee recognizes that
strong collaborative ties with Asian countries are among the
mechanisms which may contribute to the stability of the Asia/
Pacific region. The multiethnic and multicultural population of
Hawaii and its geographic location provide an ideal pathway for
a CDC supported initiative with a focus on emerging infectious
and chronic disease problems in Asia. The Committee also
recognizes this has the potential for providing frontline
protection for the United States mainland from emerging
diseases, as well as assisting Asian countries with treatment
for such diseases. The Committee encourages CDC to explore
collaboration and joint funding of projects with Asian
governments, such as Korea, to study immigrants in Hawaii as a
mechanism for addressing both infectious and chronic disease
burden and treatment in the Pacific.
Hepatitis.--The Committee is concerned that more than 75
percent of the 4 million people with hepatitis C are unaware of
their condition. The Committee encourages CDC to collaborate
with national voluntary health organizations to raise awareness
of appropriate screening and medical follow up of target
populations. The Committee is also aware of increasing rates of
hepatitis A and B infections among select adult populations, as
well as the alarming rate of individuals co-infected with both
hepatitis C and HIV. The Committee encourages CDC to help
increase hepatitis screening initiatives in the States. In
addition, The Committee encourages CDC to consider focusing on
education and awareness programs targeted at specific
populations where there is a high prevalence of hepatitis B and
where therapeutic interventions are increasingly effective.
Liver Wellness.--The Committee continues to be concerned
about the prevalence of hepatitis and encourages CDC to
consider working with voluntary health organizations and
professional societies to promote liver wellness with increased
attention toward education and prevention.
Meningococcal Disease.--Meningococcal disease is one of the
few diseases that can be fatal or severely debilitating to a
victim within a matter of hours of initial onset and yet is
vaccine-preventable in most cases. The Committee is aware of
the recent improvements in the meningitis vaccine and of recent
CDC efforts to increase the availability and focus of
information on Meningococcal disease and ways to prevent it so
that the general public will be better educated on the symptoms
and prevention methods. The Committee encourages the CDC to
improve meningococcal education and adolescent immunization
programs through partnerships with associations, such as the
National Meningitis Association, to ensure that all families,
especially those with adolescents and young adults, are
effectively educated on this disease, vaccine availability, and
all methods of prevention.
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.
Sepsis.--The Committee is aware that sepsis, an
overwhelming systemic response to infection that leads to organ
dysfunction and death, kills more that 215,000 Americans every
year. The Committee understands that new treatments have been
developed which significantly improve prognosis when sepsis is
diagnosed in a timely fashion. In addition, new guidelines have
been developed to aid health care professionals in identifying
the syndrome. Unfortunately, too few medical personnel know how
to properly diagnose sepsis. To improve patient outcomes, the
Committee encourages CDC to develop a sepsis education program
to train infectious disease physicians, emergency room doctors,
and critical care nurses in the proper identification of
sepsis.
HIV, STD, and TB Prevention
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
multi-disciplinary programs of research, surveillance,
technical assistance, and evaluation. These diseases are not
yet vaccine preventable and must be controlled and prevented by
identifying, diagnosing, and treating infected persons;
provision of confidential, culturally competent counseling to
identify and reach those who have been exposed to infection and
who may not know it; and individual and population level health
promotion to reduce high risk behaviors.
Within the total provided, $637,000 above the comparable
amount for fiscal year 2005 has been provided for tuberculosis-
related activities. All other activities are funded at the
level of the administration's request.
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.
Infertility Prevention.--The Committee notes that CDC is
charged legislatively with instituting programs to help prevent
infertility. CDC's current program activities in this matter
are undertaken by the division of HIV/STD/TB and are limited to
the prevention of venereal diseases. The Committee understands
that there are numerous additional causes of infertility beyond
sexually transmitted diseases, such as delayed child bearing,
smoking, low or excessive body weight, exposure to hazardous
environmental toxins, drug and alcohol abuse and, particularly
for men, exposure to high temperatures. The Committee
encourages CDC to consider expanding the scope of this program
and provide greater support to public education on the risks to
fertility.
Oral Fluid Rapid HIV Tests.--The Committee is supportive of
CDC's use of the oral fluid rapid HIV test in its HIV/AIDS
activities. The Committee strongly encourages CDC to move
forward as quickly as possible with the purchase of additional
tests to sustain and expand these successful efforts.
Tuberculosis.--The Committee is pleased with the efforts of
the tuberculosis control program, which has reduced the number
of new tuberculosis cases for the past 10 years. However, the
number of new tuberculosis cases in foreign-born individuals in
the United States remains a concern. Although tuberculosis
rates have been falling, the Committee is aware that similar
low rates have been achieved in the past only to see a
reemergence of the disease due to inadequate control efforts.
In the end, any savings achieved during that period were more
than used to again gain control of the incidence of the
disease. The Committee has provided $637,000 over the fiscal
year 2005 level to expand tuberculosis control efforts to
prevent a similar reemergence.
The Committee understands that TB is an enormous health
crisis in the developing world, killing 2 million people every
year. In recent years, several new vaccine candidates for TB
have been developed and have shown promising results when
tested in animals. The Committee strongly encourages CDC to
continue and, if possible, expand the existing TB vaccine
research cooperative agreement.
The Committee is aware that refugees entering the United
States with TB pose a serious public health threat. In
particular, multidrug resistant TB cases pose the deadliest and
costliest risk. The Committee recognizes that over the past
year an outbreak of TB has occurred among Hmong refugees from
Thailand who have resettled in the United States, mainly in
California, Minnesota and Wisconsin. In California alone, local
health departments have detected 25 TB cases among 3,400 Hmong
refugees from Thailand in the last 10 months, four of which are
multidrug resistant. The Committee urges CDC to make resources
available to States facing TB outbreaks among their refugee
population.
The Committee understands that the CDC plans to undertake a
new initiative, the Intensified Support and Activities to
Accelerate Control [ISAAC]. ISAAC targets tuberculosis in
African Americans, tuberculosis along the U.S./Mexico border,
allows for universal genotyping of all culture positive TB
cases, and expands clinical trials for new tools for the
diagnosis and treatment of TB. The Committee encourages the CDC
to implement ISSAC to enhance and maximize strategies to
accelerate the control and elimination of TB.
Immunization
The Committee recommends $510,706,000 for the program
authorized under section 317 of the Public Health Service Act.
The fiscal year 2005 comparable level was $480,794,000 and the
administration requested $515,920,000 for fiscal year 2006. The
Committee recommendation includes $12,794,000 in transfers
available under section 241 of the Public Health Service Act.
Within the total provided, all activities are funded at the
level requested by the administration. The Committee has
transferred $5,214,000 from Immunization to Global Health to
continue to support global vaccination efforts. This is a
technical change and should not result in any programmatic
decrease in Immunization activities.
The Omnibus Reconciliation Act of 1993 established a
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.
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 failure to immunize children in remote
areas of Alaska results in deaths each year from exposure to
open sewage lagoons and contaminated water.
Vaccine Tracking.--The Committee is pleased by CDC's
development of the Surveillance, Preparedness, Awareness and
Response System and has included sufficient resources to
provide the same level of support of these activities as in
fiscal year 2005. In light of vaccine shortages that have
occurred over the past several flu seasons, the Committee
understands that this system could serve as a valuable
surveillance and tracking system for private and public sector
inventory levels of vaccine.
HEALTH PROMOTION
The Coordinating Center for Health Promotion includes the
National Center for Chronic Disease Prevention and Health
Promotion and the National Center for Birth Defects and
Developmental Disabilities.
The Committee recommends $974,080,000 for Health Promotion
related activities at the CDC. The fiscal year 2005 comparable
level was $1,021,709,000 and the administration requested
$964,421,000.
The Committee recognizes the important role national non-
governmental health organizations play in increasing the
awareness of chronic disease prevention and birth defects and
development disabilities issues. Therefore, the Committee has
included $2,421,000 to allow for the award of projects to
support the dissemination of information on the condition or
disease and effective public health interventions or to conduct
public and professional health awareness and education efforts.
Using a competitive review process, each project should be
awarded for a 3-year project period and should not exceed
$1,000,000 per year.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Within the total provided, the following amounts are
provided for the specified activities above the comparable
amount for fiscal year 2005: $300,000 to expand Heart Disease
and Stroke related activities; $300,000 to expand Diabetes
related activities; $404,000 to expand Cancer Prevention and
Control activities; $3,000,000 to expand Tobacco related
activities; $50,000 to expand oral health related activities;
$310,000 to expand Prevention Center activities; $100,000 to
expand the Racial and Ethnic Approach to Community Health
Program; and $84,000 to expand Primary Immune Deficiency
Syndrome-related activites. All other activities are funded at
the level of the administration's request or as specified
below.
Chronic diseases have had a profound human and economic
toll on our Nation. Nearly 125 million Americans today are
living with some form of chronic condition, including cancer,
cardiovascular disease, diabetes, arthritis, and various
neurological conditions such as epilepsy. These and other
chronic diseases now account for nearly 70 percent of all
health care costs, as well as 70 percent of all deaths
annually. A 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.
Alzheimer's Disease and Healthy Aging.--The Committee
understands that a growing body of evidence suggests that many
of the same strategies that preserve overall health may also
help prevent or delay the onset of Alzheimer's disease and
dementia. Epidemiological studies reveal that individuals
taking anti-inflammatory drugs to treat conditions such as
arthritis have a lower-than-expected occurrence of Alzheimer's.
Other studies appear to link known risk factors for diabetes
and heart disease and risk factors for Alzheimer's and
dementia. CDC, in cooperation with the Alzheimer's Association,
is launching a new program aimed at educating the general
public and health professionals on ways to reduce the risks of
developing Alzheimer's disease by maintaining a healthy
lifestyle. In light of the threat Alzheimer's presents as well
as growing public interest in learning how to remain brain-
healthy, the Committee recommends $1,700,000 to continue this
important initiative.
Amyotrophic Lateral Sclerosis.--The Committee understands
that a national Amyotrophic Lateral Sclerosis [ALS] registry
may enable unprecedented progress in understanding ALS.
Although several sources of ALS patient information currently
exist in varying forms around the world, this information is
not as comprehensive as required for the needed research. The
Committee provides $1,000,000 for pilot programs to begin to
gather data for a nationwide ALS registry that will estimate
the incidence and prevalence of the disease, promote a better
understanding of the epidemiology of the disease, and provide
data that will be useful for research on improving disease
management and developing standards of care. CDC should, to the
extent practicable, identify and coordinate with existing data,
surveillance systems and registries, such as state-based ALS
registries, the Department of Veterans Affairs ALS registry and
the National Institute for Neurological Disorders and Stroke
repository.
Autoimmune Diseases.--The Committee encourages CDC to
provide resources for the awareness and prevention of
autoimmune diseases.
Breast and Cervical Cancer.--The Committee commends the CDC
for creating partnerships to address the early detection of
breast cancer, particularly in historically underserved
communities including the Native American, Hispanic, Asian
Pacific Islander, and African American populations. As part of
this initiative, the Committee is very interested in the
innovative approaches, such as that of the Men Against Breast
Cancer Partners In Survival Program, which focuses on the role
of the male support-giver as an integral component of the early
detection, patient care and survivorship of breast cancer.
Cancer Prevention and Control.--The Committee is strongly
supportive of the CDC cancer programs focused on awareness,
education and early detection and has included a significant
increase for these programs.
The growth of cancer prevention and control programs within
State health agencies has resulted in the recognition that
improved coordination of cancer control activities is essential
to maximizing resources and achieving desired cancer prevention
and control outcomes. The Committee commends CDC for its work
with health agencies to enhance the number and quality of
cancer-related programs that are available to the U.S.
population and to develop an integrated and coordinated
approach to reduce the cancer burden through prevention, early
detection, treatment, and rehabilitation.
Within the amounts provided, the following amounts are
provided for the specified activities above the comparable
amount for fiscal year 2005: $136,000 to expand comprehensive
cancer activities and $200,000 to expand activities related to
the Geraldine Ferraro Cancer Education Program. All other
activities are funded at the level of the administration's
request.
Cancer Survivorship Resource Center.--The Committee
supports the ongoing partnership between CDC and the Lance
Armstrong Foundation to address the needs of the approximately
10 million cancer survivors and their families and friends. The
Committee has included sufficient resources to provide at least
the same level of support for LiveStrong, the National Cancer
Survivorship Resource Center, as was provided in fiscal year
2005.
Chronic Kidney Disease.--The Committee previously has
expressed concern regarding the need to expand public health
strategies to combat chronic kidney disease [CKD] given that
many individuals are diagnosed too late to initiate treatment
regimens that could reduce morbidity and mortality. Twenty
million Americans have CKD, and another 20 million are at risk
of developing the disease. Individuals with diabetes or
hypertension have especially high vulnerability. Kidney disease
is the 9th leading cause of death in the United States, and
death by cardiovascular disease is 10 to 30 times higher in
kidney dialysis patients than in the general population.
Further, the number of individuals with end stage renal disease
[ESRD], irreversible kidney failure requiring either dialysis
or a transplant to remain alive, is expected to increase from
372,000 patients in 2000 to over 660,000 by 2010. Therefore,
the Committee has included an increase of $1,800,000 for CKD to
develop capacity and infrastructure at CDC for a kidney disease
surveillance, epidemiology, and health outcomes program; award
grants to support several State-based demonstration projects
for CKD prevention and control; and under the leadership of a
national voluntary health organization and in collaboration
with CDC, convene a consensus conference of experts in the area
of kidney disease and other stakeholders to lay the groundwork
for a formal Public Health Kidney Disease Action Plan for
prevention and control of kidney disease.
Chronic Obstructive Pulmonary Disease.--Chronic Obstructive
Pulmonary Disease [COPD] is the fourth leading cause of death
in the United States and the only one of the top 10 causes of
death that is on the increase. The Committee urges the CDC to
expand its data collection efforts on COPD. Specifically, the
Committee encourages the CDC to include questions on COPD in
the National Health and Nutrition Examination Survey, the
National Health Interview Study and the Behavioral Risk Factor
Surveillance Survey that asks about COPD by name.
Colorectal Cancer.--The Committee understands that
colorectal cancer is the third most commonly diagnosed cancer
among both men and woman in the United States, and the second
leading cause of cancer related deaths. When colorectal cancer
is detected and treated early, survival is greatly enhanced.
However, despite the availability of proven screening tests,
only 37 percent of colorectal cancers are diagnosed while the
disease in still in a localized stage.
The Committee is pleased with the leadership of CDC's
National Colorectal Cancer Roundtable in promoting the
availability and advisability of screening to both health care
providers and the general public. The Committee encourages the
CDC to continue to expand its partnerships with State health
departments, professional and patient organizations, and
private industry to combat this devastating disease.
Delta Health Initiative.--The Mississippi Delta Region
experiences some of the Nation's highest rates of chronic
diseases, such as diabetes, hypertension, obesity, heart
disease and stroke. The Committee recognizes the efforts of the
Delta Health Alliance in health education, coordination of
health services and health-related research in the Mississippi
Delta. The Committee believes that such collaborative,
community-based programs offer the best hope for breaking the
cycle of poor health in underprivileged areas such as the
Mississippi Delta. The Committee recommends that the CDC
collaborate with the Delta Health Alliance in addressing the
chronic health issues of the Mississippi Delta.
Diabetes.--The Committee commends CDC for implementation of
SEARCH, a pilot study to determine the incidence and prevalence
of diabetes in youth under the age of 20 years in six locations
around the United States. The Committee encourages CDC to
consider developing a plan to use the information gathered from
SEARCH to create a national registry of patients afflicted with
juvenile diabetes. In addition, the Committee encourages CDC to
take advantage of the opportunity to also collect information
about the standard of care available to people with diabetes
nationwide. Samples from this study may represent a valuable
scientific resource, and the Committee encourages CDC to
consider making these samples and information available to the
research community.
The Committee encourages the CDC to continue and expand its
efforts to standardize the measurement of C-peptide as a
surrogate marker for pancreatic beta cell function. The
development and validation of reliable, standard assays for C-
peptide have the potential to significantly accelerate
regulatory approval of new therapies to prevent or reverse
autoimmune diabetes.
Diabetes and Obesity in Minority Populations.--The
Committee is concerned by the toll that the twin epidemics of
diabetes and obesity are taking on the health of minorities. An
effective culturally-sensitive response is urgently needed to
address this escalating epidemic. The Committee encourages CDC
to fund initiatives of national and community organizations
that have the capacity to carry out coordinated health
promotion programs that will focus on diabetes and obesity in
minority communities. The Committee encourages CDC to seek out
organizations directed by and serving individuals from
communities with disproportionate diabetes and obesity rates.
The high incidence of diabetes among Native American,
Native Alaskan, and Native Hawaiian populations persists. The
Committee is pleased with the CDC's efforts to target this
population, in particular, to assist the leadership of Native
Hawaiian and Pacific Basin Islander communities. It is
important to incorporate traditional healing concepts and to
develop partnerships with community health centers. The
Committee encourages CDC to build on all its historical efforts
in this regard.
Epilepsy.--The Committee supports the CDC epilepsy program,
which is making progress in research, epidemiology and
surveillance, early detection, improved treatment, public
education and expansion of interventions to support people with
epilepsy and their families in their communities. The Committee
applauds CDC's partnership with the Epilepsy Foundation in
developing the recommendations of Living Well with Epilepsy II.
Sufficient funding has been provided to continue this
partnership and to implement ongoing epilepsy public health
programs.
Genomic Medicine.--The Committee is aware that steps need
to be taken today to prepare the public health system for the
coming widespread use of genetic technologies in healthcare.
Failing to do so may exacerbate existing health disparities and
seriously limit progress generated by the Human Genome Project.
The Committee urges CDC to move forward aggressively with the
creation and implementation of partnerships with industry and
the nonprofit sector to achieve the widest benefits from the
coming era of genomic medicine.
Geraldine Ferraro Cancer Education Program.--In fiscal year
2004, Congress provided funding to initiate the Geraldine
Ferraro Cancer Education Program, as authorized by the
Hematological Cancer Research Investment and Education Act of
2002. The Committee is pleased that CDC has established a
cooperative agreement program with national health
organizations to develop strategies to provide information and
education for patients, their family members, friends, and
caregivers with respect to hematologic cancers. The Committee
expects CDC to increase efforts to address hematologic cancer
survivorship issues and improve quality of national hematologic
data. With the additional funds provided, the Committee
strongly encourages CDC to support activities related to the
development of interactive web based education for health care
providers on the signs, symptoms and current treatment of blood
cancer by comprehensive cancer centers.
Glaucoma and Other Vision Disorders.--Age-related threats
to sight, including age-related macular degeneration, glaucoma,
cataracts and diabetic retinopathy are expected to nearly
double by the year 2030 with the aging of the baby-boomer
generation. Recognizing this emerging public health threat, the
Committee is aware of the demonstrated success of vision
screening programs in preventing blindness and vision
impairments among many of the more than 30 million adults that
suffer from eye-related disorders.
The Committee is encouraged by the CDC's exploration of
strategies to implement a national initiative to combat the
effects of eye-related disorders, especially glaucoma. The
Committee has included sufficient resources to maintain at
least the fiscal year 2005 level for vision screening and
education programs in partnership with national voluntary
health agencies and for CDC to continue to develop a national
surveillance system to monitor trends over time and assess the
economic costs of vision loss especially related to glaucoma.
In addition, the Committee has again included sufficient
resources to maintain at least the fiscal year 2005 level of
funding for a model project that is testing and evaluating the
efficacy of glaucoma screening using mobile units.
Heart Disease and Stroke.--The Committee understands that
CDC is establishing a Heart Disease and Stroke Division to
consolidate and elevate its efforts to prevent and control
heart disease, stroke and other cardiovascular diseases. The
Committee supports the goal of establishing a Heart Disease and
Stroke Prevention program in each State. The Committee
encourages CDC to maintain support for these activities in
fiscal year 2006 within the funds provided.
Inflammatory Bowel Disease.--The Committee understands that
an estimated 1 million people in the United States may suffer
from Crohn's disease or ulcerative colitis, collectively known
as inflammatory bowel disease [IBD]. In fiscal year 2005, the
Committee provided funds to continue a national IBD
epidemiology program established through a partnership between
CDC and the Crohn's and Colitis Foundation of America. The
Committee encourages the CDC to continue this important
initiative and has provided sufficient resources to do so.
Interstitial Cystitis.--The Committee is pleased by the
establishment of a cooperative agreement between the CDC and
the Interstitial Cystitis Association and has included funds to
continue the public and professional education initiative
regarding interstitial cystitis.
Lung Disease.--The Committee encourages the CDC to consider
supporting efforts to validate the importance of spirometry
screenings in early detection of lung disease. Such efforts
include further research and development of projects to
facilitate the translation of new scientific knowledge into
spirometry public health screening programs. The Committee
urges the CDC to coordinate with the National Heart, Lung and
Blood Institute in translating the results of these efforts
into guidance for public health programs, including vital signs
and screening programs.
Lupus.--The Committee recognizes that lupus is a serious,
complex, debilitating chronic autoimmune disease that can cause
inflammation and tissue damage to virtually any organ system in
the body and impacts between 1.5 and 2 million individuals. The
Committee is concerned by the lack of reliable epidemiological
data on the incidence and prevalence of all forms of lupus
among various ethnic and racial groups. The Committee
encourages CDC to consider modifying the National Lupus Patient
Registry to create a common data entry and management system
across all study sites, to collaborate with a consortium of
academic health centers with an expertise in lupus
epidemiology, and to ensure that study sites represent
different geographic regions of the United States that have a
sufficient number of individuals of all racial and ethnic
backgrounds disproportionately affected by Lupus, including
Hispanics, Asians, Native Americans, and African Americans.
Mind-Body Research.--The Committee continues to support
mind-body research and has provided sufficient funding to
continue these efforts in the same form and at the same level
as in fiscal year 2005.
National Information Center on Vision Loss.--The Committee
encourages CDC to create a National Information Center on
Vision Loss to address the need for access to appropriate
public health information to improve the well being and prevent
further disability and disease among persons who are blind or
visually impaired. The Committee encourages CDC to partner with
a national nonprofit organization that has regional offices
throughout the United States and is recognized for its
dedication and leadership in providing information to persons
who are blind.
Nutrition, Physical Activity and Obesity.--Obesity is
rampant in the United States. Between 1980 and 1994, the
prevalence of obesity in the United States has increased by 100
percent in children and adolescents. More than 20 percent of
the adult population is 30 pounds or more overweight and 10 to
15 percent of children and adolescents are overweight. Risk
factors associated with obesity--physical inactivity and
unhealthy eating--account for at least 300,000 preventable
deaths each year and increase the risk for many chronic
diseases like diabetes, heart disease and cancer. The Committee
is aware that the CDC's own statistics show that Native
Americans, including Native Alaskans and Native Hawaiians
suffer higher rates of obesity than other Americans. The
Committee has included sufficient resources to provide the same
level of support provided in fiscal year 2005 for Nutrition,
Physical Activity, and Obesity related activities.
The multiple factors contributing to the overweight and
obesity epidemic took years to develop. Reversing the epidemic
will require a long-term, well-coordinated, concerted approach
to reach Americans where they live, work, play, and pray.
Effective collaboration among the public, voluntary, and
private sectors is critical to reshape the social and physical
environment of our Nation's communities and provide the
necessary support, information, tools, and realistic strategies
needed to reverse the current obesity trends nationwide.
To reduce consumer confusion about the myriad of health
messages about obesity, diabetes, and cardiovascular disease,
the Committee encourages CDC to design and develop mechanisms
for fast-tracked translation of research into reasoned guidance
for the American public.
To prevent unhealthy weight gain and maintain healthy
weight among children and adolescents, CDC is encouraged to
work with the U.S. Department of Education to issue a report
with recommendations about reintroducing physical education
into the school day.
Oral Health.--The Committee recognizes that to effectively
reduce disparities in oral disease will require improvements at
the State and local levels. The Committee has provided
additional funding to States to strengthen their capacities to
assess the prevalence of oral diseases, to target
interventions, such as additional water fluoridation and
school-linked sealant programs, and resources to the
underserved, and to evaluate changes in policies, programs and
disease burden. The Committee encourages the CDC to advance
efforts to reduce the disparities and health burden from oral
cancers that are closely linked to chronic diseases such as
diabetes and heart disease.
The Committee is concerned about the rising obesity rate
among American's youth. Some eating habits can adversely affect
not only body weight but also oral health. The Committee has
provided $50,000 above the fiscal year 2005 level for the CDC
Division of Oral Health to develop an instructional video for
school age children on the harmful effects of excessive
consumption of soft drinks. The Committee understands that the
dental community has already developed some instructional
materials and urges CDC to work with the American Dental
Association in producing the video.
Osteoporosis and Bone Health Action Plan.--The Committee is
aware of the Surgeon General's report on Bone Health and
Osteoporosis. The Surgeon General calls for a national action
plan for bone health. The Committee encourages CDC to
collaborate with a leading national voluntary health
organization focused on osteoporosis and bone health to confer
with other relevant Federal agencies and public and private
stakeholders to develop a National Action Plan on Bone Health
and Osteoporosis.
Prevention Centers.--The Committee encourages the continued
support of center activities aimed at improving knowledge about
the effective models for 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.
Primary Immunodeficiency Diseases.--Congress has made funds
available for CDC to support the national physician education
and public awareness campaign developed by the Jeffrey Modell
Foundation. The Foundation program has generated more than
$35,000,000 in donated media coverage, resulted in substantial
increases in the number of diagnosed patients, and is a model
of public-private cooperation. The campaign has featured public
service announcements, physician symposia, publications, and
the development of website and educational materials, as well
as mailings to physicians, school nurses, daycare centers, and
others. The campaign was expanded to reach the underserved
African-American population in fiscal year 2005, and the
Committee has provided $84,000 above the fiscal year 2005 level
to further expand the program to Hispanic communities in fiscal
year 2006.
Prostatitis.--The Committee understands that up to 10
percent of the male population worldwide may benefit from
better methods to diagnose and prevent prostatitis. The
Committee encourages CDC to consider expanding its
investigation of the etiology of prostatitis.
Psoriasis.--The Committee urges CDC to consider working
with a national organization to develop a surveillance program
to ascertain and monitor psoriasis and psoriatic arthritis
prevalence and comorbidities.
Pulmonary Hypertension.--The Committee continues to be
interested in pulmonary hypertension [PH], a rare, progressive
and fatal disease that predominantly affects women, regardless
of age or race. PH causes deadly deterioration of the heart and
lungs and is a secondary condition in many other serious
disorders such as scleroderma and lupus. Because early
detection of PH is critical to a patient's survival and quality
of life, the Committee encourages CDC to consider supporting a
cooperative agreement with the pulmonary hypertension community
to foster greater awareness of the disease.
Reorganization.--The Committee understands that the CDC is
considering the reorganization of programs under the
Coordinating Center on Health Promotion, particularly programs
under the National Center on Chronic Disease Prevention and
Health Promotion. The Committee encourages the Director to work
closely with external partners to adopt changes that will
streamline administrative functions, improve and strengthen
collaboration among programs, and increase public awareness of
these serious illnesses.
REACH Initiative.--The Committee recognizes the strengths
that national/multi-geographical minority organizations may be
able to provide to the REACH Initiative. Such organizations
could have the capacity to influence communities through pre-
existing coalitions and collaborative relationships. Such
organizations may also be able to provide key support to local
organizations that may lack the infrastructure needed to fully
implement the programmatic activities required for this
important program. The Committee urges CDC to include such
organizations among the entities that are eligible to compete
for funding without preventing other applicants from receiving
these grants.
Sleep Disorders.--The Committee continues to be concerned
about the prevalence of sleep disorders and recognizes the need
for enhanced public and professional awareness on sleep and
sleep disorders. The Committee encourages CDC to consider
working with other agencies and voluntary health organizations
to support the development of a sleep education and public
awareness initiative.
Steps to a Healthier United States.--The Committee applauds
the Department's continued commitment to tackling the problems
of obesity, diabetes, and asthma. The Committee agrees that
these are three of the most critical chronic conditions
afflicting Americans. The Committee is concerned that existing
programs that address these problems have not yet been
implemented in all of the States. The Committee has provided
sufficient resources to continue this initiative and existing
programs within CDC that are aimed at obesity, diabetes, and
asthma. The Committee strongly urges CDC to coordinate the
efforts of these programs such that the best possible outcome
is achieved using these funds.
Thrombosis.--The Committee understands that thrombosis is a
serious public health problem and that there is a great need to
increase public awareness of thrombosis and thrombophilia among
the public and the medical community. Information on the basic
epidemiology of thrombosis and thrombophilia remains to be
collected. The Committee encourages CDC to expand its efforts
by partnering with a volunteer health organization to expand
its outreach and education programs regarding thrombosis and
thrombophilia.
Tobacco Use.--The Committee recognizes the effectiveness of
State and national counter-marketing campaigns in reducing
youth tobacco use and the diminishing resources at the State
and national levels for such efforts. The Committee has
provided increased funding for tobacco activities to support
counter marketing programs targeting areas with the highest
rates of youth tobacco use.
Vision Screening.--The Committee commends CDC for its
partnership with a leading voluntary health association
dedicated to fighting blindness and saving sight, improving
education and early detection of potentially blinding eye
diseases. Despite the fact that half of all blindness can be
prevented through education, early detection and treatment, it
is estimated that the number of blind and visually impaired
people will double by 2030 if nothing is done to curb vision
problems. To address this growing public health problem, the
Committee has provided sufficient resources to continue this
partnership with the same association.
Birth Defects, Developmental Disabilities, Disability and Health
Within the total provided, the following amounts are
provided for the specified activities above the comparable
amount for fiscal year 2005: $200,000 to expand autism
surveillance, awareness, and education activities; $75,000 to
expand the National Spina Bifida Program; $73,000 to expand
surveillance and epidemiological efforts of Duchenne and Becker
muscular dystrophies; $48,000 to expand support for the Special
Olympics Healthy Athletes Initiative and $500,000 to expand the
activities of the Christopher and Dana Reeve Paralysis Resource
Center; all other sub-activities are funded at the level of the
administration's request. In addition, the Committee has
provided $936,000 over the fiscal year 2005 level for
undesignated birth defect-related activities.
Autism.--The Committee is aware of the progress that has
been made with the autism programs at CDC. The Committee
acknowledges the importance of this work by the CDC in the area
of autism surveillance and research, and urges this work to
continue in a timely manner. Within funds provided, $100,000 in
new funding is available to fund the Center's surveillance and
research programs including the CADDRE and ADDM Network. The
Committee is pleased to see the work being done in the area of
the national awareness campaign and provides an additional
$100,000 for the Center to expand its work on this initiative.
Centers for Birth Defects Research and Prevention.--The
Committee encourages CDC to consider expanding the promising
research being conducted by the regional Centers for Birth
Defects Research and Prevention and maintain assistance to
States to implement and expand community-based birth defects
tracking systems, programs to prevent birth defects, and
activities to improve access to health services for children
with birth defects. The Committee also encourages CDC to
continue to support collaboration among the States on issues
related to surveillance, research and prevention through
support of the National Birth Defects Prevention Network.
CHADD Resource Center.--The Committee is aware that some
estimates indicate that as many as 7 percent of school-age
children have Attention-Deficit/Hyperactivity-Disorder [AD/HD]
and more than two-thirds of these children will continue to
experience symptoms through adulthood. The Committee has been
informed that only half of all children with AD/HD receive
necessary treatment with lower diagnostic and treatment rates
among girls, minorities and children in foster care. The
Committee continues to support the National Resource Center on
AD/HD and has provided sufficient resources to provide the same
level of support as was provided in fiscal year 2005.
Christopher and Dana Reeve Paralysis Resource Center.--The
Committee understands the growing demand for information,
resources, and public health services by individuals with
paralysis. The Committee has included $500,000 above the fiscal
year 2005 level for the Paralysis Resource Center and the
associated rehabilitation therapy program. The Committee
encourages CDC to evaluate the public health effectiveness of
the paralysis programs and explore the feasibility of health
care system-wide implementation of new rehabilitation programs.
Cooley's Anemia.--The Committee is pleased with the
progress that CDC has made with regard to the establishment of
a blood safety surveillance program for Cooley's anemia
patients, who are the largest consumers of red blood cells. Six
treatment centers throughout the Nation handle the medical
monitoring and treatment; the Cooley's Anemia Foundation
provides education and awareness, patient recruitment, and
other services; and, CDC has created an archive of tested and
analyzed blood samples. The Committee expects CDC to direct an
increasing amount of the funds available to education and
awareness, patient recruitment and other related services.
Craniofacial Malformation.--The Committee has continued
funding for CDC's initiatives to help families of children with
craniofacial malformations. The Committee commends CDC for
their work with the National Foundation for Facial
Reconstruction and has provided funds to continue the
Foundation's efforts with Arkansas, Iowa, and New York and
possibly other States to collect data on the prevalence of
these malformations, the ability of families to access
services, and the long-term outcomes associated with
craniofacial malformation. Funds are also available to analyze
and disseminate this information to families and health care
professionals and to define and categorize established
standards of optimal care.
Diamond Blackfan Anemia.--The Committee has provided
sufficient funds to continue CDC's public health outreach and
surveillance program for Diamond Blackfan Anemia [DBA]. These
funds should continue to be used to (a) educate clinicians and
blood disorder treatment centers about DBA and how to diagnose
it and (b) collaborate with a Clinical Care Center, which
already has significant experience in treating DBA patients, to
create a critical mass of DBA expertise where DBA patients may
be referred.
Disabilities Prevention.--The Committee continues to
strongly support the CDC disabilities prevention program, which
provides support to States and academic centers to reduce the
incidence and severity of disabilities, especially
developmental and secondary disabilities.
Down Syndrome.--The Committee understands that CDC is
performing a study to estimate the number of people in the
United States living with Down syndrome and identify them by
age and ethnic group and expects to have preliminary results by
the end of fiscal year 2005. A second study will document the
onset and course of secondary and related developmental and
mental disorders in individuals with Down syndrome. The
Committee has provided sufficient resources to further develop
this studies in fiscal year 2006.
Duchenne and Becker Muscular Dystrophy.--The Committee has
provided $6,000,000 to continue and expand surveillance,
epidemiological, and education efforts for Duchenne and Becker
muscular dystrophy. The Committee is pleased that the CDC and
the Parent Project Muscular Dystrophy have established a
coordinated education and outreach initiative and has provided
sufficient resources to continue this initiative at least at
the fiscal year 2005 level. The Committee requests that CDC
develop and submit to the Committee a 5-year strategic plan for
the Duchenne and Becker Muscular Dystrophy program by May 1,
2006.
Fetal Alcohol Spectrum Disorders.--The Committee is
concerned by the prevalence of Fetal Alcohol Spectrum Disorders
[FASD] in the United States and notes that drinking during
pregnancy is the Nation's leading known preventable cause of
mental retardation and birth defects. FASD affects 1 in 100
live births or as many as 40,000 infants each year, and an
individual with fetal alcohol syndrome can incur a lifetime
health cost of over $800,000. To publicize and promote
awareness of this critical updated public health information,
the Committee has provided sufficient resources to continue
these activities.
Fetal Deaths.--CDC has reported that fetal deaths at 20
weeks gestation or greater account for nearly as many deaths as
those that occur to infants during the first year of life. In
fiscal year 2005, the Committee included funding to implement a
demonstration project with several States to link existing
birth defect surveillance systems and fetal death registries
and to use that data to help develop strategies to reduce fetal
deaths. The Committee is aware that the first year of the
demonstration project was highly successful. A review of the
public health burden of fetal deaths, identification of data
gaps related to surveillance and risk factors, and a plan to
expand broader birth defects surveillance to include
surveillance of fetal deaths were produced. The Committee
supports continued funding of the project at the same level in
fiscal year 2006 to develop a detailed protocol for the
surveillance project, which should include identifying possible
data sources, developing and testing data collection
instruments and standard methods for surveillance of fetal
deaths, and pilot testing and evaluating the surveillance
project.
Fragile X.--The Committee is encouraged by the CDC's
progress in establishing a Fragile X public health program to
expand surveillance and epidemiological research of Fragile X,
as well as provide patient and provider outreach on Fragile X
and other developmental disabilities. The Committee has
provided sufficient resources to continue these activities.
Genomic Medicine.--The Committee is aware that steps need
to be taken today to prepare the public health system for the
coming widespread use of genetic technologies in healthcare.
Failing to do so may exacerbate existing health disparities and
seriously limit progress generated by the Human Genome Project.
Hemophilia.--The Committee supports CDC's continued efforts
with the National Hemophilia Foundation to carry out needed
education, prevention, blood safety surveillance, and outreach
programs for the millions of people in the United States
affected by bleeding and clotting disorders, including
hemophilia, women's bleeding disorders, and thrombophilia. The
Committee encourages CDC to consider enhancing its support of
the network to ensure continued access to this comprehensive
chronic care model for all persons with bleeding and clotting
disorders.
The Committee recognizes the important work of all
voluntary organizations concerned with hemophilia, and
encourages CDC to take steps to ensure that additional patient-
based organizations can participate in its hemophilia grant
program on an annual basis.
Hereditary Hemorrhagic Telangiectasia.--The Committee is
aware of interest in the establishment of a Hereditary
Hemorrhagic Telangiectasia [HHT] National Resource Center
through a partnership between the CDC and the national
voluntary agency representing HHT families. The Committee
encourages the CDC to examine carefully proposals to establish
such a center and give appropriate consideration to supporting
it within the funds provided.
Human Genome Project.--The Committee urges CDC to move
forward aggressively with the creation and implementation of
partnerships with industry and the nonprofit sector to achieve
the widest benefits from the coming era of genomic medicine.
Limb Loss Information Center.--The Committee understands
that more than 1.5 million Americans are living with limb loss
due to diabetes, heart disease, trauma, and cancer. A key
challenge facing individuals with limb loss is gaining access
to necessary health and rehabilitative services. The Committee
commends CDC for its collaborations with voluntary
organizations, such as the Amputee Coalition of America, to
identify strategies to remove these barriers. The Committee
continues to support the CDC's resource and information center,
which assists individuals living with disabilities, and their
families, in need of information on medical, physical, and
emotional needs, and resources and support to reintegrate
socially and economically into society. The Committee
encourages CDC to continue its support of the existing Center
at no less than the fiscal year 2005 level.
Special Olympics Healthy Athletes Initiative.--To address
the unmet health needs among its athletes, Special Olympics
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
competitions at local, State, national, and international
levels. The Committee has included $48,000 above the fiscal
year 2005 level for this program.
Spina Bifida.--The Committee recognizes that Spina Bifida
is the leading permanently disabling birth defect in the United
States. While Spina Bifida and related neural tube defects are
highly preventable through proper nutrition, including
appropriate folic acid consumption, and its secondary effects
can be mitigated through appropriate and proactive medical care
and management, such efforts have not been adequately supported
or coordinated to result in significant reductions in these
costly conditions. Also, the Committee supports the Memorandum
of Understanding between CDC and the Agency for Healthcare
Research and Quality to examine clinical treatment of Spina
Bifida and improve quality of life.
HEALTH INFORMATION AND SERVICE
The Coordinating Center for Health Information and Services
includes the National Center for Health Statistics [NCHS], a
new National Center for Health Marketing, and a new National
Center for Public Health Informatics.
The Committee recommends a program level of $223,799,000
for Health Information and Service related activities at the
CDC. This recommendation includes $134,235,000 in transfers
available under section 241 of the Public Health Service Act.
The fiscal year 2005 comparable program level was $228,673,000
and the administration requested $223,799,000.
Health Statistics
CDC's statistics give context and perspective on which we
can base important public health decisions. By aggregating the
experience of individuals, CDC gains a collective understanding
of health, 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 NCHS is the Nation's preeminent source of health
statistics and therefore provides the foundation for assessing
National health trends and developing sound programs and
policies to protect and enhance the Nation's health. The
Committee is concerned with the adequacy and overall
coordination of the various Federal programs that collect,
analyze, and report the health statistics necessary for policy
development and public health interventions. During this period
of rapid advance in health and welfare policy, medical
practice, and biomedical knowledge, the Committee is committed
to ensuring that timely and relevant health statistics are
available to guide policy decisions. The Committee has provided
additional funds for the NCHS to strengthen its data collection
infrastructure.
Eating Disorders.--The Committee is concerned about the
growing incidence and health consequences of eating disorders
among the population. The extent of the problem while estimated
by several long-term outcome studies as being high remains
unknown. The Committee urges the CDC to research the incidence
and morbidity and mortality rates of eating disorders,
including anorexia nervosa, bulimia nervosa, binge eating
disorder, and eating disorders not otherwise specified across
age, race, and sex.
ENVIRONMENTAL HEALTH AND INJURY PREVENTION
The Coordinating Center for Environmental Health and Injury
Prevention includes the National Center for Environmental
Health, the Agency for Toxic Substances and Disease Registry,
and the National Center for Injury Prevention and Control.
The Committee recommends $288,982,000 for environmental
health and injury prevention related activities at the CDC. The
fiscal year 2005 comparable level was $285,721,000 and the
administration requested $284,820,000 for fiscal year 2006.
Environmental Health
Within the total provided, $400,000 above the fiscal year
2005 level is to expand the Health Tracking Network. All other
activities are funded at the level of the administration's
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. 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.--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 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 populations in
underserved communities. To further facilitate this effort, CDC
is encouraged to partner with voluntary health organizations to
support program activity consistent with the CDC's efforts to
fund community-based interventions that apply effective
approaches demonstrated in research projects within the
scientific and public health community.
Biomonitoring.--The CDC's National Report on Human Exposure
to Environmental Chemicals is a significant new exposure tool
that provides invaluable information for setting research
priorities and for tracking trends in human exposures over
time. The Committee continues to support the CDC environmental
health laboratory's efforts to provide exposure information
about environmental chemicals. The Committee understands that
for most chemicals it is currently difficult to interpret
biomonitoring information in a health risk context. Therefore,
the Committee encourages CDC to develop the necessary methods
to better interpret human biomonitoring concentrations in the
context of potential health risks. The Committee applauds the
CDC's biomonitoring efforts and encourages the Agency to
continue this program and continue to improve its efforts to
communicate these results in context.
Childhood Lead Poisoning Prevention.--The Committee
commends the CDC for its commitment to support the enhanced
development of a portable, hand-held lead screening device that
holds great promise for increasing childhood screening rates in
underserved communities. Further development of this device
will help ensure its application in community health settings.
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.
Health Tracking Network.--The Committee has provided
$400,000 over the fiscal year 2005 level to continue and expand
the development of a Health Tracking Network, which seeks to
develop a surveillance system that can integrate environmental
hazards data with human exposure and health effects data that
have possible links to the environment. With health tracking,
public health officials can better target preventive services,
health care providers can offer better health care, and the
public will be able to develop a clear understanding of what is
occurring in their communities and how overall health can be
improved.
Landmine Survivor Network.--The Committee commends CDC for
its partnership with the Landmine Survivor Network that has
developed peer support networks for landmine survivors in six
mine-affected countries. The Committee has included sufficient
resources to continue support of the network at no less than
the fiscal year 2005 level. These funds will be used to expand
peer support networks and the number of survivors that are
reached in network and non-network countries; strengthen the
capacity of medical and rehabilitative care facilities to
address the needs of amputees; enhance economic opportunities
for survivors; and further CDC programs and research for
victims of landmines, civil strife and warfare.
Volcanic Emission and Asthma.--The problem of asthma in
Hawaii remains a serious health threat and challenge,
especially among the medically underserved. In particular, the
problem of volcanic emissions in Hawaii contributes to this and
other respiratory problems. The Committee encourages CDC to
consider potential interventions that may be helpful.
Injury Prevention and Control
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 non-occupational 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.
Within the total provided, the Committee has provided
$2,500,000 over the fiscal year 2005 level for Youth Violence
Prevention base funding; sufficient resources to support the
National Violent Death Reporting System at the fiscal year 2005
level; and undesignated funding of $780,000 to the National
Center for Injury Prevention and Control. Sufficient funds have
been included to continue or increase support for all existing
Injury Control Research Centers.
National Violent Death Reporting System.--The Committee is
supportive of the National Violent Death Reporting System,
which is a State-based system that collects data from medical
examiners, coroners, police, crime labs, and death certificates
to understand the circumstances surrounding violent deaths. The
information can be used to develop, inform, and evaluate
violence prevention programs. The Committee has provided
sufficient resources to continue this program with at least the
fiscal year 2005 level of funding. The Committee urges the CDC
to continue to work with private health and education agencies
as well as State agencies in the development and implementation
of an injury reporting system.
Suicide Prevention.--The Committee is aware that suicide
remains the third leading cause of death among adolescents aged
10-19. Research has determined that those adolescents most at
risk often suffer from mental disorders, including depressive
disorders and substance abuse. Other risk factors, which
interact with mental disorders to increase risk for adolescent
suicide, may include family discord, school-related problems,
obesity, contact with the juvenile justice system and exposure
to the suicide of others. The Committee encourages CDC to
consider the extent to which mental health screenings
incorporated into ongoing prevention efforts regarding obesity,
STDs and self-injury may serve to identify youth at risk. The
Committee requests that CDC report on its findings to the
Committee by May 1, 2006.
The Committee encourages CDC to consider supporting the
evaluation of suicide prevention planning, programs, and
communication efforts to change knowledge and attitudes and to
reduce suicide and suicidal behavior. These evaluation efforts
would support communities to identify promising and effective
suicide prevention strategies that follow the public health
model and build community resilience.
Violence Against Women.--The Committee urges CDC to
increase research on the psychological sequelae of violence
against women and expand research on special populations and
their risk for violence including adolescents, older women,
ethnic minorities, women with disabilities, and other affected
populations.
Youth Violence.--The Committee has included $2,500,000
above the fiscal year 2005 level for CDC's youth violence
prevention activities. The Committee notes that the level of
youth violence in cities around the Nation is troubling. The
city of Philadelphia, in particular, has experienced a spike in
youth violence. The Committee encourages CDC to use some of the
increase to address the growing number and seriousness of
violent acts committed by youth in urban areas such as
Philadelphia.
OCCUPATIONAL SAFETY AND HEALTH
The Committee recommends $257,121,000 for occupational
safety and health programs. The fiscal year 2005 level was
$286,041,000 and the administration requested $285,930,000 for
fiscal year 2006. The Committee recommendation includes
$87,071,000 in transfers available under section 241 of the
Public Health Service Act. Sufficient funds have been included
to maintain staffing levels at the Morgantown facility.
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 construction
sites to coal mines.
The Committee recognizes NIOSH as one of the Agency's 5
coordinating centers. Given its unique statutory requirements,
this is the appropriate placement of NIOSH within CDC's current
structure. It is the expectation of the Committee that CDC will
afford NIOSH all the rights and privileges of this status in
the organization including participation on CDC's Executive
Leadership Board as well as the Management Council given that
these are the policy and decision-making bodies of the Agency.
In fiscal year 2005, the Committee separated actual program
costs from the administration of those programs by reallocating
all administrative costs (except those of NIOSH) to a new
account: Business Services Support. This enabled CDC to more
easily interpret Congress' intent with funding increases meant
for either programs or administration of those programs. In
fiscal year 2006, the Committee recommends reallocating
$34,800,000 from the NIOSH line item to the Business Services
and Support line item. This reallocation is equal to the
administrative costs associated with NIOSH in fiscal years 2004
and 2005 and will end the need for continued central business
services assessments, except those that are assessed across the
entire Department of Health & Human Services. A reprogramming
request will be required for any additional CDC assessment on
the NIOSH budget line. All comparisons to fiscal year 2005
levels and the budget request have been adjusted to reflect
this reallocation.
The Committee recognizes that NIOSH, as the only Federal
Agency for occupational safety and health research and
prevention, provides national and international leadership to
prevent work-related illness, injury, and death by gathering
information, conducting scientific research, and translating
the knowledge gained into products and services. Examples
include the recently launched Research to Practice [r2p]
initiative, which continues to gain momentum, and the next
decade of the National Occupational Research Agenda [NORA-2].
The Committee applauds the goal of r2p, which is to reduce or
eliminate occupational disease and injury by helping to ensure
an increased impact of NIOSH-funded research in the workplace.
The Committee notes that NIOSH is now consulting with partners
and stakeholders to plan for NORA-2, which will be a review of
the decade for the 21 priority research areas, examining the
state of the science, noting key changes, identifying NORA
contributions, discussing gaps and lessons learned, and making
recommendations for the future.
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 and has included funding to
continue this important worker safety initiative.
Education and Research Centers.--The Committee recognizes
the important role Education and Research Centers [ERCs] play
in preventive health research and the training of occupational
safety and health professionals, and includes an increase of
$500,000 for ERCs over the amount appropriated for ERCs in
fiscal year 2005.
Energy Employees Occupational Illnesses.--Not later than 6
months after enactment of this Act, NIOSH should provide a
report to the Committee which: (1) identifies the cancer types
which are not included in the list of 22 ``specified cancers''
under the Energy Employees Occupational Illness Compensation
Program Act (42 U.S.C. 7384 et seq.) but for which exposure to
internal or external ionizing radiation of any type can be
shown to cause or contribute to the development of a cancer;
(2) recommend the cancer types to be added to the list of
specified cancers for individuals covered in the Special
Exposure Cohort, with a justification for including such
cancers and a ranking in order of priority based on
radiosensitivity; (3) for each Special Exposure Cohort in
effect on the date of submission of this report to Congress,
identify the number of cases by facility for which there is a
Special Exposure Cohort for each cancer type listed in item
(2). The Secretaries of Labor and Health and Human Services are
encouraged to amend their respective implementing regulations
to include the list of cancers covered in the above referenced
report for purposes of defining specified cancers for members
of special exposure cohorts.
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.
Miners' Choice Health Screening Program.--The Committee is
concerned that sufficient resources were not allocated to
implement the Miners' Choice Health Screening Program in fiscal
year 2005. The Committee urges NIOSH to implement this program
in fiscal year 2006. This program was initiated to encourage
all miners to obtain free and confidential chest x-rays to
obtain more data on the prevalence of Coal Workers'
Pneumonconiosis in support of development of new respirable
coal dust rules. The Committee is strongly supportive of these
efforts and urges NIOSH to work to improve this health
screening program thereby helping to protect the health and
safety our Nation's miners.
Mining Research Program.--The Committee has provided
sufficient resources to maintain the fiscal year 2005 level of
funding for NIOSH's Mining Research Program.
National Occupational Research Agenda.--The Committee
recommendation includes sufficient resources to maintain
funding at the fiscal year 2005 level for CDC's National
Occupational Research Agenda [NORA]. The Committee believes
that NORA is a critical scientific research program that
protects employees and employers from the high personal and
financial costs of work site health and safety losses.
Industries such as agriculture, construction, health care, and
mining benefit from the scientific research supported by NORA.
The program's research agenda focuses on prevention of disease
and injury resulting from infectious diseases, cancer, asthma,
hearing loss, musculoskeletal disorders, traumatic injuries,
and allergic reactions, among others. The Committee continues
to strongly support NORA and encourages expansion of its
research program to cover additional causes of work place
health and safety problems.
National Mesothelioma Registry.--The Committee has provided
$1,000,000 for the establishment of a National Mesothelioma
Registry to collect data regarding symptoms, pathology,
evaluation, treatment, outcomes, and quality of life and a
Tissue Bank to include the pre- and post-treatment blood (serum
and blood cells) specimens as well as tissue specimens from
biopsies and surgery. The Committee intends that not less than
$500,000 of this amount should be allocated for the collection
and maintenance of tissue specimens.
National Personal Protective Technologies Laboratory.--The
Committee provides sufficient resources to maintain the fiscal
year 2005 level of funding for the NIOSH National Personal
Protective Technologies Laboratory to expedite research and
development in, and certification of, protective equipment,
such as powered air purifying respirators, and combined self-
contained breathing apparatus/escape sets.
GLOBAL HEALTH
The Committee recommends $313,227,000 for global health
related activities at the CDC in fiscal year 2006. The fiscal
year 2005 comparable level was $308,863,000 and the
administration requested $306,079,000 for fiscal year 2006. The
Office of Global Health will lead and coordinate CDC's global
programs to promote health and prevent disease in the United
States and abroad, including ensuring rapid detection and
response to emerging health threats. Within the total provided,
all of the programs, except the global immunization program and
the global malaria program, have been funded at the level
requested by the administration.
Global HIV/AIDS.--CDC works with governments in 25
countries in Africa, Asia and Latin America and the Caribbean
focusing on primary prevention of HIV/AIDS; care and treatment
of tuberculosis and other opportunistic infections, palliative
care and appropriate use of antiretroviral medications; and
infrastructure and capacity development.
The Committee notes that funding for continuation of the
International Mother and Child HIV Prevention Initiative [MTCT]
has been requested in the budget for the Department of State
under the jurisdiction of the Foreign Operations Appropriations
Subcommittee. Therefore, the Committee does not provide any
funding for the program in the CDC, however, the Committee
remains supportive of this critical program. The Committee
encourages CDC to ensure that funds provided to the MTCT
program, the CDC GAP initiative, and the Global Fund for HIV/
AIDS, Tuberculosis, and Malaria are used in a coordinated and
complementary fashion.
Global Disease Detection.--The Committee commends CDC for
its role in strengthening the capacity of the public health
community, both at home and abroad, to respond to global
threats, such as SARS, monkeypox, West Nile virus, pandemic flu
and bioterrorism. CDC's Global Disease Detection System is
integral to these efforts. This system is designed to provide
worldwide technical support to ensure rapid and accurate
diagnoses of emerging infectious disease events, and to provide
a secure link between clinicians and laboratories and CDC and
the World Health Organization to ensure real-time reporting of
emerging threats. The Global Disease Detection System also will
support sentinel sites in key regions around the globe to
ensure prompt disease detection and referral to a regional
laboratory service. These capacities are critical to mitigate
the consequences of a catastrophic public health event, whether
the cause is an intentional act of terrorism or the natural
emergence of a deadly infectious virus, like SARS. The
Committee has provided $12,077,000 over the fiscal year 2005
level for these efforts.
Global Immunization Activities.--The Committee includes
$144,455,000 for global immunization activities, including
$101,254,000 for polio vaccine, surveillance, and program
operations for the highly successful, yet unfinished polio
eradication efforts; and $43,201,000 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.
The increased funding levels in Global Health and decreases
in Immunization capture the proper alignment of programmatic
costs within CDC under the new budget structure and will be
directed to support programmatic activities to eradicate polio
and eliminate measles worldwide. They do not represent a
decrease in support of the immunization program.
The Committee appreciates CDC's contribution to global
immunization efforts to eradicate polio and eliminate measles
worldwide. Federal dollars help leverage private dollars in
both the Polio Eradication Campaign and the Measles Initiative,
partnerships among international agencies, NGOs and CDC. Polio
eradication is close to completion; however, polio is still
endemic in six countries. Any ground lost in maintaining
``immunization days,'' surveillance and labs is disastrous.
Immunization is respected in these developing countries to the
point that they cause temporary ceasefires in countries at war.
The Committee notes that the fiscal year 2006 appropriation
recommended here assumes full funding of the Congressional
intent in the fiscal year 2005 appropriation. Accordingly,
funds requested in Immunization and Business Services support
related to Global Immunization Activities have been provided
here.
PUBLIC HEALTH RESEARCH
Public Health Research.--The Committee has provided
$31,000,000 in transfers available under section 241 of the
Public Health Service Act to fund the Public Health Research
program. The fiscal year 2005 comparable level was $31,000,000
and the administration requested $31,000,000 for this program
in fiscal year 2006. The Committee is strongly supportive of
public health and prevention research, which bridge the gap
between medical research discoveries and behaviors that people
adopt by identifying the best strategies for detecting new
diseases, assessing the health status of populations,
motivating healthy lifestyles, communicating effective health
promotion messages, and acquiring and disseminating information
in times of crisis.
Alternative Therapies.--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 encourages CDC
to consider expanding their efforts 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 urges CDC to collaborate with the National Center for
Complementary and Alternative Medicine [NCCAM] to assure that
its efforts complement efforts by NCCAM.
Food Marketing.--The Committee commends the CDC for its
role and participation in the Food Marketing and the Diets and
Health of Children and Youth study done in partnership with the
Institute of Medicine through the Food and Nutrition Board and
the Board on Children, Youth, and Families. The Committee
encourages CDC to continue its efforts to identify the causes
of obesity, particularly the science-based effects of food
marketing on the diets and health of children and youth in the
United States.
Poor Diet and Inactivity.--Hundreds of thousands of people
die prematurely each year from heart attack, stroke, and
diabetes, and scientists agree that poor diet, physical
inactivity, and being obese puts one at greater risk for those
conditions. The Committee is concerned that the recent
controversy regarding the estimates of the number of deaths due
to obesity has resulted in public confusion and ignores other
diet and physical inactivity disease rates, related deaths and
health care costs.
The Committee urges the CDC to conduct a study to estimate
the number of premature deaths, diseases, and costs due to poor
diet and physical inactivity. The study should include diet-
and inactivity-related deaths, diseases, and costs due to heart
disease, cancer, stroke, diabetes, and other diseases and those
due to a range of dietary factors. The number of diet- and
inactivity-related deaths, diseases, and costs should be
compared to other leading causes including tobacco, alcohol,
infectious diseases, etc.
PUBLIC HEALTH IMPROVEMENT AND LEADERSHIP
The Committee provides $269,055,000 for public health
improvement and leadership activities at the CDC. The fiscal
year 2005 comparable level was $266,842,000 and the
administration requested a comparable program level of
$206,541,000 for fiscal year 2006.
Leadership and Management
The Committee provides $178,672,000 for leadership and
management costs at the CDC in fiscal year 2006. The fiscal
year 2005 comparable level was $178,541,000 and the
administration requested a comparable level of $178,672,000 for
fiscal year 2006.
Director's Discretionary Fund.--The Committee has provided
$10,000,000 for a Director's Discretionary Fund. This fund will
allow the Director to quickly respond to emerging public health
issues and threats not contemplated at the time of enactment of
the appropriations.
Epidemic Services and Response.--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 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.
Leadership and Management Savings.--The Committee strongly
believes that as large a portion as possible of CDC funding
should go to programs and initiatives that improve the health
and safety of Americans. To facilitate this goal, any savings
in leadership and management may be reallocated to the
Director's Discretionary Fund upon notification of the
Committee.
PREVENTATIVE HEALTH AND HEALTH SERVICES BLOCK GRANT
The Committee has provided $100,000,000 for the
Preventative Health & Health Services Block grant. The fiscal
year 2005 comparable level was $118,526,000 and the
administration requested no funding for this program in fiscal
year 2006.
The block grant provides funding for primary prevention
activities and health services that address urgent health
problems in local communities. This flexible source of funding
can be used to target concerns where other funds do not exist
or where they are inadequate to address the extent of the
health problem. The grants are made to the 50 States, the
District of Columbia, two American Indian tribes, and eight
U.S. territories.
BUILDINGS AND FACILITIES
The Committee has provided $225,000,000 for the planning,
design, and construction of new facilities, repair and
renovation of existing CDC facilities, and data security and
storage. The fiscal year 2005 comparable level was $269,708,000
and the administration requested $30,000,000 for fiscal year
2006.
The Committee recommendation includes $200,000,000 for the
continuation of CDC's Buildings and Facilities Master Plan in
Atlanta, Georgia and $25,000,000 to complete construction of
CDC's Division of Vector Borne Infectious Diseases Laboratory
in Fort Collins, Colorado.
The Committee has again provided bill language to allow CDC
to enter into a single contract or related contracts for the
full scope of development and construction of facilities and
instructs CDC to utilize this authority, when necessary, in
constructing the Atlanta and Fort Collins facilities.
BUSINESS SERVICES AND SUPPORT
The Committee provides $296,119,000 for business services
support functions at the CDC. The fiscal year 2005 comparable
level was $278,838,000 and the administration requested a
comparable level of $263,715,000 for fiscal year 2006. These
funds will be used to support CDC-wide support functions.
The recommendation includes $34,800,000 within Business
Services and Support that was provided in fiscal year 2005, and
in the administration request, in NIOSH. The reason for this is
to provide the NIOSH share of CDC central services and support
within this activity and to eliminate the need for additional
taps and assessments.
The Committee strongly believes that as large a portion as
possible of CDC funding should go to programs and initiatives
that improve the health and safety of Americans. To facilitate
this goal, any savings in business services support may be
reallocated to the Director's Discretionary Fund upon
notification of the Committee.
TERRORISM
The Committee provides $1,566,471,000 for CDC terrorism
preparedness activities. The comparable fiscal year 2005 level
was $1,622,757,000 and the administration requested
$1,616,723,000 for these activities in fiscal year 2006.
Although these funds have been provided in the Public Health
and Social Services Emergency Fund [PHSSEF] in past
appropriations, they have always been managed by CDC. The
Committee expects that CDC will continue to closely coordinate
its terrorism preparedness activities with those of the
Department and other HHS Agencies.
Within the funds provided, $735,391,000 is for Upgrading
State and Local Capacity through grants and cooperative
agreements; $29,425,000 is for the Centers for Public Health
Preparedness; $5,424,000 is for the Advanced Practice Centers;
$26,899,000 is for other State and Local Capacity; $137,972,000
is for upgrading CDC Capacity; $10,000,000 is for anthrax
vaccine studies; $79,361,000 is for the Biosurveillance
Initiative; and $542,000,000 is for the Strategic National
Stockpile.
Blood Safety.--The Committee understands that the American
Red Cross [ARC] supplies blood to approximately one-half the
Nation's hospitals, operates the only blood system with the
capacity to deliver blood anywhere and anytime it is needed,
and is the only non-governmental organization with mandated
primary agency responsibilities under the National Response
Plan [NRP]. Among its NRP obligations, the ARC serves as a
support agency to HHS for the provision of blood and blood
products. The Committee is aware that the ARC has initiated a
Biomedical Technology Assurance Initiative to protect its
capacity to manage national blood supplies against cyber- and
bio-security threats. The Committee supports this effort and
encourages CDC to consider providing support to the Initiative
from within the funds made available for biosurvelliance,
capacity enhancement and stockpile activities.
Clinician Update Service.--The conferees are aware of the
Clinician Update Service, which the CDC has begun with World
Medical Leaders to disseminate news, information, and alerts to
physicians who are on the front lines in the effort to
recognize biological, chemical, and radiological events. The
Committee encourages CDC to consider supporting the completion
of Phase II of the project.
Modified Vaccinia Ankara.--The Committee is concerned that
individuals with weak immune systems, an estimated 20 percent
of the U.S. population, cannot take the existing animal-derived
and cell-derived smallpox vaccines currently stored in the
Strategic National Stockpile for emergency purposes. Funds have
already been appropriated under the Project Bioshield Act for
the planned stockpiling of the Modified Vaccinia Ankara [MVA]
Smallpox Vaccine for immuno-compromised Americans. The
Committee supports plans to purchase the new vaccine.
Pandemic Influenza.--The Committee notes that several
outside organizations, including the Trust for America's
Health, have made recommendations regarding pandemic
preparedness. The Committee encourages CDC to consult with
outside experts in its preparations for, and response to, a
potential pandemic.
The Committee is aware that the Department is developing a
pandemic influenza response plan. The Committee recognizes that
local public health departments, working with their States,
play essential roles in responding to influenza outbreaks,
including monitoring of local vaccine availability,
distribution and redistribution of vaccines and antiviral
medications to high priority populations, implementation of
necessary epidemic containment measures, and communication to
the public. Therefore, Committee encourages the Department to
assure that all aspects of Federal pandemic influenza planning
are consistent with operational realities at the local level
and will have the intended public health results when
implemented locally. The Committee further urges the Department
to assure that Federal pandemic flu planning avoid duplication
and inconsistency with other Federal directives concerning
public health preparedness.
State and Local Capacity.--The Committee continues to
recognize that bioterrorism events will occur at the local
level and will require local capacity, preparedness and initial
response. It is the Committee's intent that significant funding
for State and local public health infrastructure be used to
improve local public health capacity and meet the needs
determined by local public health agencies. The Committee notes
that HHS' cooperative agreement guidance now includes explicit
requirements for local concurrence with State spending plans
for public health emergency preparedness and urges CDC to
monitor and enforce these requirements.
The Committee also recognizes that HHS has incorporated the
National Response Plan into the cooperative agreement guidance
and established new CDC Preparedness Goals. The Committee urges
the Department to assure that the performance metrics for the
CDC Preparedness Goals, by which local health department
preparedness will be measured, are fully consistent with all
requirements in the Target Capabilities being developed under
Homeland Security Presidential Directive 8 by the Department of
Homeland Security.
Funds for bioterrorism prevention and response are
distributed through grants to 50 States and four metropolitan
areas. The Committee strongly recommends that these funds be
distributed based on a formula that includes factors for risk
of a terrorist event. Risk is challenging to quantify, but the
Committee suggests that CDC, in coordination with the Secretary
of Health and Human Services, consider the following and other
factors: (1) Site of headquarters or major offices of
multinational organizations; (2) site of major financial
markets; (3) site of previous incidents of international
terrorism; (4) some measure of population density versus just
population; (5) internationally recognized icons; (6) percent
of national daily mass transit riders; (7) proximity to a major
port, including major port ranked on number of cargo containers
arriving at the port per year.
Strategic National Stockpile.--The Committee appreciates
that planning and exercising plans for distribution of the
Strategic National Stockpile is an integral aspect of overall
local bioterrorism preparedness. The Committee urges CDC to
assure that requirements for and evaluation of State and local
activities with respect to the stockpile, including the Cities
Readiness Initiative, are fully integrated into and consistent
with requirements of the guidance for overall bioterrorism
preparedness.
NIH Preamble
No task before this country is more important than
safeguarding and improving the health of all Americans. For
protecting the public's health, together with educating our
citizenry, represent the mainspring of our economic and social
progress. Without question, the Nation's strength can be no
greater than the health and vitality of its population. Beyond
its human toll, needless suffering and death erode
productivity, undermine our leadership role on the global
stage, weaken our defenses and threaten to bankrupt Federal,
State, and family budgets.
History has shown that it is imperative to maintain our
long-term commitment to medical research regardless of short-
term economic conditions. Since World War II, the life span of
the average American has risen steadily, from 65 to nearly 77
years. While no single entity nor action can be credited for
that success, one organization has played a significant role--
the National Institutes of Health. The Nation's investment in
NIH has yielded a myriad of scientific achievements that are
helping to save lives, prevent illness and improve the quality
of life. From drugs to control high blood pressure, lower
cholesterol and prevent blood clots to the development of a
vaccine that eliminates the leading cause of mental retardation
in infants, NIH has played a significant role. But that role
has broadened and taken on even greater immediacy, as NIH has
taken the lead in protecting our Nation against bioterrorism
and other public health emergencies including anthrax, plague,
tularemia and West Nile virus. With these and other threats
looming, now is not the time for retrenchment; rather, it is
the time to exploit fully any opportunity that could lead to
improved health.
The Committee also encourages new initiatives to reshape
the conduct of research such as the ``NIH Roadmap for Medical
Research,'' an approach that would bring together multiple
institutes and scientific disciplines to tackle a handful of
public health concerns. Similarly, the Committee strongly urges
NIH to focus greater effort and resources on transforming basic
science discoveries into preventive measures, improved
diagnostics, drugs and treatments. The backbone of clinical
research in this country, the Nation's academic health centers,
should be nurtured and new, innovative ways should be found to
re-energize this enterprise.
To these ends, the Committee recommends $29,414,515,000 for
the NIH. This amount is $1,050,000,000 above the fiscal year
2005 appropriation and $904,731,000 over the budget request.
Biomedical Research and Development Price Index.--The
Committee is once again disappointed that the budget request
would require NIH to break its funding commitments to existing
grantees. Forcing grantees to reduce the scope of research that
is already underway would establish an unfortunate precedent
and could erode confidence in NIH. As a result, this reduction
would have caused a disproportionate impact on more junior
researchers and trainees, who need continued encouragement to
pursue careers in research. Therefore, the Committee has
included sufficient funding to enable NIH to fully pay the
committed levels on its grants. The Committee is also
disappointed that the budget request's proposed average cost
assumptions would keep NIH from purchasing the same amount of
research as in fiscal year 2005 with its new research project
grants [RPGs], when biomedical inflation, as measured by the
Department of Commerce's Biomedical Research and Development
Price Index [BRDPI], is taken into account. The funding level
recommended by the Committee will permit the average cost of
new and competing RPGs to rise by the BRDPI inflator, or 3.2
percent, instead of being held flat, as proposed in the budget
request.
Human Embryonic Stem Cell Research.--The Committee
continues to be concerned that the current administration
policy relating to human embryonic stem cell research is so
narrow that it is stifling the pace of stem cell research. The
Committee strongly believes that embryonic stem cell research
holds enormous potential for the treatment of cardiovascular
disease, Parkinson's, spinal cord injury and a vast array of
other diseases and injuries. After convening 16 in-depth
hearings on the subject, the Committee believes that with the
proper safeguards in place, this field of investigation ought
to be widened. While it originally appeared that 78 embryonic
stem cell lines would be available for research under the
Federal policy, now, nearly 4 years after the President's
announcement on August 9, 2001, only 22 lines are available to
researchers. Moreover, scientists have told the Committee that
all available stem cell lines were grown with mouse feeder
cells, making their therapeutic use for humans uncertain. The
Committee strongly urges the administration to modify the
current embryonic stem cell policy so that it provides this
area of research the greatest opportunity to lead to the
treatments and cures for which we are all hoping.
The Committee also strongly urges that the NIH explore all
avenues of stem cell research including adult stem cells and
alternative methods of establishing human embryonic stem cell
lines that do not involve the destruction of an embryo.
The Committee is also deeply concerned with the slow pace
of implementation of the current stem cell policy. The
Committee was informed by NIH this year that anticipated
spending on human embryonic stem cell research is just
$24,300,000. The Committee strongly urges the NIH to commit a
substantial amount of resources to all methods of human
embryonic stem cell research.
NATIONAL CANCER INSTITUTE
Appropriations, 2005.................................... $4,825,259,000
Budget estimate, 2006................................... 4,841,774,000
House allowance......................................... 4,841,774,000
Committee recommendation................................ 4,960,828,000
The Committee recommends an appropriation of $4,960,828,000
for the National Cancer Institute [NCI]. The budget request was
$4,841,774,000. The fiscal year 2005 appropriation was
$4,825,259,000. 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.
Blood Cancers.--The Committee acknowledges some notable
advances in the treatment of blood cancers, including leukemia,
lymphoma, and multiple myeloma. These include several new drugs
that have been approved and introduced to the market in the
last 3 years, products of a strong public-private partnership.
Despite new treatments, these cancers represent a serious
health crisis. Almost 115,000 Americans will be diagnosed with
these cancers in 2005, and nearly 55,000 will die from them.
Moreover, the 5-year survival rates for these cancers lag
behind the 64 percent 5-year survival rate for all cancers; the
rate for multiple myeloma is only 32 percent, and for non-
Hodgkin's lymphoma it stands at 59 percent. The Commmittee
encourages the Institute to strengthen its support for
translational and clinical blood cancer research. The blood
cancers strike individuals of all ages, races, and each gender,
and serve as valuable prototypes for the development of
therapies for all types of malignant disorders. The Committee
urges the institute to explore all mechanisms to support blood
cancer research to improve treatment options and rapidly move
discoveries from the laboratory bench to the patient's bedside.
Bone Marrow Failure Diseases.--The Committee encourages NCI
to expand its research efforts into bone marrow failure
diseases, including aplastic anemia, myelodysplastic disorders
[MDS], and paroxysmal nocturnal hemoglobinuria [PNH]. Each
year, between 20,000 and 30,000 Americans are diagnosed with
these diseases. In some cases, MDS, the most prevalent of these
diseases, can progress over time to become acute leukemia. More
research is critically needed to understand the causes of these
diseases, develop effective treatments and cures, and prevent
the progression of certain cases into leukemia. Furthermore,
cancer patients who undergo chemotherapy often develop bone
marrow failure diseases. The Committee encourages NCI to gain a
better understanding of the link between chemotherapy and these
diseases, and to explore the development of alternatives means
of treating cancer without causing the subsequent development
of bone marrow failure diseases.
Brain Tumors.--The Committee believes that increased
attention should be given by NCI and NINDS to brain tumor
research. The Committee encourages NCI to fund at least five
Specialized Programs 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.--Breast cancer's toll continues to threaten
the lives and the quality of life of thousands of women across
all walks of life. In addition to ongoing research activities
underway at the National Cancer Institute, the Committee
strongly urges the NCI to give increased attention to areas of
research that focus on helping women to more fully restore and
improve their quality of life after treatment, including
further breast cancer research on lymphadema, stress,
nutrition, exercise, weight, and the environment.
The Committee remains concerned about missed opportunities
in breast cancer screening, detection, prevention, control, and
early diagnosis including those in mammogram detection, reading
and analysis. The Committee strongly urges the NCI to further
accelerate advances in breast cancer screening technology and
to capitalize on existing and create new technologies that
improve early diagnosis, health outcomes, and survival.
Cancer Biobank.--The Committee believes that the cancer
biobank, because it will centralize and standardize molecular
annotation of tissues, has the potential to greatly accelerate
the understanding of cancer and the discovery and development
of new biomarkers, new diagnostics and new therapeutic
approaches. Once established, the Committee believes that it
will be most efficient to utilize existing technologies such as
high-density microarrays, given the long time frame for the
development of new technologies.
Cancer Centers and Minorities.--The Committee commends NCI
on the success of its cancer centers program. Given that
minority populations suffer disproportionately from virtually
every form of cancer, the Committee encourages NCI to provide
continued support for comprehensive cancer centers at minority
institutions focused on research, treatment, and prevention of
cancer in African American, Native Hawaiian, and other minority
communities.
Cancer Metastasis.--The NCI is encouraged to develop an
interdisciplinary and integrated approach to study bone
metastasis, by combining the expertise of oncologists, bone
biologists and metastasis experts. Key issues to address
include the generation of novel organ-like or mouse models
which closely mimic tumor bone interactions that will pave the
way for delineating novel mechanisms of how tumor cells go to
the bone; the development of novel targets for better
prognosis; and effective therapeutic targeting. Designing new
strategies to make the bone microenvironment hostile to
invading tumor cells is of high clinical relevance. The
Committee also urges NCI to expand research on osteosarcoma to
improve survival and quality of life and to prevent metastatic
osteosarcoma in children and teenagers who develop this cancer.
Chronic Lymphocytic Leukemia [CLL].--This incurable disease
is the most common form of adult leukemia in the United States.
The Committee once again urges the NCI to increase research
into CLL, including improved therapies and their rapid movement
from the laboratory to the bedside. The Committee strongly
urges the NCI to give favorable consideration to continuing and
expanding the scope of research activities funded through the
CLL Research Consortium as it works to defeat this devastating
blood disorder.
Complementary and Alternative Cancer Therapies.--The
Committee expects NCI to continue and expand its collaborative
efforts with NCCAM to support research on promising
complementary and alternative cancer therapies as well as on
their integration with traditional therapies.
DES.--The Committee continues to 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
to consult with organizations representing individuals impacted
by DES as it carries out DES research and education efforts.
Gynecologic Cancers.--In the last 5 years, approximately
130,000 women in the United States have lost their lives to
gynecologic cancer. The Committee commends the NCI for creating
a cervical cancer and endometrial cancer SPORE, bringing the
total number of gynecologic cancers SPORES to six, and expects
that the NCI will expand the number of centers in the future.
Unfortunately, 70 percent of ovarian cancer patients continue
to be diagnosed in advanced stages when 5-year survival rates
remain less then 25 percent. The Committee encourages continued
research by the four ovarian SPORES that will lead to a better
understanding of prevention and the development of a screening
tool offering women earlier diagnosis when this cancer is more
curable. The Committee also supports the expansion of NCI's
collaboration with the NICHD for faculty development of
gynecologic oncologists.
Health Cognition.--The Committee encourages NCI's Division
of Cancer Control and Population Sciences to continue to build
innovative collaborations such as the Health Cognition Group.
The activities of this group of researchers are designed to
plumb knowledge from basic research on how people process and
use health information and synthesize it with the development
and evaluation of theory-based interventions to promote healthy
behavior. Although these efforts are directed primarily to
behaviors relevant to cancer, they will also serve the broader
goal of developing theoretical frameworks that can be applied
across a range of behavioral domains and conditions.
Health Communication.--The Committee acknowledges NCI's
Division of Cancer Control and Population Sciences for
developing HINTS, the first-ever survey to collect nationally
representative information on the American public's need for,
access to, and use of cancer information. Such a database is
useful to practicing physicians, public health departments and
policymakers, among others. HINTS provides an invaluable
snapshot of how adults use the many information resources
around them to lead healthier lives and to reduce the burden of
cancer in America.
Hemophilia Cohort Study.--The Committee understands that
NCI has made plans to discontinue research funding support of
the Multi-Center Hemophilia Cohort Study. This cohort offers a
database for improving the understanding of HCV and has served
as the basis of significant peer-reviewed findings. The
Committee strongly urges the NCI to take all necessary steps to
ensure the samples obtained through this cohort are preserved
and accessible for future research. The Committee also requests
a report by May 1, 2006 on possible future research
opportunities using the cohort samples.
Imaging Systems Technologies.--The Committee is encouraged
by progress made by the NCI following its August 1999
conference on biomedical imaging, and it urges the NCI to
continue to take a leadership role with the Centers for
Medicare and Medicaid Services and the Food and Drug
Administration to avoid duplicative reviews of new imaging
technologies which may prevent their benefits from reaching
patients on a timely basis. The Committee is aware of the great
potential for improved patient care and disease management
represented by molecular imaging technologies, especially
positron emission tomography [PET] through its ability to image
the biology of many kinds of cancer and other diseases. The
Committee continues to support the NCI's increased emphasis on
examining the molecular basis of disease through imaging
technologies such as PET and MicroPET. The Committee also
continues to encourage the large-scale testing of women for
breast cancer and 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.
Liver Cancer.--The Committee remains concerned with the
increasing incidence of primary liver cancer, which is in sharp
contrast to many other forms of cancer where the incidence is
declining and the treatment options are rapidly increasing. The
Committee is aware that NCI, working with NIDDK, has convened
an Experts Conference and is moving ahead with plans to
increase resources dedicated to this disease. The Committee
urges NCI to make a substantial commitment to research on
primary liver cancer with particular focus on the development
of drugs that target the cancer without killing healthy cells
by interfering with the cellular pathways of the disease. The
Committee further urges NCI to continue to support the NIDDK
sponsored HALT-C clinical trial which has particular relevance
to the NCI mission.
Lung Cancer.--Lung cancer remains a major public health
issue and is the leading cause of cancer death among women and
minority populations. The death rate is expected to escalate as
the population ages. The Committee is encouraged by the success
of new targeted drug therapies demonstrated in recent clinical
trials in stage 4 patients. The Committee encourages the NCI to
work with the thoracic surgical community to initiate new
clinical trials that involve patients at an early stage of the
disease when surgery is a treatment option. The trials should
test the effectiveness of these new drugs as adjuvant therapy
to improve the outcome of established thoracic surgical therapy
for lung cancer.
Lymphoma.--The Committee strongly urges that the NCI take
bold action to address lymphoma as a public health problem and
to capitalize on important research advances to date. While new
treatments have become available for patients, more and
improved treatment options are needed. The Committee strongly
encourages the NCI to boost its investment in translational and
clinical lymphoma research. The Committee commends the NCI and
the NIEHS for convening a workshop on the viral and
environmental links to lymphoma and recommends that steps be
taken to strengthen the NCI investment in this area. The
Committee encourages the NCI to direct resources to: (1)
studies of adequate scope to assure the identification of
environmental risk factors for specific subtypes of lymphoma;
(2) small studies designed to improve detection and
quantification of historically difficult-to-measure
environmental factors; (3) studies that are directed toward
enhancing the understanding of the role of the immune system in
the initiation and progression of lymphoma; and (4) studies
that examine the simultaneous presence of a wide profile of
infectious agents among individuals with lymphoma. The
Committee also encourages that resources be used for research
related to long-term survivors of both non-Hodgkin's lymphoma
and Hodgkin's lymphoma. The Committee strongly supports the
recommendation of the Leukemia, Lymphoma, and Myeloma Progress
Review Group [LLM PRG] that resources be invested in
identifying the populations of patients that are at high risk
of adverse outcomes from their treatment for lymphoma.
Mesothelioma Research.--The Committee is concerned with the
pace of mesothelimoma research. This aggressive disease invades
the lining of the lungs, heart, or stomach resulting in death
in 4 to 14 months. To address these concerns, the Committee
strongly encourages the NCI to establish up to 10 mesothelioma
centers, increase research, including clinical trials,
detection and prevention methods, palliation of disease
symptoms and pain management. The Committee requests that the
NCI issue a report, by June 1, 2006 on steps taken to address
mesothelioma research.
Multidisciplinary Research.--The NCI is commended for its
innovative support of multidisciplinary training programs to
enhance the scientific workforce. The Committee encourages NCI
to explore new opportunities with the Office of Behavioral and
Social Sciences Research to increase the number of scientists
who can bridge the realms of behavioral and social science
research and public health or biomedical research.
Nanosystems Biology.--The Committee encourages NCI and the
Office of the NIH Director to support a collaborative effort to
bring nanotechnology, systems biology and molecular imaging
together to examine the molecular basis of cancer. Initial
efforts have shown that cancers such as breast cancer are not a
single disease, but may encompass many different diseases, when
examined at the molecular level. Many clinical trials of new
drugs are now considered to fail if only 10 percent of patients
benefit, yet the 10 percent may represent a specific type of
the disease, where the drug may be 100 percent effective.
Bringing these three disciplines together may allow researchers
to identify specific sub-types of cancer and to better target
new interventions. Successful results of such an effort could
lead to a molecular classification of many types of cancer and
to targeted molecular treatments for molecular-specific
diseases.
Native Hawaiians.--The Committee remains concerned about
the high incidence of breast, colon, and lung cancer among the
Native Hawaiian population. The Committee commends the NCI for
its progress toward understanding and addressing the needs of
the Hawaiian and Pacific Basin populations through its
cooperative agreement with Papa Ola Lokahi and looks forward to
a report of the prioritized health needs identified by those
assessments.
Neurofibromatosis. The Committee commends NCI for
conducting clinical trials of NF1 patients. The Committee is
concerned about recent large drops in funding for NF research,
and recognizing NF's connection to many of the most common
forms of human cancer, the Committee encourages NCI to
substantially increase its NF research portfolio in such areas
as further development of animal models, natural history
studies, therapeutic experimentation, and clinical trials. The
Committee recognizes that basic research has successfully
brought NF into the clinical era and encourages NCI to create,
fund, and implement NF clinical trials infrastructures
including NF centers, patient data bases, and tissue banks. The
Committee further encourages NCI to apply existing cancer drugs
to NF patients in clinical trials both extramurally and
intramurally, and to develop new drugs for NF which could then
apply to the general population because of NF's connection to
most forms of human cancer. The Committee is aware of
significant new advances in NF research in the past few years
in the area of tumor suppression, and encourages NCI to
continue to coordinate its efforts with other NIH institutes
and government agencies.
Ovarian Cancer.--Congress remains concerned that mortality
rates associated with ovarian cancer have not seen the
decreases that other cancer sites have experienced in the past
5 years. As the deadliest of all gynecologic cancers, ovarian
cancer takes the lives of three-quarters of all women diagnosed
with it within 5 years. Congress commends the National Cancer
Institute for its recognition of the importance of studying
this deadly women's disease and appreciates the NCI's recent
investment that is helping to increase the understanding of the
unique molecular pathways associated with ovarian cancer
through its Specialized Programs of Research Excellence
[SPOREs] program. As such, Congress strongly encourages NCI to
sustain and strengthen its commitment to and investment in
ovarian cancer and maintain the SPOREs initiatives directed
toward ovarian cancer in fiscal year 2006.
Pancreatic Cancer.--Pancreatic cancer is the country's
fourth leading cause of cancer death, killing over 32,000
individuals this year. Its 99 percent mortality rate is the
highest of all cancers, and the average life expectancy after
diagnosis with metastatic disease is just 3 to 6 months. The
Committee is pleased that the NCI is moving forward to
implement the recommendations outlined in the 2001 report by
the Pancreatic Cancer Progress Review Group [PRG] and that the
Institute is funding three pancreatic cancer SPORE grants.
However, the Committee is concerned that the current level of
funding for pancreatic cancer research does not allow for the
implementation of the PRG report and that only one of the three
SPORE grants is fully funded. In addition, the Committee
strongly urges the NCI to maintain or increase the number of
pancreatic SPOREs as it undertakes a review of its
translational research activities. Finally, the Committee notes
that the NCI's September 2004 report titled ``Pancreatic Cancer
Research'' includes a single, overall budget figure for
implementing the immediate and short-term strategies of the
Institute's strategic plan to address the PRG's
recommendations, with no details about how the money would be
used. Therefore, the Committee requests the NCI to develop a
professional judgment budget that specifically details the cost
of fully implementing the pancreatic cancer PRG and provide
this professional judgment budget to the Committee by May 1,
2006.
Prostate Cancer.--The Committee commends the NCI for the
considerable investment in prostate cancer, the leading cause
of non-cutaneous cancer death among men, and encourages NCI to
continue to support research to improve the accuracy of
screening and early detection of prostate cancer.
Radio Waves.--The Committee urges the NCI to support
research using radio waves that could prove promising in
reducing cancerous tumors. While current radio frequency
ablation requires placing electrodes directly into the tumor,
this new non-invasive technique would target only the cancer
cells while avoiding healthy tissue.
Social Work.--The Committee encourages NCI to coordinate
with the Centers for Disease Control and Prevention to conduct
further research on the outcome of social work interventions to
meet patient and family psychosocial needs in hospitals and
cancer treatment centers.
SPORE Program.--The Specialized Programs of Research
Excellence [SPORE] Program at the NCI was established to
support efforts to move laboratory findings into clinical
practice to benefit patients in the near term. The Committee
understands that the program has resulted in the translation of
some exciting research into cancer clinical trials for
vaccines, chemoprevention and dietary interventions. The
results to date from SPORE funding include multi-center
clinical trials, biomarker studies, prevention studies, genetic
registries, data sharing, and tissue banking projects, all with
critical patient focus. The Committee strongly encourages the
NCI to continue to keep this translational goal at its
forefront. The Committee further understands that the SPORE
program has been extremely successful in rapidly moving science
to practices that benefit patients; funded research that
requires a team approach to cancer; supports collaboration
across basic science, population science and clinical
investigation; and provides a rapid translation from the
laboratory to patient care. The Committee further urges that
the translational research momentum, developed under the SPORE
program, be maintained by the NCI.
Tuberous Sclerosis Complex.--Tuberous sclerosis complex, or
TSC, is a genetic disorder that triggers uncontrollable tumor
growth in multiple organs of the body, including the brain,
heart, kidneys, lungs, liver, eyes or skin. In light of its
similarities to the uncontrolled growth of cancer cells, many
scientists believe that determining the cause of tumor growth
in TSC could open the way for cures and treatments for cancer
as well. The Committee is encouraged that NCI is participating
in a Trans-NIH Tuberous Sclerosis Coordinating Committee, and
urges NCI's continued involvement in this process. The
Committee also urges NCI to collaborate with NIDDK on a
conference on nutrient sensing and insulin-signaling in cells
with inclusion of TSC research.
War on Cancer.--The Committee applauds the Director of the
National Cancer Institute for setting a bold goal to eliminate
suffering and death due to cancer by 2015. To assist Congress
in establishing priorities, the Committee requests the Director
to report to the Committee, by June 1, 2006, an outline of the
progress made since the war on cancer was declared in 1971 and
detail the specific steps that must be taken to achieve this
goal by 2010.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2005.................................... $2,941,201,000
Budget estimate, 2006................................... 2,951,270,000
House allowance......................................... 2,951,270,000
Committee recommendation................................ 3,023,381,000
The Committee recommendation includes $3,023,381,000 for
the National Heart, Lung, and Blood Institute [NHLBI]. The
fiscal year 2005 appropriation was $2,941,201,000 and the
budget request was $2,951,270,000. 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 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 Committee encourages the 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.
Behavioral Research Grants.--For many years NIH has
required that any proposed research project grant with a budget
over $500,000 in direct costs be subject to additional review
and scrutiny. The Committee is interested to know whether at
NHLBI this additional layer of review may differentially impact
large behavioral science research grants. The Committee
requests a report from NHLBI of all requests to fund research
grants over $500,000, and whether they were approved, comparing
behavioral grants to others in the pool, during fiscal years
2000-2004. The report should be transmitted no later than May
1, 2006.
Bleeding and Clotting Disorders.--The Committee commends
NHLBI for its leadership in advancing research on bleeding and
clotting disorders and their complications. The Committee
encourages NHBLI to maintain its work in this area and applauds
the Institute for its efforts, in cooperation with the National
Hemophilia Foundation, to support research on improved and
novel therapies for these disorders.
Bone Marrow Failure Diseases.--The Committee encourages
NHLBI to expand its research efforts into bone marrow failure
diseases, including aplastic anemia, myelodysplastic disorders
[MDS], and paroxysmal nocturnal hemoglobinuria [PNH]. Each
year, in some cases, MDS, the most prevalent of these diseases,
can progress over time to become acute leukemia. More research
is critically needed to understand the causes of these
diseases, to develop effective treatments and cures, and to
prevent the progression of certain cases into leukemia.
Cardiothoracic Surgery.--The Committee recognizes the
contributions of cardiothoracic surgery to the improvement in
cardiac health in this country and looks forward to the
advances that will come from further clinical research in the
field. The Committee is encouraged by the steps the Institute
is taking to establish a network for cardiothoracic surgical
investigations, and urges rapid implementation of this plan
with sufficient funding to continue the progress being made in
the treatment of heart disease.
Cardiovascular Diseases.--The Committee continues to
strongly urge the Institute to place the highest priority on
research for heart disease, stroke and other cardiovascular
diseases. Therefore, the Committee urges the NHLBI to expand
its research portfolio and increase its resources into the
causes, cure, prevention and treatment of cardiovascular
diseases. The Committee remains concerned that funding over the
years for cardiovascular disease research has not kept pace
with the scientific opportunities available, the number of
Americans afflicted with cardiovascular diseases, or their
economic toll. The Committee urges NHLBI to expand existing
studies and to invest in promising initiatives.
Cardiovascular Disease, Hypertension, and Kidney Disease.--
The Committee is aware that chronic kidney dysfunction is an
important risk factor for the development of cardiovascular
disease. Additionally, hypertension, or high blood pressure, is
the second leading cause of end-stage renal disease [ESRD],
accounting for 23.6 percent of ESRD patients. ESRD and kidney
dysfunction together affect millions of Americans and is
especially prevalent among elderly persons, African-Americans
and patients with diabetes. Given the significant morbidity and
mortality associated with cardiovascular disease among patients
with kidney disease, the Committee recognizes the urgency to
examine the relationship between cardiovascular disease and
kidney disease. The Committee encourages NHBLI and NIDDK to
work together to develop appropriate basic and clinical
research initiatives addressing the pathogenesis of
cardiovascular events in patients with kidney disease, while
exploring therapeutic and preventive interventions. The
Committee also encourages NHBLI to work with the renal
community to support ongoing educational programs directed to
health professionals, patients and the public to raise the
awareness of the relationship between cardiovascular disease,
hypertension and kidney disease.
Cardiovascular Disease With Juvenile Diabetes.--The
Committee commends NIDDK and NHLBI for their efforts in
developing new opportunities for studies on the pathogenesis of
cardiovascular disease complications among patients with
juvenile diabetes, and to evaluate opportunities for
intervention studies to reduce CVD complications among patients
with juvenile diabetes. The Committee encourages the Institutes
to closely monitor research progress in this field and to
continue to promote the clinical translation of research
findings into new therapies.
Chronic Obstructive Pulmonary Disease [COPD] National
Education and Prevention Program.--The Committee is pleased
that NHLBI held a preliminary workshop to formulate strategies
toward implementing a National Chronic Obstructive Pulmonary
Disease [COPD] Education and Prevention Program. Since COPD is
the fourth leading cause of death in the United States, the
Committee urges the NHLBI to continue its education efforts to
bring advances in medical care to the public.
Early identification of those at-risk for or who have COPD
is essential in the effort to stem the growth of the population
with COPD. The Committee encourages NHLBI to continue its
efforts in this area, including working with national lung
organizations such as the American Thoracic Society and the
American Lung Association to develop a national education
campaign for providers and the public about COPD.
Cooley's Anemia.--The Committee remains strongly supportive
of the focused research effort that is being undertaken by the
Thalassemia Clinical Research Network, which is comprised of
the leading research institutions in the field of thalassemia,
or Cooley's anemia. The Committee believes that this network is
just beginning to meet its promise and urges the Institute to
continue it and support the research projects undertaken by it.
Diamond-Blackfan Anemia.--The Committee is pleased that
NHLBI has awarded grants for research initiatives to
investigate the rare bone marrow deficiency disorder, Diamond
Blackfan Anemia [DBA]. The Committee understands that
breakthroughs in this disorder may lead to important strides in
research especially relating to blood cell formation (recovery
from cancer chemotherapy), cancer predisposition, gene
discovery, and the effectiveness of steroids and blood
transfusions as treatment options for all bone marrow failure
syndromes. The Committee commends NHLBI for its attention to
this disorder.
Down Syndrome.--The Committee encourages NHLBI to review
the causes of congenital heart disease in children with Down
Syndrome. Studies should also be encouraged in analyzing the
increased risk of leukemia in persons with Down Syndrome.
Duchenne Muscular Dystrophy.--The Committee is pleased that
NLHBI has enhanced its research and related activities
surrounding cardiac complications associated with DMD and urges
the Institute to continue to expand and enhance this work going
forward. The Committee urges NHLBI to become more involved with
NIH Muscular Dystrophy activities by joining the Muscular
Dystrophy Coordinating Committee.
Heart Failure Clinical Research Network.--The Committee is
concerned that in spite of advances in treatment, both the
number of newly diagnosed cases and the number of Americans
suffering from heart failure continues to grow, while the long-
term prognosis for patients still remains poor. The Committee
urges the NHLBI to initiate a planned research network to
conduct clinical studies using burgeoning new approaches to
improve outcomes for heart failure patients, and provide an
infrastructure to enable rapid translation of promising
research findings into enhanced patient care. The network would
have the capability of implementing multiple concurrent
clinical studies that may show promise for new therapies and
provide background for larger clinical trials.
Hemoglobinopathies.--Sickle cell anemia and thalassemia are
inherited blood disorders caused by mutations in the genes for
the hemoglobin molecule, the protein in red blood cells that
carries oxygen to all parts of the body. These conditions cause
many problems including moderate to severe anemia, chronic
pain, iron overload with its associated diabetes, liver and
heart failure, enlarged spleen, bone weakness, pulmonary
hypertension, and stroke. The Committee recognizes NHLBI's
continued commitment to invest in basic and clinical research
in sickle cell anemia and thalassemia, and encourages NHLBI to
sponsor a conference of experts to develop a report focused on
the science and management issues that are common to these
hemoglobinopathies. The Committee supports a cooperative effort
to identify areas of scientific collaboration and promising new
research directions in sickle cell anemia and thalassemia.
Hemophilia.--The Committee commends the NHLBI for its
leadership in advancing research on bleeding and clotting
disorders and the complications of these disorders. The
Committee encourages the NHBLI to maintain its work in this
area and support research on improved and novel therapies.
Innovative Technologies for Engineering Small Blood
Vessels.--The Committee understands that the supply of natural
blood vessels for multiple grafts does not meet the demand for
patients undergoing heart artery bypass surgery, and that
prosthetic grafts for children born with complex heart defects
fail at an unacceptable rate. To advance the development of
substitutes for natural blood vessels, the Committee urges the
NHLBI to continue to invest in research to address this matter.
Lung Cancer.--Chronic Obstructive Pulmonary Disease [COPD]
is the fourth leading cause of death in the United States. Lung
cancer is the leading cancer killer in both men and women and
in 2005. The Committee understands that COPD may be a predictor
of future onset of lung cancer. With 24 million people having
decreased lung function, and in the face of an ever-aging
population, the need to develop better treatment and prevention
strategies to address this linkage will only increase over the
coming decade. The Committee encourages NHLBI to collaborate
more extensively with NCI to develop appropriate research
initiatives that can be undertaken cooperatively, and
encourages NHLBI to sponsor a workshop on COPD as it relates to
lung cancer with input from the lung community.
Marfan Syndrome.--The Committee commends the NHLBI for its
support of research on this life-threatening, degenerative
genetic disorder, which is characterized by aortic aneurysms
and dissections, painful orthopedic issues, pulmonary issues
and ocular manifestations that can result in blindness. Years
of basic research are ready to be translated into a clinical
trial for a drug therapy that may potentially prevent aneurysm
development, which may benefit not only the Marfan population
but thousands of people who are afflicted with genetically
triggered aneurysms and others with similar connective tissue
disorders. The Committee urges the NHLBI to support this effort
through all available mechanisms, as deemed appropriate.
Novel Targets and Therapy Development for Clot-based
Stroke.--The Committee recognizes that an urgent need exists to
develop new therapies to reduce bleeding risk, minimize brain
damage and loss of function from stroke. The Committee urges
the NHLBI and the National Institute of Neurological Disorders
and Stroke to initiate a planned collaborative effort to
identify new molecular targets, explore promising agents, and
develop innovative therapies to quickly restore blood flow to
the brain to limit stroke damage.
Primary Immunodeficiency Diseases.--The Committee
understands that NHLBI has begun to work with the Jeffrey
Modell Foundation as part of its national physician education
and public awareness campaign for primary immunodeficiency
diseases, including co-sponsorship of physician conferences at
the NIH. The Institute also has supported the Foundation's 10
Warning Signs Poster distribution, which is widely utilized by
healthcare professionals in the Nation and globally. The
Committee encourages NHLBI to take further action in this
regard and to continue to be an active participant in the
development of educational materials, conferences, and related
initiatives, as appropriate.
Pulmonary Fibrosis.--The Committee urges the NHLBI to
increase funding for lung research, particularly in the area of
pulmonary fibrosis, a disease that is terminal and for which
there is currently no effective treatment.
Pulmonary Hypertension.--Pulmonary Hypertension [PH] is a
rare, progressive and fatal disease that predominantly affects
women, regardless of age or race. PH 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 continues to view research in this
area as a high priority and commends NHLBI's efforts to promote
PH related research. For fiscal year 2006, the Committee
encourages the Institute to increase funding for basic
research, gene therapy and clinical trials of promising
pharmaceuticals, and to take appropriate measures to ensure the
submission of high quality proposals in this area.
Scleroderma.--The Committee is encouraged by NHLBI's
growing interest in scleroderma, a chronic and progressive
disease that predominantly strikes women. Scleroderma is
disfiguring and can be life-threatening, affecting multiple
systems including the heart and lungs. The Committee commends
the NHLBI for funding the Scleroderma Lung Study, a large
multi-center trial whose focus is to find a therapy that may
alter the course of the inflammation of the lungs that occurs
in approximately 40 percent of those diagnosed with systemic
scleroderma. The Committee also commends NHLBI for its
increasing commitment to finding a cause and improved therapies
for pulmonary arterial hypertension. Pulmonary arterial
hypertension occurs in approximately 50 percent of those
diagnosed with systemic scleroderma. More research is needed
for the continued development of safe, effective treatments
where few exist for some and none for others and to identify
the causes of the complications of scleroderma that include
pulmonary fibrosis, pulmonary hypertension, myocardial
fibrosis, cardiac arrhythmias, pericarditis, and Raynaud's
Phenomenon.
Sleep Disorders.--The Committee continues to urge the
National Center on Sleep Disorders Research to partner with
other Federal agencies, such as the Centers for Disease Control
and Prevention, as well as voluntary health organizations, such
as the National Sleep Foundation, to develop a sleep education
and public awareness initiative to serve as an ongoing,
inclusive mechanism for public and professional awareness on
sleep and sleep disorders.
Specialized Centers of Clinically Oriented Research [SCCOR]
for Vascular Injury, Repair, and Remodeling.--Vascular diseases
result from clogged, weakened or otherwise damaged blood
vessels. The Committee encourages the NHLBI to initiate a
planned new SCCOR program to conduct interdependent clinical
and multidisciplinary basic research projects on the molecular
and cellular mechanisms of vascular injury, repair, and
remodeling. This program would promote patient-oriented
research to improve prevention, detection, and treatment of
vascular diseases, such as heart attack and stroke. The SCCOR
would provide resources to enable new clinical investigators to
develop skills and research capabilities to conduct relevant
research in this area.
Thrombosis and Thrombophilia.--The Committee is very
concerned about the basic science of thrombosis and
thrombophilia, major causes of death and disability in this
country. The Committee strongly urges the Institute to expand
its support for basic research into their underlying causes in
order to improve diagnosis and treatment for these conditions.
The Committee also strongly urges the Institute to support this
research and urges collaboration with the thrombophilia centers
funded by CDC.
Vascular Biology.--The Committee is very supportive of the
Institute's research initiatives and encourages NHLBI to
continue to advance the field of vascular biology, the study of
blood and blood vessels and their interactions. Vascular
biology research provides the foundation for understanding the
underlying causes of atherosclerosis, angiogenesis,
inflammation, and thrombosis. Venous and arterial thrombosis,
blood clots that can lead to heart attacks, strokes, or
respiratory dysfunction, are a particularly important and
understudied area of vascular biology. Much remains to be
learned about the basic mechanisms of pathologic thrombosis,
but research has determined that age is one of the most
important risk factors. The Committee encourages NHLBI, in
collaboration with NIA, to develop a research agenda on
thrombosis and its impact on the elderly, to improve the
diagnosis and treatment of this potentially fatal complication
of many diseases.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2005.................................... $391,829,000
Budget estimate, 2006................................... 393,269,000
House allowance......................................... 393,269,000
Committee recommendation................................ 405,269,000
The Committee recommendation includes $405,269,000 for the
National Institute of Dental and Craniofacial Research [NIDCR].
The fiscal year 2005 appropriation was $391,829,000 and the
budget requested $393,269,000. 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 Americans. 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 Abnormalities.--NIDCR is encouraged to continue its
support of research aimed at the health of oral mineralized
tissues. This includes studying the role of genetic factors and
the potential for cell-based and pharmacological therapy and
early screening for osteoporosis. Additionally, NIDCR is urged
to continue research on fibrous dysplasia/McCune Albright
syndrome and to focus on the dental abnormalities associated
with Paget's disease.
Scleroderma.--The Committee is encouraged by NIDCR's
interest in scleroderma, a chronic and progressive disease that
predominantly strikes women. Scleroderma is disfiguring and
life-threatening, and effective treatments are lacking.
Scleroderma is often associated with a number of dental and
craniofacial complications. The most major and common problems
are xerostomia and microstomia. Additional concerns are
increased frequency of caries, periodontal disease, fibrotic
changes, fungal infections, telangectasia and bone resorption
of the mandible. Additional research is needed to develop safe
and effective treatments and to identify the cause or causes of
the serious complications of scleroderma.
Temporomandibular Joint Disorders [TMJ].--The Committee
agrees with and is encouraged by recent public statements by
NIH officials that because of past and current investments in
research and patient registries, the field is now ready to
support a substantial new research investment in this complex
set of disorders. The Committee therefore strongly urges that
NIDCR take its appropriate leadership role in a substantially
expanded effort to complete the research needs and
opportunities agenda outlined in the June 2005 NIH TMJ Report
to Congress. As noted previously, the Committee expects NIDCR
to continue to collaborate and coordinate with all relevant
ICs.
Because patient advocacy groups are often the best sources
of information about affected populations and have established
mechanisms for communicating with them, the Committee urges
NIDCR to regularly consult with the TMJ Association and other
relevant groups as it develops and operates its patient
registry activities. In addition, the Committee urges NIDCR to
fund an effort to categorize and analyze the symptoms of people
with TMJ disorders that are collected in a patient advocacy
group database, in an effort to enhance future TMJ research
agendas.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2005.................................... $1,713,584,000
Budget estimate, 2006................................... 1,722,146,000
House allowance......................................... 1,722,146,000
Committee recommendation................................ 1,767,919,000
The Committee recommends an appropriation of $1,767,919,000
for the National Institute of Diabetes and Digestive and Kidney
Diseases [NIDDK]. The fiscal year 2005 appropriation was
$1,713,584,000 and the administration's request is
$1,722,146,000. The comparable amounts for the budget estimates
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.
Cooley's Anemia.--The Committee continues to support the
high quality research being conducted by the NIDDK on such
issues as iron chelation, non-invasive iron measurement, fetal
hemoglobin, and other topics critical to improving the lives of
Cooley's anemia patients. The development of a less burdensome
means of iron chelation is urgently needed. In addition, the
Committee encourages NIDDK to continue to work closely with
NIBIB to develop and perfect non-invasive means of iron
measurement.
Cystic Fibrosis [CF].--The Committee encourages NIDDK to
continue its support of CF research efforts, including
proteomics research. CF researchers are looking at the many
proteins that play a role in CF, in hopes of identifying new
drug targets to treat CF. The Committee commends the NIDDK for
its support of the program announcement for research proposals
focusing on discovery and development of compounds that will
correct protein misfolding. The Committee encourages NIDDK to
further support this especially promising area of research.
Diamond-Blackfan Anemia.--The Committee is pleased that
NIDDK will be hosting a workshop to understand the state of the
science of Diamond-Blackfan Anemia [DBA] as it relates to
research important to NIDDK, including red cell formation,
ribosomal proteins, DBA animal models, gene therapy, mechanisms
of iron overload and the development of treatment options for
patients with iron overload. The Committee strongly encourages
NIDDK to develop grant opportunities to support DBA research
initiatives in these areas.
Digestive Diseases.--Serious disorders such as colorectal
cancer, inflammatory bowel disease, irritable bowel syndrome,
hemochromatosis, celiac disease, and hepatitis take a
tremendous toll in terms of human suffering, mortality, and
economic burden. The Committee commends NIDDK on the success of
its 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
irritable bowel syndrome.
Diabetes in Native Hawaiians.--The Committee commends the
NIDDK for its focused research on diabetes in Native American,
Native Alaskan, and Native Hawaiian populations. The Committee
is pleased with the innovative multicultural diabetes
prevention campaign tailored specifically for native
populations and the collaboration with CDC in the SEARCH
epidemiological study. Additionally, the Committee requests an
update in the fiscal year 2007 appropriations justification on
recommendations resulting from the NIDDK and IHS conference
scheduled to convene in 2005, and looks forward to similar
conferences addressing prevention and treatment strategies in
Native Hawaiian communities.
Fatty Liver Disease.--The Committee notes that there is an
emerging obesity-related chronic liver disease, which may
affect as many as one in four adults and a significant number
of obese children. This diagnosis encompasses a spectrum of
severity with many cases evolving into non-alcoholic
steatohepatitis [NASH] and, ultimately, cirrhosis. NASH-related
liver disease has already become an important indicator for
liver transplantation, and in the absence of better treatments,
the need for NASH-related liver transplantation will increase
significantly over time. The Committee is pleased that NIDDK is
funding a fatty liver disease clinical trial that includes both
adult and pediatric populations. The Committee urges NIDDK to
focus research on the progression of fatty liver disease to
cirrhosis and the impact of alcohol on the progression of fatty
liver disease. The Committee notes that the recently published
new USDA nutrition guidelines regarding alcohol consumption may
not be appropriate for individuals with fatty liver disease,
and therefore urges NIDDK to focus research on this matter to
support a clarification of the USDA guidelines.
Fragile X.--Fragile X mental retardation is a single-gene
disorder that results from an unusual kind of mutation. Study
of the chain of events set in motion by this mutation may lead
to the identification of points in the process at which
interventions may ameliorate symptoms. The Committee urges
NIDDK to expand its research activities on Fragile X and to
coordinate these efforts with other Institutes working on
related activities, including NIMH and NICHD.
Glomerular Disease Research.--The Committee continues to be
pleased with the work of NIDDK in the area of glomerular
disease research, particularly as it relates to focal segmental
glomerulosclerosis. The Committee commends NIDDK for conducting
the recent Glomerular Disease Workshop in January 2005, and
urges NIDDK to issue a program announcement or other
appropriate mechanism to ensure the initiation of grant
proposals, training positions, and other activities to expand
the NIDDK portfolio in this important area of research.
Hepatitis B.--The Committee is concerned that a consensus
treatment protocol for hepatitis B does not yet exist, but is
pleased to learn that NIDDK is actively supporting preliminary
research to convene a research workshop to plan a Hepatitis B
Consensus Development Conference. The Committee is pleased that
NIDDK is taking all necessary steps to plan a successful
conference, and urges that this conference be convened as soon
as possible.
Hepatitis C.--The Committee is pleased to learn that there
have been 50 patent applications filed for new therapies for
hepatitis C and there are at least six drugs currently in early
human trials. In addition to developing new drugs, the
Committee urges NIDDK to encourage the improvement of existing
drugs to reduce their toxicity and negative side effects. The
Committee applauds NIDDK for formally adopting the goal of a 90
percent treatment effectiveness rate for hepatitis C within 10
years. The Committee encourages NIDDK to work with the National
Hemophilia Foundation in developing and advancing research
initiatives for addressing HCV within the bleeding disorders
community.
Hematology.--The Committee is aware of the high-quality
hematology research in iron metabolism, gene regulation, and
stem cell plasticity currently funded by the Institute. The
Committee encourages NIDDK to set priorities for future
research in these and new areas that significantly impact a
broad array of blood disorders, such as erythroid
differentiation, oxidant injury, and metabolomics.
Incontinence.--Many otherwise healthy, active individuals
suffer from incontinence. Fecal incontinence, also called bowel
incontinence, affects people of all ages and is associated with
a wide variety of causes. The Committee is pleased that NIDDK
is contributing to the development of standardized approaches
to measure incontinence and urges NIDDK to continue
collaborating with NICHD on the incontinence state-of-the-
science conference and on appropriate follow-up to this
conference.
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]. These extremely complex
disorders represent the major cause of morbidity from
intestinal illness. The Committee commends NIDDK for its strong
leadership in this area and encourages the Institute to
increase funding for research focused on: (1) 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) translation of basic
research findings into patient clinical trials as outlined in
the research agenda developed by the scientific community
titled ``Challenges in Inflammatory Bowel Disease.'' The
Committee also encourages NIDDK to continue to strengthen its
partnership with the IBD community and increase funding for its
successful Digestive Disease Centers program with an emphasis
on IBD.
Integration of Type 1 Diabetes Research.--The Committee
urges the NIH to facilitate the effective integration of the
various research programs funded by the special funding for
Type 1 Diabetes Research.
Interstitial Cystitis.--The Committee notes that RFAs have
been very helpful in stimulating scientific interest in
interstitial cystitis [IC]. Therefore, the Committee urges the
NIDDK to continue using this funding mechanism when investing
in IC-specific basic science research, particularly in the area
of urinary markers. The Committee also encourages the NIDDK to
sponsor a scientific symposium on IC in 2006 to follow up on
the very successful 2003 symposium. The Committee also urges
the NIDDK to hold a separate meeting of leading international
opinion leaders involved in IC research to seek clarity on the
definition of IC. The absence of a uniform definition that
accurately captures the condition and the affected population
is negatively impacting patients in terms of diagnosis and
treatment as well as researchers in terms of literature review
and their research activities. The Committee was encouraged to
learn that the NIDDK is launching an IC awareness campaign, and
it hopes the NIDDK will continue to work closely with the IC
patient community on both developing the content and executing
the campaign.
Irritable Bowel Syndrome.--The Committee is pleased that
NIDDK is formulating an action plan for digestive diseases and
that irritable bowel syndrome [IBS] will be a focus area of
this overall plan. However, given the increasing frequency of
IBS and the Committee's long-standing interest in this
condition, the Committee strongly urges the NIDDK to complete
this digestive disease plan as quickly as possible.
Kidney Disease.--Kidney disease is a rapidly growing health
problem in the United States, where an estimated 15 million
people have lost 50 percent of their kidney function and
another 20 million more Americans are at increased risk of
developing kidney disease. The marked increase in the end-stage
renal disease [ESRD] population is fueled by the large number
of patients with diabetes. Diabetes is the most common cause of
kidney disease and accounts for 34 percent of patients on
dialysis. Chronic kidney disease has emerged as a major
contributing factor to cardiovascular disease. The Committee
therefore encourages NIDDK to assign priority to expand the
kidney disease research infrastructure through a robust program
of kidney research core centers to promulgate collaborative
research on a local, regional and national level. In addition,
the Committee recommends expanded support for investigator-
initiated research projects in five priority areas of greatest
clinical importance: acute renal failure, diabetic nephropathy,
hypertension, transplantation, and uremic cardiovascular
toxicity. Research grant applications in these areas should be
encouraged with appropriate program announcements and requests
for proposals. Continued funding of grants to support
development of investigator-initiated clinical and basic
studies in these areas of high priority is essential. The
Committee wishes to commend NIDDK for moving forward with the
Clinical Trials Cooperative Group and supports collaboration
with the renal community to seek new strategies and energize
clinical investigation in the above mentioned areas.
Liver Disease Research Action Plan.--The Committee is
pleased to note that NIDDK, working with the leading scientific
experts in the field, has published a comprehensive Liver
Disease Research Action Plan to guide future research
activities. The Plan is organized into 16 chapters and
identifies numerous areas of research important to virtually
every aspect of liver disease. The Committee urges that steps
be taken to implement the plan immediately and submit a report
to the Committee prior to next year's hearings detailing what
has been accomplished to that point, as well as future plans,
with a specific timeline, for implementation of the balance of
the plan.
Mucopolysaccharidosis [MPS].--The Committee recognizes the
efforts of the NIDDK to enhance research efforts to achieve a
greater understanding and pursue development of effective
therapies for MPS disorders. In addition to the general overall
support of broad-based MPS research, the Committee supports
efforts by NIDDK to reach out to NIAMS to improve collaborative
bone and joint disease research in MPS disorders. Research
focused on the underlying pathophysiology of bone and joint
lesions, the gene mutations and substrates that are stored, and
potential therapeutic approaches continue to be of significant
interest to the Committee. The Committee commends the NIDDK on
its collaborations with NINDS, NICHD, NCRR, and ORD in
advancing broad-based MPS-related research.
Osteoporosis.--NIDDK is encouraged to support research
targeting new technologies and therapies to increase bone mass
and combat osteoporosis, through focus on: (1) genetics,
environmental and lifestyle factors, and (2) the effects of
disease, in order to address the critical research questions
highlighted in the Surgeon General's Report on Bone Health and
Osteoporosis.
Paget's Disease.--NIDDK is urged to study the functional
consequences of the recently identified gene mutations in
Paget's disease as a means of identifying new therapeutic
treatments for the disease.
Pediatric Kidney Disease.--Kidney disease remains a
persistent and poorly understood problem among infants,
children and adolescents, impairing normal growth and
development and often resulting in learning disabilities and
mental retardation. Of urgent concern today is the explosion in
the incidence of obesity among children and adolescents, a
morbidity that places more than 15 percent of America's
children at risk for developing type 2 diabetes, hypertension,
and chronic kidney disease [CKD]. These morbidities not only
represent a significant financial burden to the health care
system but also are important risk factors for the development
of cardiovascular disease. The Committee urges NIDDK to
continue to support research focused on the pathogenesis,
prevention, and treatment of kidney disease in children. The
Committee recommends that emphasis be placed on exploring the
contributions of obesity, type 2 diabetes, and hypertension to
progression of disease, and interventions that may limit
cardiovascular morbidity in patients with CKD.
Pediatric Liver Disease.--The Committee is pleased that the
NIDDK has taken steps to increase research on biliary atresia,
the most common cause of liver transplantation in children, by
creating 10 centers within the Biliary Atresia Clinical
Research Consortium. The Committee is also pleased that centers
have been added with a special focus on additional neonatal
liver diseases.
Polycystic Kidney Disease.--The Committee is pleased to
learn of the first clinical drug trial for PKD in humans and
the development of additional, innovative PKD therapies. This
progress directly benefits more than 600,000 Americans
suffering from PKD and could potentially save billions of
Medicare and Medicaid dollars for renal replacement therapy and
free up thousands of spots on the kidney transplant waiting
list. These discoveries have produced a cohesive,
interdisciplinary body of scientific work benefiting PKD
research; engendered a broad range of alternative model
research systems and reagents shared worldwide among PKD
investigators; and drawn a host of talented investigators from
other disciplines into the PKD field. The Committee urges NIDDK
to pursue fulfillment of its PKD Strategic Plan by facilitating
PKD clinical trials, expanding studies of pathophysiology and
cellular pathobiology, expanding the PKD research
infrastructure, and enhancing resources to create a supportive
environment for PKD investigators to develop new interventional
strategies and pursue long-range planning.
Primary Biliary Cirrhosis [PBC].--PBC is a rare, chronic
and progressive liver disease that causes irreversible
destruction of the bile ducts. The cause of PBC is still
unknown, but current studies suggest it may involve
autoimmunity, infection, or genetic predisposition, and does
seem to appear more often in certain families. Women are
affected 10 times more than men, and PBC is usually diagnosed
in patients between the ages of 35 to 60 years. The Committee
encourages NIDDK to further study this rare disease to
determine among other things, why women are predominantly
affected and whether there are successful treatment options
other than liver transplantation.
Prostatitis.--The Committee encourages the Institute to
provide more diverse medical specialties to supplement and
build upon the insufficient treatment options and the
background of basic information now available for prostatitis.
The genetic and molecular epidemiology, the management of
pelvic pain, the infectious origins and the symptoms of
prostatitis that are identical to symptoms of prostate cancer
need special attention.
The Committee applauds the work the Chronic Prostatitis
Collaborative Research Network [CPCRN] has undertaken. The
genetic and other possibilities linking prostate diseases is
virtually unexplored. The Committee encourage microscopic
studies of the prostatic fluid and tissue by infectious disease
specialists, pathologists, immunologists and others. The
Committee further encourages the NIDDK to increase research,
public awareness, and public education to erase the stigma
attached to this affliction that attacks young men.
Scleroderma.--The Committee encourages the NIDDK to support
scleroderma-relevant research. Scleroderma is a chronic and
progressive disease that predominantly strikes women. It is
estimated that 90 percent of patients with systemic sclerosis
have gastrointestinal [GI] involvement and that of that number
50 percent have clinically significant manifestations. GI
involvement can manifest as gastroesophageal reflux disease,
dysphagia, Barrett's esophagus, gastroparesis, ``watermelon
stomach'', malabsorption, and fibrosis of the small and large
intestines. Renal crisis affects 20 percent of those with
systemic sclerosis often within the first 5 years after
diagnosis. More research is needed in order to develop safe and
effective treatments and to identify the cause or causes of the
complications of scleroderma.
TEDDY.--The Committee commends the NIDDK for launching
TEDDY, a long-term study to identify the environmental causes
of autoimmune diabetes. The Committee urges the NIDDK to
communicate details of the study to the research community, to
provide access to study materials and data, and to develop
mechanisms to integrate new technologies into the study design.
TrialNet.--The Committee commends the NIDDK for its support
of the Type 1 Diabetes TrialNet, which has launched a natural
history study and a clinical intervention trial for juvenile
diabetes. The Committee encourages the NIDDK to continue its
efforts to translate basic and preclinical research on juvenile
diabetes into a pipeline of new therapeutic strategies that can
be evaluated through the TrialNet clinical trials network. The
Committee urges the NIDDK to develop biomarkers for the
evaluation of efficacy and the efficient operation of clinical
trials and to develop more efficient approaches to subject
recruitment for clinical trials.
Tuberous Sclerosis Complex.--Tuberous sclerosis complex, or
TSC, is a genetic disorder that triggers uncontrollable tumor
growth in multiple organs of the body including the kidneys,
where patients are at risk for polycystic kidney disease,
cancer or, most commonly, benign growths know as angiomyolipoma
that can result in kidney failure. The Committee is encouraged
that NIDDK is participating in a Trans-NIH Tuberous Sclerosis
Coordinating Committee, and urges NIDDK's continued involvement
in this process. The Committee also urges NIDDK to collaborate
with NCI on a conference on nutrient sensing and insulin-
signaling in cells with inclusion of TSC research.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2005.................................... $1,539,448,000
Budget estimate, 2006................................... 1,550,260,000
House allowance......................................... 1,550,260,000
Committee recommendation................................ 1,591,924,000
The Committee recommends an appropriation of $1,591,924,000
for the National Institute of Neurological Disorders and Stroke
[NINDS]. The fiscal year 2005 appropriation was $1,539,448,000
and the budget request is $1,550,260,000. The comparable
amounts for the budget estimates 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 is currently supporting both
pre-clinical and translational research intended to expand the
pool of therapeutic agents for treating Alzheimer's disease.
For example, a recent NINDS-supported study tested a drug that
interferes at a specific point in the cholesterol pathway that
contributes to the generation of amyloid protein, a hallmark of
Alzheimer's. The study resulted in a 99 percent reduction in
brain amyloid in a mouse model of the disease, suggesting that
this may provide a novel approach for developing a therapeutic
intervention for Alzheimer's disease. The Committee encourages
NINDS to continue to assign a high priority to Alzheimer
research, and to work closely with NIA, NIMH and other
institutes.
Amyotrophic Lateral Sclerosis [ALS].--The Committee is
pleased by the increased number of NINDS research programs on
ALS, including participation in the NIH partnership of 14
Institutes to accelerate neuroscience research, the NIH
Blueprint for Neuroscience Research, plus new interdisciplinary
collaborations with other organizations and appropriate NIH
Institutes, particularly NIEHS. The Committee commends NINDS on
its multiple initiatives involving high-throughput screening
and assay development to identify compounds with activity in
neurodegenerative disorders, including ALS. The Committee is
gratified by the development of translational research and the
clinical trials programs at NINDS and by the public's new
opportunities to benefit from better access to and
dissemination of information. The Committee is also pleased by
the series of scientific workshops held since 2003 with the
Department of Veterans Affairs [VA], the Department of Defense
[DOD], and with leading scientists from academic centers
throughout the Nation. The Committee encourages NINDS to
continue and to grow its collaborative initiatives with
voluntary health associations, other NIH Institutes, the DOD
and the VA in the effort to advance ALS research and identify
treatments and a cure for the disease.
Ataxia Telangiectasia [A-T].--A-T is a genetic disease that
attacks in early childhood. It progressively affects
coordination and severely compromises the immune system.
Children with A-T are highly likely to develop cancer, and
rarely live beyond their teens. The Committee encourages the
NINDS to work with the NCI and other appropriate Institutes to
support research aimed at understanding the underlying causes
of A-T, with the goal of translating this basic research into
treatments for the disease.
Basic Behavioral and Social Sciences Research.--The
Committee encourages NINDS to participate in trans-institute
initiatives organized by OBSSR or another institute to
strengthen basic behavioral research and enhance opportunities
for behavioral science research training.
Batten Disease.--The Committee strongly urges the Institute
to increase funding for Batten Disease research by actively
soliciting grant applications and taking aggressive steps to
assure that a vigorous research program is established. The
Committee expects to be informed of the steps taken to increase
research on Batten disease.
Brain Tumors.--The Committee continues to believe that
additional attention should be given by NINDS to identifying
causes of and treatments for brain tumors and encourages NINDS
to continue working with NCI to carry out the recommendations
of the Report of the Brain Tumor Progress Review Group.
Charcot-Marie-Tooth Disease.--The Committee continues to be
concerned about NIH support for research on Charcot-Marie-Tooth
[CMT] disease. The Committee welcomes the upcoming NINDS
workshop on peripheral neuropathies, but remains unclear as to
the degree this workshop will focus on CMT. The Committee urges
the NIH to include a significant focus on CMT in the upcoming
workshop with a goal of producing outcomes which will be
directly relevant to CMT research and lead to a relevant
program announcement or request for applications on CMT. The
Committee encourages that relevant Institutes and Centers will
participate in the workshop. In addition, the Committee
requests NIH incorporate CMT research into its Blueprint for
the Neurosciences initiative.
Down Syndrome.--The Committee commends NINDS for sponsoring
a Down Syndrome Workshop to address research priorities
relating to optimizing synaptic structure and function in
neuronal circuits important for cognition. The Committee
encourages NINDS to identify opportunities for investigating
the genetic and cellular basis for abnormalities in the
structure and function of these circuits in both the developing
and mature nervous system. In addition, NINDS is encouraged to
develop strategies to understand the incidence and impact on
cognition of obstructive sleep apnea and other disorders of
sleep. The NINDS is also encouraged to work with the NIA to
develop strategies to investigate the biology of age-related
disorders, such as Alzheimer's disease and Parkinson's disease,
in people with Down syndrome. NINDS is also encouraged to work
with the Office of the Director to develop a strategic plan for
Down syndrome research and to coordinate its research with
NICHD, NIA, NIMH and other institutes.
Duchenne Muscular Dystrophy.--The Committee remains
concerned with the amount of time taken by the NIH to comply
with requirements of the MD Care Act, which became law in
December 2001. However, the Committee is pleased NIH has funded
one additional Wellstone Muscular Dystrophy Cooperative
Research Center and is working to fund two more for a full
complement of six. The Committee further encourages the
Institute to provide adequate funding and resources for each
center. The Committee further requests that NINDS coordinate
with NIAMS on timelines for translational research, the
consensus conference and the strategic plan.
Epilepsy.--The Committee seeks intensified efforts by the
NINDS to produce breakthroughs in the prevention, treatment,
and eventual cure of epilepsy. The Committee applauds the
development of benchmarks for epilepsy research resulting from
the ``Curing Epilepsy: Focus on the Future'' conference held in
March 2000 and encourages the Institute to address important
research issues raised at the ``Living Well with Epilepsy II''
conference held in July 2003. The Committee encourages NINDS to
continue to dedicate resources for carrying out its benchmark
priorities, to develop plans and goals for the anti-epileptic
drug development program, and to report to the Committee on its
activities to further these important areas of research.
Fragile X.--The Committee urges the NINDS to intensify its
research into these issues as they relate to Fragile X, and to
coordinate this research with other Institutes working on
Fragile X, including but not limited to NIMH and NICHD.
Fragile X-associated Tremor/Ataxia Syndrome [FXTAS].--FXTAS
is a newly discovered, progressive neurological disorder that
affects older men who are carriers of a premutation in the same
gene that causes Fragile X syndrome. Identification of older
male carriers will lead to a better understanding of the true
incidence of Fragile X syndrome and afford at-risk families of
child-bearing age the opportunity to pursue genetic counseling.
NINDS, in collaboration with the National Institute on Aging,
is urged to commit additional resources and expand research
into FXTAS, including working with the other NIH institutes as
well as the Centers for Disease Control and Prevention in the
development of genetic counseling protocols for families
affected by both Fragile X and FXTAS.
Learning Disabilities.--The Committee commends NINDS for
the work conducted to explore the neurological aspects of
learning disabilities. The Committee looks forward to learning
the results of this work and encourages the Institute to
continue to coordinate with other Institutes working on related
activities.
Mucopolysaccharidosis [MPS].--The Committee commends NINDS
efforts to collaborate with the Lysosomal Storage Disorder
Research Consortium [LSDRC] in the development and release of
the July 2004 program announcement titled ``CNS Therapy
Development for Lysosomal Storage Disorders'' and the stated
intent to enhance blood brain barrier research in lysosomal
storage disorders. The Committee continues to encourage NINDS
to collaborate with all appropriate Institutes and Centers to
support ongoing MPS research, including study of the blood
brain barrier as an impediment to treatment, and use all
available mechanisms to further stimulate and enhance efforts
to better understand and treat MPS disorders.
Neurofibromatosis.--The Committee encourages NINDS to
aggressively expand its NF clinical and basic research
portfolios. The Committee commends NINDS for its leadership
role in NF research and in coordinating efforts with other
Institutes engaged in NF research. The Committee recognizes
that basic research has now successfully brought NF research
into the clinical era. The Committee therefore encourages NINDS
to continue its exemplary efforts in the creation,
implementation and funding of NF clinical trials
infrastructures and clinical trials using existing and new
drugs on NF patients. The Committee calls upon NINDS to
continue to coordinate its efforts with the other institutes at
NIH as well as other government agencies.
Neuroprosthetics.--The Committee strongly supports research
on neuroprosthetics, such as the Brain Machine Interface (or
Human Assisted Neurological Device) project. This research
offers great promise in restoring movement in individuals
suffering from a variety of neurological disorders, including
paralysis, stroke and wound-related trauma, and should be
expanded.
PET Imaging and Alzheimer's Disease.--The Committee urges
the NINDS, in collaboration with the NIA and NIMH, to expand
its research into early diagnosis of Alzheimer's using PET
imaging of the brain, and to share its results with the Centers
for Medicare and Medicaid Services.
Parkinson's Disease.--The Committee supports the innovative
multidisciplinary research and training concerning Parkinson's
disease provided by the Morris K. Udall Parkinson's Disease
Research Centers of Excellence. The Committee urges NINDS to
continue support for the Udall Centers. The Committee further
encourages the Director to create an additional Coordinating
Udall Center to further focus and manage the interdisciplinary
efforts of the Udall Centers. The additional research
opportunities and discoveries made by Udall Center scientists
are leading to improved diagnosis and treatment of patients
with Parkinson's. The Committee commends both the basic and
clinical objectives of the Centers that, together, enhance
research effectiveness in a multidisciplinary setting. The
Committee commends the NINDS for participating in a community-
wide examination of private and public Parkinson's disease
research funding through the Parkinson's Community Research
Advisory Council. The Committee strongly encourages NINDS to
continue to participate in this effort. The Committee commends
the Director for implementing the Neuroscience Blueprint, which
creates new opportunities for collaborative, directed research
across institutes and through public-private partnerships. As
the NINDS develops Blueprint initiatives for this and future
years, the Committee encourages continued collaborations
including additional intramural activities between NINDS, NIMH,
and NIA to enhance understanding of neurodegenerative diseases,
particularly Parkinson's disease. Specifically, the Committee
encourages collaborations with other institutes in the areas of
genetics, cell biology, pathology/epidemiology, non-human
models, biomarkers, neuroimaging, gene therapy, surgical
approaches, drug development, cell replacement therapy (i.e.,
stem cells), and mental health which will lead to better
treatments or a cure for this devastating and costly disease.
In particular, the Committee urges continued research on
biomarkers, for early detection of Parkinson's, and
neuroprotective compounds, to slow or stop the disease until
cures can be found. As the results of neuroprotection trials
become known, the Committee urges the Director to provide
funding for Phase III clinical trials of all the
neuroprotection compounds found to be effective, including
combinations of them. As Parkinson's is affecting men and women
at progressively younger ages, causing many to have to stop
working within a few years of their diagnosis, early diagnosis
and identification of neuroprotective compounds are critical.
Peripheral Neuropathy.--As many as 20 million Americans
suffer from peripheral neuropathy, a neurological disorder that
causes debilitating pain, weakness in the arms and legs, and
difficulty walking. Peripheral neuropathy affects approximately
one-third of diabetics, or about 5.1 million persons, while
other forms of neuropathy are inherited; associated with
cancer, kidney disease or infections like hepatitis, HIV/AIDS
or Lyme disease; or caused by autoimmunity, traumatic injuries,
poor nutrition, toxins and certain medications. While
significant research is underway on diabetic neuropathy and
HIV/AIDS-related neuropathy, the Committee strongly urges NINDS
to strengthen its research portfolio on other forms of
neuropathy. The Committee is pleased to learn that NINDS plans
to convene a workshop with distinguished scientists to identify
research goals aimed at expanding the research knowledge base
and identifying potential therapies.
Picks Disease.--The Committee urges the NINDS to initiate
funding for drug discovery efforts that focus on specific
targets relevant to treating the mechanisms underlying brain
degeneration due to frontotemporal dementia [FTD]. The
Committee further encourages the NINDS to conduct multicenter
treatment trials for symptomatic management of Pick's disease
and other FTDs. The Committee encourages the Institute to focus
on methods for discovering the causes of this family of
diseases, improving diagnostic accuracy, and providing
longitudinal characterizations so that the success of
intervention can be determined.
Rett Syndrome.--The Committee remains concerned at the
level of funding dedicated toward research into the genetic
cause of Rett syndrome, an incurable childhood neurological
disorder that is the leading cause of severe neurologic
impairment in females and the only autism spectrum disorder
that is known to have a genetic cause. While once considered
rare, increased diagnosis suggests that the prevalence of Rett
syndrome may be much greater than the current estimated
incidence of 1 in every 10,000 females. The discovery of the
specific genetic cause of Rett syndrome could help elucidate a
host of other disorders, including autism, schizophrenia,
Parkinson's, anxiety and autonomic nervous system disorders.
Accordingly, the Committee strongly urges NIH to dedicate
enhanced resources to research on the genetic cause of Rett
syndrome. The Committee also encourages NIH to coordinate with
private organizations supporting research initiatives in this
area in order to ensure the most efficient use of resources.
Spinal Muscular Atrophy.--The Committee understands that
the severity of SMA, its relatively high incidence, and the
possibility of imminent treatments have led NINDS to initiate
the SMA Therapeutics Development Program. The Committee
commends NINDS for this initiative and strongly urges NIH/NINDS
to continue to commit the resources to ensure a timely
completion of the project mission--to identify and complete
preclinical research and development of candidate therapeutics
for treating SMA by 2007. To maximize program efficiency, it is
also critical that NINDS lead efforts to integrate Therapeutics
Development efforts with emerging programs in the biotech and
pharmaceuticals industry, academic medical centers and
collaborations with voluntary health organizations to ensure
that duplication of effort is avoided. The Committee encourages
NINDS to aggressively expand its SMA basic, translational and
clinical research portfolio. The Committee understands that the
strategy for developing a treatment for SMA will guide
therapeutics development for other diseases including: Duchenne
Muscular Dystrophy, ALS, Huntington's and Alzheimer's. The
Committee strongly urges NINDS to successfully and
expeditiously execute the SMA Therapeutics Development Program
for the benefit of patients of SMA and countless other
diseases. The Committee requests that NIH report back to the
Committee, no later than June 1, 2006 with a progress report on
all aspects of SMA research.
Stroke.--The Committee continues to place a high priority
on stroke research and strongly encourages the NINDS to
increase resources for basic, clinical and translational
research and related activities into stroke. The Committee
remains concerned that funding for stroke research over the
years has not kept pace with the scientific opportunities, the
number of Americans afflicted with stroke, and the economic
toll of this disease. Therefore, the Committee encourages the
NINDS to aggressively expand its stroke education program, to
implement the long-range strategic plan for stroke research and
to continue searching for novel approaches to improve stroke
diagnosis, treatment, rehabilitation and prevention. The
Committee supports implementation of the Stroke Progress Review
Group Report and expects prior to the fiscal year 2007 hearings
a written update, including specific activities and initiatives
in this regard.
Tuberous Sclerosis Complex.--Tuberous sclerosis complex, or
TSC, is a genetic disorder that triggers uncontrollable tumor
growth in multiple organs of the body, including the brain,
heart, kidneys, lungs, liver, eyes and/or skin. Individuals
with TSC--many of whom are infants and young children--face a
lifetime of suffering with kidney failure, seizures, behavioral
disorders, autism and mental retardation. The Committee is
encouraged that NINDS has organized a Trans-NIH Tuberous
Sclerosis Coordinating Committee, and urges NINDS to continue
to take a leadership role in convening meetings of this
Committee, facilitating communication between the participating
institutes, and encouraging funding of TSC-related research.
The Committee also encourages NINDS to host a pre-clinical
translational research workshop on TSC and to include TSC in
the NINDS Pilot Therapeutic Network [NPTUNE].
Vulvodynia.--The recently published findings of NIH-
supported research indicates that millions of women suffer from
chronic pelvic and genitourinary pain conditions such as
vulvodynia. Therefore, the Committee calls on NINDS to expand
its support of research in this area, in coordination with
NICHD, ORWH, the NIH Pain Consortium and other ICs, with a
focus on etiology and multi-center therapeutic trials.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Appropriations, 2005.................................... $4,402,840,000
Budget estimate, 2006................................... 4,459,395,000
House allowance......................................... 4,359,395,000
Committee recommendation................................ 4,547,136,000
The Committee recommends an appropriation of $4,547,136,000
for the National Institute of Allergy and Infectious Diseases
[NIAID]. The budget request was $4,459,395,000. The fiscal year
2005 appropriation was $4,402,840,000. Included in these funds
is $100,000,000 to be transferred to the Global Fund to Fight
HIV/ AIDS, Malaria, and Tuberculosis. Also included is bill
language permitting up to $30,000,000 for extramural facilities
construction grants. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The NIAID is the lead NIH Institute charged with
developing vaccines and supporting research on allergies,
acquired immunodeficiency syndrome [AIDS], sexually transmitted
diseases, tuberculosis, tropical diseases, and other infectious
diseases--including those likely to be used as agents of
bioterrorism. To accomplish this mission, the NIAID supports
and conducts basic and clinical research and research training
programs in infectious diseases, whether they are naturally
occurring or the result of a bioterrorist attack, and in
diseases caused by, or associated with, disorders of the immune
system.
Anaphylaxis.--In recent years, the Committee has encouraged
the NIAID to expand research in the areas of food and drug
allergy. The Committee was pleased to learn of the Institute's
co-sponsorship of a symposium on the definition and management
of anaphylaxis, a particularly severe reaction often resulting
from allergic responses to food or medications. A recent
published report of the meeting emphasized the need for
expanded research to improve methods for diagnosing, treating,
and preventing the condition. The Committee urges the NIAID to
work with interested organizations to develop a comprehensive
research agenda on anaphylaxis. The Committee requests a report
by May 1, 2006, on how it plans to stimulate research in this
area.
Asthma.--The Committee is very pleased with NIAID's
leadership regarding asthma research and management. The
Committee urges NIAID to continue to improve its focus and
effort on asthma management, especially as it relates to
children. The Committee also urges the NIAID to collaborate
more aggressively with voluntary health organizations to
support asthma prevention, treatment, and research activities.
Additionally, recent studies suggest that a variety of viral
and bacterial agents, including agents used for immunization
may play a role in the development of asthma. The Committee
urges the Institute to expand research into the role that
infections and vaccines play in the development of asthma.
Atopic Dermatitis.--The Committee was pleased to learn
about NIAID research efforts related to atopic dermatitis
undertaken through projects such as the Immune Tolerance
Network and the Atopic Dermatitis and Vaccinia Immunization
Network. Last year, the Committee encouraged NIAID to
complement these efforts by working with NIAMS to spearhead a
multidisciplinary, multi-institute initiative to encourage
investigator-initiated research projects on AD as it relates to
smallpox vaccination as well as the progression to asthma and
other allergic diseases. The Committee requests an update in
the fiscal year 2007 appropriations justification on efforts
that have been made to foster investigator-initiated research
in this area.
Autoimmune Diseases.--The Committee applauds the formation
of two cooperative research groups, the Autoimmune Centers of
Excellence and the Cooperative Study Group for Autoimmune
Disease Prevention, which support multidisciplinary research to
understand and treat autoimmune diseases. The Committee urges
NIAID to continue its support for the prevention centers and to
encourage the participation of the wider research community in
this initiative.
Bioterrorism.--Respiratory pathogens that cause life-
threatening pneumonia are commonly proposed agents of
bioterrorism. The following are associated with acute
pneumonia/lung injury: anthrax, smallpox, plague, and
tularemia. The Committee encourages further research on the
mechanisms of pneumonia by these respiratory pathogens and the
development of new therapeutic interventions to reduce injury
and death.
Coinfection Research.--The Committee is concerned that
there is growing evidence of liver toxicity of highly active
antiretroviral therapy [HAART] in those with chronic viral
hepatitis and in particular those with decompensated liver
disease awaiting liver transplantation. There also appears to
be an emerging problem of liver cancer in co-infected patients
(HCV and/or HBV with HIV). The Committee encourages NIAID to
initiate significant research initiatives in both of these
areas.
Dystonia.--The Committee continues to support the expansion
of research and treatment developments regarding the
neurological movement disorder dystonia, given that dystonia is
the third most common movement disorder after tremor and
Parkinson's disease. The Committee encourages NINDS to support
additional research on both focal and generalized dystonia, and
commends NINDS for its study of the DYT1 gene and encourages
expansion in this area of research. The Committee is pleased
with progress made in expanding the dystonia research portfolio
resulting from the joint dystonia research program announcement
[PA], and urges NINDS to consider options for continued
progress once the program announcement expires in August 2005.
Hemophilia.--The Committee urges NIAID to continue its
efforts to develop and advance research initiatives for
addressing HCV within the bleeding disorders community. The
Committee understands that HCV continues to have a devastating
impact on this community, with nearly half of all persons with
hemophilia having contracted HCV from blood clotting factor
products.
Hepatitis.--The Committee continues to be concerned about
the prevalence of hepatitis and urges NIAID to work with public
health organizations to promote liver wellness, education, and
prevention of hepatitis.
Hepatitis C Vaccine Development.--The Committee is
encouraged to learn that a small hepatitis C vaccine human
trial has been successfully completed. The Committee urges
NIAID to implement the results of the recent workshop that was
held to discuss and evaluate efforts toward development of HCV
vaccines with the goal of spurring their development and
testing. The Committee also urges NIAID to proceed with phase
two of the human clinical trial as soon as it is scientifically
practicable. Additionally, NIAID is urged to foster the
development of an in vitro culture system for HCV as well as
new animal models for basic research and for adequately testing
vaccine candidates and antiviral drugs.
Immune Tolerance.--The Committee is encouraged by the
progress of the Immune Tolerance Network in launching clinical
trials of protocols to induce immune tolerance in patients with
Type 1 diabetes. These trials have the potential to prevent the
recurrence of autoimmunity in patients with long-standing
diabetes who have undergone islet transplantation and halt the
autoimmune attack in recently diagnosed Type 1 diabetes
patients. The Committee encourages the NIAID to continue its
strong support of this clinical network and to expand its
clinical studies promoting the translation of promising basic
discoveries.
Immune Surveillance Cell Proteomes.--The Committee
recognizes the potential threat to national security posed by
terror attacks involving biological, chemical, nuclear, and
radiological weapons. One of the challenges facing public
health officials responding to such an attack is their limited
ability to diagnose individuals who have been exposed to these
agents and do not show illness. Recent disease outbreaks--such
as SARS in Asia and Canada, avian influenza in East Asia, and
Ebola and Marburg virus in Africa--demonstrate that the speed
of diagnosis and implementation of public health measures can
mean the difference between an isolated outbreak and a global
pandemic. Therefore, the Committee strongly supports research
on immune surveillance cell proteomes (e.g. monocytes,
neutrophils, dendritic cells, B cells and NK cells) and their
response to chemical and biological pathogens. The Committee
also urges the NIAID to fund the development of a searchable
electronic database for biological proteomes, the proteomics of
immune surveillance cell interaction with pathogens (biological
and chemical), and proteins derived from the immune
surveillance cells themselves, as well as their interaction
with pathogens.
Inflammatory Bowel Disease.--The Committee continues to
note with interest a scientific research agenda for Crohn's
disease and ulcerative colitis (collectively known as
inflammatory bowel disease) titled ``Challenges in Inflammatory
Bowel Disease [IBD].'' This report identifies strong linkages
between the functions of the immune system and IBD. The
Committee encourages the Institute to expand its research
partnerships with the IBD community in fiscal year 2006 and
increase funding for research focused on: (1) the immunology of
IBD and (2) the interaction of genetics and environmental
factors in the development of the disease.
Infectious Disease Research.--The Committee believes that,
with regard to both biodefense and public health, the
development by NIAID of multi-pathogen identification arrays
that can be used to identify infectious agents through
epidemiological outbreak surveillance is critically important.
The use of whole genome expression, all exon transcription
analysis and whole genome SNP analysis studies to identify and
understand host biomarkers that may identify the type, severity
and likely response to therapeutics of infectious agents hold
great promise for the most immediate results and the Committee
encourages NIAID to pursue these lines of inquiry.
Lupus.--The Committee recognizes that Lupus is a serious,
complex, debilitating chronic autoimmune disease that causes
inflammation and tissue damage to virtually any organ system in
the body and impacts between 1.5 and 2 million individuals. The
Committee strongly urges the National Institute of Allergy and
Infectious Diseases to expand and intensify research and
related activities with respect to Lupus.
Primary Immunodeficiency Diseases.--NIAID is the lead
agency for research into this class of diseases that is known
to afflict about 500,000 Americans and may affect an equal
amount that have not yet been diagnosed. To address the complex
research needs of this group of about 140 separate diseases,
the Institute has created a research consortium comprised of
the leading experts in PI. Because of the importance of these
diseases to public health and the impact they have on the
economics of health care in this country, the Committee
believes that it is critical that the consortium be managed
efficiently, from both a scientific and an economic
perspective. The Committee requests that NIAID report to it by
May 1, 2006 on the management of the consortium, as well as its
plans for future research in this field.
Psoriasis.--Psoriasis is a common, chronic, immune-mediated
skin disease. The Committee urges NIAID to support additional
research on psoriasis and psoriatic arthritis pathogenesis,
research to develop diagnostic tests for psoriatic arthritis
and clinical research to identify new safe and effective
therapies for these diseases.
Scleroderma.--The Committee commends the NIAID for its
growing commitment to understanding the cause and to finding
improved treatments for scleroderma, a chronic and progressive
disease that predominantly strikes women. Scleroderma is
disfiguring and can be life threatening, affecting multiple
systems including the heart, lungs, kidneys, and
gastrointestinal tract. NIAID has provided a grant to fund the
SCOT Study (Scleroderma Cytoxan or Transplant). This study will
compare the differences between autologous stem cell transplant
(stem cells that are taken from the blood of the patient)
versus high dose cytoxan for the treatment of progressive
systemic scleroderma. The Committee encourages the NIAID to
continue this commitment through expanded inclusion of
scleroderma in the Autoimmune Centers of Excellence and for
continued dialogue with the Institutes that are part of the
Autoimmune Disease Coordinating Committee.
Transplantation Research.--The Committee is aware that
while 1-year organ transplantation survival has improved
remarkably over the last 15 years, there has been little
success in reversing the decline in long-term graft and patient
survival. Therefore, the Committee urges NIAID to convene an
expert conference during fiscal year 2006, in collaboration
with NIDDK and NHLBI, to develop a 5-year Transplantation
Research Action Plan identifying the most urgently needed
research to facilitate an increase in the success of organ
transplantation. The expert conference is also urged to focus
on promising new technologies in pre-transplant organ care and
post-transplant patient therapies. The Committee requests a
report by May 1, 2006 on the results of this conference
including a trans-NIH breakdown of resources committed to this
category of research. The Committee also urges the initiation
of a cohort study to assess the health outcomes of living
donors not only for the period immediately following the
donation, but for the quality of life implications in the
decades post donation.
Tuberculosis.--The World Health Organization [WHO]
estimates that nearly one-third of the world's population will
become infected with tuberculosis [TB]; and by 2020, 70 million
people will die worldwide of this disease. The Committee is
pleased with NIAID's efforts to develop an effective TB
vaccine. The Committee encourages the Institute to continue its
TB vaccine development work and expand efforts to develop new
drugs, including multi-drug resistant drugs to treat TB.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2005.................................... $1,944,067,000
Budget estimate, 2006................................... 1,955,170,000
House allowance......................................... 1,955,170,000
Committee recommendation................................ 2,002,622,000
The Committee recommendation includes $2,002,622,000 for
the National Institute of General Medical Sciences [NIGMS]. The
fiscal year 2004 appropriation was $1,955,170,000 and the
administration's request is $1,944,067,000. 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, biological
chemistry, bioinformatics, and computational biology, 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.
Basic Behavioral Research.--The Committee notes the lack of
a positive response to Congressional requests that the NIH
establish a basic behavioral research and training program
within the National Institute of General Medical Sciences as
authorized within the statutory language establishing the
Institute. The Committee notes that this recommendation was
also made to the Director of NIH by a special task force
created by the NIH to review this matter. The Committee
believes that this research will support important advances in
understanding the wide range of fundamental behavioral topics
relevant to a variety of diseases and health conditions. The
Committee strongly urges the NIGMS to consider establishing a
basic behavioral research and training program as part of its
portfolio, especially in the areas of learning, memory, and
cognition; behavioral neuroscience; behavioral genetics; the
biological basis of behavior; behavior change; stress;
psychophysiology; social psychology; methodology and
evaluation; and experimental psychology.
Basic Research on Pre-disease Pathways.--The Committee is
pleased that NIGMS, NIMH, NCI and OBSSR are collaborating to
identify scientific opportunities and areas of basic behavioral
research that should be supported by NIH. The Committee
requests a report of the recommendations from the working group
and the NIGMS's plan for implementation of the recommendations
by May 1, 2006.
Basic Behavioral Research in Roadmap.--The Committee
requests that NIGMS study the feasibility of developing one or
more funding initiatives specific to basic behavioral and
social sciences research, which is significantly
underrepresented in the New Pathways to Discovery segment.
Minorities in Research.--The Committee commends NIGMS and
its Division of Minority Opportunities in Research for their
success in increasing the number and capabilities of ethnic
minority students in the educational pipeline for biomedical
research careers in psychology and other biomedical sciences
and for mentoring them as they make the transition to graduate
school. The Committee notes the role of behavior in racial and
ethnic health disparities and that six of the ten leading
causes of death are behaviorally based. The biomedical field
involves a wide range of psychological research that addresses
critical health and behavior concerns, such as HIV/AIDS,
stress, cardiovascular disease, diabetes, cancer, substance
abuse, and mental disorders, which have disproportionately
negative effects on the health and lifespan of ethnic
minorities.
Training Programs.--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 encourages NIGMS to continue to support
these important initiatives, and is particularly pleased that
NIGMS has supported biomedical career opportunity programs for
high school and undergraduate college students in conjunction
with historically black health professions schools. The
Committee urges continued, long-term support of this program.
NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
Appropriations, 2005.................................... $1,270,321,000
Budget estimate, 2006................................... 1,277,544,000
House allowance......................................... 1,277,544,000
Committee recommendation................................ 1,310,989,000
The Committee recommends an appropriation of $1,310,989,000
for the National Institute of Child Health and Human
Development [NICHD]. The fiscal year 2005 appropriation was
$1,270,321,000 and the administration's request is
$1,277,544,000. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--The NICHD is that component of the NIH
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.
Autism.--The Committee is aware of the important research
into the genetic basis of autism spectrum disorders and of its
support for the Baby SIBS study on the incidence of autism
among children in the same families. Accordingly, the Committee
encourages the Institute to expand its support and funding for
the Baby SIBS study, and encourages the Institute to expand its
work with and support for similar public-private partnerships.
Behavioral Science.--The Committee emphasizes its strong
support for the broad portfolio of behavioral research at NICHD
and supports its efforts to determine the biological,
behavioral, and social factors that affect cognitive, social,
and personality development of children in a variety of
settings. The Committee encourages the institute to maintain
its support for research and training in behavioral science as
it engages in its priority setting process.
Childhood Diseases on the Growing Skeleton.--NICHD is urged
to support studies investigating the effects of
pharmaceuticals, lifestyle, and chronic childhood diseases on
the growing skeleton and fracture risk and bone-formation
interventions for children. The Institute is encouraged to
expand the Osteogenesis Imperfecta Clinic and osteogenesis
imperfecta research, especially in genetic therapies, animal
models, drug treatment and rehabilitation. To the extent
feasible, NICHD is encouraged to work with NIAMS to study the
rare disorders osteopetrosis and juvenile Paget's disease.
Childhood Obesity.--The Committee continues to be concerned
about rising rates of childhood obesity and would like to see
additional clinical trials that focus on the effectiveness of
behavioral interventions. The Committee recognizes the critical
importance of prevention efforts in this area and supports
continued initiatives to promote healthy behaviors in children
and adolescents, and research to prevent health risk behaviors
that contribute to this growing public health challenge.
Demographic Research.--The Committee commends NICHD for its
strong support of demographic research. Given the tremendous
changes occurring in the U.S. population, demographic research
is necessary to analyze trends and determine consequences for
the health and well-being of our Nation. The Committee strongly
encourages the Institute to assure adequate support for
demographic training and for critical databases such as
National Longitudinal Study of Adolescent Health and Fragile
Families. NICHD-supported studies like these yield objective
information about population trends and provide unbiased,
accurate data to inform policy, programs, and practices to
improve the health and productivity of the American people.
Down Syndrome.--The Committee commends NICHD for increasing
support for production of an experimental mouse model for Down
Syndrome, the Ts65Dn mouse which allowed for the first time a
pre-clinical model to test possible drugs or other treatments.
The Committee encourages the NICHD to partner with NINDS and
other agencies to define additional mouse models needed to link
important structural and functional abnormalities that underlie
cognitive difficulties to the actions of specific genes and
gene pathways. The Committee also encourages NICHD to work with
the Office of Director to develop a strategic plan for Down
Syndrome research and to coordinate its research with NICHD,
NIA, NIMH and other institutes. The Committee further
encourages the Institute to ursue clinicl trials for Down
Syndrome.
Drug Safety for Children.--The Committee recognizes the
importance of ensuring that drugs are safe and effective for
use by children and are appropriately labeled for pediatric
use. The Committee supports continued implementation of the
Best Pharmaceuticals for Children Act of 2003, which supports
the pediatric testing of off-patent drugs, as well as on-patent
drugs not being studied through existing mechanisms. The
Committee is pleased to note that in fiscal year 2004, six
studies were initiated and five additional studies are planned
for fiscal year 2005. The Committee notes that NICHD has made
numerous outreach efforts to other Institutes and Federal
agencies to further refine the priority listing process. The
Committee requests that NIH provide an update during its annual
appropriations testimony that shall include the role of other
Federal agencies in implementing the Best Pharmaceuticals for
Children Act of 2003; information on the number of studies
supported through the Research Fund; the estimated cost of each
study undertaken; the nature and type of studies undertaken,
the number of label changes resulting form completed studies;
the patent status of the drug studies; the number of drugs
remaining on the priority list and a summary of NICHD's
findings on the frequency of pediatric use for medications that
many be considered for the priority list.
Epilepsy.--Epilepsy often begins in childhood and can have
potentially devastating effects when seizures are not
controlled. This disease has a severe impact on cognition and,
even in its mildest forms, lifelong effects on employment and
other quality of life measures. Recurring seizures are also a
heavy burden for children with autism, brain tumors, cerebral
palsy, mental retardation, tuberous sclerosis and a variety of
genetic syndromes. The Committee urges the Institute to make
research in epilepsy a priority, with particular emphasis on
developmental effects, and to coordinate research efforts with
the NINDS.
Family Formation.--Families constitute the key environment
for children's development, and parents are crucial to
children's health and academic outcomes. The Committee
encourages research on effective ways to promote and sustain
healthy family formations, particularly for low-income families
and families of color. Additional research is encouraged on the
immediate and long-term impact of chronic and acute exposures
to violence on child health and development. The institute is
encouraged to include research related to family, community and
cultural factors that serve as risk or protective factors and
promote resilience from exposure to violence in the home,
communities, and schools.
Fragile X.--Title II of the Children's Health Act of 2000
authorized the establishment of at least three Fragile X
research centers. The Committee is pleased that the NICHD has
funded three Centers, and urges the NICHD to increase the
funding for existing centers of excellence by the end of fiscal
year 2006, with the goal of enhancing the Centers and
recruiting new researchers to the Fragile X field. The
Committee also encourages the NICHD to coordinate its Fragile X
research efforts internally, by partnering with others, and by
relating Fragile X research with that in other developmental
disorders, such as autism research.
Genomics and Proteomics Research.--The Committee is pleased
that NICHD has launched a major new initiative to address the
public health problem of premature birth, which affects one in
eight babies born in this country and is the leading cause of
newborn death. NICHD is encouraged to move forward with this
initiative, which focuses on genomic and proteomics, in an
effort to accelerate knowledge in the mechanisms responsible
for premature birth. The Committee intends to closely monitor
this effort because it assigns a high priority to promoting the
birth of healthy infants.
Human Infertility.--The Committee understands that the
NICHD is planning to merge its National Cooperative Program for
Infertility Research with its Specialized Cooperative Centers
Program in Reproduction Research to form the Specialized
Cooperative Centers Program in Reproduction and Infertility
Research. The Committee understands that the merger of these
center programs will allow a greater focus on human infertility
research by permitting more efficient translation of knowledge
from non-human animal models to humans. This will ensure the
rapid development of novel approaches for the diagnosis,
treatment and amelioration of such reproductive diseases and
disorders as polycystic ovarian syndrome, endometriosis,
hypogonadotropic hypogoandism and idiopathic male infertility.
Infertility and Contraceptive Research.--The Committee
notes that infertility is a disease which affects over 6
million people in the United States and is concerned that the
number appears to be growing as age, lifestyle, and
environmental factors increasingly impact reproductive health
outcomes. The Committee urges that additional research be
undertaken to improve reproductive health intervention
outcomes, as this research will not only increase the efficacy
and effectiveness of reproductive health interventions but will
significantly lower costs by reducing the number of
interventions necessary to achieve a successful outcome.
Learning Disabilities.--The Committee is pleased that NICHD
continues to place a high priority on learning disabilities
research. The efforts to address the special needs of children
affected by a learning disability and improve literacy are
showing promising results. The Committee encourages NICHD to
continue to focus on reading disability and mathematics
development research. Additionally, the Committee urges NICHD
to lead a cooperative effort to collaborate on research efforts
with other Institutes working on related activities. The
Committee encourages cooperation in areas where work can be
shared across Institutes on behalf of individuals with learning
disabilities.
Learning and School Readiness.--The Committee continues to
support NICHD's commitment to research in reading, learning
disabilities and math and science cognition. The Committee is
encouraged that NICHD has made progress on developing
comprehensive, culturally neutral and developmentally
appropriate assessments and instruments to measure cognitive,
social and emotional skills for pre-school aged children that
are necessary for school readiness.
Maternal-Fetal Medicine Units Network.--The Committee
recognizes the efforts of NICHD, through its Maternal Fetal
Medicine Units Network [MFMU], to achieve a greater
understanding and pursue development of effective treatments
for the prevention of pre-term births, low birth weight
infants, and medical complications during pregnancy such as
pregnancy-related hypertension and diabetes. The Committee is
pleased to learn that the NICHD is proceeding with a competing
renewal of the MFMU's in 2006 and encourages a sustained
research investment in this program to facilitate resolution of
these problems and promote the birth of healthy infants.
National Children's Study.--The Committee is pleased with
NICHD efforts to launch the National Children's Study, which
would be the largest study of children ever undertaken in the
United States and is intended to follow 100,000 children to age
21, examining the impacts and influences of many environmental
and genetic factors on children's health and development. The
Committee urges that the National Children's Study include an
adequate sample of children to enable examination of the health
and development outcomes of children conceived with the
assistance of reproductive health technologies.
The Committee further urges the NICHD to coordinate the
involvement of the Department, the lead Federal partners--CDC,
EPA and NIEHS--and other interested institutes, agencies and
non-Federal partners conducting research on children's
environmental health and development, such that this study is
ready for the field by no later than 2007.
National Cooperative Program for Infertility Research.--The
Committee understands that the NICHD is planning to merge its
National Cooperative Program for Infertility Research with its
Specialized Cooperative Centers Program in Reproduction
Research to form the Specialized Cooperative Centers Program in
Reproduction and Infertility Research. The Committee
understands that this merger will allow a greater focus on
human infertility research and a more efficient translation of
knowledge from non-human animal models to humans to ensure
rapid development of novel approaches for the diagnosis,
treatment and amelioration of such reproductive diseases and
disorders as polycystic ovarian syndrome, endometriosis,
hypogonadotropic, hypogoandism, and idiopathic male
infertility. The Committee looks forward to hearing more about
the progress towards this merger.
Neurofibromatosis.--Learning disabilities occur with high
frequency (30-65 percent) in children with NF and in
approximately 5 percent of the entire world's population.
Enormous advances have been made in the past few years in the
successful treatment and curing of learning disabilities in
pre-clinical NF animal models. Therefore the Committee
encourages NICHD to issue RFAs for NF research and aggressively
pursue and expand funding of clinical trials for NF patients in
the area of learning disabilities. The Committee is mindful
that finding a treatment and cure for learning disabilities
will not only benefit children, but also reduce costs of
special education.
Pediatric Kidney Disease.--The National Children's Study
provides a unique opportunity to identify pre- and post-natal
exposures that increase the risk of kidney disease,
hypertension, and the progression of chronic kidney disease
from birth to early adulthood. The Committee urges NICHD to
support research toward understanding the physiologic
mechanisms responsible for these risks to further prevent the
development of kidney diseases and the antecedents of
cardiovascular disease.
Prader-Willi Syndrome.--Prader-Willi Syndrome is the most
common known genetic cause of life threatening obesity in
children. The Committee strongly encourages the NICHD to place
a high priority on Prader-Willi Syndrome research to study
childhood obesity. Furthermore, the NICHD is urged to
incorporate Prader-Willi Syndrome into the planning process for
The National Children's Study.
Preterm Birth.--Last year, the National Center for Health
Statistics reported the first increase in the U.S. infant
mortality rate since 1958; 61 percent of this increase is
attributed to an increase in the birth of premature and low
birth weight babies. An analysis of Agency for Healthcare
Research and Quality data conducted by the March of Dimes
Perinatal Data Center estimated that the total national
hospital bill for premature babies was $15,500,000,000 in 2002.
The financial burden of prematurity is expected to continue to
worsen until prevention of preterm births is better understood
and clinical interventions are developed. The Committee is
pleased that NICHD is one of the sponsors of an Institute of
Medicine study now underway to define and address the health-
related and economic consequences of premature birth.
Primary Immunodeficiency Diseases.--The Committee continues
to be impressed with the dedication of financial and personnel
resources by NICHD to the physician education and public
awareness program conducted by the Jeffrey Modell Foundation to
reach earliest diagnosis of this class of about 140 diseases.
With regard to research on PI, the Committee is strongly
encouraged by the Institute's commitment to develop newborn
screening procedures for PI, particularly X-linked SCID,
utilizing microarray technologies. The Committee believes that
NICHD should move ahead aggressively with this initiative, in
partnership with the Foundation and private industry.
Spinal Muscular Atrophy [SMA].--SMA is the leading genetic
killer of infants and toddlers, and is the most prevalent
genetic motor neuron disease. The severity of the disease, its
relatively high incidence, and the possibility of imminent
treatments have led NINDS to initiate the SMA Project. The
Committee believes that the treatment of SMA, and the SMA
Project at NINDS, is strategically consistent with the mission
of the NICHD, with the NIH Roadmap initiative and its specific
emphasis on cross-institute research integration. The Committee
is concerned that, to date, the NICHD has not made any progress
toward working collaboratively with NINDS to support and expand
the SMA Project. The Committee strongly urges NICHD to do so
expeditiously and to report back to the Committee no later than
May 1, 2006.
Vulvodynia.--The Committee commends NICHD for its
commitment to chronic pain conditions including vulvodynia.
This condition has profound impacts on the health and quality
of life for millions of women. As a result of efforts funded by
NICHD, the number of high-quality researchers interested in
research on vulvodynia has increased. NICHD is strongly
encouraged to reissue its request for applications in this area
and to fund high-quality applications, with a particular
emphasis on etiology and multi-center therapeutic trials.
NATIONAL EYE INSTITUTE
Appropriations, 2005.................................... $669,070,000
Budget estimate, 2006................................... 673,491,000
House allowance......................................... 673,491,000
Committee recommendation................................ 693,559,000
The Committee recommends an appropriation of $693,559,000
for the National Eye Institute [NEI]. The budget request was
$673,491,000and the fiscal year 2005 appropriation was
$$669,070,000. 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.
Basic Behavioral and Social Sciences Research.--Committee
encourages NEI to participate in trans-institute initiatives
organized by OBSSR or another institute to strengthen basic
behavioral research and enhance opportunities for behavioral
science research training.
Ocular Albinism.--The Committee recognizes recent advances
in the treatment of ocular albinism by using gene therapy. The
Committee encourages the National Eye Institute to favorably
consider research grant proposals that seek to expand upon
these important findings.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
Appropriations, 2005.................................... $644,505,000
Budget estimate, 2006................................... 647,608,000
House allowance......................................... 647,608,000
Committee recommendation................................ 667,372,000
The Committee recommends an appropriation of $667,372,000
for the National Institute of Environmental Health Sciences
[NIEHS]. The budget request was $647,608,000 and the fiscal
year 2005 appropriation was $644,505,000. 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.
Asthma.--Given the link between environmental factors and
the onset of asthma, COPD, and pulmonary fibrosis, the
Committee encourages NIEHS to further develop research
initiatives, such as a large multi-center, long-term
longitudinal, and maternal/birth cohort to understand the
environmental and genetic risk factors for predisposing some
individuals to and in controlling the severity of these lung
diseases.
Basic Behavioral and Social Sciences Research.--The
Committee encourages NIEHS to participate in trans-institute
initiatives organized by OBSSR or another institute to
strengthen basic behavioral or social science research, and to
enhance opportunities for behavioral and social science
research training.
Breast Cancer.--The Committee believes that it is essential
to support research on environmental factors that may be
related to the etiology of breast cancer. The Committee
recognizes the important first step the Institute has taken
with its recently awarded grants to four research centers to
begin to study the prenatal-to-adult environmental exposures
that may predispose a woman to breast cancer. However, the
recent awards are only a small down payment in terms of
dollars, process, and focus on the comprehensive and
collaborative research that is needed. The need for more
funding and a comprehensive research strategy, as outlined by
the Breast Cancer and Environmental Research Act, is clear. The
Committee understands that the Institute will establish an
advisory board to make recommendations to the Director with
regard to the development of the research centers. The
Committee is pleased that the board will include
representatives from the breast cancer community who have had
the disease. The Committee asks that the director provide an
update in the fiscal year 2007 appropriations justification on
the progress of the centers.
Built Environment.--The Committee is pleased with the
research that NIEHS is supporting on environmental factors,
including built environment, and their relationship to the
rising prevalence of obesity among youth and adults. The
Committee urges NIEHS to continue work in this area, including
transportation choices and their impact on public health
outcomes.
Environmental Health and Nursing.--The Committee is pleased
with the coordination efforts of the NIEHS, NINR, CDC, HRSA and
EPA to address the recommendations outlined in the 2002
Roundtable Report and the IOM Report, ``Nursing, Health and
Environment.'' The Committee encourages the establishment of a
nursing research fellowship in environmental health issues.
Interagency Coordinating Committee for the Validation of
Alternative Methods [ICCVAM].--In order for the Interagency
Coordinating Committee for the Validation of Alternative
Methods [ICCVAM] to carry out its responsibilities under the
ICCVAM Authorization Act of 2000, the Committee encourages the
NIEHS to strengthen the resources for the National Toxicology
Program's Interagency Center for the Evaluation of Alternative
Toxicological Methods [NICEATM] for ICCVAM for methods
validation reviews in fiscal year 2006. The Committee is
encouraged by the National Toxicology Program's [NTP] Road Map
and Vision for NTP's toxicology program in the 21st century and
encourages NIEHS to move rapidly to implement the programs,
especially those directly aimed at strengthening the scientific
basis for many alternative methods (such as Quantitative
Structure-Activity Relationships), mechanistic screens, high
throughput assays, and toxicogenomics.
Parkinson's Disease.--The Committee encourages NIEHS to
continue funding research into environmental influences of
Parkinson's disease. The causes of Parkinson's and other
neurodegenerative disorders are increasingly shown to be a
result of the inter-relation of environment and genes. Possible
environmental triggers of Parkinson's are pesticides and/or
heavy metals. If these environmental toxins can be identified
and the mechanisms elucidated, appropriate prevention or
treatment may prevent many cases of Parkinson's, especially
concerning increasingly younger persons at risk.
Pacific Center for Environmental Health.--The Committee
commends the NIEHS for its prompt attention to the concerns of
the citizens of Hawaii related to volcanic emissions, food and
waterborne illnesses, fish contamination by pesticides and
heavy metals, and pesticide residue in food and water. The
Committee urges NIEHS to pursue an Environmental Health
Sciences Center in Hawaii to research and address these
environmental concerns and to seek workable solutions to
improve the health of Pacific Islanders.
Perchlorate.--The Committee encourages the Institute to
support clinical, mechanistic, and epidemiological studies that
focus on establishing a better understanding of the long-term
health effects of perchlorate exposure on humans and
determining with greater certainty what perchlorate exposures
are safe for the most vulnerable populations. The Committee
encourages the NIEHS to give priority in the following areas:
(1) clinical studies on humans or primates designed to provide
information on the effects of long-term exposures to low doses
of perchlorate; (2) the design and implementation of innovative
epidemiological studies that assess the possible health effects
of perchlorate exposure on the most vulnerable populations,
including pregnant women and their fetuses and newborns, and
involve appropriate control populations; and/or (3) in vitro
studies of the perchlorate influence on placental and breast
iodide transport using human tissues and animals studies, and
the effects of perchlorate on development independent of
effects on iodide transport.
Risk Sciences.--The Committee encourages NIEHS to establish
a competitive, peer-reviewed extramural program to conduct
research in risk sciences, including methodologies for
assessment, management, analysis, and communication of risks
from exposure to environmental chemicals.
NATIONAL INSTITUTE ON AGING
Appropriations, 2005.................................... $1,051,990,000
Budget estimate, 2006................................... 1,057,203,000
House allowance......................................... 1,057,203,000
Committee recommendation................................ 1,090,600,000
The Committee recommendation includes $1,090,600,000 for
the National Institute on Aging [NIA]. The budget request was
$1,057,203,000 and the fiscal year 2005 appropriation was
$1,057,203,000. 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.
Age-related Bone Health.--The Committee is aware that the
costs of age-related bone loss top $17,000,000,000 annually.
NIA is urged to address cell senescence and altered cell
phenotype in age-related bone diseases; aging's impact on bone
response to loading, bone matrix and quality, and bone marrow;
and the role of exercise, new anabolics, and stem cells in
elderly bone.
Alzheimer's Disease.--The most common cause of dementia,
Alzheimer's disease has become one of the most serious threats
to the Nation's health and economic well-being. Today, an
estimated 4.5 million Americans--1 in 10 persons over age 65
and nearly half of those over 85--suffer from Alzheimer's
disease. That toll will rise to 5.1 million by 2010 and 7.7
million by 2030 unless scientists find ways to stop or slow the
progression of the disease process. And unless answers are
found soon, Alzheimer's disease will wreak havoc, not only on
family budgets but public funds as well. Over the next decade,
Medicare spending on beneficiaries with Alzheimer's will more
than triple, to $189,000,000,000, while Medicaid spending over
the same period will rise to $27,000,000,000. In light of these
social and economic imperatives, the Committee was troubled to
learn that NIA's investment in Alzheimer research actually
declined in fiscal year 2004 from the previous year. Given the
enormous human and financial toll this disease is exacting on
society, the Committee strongly urges NIH to expand its
investment in Alzheimer research toward an overall goal of
$1,000,000,000. NIA should continue to assign the highest
priority to this effort.
Bone Marrow Failure Diseases.--Every year, between 20,000
and 30,000 Americans are diagnosed with bone marrow failure
diseases, which include aplastic anemia, myelodysplastic
disorders [MDS], and paroxysmal nocturnal hemoglobinuria [PNH].
The highest incidence of these diseases occurs with people age
60 or older, and the number of cases of these diseases will
increase each year as the American population continues to age.
The Committee urges NIA to collaborate with NHLBI and NCI on
research aimed at gaining a better understanding of the causes
of these diseases and effective treatments and cures.
Claude D. Pepper Older American 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,
and on developing top-level experts in geriatrics.
Demographic and Economic Research.--The Committee commends
NIA for supporting the Centers on the Demography of Aging
program and expanding its program to include four new centers
in 2004 and for supporting the economic and demographic
components of the Roybal Centers for Applied Gerontology
program. The Committee encourages the Institute to sustain the
economic viability of these centers programs in their quest to
conduct essential economic and demographic population research
as the United States and world age rapidly. The Committee
encourages NIA to provide the scientific knowledge on
population aging issues, especially by fully supporting the
Health and Retirement Survey and National Long-Term Care
Survey. Data from these surveys are particularly important for
understanding the budgetary impact of population aging and for
Congress as it deliberates potential changes to the Social
Security, Medicare, and Medicaid programs.
Down Syndrome.--The Committee commends NIA for its support
of studies to examine the cellular, molecular and genetic bases
for age-related neuropathological and cognitive abnormalities
in people with Down syndrome. The Committee encourages NIA to
further examine these abnormalities and to devise new methods
for diagnosing and treating them. Given that all people with
Down syndrome develop the neuropathological changes of
Alzheimer's disease, and that many or most go on to suffer
dementia, the NIA is encouraged to consider how studies of the
Down syndrome population might enhance the ability to
understand, diagnose and treat Alzheimer's disease. The
Committee encourages NIA to coordinate its research with NICHD,
NINDS, NIMH and other Institutes.
Epilepsy.--As the population ages, the Committee is
concerned about the rapidly growing incidence of epilepsy in
senior citizens. Age-related epilepsy caused by stroke,
cardiovascular disease, brain tumors and Alzheimer's disease
severely impacts the well-being, independence and health care
needs of these vulnerable patients. The Committee urges the
Institute to make research in epilepsy a priority and to
coordinate research efforts with the NINDS.
Health of Older Workers.--The Committee acknowledges NIA's
efforts to build a research agenda focused on maximizing older
workers' safety, health, productivity and life satisfaction.
NIA is encouraged to collaborate with other agencies,
institutes and centers to further develop this research agenda.
In particular, the Committee supports efforts to develop new
surveys or piggyback on existing surveys as appropriate, to
enhance the data available to NIA on aging workers, the designs
and parameters of various jobs and related health information.
Research should be conducted to assess the effectiveness,
benefits, and costs of worksite health promotion programs and
techniques tailored to older workers, and other workplace
policies that may influence health and safety.
Osteoporosis.--The Committee encourages studies on quality
of life in patients with osteoporosis before and after
treatment and strategies for optimizing treatment of frail
nursing home patients at high risk for osteoporotic fracture.
The Committee further urges NIA to expand research on the role
of environmental and lifestyle factors associated with
osteoporosis, Paget's disease, and osteogenesis imperfecta and
to work in conjunction with NIAMS on models for Paget's
disease.
Parkinson's Disease.--The Committee commends the NIA on its
collaboration with Parkinson's researchers at National
Institute of Neurological Disorders and Stroke [NINDS] Udall
Centers in helping to discover new Parkinson's susceptibility
genes, including dardarin, the most recently discovered
Parkinson's gene by a NIA scientist. This research will prove
to be invaluable in the development of improved methods of
diagnosis, as well as neuroprotective and neurorestorative
treatment of Parkinson's disease. The Committee encourages
continued collaborations including additional intramural
activities between NINDS, NIMH, and NIA to enhance
understanding of neurodegenerative diseases, particularly
Parkinson's.
Racial and Ethnic Health Disparities in Later Life.--The
Committee commends NIA's systematic attempts to build a
research agenda to help understand racial and ethnic health
disparities in later life. NIA is encouraged to build on its
behavioral genetics research program in order to assess genetic
and environmental factors in racial and ethnic differences
simultaneously, in studies that permit identification of main
effects and of interactions.
Social Psychology.--NIA is requested to study the
feasibility of expanding its portfolio of basic research on
social psychology, particularly basic research on stigma and
race; well-being; and emotion, health and disease.
Thrombosis.--The Committee is very pleased with the
Institute's plans to further research on anemia and its impact
on the elderly, and encourages NIA to continue its
collaborative research efforts with other Institutes on the
best strategies to diagnose and treat elderly patients with
anemia. The Committee believes that NIA collaboration could
also be helpful for another area of age-related hematology
research, the study of venous and arterial thrombosis, blood
clots that can lead to heart attacks, strokes, or respiratory
dysfunction. In light of research findings that age is one of
the most important risk factors for thrombosis, the Committee
urges NIA and NHLBI to collaborate on a research agenda
exploring the underlying causes of thrombosis and its impact on
the elderly.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2005.................................... $511,157,000
Budget estimate, 2006................................... 513,063,000
House allowance......................................... 513,063,000
Committee recommendation................................ 525,758,000
The Committee recommends an appropriation of $525,758,000
for the National Institute of Arthritis and Musculoskeletal and
Skin Diseases [NIAMS]. The budget requested $513,063,000 and
the fiscal year 2005 appropriation was $511,157,000. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--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
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 expenditures and lost
productivity. The research activities of this Institute serve
the concerns of many different special populations, including
women, minorities, children, and the elderly.
Bone Formation and Remodeling.--The Committee encourages
NIAMS to increase support of research on models, methods and
modalities to increase bone formation and alter bone
remodeling, and address the impact of aging, genetics, obesity,
inactivity and exercise on bone at molecular, cellular, and
tissue levels. NIAMS should work with NICHD and NIDDK to expand
research on the genetics and new treatments for the rare
disorder osteopetrosis.
Burden of Skin Diseases.--The Committee notes the release
of the recent report, ``Burden of Skin Diseases'', which
supports evidence gathered at the September 2002 workshop on
the burden of skin diseases sponsored by NIAMS. Based on these
findings, the Committee urges NIAMS to continue to expand the
research portfolio on skin disease. The Committee also
encourages that NIAMS consider potential partnerships with the
skin disease research community to address the challenges
outlined by the ``Burden of Skin Diseases'' findings.
Duchenne Muscular Dystrophy.--The Committee continues to be
concerned with the amount of time taken by NIAMS to complying
with the MD Care Act. The Committee encourages the NIAMS to
increase research for Duchenne Muscular Dystrophy. The
Committee further requests that NIAMS coordinate with NINDS on
timelines for translational research, a consensus conference
and the strategic plan.
Lupus.--The Committee recognizes lupus is a serious,
complex, debilitating chronic autoimmune disease that can cause
inflammation and tissue damage to virtually any organ system in
the body and impacts between 1.5 and 2 million individuals.
This autoimmune disorder affects the skin, bones, joints,
connective tissue and vital organs. The Committee is
disappointed with the pace of research regarding lupus and
strongly urges the Director of the National Institute of
Arthritis and Musculoskeletal and Skin Diseases to expand and
intensify research and related activities with respect to
lupus.
Marfan Syndrome.--The Committee commends NIAMS and its
collaborative efforts with other Institutes to provide vital
research on Marfan syndrome, a life-threatening, progressive
and degenerative genetic disorder that is characterized by
aortic aneurysms, painful orthopedic issues, pulmonary issues
and ocular manifestations. Years of basic research are ready to
be translated into a clinical trial for a drug therapy that may
potentially prevent and reverse many of the life-threatening
aspects of this syndrome. In addition, it may help many of the
disabling characteristics not only of Marfan syndrome but also
of other connective tissue disorders. The Committee urges NIAMS
to support this effort through all available mechanisms, as
deemed appropriate.
Mucopolysaccharidosis [MPS].--The Committee encourages the
NIAMS to work collaboratively with NIDDK in an effort to
achieve a greater understanding of the underlying
pathophysiology of bone and joint lesions in MPS disorders, the
gene mutations and substrates that are stored, and potential
therapeutic approaches to treating these debilitating aspects
of MPS and related disorders.
Osteogenesis Imperfecta.--The Committee commends NIAMS for
its support of the promising gene targeting stem cells research
that represents a potential cure for osteogenesis imperfecta
and encourages continued support of this research.
Osteoporosis.--The Committee urges the study of genetics of
osteoporosis, including studies to determine the causes of
variation in peak bone mass and rates of bone loss and
therapies to lower fracture risk in patients at high risk for
osteoporotic fractures.
Paget's Disease.--The Committee urges NIAMS to study the
role of genes and the underlying abnormal functioning of cells
involved in bone breakdown in Paget's disease patients. Further
research is needed on the role the bone microenvironment plays
in the development of Paget's disease and the molecular
processes involved.
Psoriasis.--Ten to 30 percent of psoriasis patients develop
psoriatic arthritis, a painful and potentially destructive
joint disease. The Committee urges NIAMS to support additional
genetic research to identify the genes responsible for
psoriasis susceptibility, basic research to understand the
mechanism of disease and clinical research to identify new safe
and effective therapies for these diseases.
Scleroderma.--The Committee is encouraged by NIAMS's
continued interest in scleroderma, a chronic and progressive
disease that predominantly strikes women. Scleroderma is
disfiguring and can be life-threatening, and effective
treatments are lacking. The Committee encourages NIAMS to
continue to collaborate with other Institutes, including NHLBI,
NIAID, NIDDK, NIDCR, and through the NIH Autoimmune
Coordinating Committee to generate additional research
opportunities for scleroderma that may assist to identify
genetic risk factors and the development of safe and effective
treatments.
Tuberous Sclerosis Complex.--Tuberous sclerosis complex, or
TSC, is a genetic disorder that triggers uncontrollable tumor
growth in multiple organs of the body, including the skin. The
Committee is encouraged that NIAMS is participating in a Trans-
NIH Tuberous Sclerosis Coordinating Committee, and strongly
encourages NIAMS to continue to assist the clinical research
community in the development of standardized protocols for skin
assessment and the development of pilot clinical trials.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2005.................................... $394,259,000
Budget estimate, 2006................................... 397,432,000
House allowance......................................... 397,432,000
Committee recommendation................................ 409,432,000
The Committee recommends an appropriation of $409,432,000
for the National Institute on Deafness and Other Communication
Disorders [NIDCD]. The budget requested $397,432,000 and the
fiscal year 2005 appropriation was $394,259,000. 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.
Animal Models of Hearing Loss.--It is now clear that
peripheral hearing loss leads to profound changes in the
central nervous system, including cell death and loss of
synapse function. The Committee encourages research to focus on
animal models of conductive and sensorineural hearing loss,
particularly changes in brain physiology from deafness during
development. Understanding these mechanisms is essential to
implementation of ameliorative strategies such as hearing aids
and cochlear implants.
Balance Disorders.--The Committee is aware that over 124
million Americans have experienced dizziness or a balance
problem, and the cost of medical care for patients with balance
disorders exceeds $1,400,000,000 annually. Over 50 percent of
elderly patients interviewed at home complain of balance
disorders. Despite research into the organization and function
of these balance receptors located in the inner ear, there is a
need to study the genes expressed in these tissues in order to
understand why receptors commonly fail or become dysfunctional.
Gene discovery techniques including cDNA libraries and
microarray expression profiling are likely to lead to new drugs
to treat or prevent vestibular disorders and greater
understanding of how these systems work. The Institute is urged
to expand its support of research in this promising area.
Clinical Evaluation of Hearing Loss.--The Committee
encourages NIDCD to partner with other Institutes at NIH to
support the development of functional neuroimaging technology
with more precise spatial and temporal resolution, as well as
better molecular probes to monitor brain activity.
Early Detection and Intervention.--The Committee urges the
NIDCD to continue to use its newsletter and website to promote
awareness among parents and clinicians that early
identification and treatment of hearing loss are essential for
normal language acquisition. Therefore, the Committee
encourages expanded research on the early detection, diagnosis
and intervention of infants with deafness and other
communication disorders, including progressive hearing
impairment from cytomegalovirus exposure. It is also critical
to recognize that otitis media, or middle ear infection, is
among the most frequent reasons for a sick child to visit the
doctor during the first few years of life. The Committee
recommends that the NIDCD continue to support research to
develop novel therapeutic preventative strategies to lessen
dependence on antibiotic therapies.
Environmentally-induced Hearing Loss.--The Committee
continues to be concerned by the number of Americans who suffer
from chemical and noise-induced hearing loss and strongly
supports the expansion of NIDCD's Wise Ears! Campaign among
school-age children. The Committee also supports expanded
research on prosthetic and pharmacological therapies for
hearing loss from noise stress and ototoxic drugs.
Hearing Devices for Children.--Everything that is known
about hearing aids and cochlear implants is based on adult
needs. Hearing aids also need to be optimized for children's
needs, because there are so many differences between adults and
children. Therefore the Committee encourages the NIDCD to
support a collaborative effort of researchers to participate in
a multi-center, longitudinal research project to track auditory
development and speech perception in hearing-impaired infants.
Also, the Committee encourages NIDCD to explore the feasibility
of electrical stimulation applied to the vestibular system
(analogous to the cochlear implant) to treat balance disorders.
Hereditary Hearing Loss.--The Committee applauds the
remarkable progress towards understanding the molecular basis
for hereditary hearing impairment and encourages the NIDCD to
continue to support research to identify the structure,
regulation and function of genes whose mutation results in
human communication disorders, including deafness. The
Committee continues to encourage efforts to screen for the
single and multi-genetic bases of hearing loss through
contemporary techniques, including diagnostic gene chips. The
Committee encourages the development of animal models to better
assess how gene mutations result in impaired central auditory
function.
Inner Ear Hair Cell Regeneration.--The Committee applauds
past support of regenerative studies, such as those in guinea
pigs, and urges the NIDCD to continue to give a high priority
to new and important directions in restoring hair cells of the
cochlea, such as gene therapy, adenovirus vectors and stem
cells. The Committee also encourages the NIDCD to request more
collaborative applications among scientists working on the
isolation of stem cells in the brain and scientists working in
the inner ear hair cell field.
Language Acquisition.--The Committee encourages the NIDCD
to explore the biological bases of infant speech perception and
language acquisition. This should include studies on the impact
of partial or profound hearing loss.
Learning Disabilities.--The Committee is pleased that NIDCD
continues to support research activities focused on speech
processing and on the development of expressive and receptive
language. The Committee encourages continued activity and looks
forward to learning the results of this work as they hold
significant promise for individuals with learning disabilities.
The Committee encourages the Institute to continue to
coordinate with other Institutes working on related activities.
Neurofibromatosis.--NF2 accounts for approximately 5
percent of genetic forms of deafness. Unlike other genetic
forms of deafness, NF2-associated deafness is potentially
preventable or curable if tumor growth is halted before damage
has been done to the adjacent nerve. Research is now being
conducted to cure deafness in NF2 mice through gene therapy,
with enormous implications for gene therapy in general and for
patients suffering from meningiomas and other tumors in
particular. The Committee therefore encourages NIDCD to expand
its NF2 research portfolio through all suitable mechanisms
including RFAs and clinical trials.
Pharmaceutical Research.--Recognizing the promise of new
technologies to deliver pharmaceutical agents to the inner ear,
the Committee encourages the NIDCD to initiate molecular
studies analyzing effectiveness of drugs, genes and gene
products on cell death pathways and cascades, followed by
trials to assess safety and benefits of pharmaceuticals to
prevent and better treat sensorineural hearing loss from
various causes.
Presbycusis.--Presbycusis, the gradual loss of hearing from
aging, is the most prevalent type of hearing loss and the third
leading chronic disease (following hypertension and arthritis)
in people over 65. It will become more common as the Nation's
population grows older. To improve the quality life of millions
of senior citizens, the Committee encourages research into
declining stria vascularis metabolism, an important factor, as
well as continuing studies on the central mechanisms of
presbycusis.
Tinnitus.--Recognizing that tinnitus compromises the lives
of tens of millions of Americans, the Committee encourages the
NIDCD to expand its research into causal mechanisms underlying
peripheral and central tinnitus and continue exploring
potential treatments for this affliction.
Translational Research.--The Committee encourages the NIDCD
to establish a Translational Research Branch to support
research activities aimed at accelerating the translations of
new findings in the molecular and basic sciences into new
interventions and technologies clinicians can use to treat
individuals with communication disorders.
NATIONAL INSTITUTE OF NURSING RESEARCH
Appropriations, 2005.................................... $138,072,000
Budget estimate, 2006................................... 138,729,000
House allowance......................................... 138,729,000
Committee recommendation................................ 142,549,000
The Committee recommends an appropriation of $142,549,000
for the National Institute of Nursing Research [NINR]. The
budget request was $138,729,000 and the fiscal year 2005
appropriation was $138,072,000. 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.
Nurse-managed Health Centers.--The Committee urges the NINR
to increase funding for research and demonstrations projects
involving nurse-managed health centers and advanced practice
nurses.
Nursing Shortage.--The nursing shortage has an adverse
effect on the health care delivery system as well as the health
of our Nation's citizens. A shortage of nurse faculty caused
schools of nursing to turn away thousands of qualified students
last year. NINR confronts this issue by directing 8 percent of
its budget to research training to help develop the pool of
nurse researchers who also become faculty. Training support for
fast-track baccalaureate-to-doctoral program participants is
one important initiative. The 17 recently-funded Nursing
Partnership Centers to Reduce Health Disparities is another
initiative that helps produce an adequate number of nurse
researchers. The Committee encourages these ongoing efforts.
The Committee also encourages NINR to fund research projects
located in rural areas that serve minority nursing students
through community colleges. Not only will these partnerships
between research-intensive schools of nursing and minority
serving schools of nursing train more minority nurses, but they
also expand opportunities for health disparities research.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
Appropriations, 2005.................................... $438,277,000
Budget estimate, 2006................................... 440,333,000
House allowance......................................... 440,333,000
Committee recommendation................................ 452,271,000
The Committee recommends an appropriation of $452,271,000
for the National Institute on Alcohol Abuse and Alcoholism
[NIAAA]. The budget request was $440,333,000 and the fiscal
year 2005 appropriation was $438,277,000. 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, neuroscience, and moderate
drinking.
Alaska Substance Abuse.--The Committee is aware of serious
problems with alcohol and substance abuse, 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 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 Abuse by College Students.--Colleges continue to
struggle with the consequences of alcohol abuse by students.
The Committee encourages NIAAA to continue its program of fast-
track approval for research grants to be carried out
collaboratively by scientists and college administrators who
express an urgent need for intervention. The Committee
understands that NIAAA is updating the 2001 report of the NIAAA
Task Force on College Drinking, to incorporate new findings.
The Committee further encourages NIAAA to provide this update
to college presidents and other relevant organizations.
Alcohol Dependence as a Developmental Disorder.--
Epidemiology studies show that alcohol is the drug of choice
for youth and that it is associated with a host of consequences
in this age group, including death and increased risk of harm
and other negative outcomes. The Committee is aware of more
recent data showing that 18- to 24-year-olds have the highest
prevalence of alcohol dependence of any age group. These and
other data make it clear to the Committee that alcohol has
become entrenched in the developmental processes of
adolescence, and that the developmental changes of adolescence
appear to make this age group particularly vulnerable to
alcohol's effects. The Committee urges NIAAA to continue its
youth initiative, to work toward understanding how to extricate
alcohol from adolescent development and how to change
adolescents' behaviors toward alcohol. The Committee recognizes
the importance of including scientists from several
disciplines, from behavior to genetics, to reflect the many
factors that contribute to underage drinking, and encourages
NIAAA to continue guiding the research through its team
approach.
Alcohol, Obesity, and Liver Disease.--The relationship
among the use of alcohol, the occurrence of obesity, and the
presence of liver disease has become increasingly worrisome for
clinicians. While alcohol's negative impact on weight and liver
wellness is long established, the current epidemic of obesity
and its consequent increase in liver disease creates a new
focus for research. The Committee urges NIAAA to bring greater
attention and resources to this relationship with special
emphasis on the differentiation of impact of alcohol
consumption on the liver for specific populations, such as
women, minorities, the elderly, and others.
Brain Development.--The Committee is aware of recent
evidence that the human brain continues to develop for a longer
period than previously thought, and that NIAAA has found
physical differences in how adult brains and adolescent brains
respond to certain stimuli. Biochemical and physiological
events in the brain translate into behaviors. NIAAA is urged to
continue research that will reveal biological links between
adolescent brain changes, alcohol-related behaviors, and
capacity for alcohol, and research that will reveal alcohol's
short- and long-term impact on developmental changes in the
adolescent brain.
Underage Drinking.--The Committee recognizes that alcohol
consumption represents one of the most important public health
problems among youth today and commends the NIAAA on its
efforts to collect data on the influence of environment and
genetics on adolescent drinking behaviors.
Treatments for Alcohol-use Disorders.--The Committee is
aware that 18 million American adults abuse or are dependent on
alcohol. The Committee encourages NIAAA to conduct research
that will advance behavioral and pharmaceutical treatments,
alone and in combination, for these disorders. The Committee
understands that NIAAA recently convened more than 40 experts
to establish priorities for accelerating development of
medications to treat alcohol-use disorders, and requests a copy
of the report on the outcome of that meeting, when it is
completed.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2005.................................... $1,006,419,000
Budget estimate, 2006................................... 1,010,130,000
House allowance......................................... 1,010,130,000
Committee recommendation................................ 1,035,167,000
The Committee recommends an appropriation of $1,035,167,000
for the National Institute on Drug Abuse [NIDA]. The budget
request was $1,010,130,000. The fiscal year 2005 appropriation
was $1,006,419,000. 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 and to assure
dissemination of information with respect to prevention of drug
abuse and treatment of drug abusers.
Adolescent Brain Development.--The Committee notes
neuroimaging research by NIDA and others showing that the human
brain does not fully develop until about age 25. This adds to
the rationale for referring to addiction as a ``developmental
disease.'' The Committee encourages NIDA to continue its
emphasis on adolescent brain development to better understand
how developmental processes and outcomes are affected by drug
exposure, the environment and genetics.
Clinical Trials Network.--The Committee is pleased with the
success and progress of NIDA's National Drug Abuse Treatment
Clinical Trials Network [CTN]. The CTN provides an
infrastructure to test the effectiveness of new and improved
interventions in real-life community settings with diverse
populations, enabling an expansion of treatment options for
providers and patients. The Committee suggests NIDA develop
ways to use the CTN as a vehicle to address emerging public
health needs.
Collaboration with Single State Authorities [SSAs].--The
Committee commends NIDA for its outreach and work with SAMHSA's
Center for Substance Abuse Treatment [CSAT] and State substance
abuse directors, also known as Single State Authorities [SSAs],
to reduce the current 15- to 20-year lag between the discovery
of an effective treatment intervention and its availability at
the community level. In particular, the Committee applauds NIDA
for working with SAMHSA on a recent RFA designed to strengthen
State Substance Abuse agencies' capacity to support and engage
in research that will foster statewide adoption of meritorious
science-based policies and practices. The Committee also
encourages NIDA to continue collaborative work with SSAs,
including its ``blending activities,'' to ensure that research
findings are relevant and adaptable by State substance abuse
systems.
Co-occurring Disorders.--The Committee recognizes that
addiction is a disorder that can affect the course of other
diseases, including HIV/AIDS, mental illness, trauma, cancer,
cardiovascular disease and even obesity. To adequately address
co-occurring health problems, the Committee encourages the
Institute to work with other agencies to stimulate new research
to develop effective strategies and to ensure the timely
adoption and implementation of evidence-based practices for the
prevention and treatment of co-occurring disorders.
Drug Abuse and HIV/AIDS.--The Committee understands that
one of the most significant causes of HIV virus acquisition and
transmission is drug taking practices and related risk factors
in different populations. Drug abuse prevention and treatment
interventions have been shown to be effective in reducing HIV
risk. Therefore, the Committee urges NIDA to continue
supporting research that focuses on developing and testing
drug-abuse related interventions designed to reduce the spread
of HIV/AIDS.
Drug-Induced Liver Injury.--The Committee notes that the
mechanisms and causes of Drug-Induced Liver Injury [DILI]
related to over-the-counter and prescription medications is not
well understood and therefore merits further research. The
Committee is aware that NIDDK currently funds 5 centers in the
Drug-Induced Liver Injury Network [DILIN] and encourages
increased support for the DILIN to help identify the underlying
mechanisms and patterns in DILI to better obtain data and find
patterns in DILI. The Committee also encourages NIDA to work
collaboratively with NIDDK, FDA, industry, and the liver
research community to address these priorities.
Drug Treatment in Criminal Justice Settings.--The Committee
is very concerned about the well-known connections between drug
use and crime. Research continues to demonstrate that providing
treatment to individuals involved in the criminal justice
system decreases future drug use and criminal behavior, while
improving social functioning. The Committee strongly supports
NIDA's efforts in this area, particularly the Criminal Justice
Drug Abuse Treatment Studies.
Emerging Drug Problems.--The Committee recognizes that drug
use patterns are constantly changing and is pleased with NIDA's
efforts to monitor drug use trends and to rapidly inform the
public of emerging drug problems. The Committee encourages NIDA
to continue supporting research that provides reliable data on
emerging drug trends, particularly among youth and in major
cities across the country.
Genetics Addiction.--The Committee recognizes that not
everyone who takes drugs becomes addicted. Research has shown
that genetics plays a critical role in addiction, and that the
interplay between genetics and environment is crucial. The
Institute is urged to further investigate this phenomenon.
Long-term Consequences of Marijuana Use.--The Committee is
concerned with the continuing widespread use of marijuana. The
Committee urges NIDA to continue support for efforts to assess
the long-term consequences of marijuana use on cognitive
abilities, achievement, and mental and physical health, as well
as work with the private sector to develop medications focusing
on marijuana addiction.
Medications Development.--The Committee applauds NIDA for
over a decade of leadership in working with private industry to
develop anti-addiction medications and is pleased this
collaboration has resulted in a new medication for opiate
addiction. The Committee encourages NIDA to continue its work
with the private sector to develop anti-addiction medications,
particularly for cocaine, methamphetamine, and marijuana.
Primary Care Settings and Youth.--The Committee recognizes
that primary care settings are potential key points of access
to prevent and treat problem drug use among young people. The
Committee encourages NIDA to support health services research
on effective ways to educate primary care providers about drug
abuse and develop brief behavioral interventions for preventing
and treating drug use and related health problems; and develop
methods to integrate drug abuse screening, assessment,
prevention and treatment into primary health care settings.
Reducing Health Disparities.--The Committee notes that the
consequences of drug abuse disproportionately impact
minorities, especially African American populations. The
Committee is pleased to learn that NIDA formed a Subgroup of
its Advisory Council to address this important topic.
Researchers should be encouraged to conduct more studies in
this population and to target their studies in geographic areas
where HIV/AIDS is high and/or growing among African Americans,
including in criminal justice settings.
Reducing Inhalant Abuse.--The Committee understands and is
alarmed that, for the second year in a row, NIDA's Monitoring
the Future Survey has shown an increase in the use of inhalants
by 8th graders. The Committee urges the Institute to continue
its support of research on prevention and treatment of inhalant
abuse, and to enhance public awareness on this issue.
Reducing Methamphetamine Abuse.--The Committee is very
concerned about the continued abuse of methamphetamine across
the United States. The Committee urges NIDA to continue
supporting research to address the medical consequences of
methamphetamine abuse.
Reducing Prescription Drug Abuse.--The Committee notes the
recent increases in the numbers of people who use prescription
drugs for non-medical purposes. Research targeting a reduction
in prescription drug abuse, particularly among our Nation's
youth, should continue to be a priority for NIDA.
Translational Research.--The Committee commends NIDA for
its broad and varied information dissemination programs. The
Committee also understands that the Institute is focused on
stimulating and supporting innovative research to determine the
components necessary for adopting, adapting, delivering, and
maintaining effective research-supported policies, programs,
and practices. As evidence-based strategies are developed, the
Committee urges NIDA to support research to determine how these
practices can be best implemented at the community level.
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2005.................................... $1,411,933,000
Budget estimate, 2006................................... 1,417,692,000
House allowance......................................... 1,417,692,000
Committee recommendation................................ 1,460,393,000
The Committee recommends an appropriation of $1,460,393,000
for the National Institute of Mental Health [NIMH]. The budget
request was $1,417,692,000 and the fiscal year 2005
appropriation was $1,411,933,000. The comparable amounts for
the budget estimate include funds to be transferred from the
Office of AIDS Research.
Mission.--The National Institute of Mental Health [NIMH]
supports research on mind, brain, and behavior with the aim of
reducing the public health burden of mental and behavioral
disorders. NIMH's ultimate goal is to generate research that
will lead to the ability to effectively treat mental disorders
so that individuals can truly recover from them, and,
ultimately, achieve the ability to predict and prevent them
from even occurring. A major goal for NIMH is to identify the
biological basis of mental disorders to more precisely pinpoint
targets for prevention and treatment. This means understanding
the neural basis of the illness at all levels, from molecular
to behavioral.
Adolescent Depression and Suicide.--Major depressive
disorder in adolescence--one of the major risk factors for
suicide--has become increasingly common. Suicide now accounts
for 13 percent of all adolescent deaths and ranks third as a
cause of death among teenagers. The Committee notes that NIMH
has conducted a major trial on adolescent depression which has
yielded valuable knowledge about effective treatments for
depression. The Committee strongly encourages NIMH to
strengthen its investment in understanding the clinical
epidemiology of suicidal behavior and thinking in children and
adolescents; improving the criteria for identifying those at
risk; and examining the outcomes of actions taken to assist
those found to be at risk.
Alzheimer's Disease.--Combining imaging with genetics, a
team of NIMH-funded scientists recently identified a possible
genetic marker for Alzheimer's disease, a variant of the gene
that codes for APOE, a protein involved in metabolizing
cholesterol. PET scans of normal individuals in their fifties
and sixties who carry this variant showed decreased activity in
regions of the brain known to be affected by Alzheimer's. PET
scans of younger individuals who carry this variant found
lowered metabolism in the same brain areas, suggesting that the
process at work in Alzheimer's starts decades before memory
deficits become apparent. The Committee strongly encourages
NIMH to continue to advance understanding of Alzheimer's
disease.
Aging and Mental Health.--The Committee commends the NIMH
for recently recognizing the need to place a higher priority on
the mental health needs of older persons through the 2004
recommendations promulgated by the NIMH Aging Research
Workgroup and the restructuring of the Adult and Geriatric
Treatment and Preventive Intervention Research Branch. However,
the Committee believes it is critical that studies related to
the elderly keep pace with the rapid growth of this cohort. The
Committee encourages the NIMH to devote greater resources to
research on adults over age 65 to reflect the growth in numbers
of this population. Therefore, the Committee strongly
encourages NIMH to significantly expand research in this area.
The Committee is pleased with NIMH's continued emphasis on
research involving mental disorders in the elderly population,
especially since the causes of depression in the elderly and
the factors affecting its course are not well understood. The
Committee urges NIMH to continue its level of support in this
area.
Autism Research.--The Committee commends NIMH for its
strong leadership of the Interagency Autism Coordinating
Committee [IACC], and for the institute's continued emphasis on
autism as an urgent public health problem. Autism continues to
be a top priority for NIH. The Committee supports continued
cross-Institute investments in several new centers and
projects, which have produced recent findings indicating that
the fundamental pathology may be ``miswiring'' in the brains of
autistic children, with an excess of local circuits and a
deficit of long-range circuits. NIMH research is helping to
develop new tools for detecting autism early, before age 2. In
a new study on infant siblings of children with autism, early
findings indicate that siblings later diagnosed with autism
show social deficits, visual attention impairments, and unusual
temperament by 12 months of age. This work could greatly
enhance efforts for early detection and treatment.
Basic Behavioral Science.--The Committee encourages NIMH to
continue its commitment to support basic behavioral research
focused on fundamental psychological domains and factors that
promote mental health or become disturbed in mental disorders.
The Committee is concerned that the institute may be
diminishing its support for some areas of relevant scientific
inquiry and urges the institute to support a balanced program
of grant funding and to maintain its support for research on
the promotion of mental health and the study of psychological,
social, and legal factors that influence behavior.
Combat Veterans.--The Committee is concerned about the
mental health effects of military service in Iraq and
Afghanistan, particularly since so many of the combatants are
members of the National Guard or Reserves who will have to
assimilate quickly back into civilian life after service. The
Committee urges NIMH to work closely with the Veterans
Administration and with the Department of Defense in efforts to
best address this looming problem.
Demographics.--The Committee is aware that demographics
will demand a greatly increased focus on mental disorders in
older persons, and consequently the Committee continues to be
concerned about funding for late-life mental health research at
the National Institute of Mental Health [NIMH]. The Committee
encourages NIMH to expand research in Adult and Geriatric
Treatment and Preventive.
Depression in the Workplace.--The Committee notes with
interest that recent NIMH research has demonstrated the
importance of recognizing depression in the workplace and the
cost-effectiveness of treating those affected. Employees with
depression--even compared to employees with rheumatoid
arthritis, a chronic illness that can impair job performance--
were four to five times more likely to become unemployed, to
have diminished productivity, and to exhibit increased
absenteeism. However, appropriate treatment for depression
resulted in positive changes in all three areas. The research
found that offering appropriate, evidence-based depression
treatment for employees is a cost-effective strategy for
American businesses. Further information on cost effectiveness
will become available at the completion of the ongoing NIMH-
funded study, ``Outreach and Treatment for Depression in the
Labor Force,'' which is scheduled for completion in 2006.
Disease Prevalence.--The Committee is aware that NIMH has
supported a major study that will provide critical information
concerning the prevalence of most mental disorders in this
country, as well as about the availability of quality care.
When the study is published, the Committee would like to have a
briefing to summarize the results of that study for interested
Members of Congress and staff.
Down Syndrome.--The Committee encourages the NIMH to
develop new strategies for cataloging, understanding,
diagnosing and treating behavioral disorders that are common in
people with Down syndrome. They include autism, pervasive
developmental disorder, obsessive compulsive disorder,
depression and psychosis. The Committee urges NIMH to
coordinate its research on Down syndrome with NICHD, NINDS, NIA
and other Institutes. The Committee encourages NIMH to continue
their studies on imaging of the brains of persons with Down
syndrome broadening their focus to include behavior and motor
coordination.
Epilepsy.--Recent evidence of connections between
depression and epilepsy point to relationships between the two
disorders that suggest potential common pathogenic mechanisms.
Research could help improve care for both groups of patients.
The Committee strongly urges the Institute to make research in
epilepsy a priority and to coordinate research efforts with
NINDS.
Evidence-based Treatments for Recovery and Dissemination.--
The first of several large, NIMH-funded clinical studies
testing various treatment options for those with serious mental
illnesses was completed last summer: a 13-site trial aimed at
defining the most effective and safe treatment for children and
adolescents with major depressive disorder. There has been much
debate about whether a class of antidepressant medications,
selective serotonin re-uptake inhibitors [SSRIs] can actually
increase suicidal thinking. Results of the trial revealed that
a combination of fluoxetine (Prozac) and a type of
psychotherapy called cognitive behavioral therapy [CBT] was the
most effective treatment (71 percent responded). Suicidal
thinking, which was present in 29 percent of the participants
at the beginning of the study, improved significantly in all
four treatment groups, with those receiving medication and
therapy showing the greatest reduction in suicidal thinking.
The effectiveness of these treatments over a 6-month period
from treatment initiation will soon be known. It is critical
for physicians and psychotherapists to closely monitor their
young patients on antidepressant medications for signs of
hurtful or suicidal behavior, particularly during the early
phases of treatment.
Fragile X.--Fragile X is the most common single-gene
neuropsychiatric disease known. It causes cognitive impairment,
mental disorders such as obsessive-compulsive disorder, and
extreme anxiety. The Committee commends NIMH for spearheading
three focused research meetings devoted to identifying critical
research needs, in November 2001, January 2003, and July 2004.
The Committee urges NIMH to pursue the most critical needs
identified by the meeting panels. These include controlled
studies of existing and new pharmacological treatments for
Fragile X and identification of the key molecular targets which
are likely candidates for designing drug treatments for Fragile
X and related disorders such as autism. 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. In addition, the Committee urges the
NIMH to work with industry and academia to test available
medications and bring new treatments to market.
Frontier Mental Health Needs.--The Committee commends NIMH
on its outreach efforts to determine the differences in mental
health needs which may exist in remote frontier communities,
including Alaska. 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 and Clinical Trials.--The Committee is
aware of the work being done by NIMH and its National Advisory
Mental Health Council [NAMHC] to address issues involving
health disparities and inclusion of historically underserved
minorities in clinical trials sponsored by the Institute. The
Committee supports these efforts.
Hepatitis.--The Committee urges the National Institute of
Mental Health [NIMH] to conduct and/or facilitate research to
explore the etiology and effective therapeutic management of
neuropsychiatric symptoms and disorders associated with chronic
hepatitis C and interferon-based antiviral treatment.
Learning Disabilities.--The Committee commends NIMH for the
work conducted to explore the neurological and behavioral
aspects of learning disabilities. The Committee looks forward
to learning the results of this work and encourages the
Institute to continue to coordinate with other Institutes
working on related activities.
Morbidity and Mortality.--The burden of mental disorders is
staggering, in terms of both morbidity and mortality.
Researchers supported by NIMH have found that half of all
lifetime cases of mental illness begin by age 14, and that
despite effective treatments, there are long delays between the
appearance of the first symptoms of illness and provision of
even adequate treatment. Unlike most other disabling medical
diseases, mental illness begins very early in life. Mental
disorders, then, can very aptly be called the chronic diseases
of the young. Young people with mental disorders suffer
disability when they are in the prime of life, when they would
normally be most productive. The NIMH study also found that
mental disorders really are quite common--26 percent of the
general population reported that they had symptoms sufficient
for diagnosing a mental disorder during the past 12 months.
Although some of these cases are mild ones that will resolve
without formal interventions, many more will not. The Committee
urges NIMH to continue its current efforts to focus on research
that promises to yield effective results that can be translated
to the benefit of patients, with the goal of finding new ways
to intervene early in the development of disease--or even
prevent its occurrence, and, when prevention is not possible,
to achieve rational treatments that are tailored to be most
effective to the individual patient.
Parkinson's Disease.--The Committee encourages continued
collaborations including additional intramural activities
between NINDS, NIMH, and NIA to enhance understanding of
neurodegenerative diseases, particularly Parkinson's.
Prevention Research.--The Committee places a high priority
on prevention research, particularly with respect to mental
disorders among children and adolescents, in identifying
protective factors against the negative impacts of stress among
young adults, and in developing strategies to strengthen the
family and other relationships that serve as protective
factors.
Psoriasis.--Psoriasis is associated with elevated rates of
mental disability, depression and suicidal ideation. The
Committee urges NIMH to conduct research into the mental health
aspects of psoriasis, especially as it relates to quality of
life and burden of the disease. Furthermore, a 2005 study of 44
autoimmune diseases found that only psoriasis, when present in
women around the time of pregnancy, was significantly
associated with autism, doubling the risk of autism spectrum
disorder in their children. The Committee urges NIMH to support
further study of the link between psoriasis and autism.
Psychological Impacts of Terrorism.--The Committee supports
NIMH research related to the psychological impact of both acute
and chronic exposure to threats of violence, including
terrorism and war, with particular emphasis on vulnerable
populations, such as trauma survivors, children and older
adults. The Committee encourages NIMH to expand its research
portfolio to include research related to factors that promote
detection or prediction, prevention, and post-exposure recovery
and resilience.
Suicide.--In addition to being disabling and chronic,
mental disorders can be fatal. Depression is an important risk
factor for suicide, the third leading cause of death among
adolescents. The Committee notes that there are far more
suicides each year in this country than there are homicides.
The Committee supports NIMH efforts to enhance suicide
awareness and prevention, and encourages the institute to
continue its ongoing collaborative efforts with other
institutes and with SAMHSA to address this painful topic.
Translating Behavioral Research.--The Committee commends
NIMH for undertaking a reorganization to promote the
translation of basic behavioral science into treatments for
those with mental disorders. The Committee strongly supports
NIMH's efforts to advance the application of behavioral
research and interventions in clinical settings to address the
public health burden of mental disorders and develop preventive
interventions. The Committee strongly supports additional
clinical trials that examine the effectiveness of behavioral
interventions in community-based settings. Behavioral
interventions are especially needed for children and
adolescents with mental disorders, including post-traumatic
stress disorder, eating disorders, attention deficit-
hyperactivity disorder, and the most common forms of
depression. Translational research in the behavioral and social
sciences is especially needed to address how basic behavioral
processes, such as cognition, emotion, motivation, development
and social interaction, inform the diagnosis, treatment and
delivery of services for mental disorders.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2005.................................... $488,608,000
Budget estimate, 2006................................... 490,959,000
House allowance......................................... 490,959,000
Committee recommendation................................ 502,804,000
The Committee recommendation includes $502,804,000 for the
National Human Genome Research Institute [NHGRI]. The budget
requested $490,959,000 and the fiscal year 2005 appropriation
was $488,608,000. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The Human Genome Project was an effort to
determine the location and sequence of the estimated 30,000
genes that constitute the human genome. This historic
achievement opens the genomic era of medicine. The Committee
commends the NHGRI for developing this vision for the future of
genomics.
The Institute coordinates extramural and intramural
research, as well as research training, in the areas of
genomics and genetics. The Division of Extramural Research
supports research on sequence and function of both human and
non-human genomes, human genetic variation, technology
development for genome research, database management and
analysis, and research on the ethical, legal and social
implications of human genome research. The Division of
Intramural Research focuses on applying the tools and
technologies of the successful Human Genome Project to
understanding the genetic and environmental basis of disease,
and developing DNA-based diagnostics and gene-based therapies.
Basic Behavioral and Social Sciences Research.--The
Committee encourages NHGRI to participate in trans-institute
initiatives organized by OBSSR or another institute to
strengthen basic behavioral research and enhance opportunities
for behavioral science research training.
Chromosome Abnormalities.--The Committee commends the NIH
for its efforts over the past year to encourage new scientific
work into molecular, genetic, clinical and therapeutic aspects
of chromosome abnormalities. Because of the multisystemic
consequences of a chromosome abnormality, multidisciplinary and
multi-Institute support by NIH will be required in order to
make progress that will be meaningful to those affected. The
Committee continues to urge NIH to seek ways to expand and
intensify such research, especially studies involving the
syndromes of chromosome 18.
Molecular Libraries.--The Committee commends NHGRI for
leadership in the NIH Roadmap Initiative on molecular
libraries. This includes the founding of the NIH Chemical
Genomics center, which will provide public sector researchers
with access to high-throughput screens for small organic
molecules, enabling development of new tools for exploration of
health and disease. The Committee recognizes that advances in
the use of these molecular libraries will enhance NIH's global
leadership in the future.
Targeting Disease Prevention.--The Committee commends NHGRI
for its leadership of the international haplotype mapping
[HapMap] project. The HapMap will provide a powerful new public
resource to gain a deeper understanding of human biology, and
discover the genetic and environmental factors that contribute
to disease, predict potential disease risk, optimize drug
prescribing for individuals, and identify and validate critical
new targets for therapeutic development. These new developments
also suggest that a large-scale population-based cohort study
in the United States could provide a critical path toward
improved genome-based public health and the Committee urges
NHGRI to explore the feasibility of commencing such a study.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
Appropriations, 2005.................................... $298,209,000
Budget estimate, 2006................................... 299,808,000
House allowance......................................... 299,808,000
Committee recommendation................................ 309,091,000
The Committee recommends an appropriation of $309,091,000
for the National Institute of Biomedical Imaging and
Bioengineering [NIBIB]. The budget requested $299,808,000 and
the fiscal year 2005 appropriation was $298,209,000. 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.
Professional Judgment Budget.--The Committee acknowledges
receipt of the Five-Year Professional Judgment Budget for the
National Institute of Biomedical Imaging and Bioengineering
[NIBIB] requested in House Report 108-636. The Committee notes
the Budget's central conclusion that biomedical imaging and
bioengineering ``are dynamic and ripe with opportunities for
major scientific advances'' that could be translated into
dramatic improvements in health care. The Professional Judgment
Budget recommends a measured, reasonable rate of growth for the
NIBIB to achieve the goals of the important research areas
enumerated in the report. The Committee commends the NIH and
Department of Health and Human Services for this approach and
believes that the projected rate of growth is necessary to
enable the NIBIB to achieve the scientific advances that the
Congress envisioned when it established the Institute.
The Professional Judgment Budget recognizes the role of the
NIBIB with respect to interdisciplinary research, the physical
sciences, and technology development. The NIBIB has taken a
leadership role in efforts to examine the scientific questions
that can be addressed by collaboration between life and
physical scientists, the barriers to such collaboration, and
the steps that need to be taken to bridge these disciplines.
The Committee is pleased with the role of the NIBIB has
played and will continue to play in the development of
biomedical technology related to the physical sciences.
Imaging and Engineering Advances.--The Committee urges
NIBIB to focus efforts on improving musculoskeletal disease
detection, monitoring and treatment through focused imaging and
engineering advances. The Institute also is encouraged to
develop noninvasive techniques to measure bone quality and bone
strength in humans.
Liver Imaging Techniques.--Consistent with NIBIB's mission
to improve all diagnostic imaging technologies, the Committee
urges NIBIB to make liver imaging techniques a primary focus,
speeding the development of new modalities that better capture
the early stages of various liver diseases, including cancer,
as well as offering the potential for combinations of diagnosis
and treatment. This is also necessary to develop less invasive
diagnostics for liver disease patients. The Committee urges
NIBIB to participate actively in trans-NIH initiatives that
address these priorities.
The Committee is encouraged by the potential of image-
guided surgery to improve patient outcomes. The Committee
supports the Institute's plans to hold a conference on image-
guided surgery and looks forward to learning about the results
of this conference.
PET and MicroPET Scans.--The Committee continues to
encourage the 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.
NATIONAL CENTER FOR RESEARCH RESOURCES
Appropriations, 2005.................................... $1,115,090,000
Budget estimate, 2006................................... 1,100,203,000
House allowance......................................... 1,100,203,000
Committee recommendation................................ 1,188,079,000
The Committee recommends an appropriation of $1,188,079,000
for the National Center for Research Resources [NCRR]. The
budget request was $1,100,203,000 and the fiscal year 2005
appropriation was $1,115,090,000. 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 pre-college students and the general public.
Clinical Research Curriculum Award.--The Clinical Research
Curriculum Awards or K30, has been extremely effective in
training successful clinical investigators. Funded programs
report that over 60 percent of their graduates are active
researchers who have already secured funding for their
research. The Committee supports the NIH decision to increase
the size of these awards from $200,000 to $300,000 but is
concerned that this was accomplished by reducing the number of
funded institutions. The Committee would encourage increased
support in order to expand rather than reduce the number of
institutions receiving this important award.
Clinical and Translational Science Awards [CTSA].--In
September 2003, NIH launched the NIH Roadmap for Medical
Research, a set of trans-NIH research initiatives designed to
accelerate the pace of discovery and improve the translation of
research findings into medical and health interventions for
public benefit. A critical component of the Roadmap is the
theme of re-engineering the clinical research enterprise. The
Committee has encouraged the Director to utilize the NCRR-
funded General Clinical Research Centers as the foundation of
NIH Roadmap activities related to clinical research. NIH is now
poised to capitalize on the revolutionary discoveries emerging
from basic science, and has developed an innovative proposal to
address the current difficulty recruiting and retaining
clinical researchers; the increasing regulatory burden;
fragmented training programs; and limitations and barriers due
to NIH funding mechanisms, review and programs structures. The
Committee supports NIH's efforts to integrate NIH's General
Clinical Research Centers [GCRCs] and other relevant clinical
mechanisms into a new and more efficient single application
that results in awards that combine clinical science support
with clinical career development and training. This will
transform clinical and translational sciences for the future.
The Committee has a long-standing and abiding interest in the
health of the clinical research system supported under this
appropriation, and therefore requests that NIH submit a report
by February 6, 2006. The report should describe NIH's new award
for clinical and translational sciences, which NIH expects to
fund in fiscal year 2006, describe the expected costs in fiscal
year 2006 and fiscal year 2007, and indicate the specific
components of the program and plans for transition from the
current funding mechanisms to the new awards. The Committee
expects that the new award will support the full spectrum of
clinical research activities, from early translation between
the laboratory and the patient to epidemiological studies and
health services research. The report should describe how this
will be accomplished. The Committee has included $327,000,000
for clinical research supported by the GCRCs and the CTSAs
combined. The Committee expects the total number of awards for
this combined program to remain at 79 in fiscal year 2006.
Clinical Trials Technology.--The Committee encourages NCRR
to work with grantees in the Research Centers at Minority
Institutions [RCMI] program and the General Clinical Research
Centers [GCRC] program to upgrade their clinical trials data
management capabilities.
Extramural Facilities Construction at Minority
Institutions.--The Committee encourages NCRR to give priority
consideration to supporting extramural facilities construction
projects at historically minority institutions which have
developed a comprehensive plan to address the disproportionate
impact of cancer in minority communities, and those which have
developed plans for enhancing their library facilities.
Extramural Construction.--The Committee has included bill
language identifying $30,000,000 for extramural biomedical
facility renovation and construction. This amount is the same
as the fiscal year 2005 appropriation. The fiscal year 2006
budget proposed to eliminate funding for the program. 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.
General Clinical Research Centers.--The Committee is
concerned about the growing gap between the GCRC budgets
approved by the NCRR Advisory Council and the actual budgets
awarded. The Committee requests a report comparing the Advisory
Council-approved budgets and the actual funds awarded to each
GCRC for fiscal years 2003, 2004, and 2005. The Committee
requests this same information as soon as possible.
IDeA Grants.--The Committee has provided $230,000,000 for
the Institutional Development Award [IDeA] Program authorized
by section 402(g) of the Public Health Service Act. The
Committee recognizes the importance of the Centers of
Biomedical Research Excellence and the IDeA Networks of
Biomedical Research Excellence programs and expects funding to
be maintained for both. 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.
National Primate Research Centers.--The Committee values
the critical role played by the eight National Primate Research
Centers [NPRCs]. These Centers conduct specialized basic and
applied biomedical research and offer essential and valuable
services to other researchers. Primates are increasingly
important to the Nation's public health priorities in areas
such as biodefense, heart disease, cancer, diabetes, AIDS,
kidney disease, Alzheimer's, Parkinson's and emerging
infectious diseases. In fiscal year 2004, the Committee urged
the NIH to fully commit to the NPRCs' Five Year Federal
Advancement Initiative in order to address the upgrades and
program expansions required to meet the demanding research
needs of the Nation. Nevertheless, NIH has taken only
incremental steps to increase the NPRCs' base grant funding.
The Committee strongly urges the NIH to place a higher priority
on funding these centers adequately.
Research Centers at Minority Institutions.--The Committee
continues to recognize the critical role played by minority
institutions at both the graduate and undergraduate level in
addressing the health research and training needs of minority
populations. These programs help facilitate the preparation of
a new generation of scientists at these institutions. The
Research Centers in Minority Institutions [RCMI] Program
continues to impact significantly on these problems. The
Committee encourages NIH to strengthen participation from
minority institutions and increase resources available in this
area. The Committee also encourages NIH to work with minority
institutions with a track record of producing minority scholars
in science and technology.
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE
Appropriations, 2005.................................... $122,105,000
Budget estimate, 2006................................... 122,692,000
House allowance......................................... 122,692,000
Committee recommendation................................ 126,978,000
The Committee has included $126,978,000 for the National
Center for Complementary and Alternative Medicine. The budget
request was $122,692,000 and the fiscal year 2005 appropriation
was $122,105,000. 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 assuring that complementary and alternative
therapies be rigorously reviewed to provide consumers reliable
information.
The Committee continues to strongly support the work of
NCCAM. As more and more Americans are using complementary and
alternative therapies, there is an increasing need for quality
research into this area and for sharing research findings and
other information with health professionals and the general
public.
The Committee expects that funding for existing and new
Centers supported by the office will be maintained. The
Committee expects NCCAM to renew its support of CDC's field
investigations program and expand its support of AHRQ's
literature reviews and data analysis efforts. It also commends
NCCAM's efforts 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 and expects that to continue and expand.
Antioxidants.--The Committee is aware that the role of
antioxidants in maintaining health in a variety of organ
systems has been attracting attention in recent years. Recent
evidence suggests that the delicate inner ear structures can be
protected against the ravages of acoustic trauma produced by
noise such as that encountered on the battlefield, and may have
a role to play in preventing or slowing the progression of age-
related hearing loss in the elderly by routine administration
of commonly available antioxidant food supplements. Other
applications may be found for these compounds in the treatment
or prevention of auditory or vestibular disorders. The
Committee encourages the institute to collaborate with NIDCD to
fund research in this very promising area.
Ameliorating Liver Disease.--The Committee is pleased with
NCCAM's efforts to conduct clinical trials in collaboration
with NIDDK regarding the use of milk thistle as a possible
treatment in slowing the progression of nonalcoholic
steatohepatitis and to reduce the side effects of hepatitis C
interferon treatments. The Committee looks forward to the
development and dissemination of the research results
associated with the use of milk thistle as a treatment to
ameliorate liver disease.
Bone Health.--The Committee encourages NCCAM to conduct
research on complementary and alternative medical approaches to
bone health, bone pain and nutrition, including supplements and
nutraceuticals, for osteoporosis and later life fractures.
Behavioral Research on Stress.--NCCAM is encouraged to
continue collaborations with other NIH offices, Institutes and
centers to identify mechanisms through which various stressors
produce adverse health effects, and the extent to which stress
reduction interventions improve health.
Integrative Medicine Model.--The Committee supports the
concept of integrative medicine, which reaffirms the importance
of the relationship between practitioner and patient, focuses
on the whole person, is informed by evidence, and makes use of
all appropriate therapeutic approaches, healthcare
professionals and disciplines to achieve optimal health and
healing. The Committee encourages NCCAM and other relevant ICs
to accelerate the infusion of this model throughout their
research, research training and communication activities.
Native Hawaiian Healing.--The Committee commends the NCCAM
for its plans to convene a working group in fiscal year 2005 to
establish communication and facilitate research collaborations
among traditional and conventional healing techniques.
Parkinson's Disease.--The Committee encourages NCCAM to
continue exploration of aerobic exercise and Chinese exercises
such as T'ai Chi Chuan in the treatment of Parkinson's. Recent
studies show exercise may increase neuroprotective chemicals in
the brain and decrease falls in the elderly. The Committee also
encourages continued research into magnetic stimulation for
depression and the phytomedicine Valerian for sleep
dysfunction, as both symptoms are significant non-motor co-
morbidities in Parkinson's. Finally, NCCAM is encouraged to
work the Office of Dietary Supplements in investigating
supplements which may be neuroprotective, such as berries,
alpha lipoic acid, N-acetyl-L-cysteine, acetyl-L-carnitine,
vitamin E, ginko biloba, vitamin D, vitamin B12,
phosphatidylcholine, and glyconutrients.
PET.--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.
Practice-Based Research Network.--One of the major advances
achieved through the work of NCCAM has been the development of
CAM or integrative medicine research centers at many of the
Nation's top medical centers. In order to build upon this
important new research infrastructure base, the Committee
expects NCCAM to implement one of the major recommendations of
the recent Institute of Medicine CAM report--the development
and utilization of an Integrative Medicine Practice-Based
Research Network [PBRN]. The Committee concurs with the IOM
that the PBRN model is very well-suited for the study of CAM
therapies and would greatly enhance the ability to conduct high
quality cost-effective clinical trials of CAM therapies and
treatment modalities. Such a network would also allow for the
rapid dissemination of data, which would directly affect the
provision of health care to consumers. Key to the establishment
of such a network would be funding for a data tracking system
linking the network practice members and a centralized data
coordinating center. The Committee considers the PBRN to be one
of its top priorities for NCCAM this year.
NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
Appropriations, 2005.................................... $196,159,000
Budget estimate, 2006................................... 197,379,000
House allowance......................................... 197,379,000
Committee recommendation................................ 203,367,000
The Committee has included $203,367,000 for the National
Center on Minority Health and Health Disparities. The budget
request was $197,379,000 and the fiscal year 2005 appropriation
was $196,159,000. 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.
Cancer in Minorities.--While the Committee remains
concerned about the burden of cancer in African-Americans and
other minorities, it is encouraged by opportunities that exist
for addressing this devastating toll. The Committee urges the
NCMHD to collaborate with NCRR and NCI in taking the necessary
steps to expand comprehensive Cancer Center's with a focus on
research, treatment, prevention and control of cancer across
minority and other disadvantaged populations.
Cancer in Minority Communities.--The Committee commends
NCMHD for its leadership in addressing the disproportionate
impact of cancer in minority communities. The Committee
encourages NCMHD to consider collaborating with the National
Center for Research Resources and the National Cancer Institute
in supporting the establishment of a cancer center at a
historically minority institution focused on research,
treatment, and prevention of cancer in African-American and
other minority communities.
Community-Based Organization Partnership Prevention
Centers.--The Committee encourages continued expansion of
community-based prevention initiatives and looks forward to
hearing the recommendations of the strategic planning
subcommittee on priority areas for research funding and the
NCMHD's plans for implementation.
Glomerular Injury.--The Committee understands that
glomerular injury, a group of diseases affecting the filtering
mechanisms of the kidneys, is more prevalent among African-
Americans than the general population. The Committee urges
NCMHD to explore collaboration with NIDDK to support research
activities related to glomerular injury and requests a report
on progress made in this area.
Liver Disease.--The Committee notes that many liver
diseases, such as hepatitis C, hepatitis B and nonalcoholic
steatohepatitis, are more common in the African-American,
Hispanic, Asian Pacific Islander and Native American
populations, than in European Americans. In addition, access to
and acceptance of care is particularly problematic in these
populations. The Committee therefore urges the Center to
initiate and participate with NIDDK, NIDA and NCI in research
focused on addressing and reducing these disparities.
Minority Health Disparities.--The Committee commends the
National Center on Minority Health and Health Disparities for
its leadership in addressing the long-standing problem of
health status disparities in minority and medically underserved
populations. For fiscal year 2006, the Committee continues to
encourage NCMHD to implement its successful Research Endowment
program as an ongoing initiative. Moreover, the Committee
encourages NCMHD to implement the program in a manner that is
consistent with the authorizing legislation.
Project EXPORT.--The Committee commends NCMHD for its
successful ``Project EXPORT'' initiative and urges continued
support for this important program. Also, the Committee
encourages the Director of NCMHD to coordinate with the NIH
Director and the National Center for Research Resources in
support of extramural facility construction and the development
of other research and research library infrastructure at
minority health professions schools.
Scleroderma.--The Committee encourages NCMHD to support
research that furthers the understanding of causes and
consequences of scleroderma, a chronic, degenerative disease of
collagen production, present among African-Americans, Hispanic
and Native American men and women. NCMHD is encouraged to
establish epidemiological studies to address the prevalence of
scleroderma among these populations, as statistics indicate
that African-Americans have a slightly higher incidence of
scleroderma. This population is also likely to be diagnosed at
a younger age and tends to be diagnosed more often with the
diffuse form of scleroderma.
JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH
SCIENCES
Appropriations, 2005.................................... $66,632,000
Budget estimate, 2006................................... 67,048,000
House allowance......................................... 67,048,000
Committee recommendation................................ 68,745,000
The Committee recommends an appropriation of $68,745,000
for the Fogarty International Center [FIC]. The budget request
was $67,048,000 and the fiscal year 2005 appropriation was
$66,632,000. 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 United States and the collaborating
country.
Chronic Obstructive Pulmonary Disease.--The Committee notes
that Chronic Obstructive Pulmonary Disease [COPD] is the fourth
leading cause of death worldwide, and encourages the Fogarty
International Center to expand its COPD research and training
activities.
Fragile X.--The Committee encourages the Fogarty
International Center to consider Fragile X syndrome through all
appropriate programs, such as the Fogarty International
Research Collaboration Award and the FIC Brain Disorders in the
Developing World Program.
Tuberculosis Training.--The Committee is pleased with the
Fogarty International Center's efforts to supplement grants in
AIDS International Training and Research Program [AITRP] or
International Training and Research Program in Emerging
Infectious Diseases [ERID], which trains tuberculosis experts
in the developing world. Given the magnitude of global
tuberculosis, the Committee encourages FIC to develop a
specific free-standing TB training program.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2005.................................... $323,346,000
Budget estimate, 2006................................... 326,291,000
House allowance......................................... 326,291,000
Committee recommendation................................ 335,422,000
The Committee recommends an appropriation of $355,422,000
for the National Library of Medicine [NLM]. The budget
requested $326,291,000 and the fiscal year 2005 appropriation
was $323,346,000. These amounts include $8,200,000 made
available from program evaluation funds. The recommendation
includes $4,000,000 for improvement of information systems. 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.
Communication of NIH-Supported Research Findings.--One of
the fundamental charges to NIH is to facilitate the translation
of research findings into practice, both in terms of the care
provided by health professionals and behavioral and lifestyle
changes by the public. The Committee commends the excellent
work NLM does in this regard. The Committee endorses efforts to
launch a new magazine aimed at physician offices and their
patients communicating the latest NIH research findings with
authoritative content presented in a user-friendly format.
Disease Management Technology.--The Committee urges NLM to
conduct outreach activities to all public and private sector
organizations which have demonstrated capabilities in health
information technology. The Committee is particularly
interested in disease management technology as it relates to
saving health care dollars, and improving care for chronically
ill individuals and the workforce.
Health Equity Review.--The Committee congratulates NLM for
its concern about health disparities and its sensitivity to
native populations, such as Native Americans, Alaskans, and
Hawaiians, and other minority communities. The Committee
encourages NLM to fund projects to map health disparities and
population profiles in minority communities.
Native Hawaiian Healing.--The Committee applauds the NLM's
leadership for conducting ``listening circles'' to discuss the
need for preservation and documentation of traditional cultural
healing practices. The Committee encourages the NLM to explore
the best ways of capturing and documenting this information
through continued collaboration with Native Hawaiians.
Outreach.--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.
Public Access.--The Committee has noted that the National
Institutes of Health has begun to implement its public access
policy which is geared to ensuring that NIH-funded research
results are made available as soon as possible to the public,
health care providers, educators, and scientists through the
National Library of Medicine's PubMed Central [PMC] database.
The Committee agrees with the need for, and a goal of, issuing
a balanced policy to help promote increased public access to
NIH-funded research while maintaining the integrity of the peer
review system which is essential to ensure the quality and
accuracy of medical research in the United States. The
Committee urges NIH to work with all stakeholders as it moves
forward in implementing this policy. To assist the Congress in
assessing the degree of success of this new policy, the
Committee requests a progress report by no later than February
1, 2006. Specifically, the Committee requests that the report
contain the following information: (1) the total number of
peer-reviewed articles deposited in PubMed Central since the
May 2, 2005 implementation date and the distribution of chosen
delay periods; (2) an assessment of the extent to which the
implemented policy has led to improved public access; (3) an
assessment of the impact of the policy on the peer review
system; and (4) the cost of operating the database.
PubChem.--The Committee is aware of the development of
PubChem, the informatics component of the Molecular Libraries
project of the NIH Roadmap for Medical Research. The Committee
understands that the purpose of PubChem is to create a database
of chemical structures and their biological activities. PubChem
will house both data from the new NIH molecular libraries
screening center network and compound information from the
scientific literature. The Committee expects the NIH to work
with private sector chemical information providers, with a
primary goal of maximizing progress in science while avoiding
unnecessary duplication and competition with private sector
databases.
OFFICE OF THE DIRECTOR
Appropriations, 2005.................................... $358,047,000
Budget estimate, 2006................................... 385,195,000
House allowance......................................... 482,216,000
Committee recommendation................................ 487,434,000
The Committee recommends an appropriation of $487,434,000
for the Office of the Director [OD]. The budget request was
$385,195,000 and the amount appropriated in fiscal year 2005
was $358,047,000. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
The Committee has included within the total, $97,021,000 to
support specific targeted research activities needed to develop
radiological/nuclear ($47,021,000) and chemical threat
($50,000,000) countermeasures. This funding was originally
requested in the Office of the Secretary Public health and
Social Services Emergency Fund.
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.
Office of Research on Women's Health
The Office of Research on Women's Health [ORWH] works in
collaboration with the Institutes and Center of 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/or ensuring the inclusion of women in clinical
research funded by NIH, including the development of a
computerized tracking system and the implementation of
guidelines on such inclusion. This office also promotes the
number of women in biomedical science careers.
Irritable Bowel Syndrome.--The Committee is pleased with
the increased focus on irritable bowel syndrome [IBS] at the
NIH's Office Research on Women's Health. It is estimated that
between 25 to 45 million Americans, disproportionately women,
suffer from IBS.
Office of AIDS Research
Microbicides to Prevent HIV/AIDS.--Given current scientific
advancements, an effective microbicide could be developed by
the end of the decade, and once available, could well change
the course of the epidemic. According to NIH, ``the U.S.
Government is firmly committed to accelerating the development
of safe and effective microbicides to prevent HIV'' because
microbicides may provide ``one of the most promising prevention
interventions that could be inexpensive, readily available, and
widely acceptable'' (U.S. Government Strategic Plan for
Microbicides). Despite these statements, NIH continues to spend
barely 2 percent of its HIV/AIDS research budget on
microbicides. The Committee strongly urges greater funding for
microbicide research and development at NIH. In addition, this
Committee has long advocated that NIH establish a dedicated
microbicide unit with clearly identified leadership to
accelerate and coordinate federally supported microbicide
research, and is concerned that no significant progress has
been made towards this goal. Greater leadership and
coordination on this issue is especially critical given that
consideration is being given to the possibility of a
microbicide-specific clinical trial network. If this evolves,
the notion of a dedicated microbicide unit at the NIH would be
essential.
There is an urgent need to expand the development pipeline
with more microbicide candidate products, particularly those
that target HIV in new ways. In addition to candidates that may
arise from basic research efforts, the best possibilities may
be found within pharmaceutical companies where there are dozens
of potential compounds already developed as therapeutics that
could move into clinical development as microbicides if made
available. As outlined in the NIH Roadmap, NIH has mechanisms
in place to encourage partnerships among researchers in
academia, government and the private sector. The Committee
strongly urges the leadership at NIH to support the microbicide
field by encouraging the pharmaceutical industry to allow its
drug candidates to be developed as microbicides. In the past
year, the International Partnership for Microbicides has
entered into innovative agreements with leading pharmaceutical
companies to jointly test and develop leading AIDS drugs as
microbicides. More partnerships like these between the
pharmaceutical industry and the non-profit community will be
critical, and should receive the active support of NIH
leadership.
Pediatric HIV Research.--The Committee recognizes the
importance of research into the long-term health implications
of preventive HIV drug regimens in children, the psychological
and social needs of HIV-infected children and appropriately
targeted prevention services. The Committee urges the Director
to provide the resources necessary for domestic and
international research on the long-term effects of preventive
drug regimens on HIV-exposed pediatric populations; the long-
term health, psychosocial, and prevention needs for pediatric
populations perinatally HIV-infected; the transition to
adulthood for HIV-infected pediatric populations; and safer and
more effective treatment options for pediatric populations with
HIV disease.
Pediatric HIV Vaccine Testing.--The Committee requests the
NIH Director to submit a report within 90 days of enactment of
this bill on the status of activities related to the testing of
potential HIV vaccine candidates in relevant pediatric
populations, including infants, preadolescents, and
adolescents. The report shall include an analysis of regulatory
or other barriers to developing an HIV vaccine and a
comprehensive review of current and planned clinical trials in
relevant pediatric populations. In addition, the Committee
requests that the NIH fiscal year 2007 Plan for HIV-Related
Research and future plans include: plans for expanding existing
capacity for HIV vaccine candidate testing in relevant
pediatric populations; plans for increasing coordination in
advancing pediatric HIV vaccine testing across federally funded
HIV vaccine research programs, including, but not limited to
the HIV Vaccine Trials Network, the Pediatric AIDS Clinical
Trials Group, the Food and Drug Administration, the Centers for
Disease Control and Prevention, and the Partnership for AIDS
Vaccine Evaluation; opportunities for collaboration with the
Office of the Global HIV/AIDS Coordinator; appropriate
principles for initiating HIV vaccine testing in relevant
pediatric populations, including recommendations for sequencing
the enrollment of adults and relevant pediatric populations and
for addressing issues related to human subjects protections for
children involved in clinical research; and proposed community
education efforts in support of the inclusion of relevant
pediatric populations in HIV vaccine clinical trials.
Office of Research on Women's Health
Stroke in Women.--As the second leading cause of death
among women worldwide, stroke is a major health problem. Stroke
kills more than twice as many women as do breast cancer and
AIDS combined. Acute care of women stroke victims is often
delayed, and 61 percent of all stroke-related deaths occur in
women. Recognizing that women are the single largest group at
risk for death from stroke, the Committee believes that special
attention should be focused on better understanding the gender-
related differences in stroke. Studies suggest that significant
gender differences occur in the evaluation and treatment of
stroke patients, with women often receiving fewer diagnostic
tests and intervention procedures. Increased research is needed
to understand these differences and provide a means to optimize
stroke care for all patients. Some aspects of the disease
unique to women include strokes related to pregnancy and the
use of oral contraceptives; stroke in younger women requires
increased attention. Stroke is additionally a leading cause of
serious disability among women and may contribute to late-life
cognitive decline. The Committee supports the funding of new
and continuing NIH studies that investigate the impact of
postmenopausal hormone replacement therapy on stroke risk.
Continued support of clinical and basic research on hormone
physiology in women is necessary to understanding the impact of
hormones on women's vascular systems. The Committee urges NIH
to increase research in stroke among women of all ages, with
specific attention to gender-related differences in stroke
risk, and to stroke prevention interventions, acute stroke
management, post-stroke recovery, long-term outcomes, and
quality of care. The Committee further urges NIH to increase
research into new therapies for stroke in women as well as into
ways of enhancing the vascular health of all Americans,
including: (1) observational research on differences in the way
men and women present with stroke symptoms, (2) research
addressing how stroke influences the likelihood and severity of
cognitive impairment in women, (3) a clinical trial of carotid
endarterectomy and angioplasty/stenting in women, (4) studies
of differences in how men and women respond to FDA-approved
antiplatelet agents for recurrent stroke prevention, and (5)
basic science research to address unique brain cell death and
repair mechanisms in females.
The Committee also encourages and supports NIH's
initiatives toward advancing the organization of stroke care,
including post-stroke rehabilitation, and the identification of
stroke treatment and research centers that would provide rapid,
early, continuous 24-hour treatment to stroke victims,
including the use of the clot-buster t-PA, when appropriate.
Designated areas in medical facilities equipped with the
resources and personnel for treating stroke would also promote
the early evaluation of innovative stroke treatments.
Vulvodynia.--Since fiscal year 1998, the Committee has
highlighted the need for research on the prevalence, causes and
treatment of vulvodynia, a painful and often debilitating
disorder of the female reproductive system. The Committee is
pleased that some progress has been made since that time. For
example, the NICHD has supported a major study of the
prevalence of this disorder. The published results of this
study found that as many as 6 million women suffer from
vulvodynia, making it one of the most prevalent chronic pain
conditions affecting women. The Office of Research on Women's
Health [ORWH] was crucial in supporting an important 2003
research conference on vulvodynia. These efforts have both
clearly demonstrated the need for substantial additional
research and served to heighten the research community's level
of interest in studying vulvodynia. The Committee calls upon
the Director to build upon these initial successes by
coordinating through the ORWH an expanded and collaborative
extramural and intramural research effort into the causes of
and treatments for vulvodynia. This expanded effort should
involve ORWH, NICHD, NINDS and other relevant ICs as well as
the NIH Pain Consortium. In addition, the Committee notes that
as many as 40 percent of women with vulvodynia remain
undiagnosed after visiting three or more physicians. To address
this shortcoming, the Committee urges that NIH include
information about vulvodynia on its website and that it work
with the National Vulvodynia Association, the American College
of Obstetricians and Gynecologists and other relevant groups to
implement a national education program for primary care health
professionals, patients and the general public on vulvodynia's
symptoms, diagnosis and treatment options. Finally, the
Committee encourages the Director to work with the Center for
Scientific Review and ICs to ensure that experts in vulvodynia
and related chronic pain and female reproductive system
conditions are adequately represented on peer review panels.
Office of Dietary Supplements
The Committee continues to strongly support the important
work of this Office. Use of dietary supplements has increased
significantly among Americans who want to improve their health
and prevent disease. There is a great need for additional
research to better inform consumers of the health benefits of
supplements. Accordingly, the Committee has provided additional
funds to expand this Office's efforts.
As in past years, the Committee strongly urges the Office
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. This effort is a crucial underpinning for
conducting quality research and assuring quality and
consistency for consumers of dietary supplements.
The Committee commends ODS for developing a request for
proposals for a contract with industry nonprofit associations
or foundations that currently have and maintain a database of
dietary supplement labels to develop, create, continually
update, maintain and make available to Government and research
entities a database of all supplement labels sold in the United
States. The creation of this database will allow ODS to have
access for research purposes of all known supplements
manufactured in the United States and to allow access by other
Federal agencies for ensuring safety to consumers who purchase
supplements manufactured and/or sold in the United States,
through the mandatory listing of ingredients in these products
on the label.
The Committee notes that there is great potential in work
being done on the relationship between fish oils and other
dietary supplements in combating anti-inflammatory diseases.
This also applies to work being done on the potential for
selected botanicals to reverse the development of insulin
resistance, the key pathophysiologic feature of metabolic
syndrome. Given the growing prevalence of obesity, expansion of
this area of research is clearly warranted.
A number of recent studies point to the need for an
expansion of ODS support for research into herb-drug
interactions. ODS, NCCAM and other ICs at NIH are supporting
important work in this area, and it should be expanded.
Improved dissemination of results of this research to the
public, health professionals and other interested parties is
also needed.
The Committee commends ODS for its efforts to seek input
from consumers, industry, researchers and other stakeholders on
its future agenda. ODS should continue and expand its outreach
to industry stakeholders to share information, gather ideas and
assure better coordination of privately and publicly funded
research.
Office of Behavioral and Social Sciences Research
The Office Behavioral and Social Sciences Research furthers
the mission of the NIH by emphasizing the role that behavioral
and social factors and their interaction with biomedical
variables play in health. The goals of the office are to
enhance behavioral and social sciences research and training;
integrate a biobehavioral perspective across the NIH; and
improve communication among health scientists and with the
public.
Office of Rare Disease Research
The Office of Rare Diseases was established in 1993 to
address the conditions that affect fewer than 200,000 persons
in the United States. The goals of the office are to stimulate
and coordinate research on rare diseases and to support
research to respond to the needs of patients who suffer from
the more than 6,000 rare diseases known today.
Multi-Institute Research Initiatives
Autism Spectrum Disorders.--The Committee is encouraged by
the NIH's autism research matrix and urges NIH to devote
sufficient resources to this research agenda. The Committee
urges the NIH when implementing the autism research matrix to
coordinate with autism organizations already funding research
initiatives to ensure the most efficient use of resources. The
Committee also notes the promise of particular areas cited in
the matrix, including genetic and behavioral characterizations
of the disorder and screening and early diagnosis.
Autoimmune Diseases.--The Committee commends the NIH
Autoimmune Diseases Coordinating Committee [ADCC] for fostering
collaborative, integrated multi-Institute research on issues
affecting the genetically related family of autoimmune
diseases. Implementation of autoimmune diseases research by the
ADCC should focus on high-priority, cross-cutting
opportunities, including research into the role of
environmental and infectious agents in the initiation and/or
exacerbation of autoimmune diseases. The Committee also
encourages the ADCC to identify and initiate promising areas of
autoimmune research where collaboration among the NIH
institutes enhances the potential for major advances in
understanding the common etiology of, and developing more
effective diagnostic and treatment tools for, this family of
debilitating and high-cost diseases.
Bone Health and Osteoporosis.--The Committee is pleased
that the Surgeon General has submitted the report on bone
health requested in the fiscal year 2002 Appropriations bill.
The Surgeon General calls for a national action plan to achieve
improved bone health. To this end, the Committee encourages the
NIH to establish a ``Bone Health Research Blueprint'' to
achieve the Surgeon General's objectives through enhanced
cooperation between and among the NIH research institutes. The
Blueprint should place particular emphasis on osteoporosis,
osteogenesis imperfecta, Paget's disease, other metabolic bone
diseases and rare bone disorders such as osteopetrosis. The
Committee requests a report on the status of the Bone Health
Blueprint by May 1, 2006.
Chronic Fatigue Syndrome.--The Committee is deeply
concerned that NIH has failed to expand research on chronic
fatigue syndrome [CFS] and that a June 2003 commitment to issue
a request for applications on CFS has not yet been fulfilled.
The RFA should emphasize multi-disciplinary studies to
understand the cause and progression of CFS in adults and
children, identify diagnostic markers and develop effective
treatment. The Committee also is troubled that a CFS funding
report for fiscal years 1999-2003 issued in response to
congressional requests included amounts for grants unrelated to
CFS, thus artificially inflating the total dollars awarded for
CFS research. CFS is just one condition for which this has been
a problem. The Committee requests that NIH report back to it by
May 1, 2006, on the number of CFS-specific grant applications
received and funded since fiscal year 2000.
Child Abuse and Neglect Research.--The Committee recognizes
the magnitude and significance of child abuse and neglect as a
serious public health problem claiming an estimated 896,000
victims in 2002, according to data reported by the Department
of Health and Human Services. The Committee applauds NIH for
developing and implementing a coordinated research agenda for
child abuse and neglect involving relevant NIH institutes,
including NIMH, NICHD, NIDA, NINR, and NIAAA, the Office of
Behavioral Social Science and Research and other appropriate
agencies. In response to recommendations in the 1993 National
Research Council report entitled Understanding Child Abuse and
Neglect, the NIH child abuse and neglect initiative first
addressed the knowledge gaps in child neglect. The Committee
encourages NIH to proceed with the research agenda by examining
current research gaps on the abuse of children, including
research on treatment interventions with substantiated cases of
child maltreatment. The Committee requests that the Director be
prepared to report on current and proposed NIH efforts in this
area at the fiscal year 2007 hearings.
Clinical Research and Academic Health Centers.--Past
breakthroughs in basic biomedical sciences have provided an
unprecedented supply of information for improving health and
preventing disease. But in recent years, the Nation's academic
health centers, which serve as the staging ground that deploys
the results of research to hospitals and health care providers,
have encountered obstacles that threaten to slow the pace of
clinical research, including unfunded mandates. Without a
robust infrastructure, the translation of basic science into
tangible public health improvements will be slowed. The
Committee therefore encourages the Director to take concrete
steps to address the problems encountered by academic health
centers.
Clinical Research Curriculum Award.--The Clinical Research
Curriculum Award has been extremely effective in training
successful clinical researchers. The Committee supports the NIH
decision to increase the size of these awards from $200,000 to
$300,000 but is concerned that it was accomplished by reducing
the number of funded institutions. The Committee urges the
Director to consider an increase in funding from Institutes and
Centers that support the program in order to expand rather than
reduce the number of institutions receiving this award. In
addition, the Committee reiterates its support for
implementation of the Congressionally authorized Graduate
Training in Clinical Investigation award to provide tuition and
stipend support for clinical research training program
students.
Clinical Research Workforce Training.--The Committee has
heard testimony that virtually every medical specialty is
experiencing a shortage of adequately trained clinical
investigators capable of translating basic science advances
into the diagnosis, treatment and prevention of disease. This
shortage inhibits clinical research productivity and slows the
rate at which results from basic biomedical research efforts
can be applied to the problems of patients. Improved clinical
research will have a positive effect on the quality of health
care and patient safety, and advance the application of the
principles of evidenced-based medicine to routine patient care.
The Committee urges allocation of sufficient resources for
training of physician-scientists throughout all NIH institutes,
to support studies of patient outcomes, medical effectiveness,
and disease- and treatment-specific quality of life.
Clinical Trials Technology.--The Committee recommends that
the NIH Director and the Director of the NIH Clinical Center
explore options for utilization of technology to improve
efficiency, cost savings, and sharing of information in
clinical trials being supported intramurally and extramurally.
Distribution of Resources.--The Committee believes, in
light of the doubling of the NIH budget and the emergence of
new medical research challenges such as SARS and threats of
bioweapons, NIH should encourage funding of large scale
collaborative efforts to address these and other medical
challenges. In addition, while the pace of new challenges has
increased, review time for proposals submitted to the
Institutes at NIH continues to average about 18 months. The
Committee strongly encourages the Director to develop means of
encouraging large scale multi-institution projects to address
significant areas of medical research and to devise means of
reducing the time frames between submission of proposals and
awarding of grants.
Down Syndrome Research Task Force.--The Committee urges the
Director of NIH to establish a NIH Down Syndrome Research Task
Force to develop a strategic plan for genetic and
neurobiological research relating to the cognitive dysfunction
and the progressive late-life dementia associated with Down
syndrome. The purpose of the strategic plan is to provide a
guide for coordinating Down syndrome research on cognition
across the NIH and for enhancing the development of new
research efforts based on identification of areas of greatest
scientific opportunity, especially as they relate to the
development of future treatments. The plan should include
short, intermediate and long-term goals for basic and clinical
research with strategies for achieving goals and with specified
timeframes for implementation. The Committee requests the NIH
to report to Congress by June 1, 2006 on the steps it is taking
to develop the Down Syndrome Research Task Force on Cognition.
Duchenne Muscular Dystrophy.--The Committee remains
concerned with the amount of time taken by the NIH to comply
with requirements of the MD Care Act, which became law in
December 2001. The Committee is pleased NIH has funded one
additional Wellstone Muscular Dystrophy Cooperative Research
Center and is working to fund two more for a full complement of
six. The Committee further encourages the Institute to provide
adequate funding and resources for each center. As the original
report on the activities being performed pursuant to the MD
Care Act was both late in coming and insufficient in detail,
the Committee requests that NIH submit a report to the
Committee no later than May 1, 2006 stating the current
research goals and progress made toward each goal; the
Institute or Center responsible for each goal; the total amount
of money invested toward each goal as well as projected
spending for the present and future fiscal year; opportunities
for external partnerships; and a timeline for establishing a
Duchenne/Muscular Dystrophy translational research initiative,
modeled on the lines of the spinal muscular atrophy project.
The Committee recognizes that several promising treatments and
therapies for Duchenne and Becker Muscular Dystrophy are in
development, and urges NIH to invest additional resources,
including a coordinating mechanism, necessary to expedite their
translation into practice. Furthermore, the Committee urges NIH
to work with leading stakeholders to convene a consensus
conference on translational research opportunities in early
2006, and report back to the Committee, by September 2006, with
a strategic plan for launching a translational research
initiative.
Dystonia.--The Committee is very pleased with progress
demonstrated by the NIH intramural research program in the
treatment and understanding of dystonia. NIH intramural
researchers have successfully utilized injections of Botox to
treat many patients who otherwise would be severely debilitated
by dystonia. The Committee urges continued work in this
important area of study and treatment.
Epilepsy.--While NINDS is the primary Institute for
addressing epilepsy research, several other Institutes are also
involved in related research. The Committee urges the Director
to intensify coordination of cross-cutting research on epilepsy
in all Institutes.
Fragile X.--The Committee notes the impressive progress
made by Fragile X researchers in understanding the basic neural
defects that cause this developmental disorder. NIH Institutes,
units, and its National Center for Research Resources provided
75 grants in fiscal year 2004 to find a treatment and cure for
Fragile X. The success of these translational research efforts
has made treatment of Fragile X a near-term possibility.
However, further efforts are required to translate these basic
science findings into viable treatments. Specifically,
collaborative efforts between industry, academia and NIH
Institutes are likely to be necessary to develop promising
therapeutic options for this orphan indication. The Committee
further notes that while Fragile X is a relatively common
genetic disease, the treatments being developed for Fragile X
may also be effective for a much larger number of people with
related autism spectrum disorders. Research has shown many
possible treatment strategies which merit human Fragile X
clinical trials, including--but not limited to--mGluR5
antagonists, Ampakines, aripiprazole, and lithium. The
Committee strongly urges the Director to facilitate and fund
public/private partnerships which will enable these vital
studies to proceed. In addition, privately-funded Fragile X
research is rapidly expanding, often in partnership with NIH
grants. The Committee commends the growing breadth and
diversity of this research but strongly urges the Director to
establish a coordinating mechanism to direct and coordinate
these efforts in regularly-scheduled meetings. To achieve this
mandate, the NIH is urged to convene a yearly workshop with the
research community to develop priorities for basic, clinical
and translational research as they relate to Fragile X. The
Committee also encourages the Director to increase the number
and size of institutional training grants to institutions
supporting pediatric training and the number of grants for
career development clinical research as they relate to Fragile
X.
Gene Therapy Research.--While the promise of gene therapy
has not yet been realized, the Committee is encouraged by some
promising research done in the area of thalassemia, or Cooley's
anemia. It is concerned, however, that the most innovative gene
therapy research is currently being done in Europe rather than
in the United States. The Committee urges the Director to
assess the prospects for the most promising areas for
breakthroughs in this field and to develop an aggressive
program to focus resources on it. The assessment should also
include the prospects for successes in additional
hemoglobinopathies and in an even broader range of diseases.
The goal of this effort should be nothing less than to cure a
disease in the shortest possible time utilizing gene therapy
techniques.
Heart Disease Research and Prevention Action Plan.--
Advances have been made in the identification and treatment of
risk factors for heart disease. The Committee encourages the
NIH to convene a transagency national conference on heart
disease to assess progress and opportunities and to develop a
comprehensive, long range research and prevention action plan.
Participants should include representatives from all Federal
agencies involved in heart disease research and prevention,
including the NIH and all relevant institutes and centers, CDC,
AHRQ, DOD, and pertinent voluntary nonprofit organizations,
foundations, and experts in the field. The Committee encourages
the Director to develop a long-range, strategic Heart Disease
Research and Prevention Action Plan and submit a report to the
Committee by May 1, 2006. The plan should include quantifiable
goals and benchmarks to measure progress in the battle against
heart disease, and a professional judgment budget for each year
as well as for the entire plan.
Hereditary Hemorrhagic Telangiectasia.--Hereditary
Hemorrhagic Telangiectasia [HHT], also known as Osler-Weber-
Rendu Syndrome, is a multi-system vascular genetic disorder
producing blood vessel malformations in the brain and lung
which may result in stroke, hemorrhage, aneurysm and death.
Sudden death or disability occurs in 20 percent of children and
adults but is largely preventable with proper intervention.
Because this is a multi-system disorder, the Committee
encourages the Director to formulate an NIH-wide research
agenda with the participation of the NHLBI, NINDS and NIDDK
Institutes.
Hepatitis B.--Although there has been tremendous success in
the prevention and treatment of hepatitis B, this disease
remains a serious concern. The Committee proposes that the
success of past research be built upon with new program
development and the potential for new funding. The large number
of immigrants to the United States from parts of the world
where hepatitis B is endemic will keep this disease in the
forefront of public health for years to come. For example, the
more than 8 million people who are estimated to have immigrated
from Asia to the United States in the past 10 years, alone,
will significantly add as many as 600,000 people to the more
than 1.2 million people already believed to be chronically
infected, in the United States. The Committee urges the
Director of NIH to report to Congress the amount of funding
necessary to develop programs which would stimulate new
research to find: (1) complements for the current therapies for
hepatitis B, (2) improvements in the detection and treatment of
hepatitis and liver cancer associated with hepatitis B, (3)
improvements in the prevention of the disease by development of
new vaccines, new outreach and population studies. Initiatives
that promote truly innovative approaches and stimulate and
excite new investigation in these areas is specifically
encouraged.
Human Tissue Supply.--The Committee remains interested in
matching the increased needs of NIH grantees, intramural, and
university-based researchers who rely upon human tissues and
organs to study human diseases and search for cures, including
for those researchers dedicated to the study and cure of rare
diseases. The Committee is aware that one of the leaders in
this competitive field, the National Disease Research
Interchange [NDRI], is uniquely positioned to obtain this
valuable and effective alternative research resource. More than
500 peer-reviewed research advances made by NDRI-dependent
researchers have been published during the past 4 years
contributing to the research community's fund of knowledge. The
Committee is encouraged by NDRI's role in these research
advances and applauds the Director's expanded support for NDRI
by bringing NEI, NIDDK, NIAID, NIAMS, and the Office of Rare
Diseases into the multi-Institute initiative. While this is
promising, more needs to be done to match the demand for the
use of human tissue in research. The Committee, therefore,
expects the Director to increase the core support NDRI receives
from NCRR, and to broaden the scope of the multi-Institute
initiative by strongly urging the Institute Directors of NCI,
NHGRI, NHLBI, NICHD, NIMH, and NINDS to identify and implement
program-specific initiatives to expand support for NDRI.
Islet Transplantation.--The Committee commends the NIDDK
and NIAID for the establishment of the Clinical Islet
Transplantation Consortium and the islet transplantation
clinical trial that will include Medicare-eligible individuals
whose transplant and related costs will be covered by Medicare.
The Committee encourages cooperation between the NIDDK and
NIAID and members of the Consortium to ensure the timely launch
of these clinical trials.
Kidney Disease.--The Committee is aware that kidney disease
is a major health problem in the United States, and according
to a recent CDC study is one of the fastest growing causes of
death in the United States. It is estimated that at least 15
million people have lost 50 percent of their kidney function
and another 20 million more are at increased risk of developing
kidney disease due to diabetes, cardiovascular disease and
hypertension. Of these individuals, a disproportionate share
are minorities. The Committee encourages the Director to ensure
that the NIDDK and NHBLI work closely and collaboratively to
maximize the output of our national investment in kidney
disease.
Lupus.--The Committee recognizes lupus is a serious,
complex, debilitating chronic autoimmune disease that can cause
inflammation and tissue damage to virtually any organ system in
the body. The Committee strongly urges the Director of the
National Institutes of Health to expand, intensify and
coordinate research and related activities with respect to
lupus across all relevant institutes, centers and offices,
especially the National Institute of Arthritis and
Musculoskeletal and Skin Diseases, and the National Institute
of Allergy and Infectious Diseases.
The Committee is disappointed with the pace of research
regarding lupus and strongly urges that the Director of the
National Institutes of Health conduct or support research to
expand the understanding of lupus, including: basic research to
discover the pathogenesis and pathophysiology of the disease;
research to determine the reasons underlying the
disproportionate prevalence of lupus in African American,
Hispanic, Native American, and Asian women; epidemiological
studies to address the frequency and natural history of the
disease and the differences between the sexes and among racial
and ethnic groups with respect to the disease; clinical
research for the development and evaluation of new treatments,
including new biological agents; and research to validate lupus
biomarkers; and research to develop improved diagnostic tests.
The Committee strongly urges the Institute to increase funding
for lupus research by actively soliciting grant applications
for lupus and taking aggressive steps to assure that a vigorous
research program is established.
Lymphangioleiomyomatosis [LAM].--The Committee remains very
interested in efforts to find a cure and treatments for LAM, a
progressive and fatal lung disease that strikes women, usually
in their childbearing years. Currently, there are no effective
treatments. The Committee understands that recent scientific
findings have presented new treatment approaches for clinical
testing, and that experimental trials with the drug sirolimus
have begun. The Committee urges the NHLBI, as well as the NCI,
the Office of Rare Diseases, and the NINDS to fund clinical
treatment trials through both intramural and extramural means
and to use all available mechanisms as appropriate, including
support of state-of-the-science symposia, request for
applications, and facilitating access to human tissues to
stimulate a broad range of clinical and basic LAM research. The
Committee also commends the NCRR and ORD for their roles in
supporting the Rare Lung Disease Consortium.
Lymphatic Research.--The lymphatic system is central to the
progression of disease and the maintenance of health, yet
scientific and medical knowledge of this important system is
woefully deficient. While the Committee is pleased that a
Trans-NIH Coordinating Committee on the Lymphatic System exists
to ensure that scientific knowledge and understanding about
this neglected body system will be advanced and coordinated,
adequate efforts and funding are lacking. ICs are urged to
include relevant language addressing basic and clinical
lymphatic system research in all existing and future funding
mechanisms, where such grant applications could be responsive.
The Trans-NIH Coordinating Committee should be informed of
relevant lymphatic language included within such funding
initiatives.
The Committee is encouraged to learn that the Trans-NIH
Coordinating Committee on the Lymphatic System, and in
particular the NHBLI, is working with patient advocates to
address the needs of the lymphatic disease and lymphedema
patient communities. Initiatives such as a national lymphatic
disease patient registry/tissue bank; an NIH lymphatic disease
working group and national guidelines for clinical care; an NIH
partnership funding program; intramural longitudinal studies;
and multidisciplinary centers for research, clinical care, and
medical training are strongly encouraged.
Nanosystems Biology.--The Committee encourages the
Director, along with NCI, to support a collaborative effort to
bring nanotechnology, systems biology and molecular imaging
together to examine the molecular basis of cancer, consistent
with the Director's Roadmap Initiative. Initial efforts have
shown that cancers such as breast cancer are not a single
disease, but may encompass many different diseases, when
examined at the molecular level. Many clinical trials of new
drugs are now considered to fail if only 10 percent of patients
benefit, yet that 10 percent may represent a specific type of
the disease, where the drug in question may be 100 percent
effective. Bringing these three disciplines together may allow
researchers to identify specific sub-types of cancer and to
better target new interventions. Successful results of such an
effort could lead to a molecular classification of many types
of cancer and to targeted molecular treatments for molecular-
specific disease.
Parkinson's Disease.--The Committee understands that the
Director, in accordance with the Udall Act, convened a research
conference in June 2005. The Committee strongly urges the
Director to report back to the Committee by May 1, 2006 to
address current and ongoing Parkinson's disease research
including the final analysis of the Parkinson's Disease
Research Agenda that expired this year, the goals and
conclusions from the summit held in June 2005, a thorough
examination of the existing Parkinson's research portfolio,
identification of shortcomings and opportunities for more
effective treatments and a cure for Parkinson's, and
recommendations of research goals for the next 3 years to help
scientists better understand the causes, more quickly diagnose,
and develop better treatments and a cure for Parkinson's
disease.
The Committee strongly urges the NIH to work in conjunction
with the Centers for Disease Control and Prevention to
investigate and report on geographic population clusters of
incidence of Parkinson's disease. It is estimated that more
than 1 million Americans are fighting Parkinson's disease and
60,000 cases are newly diagnosed each year. However, these
figures are only estimates. Further, it is believed that there
are increasing numbers of Americans who are diagnosed with
young onset Parkinson's disease. With a stronger understanding
of who is impacted by this devastating disease, the NIH will be
better able to better target critical research funds that will
find treatments or cures for the more than 1 million Americans
who have this progressive, neurodegenerative disease.
Peer Review of Patient-Focused Research.--In 1998, the NIH
Director's Panel on Clinical Research identified problems with
NIH peer review of clinical research grant applications and
recommended the organization of study sections capable also of
reviewing patient-oriented research and the implementation of a
system for tracking the review of these clinical research
applications. Nevertheless, a 2002 General Accounting Office
report to Congress indicated that the NIH did not have reliable
methods for identifying and tracking patient-oriented research
applications or reviewers. More recent analysis by the Center
for Scientific Review has confirmed previous studies
demonstrating that grant applications focused on patient-
oriented research are less likely to receive funding than
laboratory research grant proposals. The Committee believes it
is critically important that the Director take action to
address this disparity and requests a report regarding efforts
that are being undertaken to recruit clinical investigators to
participate in the peer review process, to assure that patient-
oriented research applications are assigned to knowledgeable
review groups, and to improve the system for tracking the
review of clinical research grants to assure that shortcomings
of the review process are identified and corrected.
Pioneer Awards.--The Committee is pleased with the
establishment of the NIH Director's Pioneer Award, an
innovative program designed to encourage investigators to
pursue high-risk research avenues of research with the
potential to result in truly groundbreaking discoveries. The
Committee is especially pleased that this program has attracted
a large number of interested, high-quality applicants, but is
concerned that relatively few awards have been made so far.
Population-Based Prevention Research.--The Committee
commends NIH for its efforts to support research in humans that
examines factors associated with preventing disease and
promoting health. The Committee urges the NIH to seek ways to
remove barriers that prevent research findings from being
translated into population-wide health improvements and to
expand its support for studies that include examination in
human populations of biological, behavioral and environmental
factors associated with disease and means to ameliorate them.
The Committee urges the Director to support additional
genetic research to identify the genes responsible for
psoriasis susceptibility, basic research to understand the
mechanism of disease and clinical research to identify new safe
and effective therapies for these diseases.
Rehabilitation Services.--The Committee recognizes the
burgeoning growth in rehabilitation services provided to
patients, especially the elderly, with musculoskeletal problems
and the urgent need to establish a solid scientific basis for
clinical practice in this area. The Committee urges the
Director to establish a research program in the National Center
for Medical Rehabilitation Research to: (1) evaluate the
efficacy and establish optimal schedules and settings for
movement based rehabilitation interventions, such as
therapeutic exercise, to improve physical function in
individuals with musculoskeletal conditions, including
arthritis, back pain, hip fracture and major joint
replacements, and (2) further knowledge of the underlying
mechanisms of repair, regeneration and recovery of these
interventions. The NCMRR is still a relatively new agency with
a small budget and its research portfolio needs to be expanded
particularly in the area of medical and physical rehabilitation
and musculoskeletal conditions. The Committee urges the
National Institute on Aging, the National Institute on
Arthritis and Musculoskeletal and Skin Diseases, and the
National Institute on Biomedical Imaging and Bioengineering to
collaborate on these initiatives.
Reproductive Health Research.--The Committee is concerned
that the NIH does not have trans-NIH information regarding the
amount of infertility and reproductive health research that is
conducted in many Institutes including NICHD, NCI, NIDDK,
NIAID, and NIEHS. The Committee is concerned that until NIH has
accurate trans-NIH information, it is not possible to lead and
coordinate this area of research to help ensure scientific and
research progress. The Committee therefore urges that the
Office of the Director ensure that such information is
available in order to permit a vigorous scientific leadership
with regard to this category of diseases that has devastating
physical, social, financial and psychological consequences.
Research Centers at Minority Health Institutions.--The
Committee continues to be pleased with the NIH Director's
implementation of various programs focused on developing
research infrastructure at minority health professions
institutions, including Research Centers at Minority
Institutions, Extramural Biomedical Research Facilities, and
the National Center on Minority Health and Health Disparities.
The Committee encourages that the NIH Director work closely
with the Director of the National Center on Minority Health and
Health Disparities to establish a program of coordination among
these various mechanisms to partner with minority health
professions schools to address their infrastructure needs.
Spinal Muscular Atrophy.--The Committee strongly urges the
OD to ensure the success of the SMA Project by providing active
and ongoing support from the OD as well as from other related
Institute Directors. While the Committee commends the active
work and progress of NINDS on the SMA Project, the Committee
remains concerned that other Institutes, to date, has made no
commitment to SMA research. The Committee reiterates its
request of last year that the OD take all necessary steps to
ensure that relevant Institutes are fully engaged by devoting
attention and resources to SMA and specifically to the SMA
Project.
Temporomandibular Joint Disorders [TMJ].--The Committee
continues its strong support of research into TMJ disorders.
The Committee agrees with and is encouraged by recent public
statements by NIH officials that because of past and current
investments in research and patient registries, the field is
now ready to support a substantial new research investment in
this complex set of disorders. The Committee therefore strongly
urges that this path be followed and that a substantially
expanded TMJ research effort be undertaken to speed up
completion of the research needs and opportunities agenda
outlined in the June 2005 NIH TMJ Report to Congress. As noted
previously, the multifaceted nature of TMJ disorders requires
an approach that coordinates the work of many interested
parties at NIH. Therefore, this expanded effort should include
increased efforts from all relevant ICs and should give
priority to collaborative, cross-cutting research.
In addition, the Committee strongly encourages the
Director, through the NIDCR and ORWH, to undertake an effort to
improve awareness among dentists and other relevant health
professionals such as internists, rheumatologists,
otolaryngologists, neurologists and other primary care
professionals about TMJ disorders. Such an effort should
include the development of a model symposium on this topic and
the presentation of this symposium at relevant major medical
society conferences.
Trans-NIH Research Initiatives.--The Committee commends NIH
for continuing to expand trans-NIH research initiatives that
foster scientific collaboration and advancement. The Committee
is particularly interested in programs like the Blueprint for
Neuroscience Research, which pools the resources and expertise
of 15 NIH institutes and centers to focus on disorders of the
nervous system. The multidimensional roots of the obesity
epidemic--encompassing behavioral, biological, and
environmental factors--call for research efforts across
Institutes and Centers, and the Committee commends the
activities undertaken through the trans-NIH Strategic Plan for
Obesity Research. The Committee urges that funds allocated to
the NIH Institutes and Centers be used for increased support of
the Neurosciences Blueprint and increased research in obesity.
Tuberous Sclerosis Complex.--Tuberous sclerosis complex, or
TSC, is a genetic disorder that triggers uncontrollable tumor
growth in multiple organs of the body, including the brain,
heart, kidneys, lungs, liver, eyes or skin. Its victims--many
of whom are infants and young children--face a lifetime of
suffering with kidney failure, seizures, behavioral disorders,
autism and mental retardation. Because of the effects of TSC on
multiple organ systems, the Committee in 2003 called upon the
NIH Director to formulate an NIH-wide research agenda. The
Committee is encouraged by recent steps taken by the Office of
the Director to establish a Trans-NIH Tuberous Sclerosis
Coordinating Committee. The Committee encourages the Office to
continue its support of this Committee and expand it to include
other Institutes such as the NEI, NIGMS and NICHD.
OFFICE OF AIDS RESEARCH
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.
The Committee requests that the Director 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.
BUILDINGS AND FACILITIES
Appropriations, 2005.................................... $110,288,000
Budget estimate, 2006................................... 81,900,000
House allowance......................................... 81,900,000
Committee recommendation................................ 113,626,000
The Committee recommends an appropriation of $113,626,000
for buildings and facilities [B&F]. The budget requested
$81,900,000 and the fiscal year 2005 appropriation was
$110,288,000.
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.
The Committee has included full-scope bill language within
this appropriation to give flexibility to the NIH to continue
work on the John E. Porter Neuroscience Research Center for
which $15,000,000 has been included. Funds have also been
included for the Animal Research Center, the Rocky Mountain
Laboratories Buffer Replacement Facility, asbestos abatement,
fire protection and health and safety compliance, air quality
improvement programs and to eliminate barriers to persons with
disabilities.
Substance Abuse and Mental Health Services Administration
Appropriations, 2005.................................... $3,391,769,000
Budget estimate, 2006................................... 3,336,023,000
House allowance......................................... 3,352,047,000
Committee recommendation................................ 3,385,086,000
The Committee recommends $3,385,086,000 for the Substance
Abuse and Mental Health Services Administration [SAMHSA] for
fiscal year 2006. This amount is $6,683,000 below the
comparable fiscal year 2005 level and $49,063,000 above the
administration request. The recommendation includes
$123,303,000 in transfers available under section 241 of the
Public Health Service Act. 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 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.
The Committee strongly supports SAMHSA's Federal leadership
role to improve the quality and availability of empirically-
based prevention and treatment services in the areas of mental
health and substance abuse. To further the translation of
research knowledge into practice, the Committee supports the
ongoing collaboration between SAMHSA and the National
Institutes of Health (specifically with the National Institute
of Mental Health, the National Institute on Drug Abuse, and the
National Institute on Alcohol Abuse and Alcoholism). Through
this partnership, services research conducted by NIH will
identify effective treatment and prevention strategies, the
findings of which will be promoted by SAMHSA through its
knowledge dissemination programs to improve the quality of
services rendered. Furthermore, outcomes from program
evaluation research conducted by SAMHSA will be communicated as
critical implementation feedback to NIH, and may ultimately
lead to further improvements in the delivery of effective
mental health and substance abuse services in community
programs nationwide.
The Committee expects that no less than the amounts
allocated in fiscal year 2005 will be spent in fiscal year 2006
on activities throughout SAMHSA addressing the needs of the
homeless. Specifically, the Committee has provided funding at
last year's level for programs directed at chronic homelessness
and for programs directed at providing mental health and
substance abuse treatment services to homeless.
The Committee notes that, according to a study released by
the New England Journal of Medicine, as many as one in four
veterans of Afghanistan and Iraq treated at Veterans Affairs
hospitals in the past 16 months have been diagnosed with mental
disorders. While many at-risk veterans will take advantage of
mental health services available through the Departments of
Defense and Veterans Affairs, concern about possible
stigmatization may lead some veterans to avoid treatment
through these sources. The Committee believes that community
outreach, early intervention and treatment for veterans will be
a significant need in the coming years and encourages SAMHSA,
through CMHS and CSAT, to develop opportunities for communities
to prepare and coordinate mental health and addiction services
for returning combat veterans and their families.
Greater availability of a rapid HIV test can increase
overall HIV testing and reduce the number of people, an
estimated 225,000 Americans, who are unaware of their HIV
infection. The Committee acknowledges that treatment services
provided by mental and behavioral health care providers for
individuals testing positive are a necessary component of rapid
HIV testing. The Committee commends SAMHSA for developing the
Rapid HIV Testing Initiative [RHTI] to train substance abuse
and mental health service providers on rapid HIV testing and
encourages SAMHSA to expand the program.
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 to fund
projects to increase knowledge about effective ways to deliver
services to rural and native communities.
CENTER FOR MENTAL HEALTH SERVICES
Appropriations, 2005.................................... $901,317,000
Budget estimate, 2006................................... 837,250,000
House allowance......................................... 880,294,000
Committee recommendation................................ 901,334,000
The Committee recommends $901,334,000 for mental health
services. This amount is $17,000 above the comparable level for
fiscal year 2005 and $64,084,000 above the administration
request. The recommendation includes $21,803,000 in transfers
available under section 241 of the Public Health Service Act.
Included in the recommendation 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.
Programs of Regional and National Significance
The Committee recommends $274,297,000 for programs of
regional and national significance. This amount is the same as
the comparable level for fiscal year 2005 and $64,084,000 above
the administration 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 remains deeply concerned that suicide is the
third leading cause of death among adolescents. Consistent with
the recommendations of the President's New Freedom Commission
on Mental Health, the Committee in fiscal year 2005 called upon
SAMHSA to award grants to local educational systems or non-
profit entities in conjunction with local educational systems
to test the use of screening mechanisms and to identify
evidence-based practices for facilitating treatment for youth
at risk. The Committee has provided funding at last year's
level for SAMHSA to continue this effort in fiscal year 2006.
In addition, the Committee has provided $11,000,000 for
State and campus-based programs that address youth suicide
prevention. This is an increase of $2,556,000 above the
comparable level for fiscal year 2005 and the administration
request. The Committee has included funding at last year's
level to continue supporting the National Suicide Prevention
Resource Center. This important initiative supports technical
assistance in developing, implementing and evaluating effective
suicide prevention programs. The Resource Center serves as a
training and field support and acts as a clearinghouse for all
pertinent best practices information regarding suicide
prevention, and it promotes evaluation of suicide prevention
programs to ensure that effective techniques, strategies, and
recommended best practices are made available to users. The
Committee also continues funding at last year's level for the
Suicide Prevention Hotline program.
The Committee notes that the National Strategy for Suicide
Prevention calls for the establishment of public/private
partnerships for the purpose of advancing and coordinating the
implementation of the National Strategy. While much progress
has been made, many of the objectives included in the National
Strategy have not been completed. The Committee commends SAMHSA
for its work on examining the National Strategy objectives with
the goal of developing a priority work plan and encourages
SAMHSA to establish a coordinating body aimed at advancing the
objectives of the National Strategy.
The Committee continues to strongly support funding for
prevention of youth violence. The Committee intends that no
less than last year's level of funding be used for this
initiative, which includes the Safe Schools/Healthy Students
interdepartmental program. The administration proposed cutting
this program by $27,427,000. The Committee believes that
enhanced school and community-based services can strengthen
healthy child development, thus reducing violent behavior and
substance use. Since 1999, over 180 communities have received
and benefited from these grants. The Committee therefore is
providing funding at last year's level to assist 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 provides funding at last year's level for the
consumer and consumer-supporter national technical assistance
centers. The Committee directs CMHS to support multi-year
grants to five such national technical assistance centers.
The Committee recommendation restores funding to the State
Infrastructure Planning Grants activity. The administration
request proposed to shift the funding source for this program
to the CMHS block grant setaside. State Infrastructure Planning
Grants are a critical initiative that informs both States and
SAMHSA on practical implementation issues and mechanics related
to the new performance and outcome data reporting requirements
included in SAMHSA's Data Strategy.
The Committee recommendation includes funding at last
year's level for the elderly treatment and outreach program.
The Committee notes that while many older Americans experience
depression, dementia, anxiety and substance abuse disorders,
far too often these conditions are not recognized or treated.
Outreach to elderly persons conducted in places frequented by
seniors, such as senior centers, meal sites, primary care
settings and other locations, is needed. The elderly treatment
and outreach program helps local communities establish the
infrastructure necessary to better serve the mental health
needs of older adults.
The Committee recommendation fully funds the administration
request for the State Incentive Grants for Transformation
program. The Committee directs SAMHSA to ensure that State
mental health planning and advisory councils play a significant
role in the development of comprehensive State plans under this
new program, because the councils represent the consumer and
family voice in States across the country.
The Committee believes that research-based prevention and
wellness promotion efforts that strengthen parenting and
enhance child resilience in the face of adversity can have a
significant impact on the mental health of children and youth.
While some programs that use such a strengths-based approach
exist for families already in contact with the juvenile justice
system or immediate risk for dissolution, evidence suggests
that they may be particularly effective for families that have
one or more risk factors but are not yet in crisis and may not
have had contact with child protective services or other
government agencies. The Committee requests CMHS to provide it
with a report by May 1, 2006 that reviews the effectiveness of
such programs and the best ways to implement them so they reach
families in need, and offers recommendations for future
preventive efforts in this area.
Community Mental Health Services Block Grant
The Committee recommends $432,756,000 for the community
mental health services block grant, which is the same as the
comparable fiscal year 2005 amount and the administration
request. The recommendation includes $21,803,000 in transfers
available under section 241 of the Public Health Service Act.
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 59 eligible States and Territories through a formula based
upon specified economic and demographic factors. Applications
must include an annual plan for providing comprehensive
community mental health services to adults with a serious
mental illness and children with a serious emotional
disturbance. Because the mental health needs of our Nation's
elderly population are often not met by existing programs and
because the need for such services is dramatically and rapidly
increasing, the Committee encourages SAMHSA to require that
States' plans include specific provisions for mental health
services for older adults.
Children's Mental Health Services
The Committee recommends $105,129,000 for the children's
mental health services program. This amount is $17,000 above
the comparable fiscal year 2005 level and the same as the
administration 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.
Projects for Assistance in Transition From Homelessness [PATH]
The Committee recommends $54,809,000 for the PATH Program.
This amount is the same as the comparable fiscal year 2005
level and the administration request.
PATH provides outreach, mental health, and case management
services and other community support services to individuals
with serious mental illness who are homeless or at risk of
becoming homeless. 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 $34,343,000 for the protection and
advocacy program, which is the same as the comparable fiscal
year 2005 level and the administration 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 incomes.
CENTER FOR SUBSTANCE ABUSE TREATMENT
Appropriations, 2005.................................... $2,197,921,000
Budget estimate, 2006................................... 2,222,607,000
House allowance......................................... 2,184,986,000
Committee recommendation................................ 2,187,646,000
The Committee recommends $2,187,646,000 for substance abuse
treatment programs. This amount is $10,275,000 below the
comparable fiscal year 2005 funding level and $34,961,000 below
the administration request. The recommendation includes
$83,500,000 in transfers available under section 241 of the
Public Health Service Act. 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 commends the Center for Substance Treatment
[CSAT] for its ongoing collaboration with the National
Institute on Drug Abuse [NIDA]. The Committee continues to be
pleased that the CSAT/NIDA collaboration with State substance
abuse directors, also known as Single State Authorities [SSAs]
for Substance Abuse, is improving the manner in which evidence-
based practices are used in our publicly funded system. The
Committee encourages CSAT to continue its Blending Initiative
with NIDA and SSAs to ensure that research findings are
relevant and adaptable by State substance abuse systems.
Programs of Regional and National Significance
The Committee recommends $412,091,000 for programs of
regional and national significance [PRNS]. The recommendation
includes $4,300,000 in transfers available under section 241 of
the Public Health Service Act. The recommendation is
$10,275,000 below the comparable fiscal year 2005 level and
$34,961,000 below the administration request.
Programs of regional and national significance include
three primary activities: best practice programs 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 $100,000,000 for the
Access to Recovery program. The Committee expects that
addictive disorder clinical treatment providers participating
in the Access to Recovery program, as well as their respective
staff, shall meet the certification, accreditation, and/or
licensing standards recognized in their respective States.
The Committee recommends funding at no less than last
year's level for the Addiction Technology Transfer Centers
[ATTCs]. The ATTC Network operates as 14 regional centers and
one national office to translate the latest science of
addiction, including evidence-based addiction treatment. The
ATTCs are also an important component of the CSAT/NIDA Blending
Initiative that seeks to improve the manner in which research
findings are moved into every day practice.
The Committee continues to be concerned about the incidence
of drug addiction among pregnant and parenting women. The
unavailability of family-based treatment is manifested in the
overrepresentation of substance-abusing mothers in the child
welfare system. Up to 80 percent of the families who come to
the attention of child welfare agencies are substance abusing.
The absence of treatment opportunities for families has also
extended to the criminal justice system. Nearly 70 percent of
the women behind bars are suffering from untreated addiction.
Most of these women offenders are mothers: approximately 65
percent of women in State prisons, and 59 percent of women in
Federal prisons have young children.
SAMHSA's evaluation of both the Residential Women and
Children [RWC] and Pregnant and Postpartum Women [PPW] programs
showed significantly reduced alcohol and drug use, as well as
decreased criminal behavior. Rates of premature delivery, low
birth weight, and infant mortality were improved for
participating women. In addition, treatment costs were offset
three to four times by savings from reduced costs of crime,
foster care, Temporary Assistance to Needy Families [TANF], and
adverse birth outcomes. The Committee believes that increased
capacity for family-based treatment programs is imperative.
Within the funds appropriated for CSAT, the Committee
recommends $11,000,000 for treatment programs for pregnant,
postpartum, and residential women and their children. This
amount is $1,080,000 above the comparable level for fiscal year
2005 and the administration request. No less than last year's
funding shall be used for the Residential Treatment Program for
Pregnant and Postpartum Women [PPW], authorized under section
508 of the Public Health Service Act. In addition, the
Committee strongly urges SAMHSA to explore ways to increase
family treatment capacity.
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends $1,775,555,000 for the substance
abuse prevention and treatment block grant. The recommendation
includes $79,200,000 in transfers available under section 241
of the Public Health Service Act. The recommendation is the
same as the comparable level for fiscal year 2005 and the
administration 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 Committee wishes to express its strong support for
increased funding for the Substance Abuse Prevention and
Treatment [SAPT] Block Grant, an effective and efficient
funding stream that flows to every State and territory. The
Committee is aware that the SAPT Block Grant funds critical
prevention and treatment services for our Nation's most
vulnerable citizens, including those with HIV/AIDS, pregnant
women, and others who can not afford these lifesaving services.
The Committee continues to believe that the most effective and
efficient way to support substance abuse programs in every
State and territory is to direct the bulk of available new
resources into the SAPT Block Grant.
The Committee is aware of SAMHSA's efforts to improve the
quality of substance abuse prevention and treatment data by
seeking information on a core set of National Outcome Measures
[NOMS] across all SAMHSA funding mechanisms, including services
funded by the SAPT Block Grant. The Committee is also aware of
SAMHSA's work to implement a State Outcomes Measurement and
Management System [SOMMS] as the mechanism to achieve this
initiative. The Committee commends SAMHSA for working with
States and territories to streamline data reporting
requirements and reduce reporting burden while improving
accountability. The Committee strongly encourages SAMHSA to
continue to work with States and territories to reach consensus
on all aspects of SOMMS planning, implementation and
evaluation.
The Committee recognizes that States receiving the HIV set-
aside within their Substance Abuse Prevention and Treatment
Block Grant are well positioned to offer hepatitis prevention
services to high risk clients, and encourages set-aside dollars
to be used to support hepatitis prevention. The Committee
recognizes that the majority of new hepatitis C virus
infections are related to drug use, and asks SAMHSA to
encourage all grantees to incorporate hepatitis prevention
services, such as hepatitis C screening, into existing drug
treatment programs.
CENTER FOR SUBSTANCE ABUSE PREVENTION
Appropriations, 2005.................................... $198,725,000
Budget estimate, 2006................................... 184,349,000
House allowance......................................... 194,950,000
Committee recommendation................................ 202,289,000
The Committee recommends $202,289,000 for programs to
prevent substance abuse, which is $3,564,000 above the
comparable fiscal year 2005 level and $17,940,000 above the
administration request.
The Committee recognizes the important role played by the
20 percent prevention services set-aside within the Substance
Abuse Prevention and Treatment [SAPT] Block Grant. This vital
substance abuse prevention funding helped contribute to the
fact that 600,000 fewer teens used drugs in 2004 compared to
2001, according to the Monitoring the Future survey. The
Committee also supports the need to recognize substance abuse
prevention as a unique, separate and distinct field and
encourages SAMHSA to promote programming consistent with this
finding, including a strong role for CSAP as the Federal
Government's lead agency for substance abuse prevention.
The Committee is concerned about the intersection of
methamphetamine abuse and the transmission of infectious
diseases such as HIV and Hepatitis C. Both SAMHSA and the
Centers for Disease Control and Prevention [CDC] have funded
crucial programs targeting methamphetamine abuse and infectious
disease prevention. However, the intersection of
methamphetamine abuse and infectious disease has not been
adequately addressed. Recognizing that the two agencies have
different responsibilities in responding to the damage caused
by the drug abuse epidemic, the Committee requests that SAMHSA
and CDC draft a list of priorities to address the intersections
of these two epidemics and provide a collaborative written
report by April 1, 2006, designating a coordinating plan
between SAMSHA and CDC. The plan should include a proposed
infrastructure, needed resources, mechanisms of communication,
and community involvement representing populations at high-risk
to coordinate prevention, community outreach, professional
training, treatment and new and existing grant programs to
effectively address the intersection of the crystal
methamphetamine epidemic and rising HIV rates.
Programs of Regional and National Significance
The Committee has provided $202,289,000 for programs of
regional and national significance [PRNS]. The recommendation
is $3,564,000 above the comparable fiscal year 2005 level and
$17,940,000 above the administration request. The Center for
Substance Abuse Prevention is the sole Federal organization
with responsibility for improving accessibility 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 recommendation includes $93,488,000 for the
Strategic Prevention Framework State Incentive Grant [SPFSIG]
program, which is designed to promote, bolster and sustain
prevention infrastructure for every State in the country. The
Committee recognizes that a linchpin of this program is State
flexibility so that each State may tailor initiatives and
direct resources in ways that are most appropriate for its own
jurisdiction. The Committee encourages SAMHSA to promote
maximum State flexibility in managing the SPFSIG program and
the 20 percent prevention set-aside within the Substance Abuse
Prevention and Treatment [SAPT] Block Grant so that each State
may employ a range of effective prevention strategies to meet
their own unique needs and local circumstances.
The Committee expects SAMHSA to ensure that SPFSIG grantees
do not fund duplicative sub-state anti-drug coalition
infrastructures, but utilize those already functioning and
funded by programs such as the Drug Free Communities program.
The Committee remains very concerned about the prevalence
of methamphetamine use. According to the National Survey on
Drug Use and Health [NSDUH], approximately 12.3 million
Americans ages 12 or over tried methamphetamine in 2003. In
more than three-quarters of Western States, methamphetamine and
amphetamine-related treatment admissions rates are higher than
those for cocaine or heroin. While methamphetamine is a serious
problem on the West Coast, in the Mountain States and in parts
of the Midwest, recent data suggest that the problem may be
spreading eastward. Since fiscal year 2003 the Committee has
provided $14,000,000 to twelve States for grants aimed at
expanding the capacity of health care and community
organizations to address methamphetamine abuse. The Committee
is disturbed that the administration did not request funding
for this program in fiscal year 2006. The Committee's
recommendation includes $4,000,000 to continue this program.
With the consolidation of the contracts for the National
Clearinghouse for Alcohol and Other Drug Information and the
Mental Health Clearinghouse, the Committee expects SAMHSA to
ensure that the funding and materials available for substance
abuse prevention be maintained at no less than current levels.
The Committee recommendation includes $850,000 for the
third year of the Ad Council's parent-oriented media campaign
to combat underage drinking. Previous funding for the campaign
was provided through the Office of the Secretary.
PROGRAM MANAGEMENT
The Committee recommends $93,817,000 for program management
activities of the agency. The recommendation includes
$18,000,000 in transfers available under section 241 of the
Public Health Service Act. The recommendation is $11,000 above
the comparable level for fiscal year 2005 and $2,000,000 above
the budget request.
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.
Last year the Committee included funds for SAMHSA to
``establish surveillance measures to address the mental and
behavioral health needs of the population of the United
States.'' The Committee is pleased that SAMHSA decided to work
with the Centers for Disease Control and Prevention [CDC] to
include questions on mental health in a CDC survey known as the
Behavioral Risk Factor Surveillance System. The funds are being
used to test appropriate questions and to help defray the cost
of including them in the survey. Funds are also being provided
to help States respond to the surveys. The Committee
recommendation for fiscal year 2006 includes $2,000,000 to
expand on the collaborative effort by SAMHSA and CDC to
establish a population-based source of data on the mental and
behavioral health needs in this country. These data will help
policymakers implement the recommendations of the President's
New Freedom Commission on Mental Health report ``Achieving the
Promise: Transforming Mental Health Care in America.''
The Committee recognizes the benefits of client level data
reporting in order to build a more accurate picture of
Americans in need of prevention and treatment services. The
Committee strongly encourages SAMHSA to reach out to the
Department of Justice, Department of Education, Health
Resources and Services Administration [HRSA] and other Federal
agencies to ensure that all Federal grants seek client level
data reporting in order to complement and coordinate with
SAMHSA's National Outcomes Measurement [NOMS] and State
Outcomes Measurement and Management Initiative [SOMMS]
initiatives.
Agency for Healthcare Research and Quality
Appropriations, 2005.................................... $318,695,000
Budget estimate, 2006................................... 318,695,000
House allowance......................................... 318,695,000
Committee recommendation................................ 323,695,000
The Committee recommends $323,695,000 for the Agency for
Healthcare Research and Quality [AHRQ]. This amount is
$5,000,000 above both the administration request and the
comparable funding level for fiscal year 2005. The Committee
has funded AHRQ through transfers available under section 241
of the Public Health Service Act.
The Agency for Healthcare Research and Quality was
established in 1990 to promote improvements in clinical
practice and patient outcomes, promote improvements in the
financing, organization, and delivery of health care services,
and increase access to quality care. AHRQ is the Federal agency
charged to produce and disseminate scientific and policy-
relevant information about the cost, quality, access, and
medical effectiveness of health care. AHRQ provides
policymakers, health care professionals, and the public with
the information necessary to improve cost effectiveness and
appropriateness of health care and to reduce the costs of
health care.
HEALTH COSTS, QUALITY, AND OUTCOMES
The Committee provides $265,695,000 for research on health
costs, quality and outcomes [HCQO]. This amount is $5,000,000
above both the administration request and the comparable amount
for fiscal year 2005. 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.
For fiscal year 2006, the Committee directs AHRQ to devote
$84,000,000 of the total amount provided for HCQO to
determining ways to reduce medical errors. Of this amount,
$50,000,000 will support the Department's initiative to promote
the development, adoption and diffusion of information
technology in health care.
The Committee recognizes the work that AHRQ has done
regarding comparative effectiveness research. Comparative
effectiveness research has the potential to lower health care
costs while improving quality of care. The Committee directs
AHRQ to devote $20,000,000 of the total amount provided to
research authorized under Section 1013 of the Medicare
Prescription Drug, Improvement and Modernization Act of 2003.
The Committee's recommendation is $5,000,0000 more than the
amount provided last year. The increased funding will allow
AHRQ to continue and build upon the priority list of conditions
identified in fiscal year 2005.
Autoimmune Disease.--In order to support continued HHS-wide
implementation of the HHS Autoimmune Diseases Research Plan,
the Committee encourages AHRQ to estimate the annual treatment
and societal costs of autoimmune diseases in the United States,
in order to project their future impact and burden on the
healthcare system.
Duchenne Muscular Dystrophy.--The Committee is pleased AHRQ
is studying standards of care issues associated with patients
diagnosed with Duchenne Muscular Dystrophy. The Committee urges
AHRQ to build on this work by partnering with CDC to convene a
consensus conference to develop these standards.
Elderly Mental Health.--The Committee is seriously
concerned about the prevalence of undiagnosed and untreated
mental illness among older Americans. Affective disorders,
including depression, anxiety, dementia, and substance abuse
and dependence, are often misdiagnosed or not recognized at all
by primary and specialty care physicians in their elderly
patients. While effective treatments for these conditions are
available, there is an urgent need to translate advancements
from biomedical and behavioral research to clinical practice.
The Committee urges AHRQ to support evidence-based research
projects focused on the diagnosis and treatment of mental
illnesses in the geriatric population, and to disseminate
evidence-based reports to physicians and other health care
professionals.
Health Disparities.--The Committee remains disturbed by the
March 2002 Institute of Medicine report regarding the
disparities of medical care delivery to minorities. The
Committee encourages AHRQ to carefully evaluate the analysis,
findings, and recommendations of this study in order to pursue
creative ways to improve health care delivery for all minority
populations, including African-Americans, those of Hispanic and
Asian origin, Native Americans, Alaskans and Native Hawaiians.
Hospital-based Initiative.--The Committee urges AHRQ to
work with multi-site academic medical centers to identify and
implement programs to improve patient safety in a hospital
setting. The Committee is interested in patient safety
improvements that are designed for rapid turnaround and for
developing practical and replicable projects in the future.
Investigator-initiated Research.--The Committee notes that
the Department reallocated $11,518,000 from AHRQ in fiscal year
2005 to fund the Department's health information technology
initiative. While the Committee strongly supports this
initiative, it notes that this reallocation delayed the start
of several non-patient safety grant programs. Research outside
of targeted areas such as patient safety, health IT and
comparative effectiveness is a critical part of AHRQ's mission
yet these grants are a diminishing portion of the agency's
research portfolio. The Committee notes that important
initiatives like the patient safety program were based on
investigator-initiated research. The Committee strongly urges
AHRQ to maximixe investigator-initiated research.
Nurse-Managed Health Centers.--The Committee encourages
AHRQ to include nurse managed health centers and advanced
practice nurses in research and demonstration projects
conducted by the agency.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee provides $55,300,000 for health insurance and
medical expenditures panel surveys [MEPS], which is the same as
the administration request and the comparable fiscal year 2004
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 $2,700,000 for program support.
This amount is the same as the administration request and the
comparable fiscal year 2005 level. This activity supports the
overall management of the Agency.
Centers for Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriations, 2005
$123,779,019,000
Budget estimate, 2006
156,954,419,000
House allowance
156,954,419,000
Committee recommendation
156,954,419,000
The Committee recommends $156,954,419,000 for Grants to
States for Medicaid. This amount is $33,175,400,000 more than
the fiscal year 2005 appropriation and the same as the
administration's request and House allowance. This amount
excludes $58,517,290,000 in fiscal year 2005 advance
appropriations for fiscal year 2006. In addition,
$62,783,825,000 is provided for the first quarter of fiscal
year 2007, as requested by the administration. Fiscal year 2006
funding increases by $22,910,109,000 to fund obligations
incurred but not reported in fiscal year 2005, thus reflecting
the shift in the program from a cash basis of accounting to
accrual-based accounting. 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 is based upon
the State's average per capita income relative to the national
average, and shall be no less than 50 percent and no more than
83 percent.
PAYMENTS TO HEALTH CARE TRUST FUNDS
Appropriations, 2005
$114,608,900,000
Budget estimate, 2006
177,822,200,000
House allowance
177,742,200,000
Committee recommendation
177,822,200,000
The Committee recommends $177,822,200,000 for Federal
payments to health care trust funds. This amount is the same as
the administration's request, $80,000,000 more than the House
allowance, and is an increase of $63,213,300,000 from the
fiscal year 2005 appropriation. The significant funding
increase is largely due to the cost of the new prescription
drug benefit. This entitlement account includes the general
fund subsidy to the Federal Supplementary Medical Insurance
Trust Fund for Medicare Part B benefits and for Medicare Part D
drug benefits and administration, plus other reimbursements to
the Federal Hospital Insurance Trust Fund for Part A benefits
and related administrative costs that have not been financed by
payroll taxes or premium contributions. The Committee has
provided $128,015,000,000 for the Federal payment to the
Supplementary Medical Insurance Trust Fund. This payment
provides matching funds for premiums paid by Medicare Part B
enrollees. This amount is the same as the administration's
request and is $14,013,000,000 more than the fiscal year 2005
amount. The Committee further provides $53,596,000,000 for the
general fund share of benefits paid under Public Law 108-173,
the Medicare Prescription Drug, Improvement and Modernization
Act of 2003. The Committee includes bill language requested by
the administration providing indefinite authority for paying
the General Revenue portion of the Part B premium match and
provides resources for the Part D drug benefit program in the
event that the annual appropriation is insufficient. The
recommendation also includes $202,000,000 for hospital
insurance for the uninsured. This amount is the same as the
administration's request and is $115,000,000 more than the
fiscal year 2005 amount. The Committee also recommends
$206,000,000 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 an increase of $7,000,000 over the
fiscal year 2005 level, reflecting an increase on the number of
covered individuals who are currently enrolled. The Committee
recommendation includes $164,000,000 to be transferred to the
Hospital Insurance Trust Fund as the general fund share of CMS
Program Management administrative expenses. This amount is the
same as the administration's request and is $51,000,000 less
than the fiscal year 2005 amount. The Committee recommendation
also includes $677,000,000 to be transferred to the
Supplementary Insurance Trust Fund as the general fund share of
Part D administrative expenses. This amount is the same as the
administration's request. The recommendation also provides
$99,100,000 for State low-income determination activities
through the prescription drug account. This amount is the same
as the administration's request and is $6,800,000 less than the
2005 amount. The Committee recommends $80,000,000 as
reimbursement to the Health Care Fraud and Abuse Control
[HCFAC] fund, described in a separate account, for new program
integrity activities to be funded as discretionary spending.
The House did not fund this account.
HEALTH CARE FRAUD AND ABUSE CONTROL
Appropriations, 2005....................................................
Budget estimate, 2006................................... $80,000,000
House allowance.........................................................
Committee recommendation................................ 80,000,000
The Committee recommends $80,000,000 for program integrity
activities to be funded in fiscal year 2006 through a
discretionary cap adjustment. These funds will be reimbursed
from the Payment to the Health Care Trust Funds appropriation.
Of this total, $75,000,000 is for program integrity activities
related to the new Part D prescription drug benefit and
$5,000,000 for enhanced Medicaid financial management. The
House did not fund this account.
The Committee notes that mandatory funding for program
integrity activities has not increased since fiscal year 2003
and that the Part D prescription drug legislation did not
include resources for program oversight. The Committee
recommends $75,000,000 to be used to initiate program integrity
efforts related to the new prescription drug benefit in the
Medicare Integrity Program. The Committee recommends $5,000,000
to augment the role of the CMS in financial management and
oversight of program integrity efforts in the Medicaid and
SCHIP grant programs.
The Committee encourages CMS to consider implementing a
Medicare analysis and detection system, aimed at reducing
fraud, waste, and abuse through use of supercomputing
technology.
PROGRAM MANAGEMENT
Appropriations, 2005.................................... $2,664,911,000
Budget estimate, 2006................................... 3,177,478,000
House allowance......................................... 3,180,284,000
Committee recommendation................................ 3,203,418,000
The Committee recommends $3,203,418,000 for CMS program
management, which is $25,940,000 more than the amount requested
by the administration $23,134,000 more than the House
allowance, and $538,507,000 more than the fiscal year 2005
enacted level. Fiscal year 2006 marks the first year that
funding for ongoing Medicare Modernization Act [MMA] activities
is included in the CMS Program Management appropriation. The
Committee recommends the budget request of $560,000,000 for
ongoing MMA activities in fiscal year 2006.
Research, Demonstrations, and Evaluations
The Committee recommends $78,494,000 for research,
demonstrations, and evaluation activities. This amount is
$33,300,000 more than the budget request, and $1,000,000 more
than the 2005 level.
CMS research and demonstration activities facilitate
informed, rational Medicare and Medicaid policy choices and
decision making. These studies and evaluations include projects
to measure the impact of Medicare and Medicaid policy analysis
and decision making, projects to measure the impact of Medicare
and Medicaid on health care costs, projects to measure patient
outcomes in a variety of treatment settings, and projects to
develop alternative strategies for reimbursement, coverage, and
program management.
The Committee has included $40,000,000 for Real Choice
Systems Change Grants for Community Living to States to fund
initiatives that establish enduring and systemic improvements
in long-term services and supports. Given the progress to date,
the Committee recommends the issuance of a grant solicitation
designed to provide a greater level of support to grantees to
effectively identify and target requisite components of a
coherent and integrated system of long-term care supports. The
Secretary shall also allocate a portion of funding to: provide
technical assistance to grantees on the development of a
strategic plan to achieve systems transformation; maintain an
information system that facilitates acquisition of data and
information necessary to assess the progress of states in
transforming their long-term care systems; and conduct an
evaluation that would provide specific, measurable indicators
of whether systems transformation has been achieved.
The Committee commends CMS for implementing section 1860d-
4(c)(2) of the Medicare Modernization Act requiring Part D
prescription drug sponsors to provide medication therapy
management services [MTMP] to targeted Medicare Part D
enrollees. MTMP are critical to improving health outcomes and
to reducing medication errors for targeted Medicare
beneficiaries with chronic conditions and high drug costs. The
Committee encourages CMS to conduct a demonstration project to
identify effective MTMP models for targeted Medicare Part D
enrollees, capable of implementation on a large scale. This
demonstration project should include approaches that emphasize
evidence-based prescribing, prospective medication management,
technological innovation, and outcomes reporting.
Medicare Operations
The Committee recommends $2,184,984,000 for Medicare
operations, which is $5,003,000 less than the amount requested
by the administration. In addition, $720,000,000 is available
for the Medicare Integrity Program within the mandatory budget
as well as $80,000,000 recommended in this bill for a new
Health Care Fraud and Abuse Control account.
The Medicare operations line item covers a broad range of
activities including claims processing and program safeguard
activities performed by Medicare contractors. These contractors
also provide information, guidance, and technical support to
both providers and beneficiaries. In addition, this line item
includes a variety of projects that extend beyond the
traditional fee-for-service arena.
The Committee recommends that not less than $31,700,000 be
made available for the State Health Insurance Counseling
Program. SHIPs provide one-on-one counseling to beneficiaries
on complex Medicare-related topics, including Medicare
entitlement and enrollment, health plan options, prescription
drug benefits, Medigap and long-term care insurance, and
Medicaid.
The Committee recommends that $79,934,000 be made available
for obligation over a 2-year period ending September 30, 2007,
for contract costs pursuant to the development of the
Healthcare Integrated General Ledger Accounting System
[HIGLAS].
CMS is encouraged to explore alternative approaches for
recruiting, training and employing the severely disabled for 1-
800-MEDICARE. The outcome will identify work activities
performed by severely disabled individuals that fully support
the needs of the 1-800-MEDICARE program and promote the
employment of people with disabilities. CMS is encouraged to
work directly with the National Industries for the Severely
Handicapped [NISH] organization to develop the approach and to
subsequently implement within the 1-800-MEDICARE program.
Medicare contractors partner with Federal Government to
administer the Medicare fee-for-service program. Contractors
pay over 1 billion Medicare fee-for-service claims annually,
are the first line of defense against Medicare fraud, and are
the primary contact for Medicare providers and beneficiaries.
Without adequate funding, contractors are not able to pay
claims, respond to beneficiary and provider inquiries timely,
and effectively combat fraud and abuse. The Committee is
pleased CMS eliminated the 5 percent cap on transferring funds
among Medicare functions so that contractors have greater
flexibility to manage their budgets in a manner that best
matches program requirements. Budget flexibility is important
to Medicare contractors, particularly in a tight funding
environment. The Committee understands an existing statute
capped Medicare Integrity Program [MIP] funding at $720,000,000
in fiscal year 2003. The Committee believes that Medicare
contractors must be given greater flexibility to effectively
manage their MIP resources given the continuing increases in
claims volume. In fact claims have risen by more than 16
percent since MIP was last increased. The Committee strongly
recommends CMS give Medicare Contractors and Program Safeguard
Contractors greater flexibility to manage their Medicare
Integrity Program [MIP] funding in a manner that best matches
program requirements including increases in workload. The
Committee expects CMS to report on its plans to provide this
flexibility to contractors in its fiscal year 2007
congressional justification.
State Survey and Certification
The Committee recommends $260,735,000, the budget estimate
and House allowance, for Medicare State survey and
certification activities, which is $2,000,000 more than the
fiscal year 2005 level.
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.
Federal Administration
The Committee recommends $655,000,000 for Federal
administration costs, which is an increase of $73,507,000, over
the fiscal year 2005 level. This funding level allows for fixed
cost increases associated with the current staffing level of
4,398 full-time equivalent positions. Savings from the request
level of $657,357,000 are expected to be made in travel
expenses and such administrative costs as printing and postage.
The Committee recommends continuing the Healthy Start, Grow
Smart program, which disseminates informational brochures to
new Medicaid-eligible mothers. These brochures are distributed
at the time of birth, then monthly over the first year of each
child's life. Each publication focuses on activities that
stimulate infant brain development and build the skills these
children need to be successful in school. In addition to these
educational suggestions, Healthy Start pamphlets include vital
health and safety information for new parents.
During last year's consideration of the Omnibus
Appropriations Act, the Committee expressed its concerns with
the lack of adequate funding for section 508 of the Medicare
Modernization Act. The Committee directed CMS to report back on
the number of hospitals that qualified for reclassification
under section 508; the number of hospitals that qualified but
received no funding; and a cost estimate, by year, of the
amounts needed to fully fund these hospitals over 3 years. The
Committee recently received the required report from CMS,
several months late and well into this year's appropriations
process. The report finds the cost to fully fund section 508
reclassification for hospitals that qualified for funding but
received no funds to be approximately $1,050,000,000 to
$1,080,000,000 for 3 years or $350,000,000 to $360,000,000 for
1 year. The Committee believes that it is important to find
resources to expand section 508 reclassifications to as many
unfunded hospitals as possible as a necessary first step in
addressing the inequities caused by the existing wage index
determinations, while a long-term solution is developed.
The Committee expects that programs funded under the
authority of the Ryan White Act (title XXVI of the Public
Health Service Act) continue to be considered as payors of last
resort in any Federal or State health benefits program. The
Committee expects CMS to conform its program guidance to
preserve the status of Ryan White funds as the payor of last
resort. The Committee further requests that the Government
Accountability Office study the legislative intent regarding
the interaction of Ryan White and Medicare Part D spending, and
report its findings by October 1, 2005. The report should
examine whether Ryan White spending should be able to provide
``wrap around'' coverage which counts toward true out-of-pocket
costs and thus catastrophic coverage under Part D of the
Medicare Modernization Act.
The Committee commends CMS for its outreach efforts to help
dually eligible beneficiaries transfer from Medicaid
prescription drug coverage to the new Medicare Part D program.
However, the Committee believes that low-income dual eligible
persons with mental disabilities will need additional
assistance with Part D enrollment decisions and both
pharmaceutical and formulary changes. The Committee urges CMS
to support one-on-one pharmaceutical benefits counseling
through community-based organizations and safety net mental
health providers in order to address this need.
The Committee is very pleased with the demonstration
project at participating sites licensed by the Program for
Reversing Heart Disease and encourages its continuation. The
Committee further urges CMS to continue with the demonstration
project being conducted at the Mind Body Institute of Boston,
Massachusetts.
The Committee is very pleased with the efforts of CMS to
address the extraordinary adverse health status of Native
Hawaiians in Waimanalo, Hawaii. The Committee continues to urge
additional focus upon American Samoan residents in that
geographical area utilizing the expertise of the Waimanalo
Health Center.
The Committee urges the Centers for Medicare and Medicaid
Services to consider waivers for rural or isolated area
demonstration projects when calculating such requirements as
population density in the State of Hawaii.
The Committee urges CMS to provide for reimbursement for
services rendered to Native Hawaiians in federally qualified
health centers in the same manner that it currently does for
American Indians and Alaskan Natives. Further, the Committee
requests a report on this matter by next year's budget
hearings.
The Committee is aware that legislation authorizing direct
Medicare reimbursement to nurse practitioners providing
reimbursable Medicare Services, was passed by Congress and
signed into law, effective January 1, 1998. Since that time
nurse practitioners have been providing reimbursable care to
patients as Part B providers. Despite their ability to provide
and bill for services rendered in all of these areas, they are
still unable to refer patients to home health or hospice care.
The apparent reason is that an expanded interpretation of the
word ``physician'' is needed in Part A, Section 1814, of the
Medicare law in order for home health agencies and hospice
centers to accept these referrals.
The Committee is very aware that nurse practitioners have
been demonstrated to provide safe and responsible care to the
patients they serve. They have expert knowledge that allows
them to provide high level assessments of patients needs and
recognize when additional care, such as home health and hospice
care is needed or not needed by their patients. The Committee
urges CMS to reinterpret the statute that will authorize home
health agencies and hospices to accept orders from nurse
practitioners.
The Committee recognizes that rural residents account for
25 percent of the general population in the United States with
a disproportionate number of them being seniors. Additionally,
67 percent of the country's primary care health professional
shortage areas are located in rural areas and access to
specialized care is limited for seniors. The Committee urges
CMS to consider funding projects with a focus on rural
healthcare, specifically those serving minority populations
such as Native Hawaiians, Native Alaskans, and Native
Americans.
The Committee expects CMS to promulgate regulations
providing the option of direct access to licensed audiologists
under similar terms and conditions used by the Department of
Veterans Affairs and the Office of Personnel Management. The
Department of Veterans Affairs reports that direct access
provides high-quality, efficient, and cost-effective hearing
care.
The Secretary of HHS is encouraged to include, in
negotiating Prime contracts supporting the Medicare
Prescription Drug Plan Program Part D, small business and small
disadvantaged business subcontracting plan requirements. These
subcontract plans should achieve a participation rate of not
less than 5 percent of the total value of prime contract award
for each fiscal year.
The Committee expects CMS to conduct a demonstration to
develop a pilot program to assist patients with expensive
chronic illnesses, including hepatitis, in securing private
health insurance. Non-profit organizations such as Patient
Services, Inc. have had success on a State level in assisting
families burdened by chronic illness in retaining or obtaining
insurance coverage. This transitional support has saved State
dollars by reducing reliance on Medicaid and keeping patients
with expensive chronic illnesses insured. The Committee is
hopeful that this model can be expanded to achieve savings on a
national level.
Those State Pharmaceutical Assistance Programs (SPAPs)
whose outreach plans have been approved and awarded outreach
grants by CMS may rollover any unspent fiscal year 2005 grant
monies into the next Federal fiscal year to be used to bring
the initiative to completion (section 221).
A qualified pharmacy workforce is necessary to fully
implement efforts to improve the quality of care received by
our Nation's seniors, particularly high-risk seniors who have
multiple chronic conditions and are taking multiple
medications. The committee therefore urges CMS to carefully
review its decision to cut Medicare funding for second-year,
specialized pharmacy residency programs, which provide
specialized training to medication use experts in areas like
geriatrics, oncology, and critical care, taking into account
new data submitted by national pharmacist associations, and
provide a full report back to the Committee within 3 months
with the Agency's rationale for any decision that results in
these programs remaining un-funded.
Deep-vein thrombosis affects more than 2 million Americans
each year and its complications also take a toll on our
Nation's hospital systems, costing approximately $860,000,000
annually. It has been brought to the Committee's attention that
there is a large gap between knowledge and practice where deep-
vein thrombosis and associated morbidity and mortality
including Pulmonary Embolus and Post Thrombotic Syndrome are
concerned. In order to identify ways to reduce the burden of
deep-vein thrombosis and associated complications including
death in the inpatient setting, the Center for Medicare and
Medicaid Services is encouraged to develop a demonstration
project, with from experts in the field to: analyze ongoing
practices to appropriately assess and prophylax ``at risk''
surgical and medical patients; implement a process within
demonstration study sites to improve appropriate prophylaxis;
and, create a follow-up report on steps of implementation and
an outcomes report, to define the impact of the program.
The Committee supports programs that can demonstrate the
feasibility of achieving quality improvement as well as cost
savings to the Medicare program through improved quality of
care. In this regard, the Committee encourages CMS to consider
a quality-focused cost containment in cardiac surgery for
Medicare beneficiaries pilot program to demonstrate and
quantify cost savings possible through quality improvement
efforts.
Revitalization Plan
The Committee recommends the budget request and House
allowance of $24,205,000 in 2-year budget authority, as the
third-year investment in CMS's efforts to make significant
improvements to key aspects of managing the Agency and the
Medicare program. First-year funding in fiscal year 2004 was
$29,619,000 and second-year funding was $24,205,000 for fiscal
year 2005. Funding in fiscal year 2006 will target system-
related improvements, and continue addressing long-term
information technology issues, including Medicare claims
processing redesign activities. The Committee urges CMS to
augment information technology activities utilizing resources
available under the Quality Improvement Organization program.
HMO Loan and Loan Guarantee Fund
The Committee concurs with requested bill language making
receipts of this fund available for payment of obligations, but
prohibiting the issuance of additional direct loans or loan
guarantees to health maintenance organizations from this fund.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2005.................................... $2,873,802,000
Budget estimate, 2006................................... 2,071,943,000
House allowance......................................... 2,121,643,000
Committee recommendation................................ 2,121,643,000
The Committee recommends $2,121,643,000 be made available
in fiscal year 2006 for payments to States for child support
enforcement and family support programs. The comparable funding
level for fiscal year 2005 is $2,873,802,000 and the budget
request includes $2,071,943,000 for this program. The Committee
recommendation provides the full amount requested under current
law. The budget request includes net savings of $49,700,000
based on proposed legislation.
These payments support the States' efforts to promote the
self-sufficiency and economic security of low-income families.
These funds also support efforts to locate non-custodial
parents, determine paternity when necessary, and establish and
enforce orders of support. The appropriation, when combined
with the $1,200,000,000 in advance funding provided in last
year's bill, an estimated $208,000,000 from offsetting
collections, and an estimated carryover of $740,173,000,
supports a program level of $4,269,816,000.
The Committee also has provided $1,200,000,000 in advance
funding for the first quarter of fiscal year 2007 for the child
support enforcement program, the same as the budget request.
LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM
Appropriations, 2005.................................... $2,182,399,000
Budget estimate, 2006................................... 2,000,000,000
House allowance......................................... 2,006,799,000
Committee recommendation................................ 2,183,000,000
The Committee recommends $2,183,000,000 for fiscal year
2006 for LIHEAP. The comparable funding level for fiscal year
2005 is $2,182,399,000 and the budget request includes
$2,000,000,000 for this program. LIHEAP is made up of two
components: the State grant program and the contingency fund.
The Committee recommendation includes $1,883,000,000 for
fiscal year 2006 for the State grant program. The comparable
funding level for fiscal year 2005 is $1,884,799,000 and the
budget request includes $1,800,000,000 for this program. Within
the funds provided, the Committee recommends $500,000 for a
feasibility study, as requested by the administration. 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. These
resources are distributed by formula to these entities as
defined by statute, based in part on each State's share of home
energy expenditures by low-income households.
The Committee recommendation includes $300,000,000 for
fiscal year 2006 for an emergency fund to meet the additional
home energy assistance needs arising from a natural disaster or
other emergencies. The comparable funding level for fiscal year
2005 is $297,600,000 and the budget request does not include
funds designated as emergency for this program, but did request
$200,000,000 for the contingency fund.
The Committee intends that up to $27,500,000 of the amount
recommended for LIHEAP for fiscal year 2006 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, 2005.................................... $484,394,000
Budget estimate, 2006................................... 552,040,000
House allowance......................................... 560,919,000
Committee recommendation................................ 571,140,000
The Committee recommends $571,140,000 for fiscal year 2006
for refugee and entrant assistance. The comparable funding
level for fiscal year 2005 is $484,394,000 and the budget
request includes $552,040,000 for this program.
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. Based on an estimated refugee admission
ceiling of 70,000, this appropriation enables States 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.
In order to carry out the refugee and entrant assistance
program, the Committee recommends $268,229,000 for transitional
and medical assistance including State administration and the
voluntary agency program, of which $4,100,000 is from emergency
funds; $9,915,000 for victims of trafficking; $151,121,000 for
social services; $4,796,000 for preventive health; and
$49,081,000 for targeted assistance.
For unaccompanied children, pursuant to section 462 of the
Homeland Security Act of 2002, the Committee recommends
$78,083,000, of which $15,000,000 is from emergency funds.
Funds are provided for the care and placement of unaccompanied
alien minors in the Office of Refugee Resettlement. In fiscal
year 2006 there will be approximately 9,600 placements for
unaccompanied alien children apprehended in the United States
by INS/Homeland Security agents, Border Patrol officers, or
other law enforcement agencies. These children are then taken
into care pending resolution of their claims for relief under
U.S. immigration law, released to an adult family member, or
released to a responsible adult guardian.
The Committee also recommends $9,915,000 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. The Committee recommends ORR support core funding of
strong regional programs that invest carefully in building
their rehabilitation programs that produce research and
knowledge in this new field. Those organizations can then be
expected to organize training for mainstream health care
providers.
The Committee bill includes $19,100,000 in emergency funds
for the unanticipated and significantly increased demand for
services to individuals eligible for assistance, of which
$4,100,000 is for transitional and medical services and
$15,000,000 is for unaccompanied alien children programs. An
increasing share of refugee admissions are coming from Africa
and Thailand and these refugees have far more costly medical
needs than previous arrivals from Russia and Southeast Asian
countries due in part to increased health screening tests and
lab cultures, increased medical treatment for parasites, HIV,
and multiple drug-resistant TB, and increased prostheses and
rehabilitation for machete victims. These refugees also tend to
stay on refugee cash assistance longer because they require
more intensive services for reading and writing in their native
language, English as a Second Language, and job placement.
There also has been a much higher than anticipated increase in
unaccompanied alien children entering the United States and
being placed in the care of ORR. While the fiscal year 2005
appropriation assumed an increase of 20 percent in this
program, the actual increases are close to 30 percent. These
additional funds are needed to address these unanticipated
situations.
The Committee is deeply concerned that accompanied
children, even as young as nursing infants, who are apprehended
by the Department of Homeland Security [DHS] are being
separated from their parents and being placed in the
unaccompanied alien children program while their parents are
held in separate adult facilities. The Committee is pleased
that ORR has taken the initiative to work with DHS to correct
this problem and anticipates a prompt resolution.
The Committee is aware that at times ORR allows individual
abused, abandoned, or neglected children in its custody to
access State dependency proceedings for ultimate care and
placement in State foster care or under legal guardianship. The
Committee urges ORR to continue this practice in such cases as
it is appropriate.
The Committee is pleased with the steps the ORR has taken
to improve access to legal representation for children served
through this program. ORR has participated in roundtables, and
met with various groups to better understand the issue. They
have also put together a comprehensive list of pro bono
attorneys and guardians to ensure that the children's needs are
being served and are currently working on a program that would
ensure that resources are available to unaccompanied alien
children. The Committee commends ORR for their commitment to
providing unaccompanied alien children in its care access to a
comprehensive range of services, from legal representatives to
access to necessary unique medical care.
The Committee directs that not later than 1 year after the
date of enactment of this Act the Secretary of Health and Human
Services shall submit a report on progress made by ORR to
deinstitutionalize the care provided to unaccompanied children
in its custody, including the utilization of community-based,
child welfare centered services.
The Committee is pleased that the majority of the 15,000
Hmong refugees that were admitted will have arrived by the end
of fiscal year 2005. The Committee was concerned that unlike
prior groups of Hmong refugees, which were made up of military
and political leaders with the means and education to succeed
in America, these immigrants had spent their lives in a refugee
camp. Few, if any, spoke English. Most are under 18 and have
little schooling. Even with the greater level of education and
skills possessed by prior refugees, statistics indicated that
about 38 percent of current Hmong-Americans live in poverty.
Section 412(a)(7) of title IV of the Immigration and
Nationality Act authorizes the use of funds appropriated under
this account to be used to carry out monitoring, evaluation,
and data collection activities to determine the effectiveness
of funded programs and to monitor the performance of States and
other grantees.
CHILD CARE AND DEVELOPMENT BLOCK GRANT
Appropriations, 2005.................................... $2,082,921,000
Budget estimate, 2006................................... 2,082,910,000
House allowance......................................... 2,082,910,000
Committee recommendation................................ 2,082,910,000
The Committee recommends $2,082,910,000 for fiscal year
2006 for the child care and development block grant. The
comparable funding level for fiscal year 2005 is $2,082,921,000
and the budget request includes $2,082,910,000 for this
program.
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 to
allow States to continue funding the activities previously
provided under the consolidated programs.
The Committee recommendation continues specific earmarks in
appropriations language, also included in the budget request,
that provide targeted resources to specific policy priorities
including $19,120,000 for the purposes of supporting before and
afterschool services, as well as resource and referral
programs. This represents the Federal commitment to the
activities previously funded under the dependent care block
grant. The Committee 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 continue 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 an additional
$272,672,000 for child care quality activities, and sets aside
$100,000,000 specifically for an infant care quality
initiative. These funds are recommended in addition to the 4
percent quality earmark established in the authorizing
legislation. The Committee has provided these additional
quality funds because of the considerable research that
demonstrates the importance of serving children in high quality
child care settings which include nurturing providers who are
educated in child development and adequately compensated. While
considerable progress has been made, the Committee believes
States should continue to invest in education and training
linked to compensation of the child care workforce in order to
improve the overall quality of child care.
The Committee recommendation also provides $10,000,000 for
child care research, demonstration and evaluation activities.
The Committee recommendation for resource and referral
activities also includes $1,000,000 to continue support for the
National Association of Child Care Resource and Referral
Agencies' information service, Child Care Aware, and the
national toll-free information hotline which links families to
local child care services and programs.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2005.................................... $1,700,000,000
Budget estimate, 2006................................... 1,700,000,000
House allowance......................................... 1,700,000,000
Committee recommendation................................ 1,700,000,000
The Committee recommends $1,700,000,000 for fiscal year
2006 for the social services block grant. The comparable
funding level for fiscal year 2005 is $1,700,000,000 and the
budget request includes $1,700,000,000 for this program. The
Committee has included bill language that allows States to
transfer up to 10 percent of their TANF allotment to the social
services block grant.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriations, 2005.................................... $9,007,770,000
Budget estimate, 2006................................... 8,386,293,000
House allowance......................................... 8,688,707,000
Committee recommendation................................ 9,000,832,000
The Committee recommends $9,000,832,000 for fiscal year
2006 for children and families services programs. The
comparable funding level for fiscal year 2005 is $9,007,770,000
and the budget request includes $8,386,293,000 for this
program. In addition, $10,500,000 in transfers are available
under section 241 of the Public Health Service Act.
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
The Committee recommends $6,874,314,000 for fiscal year
2006 for Head Start. The comparable funding level for fiscal
year 2005 is $6,843,114,000 and the budget request includes
$6,899,336,000 for this program. The Committee recommendation
includes $1,388,800,000 in advance funding that will become
available on October 1, 2007. The Committee recommendation does
not include the $45,000,000 requested in the budget for a State
pilot project that would allow States to directly administer
the Head Start program.
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 is aware that studies on early childhood that
provide clear evidence that the brain undergoes its most
dramatic development during the first 3 years of life, when
children acquire the ability to think, speak, learn, and
reason. Disparities in children's cognitive and social
abilities become evident well before they enter Head Start or
pre-kindergarten programs at age 4. Early Head Start minimizes
these disparities so that children are ready to enter school
and learn. The National Evaluation of Early Head Start
concluded that Early Head Start is making a positive difference
in areas associated with children's success in school, family
self-sufficiency, and parental support of child development.
Currently only 3 percent of estimated eligible infants and
toddlers are enrolled in Early Head Start. Over the past 5
years, the Committee has significantly increased funding for
Early Head Start, to provide more low-income infants and
toddlers with the positive experiences they need for later
school and life successes. The Committee intends to continue
this important investment.
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, as authorized, in remote
Native American communities.
The Committee strongly supports the effort to strengthen
the qualifications of Head Start teachers. While the Committee
is pleased that the percentage of teachers with an associate,
baccalaureate, or advanced degree in early childhood education,
or a degree in a related field with experience in teaching
preschool children has reached 65 percent, the Committee
encourages Head Start to continue to work toward the goal of
100 percent. The Committee expects the Department to focus
staff development efforts on increasing the educational level
of Head Start teachers in order to meet this goal.
The Committee is aware that in May 2005, the Secretary made
$35,000,000 in additional fiscal year 2005 funds available to
Migrant and Seasonal Head Start programs and that these funds,
which will be awarded on competitive basis, will allow for at
least 4,000 additional children to access Migrant and Seasonal
Head Start. The Committee acknowledges that these expansion
funds will increase access to this important program, however
additional funding may be necessary to adequately serve this
population. The Committee requests that the Secretary submit a
report on the Bureau's ongoing plans to ensure that Migrant and
Seasonal Head Start programs are able to serve a larger
percentage of the children eligible for services. The Committee
continues to point to the 2001 study published by the U.S.
Department of Health and Human Services which documented that
only 19 percent of eligible children were able to access
Migrant and Seasonal Head Start.
The Head Start Bureau shall continue to provide the
Committee with the number and cost of buses purchased, by
region with Head Start in the annual congressional budget
justification.
The Committee is conscious of efforts currently being
undertaken to improve pre-literacy skills in Head Start
children and lauds the administration for its commitment to
this effort. However, the Committee continues to caution
against anything that would detract from the comprehensive
nature of the program in delivering early childhood development
and family services. While school readiness is front and center
in the goals of Head Start, the elements necessary to achieve
that readiness range from adequate nutrition and health
screening, to social and emotional development and family
building, as well as the cognitive growth of young children.
The Committee is aware that the Government Accountability
Office came out on May 17 with the report, ``Head Start:
Further Development Could Allow Results of New Test to be Used
for Decision Making,'' on the National Reporting System [NRS]
test. The report stated that analysis was currently incomplete
to support its use for the purposes of accountability and
targeting training and technical assistance, that grantees have
not yet shown that the NRS provides the scope and quality of
assessment information needed for holding grantees accountable,
and that language experts raised serious concerns about whether
the Spanish version of the NRS adequately measures the skills
of Spanish-speaking children and whether results from the
English and Spanish. Therefore, the Committee directs the
Secretary to submit a report to House and Senate Committees on
Appropriations, not later than 90 days after enactment of this
Act, addressing: (1) a detailed justification to Congress
regarding the planned uses of the NRS results and data in terms
of program evaluation, professional development, technical
assistance, and other activities; (2) an itemization of the
costs of development, implementation, and analysis of the NRS,
detailing by name, amount, and description of activities each
contract or grant to persons or entities involved in its
design, development, implementation, or analysis; and (3) the
recommendations made by the Technical Working Group established
by the Secretary, including an explanation of how the Secretary
has addressed or plans to address the Working Group's and the
GAO's recommendations.
Consolidated Runaway and Homeless Youth Program
The Committee recommends $88,724,000 for fiscal year 2006
for the consolidated runaway and homeless youth program. The
comparable funding level for fiscal year 2005 is $88,724,000
and the budget request includes $88,728,000 for this program.
This program was reauthorized under the Runaway, Homeless, and
Missing Children Protection Act of 2003. In this
reauthorization a statutory formula was established to
distribute funds between the Basic Center Program and the
Transitional Living Program.
This program addresses the crisis needs of runaway and
homeless youth and their families through support to local and
State governments and private agencies. Basic centers and
transitional living programs help address the needs of some of
the estimated 500,000 to 1.5 million and homeless youth, many
of whom are running away from unsafe or unhealthy living
environments. These programs have been proven effective at
supporting positive youth development, securing stable and safe
living arrangements and providing the skills required to engage
in positive relationships with caring adults and contribute to
society.
The Committee also recognizes the need for and value of
expanding transitional living opportunities for all homeless
youth. Therefore, the Committee seeks to preserve the
flexibility afforded in current law to respond to the needs of
the young people who are most at-risk and in greatest need of
transitional living opportunities in their communities by
providing additional resources to the existing portfolio of
consolidated Runaway and Homeless Youth Act programs.
It is the Committee's expectation that current and future
TLP grantees will continue to provide transitional living
opportunities and support to pregnant and parenting homeless
youth, as is their current practice. To further ensure that
pregnant and parenting homeless youth are able to access
transitional living opportunities and support in their
communities, the Committee encourages the Secretary, acting
through the network of federally-funded runaway and homeless
youth training and technical assistance providers, to offer
guidance to grantees and others on the programmatic
modifications required to address the unique needs of pregnant
and parenting youth and on the various sources of funding
available for residential services to this population.
Maternity Group Homes
The Committee recommendation does not include the
$10,000,000 requested in the budget for the maternity group
homes program. Under this proposed program, the ACF would
provide targeted funding for community-based, adult-supervised
group homes for young mothers and their children. These homes
would 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.
The Committee expects the Family and Youth Services Bureau
to continue to provide the technical assistance needed to
enable TLP grantees and their community partners to address the
unique needs of young mothers and their children, as well as
helping interested entities in identifying sources of funding
currently available to provide residential services to this
population.
Runaway Youth Prevention Program
The Committee recommends $15,179,000 for fiscal year 2006
for the runaway youth prevention program. The comparable
funding level for fiscal year 2005 is $15,178,000 and the
budget request includes $15,179,000 for this program. 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. The goal of this program is to help young people leave
the streets.
Child Abuse Programs
The Committee recommends $101,779,000 for fiscal year 2006
for child abuse programs. The comparable funding level for
fiscal year 2005 is $101,778,000 and the budget request
includes $101,784,000 for this program. The recommendation
includes $27,280,000 for State grants, $31,640,000 for
discretionary activities, and $42,859,000 for community based
child abuse prevention.
These programs seek to improve and increase activities at
all levels of government which identify, prevent, and treat
child abuse and neglect through State grants, technical
assistance, research, demonstration, and service improvement.
Abandoned Infants Assistance
The Committee recommends $11,955,000 for fiscal year 2006
for abandoned infants assistance. The comparable funding level
for fiscal year 2005 is $11,955,000 and the budget request
includes $11,955,000 for this program.
This program provides grants to public and private non-
profit agencies, State and county child welfare agencies,
universities, and community-based organizations to develop,
implement, and operate demonstration projects that will prevent
the abandonment of infants and young children, especially those
impacted by substance abuse and HIV and who are at-risk of
being or are currently abandoned. By providing respite care for
families and care givers and assisting abandoned infants and
children to reside with their natural families or in foster
care. The Committee recognizes that the rates of prenatal
substance abuse and maternal HIV/AIDS have increased, that the
related problem of infants abandoned or boarding in hospitals
has grown, and that existing grantees have experienced a large
increase in demand for services nationwide.
Child Welfare Services
The Committee recommends $289,650,000 for fiscal year 2006
for child welfare services. The comparable funding level for
fiscal year 2005 is $289,650,000 and the budget request
includes $289,650,000 for this program.
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. These services are
provided without regard to income.
Child Welfare Training
The Committee recommends $7,409,000 for fiscal year 2006
for child welfare training. The comparable funding level for
fiscal year 2005 is $7,409,000 and the budget request includes
$7,409,000 for this program.
Under section 426, title IV-B of the Social Security Act,
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.
Given research on failings in the Child and Family Services
Reviews [CFSRs] and the States' continuing challenges in
recruiting and retaining qualified child welfare personnel,
particularly those who hold a degree in social work, the
Committee encourages ACF to continue to provide grants to
schools of social work and traineeships to social work students
being trained in the specialty of child welfare. The Committee
also encourages ACF to provide funding for research into how
specially trained social work personnel affect outcomes for
children and families.
Adoption Opportunities
The Committee recommends $27,119,000 for fiscal year 2006
for adoption opportunities. The comparable funding level for
fiscal year 2005 is $27,116,000 and the budget request includes
$27,119,000 for this program.
This program eliminates barriers to adoption and helps find
permanent homes for children who would benefit by adoption,
particularly children with special needs.
Adoption Incentives
The Committee recommends $22,846,000 for fiscal year 2006
for adoption incentives. The comparable funding level for
fiscal year 2005 is $31,846,000 and the budget request includes
$31,846,000 for this program. Fewer resources were needed in
fiscal year 2005 to make bonus payments to States for the full
amount for which they were eligible under this program, so the
reduction recommended by the Committee will not have any impact
on this program, unused funds will supplement the fiscal year
2006 appropriation in order to maintain a robust incentives
program.
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 prior to September 30, 2007.
Adoption Awareness
The Committee recommends $12,802,000 for fiscal year 2006
for adoption awareness. The comparable funding level for fiscal
year 2005 is $12,802,000 and the budget request includes
$12,802,000 for this program.
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 Infant Adoption Awareness Training
Program provides grants to support adoption organizations in
the training of designated health staff, in eligible health
centers that provide health services to pregnant women, to
inform them about adoption and make referrals on request on an
equal basis with all other courses of action. Within the
Committee recommendation, $9,826,000 is available for this
purpose.
The Special Needs Adoption Campaign supports grants to
carry out a national campaign to inform the public about the
adoption of children with special needs. The Committee
recommendation includes $2,976,000 to continue this important
activity.
Compassion Capital Fund
The Committee recommends $95,000,000 for fiscal year 2006
for the compassion capital fund. The comparable funding level
for fiscal year 2005 is $54,549,000 and the budget request
includes $100,000,000 for this program.
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.
Funds available will support grants to charitable
organizations to emulate model social service programs and to
encourage research on the best practices of social service
organizations.
Of the funds provided, $45,000,000 is for a new anti-gang
initiative. Competitive grants will be awarded to community and
faith-based organizations that will foster supportive
relationships with youths ages 8-17 through targeted street
outreach, direct youths to social services, and present
alternatives to gang involvement. These grants will be
especially helpful in urban areas such as Philadelphia that
have experienced alarming increases in youth gang violence.
Social Services Research
The Committee recommends $32,012,000 for fiscal year 2006
for the social services research. The comparable funding level
for fiscal year 2005 is $32,012,000 and the budget request
includes $6,000,000 for this program.
The Committee has funded $6,000,000 of this program through
transfers available under section 241 of the Public Health
Service Act. 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 notes ACF's efforts to assist States with
meeting the extensive record-keeping, reporting and tracking
requirements of the TANF program. Working through the State
information technology consortium, ACF is providing States with
the tools necessary to strengthen and improve the complex IT
systems required to support TANF. Plans are now underway to
pilot test a data exchange program that will offer States a
faster, less expensive means of validating, accessing,
modifying and recording TANF data elements. Similarly, on
behalf of Child Support Enforcement, the consortium is helping
to expand data exchange capabilities between the courts and
State child support enforcement agencies as well as increase
collection efficiency in States and tribal organizations. Next
steps include accessing existing databases used as primary
sources for collection-related data of non-custodial parents,
and enhancing data-matching capabilities to ensure the
integrity of the information being collected. The Committee
recommends that both collaborative efforts with the State
information technology consortium be continued at their current
levels.
Abstinence Education
The Committee recommends $105,500,000 for fiscal year 2006
for community based abstinence education. The comparable
funding level for fiscal year 2005 is $103,698,000 and the
budget request includes $142,545,000 for this program. Within
the Committee recommendation, $101,000,000 is provided for
community-based abstinence education, $4,500,000 is provided
through an evaluation set-aside, as requested by the
administration. In addition, $50,000,000 is available from pre-
appropriated mandatory funds.
This program provides support for the development and
implementation of abstinence education programs for
adolescents, ages 12 through 18. These programs are unique in
that their entire focus is to educate young people and create
an environment within communities that supports teen decisions
to postpone sexual activity until marriage.
Of the funds provided up to $10,000,000 may be available
for a national abstinence media campaign. The Committee
understands that a portion of fiscal year 2005 funds will be
used for evaluation purposes. The Committee intends that ACF
use available funds to continue support for an independent
group to conduct a thorough and rigorous evaluation of this
campaign.
Developmental Disabilities
The Committee recommends $171,561,000 for fiscal year 2006
for programs administered by the Administration on
Developmental Disabilities. The comparable funding level for
fiscal year 2005 is $168,575,000 and the budget request
includes $168,561,000 for these programs. Within the funds
provided, $156,682,000 is for carrying out the Developmental
Disability Act, and $14,879,000 is for carrying out the Help
America Vote Act of 2002.
The Administration on Developmental Disabilities supports
community-based delivery of services which promote the rights
of persons of all ages with developmental disabilities.
Developmental disability is defined as severe, chronic
disability attributed to mental or physical impairments
manifested before age 22, which causes substantial limitations
in major life activities. The ADD also administers monies for
election assistance for individuals with disabilities. This
program is for individuals with any type of disability.
Of the funds provided, the Committee recommends $72,496,000
for State councils. These councils assist each State in
promoting the development of a comprehensive, statewide,
consumer and family-centered system which provides a
coordinated array of culturally-competent services, and other
assistance for individuals with development disabilities. State
councils undertake a range of activities including
demonstration of new approaches, program and policy analysis,
interagency collaboration and coordination, outreach and
training.
The Committee recommends $39,109,000 for protection and
advocacy grants. 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 recommends $14,879,000 for disabled voter
services. Of these funds, $10,000,000 is to promote disabled
voter access, and the remaining $4,879,000 is for disabled
voters protection and advocacy systems. The election assistance
for individuals with disabilities program was authorized in the
Help America Vote Act of 2002. The program enables an applicant
to establish, expand, and improve access to, and participation
by, any individual with a disability in the election process.
The Committee recommends $11,529,000 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 potential benefits that assistive technology can
have for individuals with developmental disabilities. Of these
funds, $4,000,000 is available to expand activities of the
Family Support Program. The Committee's placement of funds for
family support within the Projects of National Significance
account does not provide ACF with discretion on this definition
of family support as defined in Title II of the Developmental
Disability Act. The Committee makes a crucial distinction
between support services designed for families of children with
disabilities and support services designed for an individual
with a disability. The Committee intends that these funds be
used for the support and assistance of families of children
with disabilities, in accordance with the statute.
The Committee recommends $33,548,000 for the University
Centers for Excellence in Developmental Disabilities [UCEDDs]
which is a network of 61 centers that are interdisciplinary
education, research and public service units of a university
system or are public or non-profit entities associated with
universities. UCEDDs conduct research, develop evidence based
practices and teach thousands of parents, professionals,
students and people with disabilities about critical disability
areas such as early intervention, health care, community-based
services, inclusive and meaningful education, transition from
school to work, employment, housing, assistive technology,
aging with a disability and transportation. The Centers serve
as the major vehicle to translate disability related research
into community practice and service systems and to train the
next cohort of future professionals who will provide services
and supports to an increasingly diverse population of people
with disabilities.
The increase provided in the bill will allow funding for
the three new Centers established in fiscal year 2005 to be
increased to the same grant award level as the existing 61
Centers, as well as to establish additional Center grants in
the States that currently have unserved and underserved
populations, and support additional training initiatives.
Native American Programs
The Committee recommends $44,780,000 for fiscal year 2006
for Native American programs. The comparable funding level for
fiscal year 2005 is $44,786,000 and the budget request includes
$44,780,000 for this program.
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.
Community Services
The Committee recommends $708,895,000 for fiscal year 2006
for the community services programs. The comparable funding
level for fiscal year 2005 is $726,506,000 and the budget
request includes $24,699,000 for this program.
Within the funds provided, the Committee recommends
$636,793,000 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 rejects the administration's recommendation
to eliminate the community services block grant funding.
Although a restrictive Committee allocation prevented CSBG
funding from being increased this year, the Committee continues
to recognize the importance of CSBG and the Community Action
Agencies it funds in helping meet the extraordinary challenges
facing low-income communities.
The Nation's Community Action Agency network relies on CSBG
funding to help initiate and administer programs designed to
alleviate poverty. The universal characteristic of these CSBG-
funded programs is that they provide people with the resources
and the tools to become self-sufficient. The Committee
understands that the Department of Health and Human Services,
and its Office of Community Services in particular, could
better use this network in developing future policy
initiatives. The Committee notes that in a number of States,
including Iowa and Pennsylvania, CAA-initiated family
development and self-sufficiency programs are a integral
component of welfare reform efforts. The administration is
encouraged to look for further nationwide linkages between
those individuals seeking to leave the welfare system and
become self-sufficient and the many family development and
self-sufficiency strategies operated by Community Action
Agencies.
The Committee expects the Office of Community Services
[OCS] to release funding to States in the most timely manner
and also expects States to make 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.
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 other discretionary programs are funded from this
account. Funding for these programs is recommended at the
following levels for fiscal year 2006: community economic
development, $32,731,000; individual development accounts,
$24,699,000; rural community facilities, $7,492,000; and
community food and nutrition, $7,180,000. The Committee did not
provide funds for the national youth sports program.
The Committee continues to support strongly the Community
Economic Development program because of the substantial record
of achievement that Community Development Corporations have
complied in working in distressed urban and rural communities.
The Committee, in particular, notes that Federal funds leverage
substantial non-Federal resources in meeting the objectives of
this program. Therefore, it is the Committee's intent that
appropriated funds should be allocated to the maximum extent
possible in the form of grants to qualified Community
Development Corporations in order to maximize the leveraging
power of the Federal investment and the number and amount of
set-asides should be reduced to the most minimal levels. The
Committee requests an operation plan for how OCS plans to use
appropriated funds consistent with the Committee's
expectations. This plan should include a detailed breakdown of
planned expenditures for program support, technical assistance,
contracts, and research and grants.
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
$5,436,000 for the Job Opportunities for Low-Income Individuals
[JOLI] program authorized under the Family Support Act to
target community development activities to create jobs for
people on public assistance. This demonstration program
provides grants on a competitive basis to non-profit
organizations to create new employment and business
opportunities for TANF recipients and other low-income
individuals. Funding also supports technical and financial
assistance for private employers that will result in the
creation of full-time permanent jobs for eligible individuals.
The Committee recognizes that continued funding of this program
would provide opportunities for more low-income individuals.
The Committee expects that experienced community development
corporations be given appropriate consideration for grants
under this program.
Most of the drinking water and wastewater 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 funds available from the Rural Community
Facilities Program to assist a number of communities in gaining
access to adequate community facilities, gaining financing for
new or improved water and wastewater systems and in complying
with Federal standards.
The Committee has included bill language allocating funding
to the Office of Community Services for Rural Community
Facilities Technical Assistance as authorized under section
680(3)(B) of the Community Services Block Grant Act. In
providing this funding, the Committee expects that it be used
solely for the purpose of improving water and wastewater
facilities in poor, rural communities. The Committee intends
that funds provided above the request shall be made available
to the six regional RCAPs.
The Committee is concerned that many small and very small
community water and wastewater treatment systems might be most
vulnerable to terrorist attack, and yet least prepared to deal
with the issue. The Committee urges OCS to continue to support
RCAP Small Community Infrastructure Safety and Security
Training and Technical Assistance project, which provides
State, regional and national infrastructure safety and security
training workshops and on-site technical assistance targeted to
small and very small community water and wastewater treatment
systems. The goal of the project is to improve the capacity of
small systems to better prepare for emergencies, develop
emergency preparedness training manuals for small water
systems, identify appropriate technologies to secure such
systems, and provide technical assistance to small communities
struggling to deal with these issues.
Domestic Violence Hotline
The Committee recommends $3,000,000 for fiscal year 2006
for the national domestic violence hotline. The comparable
funding level for fiscal year 2005 is $3,224,000 and the budget
request includes $3,000,000 for this program.
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.
Battered Women's Shelters
The Committee recommends $125,991,000 for fiscal year 2006
for battered women's shelters program. The comparable funding
level for fiscal year 2005 is $125,630,000 and the budget
request includes $125,991,000 for this program.
This is a formula grant program to support community-based
projects which operate shelters and provide related assistance
for victims of domestic violence and their dependents. Emphasis
is given to projects which provide counseling, advocacy, and
self-help services to victims and their children.
Early Learning Opportunities Program
The Committee does not include funds for fiscal year 2006
for the early learning opportunities program. The comparable
funding level for fiscal year 2005 is $35,712,000 and the
budget request did not include funds for 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 recommends $1,400,000 for fiscal year 2006
for the operation of the Department's Center for Faith-Based
and Community Initiatives. The comparable funding level for
fiscal year 2005 is $1,375,000 and the budget request includes
$1,400,000 for this program.
Mentoring Children of Prisoners
The Committee recommends $49,993,000 for fiscal year 2006
for mentoring children of prisoners. The comparable funding
level for fiscal year 2005 is $49,598,000 and the budget
request includes $49,993,000 for this program.
The mentoring children of prisoners program was authorized
in 2001 under section 439 of the Social Security Act. The
purpose of this program is to help children while their parents
are imprisoned and includes activities that keep children
connected to a parent in prison in order to increase the
chances that the family will come together successfully when
the parent is released. As a group, children of prisoners are
less likely than their peers to succeed in school and more
likely to become engaged in delinquent behavior.
Independent Living Training Vouchers
The Committee recommends $46,623,000 for fiscal year 2006
for independent living training vouchers. The comparable
funding level for fiscal year 2005 is $46,623,000 and the
budget request includes $59,999,000 for this program.
These funds will support vouchers of up to $5,000 for
college tuition, or vocational training for individuals who age
out of the foster care system so they can be better prepared to
live independently and contribute productively to society.
Studies have shown that 25,000 youth leave foster care each
year at age 18 and just 50 percent will have graduated high
school, 52 percent will be unemployed and 25 percent will be
homeless for one or more nights.
Program Administration
The Committee recommends $186,000,000 for fiscal year 2006
for program administration. The comparable funding level for
fiscal year 2005 is $185,210,000 and the budget request
includes $185,217,000 for this program.
The Committee continues its interest in the Department's
Child and Family Services 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. The
Committee directs ACF to continue to provide information on the
progress of the reviews in the annual congressional
justification.
PROMOTING SAFE AND STABLE FAMILIES
Appropriations, 2005.................................... $403,586,000
Budget estimate, 2006................................... 410,000,000
House allowance......................................... 404,000,000
Committee recommendation................................ 395,000,000
The Committee recommends $395,000,000 for fiscal year 2006
for promoting safe and stable families. The comparable funding
level for fiscal year 2005 is $403,586,000 and the budget
request includes $410,000,000 for this program.
Funding available provides grants to States in support of:
(1) family preservation services; (2) time-limited family
reunification services; (3) community-based family support
services; and (4) adoption promotion and support services. The
Committee notes that most of the Federal funding related to
child welfare is provided for the removal and placement of
children outside of their own homes. Funds available through
the Promoting Safe and Stable Families program are focused on
supporting those activities that can prevent family crises from
emerging which might require the temporary or permanent removal
of a child from his or her own home.
The Promoting Safe and Stable Families program is comprised
of $305,000,000 in capped entitlement funds authorized by the
Social Security Act and $90,000,000 in discretionary
appropriations.
PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE
Appropriations, 2005.................................... $5,037,900,000
Budget estimate, 2006................................... 4,852,800,000
House allowance......................................... 4,852,800,000
Committee recommendation................................ 4,852,800,000
The Committee recommends $4,852,800,000 for fiscal year
2006 for payments to States for foster care and adoption
assistance. The comparable funding level for fiscal year 2005
is $5,037,900,000 and the budget request includes
$4,852,800,000 for this program. In addition, the Committee
recommendation concurs with the administration's request of
$1,730,000 for an advance appropriation for the first quarter
of fiscal year 2007.
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.
Administration on Aging
Appropriations, 2005.................................... $1,393,342,000
Budget estimate, 2006................................... 1,369,028,000
House allowance......................................... 1,376,217,000
Committee recommendation................................ 1,391,699,000
The Committee recommends an appropriation of $1,391,699,000
for aging programs. This amount is $1,643,000 below the
comparable fiscal year 2005 level and $22,671,000 above the
administration request.
Supportive Services and Senior Centers
The Committee recommends an appropriation of $354,136,000
for supportive services and senior centers, which is the same
as the comparable fiscal year 2005 level and the administration
request. 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 $21,616,000 for preventive health
services, which is the same as the comparable fiscal year 2005
level and the administration 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.
Protection of Vulnerable Older Americans
The Committee recommends $20,360,000 for grants to States
for protection of vulnerable older Americans. This is
$1,072,000 above the comparable fiscal year 2005 level and
$1,000,000 above the administration request. Within the
Committee recommendation, $15,162,000 is for the ombudsman
services program and $5,198,000 is for the prevention of elder
abuse program. 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.
National Family Caregiver Support Program
The Committee recommends $160,744,000 for the national
family caregiver support program, which is $5,000,000 above the
comparable fiscal year 2005 level and the administration
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 $6,304,000 to carry
out the Native American Caregiver Support Program, which is the
same as the comparable fiscal year 2005 level and the
administration request. 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.
Congregate and Home-delivered Nutrition Services
For congregate nutrition services, the Committee recommends
an appropriation of $387,274,000, which is the same as the
comparable fiscal year 2005 level and the administration
request. For home-delivered meals, the Committee recommends
$182,827,000, which is the same as the comparable fiscal year
2005 level and $1,000 above 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.
Nutrition Services Incentives Program
The Committee recommendation includes $148,596,000 for the
nutrition services incentives program [NSIP], the same as the
comparable fiscal year 2005 funding level and the
administration request. This program augments funding for
congregate and home-delivered meals provided to older adults.
Funds provided under this program are dedicated exclusively to
the provision of meals. NSIP rewards effective performance by
States and Tribal organizations in the efficient delivery of
nutritious meals to older individuals through the use of cash
or commodities.
Aging Grants to Indian Tribes and Native Hawaiian Organizations
The Committee recommends $26,398,000 for grants to Native
Americans, which is the same as the comparable fiscal year 2005
funding level and 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.
The Committee recognizes that this program is the primary
vehicle for providing nutrition and other supportive services
to Indian, Alaska Native, and Native Hawaiian elders. The
Committee urges the Administration on Aging to devote its
attention toward this purpose.
Training, Research, and Discretionary Projects
The Committee recommends $40,513,000 for training,
research, and discretionary projects, which is $2,773,000 below
the comparable fiscal year 2005 level and $16,670,000 above the
administration 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 that administer the Older
Americans Act. Given the enormous demands on Alzheimer's family
caregivers, the Committee has included $1,000,000 to support an
Alzheimer's family contact center for round-the-clock help to
Alzheimer's families in crisis.
The Committee continues to support funding at no less than
last year's level for national programs scheduled to be
refunded in fiscal year 2006 that address a variety of issues,
including elder abuse, Native American issues, and legal
services.
The Committee encourages the Administration on Aging to
facilitate the expansion of demonstration projects gauging the
efficiency of nurse-managed Geriatric Wellness Centers.
The Committee expects the Administration on Aging to
continue to fund the national program of statewide senior legal
services hotlines (also called legal helplines) at their
current levels and ideally to provide an increase in the number
of States served by these legal hotlines.
The Committee is aware of innovative program models aimed
at mobilizing older Americans, particularly the 77 million baby
boomers, to serve their communities. The Committee encourages
the agency to develop partnerships with organizations that
enable older Americans to help meet critical social needs
effectively.
Aging Network Support Activities
The Committee recommends $13,266,000 for aging network
support activities, the same as the comparable amount for
fiscal year 2005 and the administration request. The Committee
recommendation includes funding at the administration request
level for the Eldercare Locator and for the Pension Information
and Counseling Program.
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 more than 700,000 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 how to pursue claims when pension problems arise.
The information dissemination and outreach activities of the
pension counseling projects have served over 25,000 people and
has helped obtain more than $50,000,000 in retirement benefits
for older individuals.
The Committee has provided funding at the administration
request level for the National Long Term Care Ombudsman
Resource Center, the National Center on Elder Abuse and the
Health Care Anti-Fraud, Waste and Abuse Program.
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 20 years. The Committee recommends a funding
level of $11,786,000 for Alzheimer's disease demonstration
grants to States. This is the same as the comparable fiscal
year 2005 funding level and the administration 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, caregiving comes at
enormous physical, emotional, and financial sacrifice. The
Alzheimer's disease demonstration grant program currently
provides matching grants to 38 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.
White House Conference on Aging
The Committee recommendation does not include funding for
the White House Conference on Aging. This conference will be
held in December 2005 and is required by the Older Americans
Act Amendments of 2000. White House Conferences on Aging are
decennial events held to develop recommendations for the
President and Congress on issues, policy, and research in the
field of aging.
Program Administration
The Committee recommends $17,879,000 for program
administration, which is $422,000 below the comparable fiscal
year 2005 funding level and the same as the administration
request. These funds support salaries and related expenses for
program management and oversight activities.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriations, 2005.................................... $369,931,000
Budget estimate, 2006................................... 359,176,000
House allowance......................................... 344,546,000
Committee recommendation................................ 359,465,000
The Committee recommends $359,465,000 for general
departmental management [GDM]. This amount is $10,466,000 below
the comparable level for fiscal year 2005 and $289,000 above
the administration request. The Committee recommendation
includes the transfer of $5,851,000 from Medicare trust funds,
which is the same as the administration request. In addition,
for policy evaluation activities the Committee recommends
$39,552,000 in transfers available under section 241 of the
Public Health Service Act.
The Committee directs that specific information requests
from the chairman and ranking member 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.
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 recommendation includes $3,000,000 for the
Citizens' Health Care Working Group which was authorized by the
Medicare Prescription Drug, Improvement, and Modernization Act
of 2003. These funds are available for all activities of the
Working Group, including preparation and distribution of
reports.
Advance Directives.--The Committee believes that through
the execution of advance directives, including living wills and
durable powers of attorney for health care according to the
laws of the State in which they reside, individuals can better
protect their right to express their wishes about end-of-life
care and have those wishes respected. The Committee directs the
Secretary to conduct a study to determine the best way to
promote the use of advance directives among competent adults as
a means of specifying their wishes about end of life care, and
provide recommendations to Congress on changes to Federal law
needed to ensure appropriate use of advance directives. As part
of that study, the Department shall consider that decisions
relating to advance directives are often made without adequate
information about what it is like to live with a significant
disability. The Committee intends that the study directly
involve persons with disabilities, family members, disability
experts and organizations in assessing this reality and
identifying what information and support is necessary. This
study should also review options related to those individuals
whose significant cognitive disabilities limit or prohibit them
from making decisions about directing their care and treatment.
Childhood Drinking.--In April 2004 the Secretary created,
at the request of Congress, an Interagency Coordinating
Committee on the Prevention of Underage Drinking [ICCPUD],
chaired by the Administrator of SAMHSA. Since then the ICCPUD
has developed a draft plan for combating underage drinking
which contained a complete listing of Federal programs related
to underage drinking prevention. However, the Committee is
concerned that the ICCPUD has not made more progress; it has
not produced meaningful coordination among Federal agencies,
identified effective and underperforming programs, or created a
plan for improving Federal data collection. In addition, the
ICCPUD has not identified the resources currently available for
programs targeting underage drinking or made recommendations on
the allocation of additional resources. Finally, the interim
plan lacks measurable goals or benchmarks which would serve to
monitor the progress and accountability of the ICCPUD's
efforts. The Committee looks forward to the ICCPUD's final plan
to be issued later this year and hopes that it will address
these issues.
Chiropractic Care.--The Committee notes that chiropractic
health care services are now available to beneficiaries within
the Department of Veterans' Affairs health care system, the
Department of Defense health care program for active duty
military personnel and, through a demonstration, within the
Medicare health program. Despite this broad integration of
chiropractic care into the mainstream of Federal and private
sector health care systems, the Committee notes that there are
not Doctors of Chiropractic Medicine commissioned to serve
within the U.S. Public Service Commissioned Corps. The
Committee notes that authority for the Surgeon General to
appoint such commissioned officers exists under current law,
but that none have been appointed. The Committee encourages the
Surgeon General to begin to develop a plan to commission
Doctors of Chiropractic into the U.S. Public Health Service
Commissioned Corps and directs the Surgeon General to update
the Committee on its progress within 6 months after enactment
of this Act.
Chronic Fatigue.--The Committee is pleased that the
Department's Chronic Fatigue Syndrome Advisory Committee
[CFSAC] has been meeting quarterly. This advisory committee
serves an important role in setting priorities for Federal
research and education programs related to chronic fatigue
syndrome [CFS] and in keeping the Department abreast of the
needs of persons with CFS. The Committee awaits the Secretary's
written response to the CFSAC's recommendations dated August
23, 2004.
Health Disparities.--The Committee is committed to ensuring
the overall improved health of the American people, and
strongly urges the Secretary to intensify efforts to implement
recommendations developed by the Institute of Medicine's
Unequal Treatment: Confronting Racial and Ethnic Disparities in
Health Care study. The recommendations offer significant
guidelines and opportunities for eliminating health disparities
and improving health across all populations. The Committee
expects the Secretary to report on the progress of this action
during next year's appropriations hearings.
Hepatitis C-HIV Co-infection.--The Committee is concerned
with the growing co-infection of individuals with both HIV and
hepatitis C and notes that the largest single cause of death of
individuals with HIV infection is now liver disease. The
Committee is pleased that, in response to this high co-
infection rate, approximately 20 of the State AIDS Drug
Assistance Programs [ADAP] have now included Hepatitis C
pharmaceuticals on their formularies. The Committee notes that
the Ryan White Care Act requires the Secretary to issue
guidelines regarding appropriate treatments under the program
and requests that the Secretary review and re-issue these
treatment guidelines to address the treatment issues and
formulary requirements associated with the significant co-
infection rate of HIV and hepatitis C.
HIV1-2 Rapid Testing.--The Committee is aware that wide-
scale deployment of new oral fluid testing for AIDS is a
significant step towards helping citizens, throughout the
United States and around the world, to know their HIV status.
The Committee urges the Secretary to significantly increase the
use of bulk purchasing and wide-scale deployment of FDA-
approved oral fluid HIV1-2 rapid tests for domestic and
international programs.
Parental Website.--It has come to the Committee's attention
that an independent study reviewed 4parents.gov, the
Department's website created to help parents counsel their
teenagers about risky health behaviors. While noting positive
aspects about the website, the study found numerous examples of
inaccurate information. The Committee is aware that this web
site was designed by outside contractors, not by the
Department's public health experts. The Committee directs the
Department to review the findings of the study, undertake a
review of the website by Departmental public health and
scientific experts, and make any necessary changes to conform
with scientific evidence. The Committee also directs the
Department to include scientifically accurate information about
underage drinking and tobacco use.
Sleep Disorders.--At the National Institutes of Health's
Frontiers of Knowledge in Sleep and Sleep Disorders conference
in March of 2004, the U.S. Surgeon General reported on the
profound impact that chronic sleep loss and untreated sleep
disorders have on Americans of all ages and that the public
health model is well suited to translate these essential health
messages to society. The Committee urges the Surgeon General to
consider development of a Surgeon General's Report on Sleep and
Sleep Disorders.
Adolescent Family Life
The Committee has provided $30,742,000 for the Adolescent
Family Life Program [AFL], which is the same as the
administration request. This is $158,000 below the comparable
fiscal year 2005 level.
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.
Minority Health
The Committee recommends $50,980,000 for the Office of
Minority Health, which is $462,000 above the comparable level
for fiscal year 2005 and $3,744,000 above the administration
request.
The Office of Minority Health [OMH] focuses on strategies
designed to decrease the disparities and to improve the health
status of racial and ethnic minority populations in the United
States. OMH establishes goals, and coordinates all departmental
activity related to improving health outcomes for disadvantaged
and minority individuals. OMH supports several demonstration
projects, including the Minority Community Health Coalition,
the Bilingual/Bicultural Service, the Center for Linguistic and
Cultural Competency in Health Care, and the Family and
Community Violence Prevention Program.
The Committee expects OMH and the National Center for
Minority Health and Health Disparities at the National
Institutes of Health to play a joint role in coordinating and
monitoring the implementation of the Department's elimination
of health disparities initiatives and strategic plans. The
Committee expects the Secretary to report on the progress and
implementation of the strategic plans during next year's
appropriations hearings, and to include a progress update in
the Department's Budget Justification.
Office on Women's Health
The Committee recommends $28,715,000 for the Office on
Women's Health. This is $103,000 below the comparable level for
fiscal year 2005 and the same as the administration request.
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.
Bodywise.--The Committee is impressed with the efforts of
the OWH to address the growing problem of negative body image
and eating disorders through the Bodywise Project. This has
been a widely successful project and the Committee urges the
Secretary to continue this educational initiative and broaden
the efforts by collaborating with the Department of Education
to disperse the educational materials resulting from Bodywise
and expand the educational project to target all levels of
education from elementary to high school.
Lupus.--The Committee understands that Lupus is a serious,
complex, debilitating chronic autoimmune disease that can cause
inflammation and tissue damage to virtually any organ system in
the body and impacts an estimated 1.5 and 2 million
individuals. The Committee is aware that public and
professional recognition and understanding of lupus is
extremely low, contributing to misdiagnoses or late diagnoses
that can result in disability or death. The Committee strongly
urges OWH to develop and implement a sustained lupus awareness
and education campaign aimed at reaching health care
professionals and the general public, with an emphasis on
reaching women at greatest risk for developing Lupus.
Offices of Women's Health.--The Committee has great
interest in women's health and wants to encourage further
health research, education, and services for women. The
Committee also recognizes that the Offices of Women's Health
within the Department, the Food and Drug Administration, the
Centers for Disease Control and Prevention, the Health
Resources and Services Administration, and the Agency for
Healthcare Research and Quality provide critical services in
support of these needs. The Committee strongly encourages the
Secretary to see that these offices continue to receive
sufficient funding to assure their ability to continue to meet
their missions.
Afghanistan
The Committee recommendation includes $5,952,000 for the
Secretary's Afghanistan health initiative. This amount is the
same as the comparable fiscal year 2005 funding level and the
administration request. Funds will be used in partnership with
the Department of Defense for medical training activities at
the Rabia Balkhi Women's Hospital in Kabul, and for support of
maternal and child health throughout Afghanistan.
Embryo Adoption
The Committee continues to believe that increasing public
awareness of embryo donation and adoption remains an important
goal. The Committee has provided $2,000,000 for the
Department's embryo adoption awareness campaign, which is
$1,008,000 more than the comparable fiscal year 2005 funding
level and the administration request.
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 $52,415,000. This amount is the same as
the comparable fiscal year 2005 level and the administration
request. 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.
Information Technology Security and Innovation Fund
The Committee recommendation does not include funding for
the Information Technology Security and Innovation Fund, which
is $14,695,000 below the comparable fiscal year 2005 level and
$14,630,000 below the administration request. This activity
funds investments such as information technology services,
security and infrastructure that enable common administrative
systems throughout the Department.
OFFICE OF MEDICARE HEARINGS AND APPEALS
Appropriations, 2005.................................... $57,536,000
Budget estimate, 2006................................... 80,000,000
House allowance......................................... 60,000,000
Committee recommendation................................ 75,000,000
The Committee provides $75,000,000 for the Office of
Medicare Hearings and Appeals, which is $17,464,000 above the
comparable fiscal year 2005 level and $5,000,000 below the
administration request.
The Office of Medicare Hearings and Appeals is responsible
for hearing Medicare appeals at the administrative law judge
level, which is the third level of Medicare claims appeals.
Since fiscal year 1995 these appeals have been processed by the
Social Security Administration under an interagency agreement
with the Centers for Medicare and Medicaid Services. This
function was transferred to the Office of the Secretary by the
Medicare Prescription Drug, Improvement and Modernization Act
of 2003.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
Appropriations, 2005.................................... $24,011,000
Budget estimate, 2006................................... 77,750,000
House allowance......................................... 75,000,000
Committee recommendation................................ 45,150,000
The Committee provides $45,150,000 to the Office of the
National Coordinator for Health Information Technology
[ONCHIT]. This amount is $21,139,000 above the comparable
fiscal year 2005 level and $32,600,000 below the administration
request. The Committee recommendation includes $12,350,000 in
transfers available under section 241 of the Public Health
Service Act. In addition, the Committee has provided
$50,000,000 for health information technology to the Agency for
Healthcare Research and Quality.
The Office of The National Coordinator for Health
Information Technology is responsible for promoting the use of
electronic health records in clinical practice, coordinating
Federal health information systems and collaborating with the
private sector to develop standards for a nationwide
interoperable health information technology infrastructure.
The Committee urges the Coordinator for the ONCHIT to
conduct outreach activities to all public and private sector
organizations which have demonstrated capabilities in health
information technology. The Committee is particularly
interested in disease management technology as it relates to
saving health care dollars, and improving care for chronically
ill individuals and the workforce.
Interoperability.--The Committee commends the efforts by
the Secretary to increase interoperability within healthcare.
Through the Consolidated Health Informatics [CHI] Project, 24
electronic standards have been identified to allow sharing of
clinical information. The Committee urges the Secretary to
implement procedures to enable the Department to accept the
optional submission of data derived from health care reporting
requirements for the purposes of quality, surveillance,
epidemiology, adverse event reporting, or research using the
electronic standards identified under the CHI project.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2005.................................... $39,930,000
Budget estimate, 2006................................... 39,813,000
House allowance......................................... 39,813,000
Committee recommendation................................ 39,813,000
The Committee recommends an appropriation of $39,813,000
for the Office of Inspector General, which is the same as the
administration request. The fiscal year 2005 comparable level
was $39,930,000. In addition to discretionary funds, the Health
Insurance Portability and Accountability Act of 1996 provides
$160,000,000 in mandatory funds for the Office of Inspector
General in fiscal year 2006; the total funds provided to the
Office by this bill and the authorizing bill would be
$199,813,000 in fiscal year 2006.
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.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2005.................................... $35,013,000
Budget estimate, 2006................................... 34,996,000
House allowance......................................... 34,996,000
Committee recommendation................................ 34,996,000
The Committee recommends $34,996,000 for the Office for
Civil Rights [OCR]. This is the same as the administration
request. The comparable fiscal year 2005 level was $35,013,000.
The recommendation includes the transfer of $3,314,000 from the
Medicare trust funds.
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.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriations, 2005.................................... $330,636,000
Budget estimate, 2006................................... 328,552,000
House allowance......................................... 328,552,000
Committee recommendation................................ 328,552,000
The Committee provides an estimated $328,552,000 for
retirement pay and medical benefits for commissioned officers
of the U.S. Public Health Service, the same as the
administration request. The comparable level for fiscal year
2005 was $330,636,000.
This account provides for: retirement payments to U.S.
Public Health Service officers who are retired for age,
disability, or length of service; payments to survivors of
deceased officers; medical care to active duty and retired
members and dependents and beneficiaries; and for payments to
the Social Security Administration for military service
credits.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
Appropriations, 2005.................................... $2,407,415,000
Budget estimate, 2006................................... 2,427,833,000
House allowance......................................... 183,589,000
Committee recommendation................................ 183,589,000
The Committee provides $183,589,000 to the Public Health
and Social Services Emergency Fund. This is $2,223,826,000
below the comparable fiscal year 2005 level and $2,244,244,000
below the administration request. The Committee's
recommendation for fiscal year 2006 includes $63,589,000 for
bioterrorism preparedness within the Office of the Secretary
and $120,000,000 for pandemic flu activities.
The Committee has provided funding for bioterrorism
preparedness directly to other agencies within the Department
instead of to this account as it has done in the past. When
these funding levels are included, the Committee has provided a
total of $2,357,581,000 for bioterrorism preparedness, which is
$49,834,000 less than the comparable fiscal year 2005 level and
$70,252,000 less than the administration request.
The Committee is aware that a recent study projected that
over half a million Americans could die and over 2.3 million
could be hospitalized if a moderately severe strain of a
pandemic flu virus hits the United States. Given the potential
for such a scenario, the Committee urges the Department to
finalize its August 2004 draft Pandemic Influenza Preparedness
and Response Plan and make it publicly available. In addition,
the Committee urges the Department to examine the study's key
recommendations, including those relating to stockpiling
medical supplies, and developing emergency communications
plans; stockpiling additional antivirals and developing surge
capacity plans for hospitals and health care providers; and
increasing vaccine production and the development of new
technologies for vaccines.
General Provisions, Department of Health and Human Services
The Committee recommendation continues a provision placing
a $50,000 ceiling on official representation expenses (sec.
201).
The Committee recommendation continues a provision which
limits the assignment of certain public health personnel (sec.
202).
The Committee recommendation retains language regarding
set-asides in the authorizing statute of the National
Institutes of Health (sec. 203).
The Committee recommendation continues a provision limiting
the use of grant funds to pay individuals no more than an
annual rate of Executive Level I (sec. 204).
The Committee recommendation continues a provision
restricting the Secretary's use of taps for program evaluation
activities unless a report is submitted to the Appropriations
Committees on the proposed use of funds (sec. 205).
The Committee recommendation includes language authorizing
the transfer of up to 2.5 percent of Public Health Service
funds for evaluation activities (sec. 206).
The Committee modifies a provision restricting transfers of
appropriated funds and requires a 15 day notification to both
the House and Senate Appropriations Committees (sec. 207).
The Committee recommendation continues a provision
permitting the transfer of up to 3 percent of AIDS funds among
Institutes and Centers by the Director of NIH and the Director
of the Office of AIDS Research at NIH (sec. 208).
The Committee recommendation retains language which
requires that the use of AIDS research funds be determined
jointly by the Director of the National Institutes of Health
and the Director of the Office of AIDS Research and that those
funds be allocated directly to the Office of AIDS Research for
distribution to the Institutes and Centers consistent with the
AIDS research plan (sec. 209).
The Committee recommendation continues a provision
regarding requirements for family planning applicants (sec.
210).
The Committee recommendation retains language which
restricts the use of funds to carry out the Medicare Advantage
Program if the Secretary denies participation to an otherwise
eligible entity (sec. 211).
The Committee recommendation retains language which States
that no provider services under Title X of the PHS Act may be
exempt from State laws regarding child abuse (sec. 212).
The Committee recommendation retains language which
prohibits the Secretary from withholding substance abuse
treatment funds (sec. 213).
The Committee recommendation continues a provision which
facilitates the expenditure of funds for international AIDS
activities (sec. 214).
The Committee recommendation includes a provision allowing
the Division of Federal Occupational Health to use personal
services contracting to employ professional, administrative,
and occupational health professionals (sec. 215).
The Committee recommendation retains a provision
authorizing the Director of the National Institutes of Health
to enter into certain transactions to carry out research in
support of the NIH Roadmap Initiative of the Director (sec.
216).
The Committee includes a provision that permits the Centers
for Disease Control and Prevention and the Agency for Toxic
Substances and Disease Registry to transfer funds that are
available for Individual Learning Accounts to ``Disease
Control, Research, and Training'' (sec. 217).
The Committee recommendation includes bill language
allowing use of funds to continue operating the Council on
Graduate Medical Education (sec. 218).
The Committee recommendation includes a general provision,
which rescinds $10,000,000 in unobligated balances from amounts
appropriated in Public Law 108-11 under the heading ``Public
Health and Social Services Emergency Fund'', the smallpox
compensation program (sec. 219).
The Committee recommendation rescinds $15,912,000 of
unobligated balances in the Health Professions Student Loan
Program (sec. 220).
The Committee recommendation extends availability of funds
for the State Pharmaceutical Assistance Programs (sec. 221).
TITLE III--DEPARTMENT OF EDUCATION
Education for the Disadvantaged
Appropriations, 2005.................................... $14,843,974,000
Budget estimate, 2006................................... 16,431,473,000
House allowance......................................... 14,728,735,000
Committee recommendation................................ 14,525,135,000
The Committee recommends an appropriation of
$14,525,135,000 for education for the disadvantaged. The
comparable funding level for fiscal year 2005 is
$14,843,974,000 and the budget request includes $16,431,473,000
for this account.
The programs in the education for the disadvantaged account
help ensure that poor and low-achieving children are not left
behind in the Nation's effort to raise the academic performance
of all children and youth. That goal is more pressing than ever
since the passage of the No Child Left Behind Act, which
incorporates numerous accountability measures into Title I
programs, especially part A grants to local educational
agencies--the largest Federal elementary and secondary
education program.
In particular, the law strengthens Title I accountability
by requiring States to implement statewide accountability
systems covering all public schools and students. These systems
must be based on challenging State standards in reading and
mathematics, annual statewide progress objectives ensuring that
all groups of students reach proficiency in reading and math by
the end of the 2013-2014 school year, and annual testing for
all students in grades 3-8. State progress objectives and
assessment results must be broken out by poverty, race and
ethnicity, disability, and limited English proficiency. States,
school districts, and schools must report annually on their
progress toward statewide proficiency goals. Districts and
schools that fail to make adequate yearly progress [AYP] toward
these goals will, over time, be subject to increasingly
rigorous improvement, corrective action, and restructuring
measures aimed at getting them back on course to meet State
standards. Students attending schools that fail to meet annual
State AYP objectives for 2 consecutive years will be permitted
to transfer to a better public school or, if the school
continues to fail to meet AYP for 3 years or more, to use Title
I funds to obtain educational services from a public- or
private-sector provider selected by their parents.
Funds appropriated in this account primarily support
activities in the 2006-2007 school year.
Grants to Local Educational Agencies
Title I Grants to Local Educational Agencies [LEAs] provide
supplemental education funding, especially in high-poverty
areas, for local programs that provide extra academic support
to help raise the achievement of eligible students or, in the
case of schoolwide programs, help all students in high-poverty
schools to meet challenging State academic standards. The
program serves more than 15 million students in nearly all
school districts and more than half of all public schools--
including two-thirds of the Nation's elementary schools.
Title I schools help students reach challenging State
standards through one of two models: ``targeted assistance''
that supplements the regular education program of individual
children deemed most in need of special assistance, or a
``schoolwide'' approach that allows schools to use Title I
funds--in combination with other Federal, State, and local
funds--to improve the overall instructional program for all
children in a school.
Starting with the fiscal year 2004 appropriation, States
are required to reserve 4 percent of their allocation under
this program for school improvement activities, unless such
action would require a State to reduce the grant award of a
local educational agency to an amount below the preceding year.
At the funding level recommended by the Committee for fiscal
year 2006, this set-aside could generate up to $504,000,000 for
this purpose. States must distribute 95 percent of these
reserved funds to local educational agencies for schools
identified for improvement, corrective action, or
restructuring. The Committee is concerned about the effect of
the authorizing language, which in some States is requiring
high-poverty districts to receive much less funding than they
would otherwise receive, in order for States to ``hold
harmless'' other districts and redistribute the required amount
of school improvement funds. As a result, districts with the
most eligible children in those States are not receiving the
funds needed to serve their students adequately. In addition,
some States are not able to set aside the full 4 percent, which
means fewer resources to help struggling schools implement
school improvement plans, support public school choice or offer
supplemental education services.
More than any other Federal program, Title I grants to LEAs
are critical to the success of the No Child Left Behind Act.
The Committee recommends $12,839,571,000 for this program. The
comparable funding level for fiscal year 2005 is
$12,739,571,000 and the budget request includes $13,342,309,000
for Title I grants to LEAs. The Committee recommendation
proposes an increase of 46.5 percent over the amount provided
prior to passage of the No Child Left Behind Act. These Federal
resources represent the significant commitment this Committee
has made to provide the resources necessary to help all
children succeed in school.
The appropriation for Title I grants to LEAs primarily
supports activities associated with the 2006-2007 academic
year. Of the funds available for this program, up to $3,472,000
shall be available on October 1, 2005, not less than
$5,452,798,000 will become available on July 1, 2006 and
$7,383,301,000 will become available on October 1, 2006. The
funds that become available on July 1, 2006 and October 1, 2006
will remain available for obligation until September 30, 2007.
Title I grants are distributed through four formulas:
basic, concentration, targeted, and education finance incentive
grant [EFIG].
For Title I basic grants, including up to $3,472,000
transferred to the Census Bureau for poverty updates, the
Committee recommends an appropriation of $6,934,854,000. The
comparable funding level for fiscal year 2005 and the budget
request are both $6,934,854,000 for the basic grants funding
stream. Basic grants are awarded to school districts with at
least 10 poor children who make up more than 2 percent of
enrollment.
For concentration grants, the Committee recommends an
appropriation of $1,365,031,000. The comparable funding level
for fiscal year 2005 and the budget request are both
$1,365,031,000. 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 exceeds 6,500 or 15
percent of the total school-aged population.
Last year, Congress provided all of the additional funding
for Title I grants to LEAs above the fiscal year 2004 level
through the EFIG and targeted formulas. The Committee
recommends allocating all of the increase proposed this year in
a similar manner. The Committee notes that analysis conducted
by the Congressional Research Service has demonstrated that
these formulas deliver a larger share of Title I funds to high-
poverty school districts than any other Title I formula. In
addition, the EFIG formula uses State-level ``equity'' and
``effort'' factors to make allocations to States that are
intended to encourage States to spend more on education and to
improve the equity of State funding systems. Once State
allocations are determined, suballocations to the LEA level are
based on a modified version of the targeted grants formula,
described below.
The targeted grants formula weights child counts to make
higher payments to school districts with high numbers or
percentages of poor students. For these grants, the Committee
recommends an appropriation of $2,269,843,000. The comparable
funding level for fiscal year 2005 is $2,219,843,000 and the
budget request includes $2,822,581,000 for this funding stream.
The Committee recommends an appropriation of $2,269,843,000
for education finance incentive grants. The comparable funding
level for fiscal year 2005 and the budget request both are
$2,219,843,000 for the EFIG funding stream.
William F. Goodling Even Start Family Literacy Program
The Committee does not recommend additional funds for the
Even Start program. The comparable funding level for fiscal
year 2005 is $225,095,000 and the budget request does not
include any funds for this program.
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.
Funding is provided to States based on their relative share of
Title I, Part A funds and States use these resources to make
competitive subgrants to partnerships comprised of local
educational agencies and other organizations serving families
in high-poverty areas.
Reading First State Grants
The Committee recommends $1,041,600,000 for the Reading
First State Grants program, the same amount as the comparable
funding level for fiscal year 2005 and the budget request.
Reading First is a comprehensive effort 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 the end
of 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.
The Committee intends for funds available under the Reading
First program to encourage and support the use of reading
programs with the strongest possible scientific evidence of
effectiveness. The Committee urges the Department to provide
clear guidance to its technical assistance centers and the
States to: fully consider scientific evidence of effectiveness
in rating programs for use under Reading First; contemplate
expanded lists of allowable programs that include innovative
programs with scientific evidence of effectiveness; when
awarding new grants, consider giving preference to those
schools that select programs with strong, scientific evidence
of effectiveness; emphasize that the Department has not
established a predetermined approved list of reading materials;
and allow comprehensive reading programs that have scientific
evidence of effectiveness to be implemented in full, as they
have been researched, without modification to conform to other
models of instruction. The Committee also is concerned that
certain practices under the Reading First program may unduly
interfere with local control of curriculum. The Committee notes
that Reading First materials decisions are to be made at the
school level, subject to the approval of the State.
Early Reading First
The Committee recommends $104,160,000 for the Early Reading
First program, the same amount as the comparable funding level
for fiscal year 2005 and the budget request.
Early Reading First complements 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 are targeted to communities with high numbers of low-
income families.
Striving Readers
The Committee recommends $35,000,000 for the Striving
Readers initiative. The comparable fiscal year 2005 funding
level is $24,800,000 and the budget request includes
$200,000,000 for the Striving Readers program. This program
supports grants to develop, implement, and evaluate reading
interventions for middle- or high-school students reading
significantly below grade level. Under this program, awards
will be made to local educational agencies eligible to receive
funds under Part A of Title I with one or more high schools or
middle schools serving a significant number of students reading
below grade level. Awards also may be made to partnerships
including institutions of higher education and eligible
nonprofit or for-profit organizations. The Committee intends
that funds provided in this bill be utilized in accordance with
the priorities established in the statement of the managers
accompanying the fiscal year 2005 appropriations Act that
relate to a rigorous evaluation requirement and parity in
funding for middle schools and high schools.
Improving Literacy Through School Libraries
The Committee recommends $19,683,000 for the Improving
Literacy Through School Libraries program, the same amount as
the comparable funding level for fiscal year 2005 and the
budget request.
This program provides 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 Reading First initiative.
LEAs with a child-poverty rate of at least 20 percent are
eligible for the competitive awards. Funds may be used to
acquire 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.
The Committee is concerned that funds provided under this
program are not reaching those schools that are most in need of
financial assistance for updating their school libraries,
either because they are not applying for funds or are
unsuccessful in writing their grant applications. The Committee
encourages the Department to work with the Institute of Museum
and Library Services and other relevant organizations to
improve awareness, among the most needy schools, of the
availability of this financial assistance, and to help them
increase their success rates in competing for available funds.
The Committee requests that the Department explain in its
fiscal year 2007 congressional budget justification the actions
it has taken or will take to address this issue with respect to
the 2006 and future grant competitions.
High School Intervention
The Committee recommendation does not include any funding
for the new High School Intervention initiative. The budget
proposed $1,240,000,000 for this new initiative. Funds would
have been used to develop, implement and evaluate interventions
that increase the achievement of all high school students,
particularly those at risk of failing to meet challenging State
academic content standards; eliminate achievement gaps between
student from different socioeconomic backgrounds; and help all
students graduate with the education, skills, and knowledge to
succeed in postsecondary education and a high-technology
economy. The proposed initiative would have provided funds to
States based on a formula and SEAs would then make competitive
grants to LEAs using 95 percent of appropriated funds.
The budget request proposes bill language that would
authorize this new high school initiative and require each
State to participate in 12th grade State National Assessment of
Educational Progress reading and math assessments. The
Committee bill does not include the requested language.
The Committee is supportive of the administration's goal of
preparing all students for postsecondary education and the
high-technology economy. However, the Committee notes that this
initiative has not been acted on by the appropriate authorizing
committees of Congress and would have been funded by the
elimination of GEAR-UP, certain TRIO activities and the Perkins
Vocational and Technical Education program, each of which have
been restored to their fiscal year 2005 funding levels.
Migrant Education Program
The Committee recommends $390,428,000 for the Migrant
Education program, the same amount as the comparable fiscal
year 2005 funding level and the budget request.
The Title I Migrant Education 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 actual counts of migratory
children ages 3 through 21 residing within the States in the
previous year. 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, as well as identifying and improving services to the
migrant student population.
Neglected and Delinquent
The Committee recommends $51,000,000 for the Title I
neglected and delinquent program. The comparable funding level
for fiscal year 2005 and the budget request both are
$49,600,000 for the neglected and delinquent program.
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 at least 15 percent, but
not more than 30 percent, of their neglected and delinquent
funds to help students in State-operated institutions make the
transition into locally operated programs and to support the
successful reentry of youth offenders, who are age 20 or
younger and have received a secondary school diploma or its
recognized equivalent. Reentry activities may include
strategies designed to expose the youth to, and prepare the
youth for, postsecondary education, or vocational and technical
training programs.
Under the No Child Left Behind Act, the Congress provided
the Secretary with the authority to reserve up to 2.5 percent
of the appropriation for national activities. The Committee
continues to urge the Secretary to fully utilize this authority
to support capacity building in and dissemination of best
practices to State agency programs and to develop a uniform
model for evaluating State performance under this program.
Evaluation
The Committee recommends $9,424,000 for evaluation of Title
I programs, the same amount as the comparable funding level for
fiscal year 2005 and the budget request.
Evaluation funds are used to support large-scale national
surveys that examine how the Title I programs are contributing
to student academic achievement. Funds also are used to
evaluate State assessment and accountability systems and
analyze the effectiveness of educational programs supported
with Title I funds.
Comprehensive School Reform Demonstration
The Committee does not recommend additional funds for the
comprehensive school reform demonstration program. The
comparable funding level for fiscal year 2005 is $205,344,000
and the budget request did not include any funds for the
comprehensive school reform program.
This program provided schools with funding to develop or
adopt, and implement, comprehensive school reforms that will
enable children in participating schools to meet State
standards. The Department allocated funds to States based on
their relative shares of the previous year's Title I basic
grants funds.
High School Equivalency Program
The Committee recommends $18,737,000 for the high school
equivalency program [HEP], the same amount as the comparable
funding level for fiscal year 2005 and the budget request.
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. At the
funding level recommended by the Committee, HEP will serve
roughly 7,000 migrants.
College Assistance Migrant Program
For the College Assistance Migrant Program [CAMP], the
Committee recommends $15,532,000, the same amount as the
comparable funding level for fiscal year 2005 and the budget
request.
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.
The Committee encourages the Department to consider
efficient and effective means for collecting performance
outcome data related to postsecondary persistence and
completion rates of CAMP program participants beyond those
measures currently employed. The Committee notes that the
follow-up services set aside may be used to monitor and report
on the progress of students participating in projects during
such students' subsequent years in college.
Impact Aid
Appropriations, 2005.................................... $1,243,862,000
Budget estimate, 2006................................... 1,240,862,000
House allowance......................................... 1,240,862,000
Committee recommendation................................ 1,240,862,000
The Committee recommends an appropriation of $1,240,862,000
for impact aid for the Department of Education. The comparable
funding level for fiscal year 2005 is $1,243,862,000 and the
budget request proposes $1,240,862,000 for this purpose.
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.
The Committee bill includes language that provides for
continued eligibility for students affected by the deployment
or death of their military parent, as long as these children
still attend the same school district. This language was
included in the budget request and last year's appropriation
bill.
Basic Support Payments.--The Committee recommends
$1,102,896,000 for basic support payments. The comparable
funding level for fiscal year 2005 and the budget request both
are $1,075,018,000. Under this statutory formula, payments are
made on behalf of all categories of federally connected
children, with a priority placed on making payments first to
heavily impacted school districts and providing any remaining
funds for regular Basic Support Payments.
Payments for Children with Disabilities.--The Committee
bill includes $49,966,000 for this purpose, the same amount as
the comparable funding level for fiscal year 2005 and the
budget request. Under this program, additional payments are
made for certain federally connected children eligible for
services under the Individuals with Disabilities Education Act.
Facilities Maintenance.--The Committee recommends
$5,000,000 for facilities maintenance. The comparable funding
level for fiscal year 2005 and the budget request both are
$7,838,000 for this purpose. This activity provides funding for
emergency repairs and comprehensive capital improvements to
certain school facilities owned by the Department of Education
and used by local educational agencies to serve federally
connected military dependent students. Funds appropriated for
this purpose are available until expended.
Construction.--The Committee recommends $18,000,000 for
this program. The comparable fiscal year 2005 funding level is
$48,544,000 and the budget request includes $45,544,000 for
this purpose. Formula and competitive grants are awarded to
eligible LEAs for emergency repairs and modernization of school
facilities. Funds appropriated for the construction activity
are available for obligation for a period of 2 years.
While the Committee recommendation is less than last year,
formula and competitive grant funds will still be made
available under this appropriation for those districts in need
of and eligible for additional financial assistance to improve
their school facilities. In addition, funds are still remaining
from the fiscal year 2005 appropriation for competitive grants
under this program.
Payments for Federal Property.--The Committee recommends
$65,000,000 for this activity. The comparable funding level for
fiscal year 2005 and the budget request both are $62,496,000
for this program. 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.
School Improvement Programs
Appropriations, 2005.................................... $5,619,657,000
Budget estimate, 2006................................... 5,332,219,000
House allowance......................................... 5,393,765,000
Committee recommendation................................ 5,457,953,000
The Committee recommends an appropriation of $5,457,953,000
for school improvement programs. The comparable funding level
in fiscal year 2005 for this account is $5,619,657,000 and the
budget request includes $5,332,219,000.
State Grants for Improving Teacher Quality
The No Child Left Behind Act requires States to ensure that
all teachers teaching in core academic subjects are ``highly
qualified'' by the end of the 2005-2006 school year. The
Committee recommends $2,916,605,000 for State grants for
improving teacher quality, the same as both the comparable
funding level for fiscal year 2005 and the budget request.
The appropriation for this program primarily supports
activities associated with the 2006-2007 academic year. Of the
funds provided, $1,481,605,000 will become available on July 1,
2006 and $1,435,000,000 will become available on October 1,
2006. These funds will remain available for obligation until
September 30, 2007.
Under the Committee recommendation, funding for programs
that specifically support high-quality professional development
for teachers and school leadership will have increased by 40
percent since passage of the No Child Left Behind Act. The
Committee recommendation for fiscal year 2006 includes nearly
$3,600,000,000 for such activities in recognition of the
critical role that these individuals occupy in educating the
Nation's children and the significant academic benefit that
students may derive from the presence of a highly qualified
teacher in their classroom. In addition, State and local
educational agencies have considerable flexibility to use funds
from their Title I grants to LEAs allocations, as well as other
State grant program dollars in support of high-quality
professional development opportunities.
States and LEAs may use the funds for a range of activities
related to the certification, recruitment, professional
development, and support of teachers and administrators.
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.
These funds may also be used by districts to hire teachers
to reduce class sizes. The Committee recognizes that smaller
classes, particularly in the early grades, can have a positive
impact on students by improving classroom discipline, providing
students with more individualized attention, and allowing
parents and teachers to work more closely together. 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.
Early Childhood Educator Professional Development
The Committee recommends $14,696,000 to support
professional development activities for early childhood
educators and caregivers in high-poverty communities. The
comparable funding level for fiscal year 2005 and the budget
request are both $14,696,000 for this program. From this
appropriation, the Secretary makes competitive grants to
partnerships of early childhood and family literacy caregivers
and educators in order to provide high quality, sustained and
intensive professional development for early childhood
educators to help them provide developmentally appropriate
school-readiness services for preschool-age children.
Mathematics and Science Partnerships
The Committee recommends $178,560,000 for the mathematics
and science partnerships program. The comparable funding level
for fiscal year 2005 is $178,560,000 and the budget request
includes $269,000,000 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.
When the appropriation for this program is $100,000,000 or
greater, the Secretary is authorized to award grants to States
by a formula which includes consideration of the number of
children aged 5 to 17 below the poverty line. States then are
required to make grants competitively 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.
The budget request includes legislative language that would
allow the Secretary to use $120,000,000 in appropriated funds
to make competitive awards to projects designed to improve the
mathematics learning of secondary students. The Committee has
not provided this requested authority.
Innovative Education Program Strategies State Grants
The Committee recommends $100,000,000 for innovative
education program strategies State grants. The comparable
funding level for fiscal year 2005 is $198,400,000 and the
budget request is $100,000,000 for this purpose.
The innovative education program is a flexible source of
Federal funds that provides support to States and LEAs for
developing education reform initiatives that will improve the
performance of students, schools, and teachers.
Educational Technology State Grants
The Committee recommends $425,000,000 for educational
technology State grants. The comparable funding level for
fiscal year 2005 is $496,000,000 and the budget request did not
include any funds for this program.
The educational technology State grants program supports
efforts to integrate technology into curricula to improve
student learning. Funds flow by formula to States and may be
used for the purchase of hardware and software, teacher
training on integrating technology into the curriculum, and
efforts to use technology to improve communication with
parents, among other related purposes. An LEA must use at least
25 percent of its formula allocation for professional
development in the integration of technology into the curricula
unless it can demonstrate that it already provides such high-
quality professional development.
Supplemental Education Grants
The Committee recommendation includes $18,183,000 for the
supplemental education grants program, the same as both the
comparable funding level for fiscal year 2005 and the budget
request. This grant program was authorized by the Compact of
Free Association Amendments Act of 2003. The Act discontinued
the eligibility of Republic of Marshall Islands [RMI] and the
Federated States of Micronesia [FSM] for funding available from
Adult, Dislocated Worker and Youth Workforce Investment Act
programs, Head Start, Title I Grants to LEAs, Adult and
Vocational Education State Grants, Federal Work-Study and
Federal Supplemental Educational Opportunities Grants. In place
of funding from these sources, the Act provided a separate
supplemental education grant program that provides these
entities with a more flexible source of funds that can be
tailored to local needs. These funds will be transferred from
the Department of Education to the Secretary of Interior for
grants to these entities. The Committee bill includes language
that allows up to 5 percent to be used by the FSM and RMI to
purchase oversight and technical assistance, which may include
reimbursement of the Departments of Labor, Health and Human
Services and Education for such services. Of the funds
appropriated, $12,132,000 is for the Federated States of
Micronesia and $6,051,000 is for the Republic of the Marshall
Islands.
21st Century Community Learning Centers
The Committee recommends an appropriation of $991,077,000
for the 21st Century Community Learning Centers program, the
same as both the comparable level for fiscal year 2005 and the
budget request.
Funds are allocated to States by formula, which in turn,
award at least 95 percent of their allocations to local
educational agencies, community-based organizations and other
public and private entities. Grantees use these resources to
establish or expand community learning centers that provide
activities offering significant extended learning
opportunities, such as before- and after-school programs,
recreational activities, drug and violence prevention and
family literacy programs for students and related services to
their families. Centers must target their services on students
who attend schools that are eligible to operate a schoolwide
program under Title I of the Elementary and Secondary Education
Act or serve high percentages of students from low-income
families.
State Assessments and Enhanced Assessment Instruments
The Committee recommends $411,680,000 for State
assessments, the same as both the comparable funding level for
fiscal year 2005 and the budget request.
A key accountability measure in the No Child Left Behind
Act requires annual State assessments in reading and
mathematics for all students in grades 3-8 beginning in the
2005-2006 school year. The new assessments will be used to
determine whether States, LEAs, and schools are making adequate
yearly progress toward the goal of helping all students attain
proficiency within 12 years of the 2001-2002 school year.
This program has two components. The first provides formula
grants to States to pay the cost of developing standards and
assessments required by the new law. The statute includes
funding ``trigger amounts'' for fiscal years 2002-2007; States
may defer the new assessments for each year the appropriation
falls below the trigger level. The trigger for fiscal year 2006
is $400,000,000. The Committee recommendation includes
$400,000,000 for this purpose.
Under the second component of State assessments--Grants for
Enhanced Assessment Instruments--appropriations in excess of
the trigger level are used for a competitive grant program
designed to support efforts by States to improve the quality
and fairness of their assessment systems. The Committee
recommendation for the second component is $11,680,000, the
same as both the comparable funding level for fiscal year 2005
and the budget request.
The Committee continues to be concerned that many schools
are unable to properly assess the performance of students with
disabilities and students with limited English proficiency.
Therefore, the Committee urges the Department to place a high
priority on grant applications that aim to improve the quality
of State assessments for these two groups of students and to
ensure the most accurate means of measuring their performance
on these assessments.
High School Assessments
The Committee recommendation does not include funds for the
proposed High School Assessments program. The budget request
includes $250,000,000 for this new activity. This proposed
program was designed to complement the administration's High
School Reform initiative. Funds requested under this program
would be used to provide grants to States to pay for the
reading and math assessments that would be required in two
additional grades during high school by school year 2009-2010.
The budget request includes legislative language which would
authorize this program. As noted earlier, the High School
Reform proposal has not been considered by the appropriate
authorizing committees of Congress, so the Committee has not
included the legislative language or provided the requested
funds.
Javits Gifted and Talented Education
The Committee recommends $11,022,000 for the Javits Gifted
and Talented Students Education Program, the same as the
comparable fiscal year 2005 funding level. The President's
budget proposes to eliminate funding for this program. Funds
are used for awards to State and local education agencies,
institutions of higher education, and other public and private
agencies for research, demonstration, and training activities
designed to enhance the capability of elementary and secondary
schools to meet the special educational needs of gifted and
talented students.
Foreign Language Assistance
The Committee recommends $25,000,000 for the Foreign
Language Assistance program. The comparable funding level for
fiscal year 2005 is $17,856,000 and the budget request proposes
eliminating funds for foreign language assistance activities.
The Committee recommendation provides funds above what is
needed for continuation costs for current activities. These
additional funds shall be used for a new grant competition to
school districts with poverty rates of 15 percent or more, to
help the highest-need elementary schools within such districts
establish foreign language instruction programs.
Funds from this program support competitive grants to
increase the quality and quantity of foreign language
instruction. At least 75 percent of the appropriation must be
used to expand foreign language education in the elementary
grades. The Committee has included bill language that prohibits
Foreign Language Assistance program funds from being be used
for the Foreign Language Incentive program.
The Committee is concerned that this program, which is the
only Federal program designed to help schools meet the need for
foreign language instruction, is unavailable to the poorest
schools because grant recipients must provide a 50 percent
match from non-Federal sources. The Committee, therefore,
strongly urges the Secretary to use her ability to waive the
matching requirement for qualifying schools and to increase
awareness of this accommodation among the affected school
population. The Committee also believes that the sustainability
preference established in the authorizing legislation should
not prohibit the highest-need applicants from receiving one or
more grants under this program or from being eligible to have
the matching requirement waived during their initial or
subsequent grants.
Education for Homeless Children and Youth
For carrying out education activities authorized by Title
VII, subtitle B of the Stewart B. McKinney Homeless Assistance
Act, the Committee recommends $62,496,000. The comparable
fiscal year 2005 funding level and the budget request both are
$62,496,000.
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 make subgrants to LEAs to support the
education of those children. Grants are made to States based on
the total that each State receives in Title I grants to LEAs.
Under the McKinney-Vento Homeless Children and Youths
Program, State educational agencies [SEAs] must ensure that
homeless children and youth have equal access to the same free
public education, including a public preschool education, as is
provided to other children and youth. States must review and
undertake steps to revise any laws, regulations, practices, or
policies that may act as barriers to the enrollment,
attendance, or success in school of homeless children and
youth.
Training and Advisory Services
For training and advisory services authorized by Title IV
of the Civil Rights Act, the Committee recommends $7,185,000.
The comparable fiscal year 2005 funding level and the budget
request both are $7,185,000 for these services.
The funds provided will support awards to operate the 10
regional equity assistance centers [EACs]. 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.
Education for Native Hawaiians
For programs for the education of Native Hawaiians, the
Committee recommends $34,500,000. The comparable fiscal year
2005 funding level is $34,224,000 and the budget request is
$32,624,000 for these programs.
The Committee bill includes language allowing $1,250,000 of
the funds recommended to be used for construction and
renovation of Native Hawaiian educational facilities.
Education for Native Hawaiians.--The Committee recognizes
the Department's continuing support in working with the Native
Hawaiian Education Council as a vehicle for assessing,
evaluating, and coordinating all education programs for Native
Hawaiians. The Committee urges the Secretary to work with the
Executive Director of the Council to ensure adequate funds are
set aside to perform the tasks assigned to the Council in title
VII of the No Child Left Behind Act. In addition, the Committee
requests that the Department provide the Council with the
grantee reports on a timely basis to allow the Council to fully
undertake the assessment, evaluation and issuance of
recommendations, as required by law.
Native Hawaiian Law Center of Excellence.--The Committee
commends the Department's support in establishing a Center of
Excellence in Native Hawaiian Law at the University of Hawaii.
This Center will provide a forum for the examination and
preservation of law with respect to the Native Hawaiian culture
and spirit. The Committee bill includes language stipulating
that $1,250,000 shall be used for a grant to the Center of
Excellence at the University of Hawaii School of Law.
Alaska Native Educational Equity
The Committee recommends $34,500,000 for the Alaska Native
educational equity assistance program. The comparable fiscal
year 2005 funding level is $34,224,000 and the budget request
includes $31,224,000 for this purpose.
These funds address the severe educational handicaps of
Alaska Native schoolchildren. Funds are used for the
development of supplemental educational programs to benefit
Alaska Natives. The Committee bill includes language which
allows funding provided by this program to be used for
construction. The Committee expects the Department to use some
of these funds to address the construction needs of rural
schools.
Rural Education
The Committee recommends $170,624,000 for rural education
programs, the same as both the comparable fiscal year 2005
funding level and the budget request.
The Committee strongly supports the continued use of
Federal funding specifically for rural education. Rural schools
face difficult challenges in meeting the mandates in the No
Child Left Behind Act, particularly in the areas of attracting
highly qualified teachers and adapting to new assessment
requirements and reporting expectations. The rural education
programs are intended to help level the playing field for small
and high-poverty rural school systems that typically receive
less Federal formula funding than their urban and suburban
counterparts, and are frequently unable to compete for
competitive grants. In addition to providing more total funding
for such districts, the program also allows these districts to
combine funds from four categorical programs and use the money
to address their highest priorities, such as recruiting
teachers, purchasing technology, or upgrading curricula.
The Committee expects that rural education funding will be
equally divided between the Small, Rural Schools Achievement
Program, which provides funds to LEAs that serve a small number
of students, and the Rural and Low-Income Schools Program,
which provides funds to LEAs that serve concentrations of poor
students, regardless of the number of students served.
Comprehensive Centers
The Committee recommends $56,825,000 for the comprehensive
centers program, the same as both the comparable fiscal year
2005 funding level and the budget request.
These funds will provide continued support to 10-20
comprehensive centers expected to be established before
September 2005. At least one center will operate in each of the
10 regions of the United States. The centers, which would be
operated by research organizations, agencies, institutions of
higher education or partnerships thereof, would provide
training and technical assistance on various issues to States,
LEAs, and schools as identified through needs assessments
undertaken in each region. Grantees will develop 5-year plans
for undertaking authorized activities that address the needs of
States in a region and develop an advisory board to advise the
center on allocation of resources, maintaining a high standard
of quality in services delivery and ensuring that activities
promote progress toward improving student achievement. The
National Center for Education Evaluation and Regional
Assistance will provide for ongoing independent evaluation of
each center to assess whether each is meeting its objectives.
Indian Education
Appropriations, 2005.................................... $119,889,000
Budget estimate, 2006................................... 119,889,000
House allowance......................................... 119,889,000
Committee recommendation................................ 119,889,000
The Committee recommends $119,889,000 for Indian Education
programs. The comparable fiscal year 2005 funding level and the
budget request both are $119,889,000 for such activities.
Grants to Local Education Agencies
For grants to local education agencies, the Committee
recommends $96,294,000. The comparable fiscal year 2005 funding
level is $95,165,000 and the budget request includes
$96,294,000 for authorized activities.
These funds provide financial support to elementary and
secondary school programs that serve Indian students, including
preschool children. Funds are awarded on a formula basis to
local educational agencies, schools supported and operated by
the Bureau of Indian Affairs, and in some cases directly to
Indian Tribes.
Special Programs for Indian Children
The Committee recommends $19,595,000 for special programs
for Indian children, the same as the comparable fiscal year
2005 funding level and the budget request.
Funds are used for demonstration grants to improve Indian
student achievement through early childhood education and
college preparation programs, and for professional development
grants for training Indians who are preparing to begin careers
in teaching and school administration.
National Activities
The Committee recommends $4,000,000 for national
activities. The comparable fiscal year 2005 amount is
$5,129,000 and the budget request is $4,000,000 for authorized
activities. Funds will be used to expand efforts to improve
research, evaluation, and data collection on the status and
effectiveness of Indian education programs.
Innovation and Improvement
Appropriations, 2005.................................... $1,092,642,000
Budget estimate, 2006................................... 1,307,871,000
House allowance......................................... 708,522,000
Committee recommendation................................ 1,057,385,000
The Committee recommends an appropriation of $1,057,385,000
for programs within the innovation and improvement account. The
comparable fiscal year 2005 funding level for these programs is
$1,092,642,000 and the budget request includes $1,307,871,000
for this account.
Troops-to-Teachers
The Committee recommends an appropriation of $14,793,000
for the Troops-to-Teachers program, the same as both the
comparable funding level for fiscal year 2005 and the budget
request.
This program supports the Defense Department's Troops to
Teachers program, which helps recruit and prepare retiring and
former military personnel to become highly qualified teachers
serving in high-poverty school districts. The Secretary of
Education transfers program funds to the Department of Defense
for the Defense Activity for Non-Traditional Education Support
to provide assistance, including stipends of up to $5,000 and
bonuses of up to $10,000, to eligible members of the Armed
Forces so that they can obtain teacher certification or
licensing. In addition, the program helps these individuals
find employment in a school.
The Committee notes that the GAO and Department are
required to report to Congress on the effectiveness of this
program in placing highly-qualified teachers in high-need
districts. The Committee looks forward to receiving a copy of
the report and urges the Department to utilize the findings in
implementing this program.
Transition to Teaching
The Committee recommends $44,933,000 for the transition to
teaching program, the same as both the comparable fiscal year
2005 funding level and the budget request.
This program provides grants to help support efforts to
recruit, train, and place nontraditional teaching candidates
into teaching positions and to support them during their first
years in the classroom. In particular, this program is intended
to attract mid-career professionals and recent college
graduates. Program participants are placed in high-need schools
in high-need LEAs.
The Committee encourages the Department to continue to work
with grantees to ensure that appropriated funds are used
effectively to recruit highly qualified teachers to and retain
them in employment in high need schools. The Committee looks
forward to receiving more performance outcome information
regarding this program, and, in particular, the results of the
ongoing evaluation of grantee progress toward their goals and
objectives.
National Writing Project
The Committee recommends $23,000,000 for the National
Writing Project. The comparable funding level for fiscal year
2005 is $20,336,000 and the budget request proposes to
eliminate Federal funding for this program.
These funds are awarded to the National Writing Project, a
nonprofit organization that supports and promotes K-16 teacher
training programs in the effective teaching of writing. From
the funds provided by the fiscal year 2006 appropriation, the
Committee intends that $500,000 shall be used to continue
support for the pilot program on the integration of technology
training in the NWP program.
Teaching of Traditional American History
The Committee recommends $121,000,000 for the teaching of
traditional American history program. The comparable fiscal
year 2005 funding level is $119,040,000 and the budget request
is $119,040,000 for this activity. This program supports
competitive grants to LEAs, and funds may be used only to
undertake activities that are related to American history, and
cannot be used for social studies coursework. 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 Committee
directs the Department to continue its current policy of
awarding 3-year grants.
The budget request includes bill language that would allow
the Department to reserve up to 3 percent of funds appropriated
for this program for national activities. The Committee bill
includes the requested language. The Committee requests that
the Department prepare and submit an operating plan to the
House and Senate Committees on Appropriations, within 30 days
of enactment of this Act, on how these reserved funds will be
used to support the intent of this program.
School Leadership
The Committee recommends $15,000,000 for the school
leadership program. The comparable fiscal year 2005 funding
level is $14,880,000 and the budget request proposes to
eliminate funding for this program. This program provides
competitive grants to assist high-need LEAs to recruit and
train principals and assistant principals through activities
such as professional development and training programs. The
Committee continues to recognize the critical role that
principals and assistant principals play in creating an
environment that fosters effective teaching and high academic
achievement for students.
Advanced Credentialing
The Committee recommends $10,000,000 for the advanced
credentialing program. The comparable fiscal year 2005 funding
level is $16,864,000 and the budget request includes $8,000,000
for one component of the authorized program.
The Committee recommendation includes $10,000,000 for the
National Board for Professional Teaching Standards [NBPTS]. The
comparable fiscal year 2005 funding level is $9,920,000 and the
budget request proposes to eliminate funding for the National
Board. Funds available assist the Board's work in providing
financial support to States for teachers applying for
certification, increasing the number of minority teachers
seeking certification and developing outreach programs about
the advanced certification program. The fiscal year 2006
appropriation will support continuation of an award to the
National Board for Professional Teaching Standards.
The Committee continues its strong support of the National
Board for Professional Teaching Standards, based on the
significant body of rigorous research that has demonstrated the
benefits to students from being taught by a Board-certified
educator. The Committee notes that the National Board has
developed standards that describe the knowledge and skills
characterizing effective teaching in 24 different areas,
including school counseling. The accomplished educators who
achieve certification in these standards do so by demonstrating
their understanding through actual teaching, as well as through
a written exam and teaching portfolio. The Committee believes
that these activities are consistent with the mission of the
National Board, which is to advance the quality of teaching and
learning in the United States.
Charter Schools Grants
The Committee recommends $216,952,000 for the support of
charter schools. The comparable fiscal year 2005 funding level
is $216,952,000 and the budget request is $218,702,000 for this
program.
This program supports the planning, development, and
initial implementation of charter schools, which are public
schools that receive exemption from many statutory and
regulatory requirements in exchange for promising to meet
agreed-upon accountability measures. State educational agencies
that have the authority under State law to approve charter
schools are eligible to compete for grants. If an eligible SEA
does not participate, charter schools from the State may apply
directly to the Secretary. The authorizing statute requires
that amounts appropriated in excess of $200,000,000 and less
than $300,000,000 be used for 5-year competitive grants to
States that operate per-pupil facilities aid programs for
charters schools. Federal funds are used to match State funded
programs in order to provide charter schools with additional
resources for charter school facilities financing. At the
Committee recommendation, almost $17,000,000 will be available
to continue support for per-pupil facilities aid grants.
The Committee notes that the Department plans to use
$8,000,000 in appropriated funds for national activities, which
may include support for a rigorous evaluation of charter
schools and the expansion of State capacity to administer their
charter schools. The Committee encourages the Department to
support such efforts and requests that additional information
on these activities be included in the fiscal year 2007
congressional budget justification.
Credit Enhancement for Charter School Facilities
The Committee does not recommend additional for this
program. The comparable funding level for fiscal year 2005 and
the budget request both are $36,981,000 for this purpose. The
Committee notes that the authorization for this program expired
in fiscal year 2005, and due to limited resources, does not
fund this unauthorized activity. The budget request includes
bill language that would continue to authorize this activity in
fiscal year 2006.
This program provides assistance to help charter schools
meet their facility needs. Funds are provided on a competitive
basis to public and non-profit entitities, to leverage non-
Federal funds that help charter schools obtain school
facilities through purchase, lease, renovation and
construction.
Voluntary Public School Choice
The Committee recommends $26,543,000 for the voluntary
public school choice program, the same as both the comparable
funding level for fiscal year 2005 and the budget request.
This program supports efforts by States and school
districts to establish or expand State- or district-wide public
school choice programs, especially for parents whose children
attend low-performing public schools.
Magnet Schools Assistance
The Committee recommends $107,771,000 for the magnet
schools assistance program, the same as both the comparable
fiscal year 2005 funding level and the budget request.
This program supports grants to local educational agencies
to establish and operate magnet schools that are part of a
court-ordered or federally approved voluntary desegregation
plan. Magnet schools are designed to attract substantial
numbers of students from different social, economic, ethnic,
and racial backgrounds. Grantees may use funds for planning and
promotional materials, teacher salaries, purchase of computers,
and other educational materials and equipment.
Choice Incentive Fund
The Committee does not recommend any funding for this
proposed program, which is not specifically authorized. The
budget request includes $50,000,000 for this purpose. Through
this proposed program, funds would be used to award competitive
grants to establish or expand public or private school choice
opportunities.
Fund for the Improvement of Education
The Committee recommends an appropriation of $417,924,000
for the Fund for the Improvement of Education [FIE]. The
comparable funding level for fiscal year 2005 is $414,078,000
and the budget request includes $106,296,000 for comparable
activities.
The Committee recommendation includes $700,000 for the
National Institute of Building Sciences to continue operation
of the National Clearinghouse for Educational Facilities, the
Nation's sole source for comprehensive information about school
planning, design, financing, construction and maintenance. The
Committee recommends an additional $300,000 for this purpose
within Safe and Drug-Free Schools and Communities National
Programs to address issues related to school safety and healthy
school buildings.
The Committee recommends $25,296,000 to award a contract to
Reading Is Fundamental, Inc. [RIF] to provide reading-
motivation activities. The comparable funding level for fiscal
year 2005 and the budget request both are $25,296,000 for this
purpose. RIF, a private nonprofit organization, helps prepare
young children and motivate older children to read, through
activities including the distribution of books. Federal funds
provide up to 75 percent of the costs of books, except for
migrant and seasonal farmworker programs which may receive up
to 100 percent of the costs of books.
The administration proposes $40,000,000 for a new adjunct
teacher corps initiative. Through this new categorical grant
program, the Department of Education would make competitive
grants to partnerships of school districts and public and
private institutions to create opportunities for professionals
to teach secondary-school courses in the core academic
subjects, particularly math and science. Due to budget
constraints, the Committee recommendation does not include
funds for this purpose.
The Committee recommendation does not include any funds for
State scholars capacity building. The comparable funding level
for fiscal year 2005 is $2,500,000 and the budget request
includes $12,000,000 for this program. This program supports
State-level business and education partnerships that encourage
high school students to complete a rigorous curriculum in core
academic subjects.
The administration recommended eliminating funding for
activities listed below.
The Committee recommends $21,000,000 for the Star Schools
program. The comparable funding level for fiscal year 2005 is
$20,832,000. The Star Schools program is designed to improve
instruction in math, science, foreign languages, and other
areas such as vocational education, to underserved populations
by means of telecommunications technologies.
The Committee recommends $11,000,000 for the Ready to Teach
program. The comparable funding level for fiscal year 2005 is
$14,291,000. Ready to Teach is the successor to the Public
Broadcasting Service's Mathline program, which was one of the
first to provide online professional development and continuing
education for teachers. Ready to Teach was reauthorized by the
No Child Left Behind Act of 2001 and continues to evolve to
enhance teacher quality and meet the goals of that Act. Ready
to Teach encompasses funding for PBS TeacherLine and one or
more nonprofit entities, for the purpose of continuing to
develop telecommunications-based programs to improve teacher
quality in core areas. It also includes digital educational
programming grants, which encourages community partnerships
among local public television stations, State and local
educational agencies, and other institutions to develop and
distribute digital instructional content based on State and
local standards.
The Committee recommendation includes $10,000,000 for the
Education through Cultural and Historical Organizations [ECHO]
Act of 2001, as authorized by the No Child Left Behind Act. The
comparable funding level for fiscal year 2005 is $8,631,000 and
the budget request did not include any funds for this purpose.
Programs authorized under ECHO provide a broad range of
educational, cultural, and job training opportunities for
students from communities across the Nation, including Alaska,
Hawaii and Massachusetts. Funds also are available to support a
range of services to the Mississippi Band of Choctaw Indians.
The Committee has included $35,700,000 for arts in
education. The comparable funding level for fiscal year 2005 is
$35,633,000. Within the total, $6,369,000 is for the John F.
Kennedy Center for the Performing Arts; $7,440,000 is for VSA
arts; $13,455,000 is for the competitive art education model
grant program for the development of model projects that
effectively strengthen and integrate arts and cultural
partnerships into the core curriculum; $7,936,000 is for grants
for professional development for music, dance, drama, and
visual arts educators to be administered by the U.S. Department
of Education; $500,000 is to continue the evaluation and
national dissemination of information regarding model programs
and professional development projects funded through the Arts
in Education section, including dissemination promising
practices from funded projects and technical assistance for
self-evaluation.
The Committee recommends $42,000,000 for Parental
Information and Resource Centers, which provide training,
information, and support to parents, State and local education
agencies, and other organizations that carry out parent
education and family involvement programs. The comparable
funding level for fiscal year 2005 is $41,886,000. The
Committee notes that research overwhelmingly demonstrates that
parent involvement in children's learning is positively related
to student achievement.
The Committee also notes that the No Child Left Behind Act
requires grantees to use at least 30 percent of their awards to
establish, expand, or operate Parents as Teachers, Home
Instruction Program for Preschool Youngsters, or other early
childhood parent education programs.
The Committee recommends $5,000,000 to continue support for
the Mental Health Integration in School program. The comparable
funding level for fiscal year 2005 is $4,960,000. This program
supports grants to or contracts with State educational
agencies, local educational agencies or Indian tribes to
increases student access to mental health care by linking
schools with their local mental health systems. The Committee
expects this program to continue to be carried out by the
Office of Safe and Drug-Free Schools.
The Committee includes $3,000,000 for the women's
educational equity program. The comparable funding level for
fiscal year 2005 is $2,956,000. This program supports projects
that assist in the local implementation of gender equity
policies and practices.
The Committee recommendation includes $1,500,000 for
activities authorized by the Excellence in Economics Education
Act. The comparable fiscal year 2005 funding is $1,488,000.
These funds will support a grant to a non profit educational
organization to promote economic and financial literacy among
kindergarten through 12th grade students.
The Committee is pleased that, according to a nationwide
survey of more than 4,000 high school seniors conducted by the
Jump$tart Coalition, the level of financial literacy among 12th
grade students has increased. However, with an average score of
just 52.3 percent on the national exam, there is still much
room for improvement. The Committee urges the Department to
continue funding programs that improve the money management
skills of young people through the inclusion of financial
literacy materials, standards and assessments in high school
math, economics and business courses.
The Committee recommendation includes $10,000,000 to carry
out the American History and Civics Education Act of 2004. From
the amount available, $5,000,000 shall be used to establish
Presidential Academies for Teaching of American History and
Civics. These Presidential Academies will strengthen the
knowledge and teaching capacity of K-12 teachers of American
history and civics. The remaining $5,000,000 will support the
establishment of Congressional Academies for Students of
American History and Civics. These Congressional Academies will
help outstanding students of American history and civics
develop a broader and deeper understanding of these subject
matters.
The Committee expects funds to be awarded on a competitive
basis to institutions of higher education, non-profit
educational institutions, and consortia thereof, to establish
and operate such Academies. The Committee further intends grant
awards to last for a period of 2 years. The Committee urges the
Secretary to give considerable weight to sustainability plans,
which shall be required of applicants to show how they plan to
sustain their project after their grant expires, when
considering awards under this program.
The Committee recommendation also includes resources for
the following activities: teacher quality initiatives;
evaluation and data quality initiatives designed to improve the
quality of data collected from, and evaluations conducted by,
grantees under elementary and secondary education programs;
Reach Out and Read; and peer review.
Teacher Incentive Fund
The Committee recommendation does not include any funds for
this new program. The budget request includes $500,000,000 for
this new activity.
Under the budget request, $450,000,000 would be available
for formula grants to States for monetary awards to teachers
who raise student achievement or reduce the achievement gap,
and to ``highly qualified'' teachers who teach in high-need
schools. Under the proposed program, States would be required
to spend at least 25 percent of their funds for each of these
two activities. The remaining $50,000,000 proposed in the
budget request would be available for competitive grants from
the U.S. Department of Education to partnerships of State
educational agencies, local educational agencies and non-profit
organizations for the development and implementation of
performance-based teacher compensation systems in States and
school districts.
The budget request includes bill language that would
authorize this new program. However, the Committee notes that
this program was not specifically authorized under the No Child
Left Behind Act, so it is not included in the Committee bill.
Ready to Learn Television
The Committee recommends an appropriation of $25,000,000
for the Ready to Learn Television program. The comparable
funding level for fiscal year 2005 and the budget request both
are $23,312,000 for this purpose.
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. The program also supports
the development, production, and dissemination of educational
materials designed to help parents, children, and caregivers
obtain the maximum advantage from educational programming.
The original objective of RTL was to place educational
programming within the reach of every American child,
especially those in culturally disadvantaged households or
communities.
The Committee commends the research collaboration of WGBH
Between the Lions, Sesame Workshop, and the National Center for
Rural Early Childhood Education regarding Ready to Learn
television shows and outreach programming. This new research
for the first time shows the unique learning that occurs in
rural areas and how they can be best addressed with
technologically accessible enhancing programming coupled with
regular public broadcasting of a variety of RTL television
shows.
The Committee notes that awards have yet to be made with
fiscal year 2005 funds available for this program. The
Committee understands that the competition placed a priority on
reading programming, but does not intend to restrict program
content to that subject only. The Committee appreciates the
Department's commitment to creating high-quality learning
environments for children through this program and intends that
funds provided in last year's bill and this Act will support
the Department's broad view of the educational value of this
program. While successful reading is clearly an important
foundation that will allow children to achieve at grade level
in future years, it is not the only factor that will help them
reach that goal.
The Committee appreciates and continues to support the
community outreach efforts that support programming developed
and delivered through the Ready to Learn partnership during
prior funding cycles. While not all of the local outreach
activities achieved their goal of adequately supporting Ready
to Learn programming, many leveraged significant local
resources, fostered broad community collaboration with a small
amount of Federal funding, and led to more frequent and longer
periods of reading and other learning activities by those
adults who attended local training workshops. The Committee
notes that this small investment in local community outreach
greatly extended the scope and educational value of this
program, not only through the services offered to parents but
also because of the incentive that it created for local
stations to air Ready to Learn programming. The Committee
believes this framework should continue to be supported and
strongly urges the Department to utilize funds appropriated in
fiscal year 2005 and continued in fiscal year 2006 for this
purpose.
Dropout Prevention
The Committee does not recommend additional funds for the
dropout prevention program. The comparable funding level for
fiscal year 2005 is $4,930,000 and the budget request did not
include any funding for the dropout prevention program. These
funds are used to help schools implement effective school
dropout prevention and re-entry programs.
In addition, the Committee notes that in fiscal year 2005,
States reserved more than $105,000,000 from their Title I, Part
A allocations to operate State-administered projects in LEAs
with the highest dropout rates and in areas serving a large
number of children in local correctional facilities, as is
required by law.
Close Up Fellowships
The Committee recommendation includes $1,469,000 for Close
Up Fellowships. The comparable funding level for fiscal year
2005 is $1,469,000 and the budget request did not include any
funds for this purpose. The Close Up Fellowships, formerly
called Ellender Fellowships, which is administered by the Close
Up Foundation of Washington, DC, provides fellowships to
students from low-income families and their teachers to enable
them to spend 1 week in Washington attending seminars and
meeting with representatives of the three branches of the
Federal Government.
The Committee notes that the Close Up Foundation, in
collaboration with the Secretary of Education, is required to
develop and implement procedures for measuring the efficacy of
the Foundation's authorized programs, including the extent to
which the programs are providing young people with an increased
understanding of the Federal Government; heightening a sense of
civic responsibility among young people; and enhancing the
skills of educators in teaching young people about civic
responsibility, the Federal Government, and attaining
citizenship competencies. The Committee requests a more
complete discussion of the actions taken to meet this statutory
requirement, as well as program performance information, in the
fiscal year 2007 Congressional Budget Justification.
Advanced Placement Program
The Committee recommends $33,000,000 for Advanced
Placement. The comparable funding level for fiscal year 2005 is
$29,760,000 and the budget request includes $51,500,000 for the
Advanced Placement program.
The first priority of the program is to subsidize test fees
for low-income students who are enrolled in an Advanced
Placement class and plan to take an Advanced Placement test.
The balance of the funds are allocated for Advanced Placement
Incentive Program grants, which are used to expand access for
low-income individuals to Advanced Placement programs. Eligible
activities include teacher training and participation in online
Advanced Placement courses, among other related purposes.
Safe Schools and Citizenship Education
Appropriations, 2005.................................... $833,987,000
Budget estimate, 2006................................... 396,767,000
House allowance......................................... 763,870,000
Committee recommendation................................ 697,300,000
Safe and Drug-Free Schools and Communities
The Committee recommends a total of $697,300,000 for
activities to promote Safe Schools and Citizenship Education.
The comparable fiscal year 2005 funding level is $833,987,000
and the budget request includes $396,767,000 for these
activities.
State Grant Program.--The Committee recommends $300,000,000
for the safe and drug-free schools and communities State grant
program. The comparable fiscal year 2005 funding level is
$437,381,000 and the budget request did not include any funds
for this purpose. The State grant program is the backbone of
youth drug prevention efforts in the United States. This
formula-based State grant program provides resources to
Governors, State educational agencies and local educational
agencies for developing and implementing activities that help
create and maintain safe and drug-free learning environments in
and around schools.
National Programs.--The Committee has included $150,000,000
for the national programs portion of the safe and drug-free
schools and communities program. The comparable funding level
for fiscal year 2005 is $152,537,000 and the budget request
includes $267,967,000 for these programs. The Committee does
not recommend additional funding for Project SERV (School
Emergency Response to Violence), which provides education-
related services to LEAs in which the learning environment has
been disrupted due to a violent or traumatic crisis. The budget
request includes $5,000,000 for Project SERV. However, the
Committee notes that the Department currently has roughly
$8,000,000 available for this purpose. These funds are
available until expended. The Committee will monitor the
availability of funding and consider action in subsequent
appropriations bills.
The Committee continues to be concerned about the
increasing problem of alcohol and drug abuse on college
campuses. The Committee has included bill language requiring
the Department to spend $850,000 on a program under the
guidelines in section 120(f) of Public Law 105-244. This
program identifies and provides models of alcohol and drug
abuse prevention and education programs in higher education.
The Committee includes these funds within the requested
$10,000,000 for post-secondary alcohol prevention efforts
proposed in the budget request.
The Committee expects that the Department will provide
$300,000 for the continued operation of the National
Clearinghouse for Educational Facilities. These funds will be
used to address issues related to school safety and healthy
school buildings. The Committee has included additional funds
for the Clearinghouse through the Fund for the Improvement of
Education.
The Committee recommendation does not include $87,500,000
as requested by the Department for a new grant program for
local educational agencies. This program was proposed to
replace the State grant program, a proposal rejected by the
Commmittee.
The Committee recommendation includes $30,000,000 to
continue the school safety initiative. The budget request
includes $30,000,000 to support grants and technical assistance
to elementary and secondary schools for responding to emergency
response challenges identified in the Department of Homeland
Security's Critical Infrastructure plan. The Committee notes
that not all districts in need of planning funds previously
provided have received them, so the Department is encouraged to
consider running an additional planning grant competition to
ensure that the most at-risk districts receive planning grants
before moving to this next phase. The Committee expects to
receive a letter report on the plan for fiscal year 2006 funds,
prior to the announcement of the next grant competition under
this program.
The Committee recommendation includes $7,492,000 for
school-based drug testing programs for students. The comparable
fiscal year 2005 funding level is $9,920,000 and the budget
request includes $25,000,000. The Committee expects that this
funding will be used to continue and evaluate current drug
testing grants.
The Committee recommendation also includes $9,372,000 to
continue data management improvement grants and related
technical assistance; $82,336,000 for safe schools healthy
students; $2,000,000 for the required impact evaluation;
$2,000,000 for information and materials; $2,000,000 for data
collection and analysis; $1,500,000 for other joint project
with Federal agencies; and $3,000,000 for other program
improvement activities.
Research studies have found that mental health greatly
affects academic achievement and educational outcomes. The
Committee recognizes the negative impact that depression,
anxiety, substance abuse, and other mental disorders can have
on a youth's academic performance and urges the Office of Safe
and Drug Free Schools to join the Substance Abuse and Mental
Health Services Administration, the Centers for Disease
Control, and other Federal agency efforts to take concrete
steps to improve the mental health of America's youth through
the early identification of mental health problems, including
the use of voluntary, evidence-based mental health screening of
adolescents. The Committee urges the Department to continue to
promote school-wide mental health strategies, provide training
to school personnel to recognize early warning signs of mental
illness, and increase access to high-quality mental health
services. In addition, the Department is encouraged to include
an evaluation component to determine the most effective
programs and practices for the early identification of youth
mental illness.
Alcohol Abuse Reduction
The Committee recommends $33,500,000 for grants to LEAs to
develop and implement programs to reduce underage drinking in
secondary schools. The comparable funding level for fiscal year
2005 is $32,736,000 and the budget request did not include any
funds for this purpose. The Committee directs the Department
and the Substance Abuse and Mental Health Services
Administration [SAMHSA] in the Department of Health and Human
Services to work together on this effort.
Mentoring
The Committee recommends $49,307,000 to support mentoring
programs and activities for children who are at risk of failing
academically, dropping out of school, getting involved in
criminal or delinquent activities, or who lack strong positive
role models. The comparable fiscal year 2005 funding level and
the budget request both are $49,307,000 for this purpose.
Character Education
The Committee recommends $24,493,000 to provide support for
the design and implementation of character education programs.
The comparable funding level for fiscal year 2005 and the
budget request both are $24,493,000 for this purpose.
Elementary and Secondary School Counseling
The Committee recommends $36,000,000 to establish or expand
counseling programs in elementary schools. The comparable
fiscal year 2005 funding level is $34,720,000 and the
President's budget proposes to eliminate funding for this
program. As authorized by the No Child Left Behind Act, all
amounts appropriated up to $40,000,000 are used only for
elementary school counseling programs.
Carol M. White Physical Education for Progress Program
The Committee recommends $74,000,000 to help LEAs and
community-based organizations initiate, expand and improve
physical education programs for students in grades K-12, as
authorized by Public Law 107-110. The comparable funding level
for fiscal year 2005 is $73,408,000 and the budget request
includes $55,000,000 for this program. Provision of this
funding will help schools and communities nationwide improve
their structured physical education programs for students and
help children develop healthy lifestyles to combat the epidemic
of obesity in the Nation. The Committee does not agree with the
administration's proposal to phase-out and eventually eliminate
funding for this program.
The Committee notes that in the past 15 years, obesity has
increased by over 50 percent among adults and in the past 20
years, obesity has increased by 100 percent among children and
adolescents. The National Institute of Child Health and Human
Development [NICHD] Study of Early Child Care and Youth
Development found that third grade children in the study
received an average of 25 minutes per week in school of
moderate to vigorous activity, while experts in the United
States have recommended that young people should participate in
physical activity of at least moderate intensity for 30 to 60
minutes each day. While not nationally represented, this
information is consistent with the 2002 Youth Risk Behavior
Surveillance System which found that only roughly one-half of
all students report attending a physical education class one or
more times a week. The Committee believes Federal funding is
critical to the effort to reducing these trends and helping
improve the health of the American public.
Civic Education
The Committee recommends $30,000,000 for grants to improve
the quality of civics and government education, to foster civic
competence and responsibility, and to improve the quality of
civic and economic education through exchange programs with
emerging democracies. The comparable fiscal year 2005 funding
level is $29,405,000 and the budget request proposed to
eliminate funding for this purpose.
Civic Education program funds support both the We the
People programs and the Cooperative Education Exchange. The
Committee recommends $17,560,000 for the nonprofit Center for
Civic Education to support the We the People programs. We the
People has two primary components: the Citizen and the
Constitution program, which provides teacher training,
curriculum materials, and classroom instruction for upper
elementary, middle, and high school students; and Project
Citizen, a program for middle school students that focuses on
the role of State and local governments in the American Federal
system.
Within the amount for the We the People program, the
Committee recommends the following: that $3,087,000 be reserved
to continue the comprehensive program to improve public
knowledge, understanding, and support of American democratic
institutions which is a cooperative project among the Center
for Civic Education, the Center on Congress at Indiana
University, and the Trust for Representative Democracy at the
National Conference of State Legislatures; and that $1,543,000
be used for continuation and expansion of the school violence
prevention demonstration program including the Native American
program.
The Committee recommends $12,440,000 for the Cooperative
Education Exchange program. Within this amount, the Committee
has included $4,665,000 for the Center for Civic Education and
$4,665,000 for the National Council on Economic Education. The
remaining $3,110,000 should be used for a competitive grant
program for civics and government education, and for economic
education.
English Language Acquisition
Appropriations, 2005.................................... $675,765,000
Budget estimate, 2006................................... 675,765,000
House allowance......................................... 675,765,000
Committee recommendation................................ 675,765,000
The Committee recommends an appropriation of $675,765,000
for English language acquisition. The comparable funding level
for fiscal year 2005 and the budget request both are
$675,765,000 for authorized activities.
The Department makes formula grants to States based on each
State's share of the Nation's limited-English-proficient and
recent immigrant student population. The program is designed to
increase the capacity of States and school districts to address
the needs of these students. The No Child Left Behind Act also
requires that 6.5 percent of the appropriation, an amount equal
to $43,925,000 at the Committee recommendation funding level,
be used to support national activities, which include
professional development activities designed to increase the
number of highly qualified teachers serving limited English
proficient students; a National Clearinghouse for English
Language Acquisition and Language Instructional Programs; and
evaluation activities. The budget request includes language
that would allow national activities funds to be available for
2 years. The Committee bill includes the requested language.
At the level of the Committee recommendation, the State
grant portion of this account will increase by more than
$44,000,000, as funding for expiring projects under the prior
law are redirected to the State grant program. These additional
funds will help States improve the educational outcomes for
limited English proficient students.
Special Education
Appropriations, 2005.................................... $11,673,606,000
Budget estimate, 2006................................... 12,126,130,000
House allowance......................................... 11,813,783,000
Committee recommendation................................ 11,774,107,000
The Committee recommends $11,774,107,000 for special
education programs authorized by the Individuals with
Disabilities Education Act [IDEA]. The comparable fiscal year
2005 funding level is $11,673,606,000 and the budget request
includes $12,126,130,000 for such programs.
Office of Special Education and Rehabilitative Services [OSERS]
No Child Left Behind [NCLB].--The Committee notes that the
Department recently announced changes in NCLB policy regarding
students with disabilities who have shown academic
difficulties. The Department estimates that 2 percent of
students with academic disabilities can make progress toward
grade-level standards when they receive high-quality
instruction and when their assessments are based on modified
academic achievement standards assessments. The Committee is
concerned that States do not yet have the tools and resources
to appropriately implement the new policy in the 2005-2006
school year. To help States prepare for future implementation
based on the promulgation of final regulations, the Committee
strongly urges OSERS to provide support guidance to States, and
LEAs, and parents that will define how students are identified
for this category and ensure that eligible students have every
possible opportunity for full and consistent participation in
the general education curriculum and be on track to graduate
with a regular diploma.
Office of Special Education Programs [OSEP]
Specific Learning Disabilities [SLD].--The Committee urges
OSEP to ensure that the National Research Center on Learning
Disabilities [NRCLD] continues to conduct and synthesize
research on how to best implement and take to scale
identification methods that rely on students' responses to
scientific research-based instruction. OSEP, through the NRCLD,
should assist States and LEAs in identifying the criteria for
determining an SLD and ensuring the consistency and integrity
of the classification system across the States, and provide
guidance and technical assistance systems for the improvement
of SLD identification and eligibility. The NRCLD should
disseminate to and assist both States and LEAs with replicable
models that produce measurable positive improvements in student
learning. The NRCLD should coordinate with the PTIs, the
National Dissemination Center for Children with Disabilities
and other national partners to disseminate information about
accurate identification of SLDs to parents. The Committee
encourages OSEP to coordinate efforts within the Department of
Education, NIH, NSF and other Federal agencies working on
related activities.
No Child Left Behind [NCLB] and the Individuals with
Disabilities Education Improvement Act of 2004.--The Committee
urges OSEP to educate parents of students with learning
disabilities with the critical information they need to
understand the impact of decisions made by the IEP team
regarding assessments required by NCLB, school choice,
supplemental education services, and other provisions of NCLB.
Grants to States
The Committee recommends $10,689,746,000 for special
education grants to States, as authorized under part B of the
IDEA. The comparable fiscal year 2005 funding level is
$10,589,746,000 and the budget request includes
$11,097,746,000. This program provides formula grants to assist
States, Outlying Areas, and other entities in meeting the costs
of providing special education and related services for
children with disabilities. States pass along most of these
funds to local educational agencies, but may reserve some for
program monitoring, enforcement, technical assistance and other
activities.
The appropriation for this program primarily supports
activities associated with the 2006-2007 academic year. Of the
funds available for this program, $5,265,546,000 will become
available on July 1, 2006 and $5,424,200,000 will become
available on October 1, 2006. These funds will remain available
for obligation until September 30, 2007.
The reauthorization established a new activity under this
program, which allows funds to be used by the Secretary for
grants to and contracts with States that improve their capacity
to collect data required under the Act. The reauthorization
also established a separate program for IDEA studies and
evaluations, which is now funded as a separate program under
the Institute of Education Sciences. Studies and evaluations
were funded previously under this program, in accordance with
the former law.
The Committee's recommended funding level represents
approximately 18 percent of the average per-pupil expenditure,
an increase of 50 percent from the level in fiscal year 2000
when the Federal share of average per-pupil expenditure was 12
percent.
The budget request includes language capping the Department
of Interior set-aside at the prior year level, adjusted by the
increase in inflation. The Committee bill includes this
language.
Preschool Grants
The Committee recommends $384,597,000 for preschool grants.
The comparable fiscal year 2005 funding level and the budget
request both are $384,597,000. The preschool grants program
provides formula grants to States to make available special
education and related services for children with disabilities
aged 3 through 5. States are eligible for funds, which they in
turn pass on to local educational agencies, if they serve all
eligible children with disabilities aged 3 through 5 and have
an approved application under the Individuals with Disabilities
Education Act.
Grants for Infants and Families
The Committee recommends $444,308,000 for grants for the
infants and families program under part C of the IDEA. The
comparable fiscal year 2005 funding level and the budget
request both are $440,808,000. This program provides formula
grants to States, Outlying Areas and other entities 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.
The Individuals with Disabilities Education Improvement Act
of 2004 created a new State Incentive Grant program, triggered
when the appropriation for this program exceeds $460,000,000.
Under this new authority, 15 percent of the appropriation is
reserved by the Secretary for grants to States that have chosen
to extend Part C services to 3-year-old children through their
enrollment in kindergarten or elementary school who otherwise
would be eligible for services under the Preschool Grants
program.
State Personnel Development
The Committee recommends $50,653,000 for the State
personnel development program. The comparable fiscal year 2005
funding level is $50,653,000 and the budget request does not
include any funds for this program. The program formerly was
known as the State improvement grant program, until it was
changed by the Individuals with Disabilities Education
Improvement Act of 2004. Under the reauthorization, this
program focuses on the professional development needs in States
by requiring that 90 percent of funds be used for professional
development activities. The program supports grants to State
educational agencies to help them reform and improve their
personnel preparation and professional development related to
early intervention, educational and transition services that
improve outcomes for students with disabilities.
Under this program, competitive grants are made when the
appropriation is less than $100,000,000, but are made by
formula to States when the appropriation exceeds this amount
and $100,000,000 is remaining after covering continuation
costs.
Transition Initiative
The Committee recommendation does not include any funds for
this new program. The budget request includes $5,000,000 for
this new initiative. Funds would be used to help States improve
high school graduation rates, transition activities, and post-
school outcomes, establish better data collection systems, and
analyze and use student information. Grants would be made to
State educational agencies on a competitive basis.
The Committee notes that the budget request includes
$2,000,000 under the demonstration and training program in the
Rehabilitation Services and Disability Research account to
support this initiative. Funds are available under that program
for this initiative, but the Committee is unable to provide the
additional special education funds requested for the new
program given budgetary constraints.
Technical Assistance and Dissemination
The Committee recommends $49,397,000 for technical
assistance and dissemination. The comparable fiscal year 2005
funding level is $52,396,000 and the budget request is
$49,397,000 for these activities. This program supports awards
for technical assistance, model demonstration projects, the
dissemination of useful information and other activities.
Funding supports activities that are designed to improve the
services provided under IDEA.
Personnel Preparation
The Committee recommends $90,626,000 for the personnel
preparation program. The comparable fiscal year 2005 funding
level and the budget request both are $90,626,000 for this
program. Funds support competitive awards to help address
State-identified needs for personnel who are qualified to work
with children with disabilities, including special education
teachers and related services personnel.
The Committee is particularly concerned about the shortage
of qualified occupational therapists available to work in
school systems, to assist children with disabilities, and with
the shortage of leadership-level faculty to train such
professionals. The Committee intends that funds be used to
address these shortages.
Parent Information Centers
The Committee recommends $25,964,000 for parent information
centers. The comparable fiscal year 2005 funding level and the
budget request both are $25,964,000 for authorized activities.
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 $38,816,000 for technology and
media services. The comparable fiscal year 2005 funding level
is $38,816,000 and the budget request includes $31,992,000 for
such activities. 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 $12,000,000 for
Recording for the Blind and Dyslexic, Inc. [RFB&D]. 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 administration proposed eliminating support of
RFB&D for these activities.
The Committee also recommends $1,500,000 to continue
support of the Reading Rockets program. Last year, this program
received $1,488,000. The administration proposed eliminating
support for 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 Reading Rockets
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.
The Committee notes that, within the budget request, funds
are available to provide better access to educational media and
materials for individuals with disabilities, including
activities related to the National Instructional Materials
Accessibility Standard. The Committee supports these efforts,
and encourages the Department to provide sufficient funds to
fulfill the requirements related to this standard established
by the Individuals with Disabilities Education Improvement Act
of 2004.
Rehabilitation Services and Disability Research
Appropriations, 2005.................................... $3,074,574,000
Budget estimate, 2006................................... 3,059,298,000
House allowance......................................... 3,128,638,000
Committee recommendation................................ 3,133,638,000
The Committee recommends $3,133,638,000 for rehabilitation
services and disability research. The comparable fiscal year
2005 funding level is $3,074,574,000 and the budget request
includes $3,059,298,000 for programs in this account.
The authorizing statute for programs funded in this
account, except for those authorized under the Assistive
Technology Act, expired September 30, 2004. The program
descriptions provided below assume the continuation of current
law.
The Committee recognizes the importance, efficiency, and
return on the taxpayer dollar of community rehabilitation
programs and other nonprofit organizations in providing support
for people with disabilities. The Committee urges the
Rehabilitation Services Administration to support the
utilization of community rehabilitation programs to the maximum
extent possible in the delivery of employment and other support
services to people with disabilities.
Vocational Rehabilitation State Grants
The Committee provides $2,720,192,000 for vocational
rehabilitation grants to States. The Committee recommendation
provides the full amount authorized by the Rehabilitation Act
of 1973. The comparable funding level for fiscal year 2005 is
$2,635,845,000.
Basic State grant funds assist States in providing a range
of services to help persons with physical and mental
disabilities prepare for and engage in meaningful employment.
Authorizing legislation requires States to give priority to
persons with the most 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 2006 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.
Client Assistance
The Committee recommends $11,901,000 for the client
assistance program. The comparable fiscal year 2005 funding
level and the budget request both are $11,901,000 for
authorized activities.
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
increases in minimum grants are guaranteed to each of the 50
States, the District of Columbia, and Puerto Rico, and
guaranteed to each of the outlying areas, by a percentage not
to exceed the percentage increase in the appropriation. States
must operate client assistance programs in order to receive
vocational rehabilitation State grant funds.
Training
The Committee recommends $38,826,000 for training
rehabilitation personnel. The comparable fiscal year 2005
funding level and the budget request both are $38,826,000 for
training activities.
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 $6,577,000 for demonstration
and training programs for persons with disabilities. The
comparable fiscal year 2005 funding level is $25,607,000 and
the budget request includes $6,577,000 for authorized
activities. 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 pleased with the partnership between RSA
and the American Academy of Orthotists and Prosthetists to
support and improve the quality of applied orthotic and
prosthetic research and help meet the increasing demand for
provider services. The Committee has provided sufficient funds
to support this partnership at its current level. Funds are to
be used to further develop the orthotic and prosthetic
awareness campaign, which includes an educational outreach
initiative designed to recruit and retain professionals. Funds
also will continue to support a series of consensus conferences
and the dissemination of best practices to the field.
Migrant and Seasonal Farmworkers
The Committee recommends $2,302,000 for migrant and
seasonal farmworkers, the same amount as the comparable fiscal
year 2005 funding level. The Department proposes eliminating
separate funding for this program.
This program provides 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 $2,543,000 for recreational
programs, the same amount as the comparable fiscal year 2005
funding level. The budget request does not include funding for
this program.
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 $16,656,000 for protection and
advocacy of individual rights. The comparable fiscal year 2005
funding level and the budget request both are $16,656,000.
This program provides grants to agencies to protect and
advocate for the legal and human rights of persons with
disabilities who are not eligible for protection and advocacy
services available through the Developmental Disabilities
Assistance and Bill of Rights Act or the Protection and
Advocacy for Individuals with Mental Illness Act.
Projects with Industry
The Committee recommends $19,735,000 for projects with
industry. The comparable fiscal year 2005 funding level is
$21,625,000 and the administration proposes eliminating
separate funding for this program.
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 supports 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 $30,000,000 for the supported
employment State grant program. The comparable fiscal year 2005
funding level is $37,379,000 and the administration proposes
eliminating separate funding for this program.
This program assists the most severely disabled individuals
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 $22,816,000 for independent living
State grants. The comparable funding level for fiscal year 2005
and the budget request both are $22,816,000 for authorized
activities.
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
The Committee recommends $75,392,000 for independent living
centers. The comparable fiscal year 2005 funding level and the
budget request both are $75,392,000 for the centers.
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 $33,227,000 for independent living
services to older blind individuals. The comparable fiscal year
2005 funding level and the budget request both are $33,227,000
for these activities. Through this program, 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.
Program Improvement Activities
The Committee recommends $843,000 for program improvement
activities. The comparable fiscal year 2005 funding level and
the budget request both are $843,000 for authorized activities.
In fiscal year 2006, 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 technical assistance and other
ongoing program improvement activities, such as improved
program performance measurement.
Evaluation
The Committee recommends $1,488,000 for evaluation
activities. The comparable fiscal year 2005 funding level and
the budget request both are $1,488,000 for such activities.
These funds support evaluations of the impact and
effectiveness of programs authorized by the Rehabilitation Act.
The Committee recommendation continues to support a new multi-
year study of the State Vocational Rehabilitation Services
program. 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 recommends $8,597,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults. The comparable
fiscal year 2005 funding level is $10,581,000 and the budget
request includes $8,597,000 for this purpose. The difference
between fiscal year 2005 funding and the Committee
recommendation relates to earmarked funds provided in the
Consolidated Appropriations Act, 2005. These funds are still
available for expenditure and it is estimated it could take
another 2 years before they are exhausted.
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 agencies. At
the recommended level, the center would serve more than 110
persons with deaf-blindness at its headquarters facility and
provide field services to approximately 2,500 individuals and
families and approximately 1,100 organizations.
National Institute on Disability and Rehabilitation Research
The Committee recommends $107,783,000 for the National
Institute on Disability and Rehabilitation Research [NIDRR].
The comparable fiscal year 2005 funding level and the budget
request both are $107,783,000 for authorized activities.
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 recommendation includes $11,863,000, as
proposed in the budget request, for NIDRR's spinal cord injury
model systems projects. The Committee intends that these funds
should be used to support investments that would facilitate
multi-center research and encourages NIDRR to continue its
collaboration with other Federal agencies in order to leverage
Federal investments in this area.
Assistive Technology
The Committee recommends $34,760,000 for assistive
technology. The comparable fiscal year 2005 funding level is
$29,760,000. The budget request includes $15,000,000 solely for
the alternative financing program.
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. The
program support various activities that help States to develop
comprehensive, consumer-responsive statewide programs that
increase access to, and the availability of, assistive
technology devices and services. Under the recent
reauthorization, the administration of this program was moved
to the Rehabilitation Services Administration from the National
Institute on Disability and Rehabilitation Research. The
reauthorization also requires that an annual report be
submitted to Congress by December 31 of each year.
The Committee recommendation includes $25,300,000 for State
grant activities authorized under section 4, $4,500,000 for
protection and advocacy systems authorized by section 5, and
$1,200,000 for technical assistance activities authorized under
section 6.
The Committee recommendation also includes $3,760,000 for
the alternative financing program. The Committee recommendation
includes bill language requested by the administration designed
to encourage States to support alternative financing programs.
These changes allow States to receive less than $500,000 for an
award, require a match of 25 percent and enable States to
receive more than one grant. The Committee urges the Department
to ensure that grantees design and operate their programs in a
consumer-directed fashion. The Committee also urges the
Department to utilize these funds to expand the number of
States operating alternative financing programs.
Special Institutions for Persons With Disabilities
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriations, 2005.................................... $16,864,000
Budget estimate, 2006................................... 16,864,000
House allowance......................................... 17,000,000
Committee recommendation................................ 18,500,000
The Committee recommends $18,500,000 for the American
Printing House for the Blind [APH]. The comparable fiscal year
2005 funding level is $16,864,000 and the budget request
includes $16,864,000 for this purpose.
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 almost 60
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. Appropriated funds may be used for staff salaries
and expenses, as well as equipment purchases and other
acquisitions consistent with the purpose of the Act to Promote
the Education of the Blind.
In addition to its ongoing activities, the Individuals with
Disabilities Education Improvement Act assigned to the American
Printing House for the Blind the responsibility of establishing
and maintaining a National Instructional Materials Access
Center. The Center will serve as a national clearinghouse,
maintaining a repository of textbook files provided in the
National Instructional Materials Accessibility Standard format
by textbook publishers. The Center will manage the transfer of
these files to State Education Agencies for production in media
that are readily accessible to the blind, visually impaired,
and print disabled. The Committee supports this effort, and
encourages the Department to provide sufficient funds to
fulfill the requirements of the law.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2005.................................... $55,344,000
Budget estimate, 2006................................... 54,472,000
House allowance......................................... 56,137,000
Committee recommendation................................ 57,279,000
The Committee recommends $57,279,000 for the National
Technical Institute for the Deaf [NTID]. The comparable fiscal
year 2005 funding level is $55,344,000 and the budget request
includes $54,472,000 for this purpose.
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, $800,000 is for
construction. At the discretion of the Institute, funds may be
used for the Endowment Grant program.
GALLAUDET UNIVERSITY
Appropriations, 2005.................................... $104,557,000
Budget estimate, 2006................................... 104,557,000
House allowance......................................... 107,657,000
Committee recommendation................................ 108,500,000
The Committee recommends $108,500,000 for Gallaudet
University. The comparable fiscal year 2005 funding level and
the budget request both are $104,557,000 for the university.
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 and
who are deaf. 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 continue to offer competitive pay
increases for faculty and staff, support investments in
information technology and address other cost increases and
program improvements. Funds also are available, at the
discretion of the University, for the Endowment Grant program.
Vocational and Adult Education
Appropriations, 2005.................................... $2,037,733,000
Budget estimate, 2006................................... 215,734,000
House allowance......................................... 1,991,782,000
Committee recommendation................................ 1,923,766,000
The Committee recommendation includes a total of
$1,923,766,000 for vocational and adult education, consisting
of $1,309,400,000 for vocational education, $585,406,000 for
adult education and $28,960,000 for other activities. The
comparable funding level in fiscal year 2005 is $2,037,733,000
and the budget request includes $215,734,000 for this account.
The authorizing statute for vocational and adult education
programs and the State grants for incarcerated youth offenders
program funded in this account expired September 30, 2004.
Descriptions for these programs provided below assume the
continuation of current law.
VOCATIONAL EDUCATION
The Committee recommends $1,309,400,000 for vocational
education. The comparable fiscal year 2005 funding level is
$1,326,107,000 and the budget request does not include any
funds for these activities. The administration proposed to
redirect the funds currently allocated for vocational education
to a new High School initiative. The Committee notes that this
initiative has not been acted on by the appropriate authorizing
committees of Congress.
Basic Grants.--The Committee recommends $1,194,331,000 for
basic grants, the same amount as the comparable fiscal year
2005 funding level. The budget request does not include any
funds for this purpose. 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.
Of the funds available for this program, $403,331,000 will
become available on July 1, 2006 and $791,000,000 will become
available on October 1, 2006. These funds will remain available
for obligation until September 30, 2007.
Tech-Prep Education.--The Committee recommends $105,812,000
for tech-prep programs. The comparable fiscal year 2005 funding
level is $105,812,000 and the budget request proposes to
eliminate funding for this program. 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.
National Programs, Research.--The Committee recommends
$9,257,000 for national research programs and other national
activities. The comparable fiscal year 2005 funding level is
$11,757,000 and the budget request proposes to eliminate
separate funding for this program. The Committee recommendation
maintains the current spending on national programs because
$2,500,000 has been utilized under this appropriation for the
State Scholars program. Funding for State Scholars was
requested under the Fund for the Improvement of Education.
Funds provided under this program support research,
development, dissemination, evaluation and assessment designed
to improve the quality and effectiveness of vocational and
technical education. Funds have been provided to the National
Research Center for Career and Technical Education and the
National Dissemination Center for Career and Technical
Education to conduct research and provide technical assistance
to vocational educators. The results of the applied research
done by these Centers 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 does not include additional funding for this
program. The comparable fiscal year 2005 funding level is
$4,900,000 and the budget request proposes to eliminate funding
for this program. Under this demonstration authority, the
Secretary has awarded 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 have been used for curriculum, professional
development, equipment, and other start-up and operational
costs.
The Committee notes that evaluations for the first round of
funded grantees will be available this year. The Committee
urges the Department to identify effective programs from these
projects that have positive findings, based on rigorous
evaluations, and disseminate them to States, so they can
further benefit from the investment made in this program.
Occupational and Employment Information Program.--The
Committee does not recommend additional funds for activities
authorized by section 118 of the Carl Perkins Act. The
comparable fiscal year 2005 funding level is $9,307,000, and
the budget request proposes to eliminate this program. The Act
requires that at least 85 percent of the amount appropriated be
provided directly to State entities to develop and deliver
occupational and career information to students, job seekers,
employers, education, employment and training programs.
ADULT EDUCATION
The Committee recommends $585,406,000 for adult education,
the same amount as the comparable fiscal year 2005 funding
level. The budget request includes $215,734,000 for this
purpose.
Adult Education State Programs.--For adult education State
programs, the Committee recommends $569,672,000, the same
amount as the comparable fiscal year 2005 funding level. The
budget request includes $200,000,000 for authorized activities.
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,
$68,582,000 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 Committee is pleased with the progress States are
making in reporting on and improving performance outcomes
generated by this program and urges the Department to continue
to work with States to assist them in these efforts. The
Commmittee recognizes the diverse population eligible for
services under this program, ranging from adults striving to
complete their secondary education to workers requiring better
English skills to benefit from employer-provided job training
and to grandparents desiring the skills necessary to help
grandchildren to learn to read. The Committee also notes that
while some participants cite employment as their reason for
enrolling in an adult education program, many program
participants do not establish this as a goal. Furthermore, even
if employment is a goal, increased earnings might not be
associated with the career goals of the more than one-third of
adult education participants currently employed. Therefore, the
Committee has recommended level funding for this program, and
urges the Department to consider these facts when assessing
program performance under the Adult Education program and the
appropriateness of including this education program under the
Administration's initiative to identify common measures for job
training and employment programs.
National Activities.--The Committee recommends $9,096,000
for national leadership activities. The comparable funding
level for fiscal year 2005 and the budget request both are
$9,096,000 for this purpose. Under this program, the Department
supports applied research, development, dissemination,
evaluation and program improvement activities to assist States
in their efforts to improve the quality of adult education
programs.
National Institute for Literacy.--The Committee recommends
$6,638,000 for the National Institute for Literacy, authorized
under section 242 of the Adult Education and Family Literacy
Act. The comparable fiscal year 2005 funding level and the
budget request both are $6,638,000 for this purpose. The
Institute provides leadership and coordination for national
literacy efforts by conducting research and demonstrations on
literacy, 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.
Smaller Learning Communities
The Committee does not recommend additional funds for this
program. The comparable fiscal year 2005 funding level is
$94,476,000 and the budget request does not include any funds
for this purpose. This program has supported competitive grants
to local educational agencies to enable them to create smaller
learning communities in large schools. Funds have been used to
study, research, develop and implement strategies for creating
smaller learning communities, as well as professional
development for staff. Two types of grants were made under this
program: 1-year planning grants, which help LEAs plan smaller
learning communities and 3-year implementation grants, which
help create or expand such learning environments.
The Committee notes that the fiscal year 2004 and 2005
appropriations are still available for obligation and the
Department lapsed more than $26,000,000 from the fiscal year
2003 appropriation because of a lack of fundable applications.
Community Technology Centers
The Committee recommends $4,960,000 for community
technology centers, the same amount as the comparable funding
level for fiscal year 2005. The budget request proposes to
eliminate funding for this program. 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.
State Grants for Incarcerated Youth Offenders
The Committee has included $24,000,000 for education and
training for incarcerated youth offenders. The comparable
funding level for fiscal year 2005 is $21,824,000. The
Administration proposes to eliminate funding for these
activities. 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. Under current
law, each student is eligible for a grant of not more than
$1,500 annually for tuition, books, and essential materials,
and not more than $300 annually for related services such as
career development, substance abuse counseling, parenting
skills training, and health education. In order to participate
in a program, a student must be no more than 25 years of age
and be eligible to be released from prison within 5 years.
Youth offender grants are for a period not to exceed 5 years, 1
year of which may be devoted to study in remedial or graduate
education.
The Committee expects the Department to administer this
program through the Office of Correctional Education within the
Office of Vocational and Adult Education. The Committee notes
that this would be consistent with the Department's recent
reorganization, which designated the Under Secretary with the
authority to coordinate the efforts of postsecondary programs
and initiatives.
Literacy Programs for Prisoners
The Committee recommendation does not include funds for
this program. The comparable funding level for fiscal year 2005
is $4,960,000 and the budget request does not include any funds
for this purpose. Under this program, grants have been made to
State and local correctional education agencies and
correctional education agencies to establish and operate
programs that develop and improve the life skills of prisoners
so they may more effectively reintegrate into society.
Student Financial Assistance
Appropriations, 2005.................................... $14,265,749,000
Budget estimate, 2006................................... 15,050,977,000
House allowance......................................... 15,283,752,000
Committee recommendation................................ 15,103,795,000
The Committee recommends an appropriation of
$15,103,795,000 for student financial assistance. The
comparable fiscal year 2005 funding level is $14,265,749,000
and the budget request includes $15,050,977,000 for this
purpose.
Programs in this account are authorized through September
30, 2005. Program authorities and descriptions assume the
continuation of current law.
Federal Pell Grant Program
For Pell grant awards in the 2006-2007 academic year, the
Committee recommends $13,177,000,000 to maintain the record
maximum Pell Grant award level of $4,050. The Committee is very
supportive of the President's proposal to increase the Pell
Grant maximum award using mandatory funds. This proposal would
have guaranteed $100 increases in the Pell Grant maximum award
for each of the next 5 years. Unfortunately, the Budget
Resolution rejected this proposal and proposed that an increase
in the maximum award should compete against funding for other
student aid programs, vocational and technical education and
other activities funded in this bill. The Committee encourages
the Administration to make this worthwhile proposal again next
year and take necessary action to ensure its adoption.
Pell grants provide need-based financial assistance that
helps low- and middle-income undergraduate students and their
families defray a portion of 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 Committee has deferred action on the proposed enhanced
Pell grants for State scholars program. This program is not
currently authorized. The budget request includes $33,000,000
to provide additional Pell grant support to students completing
specific challenging coursework while in secondary school.
The Committee bill also includes language in section 305 of
the general provisions to pay off the estimated $4,300,000,000
accumulated shortfall in the Pell Grant program. The
administration provided mandatory funds within its budget
request for this purpose. These funds are provided pursuant to
section 303 of the Concurrent Resolution on the Budget for
fiscal year 2006 (H. Con. Res. 95, House Report 109-62) and are
not reflected in the totals for this program or account.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $804,763,000 for Federal
supplemental educational opportunity grants [SEOG]. The
comparable fiscal year 2005 funding level and the budget
request both are $778,720,000 for this purpose. This program
provides funds to postsecondary institutions for need-based
grants to undergraduate students. Institutions must contribute
25 percent towards 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 $990,257,000 for the Federal
work-study program, the same amount as both the comparable
fiscal year 2005 funding level and the budget request.
This program provides grants to more than 3,300
institutions to help an estimated 800,000 undergraduate,
graduate, and professional students meet the costs of
postsecondary education through part-time employment. Work-
study jobs must pay at least the Federal minimum wage and
institutions must provide 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.
Of the amount recommended by the Committee, $6,000,000 is
available for this program.
Federal Perkins Loans
The Committee bill does not include additional funds for
Federal Perkins loans capital contributions. The comparable
fiscal year 2005 funding level did not include such funds and
the budget request does not provide any funds for this purpose.
The Federal Perkins loan program supports student loan
revolving funds built up with capital contributions to nearly
1,900 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 recommends $66,132,000 for loan
cancellations, the same amount as the comparable funding level
for fiscal year 2005. The budget request did not include any
funds for this purpose. 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.
The Committee recommendation will maintain a robust loan
program that will support more than $1,100,000,000 in loans to
more than 550,000 individuals.
Presidential Math and Science Scholars
The Committee recommendation does not include funds for
this new program. The budget request includes $50,000,000 for
this purpose, based on proposed legislation.
This proposed program would support a public-private
partnership designed to provide grant aid to low-income math
and science students. Grants of up to $5,000 for each eligible
student would be available through this proposed partnership.
Leveraging Educational Assistance Partnership Program
For the leveraging educational assistance partnership
[LEAP] program, the Committee recommends $65,643,000, the same
amount as the comparable funding level for fiscal year 2005.
The budget proposes to eliminate funding for this program.
The leveraging educational assistance partnership program
provides a Federal match to States as an incentive for
providing need-based grant and work-study assistance to
eligible postsecondary students. When the appropriation exceeds
$30,000,000, amounts above this threshold must be matched by
States on a 2:1 basis. Federally supported grants and job
earnings are limited to $5,000 per award year for full-time
students.
Student Aid Administration
Appropriations, 2005.................................... $119,084,000
Budget estimate, 2006................................... 939,285,000
House allowance......................................... 124,084,000
Committee recommendation................................ 120,000,000
The Committee recommends $120,000,000 in discretionary
resources for the Student Aid Administration account. The
comparable fiscal year 2005 discretionary funding level is
$119,084,000 and the budget request includes $939,285,000 in
such funding. However, the budget request assumes enactment of
a proposal to rescind mandatory budget authority available in
Section 458 of the Higher Education Act and to provide these
funds through discretionary appropriations. The Committee does
not agree with the administration's legislative proposal to
fund this new account solely through annual appropriations.
Funds appropriated for the Student Aid Administration
account, in addition to mandatory funding available through
Section 458 of the Higher Education Act, will support the
Department's student aid management expenses. The Office of
Federal Student Aid and Office of Postsecondary Education have
primary responsibility for administering Federal student
financial assistance programs.
Loans for Short-Term Training
Appropriations, 2005....................................................
Budget estimate, 2006................................... $11,000,000
House allowance.........................................................
Committee recommendation................................................
The Committee defers action on this program, which is to be
established by proposed legislation. The budget request
includes $11,000,000 for this new activity. Under this proposed
program, dislocated workers, the unemployed, transitioning and
older workers, and students would be eligible to borrow funds
to engage in training needed to acquire new or upgraded skills
through short-term training programs. Such training programs
must lead to an industry credential, certificate, or employer-
endorsed technical or occupational skill.
Higher Education
Appropriations, 2005.................................... $2,116,698,000
Budget estimate, 2006................................... 1,202,315,000
House allowance......................................... 1,936,936,000
Committee recommendation................................ 2,104,508,000
The Committee recommends an appropriation of $2,104,508,000
for higher education programs. The comparable fiscal year 2005
funding level is $2,116,698,000 and the budget request includes
$1,202,315,000 for such activities.
Except for the activities authorized by the Mutual
Educational and Cultural Exchange Act of 1961, programs in this
account are authorized through September 30, 2005. Program
authorities and descriptions assume the continuation of current
law.
Aid for Institutional Development
The Committee recommends $510,923,000 for aid for
institutional development authorized by titles III and V of the
Higher Education Act. The comparable funding level for fiscal
year 2005 is $507,764,000 and the budget request includes
$505,519,000 for authorized activities.
Strengthening Institutions.--The Committee bill includes
$80,338,000 for the part A strengthening institutions program.
The comparable fiscal year 2005 funding level and the budget
request both are $80,338,000 for this activity. 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 $95,873,000 for institutions at which Hispanic
students make up at least 25 percent of enrollment. The
comparable fiscal year 2005 funding level is $95,106,000 and
the budget request includes $95,873,000 for these institutions.
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 recommends $240,500,000 for part B
grants. The comparable fiscal year 2005 funding level is
$238,576,000 and the budget request includes $240,500,000 for
authorized activities. 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.
Strengthening Historically Black Graduate Institutions.--
The Committee recommends $58,500,000 for the part B, section
326 program. The comparable fiscal year 2005 funding level is
$58,032,000 and the budget request includes $58,500,000 for
such activities. 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 $11,904,000 for this
program, the same amount as last year. The budget request
includes $6,500,000 for authorized activities. 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 educational facilities; student services; and
the purchase of library and other educational materials. As
initial funding cycles expire, the Committee encourages the
Department to use simplified application forms to permit
participating institutions to obtain continuation funding for
successful programs funded under this program.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $23,808,000 for
strengthening tribal colleges and universities [TCUs]. The
comparable funding level for fiscal year 2005 and the budget
request both are $23,808,000 for this program. Tribal colleges
and universities rely on a portion of the funds provided to
address developmental needs, including faculty development,
curriculum and student services.
International Education and Foreign Language Studies
The bill includes a total of $106,819,000 for international
education and foreign language programs. The comparable fiscal
year 2005 funding level is $106,818,000 and the budget request
includes $106,819,000 for such activities.
The Committee bill includes language allowing funds to be
used to support visits and study in foreign countries by
individuals who plan to utilize their language skills in world
areas vital to the United States national security in the
fields of government, international development and the
professions. Bill language also allows up to 1 percent of the
funds provided to be used for program evaluation, national
outreach and information dissemination activities. This
language is continued from last year's bill.
Domestic Programs.--The Committee recommends $92,466,000
for domestic program activities related to international
education and foreign language studies, including international
business education, under title VI of the HEA. The comparable
fiscal year 2005 funding level is $92,465,000 and the budget
request includes $92,466,000 for authorized activities.
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 $12,737,000 for
overseas programs authorized under the Mutual Educational and
Cultural Exchange Act of 1961, popularly known as the
Fulbright-Hays Act. The comparable fiscal year 2005 funding
level and the budget request both are $12,737,000 for these
programs. 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 $1,616,000 for the Institute for International
Public Policy. The comparable funding level for fiscal year
2005 and the budget request both are $1,616,000 for authorized
activities. 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.
Fund for the Improvement of Postsecondary Education
The Committee recommends $162,211,000 for the Fund for the
Improvement of Postsecondary Education [FIPSE]. The comparable
fiscal year 2005 funding level is $162,108,000 and the budget
request includes $22,211,000 for this purpose. 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 the
Department with advice from an independent board and 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 $17,423,000, the full
amount requested for the comprehensive program, as well as
funds for international consortia programs.
Minority Science and Engineering Improvement
The Committee recommends $8,818,000 for the Minority
Science and Engineering Improvement program [MSEIP]. The
comparable fiscal year 2005 funding level and the budget
request both are $8,818,000 for this program. Funds are used to
provide 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.
Interest Subsidy Grants
The Committee does not recommend additional funds for
interest subsidy grants. The comparable fiscal year 2005
funding level is $1,488,000 and the budget request does not
include funds for these grants. Unobligated balances from prior
year appropriations are available to meet the Federal
commitment to pay interest subsidies on 13 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.
Tribally Controlled Postsecondary Vocational Institutions
The Committee recommends $7,440,000 on a current-funded
basis for tribally controlled postsecondary vocational
institutions. The comparable fiscal year 2005 funding level and
the budget request both are $7,440,000 for this purpose. This
program provides grants for the operation and improvement of
two tribally controlled postsecondary vocational institutions
to ensure continued and expanding opportunities for Indian
students: United Tribes Technical College in Bismarck, North
Dakota, and Crownpoint Institute of Technology in Crownpoint,
New Mexico.
The Committee bill includes language carried over from last
year's bill that allows grantees to charge the regular indirect
cost rate to their grants.
Federal TRIO Programs
The Committee recommends $836,543,000 for Federal TRIO
Programs. The comparable fiscal year 2005 funding level is
$836,543,000 and the budget request includes $369,390,000 for
authorized activities. The budget request redirects the savings
from the reduction proposed for TRIO programs to provide
support for a proposed High School initiative.
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.
Gaining Early Awareness and Readiness for Undergraduate Programs
[GEARUP]
The Committee recommends $306,488,000 for GEARUP. The
comparable fiscal year 2005 funding level is $306,488,000 and
the budget request does not include any funds for this purpose.
The budget proposes to redirect these funds to provide support
for a proposed High School intiative.
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.
Byrd Honors Scholarships
The Committee recommends $41,000,000 for the Byrd honors
scholarship program. The comparable fiscal year 2005 funding
level is $40,672,000 and the budget request does not include
any funds for this program.
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 2006, and continue support for the 2003,
2004, and 2005 cohorts of students in their fourth, third and
second years of study, respectively. The amount recommended
will provide scholarships of $1,500 to 27,333 students.
Javits Fellowships
The Committee recommends $9,797,000 for the Javits
Fellowships program. The comparable fiscal year 2005 funding
level and the budget request both are $9,797,000 for this
program.
The Javits Fellowships program provides fellowships of up
to 4 years to students of superior ability who are pursuing
doctoral degrees in the arts, humanities, and social sciences
at any institution of their choice. Each fellowship consists of
a student stipend to cover living costs, and an institutional
payment to cover each fellow's tuition and other expenses.
Funds provided in the fiscal year 2006 appropriation support
fellowships for the 2007-2008 academic year.
Graduate Assistance in Areas of National Need [GAANN]
The Committee recommends $30,371,000 for graduate
assistance in areas of national need. The comparable fiscal
year 2005 funding level and the budget request both are
$30,371,000 for GAANN. 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 2004, 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.
Teacher Quality Enhancement Grants
The Committee recommends $58,000,000 for the teacher
quality enhancement grants program. The comparable fiscal year
2005 funding level is $68,337,000 and the budget request
proposes to eliminate funding for this program.
The program was established to support initiatives that
best meet 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 Committee bill includes language that would allow the
Department to fund awards under the three program areas at the
discretion of the Department, instead of as mandated by the
Higher Education Act. The Committee continues this language
from last year's bill in order to prevent funds available under
this program from going unused.
Under the State grant program, funds may be used for a
variety of State-level reforms, including more rigorous teacher
certification and licensure requirements; provision of high-
quality alternative routes to certification; development of
systems to reward high-performing teachers and principals; and
development of efforts to reduce the shortage of qualified
teachers in high-poverty areas.
Teacher training partnership grants, which are awarded to
local partnerships comprised of at least one school of arts and
science, one school or program of education, a local education
agency, and a K-12 school, may be used for a variety of
activities designed to improve teacher preparation and
performance, including efforts to provide increased academic
study in a proposed teaching specialty area; to prepare
teachers to use technology effectively in the classroom; to
provide preservice clinical experiences; and to integrate
reliable research-based teaching methods into the curriculum.
Partnerships may work with other entities, with those involving
businesses receiving priority consideration. Partnerships are
eligible to receive a one-time-only grant to encourage reform
and improvement at the local level.
The recruitment grant program supports efforts to reduce
shortages of qualified teachers in high-need school districts
as well as provide assistance for high-quality teacher
preparation and induction programs to meet the specific
educational needs of the local area.
Child Care Access Means Parents in Schools
The Committee recommends an appropriation of $15,970,000
for the Child Care Access Means Parents in School [CCAMPIS]
program. The comparable fiscal year 2005 funding level and the
budget request both are $15,970,000 for this program. CCAMPIS
was established in the Higher Education Amendments of 1998 to
support the efforts of a growing number of non-traditional
students who are struggling to complete their college degrees
at the same time that they take care of their children.
Discretionary grants of up to 4 years are made to institutions
of higher education to support or establish a campus-based
childcare program primarily serving the needs of low-income
students enrolled at the institution.
Community College Access
The Committee recommendation does not include any resources
for this proposed program. The budget request includes
$125,000,000 for this purpose.
Under this proposed program, funds would support
competitive awards that serve as an incentive for States and
partnerships to increases access, particularly for low-income
and minority students, to a college education. Two main
activities would be supported under this proposed program,
community college access grants and state consortia
initiatives. Community college access grants would create
incentives for community colleges to create dual enrollment
programs. Grants under the state consortia initiative would
provide incentives to States to establish credit transfer
programs across State lines.
Demonstration Projects to Ensure Quality Higher Education for Students
With Disabilities
The Committee recommends $6,944,000 for this program, the
same amount as the comparable fiscal year 2005 funding level.
The budget proposes no funding for this program. This program's
purpose is to ensure that students with disabilities receive a
high-quality postsecondary education. Grants are made to
support model demonstration projects that provide technical
assistance and professional development activities for faculty
and administrators in institutions of higher education.
The Committee recognizes that the Department has made
limited efforts to work with grantees to collect the type of
outcome data that would demonstrate the value of this program.
The Committee is aware of the significant progress that
grantees have made in developing standards for information
dissemination, faculty and staff awareness, policies and
procedures, and program administration and evaluation that
institutions of higher education can adopt to more effectively
support students with disabilities. The Committee urges the
Department to utilize resources available under the GPRA/data
collection program to support a rigorous evaluation of outcomes
achieved by grantees funded under this program and to identify
the impact that these funds are having on improving
opportunities for students with disabilities at institutions of
higher education throughout the United States.
Underground Railroad Program
The Committee recommendation includes $2,204,000 for the
Underground Railroad program, the same amount as the comparable
fiscal year 2005 funding level. The budget request does not
include any funds for this activity. The program was authorized
by the Higher Education Amendments of 1998 and was funded for
the first time in fiscal year 1999. Grants are provided to
research, display, interpret, and collect artifacts relating to
the history of the underground railroad. Educational
organizations receiving funds must demonstrate substantial
private support through a public-private partnership, create an
endowment fund that provides for ongoing operation of the
facility, and establish a network of satellite centers
throughout the United States to share information and teach
people about the significance of the Underground Railroad in
American history.
GPRA/Higher Education Act Program Evaluation
The Committee recommends $980,000 for data collection
associated with the Government Performance and Results Act data
collection and to evaluate programs authorized by the Higher
Education Act. The comparable fiscal year 2005 funding level
and the budget request both are $980,000 for these activities.
These funds are used to comply with the Government Performance
and Results Act, which requires the collection of data and
evaluation of Higher Education programs and the performance of
recipients of Higher Education funds.
B.J. Stupak Olympic Scholarships
The Committee recommendation does not include funding for
this program. The comparable fiscal year 2005 funding level is
$980,000 and the budget request did not include funds for this
activity. Funds appropriated in fiscal year 2005 will be used
to provide financial assistance to athletes who are training at
the United States Olympic Education Center or one of the United
States Olympic Training Centers and who are pursuing a
postsecondary education at an institution of higher education.
Unlike most other Federal student aid programs, scholarships
are provided without consideration of expected family
contributions.
Thurgood Marshall Legal Educational Opportunity Program
The Committee recommendation does not include any funds for
the Thurgood Marshall Legal Educational Opportunity Program.
The comparable funding level for fiscal year 2005 is $2,976,000
and the budget request does not include any funds for this
purpose.
Under this program, funds help low-income, minority or
disadvantaged college students with the information,
preparation and financial assistance to enter and complete law
school study. The Higher Education Act stipulates that the
Secretary make an award to or contract with the Council on
Legal Education Opportunity to carry out authorized activities.
Howard University
Appropriations, 2005.................................... $238,790,000
Budget estimate, 2006................................... 238,789,000
House allowance......................................... 240,790,000
Committee recommendation................................ 238,789,000
The Committee recommends an appropriation of $238,789,000
for Howard University. The comparable fiscal year 2005 funding
level is $238,790,000 and the budget request includes
$238,789,000 for this purpose. Howard University is located in
the District of Columbia and offers undergraduate, graduate,
and professional degrees through 12 schools and colleges. The
university also administers the Howard University Hospital,
which provides both inpatient and outpatient care, as well as
training in the health professions. Federal funds from this
account support more than 50 percent of the university's
projected educational and general expenditures, excluding the
hospital. The Committee recommends, within the funds provided,
not less than $3,600,000 shall be for the endowment program.
Howard University Hospital.--Within the funds provided, the
Committee recommends $29,759,000 for the Howard University
Hospital. The comparable fiscal year 2005 funding level and the
budget request both are $29,759,000 for this purpose. The
hospital serves as a major acute and ambulatory care center for
the District of Columbia and functions as a major teaching
facility attached to the university. The Federal appropriation
provides partial funding for the hospital's operations.
College Housing and Academic Facilities Loans
Appropriations, 2005.................................... $573,000
Budget estimate, 2006................................... 573,000
House allowance......................................... 573,000
Committee recommendation................................ 573,000
Federal Administration.--The Committee bill includes
$573,000 for Federal administration of the CHAFL program. The
comparable fiscal year 2005 funding level and the budget
request both are $573,000 for such expenses.
These funds will be used to reimburse the Department for
expenses incurred in managing the existing CHAFL loan portfolio
during fiscal year 2006. These expenses include salaries and
benefits, travel, printing, contracts (including contracted
loan servicing activities), and other expenses directly related
to the administration of the CHAFL Program.
Historically Black College and University Capital Financing Program
Appropriations, 2005.................................... $210,000
Budget estimate, 2006................................... 210,000
House allowance......................................... 210,000
Committee recommendation................................ 210,000
Federal Administration.--The Committee recommends $210,000
for Federal administration of the Historically Black College
and University [HBCU] Capital Financing Program. The comparable
fiscal year 2005 funding level and the budget request both are
$210,000 for this activity.
The HBCU Capital Financing Program makes capital available
to HBCUs for construction, renovation, and repair of academic
facilities by providing a Federal guarantee for private sector
construction bonds. Construction loans will be made from the
proceeds of the sale of the bonds.
Institute of Education Science
Appropriations, 2005.................................... $523,234,000
Budget estimate, 2006................................... 479,064,000
House allowance......................................... 522,696,000
Committee recommendation................................ 522,695,000
The bill includes $522,695,000 for the Institute of
Education Sciences. The comparable fiscal year 2005 funding
level is $523,234,000 and the budget request includes
$479,064,000 for comparable activities. This account supports
education research, data collection and analysis activities,
and the assessment of student progress.
Research, Development and Dissemination
The Committee recommends $164,194,000 for education
research, development and national dissemination activities.
The comparable fiscal year 2005 amount and the budget request
both are $164,194,000 for these activities. Funds are available
for obligation for 2 fiscal years. These funds support
research, development, and dissemination activities that are
aimed at expanding fundamental knowledge of education and
promoting the use of research and development findings in the
design of efforts to improve education.
The Committee strongly supports the premise that
developing, identifying and implementing scientifically based
research is critical to the success of the No Child Left Behind
Act [NCLB] and to the increased effectiveness generally of
education programs and interventions. The Committee recognizes
the current scarcity of educational interventions that have
been proven effective in research that meets the rigorous
standards set out in the NCLB. In particular, the Committee
believes that a greater focus must be placed on the use of
randomized controlled trials, longitudinal studies, and other
research that meets the standards set by the National Research
Council. The Committee commends the Department for its efforts
in this area.
The Committee strongly supports the Department's efforts to
carry out authorized evaluations of Federal education programs
using rigorous methodologies, particularly random assignment,
that are capable of producing scientifically valid knowledge
regarding which program activities are effective. To ensure
that such evaluations have sufficient participation required to
make them scientifically valid, the Committee urges the
Department, wherever feasible and not specifically prohibited
by the authorizing legislation, to take appropriate action to
secure grantee involvement, which may include requests to be
randomly assigned to intervention and control groups. The
Committee notes that the National Board for Education Sciences
recently recommended such a policy.
The Committee recognizes the critical role that IES plays
in achieving the important goals set by the No Child Left
Behind Act and encourages IES to continue its progress in
translating scientifically based research findings into
classroom practice. The Committee would like to see increased
support for programs that bring advances in cognitive,
developmental, educational and neuroscience research into the
classroom by informing curriculum development in schools and in
graduate schools of education. Research that focuses on the key
processes of attention, memory, reasoning, and cognitive styles
are essential for learning and are likely to produce
substantial gains in academic achievement.
Statistics
The Committee recommends $90,931,000 for data-gathering and
statistical-analysis activities of the National Center for
Education Statistics [NCES]. The comparable fiscal year 2005
funding level and the budget request both are $90,931,000 for
this purpose.
The NCES collects, analyzes, and reports statistics on
education in the United States. Activities are carried out
directly and through grants and contracts. The Center collects
data on educational institutions at all levels, longitudinal
data on student progress, and data relevant to public policy.
The NCES also provides technical assistance to State and local
education agencies and postsecondary institutions.
Regional Educational Laboratories
The Committee recommends $66,131,000 to continue support
for the regional educational laboratories. The comparable
fiscal year 2005 funding level is $66,132,000 and the budget
request proposes to eliminate funding for this purpose. Program
funds support a network of 10 laboratories that are responsible
for promoting the use of broad-based systemic strategies to
improve student achievement.
Fiscal year 2006 funding will support a new competition
under this program. The Committee believes it is important that
the research, development, dissemination, and technical
assistance activities carried out by the regional educational
laboratories be consistent with the standards for
scientifically based research prescribed in the Education
Sciences Reform Act of 2002. The Committee therefore urges IES
to ensure, through its competitive selection and evaluation of
the laboratories and system of peer review of laboratory
activities, that the laboratories adhere to these rigorous
research standards. The Committee believes that the
laboratories have an important role to play in helping parents,
States and school districts improve student achievement as
called for in No Child Left Behind.
Research and Innovation in Special Education
The Committee recommends $72,566,000 for research and
innovation in special education. The comparable funding level
for fiscal year 2005 is $83,104,000 and the budget request
includes $72,566,000 for this purpose. The reauthorization of
the Individuals with Disabilities Education Act created a new
National Center for Special Education Research. This new center
will address gaps in scientific knowledge in order to improve
special education and early intervention services and outcomes
for infants, toddlers, and children with disabilities. Funds
provided to the center will be available for obligation for 2
fiscal years.
Similarly, the Committee recognizes the new role IES will
play in special education research with the enactment and
implementation of the Individuals with Disabilities Education
Improvement Act of 2004. The Committee encourages IES to
investigate alternative assessment models for determining
learning disabilities for the purposes of special education
placement in the absence of the discrepancy criterion
requirement and the effectiveness of behavioral interventions
and early intervening services. The Committee encourages IES to
commit funding for research focusing on pupil services and
related services providers.
Special Education Studies and Evaluations
The Committee recommends $10,000,000 for special education
studies and evaluations. Funding for this activity was made
available previously as a set-aside from the Special Education
State Grants program until this new authority was created by
the Individuals with Disabilities Education Improvement Act of
2004. The budget request includes $10,000,000 for this purpose.
This program will support competitive grants, contracts and
cooperative agreements to assess the implementation of the
Individuals with Disabilities Education Act. Funds also will be
used to evaluate the effectiveness of State and local efforts
to deliver special education services and early intervention
programs. Funds are available for obligation for 2 fiscal
years.
The Committee is concerned that school districts across the
country are inadequately prepared to provide appropriate
educational services to students with intellectual disabilities
(mental retardation and related disabilities). This lack of
preparedness is particularly acute as it relates to the
universal design of standards, curriculum, instructional
strategies and materials, and assessments. This too often
results in a lack of access to the general education curriculum
and families and teachers developing curricula, instructional
materials and assessments on an ad hoc basis. The Committee
urges the Department to prepare a comprehensive plan to address
this matter that would be sufficiently detailed to serve as an
outline for proposals for K-12 projects to meet the needs of
intellectual disabilities. Consideration should be given to
research, model demonstration, technical assistance and
dissemination, technology innovations, personnel preparation
and other means to develop and apply universally designed
standards, curriculum instructional strategies and materials,
and assessments. The plan also shall include proposed funding
levels and timelines for implementing the various research,
development and dissemination activities and other components
of the plan. The Department is urged to consult with experts in
the field, including the several national organizations
representing the interests of children with intellectual
disabilities in the development of this plan. Finally, the
Committee requests the Department to submit a report to the
House and Senate Committees on Appropriations not later than
April 15, 2006 on this issue.
Statewide Data Systems
The Committee recommendation includes $24,800,000 for
Statewide Data Systems. The comparable funding level for fiscal
year 2005 and the budget request both are $24,800,000.
Under this program, the Department awards grants
competitively to State Educational Agencies to enable such
agencies to design, develop, and implement statewide,
longitudinal data systems to manage, analyze, disaggregate, and
use individual student data. Funds are available for obligation
for 2 fiscal years. The Committee believes these funds are
necessary to help States measure individual student
performance, particularly as it relates to adequate yearly
progress goals, more efficiently and accurately. The Committee
urges the Department to continue to support those States that
currently have the most limited ability to collect, analyze and
report student achievement data when considering applications
for funds available through this program.
Assessment
The Committee recommends $94,073,000 for assessment. The
comparable fiscal year 2005 funding level is $94,073,000 and
the budget request includes $116,573,000 for authorized
activities.
These funds provide support for the National Assessment of
Educational Progress [NAEP], a congressionally mandated
assessment created to measure the educational achievement of
American students. The primary goal of NAEP is to determine and
report the status and trends over time in educational
achievement, subject by subject. Beginning in 2002, the
Department began paying for State participation in biennial
reading and mathematics assessments in grades 4 and 8.
The budget request includes an increase of $22,500,000 to
expand the State NAEP to reading and mathematics in the 12th
grade. The Committee recommendation does not include these
funds.
Within the funds appropriated, the Committee recommends
$5,088,000 for the National Assessment Governing Board [NAGB],
which is responsible for formulating policy for NAEP. The
comparable fiscal year 2005 amount and the budget request both
are $5,088,000 for NAGB.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2005.................................... $419,280,000
Budget estimate, 2006................................... 418,992,000
House allowance......................................... 410,612,000
Committee recommendation................................ 418,992,000
The Committee recommends $418,992,000, for program
administration. The comparable fiscal year 2005 funding level
is $419,280,000 and the budget request includes $418,992,000
for this purpose.
Funds support personnel compensation and benefits, travel,
rent, communications, utilities, printing, equipment and
supplies, automated data processing, and other services
required to award, administer, and monitor approximately 180
Federal education programs. Support for program evaluation and
studies and advisory councils is also provided under this
activity.
The Committee is concerned that the Department, in
implementing Reading First and other programs authorized by the
No Child Left Behind Act which are required to implement
activities that are backed by scientifically based research,
may not be effectively helping States and local educational
agencies implement programs shown to work in randomized
controlled trials and other rigorous studies. The Committee
therefore requests the Secretary to submit a report to the
Committee, within 90 days of the enactment of this Act, on the
actions that program offices have taken or will take in the
selection, oversight, and evaluation of grantees, to ensure
that grantees effectively implement such research-based
programs, including close replication of the specific elements
of these programs.
The Committee understands that the Department is taking
steps to implement the proposed reorganization of the regional
office structure within the Rehabilitation Services
Administration [RSA] that was described in the fiscal year 2006
congressional budget justification. The Committee is concerned
about the impact that this proposal will have on regional
office staff, as well as the ability of the Department to
effectively administer RSA programs. The Committee understands
that the Department believes that its proposed reorganization
will result in more consistent, timely and higher quality
policy guidance, technical assistance and program monitoring.
The Committee believes these are worthy goals, given the
millions of individuals served through RSA programs. Therefore,
the Committee requests a report that describes the steps taken
to reach out to stakeholder groups on this issue; a detailed
plan for ensuring that policy guidance, technical assistance
and program monitoring will be of higher quality and more
timely than that currently available; and the specific
performance goals under the proposed reorganization for
frequency of monitoring visits, and timeliness and relevancy of
technical assistance, compared to the actual performance under
the current administrative structure. The Committee expects to
receive this report not later than 60 days after enactment of
this Act, but urges the Department to make it available as soon
as possible.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2005.................................... $89,375,000
Budget estimate, 2006................................... 91,526,000
House allowance......................................... 91,526,000
Committee recommendation................................ 91,526,000
The Committee bill includes $91,526,000 for the Office for
Civil Rights [OCR]. The comparable fiscal year 2005 amount was
$89,375,000 and the budget request is $91,526,000 for this
purpose.
The Office for Civil Rights is responsible for the
enforcement of laws that prohibit discrimination on the basis
of race, color, national origin, sex, disability, and age in
all programs and institutions funded by the Department of
Education. To carry out this responsibility, OCR investigates
and resolves discrimination complaints, monitors desegregation
and equal educational opportunity plans, reviews possible
discriminatory practices by recipients of Federal education
funds, and provides technical assistance to recipients of funds
to help them meet civil rights requirements.
The Committee understands that Title IX of the Education
Amendments of 1972 and their implementing regulations, which
prohibit discrimination on the basis of sex in federally funded
education programs or activities, have been instrumental in
providing unprecedented opportunities for women in the Nation's
classrooms and athletic programs. While much progress has been
made, the Committee continues to recognize that more needs to
be done to ensure equal access for women. The Committee
believes that the intent of the Department's clarification is
to provide institutions with additional guidance on compliance
with the third part of the three-part test, as stated in the
Department's March 17, 2005 Dear Colleague. The Committee
acknowledges this effort, but is concerned that confusion has
been created with regard to the use of interest surveys to
demonstrate compliance. The Committee believes survey results
are not sufficient to demonstrate compliance if other evidence
exists, such as requests for athletic teams, that contradicts
the conclusions drawn from the survey. The Committee urges the
Department to clarify that a presumption of compliance is not
achieved by a survey if evidence to the contrary exists,
whether that knowledge is known or it is reasonable to expect
an institution to have known. Further, the Committee urges that
the Department clarify that institutions must show that they
have made reasonable, good faith efforts to explore such
evidence if they choose to use part three of the three-part
test to comply with Title IX. The Committee also encourages the
Department to provide additional technical assistance to
institutions on the appropriate use of interest surveys to
comply with Title IX.
The Committee requests that the Department prepare a
report, based on random compliance reviews of institutions
utilizing interest surveys, to determine what actions, if any,
they take to gather and consider other sources of information
for assessing student interest used in demonstrating compliance
with part three of the Title IX test. The report should include
what other information was considered in assessing student
interest, if any, and the decisions made about athletic
opportunities at these institutions. The Committee requests to
receive this report no later than March 17, 2006.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2005.................................... $47,327,000
Budget estimate, 2006................................... 49,408,000
House allowance......................................... 49,000,000
Committee recommendation................................ 49,408,000
The Committee recommends $49,408,000 for the Office of the
Inspector General. The comparable fiscal year 2005 amount is
$47,327,000 and the budget request includes $49,408,000 for
authorized activities.
The Office of the Inspector General has the authority to
investigate all departmental programs and administrative
activities, including those under contract or grant, to prevent
and detect fraud and abuse, and to ensure the quality and
integrity of those programs. The Office investigates alleged
misuse of Federal funds, and conducts audits to determine
compliance with laws and regulations, efficiency of operations,
and effectiveness in achieving program goals.
General Provisions
The Committee bill contains language which has been
included in the bill since 1974, prohibiting the use of funds
for the transportation of students or teachers in order to
overcome racial imbalance (sec. 301).
The Committee bill contains language included in the bill
since 1977, prohibiting the transportation of students other
than to the school nearest to the student's home (sec. 302).
The Committee bill contains language which has been
included in the bill since 1980, prohibiting the use of funds
to prevent the implementation of programs of voluntary prayer
and meditation in public schools (sec. 303).
The Committee bill includes a provision giving the
Secretary of Education authority to transfer up to 1 percent of
any discretionary funds between appropriations (sec. 304).
The Committee bill includes a new provision, pursuant to
section 303 of the Congressional Budget Resolution, to
eliminate the accumulated shortfall in the Pell Grant program
(sec. 305).
The Committee bill includes a new provision which expands
the programs authorized under subpart 12 of part D of title V
of the Elementary and Secondary Education Act of 1965 (sec.
306).
TITLE IV--RELATED AGENCIES
Committee for Purchase from People Who Are Blind or Severely Disabled
Appropriations, 2005.................................... $4,669,000
Budget estimate, 2006................................... 4,669,000
House allowance......................................... 4,669,000
Committee recommendation................................ 4,669,000
The Committee recommends $4,669,000 for fiscal year 2006
for Committee for Purchase from People Who Are Blind or
Severely Disabled. The comparable funding level for fiscal year
2005 is $4,669,000 and the budget request includes $4,669,000
for this program.
The Committee for Purchase From People Who Are Blind or
Severely Disabled was established by the Javits, Wagner-O'Day
Act of 1938 as amended. Its primary objective is to increase
the employment opportunities for people who are blind or have
other severe disabilities and, whenever possible, to prepare
them to engage in competitive employment.
Corporation for National and Community Service
Appropriations, 2005.................................... $927,006,000
Budget estimate, 2006................................... 921,049,000
House allocation........................................ 909,049,000
Committee recommendation................................ 935,205,000
The Committee recommends $935,205,000 for the Corporation
for National and Community Service, an increase of $8,199,000
over the fiscal year 2005 enacted level and $14,156,000 above
the budget request.
The Committee requests that the Corporation include
information in the fiscal year 2007 budget justification on the
economic impact of its programs.
The Corporation for National and Community Service, a
Corporation owned by the Federal Government, was established by
the National and Community Service Trust Act of 1993 (Public
Law 103-82) to enhance opportunities for national and community
service and provide national service education awards. The
Corporation makes grants to States, institutions of higher
education, public and private nonprofit organizations, and
others to create service opportunities for students, out-of-
school youth, and adults.
DOMESTIC VOLUNTEER SERVICE PROGRAMS
The Committee recommends $316,212,000 for fiscal year 2006
for the domestic volunteer service programs of the Corporation
for National and Community Service. The comparable funding
level for fiscal year 2005 is $353,745,000 and the budget
request includes $359,962,000 for these programs. Programs
authorized under the Domestic Volunteer Service Act include:
the Volunteers in Service to America Program [VISTA]; the
Foster Grandparent Program; the Senior Companion Program; and
the Retired and Senior Volunteer Program.
VISTA
The Committee recommends $96,428,000 for fiscal year 2006
for the Volunteers in Service to America [VISTA] Program. The
comparable funding level for fiscal year 2005 is $94,240,000
and the budget request includes $96,428,000 for this program.
VISTA, created in 1964 under the Economic Opportunity Act,
provides capacity building for small community-based
organizations. VISTA volunteers raise resources for local
projects, recruit and organize volunteers, and establish and
expand local community-based programs in housing, employment,
health, and economic development activities.
The Committee is pleased by reports that the Corporation is
moving toward integrating grant writing and issue specific
presentations into the training sessions currently given to all
new VISTA members. The Committee feels that more substantive
training is needed to enhance the effectiveness of VISTA
members in their placements. As part of their capacity-building
mission, VISTA members are increasingly called upon to write
grant applications and to raise funds as a way of making their
service projects self-sufficient, requiring knowledge of grant
writing that cannot be gained in the local organization, as
well as training in the general field in which they are slated
to serve. The Committee looks forward to a report in the fiscal
year 2007 budget justification on the percentage of training
funds and percentage of training time spent on each of the
following categories: organizational training, grant writing
and fundraising training, and issue specific training (i.e.
early childhood education, environment, disaster assistance,
etc).
Special Volunteer Programs
The Committee has included no funding for the Special
Volunteer programs. The comparable funding level for fiscal
year 2005 was $4,960,000. The budget requested $4,000,000 for
an expansion of Teach For America under the Special Volunteer
Programs. Teach for America has been a long-standing grantee
under the Americorps State and National Program. Therefore, the
Committee has recommended that funds for this expansion be
allocated within the appropriation for the National and
Community Service Act programs.
The Special Volunteer Program is authorized under Part C of
Title I of the Domestic Volunteer Service Act of 1973, which
provides grants to volunteer organizations to encourage and
enable persons from all age groups to perform volunteer service
in agencies, institutions, and situations of need.
National Senior Volunteer Corps
The Committee recommends $219,784,000 for fiscal year 2006
for the National Senior Volunteer Corps programs. The
comparable funding level for fiscal year 2005 is $215,857,000
and the budget request includes $219,784,000 for these
programs. The Committee recognizes the valuable contributions
of seniors participating in the Foster Grandparent [FGP],
Retired and Senior Volunteer Program [RSVP], and Senior
Companion Programs [SCP]. In accordance with the Domestic
Volunteer Service Act [DVSA], the Committee intends that at
least one-third of each program's increase over the fiscal year
2005 level shall be used to fund Programs of National
Significance [PNS] expansion grants to allow existing FGP,
RSVP, and SCP programs to expand the number of volunteers
serving in areas of critical need as identified by Congress in
the DVSA. All remaining funds shall be used to fund an
administrative cost increase for each existing program
nationwide. The amount to be allocated to individual grantees
shall be calculated based on a percentage of the entire Federal
grant award in fiscal year 2005, including the amount specified
for payment of non-taxable stipends. The Committee directs that
the Corporation shall comply with the directive that use of PNS
funding increases in the FGP, RSVP, SCP, and VISTA shall not be
restricted to any particular activity. The Committee further
directs that the Corporation shall not stipulate a minimum or
maximum for PNS grant augmentation.
In addition, the maximum dollars CNCS may use in fiscal
year 2006 for Communications and Training, Technical
Assistance, and Recruitment and Retention activities shall not
exceed the amount enacted for these two activities in fiscal
year 2005. Funds appropriated for fiscal year 2006 may not be
used to implement or support service collaboration agreements
or any other changes in the administration and/or governance of
national service programs prior to passage of a bill by the
authorizing committee of jurisdiction specifying such changes.
In addition, none of these increases may be used to fund
demonstration activities.
Foster Grandparent Program
The Committee recommends $112,058,000 for fiscal year 2006
for the Foster Grandparent Program. The comparable funding
level for fiscal year 2005 is $111,424,000 and the budget
request includes $112,058,000 for this program.
This program provides volunteer opportunities to seniors
age 60 and over who serve at-risk youth. This program not only
involves seniors in their communities, but it also provides a
host of services to children.
Senior Companion Program
The Committee recommends $47,438,000 for fiscal year 2006
for the Senior Companion Program. The comparable funding level
for fiscal year 2005 is $45,905,000 and the budget request
includes $47,438,000 for this program.
This program enables senior citizens to provide personal
assistance and companionship to adults with physical, mental,
or emotional difficulties. Senior companions provide vital in-
home services to elderly Americans who would otherwise have to
enter nursing homes. The volunteers also provide respite care
to relieve care givers.
Retired and Senior Volunteer Program
The Committee recommends $60,288,000 for fiscal year 2006
for the Retired and Senior Volunteer Program. The comparable
funding level for fiscal year 2005 is $58,528,000 and the
budget request includes $60,288,000 for this program. This
program involves persons age 55 and over in volunteer
opportunities in their communities such as tutoring youth,
responding to natural disasters, teaching parenting skills to
teen parents, and mentoring troubled youth.
Program Administration
The Committee included funds for the administration of the
DVSA program administration in the NCSA Salaries and Expenses
account. The Committee believes that the integration of these
accounts will streamline the management of the Corporation and
increase efficiency and accountability across the agency. The
comparable funding level for fiscal year 2005 is $38,688,000
and the budget request includes $39,750,000 for program
administration.
NATIONAL AND COMMUNITY SERVICE PROGRAMS
The Committee recommends $546,243,000 for the programs
authorized under the National Community Service Act of 1990, an
increase of $4,726,000 over the fiscal year 2005 enacted level
and $18,156,000 above the budget request.
The National and Community Service Programs of the
Corporation for National and Community Service include: the
AmeriCorps program (including AmeriCorps State and National and
the National Civilian Community Corps); Learn and Serve
America, Innovation, Demonstration, Assistance and Evaluation
activities; State Commission Administration grants; and the
National Service Trust.
The Committee recommendation includes: $546,243,000 for the
Corporation's programs operating expenses. This appropriation
provides $280,000,000 for AmeriCorps State and National
operating grants (including $12,642,000 for State
administrative expenses); $149,000,000 for the National Service
Trust; $15,945,000 for subtitle H fund activities; $27,000,000
for AmeriCorps NCCC; $42,656,000 for Learn and Serve;
$4,000,000 for audits and evaluations; $10,000,000 for the
Points of Light Foundation; $5,000,000 for America's Promise.
AmeriCorps Grants Program (not including NCCC)
Within the amount provided for AmeriCorps grants, the
Committee is providing $55,000,000 for national direct
grantees.
The Committee requests that the Corporation continue
providing monthly reports to the Committee on Appropriations
and the Corporation's Inspector General on the actual and
projected year-end level of AmeriCorps membership enrollment,
usage, and earnings, and the financial status of the Trust fund
(revenue, expenses, outstanding liabilities, reserve, etc.).
To keep the Committee better informed of the recipients
receiving AmeriCorps funding, the Committee directs the
Corporation to publish in its fiscal year 2007 budget
justifications a list of recipients that have received more
than $500,000 from the Corporation, delineated by program, and
the amount and source of both other Federal and non-Federal
funds that were received by each recipient.
Innovation, Assistance and Other Activities
Within the amount recommended for innovation,
demonstration, and assistance activities, the Committee
recommends $1,300,000 for next generation grants; $500,000 for
Martin Luther King Jr. Day grants; $725,000 for Service
Learning Clearinghouse and Exchange; $2,250,000 for training
and technical assistance; $4,338,000 for disability programs;
$400,000 for Presidential Freedom Scholarships; $125,000 for
Faith-Based and Community Initiatives; $52,000 for the
Presidential Council on Service; $250,000 for Presidential
Volunteer Service Award; $5,000 for the National Volunteer
Hotline; $4,000,000 for Teach for America; and $2,000,000 for
Communities in Schools, Inc. The Committee is not allocating
any money for the challenge grant programs in fiscal year 2006,
in accordance with the budget request and House allocation.
AmeriCorps National Civilian Community Corps
Within the amount provided, $1,500,000 is to conduct an
evaluation of current NCCC site placement and expansion of new
sites in the Southern and Midwestern United States, in
accordance with the report issued on March 1, 2005.
SALARIES AND EXPENSES
The Committee recommends an appropriation of $66,750,000
for the Corporation's salaries and expenses. This amount is
equal to the budget request and $2,270,000 above the fiscal
year 2005 enacted level. This includes $39,750,000 for
administration of the DVSA programs. The Committee reiterates
the directive under the program account that the Corporation
must fund all staffing needs from the salaries and expenses
account.
The salaries and expenses appropriation provides funds for
staff salaries, benefits, travel, training, rent, advisory and
assistance services, communications and utilities expenses,
supplies, equipment, and other operating expenses necessary for
management of the Corporation's activities under the National
and Community Service Act of 1990 and the Domestic Volunteer
Service Act of 1973.
The Committee is disappointed in the quality of assistance
provided by the Corporation during the reorganization of the
Corporation's appropriation. Periodically, the Committee
requires technical assistance from officers of the Corporation.
The Committee expects that such assistance will be provided
without prejudice in a straightforward and timely manner.
The Committee is aware that local administrative support
offices are critical to the success of programs such as the
National Senior Volunteer Corps, especially in areas that are
difficult to reach such as rural areas and islands like Hawaii.
Mainland United States is over 1,500 miles from the State of
Hawaii and the Committee is concerned that program support
would suffer from locating that support across this distance.
The Committee urges the Department to continue funding existing
full-time, local administrative CNCS offices.
OFFICE OF INSPECTOR GENERAL
The Committee recommends an appropriation of $6,000,000 for
the Office of Inspector General [OIG]. This amount is equal to
the budget request and $48,000 above the fiscal year 2005
enacted level.
The Committee directs the OIG to continue reviewing the
Corporation's management of the National Service Trust fund.
The Committee directs the OIG to review the monthly Trust
reports and to notify the Committees on Appropriations on the
accuracy of the reports.
The goals of the Office of Inspector General are to
increase organizational efficiency and effectiveness and to
prevent fraud, waste, and abuse. The Office of Inspector
General within the Corporation for National and Community
Service was transferred to the Corporation from the former
ACTION agency when ACTION was abolished and merged into the
Corporation in April 1994.
ADMINISTRATIVE PROVISIONS
The Committee has included four administrative provisions
carried in prior year appropriations acts as follows: language
regarding: qualified student loans eligible for education
awards; the availability of funds for the placement of
volunteers with disabilities; the Inspector General to levy
sanctions in accordance with standard Inspector General audit
resolutions procedures; and language regarding the Corporation
to make significant changes to program requirements or policy
through public rulemaking and public notice and grant selection
process.
Corporation for Public Broadcasting
Appropriations, 2006.................................... $400,000,000
Appropriations, 2007.................................... 400,000,000
Budget estimate, 2008...................................................
House allowance......................................... 400,000,000
Committee recommendation................................ 400,000,000
The Committee recommends $400,000,000 be made available for
the Corporation for Public Broadcasting [CPB], an advance
appropriation for fiscal year 2008. The comparable funding
level provided last year was $400,000,000 for fiscal year 2007.
The budget request does not include advance funds for this
program.
In addition, the Committee recommends $35,000,000 be made
available in fiscal year 2006 for the conversion to digital
broadcasting. The comparable funding level for fiscal year 2005
was $39,387,000. The budget request included no funding for
this purpose. The House included authority to permit CPB to
spend up to $30,000,000 in previously appropriated fiscal year
2006 funds for digital conversion activities.
In addition, the Committee recommends $40,000,000 be made
available in fiscal year 2006 for the replacement project of
the interconnection system. In fiscal year 2005, $39,680,000
was appropriated for this purpose. The House included authority
to permit CPB to spend up to $52,000,000 in previously
appropriated fiscal year 2006 funds for the Satellite
Interconnection system.
The current interconnection system is entirely satellite
based. This satellite is currently nearing the end of its
useful life, and while satellite technology is currently the
most cost-effective method for distribution in a point-to-
multipoint system, terrestrial technology is far more
economical when data is distributed between single points. The
Next Generation Interconnection System will utilize a
combination of satellite and terrestrial technologies for a
more flexible system. In addition, a portion of the provided
funds will be used to upgrade existing ground station and
transmit/receive equipment to be compatible with the new
system.
The Committee recognizes the importance of the partnership
CPB has with the National Minority Public Broadcasting
Consortia, which helps develop, acquire, and distribute public
television programming to serve the needs of African American,
Asian American, Latino, Native American, Pacific Islander, and
many other viewers. As many communities in the Nation welcome
increased numbers of citizens of diverse ethnic backgrounds,
the local public television stations should strive to meet
these viewers' needs. With an increased focus on programming to
meet local community needs, the Committee encourages CPB to
continue to support and expand this critical partnership.
The Committee is aware that public radio stations are
taking advantage of experimental authority to develop their
digital operations including multicasting. We encourage the
Corporation to work with the Federal Communications Commission
to enable public radio and television stations to utilize the
full range of digital broadcasting technology as soon as
possible, including the use of multicasting for public radio
stations.
Federal Mediation and Conciliation Service
Appropriations, 2005.................................... $44,439,000
Budget estimate, 2006................................... 42,331,000
House allowance......................................... 42,331,000
Committee recommendation................................ 43,439,000
The Committee recommends $43,439,000 for fiscal year 2006
for the Federal Mediation and Conciliation Service [FMCS]. The
comparable funding level for fiscal year 2005 is $44,439,000
and the budget request includes $42,331,000 for this program.
The FMCS was established by Congress in 1947 to provide
mediation, conciliation, and arbitration services to labor and
management. FMCS is authorized to provide dispute resolution
consultation and training to all Federal agencies.
The Committee continues to support the FMCS program to
prevent youth violence and is especially pleased with the
initiative to train educators in conflict resolution. The
Committee commends FMCS for their innovative look at youth
violence conflict resolution and their development of a CD-ROM
that will address this issue among preschool and elementary age
children.
Federal Mine Safety and Health Review Commission
Appropriations, 2005.................................... $7,809,000
Budget estimate, 2006................................... 7,809,000
House allowance......................................... 7,809,000
Committee recommendation................................ 7,809,000
The Committee recommends $7,809,000 for fiscal year 2006
for the Federal Mine Safety and Health Review Commission. The
comparable funding level for fiscal year 2005 is $7,809,000 and
the budget request includes $7,809,000 for this program.
The Federal Mine Safety and Health Review Commission
provides administrative trial and appellate review of legal
disputes under the Federal Mine Safety and Health Act of 1977.
The five-member Commission provides review of the Commission's
administrative law judge decisions.
Institute of Museum and Library Services
Appropriations, 2005.................................... $280,564,000
Budget estimate, 2006................................... 262,240,000
House allowance......................................... 249,640,000
Committee recommendation................................ 290,129,000
The Committee recommends $290,129,000 for fiscal year 2006
for the Institute of Museum and Library Services. The
comparable funding level for fiscal year 2005 is $280,564,000
and the budget request includes 262,240,000 for this program.
Office of Museum Services Operations Grants
The Committee recommends $17,500,000 for operations grants.
These funds support grants to museums for building increased
public access, expanding educational services, reaching
families and children, and using technology more effectively in
support of these goals. In addition, non-competitive grants are
awarded for technical assistance in four types of assessments:
Institutional, Collections Management, Public Dimension, and
Governance. In addition to the total recommended, $992,000 has
been provided for the 21st Century Museum Professionals
program, $446,000 for museum assessment, $850,000 for Native
American Museum service grants, and $850,000 for Museum Grants
for African American History and Culture.
Museum Conservation Programs
The Committee recommends $3,615,000 for Conservation
programs. These funds support grants to allow museums to survey
collections, perform training, research, treatment, and
environmental improvements. In addition, grantees may receive
additional funds to develop an education component that relates
to their conservation project. In addition, non-competitive
grants are awarded for technical assistance in conservation
efforts.
Museum National Leadership Projects
The Committee recommends $29,000,000 for National
Leadership projects. The National Leadership Grants encourage
innovation in meeting community needs, widespread and creative
use of new technologies, greater public access to museum
collections, and an extended impact of Federal dollars through
collaborative projects.
Office of Library Services State Grants
The Committee recommends $165,000,000 for State grants.
Funds are provided to States by formula to carry out 5-year
State plans. These plans must set goals and priorities for the
State consistent with the purpose of the Act, describe
activities to meet the goals and priorities and describe the
methods by which progress toward the goals and priorities and
the success of activities will be evaluated. States may
apportion their funds between two activities, technology and
targeted services. For technology, States may use funds for
electronic linkages among libraries, linkages to educational,
social and information services, accessing information through
electronic networks, or link different types of libraries or
share resources among libraries. For targeted services, States
may direct library and information services to persons having
difficulty using a library, underserved urban and rural
communities, and children from low income families. In addition
to the total recommended, $3,675,000 has been provided for
library services to Native Americans and Native Hawaiians. The
Committee is aware that many traditional healers are aging and
the world may soon lose the knowledge that they possess. For
that reason, the Committee encourages IMLS to work for the
preservation and documentation of Native Hawaiian traditional
cultural healing practices. It is essential that these
practices be documented in creative media formats due to the
variety and complexity of the practices and the healers.
Library National Leadership Projects
The Committee recommends $33,284,000 for national
leadership projects. These funds support activities of national
significance to enhance the quality of library services
nationwide and to provide coordination between libraries and
museums. Activities are carried out through grants and
contracts awarded on a competitive basis to libraries,
agencies, institutions of higher education and museums.
Priority is given to projects that focus on education and
training of library personnel, research and development for the
improvement of libraries, preservation, digitization of library
materials, partnerships between libraries and museums and other
activities that enhance the quality of library services
nationwide. In addition to the total recommended, $23,000,000
has been provided for the 21st Century Librarian Initiative.
Museum and Library Services Administration
The Committee recommends $11,917,000 for program
administration, the same as the budget request. Funds support
personnel compensation and benefits, travel, rent,
communications, utilities, printing, equipment and supplies,
automated data processing, and other services.
Medicare Payment Advisory Commission
Appropriations, 2005.................................... $9,899,000
Budget estimate, 2006................................... 10,168,000
House allowance......................................... 10,168,000
Committee recommendation................................ 10,168,000
The Committee recommends $10,168,000 for fiscal year 2006
for the Medicare Payment Advisory Commission. The comparable
funding level for fiscal year 2005 is $9,899,000 and the budget
request includes $10,168,000 for this program.
The Medicare Payment Advisory Commission [MedPAC] was
established by Congress as part of the Balanced Budget Act of
1997 (Public Law 105-33). Congress merged the Physician Payment
Review Commission with the Prospective Payment Assessment
Commission to create MedPAC.
National Commission on Libraries and Information Science
Appropriations, 2005.................................... $993,000
Budget estimate, 2006................................... 993,000
House allowance......................................... 993,000
Committee recommendation................................ 993,000
The Committee recommends $993,000 for fiscal year 2006 for
the National Commission on Libraries and Information Science.
The comparable funding level for fiscal year 2005 is $993,000
and the budget request includes $993,000 for this program.
The Commission determines the need for, and makes
recommendations on, library and information services, and
advises the President and Congress on the development and
implementation of national policy in library and information
sciences.
National Council on Disability
Appropriations, 2005.................................... $3,344,000
Budget estimate, 2006................................... 2,800,000
House allowance......................................... 2,800,000
Committee recommendation................................ 3,344,000
The Committee recommends $3,344,000 for fiscal year 2006
for the National Council on Disability. The comparable funding
level for fiscal year 2005 is $3,344,000 and the budget request
includes $2,800,000 for this program.
The Council is mandated to make recommendations to the
President, the Congress, the Rehabilitation Services
Administration, and the National Institute on Disability and
Rehabilitation Research, on the public issues of concern to
individuals with disabilities. The Council gathers information
on the implementation, effectiveness, and impact of the
Americans with Disabilities Act and looks at emerging policy
issues as they affect persons with disabilities and their
ability to enter or reenter the Nation's work force and to live
independently.
National Labor Relations Board
Appropriations, 2005.................................... $249,860,000
Budget estimate, 2006................................... 252,268,000
House allowance......................................... 252,268,000
Committee recommendation................................ 252,268,000
The Committee recommends $252,268,000 for fiscal year 2006
for the National Labor Relations Board [NLRB]. The comparable
funding level for fiscal year 2005 is $249,860,000 and the
budget request includes $252,268,000 for this program.
The Committee continues to be concerned that the NLRB's
plan to restructure its regional offices will slow the decision
making process in some regions and hurt workers access to a
fair and timely hearing. The Committee reiterates its
opposition to the elimination of Region 30 and the subsequent
downgrading of the Region 30 Office to sub-regional status.
Downgrading this office will force interested parties to travel
long distances while increasing the backlog of cases in Region
18.
The NLRB is a law enforcement agency which adjudicates
disputes under the National Labor Relations Act.
The Committee is aware that the mission of the NLRB is to
carry out the statutory responsibilities of the National Labor
Relations Act as efficiently as possible and in a manner that
gives full effect to the rights afforded to employees, unions,
and employers under the Act. The Committee strongly supports
this mission and understands that the caseload fluctuates based
on economic conditions and changes in labor regulations. The
Committee continues to be disappointed that the Administration
has repeatedly underestimated the funding necessary to process
the increase in case intakes, but stands firm in its commitment
to ensure that all cases are heard and given due process.
National Mediation Board
Appropriations, 2005.................................... $11,628,000
Budget estimate, 2006................................... 11,628,000
House allowance......................................... 11,628,000
Committee recommendation................................ 11,628,000
The Committee recommends $11,628,000 for fiscal year 2006
for the National Mediation Board. The comparable funding level
for fiscal year 2005 is $11,628,000 and the budget request
includes $11,628,000 for this program.
The National Mediation Board protects interstate commerce
as it mediates labor-management relations in the railroad and
airline industries under the Railway Labor Act. The Board
mediates collective bargaining disputes, determines the choice
of employee bargaining representatives through elections, and
administers arbitration of employee grievances.
The Committee notes that the National Mediation Board has
yet to issue a final rule regarding certain administrative
changes to case management. The Committee has made repeated
statements that the institution of a fee, such as the one
outlined in the initial proposed rule, would require statutory
authorization that the Board currently lacks. The fiscal year
2006 President's Budget included no request to change the
authorization of the Board to include the collection of any
fees. Therefore, the Committee concludes that the Board has
abandoned the effort to institute new fees in the coming year
and expects that any final rule the Board may publish will omit
the fee proposal.
Occupational Safety and Health Review Commission
Appropriations, 2005.................................... $10,510,000
Budget estimate, 2006................................... 10,510,000
House allowance......................................... 10,510,000
Committee recommendation................................ 10,510,000
The Committee recommends $10,510,000 for fiscal year 2006
for the Occupational Safety and Health Review Commission. The
comparable funding level for fiscal year 2005 is $10,510,000
and the budget request includes $10,510,000 for this program.
The Commission serves as a court to justly and
expeditiously resolve disputes between the Occupational Safety
and Health Administration [OSHA] and employers charged with
violations of health and safety standards enforced by OSHA.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
Appropriations, 2005.................................... $99,200,000
Budget estimate, 2006................................... 97,000,000
House allowance......................................... 97,000,000
Committee recommendation................................ 97,000,000
The Committee recommends $97,000,000 for fiscal year 2006
for the Dual Benefits Payments Account, of these funds
$7,000,000 is from income taxes on vested dual benefits. The
comparable funding level for fiscal year 2005 is $99,200,000
and the budget request includes $97,000,000 for this program.
This appropriation provides for vested dual benefit
payments authorized by the Railroad Retirement Act of 1974, as
amended by the Omnibus Reconciliation Act of 1981. This
separate account, established for the payment of dual benefits,
is funded by general fund appropriations and income tax
receipts of vested dual benefits.
FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT
Appropriations, 2005.................................... $150,000
Budget estimate, 2006................................... 150,000
House allowance......................................... 150,000
Committee recommendation................................ 150,000
The Committee recommends $150,000 for fiscal year 2006 for
interest earned on unnegotiated checks. The comparable funding
level for fiscal year 2005 is $150,000 and the budget request
includes $150,000 for this program.
LIMITATION ON ADMINISTRATION
Appropriations, 2005.................................... $102,543,000
Budget estimate, 2006................................... 102,543,000
House allowance......................................... 102,543,000
Committee recommendation................................ 102,543,000
The Committee recommends $102,543,000 for fiscal year 2006
for the administration of railroad retirement/survivor benefit
programs. The comparable funding level for fiscal year 2005 is
$102,543,000 and the budget request includes $102,543,000 for
this program.
The Board administers comprehensive retirement-survivor and
unemployment-sickness insurance benefit programs for the
Nation's railroad workers and their families. This account
limits the amount of funds in the railroad retirement and
railroad unemployment insurance trust funds which may be used
by the Board for administrative expenses.
The Committee has included language to prohibit funds from
the railroad retirement trust fund from being spent on any
charges over and above the actual cost of administering the
trust fund, including commercial rental rates.
LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2005.................................... $7,196,000
Budget estimate, 2006................................... 7,196,000
House allowance......................................... 7,196,000
Committee recommendation................................ 7,196,000
The Committee recommends $7,196,000 for fiscal year 2006
for the Office of the Inspector General. The comparable funding
level for fiscal year 2005 is $7,196,000 and the budget request
includes $7,196,000 for this program.
The Committee has included bill language to allow the
Office of the Inspector General to use funds to conduct audits,
investigations, and reviews of the Medicare program. The
Committee finds that as long as the RRB has the authority to
negotiate and administer the separate Medicare contract, the
RRB Inspector General should not be prohibited from using funds
to review, audit, or investigate the Railroad Retirement
Board's separate Medicare contract.
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriations, 2005.................................... $20,454,000
Budget estimate, 2006................................... 20,470,000
House allowance......................................... 20,470,000
Committee recommendation................................ 20,470,000
The Committee recommends an appropriation of $20,470,000
for payments to Social Security trust funds. The comparable
fiscal year 2005 funding level is $20,454,000 and the budget
request includes $20,470,000 for this purpose. This amount
reimburses the old age and survivors and disability insurance
trust funds for special payments to certain uninsured persons,
costs incurred administering pension reform activities, and the
value of the interest for benefit checks issued but not
negotiated. This appropriation restores the trust funds to the
same financial position they would have been in had they not
borne these costs, properly charged to the general funds.
SUPPLEMENTAL SECURITY INCOME
Appropriations, 2005.................................... $28,586,829,000
Budget estimate, 2006................................... 29,533,174,000
House allowance......................................... 29,533,174,000
Committee recommendation................................ 29,510,574,000
The Committee recommends an appropriation of
$29,510,574,000 for supplemental security income. This is in
addition to the $10,930,000,000 appropriated last year as an
advance for the first quarter of fiscal year 2006. The
comparable fiscal year 2005 funding level is $28,586,829,000
and the budget request includes $29,533,174,000. The Committee
also recommends an advance appropriation of $11,110,000,000 for
the first quarter of fiscal year 2007 to ensure uninterrupted
benefits payments. The program level supported by the Committee
recommendation is $40,440,574,000, compared to the total
program level requested in the budget of $40,463,174,000. The
Committee recommendation also includes bill language which
adjusts the timing of the October 2006 SSI benefit payment.
These funds are used to pay benefits under the SSI Program,
which was established to ensure a Federal minimum monthly
benefit for aged, blind, and disabled individuals, enabling
them to meet basic needs. It is estimated that approximately 7
million persons will receive SSI benefits each month during
fiscal year 2006. In many cases, SSI benefits supplement income
from other sources, including Social Security benefits. The
funds are also used to reimburse the Social Security trust
funds for the administrative costs for the program with a final
settlement by the end of the subsequent fiscal year as required
by law, to reimburse vocational rehabilitation agencies for
costs incurred in successfully rehabilitating SSI recipients
and for research and demonstration projects.
Beneficiary Services
The Committee recommendation includes $52,000,000 for
beneficiary services. The comparable funding level in fiscal
year 2005 is $45,929,000 and the budget request includes
$52,000,000 for these services. This amount is available for
payments to Employment Networks for successful outcomes or
milestone payments under the Ticket to Work program and for
reimbursement of State vocational rehabilitation agencies and
alternate public or private providers. Carryover budget
authority of more than $130,000,000 is available for
obligations made during fiscal years 2005 and 2006.
Research and Demonstration Projects
The Committee recommendation includes $27,000,000 for
research and demonstration projects conducted under sections
1110 and 1115 of the Social Security Act. The comparable fiscal
year 2005 funding level is $35,000,000 and the budget request
includes $27,000,000 for authorized activities.
This amount will support SSA's efforts to strengthen its
policy evaluation capability and focus on research of: program
issues, the impact of demographic changes on future workloads
and effective return-to-work strategies for disabled
beneficiaries.
Administration
The Committee recommendation includes $2,874,400,000 for
payment to the Social Security trust funds for the SSI
Program's share of SSA's base administrative expenses. The
comparable fiscal year 2005 amount is $2,986,900,000 and the
budget request includes $2,897,000,000 for such activities.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriations, 2005.................................... $8,729,901,000
Budget estimate, 2006................................... 9,388,400,000
House allowance......................................... 9,279,700,000
Committee recommendation................................ 9,329,400,000
The Committee recommends a program funding level of
$9,329,400,000 for the limitation on administrative expenses.
The comparable fiscal year 2005 funding level is $8,729,901,000
and the budget request includes $9,388,400,000 for this
purpose.
This account provides resources from the Social Security
trust funds to administer the Social Security retirement and
survivors and disability insurance programs, and certain Social
Security health insurance functions. As authorized by law, it
also provides resources from the trust funds for certain
nontrust fund administrative costs, which are reimbursed from
the general funds. These include administration of the
supplemental security income program for the aged, blind and
disabled; work associated with the Pension Reform Act of 1984;
and the portion of the annual wage reporting work done by the
Social Security Administration for the benefit of the Internal
Revenue Service. The dollars provided also support automated
data processing activities and fund the State disability
determination services which make initial and continuing
disability determinations on behalf of the Social Security
Administration. Additionally, the limitation provides funding
for computer support, and other administrative costs.
The Committee recommendation includes $9,209,400,000 for
routine operating expenses of the Agency, as well as the
resources derived from the user fees which are discussed below.
The budget request includes bill language earmarking not
less than $412,000,000 of funds available within this account
for continuing disability reviews under Social Security's
disability programs. The Committee bill language includes this
earmark and also includes an additional $189,000,000 for this
purpose requested in the budget and provided for by section
404(b)(1) of the Concurrent Resolution on the Budget for fiscal
year 2006. The Committee requests that the Social Security
Administration provide reports to the Committee for each fiscal
year 2005, 2006, and 2007 that detail the amount of funds spent
on continuing disability reviews for each year and the number
of such reviews, by category of review; the results of such
continuing disability reviews in terms of cessation of benefits
or determinations of continuing eligibility, by programs; and
the amount of savings generated over the short-, medium-, and
long-term by each program administered by the Agency. The
Committee notes that during the last period of special funding
for continuing disability reviews the benefit to cost ratio was
more than $10 for each $1 spent on this workload.
The Committee bill also includes language that authorizes
fiscal year 2006 funds available to SSA to be used to complete
Medicare appeals received by the Agency prior to July 1, 2005.
Medicare appeals filed after this date were transferred to the
Department of Health and Human Services, as required by the
Medicare Prescription Drug, Improvement and Modernization Act
of 2003. The Committee bill also allows the Commissioner of
Social Security to enter into a reimbursable agreement with the
Secretary of Health and Human Services to provide assistance
with and process Medicare appeals work received prior to
October 1, 2005. This language will ensure that Medicare
beneficiaries are not impacted negatively by the transfer of
this workload.
The Committee recommendation also includes $320,000,000,
the full amount included in the budget request, to support the
implementation of the Medicare Prescription Drug Benefit
program. These resources will be used to identify low-income
beneficiaries who may be eligible for financial assistance with
their prescription drug costs; to make eligibility
determinations for those individuals eligible for financial
assistance; and to withhold premiums associated with
beneficiaries' plans; and to calculate Medicare Part B premiums
for high-income beneficiaries.
The Committee encourages SSA officials to educate
adjudicators at all levels about the functional impact of CFS
and the application of the April 1999 CFS ruling (99-2p) to
ensure that adjudicators remain up-to-date on the evaluation of
disability that results from this condition. The Committee
encourages SSA to examine obstacles to benefits for persons
with CFS and to keep medical information updated throughout all
levels of the application and review process.
Social Security Advisory Board
The Committee has included not less than $2,000,000 within
the limitation on administrative expenses account for the
Social Security Advisory Board for fiscal year 2006.
User Fees
In addition to other amounts provided, the Committee
recommends $120,000,000 for administrative activities funded
from user fees. Of this amount, $119,000,000 is derived from
fees paid to SSA by States that request SSA to administer State
SSI supplementary payments. The remaining $1,000,000 will be
generated from a fee payment process for non-attorney
representatives of claimants.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2005.................................... $90,378,000
Budget estimate, 2006................................... 93,000,000
House allowance......................................... 92,805,000
Committee recommendation................................ 93,000,000
The Committee recommends $93,000,000 for activities for the
Office of the Inspector General. The comparable fiscal year
2005 funding level is $90,378,000 and the budget request
includes $93,000,000 for this office. This includes a general
fund appropriation of $26,000,000 together with an obligation
limitation of $67,000,000 from the Federal old-age and
survivors insurance trust fund and the Federal disability
insurance trust fund.
TITLE V--GENERAL PROVISIONS
The Committee recommendation includes provisions which:
authorize transfers of unexpended balances (sec. 501); limit
funding to 1 year availability unless otherwise specified (sec.
502); limit lobbying and related activities (sec. 503); limit
official representation expenses (sec. 504); prohibit funding
of any program to carry out distribution of sterile needles for
the hypodermic injection of any illegal drug (sec. 505);
clarify Federal funding as a component of State and local grant
funds (sec. 506); limit use of funds for abortion (sec. 507 and
sec. 508); restrict human embryo research (sec. 509); limit the
use of funds for promotion of legalization of controlled
substances included last year (sec. 510); limits use of funds
to enter into or review contracts with entities subject to the
requirement in section 4212(d) of title 38, United States Code,
if the report required by that section has not been submitted
(sec. 511); prohibits the use of funds to promulgate
regulations regarding the individual health identifier (sec.
512); prohibits transfer of funds made available in this Act to
any department, agency, or instrumentality of the U.S.
Government, except as otherwise provided by this or any other
Act (sec. 513); prohibits funds for the Railroad Retirement
Board from being used for a non-governmental disbursing agent
(sec. 514); maintains a provision clarifying procedures for
reprogramming of funds (sec. 515); and specifies that none of
the funds made available by this Act may be used to reimburse,
or provide reimbursement for drugs approved to treat erectile
dysfunction (sec. 516).
BUDGETARY IMPACT OF BILL
PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
AMENDED
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Budget authority Outlays
---------------------------------------------------
Committee Amount of Committee Amount of
allocation bill allocation bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
to its subcommittees of amounts in the Budget Resolution
for 2006: Subcommittee on Labor-HHS-Education.
Discretionary........................................... 141,344 141,653 142,975 \1\ 141,350
Mandatory............................................... 405,311 405,311 405,171 \1\ 405,171
Projection of outlays associated with the recommendation:
2006.................................................... ........... ........... ........... \2\ 368,096
2007.................................................... ........... ........... ........... 58,074
2008.................................................... ........... ........... ........... 15,470
2009.................................................... ........... ........... ........... 3,789
2010 and future years................................... ........... ........... ........... 542
Financial assistance to State and local governments for NA 221,957 NA 159,755
2006.......................................................
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.
\2\ Excludes outlays from prior-year budget authority.
NA: Not applicable.
COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE
SENATE
Paragraph 7 of rule XVI requires that Committee report on
general appropriations bills identify each Committee amendment
to the House bill ``which proposes an item of appropriation
which is not made to carry out the provisions of an existing
law, a treaty stipulation, or an act or resolution previously
passed by the Senate during that session.''
The following items are identified pursuant to this
requirement: Workforce Investment Act; Title VII and Title VIII
of the Public Health Services Act; National Cord Blood Stem
Cell Bank Program; Universal Newborn Hearing Screening; Organ
Transplantation; Rural Hospital Flexibility Grants; Denali
Commission; Family Planning; State Offices of Rural Health;
Rural and Community Access to Emergency Devices; Trauma/EMS;
Infectious Diseases; Health Promotion; Health Information and
Services; Environmental Health and Injury; Occupational Safety
and Health; Global Health; Public Health Research; Public
Health Improvement and Leadership; Preventive Health and Health
Services Block Grant; CDC Business Services; Title V of the
Public Health Services Act; Adolescent Family Life; Office of
Minority Health; Office of Disease Prevention and Health
Promotion; Low Income Home Energy Assistance Program; Refugee
and Entrant Assistance; Child Care and Development Block Grant;
Head Start; Abstinence Education; Native American Programs;
Community Services; Alzheimer's Disease Demonstration Grants to
States; High school equivalency program; College assistance
migrant program; State grants for incarcerated youth offenders;
Rehabilitation Services and Disability Research, except
sections 4, 5 and 6 of the Assistive Technology Program;
National Technical Institute for the Deaf; Gallaudet
University; Vocational Education; Adult Education; Student
Financial Assistance; Student Aid Administration; Higher
Education, except for section 102(b)(6) of the Mutual
Educational and Cultural Exchange Act; Corporation for National
and Community Service; National Council on Disability.
COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE STANDING RULES OF THE
SENATE
Pursuant to paragraph 7(c) of rule XXVI, on July 14, 2005,
the Committee ordered reported, H.R. 3010, making
appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal
year ending September 30, 2006, and for other purposes, with an
amendment in the nature of a substitute, provided that the bill
be subject to further amendment and the bill be consistent with
its budget allocation, by a recorded vote of 27-0, a quorum
being present. The vote was as follows:
Yeas Nays
Chairman Cochran
Mr. Stevens
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. McConnell
Mr. Burns
Mr. Shelby
Mr. Gregg deg.
Mr. Bennett
Mr. Craig
Mrs. Hutchison
Mr. DeWine
Mr. Brownback
Mr. Allard
Mr. Byrd
Mr. Inouye
Mr. Leahy
Mr. Harkin
Ms. Mikulski
Mr. Reid
Mr. Kohl
Mrs. Murray
Mr. Dorgan
Mrs. Feinstein
Mr. Durbin
Mr. Johnson
Ms. Landrieu
COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE
SENATE
Paragraph 12 of rule XXVI requires that Committee reports
on a bill or a joint resolution repealing or amending any
statute include ``(a) the text of the statute or part thereof
which is proposed to be repealed; and (b) a comparative print
of that part of the bill or joint resolution making the
amendment and of the statute or part thereof proposed to be
amended, showing by stricken through type and italics, parallel
columns, or other appropriate typographical devices the
omissions and insertions which would be made by the bill or
joint resolution if enacted in the form recommended by the
committee.''
With respect to this bill, it is the opinion of the
Committee that it is necessary to dispense with these
requirements in order to expedite the business of the
Senate. deg.
NO CHILD LEFT BEHIND ACT OF 2001, PUBLIC LAW 107-110
* * * * * * *
``Subpart 12--Educational, Cultural, Apprenticeship, and Exchange
Programs for Alaska Natives, Native Hawaiians, and Their Historical
Whaling and Trading Partners in Massachusetts
``SEC. 5521. SHORT TITLE.
``This subpart may be cited as the `Alaska Native and
Native Hawaiian Education Through Cultural and Historical
Organizations Act'.
``SEC. 5522. FINDINGS AND PURPOSES.
``(a) * * *
* * * * * * *
``(b) Purposes.--The purposes of this subpart are the
following:
``(1) To authorize and develop 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.
``(2) To authorize and develop internship and
apprentice programs to assist Alaska Natives, Native
Hawaiians, and children and families of Massachusetts
linked by history and tradition with Alaska and Hawaii
to prepare for careers with cultural institutions.
``(3) To supplement programs and authorities in the
area of education to further the objectives of this
subpart.
``(4) To authorize and develop cultural and
educational programs relating to the Mississippi Band
of Choctaw Indians.''
``SEC. 5523. PROGRAM AUTHORIZATION.
``(a) Grants and Contracts.--In order to carry out programs
that fulfill the purposes of this subpart, the Secretary is
authorized to make grants to, or enter into contracts with, the
following:
``(1) The Alaska Native Heritage Center in
Anchorage, Alaska.
``(2) The Inupiat Heritage Center in Barrow,
Alaska.
``(3) The Bishop Museum in Hawaii.
``(4) The Peabody-Essex Museum in Salem,
Massachusetts.
``(5) The New Bedford Whaling Museum and the New
Bedford Oceanarium in New Bedford, Massachusetts.
``(6) The Mississippi Band of Choctaw Indians in
Choctaw, Mississippi.''
``[(6)] (7) Other Alaska Native and Native Hawaiian
cultural and educational organizations.
``[(7)] (8) Cultural and educational organizations
with experience in developing or operating programs
that illustrate and interpret the contributions of
Alaska Natives, Native Hawaiians, the whaling industry,
and the China trade to the economic, social, and
environmental history of the United States.
``[(8)] (9) Consortia of the organizations and
entities described in this subsection.
* * * * * * *
``SEC. 5525. AVAILABILITY OF FUNDS.
``If sufficient funds are made available under section 5401
to carry out this subpart for a fiscal year, the Secretary
shall make available, to support activities described in
section 5523(b), the following amounts:
``(1) Not less than $2,000,000 each to--
``(A) the New Bedford Whaling Museum, in
partnership with the New Bedford Oceanarium, in
Massachusetts; and
``(B) the Inupiat Heritage Center in
Alaska.
``(2) For the New Trade Winds project, not less
than $1,000,000 each to--
``(A) the Alaska Native Heritage Center in
Alaska;
``(B) the Bishop Museum in Hawaii; and
``(C) the Peabody-Essex Museum in
Massachusetts.
``(3) For internship and apprenticeship programs
(including the Museum Action Corps of the Peabody-Essex
Museum), not less than $1,000,000 each to--
``(A) the Alaska Native Heritage Center in
Alaska;
``(B) the Bishop Museum in Hawaii; and
``(C) the Peabody-Essex Museum in
Massachusetts.
``(4) For cultural and educational programs, not
less than $2,000,000 to the Mississippi Band of Choctaw
Indians in Choctaw, Mississippi.''
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL YEAR 2006
[In thousands of dollars]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation compared with (+ or
Committee )
Item 2005 comparable Budget estimate House allowance recommendation -----------------------------------------------------
2005 comparable Budget estimate House allowance
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I--DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
Grants to States:
Adult Training, current year.................................. 184,618 153,736 153,736 181,618 -3,000 +27,882 +27,882
Advance from prior year................................... (706,304) (712,000) (712,000) (712,000) (+5,696) ................ ................
Fiscal year 2007.......................................... 712,000 712,000 712,000 712,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Adult Training.......................................... 896,618 865,736 865,736 893,618 -3,000 +27,882 +27,882
Youth Training................................................ 986,288 950,000 950,000 986,288 ................ +36,288 +36,288
Dislocated Worker Assistance, current year.................... 345,264 226,867 345,264 345,264 ................ +118,397 ................
Advance from prior year................................... (841,216) (848,000) (848,000) (848,000) (+6,784) ................ ................
Fiscal year 2007.......................................... 848,000 848,000 848,000 848,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Dislocated Worker Assistance............................ 1,193,264 1,074,867 1,193,264 1,193,264 ................ +118,397 ................
Federally Administered Programs:
Dislocated Worker Assistance National Reserve:
Current year.............................................. 70,800 56,717 ................ 70,800 ................ +14,083 +70,800
Advance from prior year................................... (210,304) (212,000) (212,000) (212,000) (+1,696) ................ ................
Fiscal year 2007.......................................... 212,000 212,000 212,000 212,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Dislocated Worker Assistance Nat'l Reserve.............. 282,800 268,717 212,000 282,800 ................ +14,083 +70,800
Less funding reserved for Community College Initiative (-125,000) ................ ................ (-125,000) ................ (-125,000) (-125,000)
(NA).....................................................
-----------------------------------------------------------------------------------------------------------------------------
Dislocated Worker Assistance Nat'l Reserve............ 157,800 268,717 212,000 157,800 ................ -110,917 -54,200
-----------------------------------------------------------------------------------------------------------------------------
Total, Dislocated Worker Assistance................... 1,476,064 1,343,584 1,405,264 1,476,064 ................ +132,480 +70,800
Native Americans.............................................. 54,238 54,238 54,238 54,238 ................ ................ ................
Migrant and Seasonal Farmworkers.............................. 75,759 ................ 75,759 80,053 +4,294 +80,053 +4,294
Job Corps:
Operations................................................ 844,670 851,019 851,019 881,000 +36,330 +29,981 +29,981
Advance from prior year............................... (586,272) (591,000) (591,000) (591,000) (+4,728) ................ ................
Fiscal year 2007...................................... 591,000 591,000 591,000 591,000 ................ ................ ................
Construction and Renovation............................... 16,190 ................ ................ 10,000 -6,190 +10,000 +10,000
Advance from prior year............................... (99,200) (100,000) (100,000) (100,000) (+800) ................ ................
Fiscal year 2007...................................... 100,000 75,000 100,000 100,000 ................ +25,000 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Job Corps................................. 1,551,860 1,517,019 1,542,019 1,582,000 +30,140 +64,981 +39,981
National Activities:
Pilots, Demonstrations and Research....................... 85,167 30,000 74,000 90,367 +5,200 +60,367 +16,367
Responsible Reintegration of Youthful Offender............ 49,600 ................ ................ 50,000 +400 +50,000 +50,000
Evaluation................................................ 7,936 7,936 7,936 7,936 ................ ................ ................
Prisoner Re-entry......................................... 19,840 35,000 19,840 19,840 ................ -15,160 ................
Community College initiative.............................. 124,000 250,000 125,000 ................ -124,000 -250,000 -125,000
Community College initiative (NA) \1\................. (125,000) ................ ................ (125,000) ................ (+125,000) (+125,000)
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, CC initiative, program level.............. 249,000 250,000 125,000 125,000 -124,000 -125,000 ................
Denali Commission......................................... 6,944 ................ ................ 6,944 ................ +6,944 +6,944
Other..................................................... 3,458 2,000 2,000 3,458 ................ +1,458 +1,458
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, National activities........................... 296,945 324,936 228,776 178,545 -118,400 -146,391 -50,231
=============================================================================================================================
Subtotal, Federal activities............................ 2,261,602 2,164,910 2,112,792 2,177,636 -83,966 +12,726 +64,844
Current Year........................................ 1,358,602 1,286,910 1,209,792 1,274,636 -83,966 -12,274 +64,844
Fiscal year 2007.................................... 903,000 878,000 903,000 903,000 ................ +25,000 ................
=============================================================================================================================
Total, Training and Employment Services................. 5,337,772 5,055,513 5,121,792 5,250,806 -86,966 +195,293 +129,014
Current Year........................................ (2,874,772) (2,617,513) (2,658,792) (2,787,806) (-86,966) (+170,293) (+129,014)
Fiscal year 2007.................................... (2,463,000) (2,438,000) (2,463,000) (2,463,000) ................ (+25,000) ................
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS.................. 436,678 436,678 436,678 436,678 ................ ................ ................
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES...................... 1,057,300 966,400 966,400 966,400 -90,900 ................ ................
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Unemployment Compensation:
State Operations.............................................. 2,663,040 2,622,499 2,622,499 2,600,000 -63,040 -22,499 -22,499
National Activities........................................... 10,416 10,416 10,416 10,000 -416 -416 -416
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation......................... 2,673,456 2,632,915 2,632,915 2,610,000 -63,456 -22,915 -22,915
Employment Service:
Allotments to States:
Federal Funds............................................. 23,114 23,300 23,300 23,114 ................ -186 -186
Trust Funds............................................... 757,478 672,700 672,700 723,188 -34,290 +50,488 +50,488
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, allotments to States.......................... 780,592 696,000 696,000 746,302 -34,290 +50,302 +50,302
ES National Activities........................................ 64,976 33,766 33,766 33,766 -31,210 ................ ................
=============================================================================================================================
Subtotal, Employment Service................................ 845,568 729,766 729,766 780,068 -65,500 +50,302 +50,302
Federal Funds........................................... 23,114 23,300 23,300 23,114 ................ -186 -186
Trust Funds............................................. 822,454 706,466 706,466 756,954 -65,500 +50,488 +50,488
One-Stop Career Centers/Labor Market Information.................. 97,974 87,974 87,974 90,000 -7,974 +2,026 +2,026
Work Incentives Grants............................................ 19,711 19,711 19,711 19,711 ................ ................ ................
=============================================================================================================================
Total, State Unemployment & Employment Srvcs................ 3,636,709 3,470,366 3,470,366 3,499,779 -136,930 +29,413 +29,413
Federal Funds........................................... 140,799 130,985 130,985 132,825 -7,974 +1,840 +1,840
Trust Funds............................................. 3,495,910 3,339,381 3,339,381 3,366,954 -128,956 +27,573 +27,573
ADVANCES TO THE UI AND OTHER TRUST FUNDS \2\...................... 517,000 465,000 465,000 465,000 -52,000 ................ ................
PROGRAM ADMINISTRATION
Adult Employment and Training..................................... 38,874 44,631 44,631 43,631 +4,757 -1,000 -1,000
Trust Funds................................................... 6,901 7,925 7,925 7,925 +1,024 ................ ................
Youth Employment and Training..................................... 39,627 38,805 38,805 38,805 -822 ................ ................
Employment Security............................................... 6,045 6,039 6,039 6,039 -6 ................ ................
Trust Funds................................................... 48,235 77,952 77,952 72,841 +24,606 -5,111 -5,111
Apprenticeship Services........................................... 21,136 21,655 21,655 21,655 +519 ................ ................
Executive Direction............................................... 6,845 6,993 6,993 6,993 +148 ................ ................
Trust Funds................................................... 2,065 2,111 2,111 2,111 +46 ................ ................
Welfare to Work................................................... 373 ................ ................ ................ -373 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Program Administration............................... 170,101 206,111 206,111 200,000 +29,899 -6,111 -6,111
Federal Funds........................................... 112,900 118,123 118,123 117,123 +4,223 -1,000 -1,000
Trust Funds............................................. 57,201 87,988 87,988 82,877 +25,676 -5,111 -5,111
=============================================================================================================================
Total, Employment and Training Administration............... 11,155,560 10,600,068 10,666,347 10,818,663 -336,897 +218,595 +152,316
Federal Funds........................................... 7,602,449 7,172,699 7,238,978 7,368,832 -233,617 +196,133 +129,854
Current Year........................................ (5,139,449) (4,734,699) (4,775,978) (4,905,832) (-233,617) (+171,133) (+129,854)
Fiscal year 2007.................................... (2,463,000) (2,438,000) (2,463,000) (2,463,000) ................ (+25,000) ................
Trust Funds............................................. 3,553,111 3,427,369 3,427,369 3,449,831 -103,280 +22,462 +22,462
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
Enforcement and Participant Assistance............................ 109,374 114,462 114,462 112,362 +2,988 -2,100 -2,100
Policy and Compliance Assistance.................................. 17,357 17,458 17,458 17,458 +101 ................ ................
Executive Leadership, Program Oversight and Admin................. 4,482 5,080 5,080 5,080 +598 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, EBSA................................................. 131,213 137,000 137,000 134,900 +3,687 -2,100 -2,100
PENSION BENEFIT GUARANTY CORPORATION
Pension insurance activities...................................... (12,211) (42,122) (42,122) (42,122) (+29,911) ................ ................
Pension plan termination.......................................... (169,739) (161,117) (161,117) (161,117) (-8,622) ................ ................
Operational support............................................... (84,380) (93,739) (93,739) (93,739) (+9,359) ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, PBGC (Program level)................................. (266,330) (296,978) (296,978) (296,978) (+30,648) ................ ................
EMPLOYMENT STANDARDS ADMINISTRATION
SALARIES AND EXPENSES
Enforcement of Wage and Hour Standards............................ 164,493 167,359 167,359 167,359 +2,866 ................ ................
Office of Labor-Management Standards.............................. 41,681 48,799 48,799 43,599 +1,918 -5,200 -5,200
Federal Contractor EEO Standards Enforcement...................... 80,059 82,106 82,106 82,106 +2,047 ................ ................
Federal Programs for Workers' Compensation........................ 97,339 100,129 100,129 100,129 +2,790 ................ ................
Trust Funds................................................... 2,023 2,048 2,048 2,048 +25 ................ ................
Program Direction and Support..................................... 15,252 15,891 15,891 17,375 +2,123 +1,484 +1,484
-----------------------------------------------------------------------------------------------------------------------------
Total, ESA salaries and expenses............................ 400,847 416,332 416,332 412,616 +11,769 -3,716 -3,716
Federal Funds........................................... 398,824 414,284 414,284 410,568 +11,744 -3,716 -3,716
Trust Funds............................................. 2,023 2,048 2,048 2,048 +25 ................ ................
SPECIAL BENEFITS
Federal employees compensation benefits........................... 230,000 234,000 234,000 234,000 +4,000 ................ ................
Longshore and harbor workers' benefits............................ 3,000 3,000 3,000 3,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Special Benefits..................................... 233,000 237,000 237,000 237,000 +4,000 ................ ................
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Benefit payments.................................................. 358,806 308,000 308,000 308,000 -50,806 ................ ................
Administration.................................................... 5,191 5,250 5,250 5,250 +59 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Fiscal year 2006 program level.................... 363,997 313,250 313,250 313,250 -50,747 ................ ................
Less funds advanced in prior year....................... -88,000 -81,000 -81,000 -81,000 +7,000 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Current Year, Fiscal year 2006................. 275,997 232,250 232,250 232,250 -43,747 ................ ................
New advances, 1st quarter Fiscal year 2007.............. 81,000 74,000 74,000 74,000 -7,000 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Special Benefits for Disabled Coal Miners...... 356,997 306,250 306,250 306,250 -50,747 ................ ................
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND, Part B 40,321 96,081 96,081 96,081 +55,760 ................ ................
Administrative Expenses..........................................
BLACK LUNG DISABILITY TRUST FUND
Benefit payments and interest on advances......................... 1,004,951 1,010,011 1,010,011 1,010,011 +5,060 ................ ................
Employment Standards Adm. S&E..................................... 32,615 33,050 33,050 33,050 +435 ................ ................
Departmental Management S&E....................................... 23,705 24,239 24,239 24,239 +534 ................ ................
Departmental Management, Inspector General........................ 342 344 344 344 +2 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Black Lung Disability............................. 1,061,613 1,067,644 1,067,644 1,067,644 +6,031 ................ ................
Treasury Administrative Costs..................................... 356 356 356 356 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund..................... 1,061,969 1,068,000 1,068,000 1,068,000 +6,031 ................ ................
=============================================================================================================================
Total, Employment Standards Administration.................. 2,093,134 2,123,663 2,123,663 2,119,947 +26,813 -3,716 -3,716
Federal Funds........................................... 2,091,111 2,121,615 2,121,615 2,117,899 +26,788 -3,716 -3,716
Current year........................................ (2,010,111) (2,047,615) (2,047,615) (2,043,899) (+33,788) (-3,716) (-3,716)
Fiscal year 2007.................................... (81,000) (74,000) (74,000) (74,000) (-7,000) ................ ................
Trust Funds............................................. 2,023 2,048 2,048 2,048 +25 ................ ................
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Safety and Health Standards....................................... 16,003 16,628 16,628 16,628 +625 ................ ................
Federal Enforcement............................................... 169,652 174,318 174,318 174,318 +4,666 ................ ................
State Programs.................................................... 91,013 92,013 92,013 92,013 +1,000 ................ ................
Technical Support................................................. 20,742 21,652 21,652 21,652 +910 ................ ................
Compliance Assistance:
Federal Assistance............................................ 70,859 73,278 73,278 73,278 +2,419 ................ ................
State Consultation Grants..................................... 53,362 53,896 53,896 53,896 +534 ................ ................
Training Grants............................................... 10,218 ................ 10,218 10,510 +292 +10,510 +292
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Compliance Assistance............................. 134,439 127,174 137,392 137,684 +3,245 +10,510 +292
Safety and Health Statistics...................................... 22,203 24,498 24,498 24,498 +2,295 ................ ................
Executive Direction and Administration............................ 10,106 10,698 10,698 10,698 +592 ................ ................
=============================================================================================================================
Total, OSHA................................................. 464,158 466,981 477,199 477,491 +13,333 +10,510 +292
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Coal Enforcement.................................................. 115,251 118,335 118,335 118,335 +3,084 ................ ................
Metal/Non-Metal Enforcement....................................... 66,752 68,750 68,750 68,750 +1,998 ................ ................
Standards Development............................................. 2,334 2,506 2,506 2,506 +172 ................ ................
Assessments....................................................... 5,238 5,445 5,445 5,445 +207 ................ ................
Educational Policy and Development................................ 31,255 32,021 32,021 32,021 +766 ................ ................
Technical Support................................................. 25,111 25,736 25,736 25,736 +625 ................ ................
Program evaluation and information resources (PEIR)............... 17,525 15,671 15,671 15,671 -1,854 ................ ................
Program Administration............................................ 15,670 12,026 12,026 12,026 -3,644 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Mine Safety and Health Administration................ 279,136 280,490 280,490 280,490 +1,354 ................ ................
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
Employment and Unemployment Statistics............................ 162,714 167,047 167,047 167,047 +4,333 ................ ................
Labor Market Information (Trust Funds)............................ 77,845 77,845 77,845 77,845 ................ ................ ................
Prices and Cost of Living......................................... 169,370 174,779 174,779 174,779 +5,409 ................ ................
Compensation and Working Conditions............................... 78,942 81,532 81,532 81,532 +2,590 ................ ................
Productivity and Technology....................................... 10,503 10,847 10,847 10,847 +344 ................ ................
Executive Direction and Staff Services............................ 29,629 30,473 30,473 30,473 +844 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Bureau of Labor Statistics........................... 529,003 542,523 542,523 542,523 +13,520 ................ ................
Federal Funds........................................... 451,158 464,678 464,678 464,678 +13,520 ................ ................
Trust Funds............................................. 77,845 77,845 77,845 77,845 ................ ................ ................
OFFICE OF DISABILITY EMPLOYMENT POLICY
Ofce of Disability Employ. Policy, Salaries & expenses............ 47,164 27,934 27,934 47,164 ................ +19,230 +19,230
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
Executive Direction............................................... 26,720 29,504 24,864 26,720 ................ -2,784 +1,856
Departmental IT Crosscut.......................................... 29,760 29,760 29,760 29,760 ................ ................ ................
Departmental Management Crosscut.................................. 4,960 1,700 1,700 1,700 -3,260 ................ ................
Legal Services.................................................... 79,769 81,907 81,907 80,000 +231 -1,907 -1,907
Trust Funds................................................... 311 311 311 311 ................ ................ ................
International Labor Affairs....................................... 93,248 12,419 12,419 93,248 ................ +80,829 +80,829
Administration and Management..................................... 32,414 33,197 33,197 33,197 +783 ................ ................
Frances Perkins building security enhancements.................... 6,944 6,944 6,944 6,944 ................ ................ ................
Adjudication...................................................... 25,665 27,126 27,126 27,126 +1,461 ................ ................
Women's Bureau.................................................... 9,478 9,764 9,764 9,764 +286 ................ ................
Civil Rights Activities........................................... 6,237 6,451 6,451 6,451 +214 ................ ................
Chief Financial Officer........................................... 5,182 5,340 5,340 5,340 +158 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Salaries and expenses................................ 320,688 244,423 239,783 320,561 -127 +76,138 +80,778
Federal Funds........................................... 320,377 244,112 239,472 320,250 -127 +76,138 +80,778
Trust Funds............................................. 311 311 311 311 ................ ................ ................
VETERANS EMPLOYMENT AND TRAINING
State administration, Grants...................................... 161,097 162,415 162,415 162,415 +1,318 ................ ................
Federal Administration............................................ 30,438 30,435 31,935 30,435 -3 ................ -1,500
National Veterans Training Institute.............................. 1,984 1,984 2,484 1,984 ................ ................ -500
Homeless Veterans Program......................................... 20,832 22,000 25,000 22,000 +1,168 ................ -3,000
Veterans Workforce Investment Programs............................ 8,482 7,500 7,500 7,500 -982 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Veterans Employment and Training..................... 222,833 224,334 229,334 224,334 +1,501 ................ -5,000
Federal Funds........................................... 29,314 29,500 32,500 29,500 +186 ................ -3,000
Trust Funds............................................. 193,519 194,834 196,834 194,834 +1,315 ................ -2,000
OFFICE OF THE INSPECTOR GENERAL
Program Activities................................................ 63,478 65,211 65,211 67,211 +3,733 +2,000 +2,000
Trust Funds................................................... 5,517 5,608 5,608 5,608 +91 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Office of the Inspector General...................... 68,995 70,819 70,819 72,819 +3,824 +2,000 +2,000
Federal funds........................................... 63,478 65,211 65,211 67,211 +3,733 +2,000 +2,000
Trust funds............................................. 5,517 5,608 5,608 5,608 +91 ................ ................
=============================================================================================================================
Total, Departmental Management.............................. 612,516 539,576 539,936 617,714 +5,198 +78,138 +77,778
Federal Funds........................................... 413,169 338,823 337,183 416,961 +3,792 +78,138 +79,778
Trust Funds............................................. 199,347 200,753 202,753 200,753 +1,406 ................ -2,000
WORKING CAPITAL FUND
Working capital fund.............................................. 9,920 6,230 6,230 6,230 -3,690 ................ ................
=============================================================================================================================
Total, Title I, Department of Labor......................... 15,321,804 14,724,465 14,801,322 15,045,122 -276,682 +320,657 +243,800
Federal Funds........................................... 11,489,478 11,016,450 11,091,307 11,314,645 -174,833 +298,195 +223,338
Current Year........................................ (8,945,478) (8,504,450) (8,554,307) (8,777,645) (-167,833) (+273,195) (+223,338)
Fiscal year 2007.................................... (2,544,000) (2,512,000) (2,537,000) (2,537,000) (-7,000) (+25,000) ................
Trust Funds............................................. 3,832,326 3,708,015 3,710,015 3,730,477 -101,849 +22,462 +20,462
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION
HEALTH RESOURCES AND SERVICES
BUREAU OF PRIMARY HEALTH CARE
Community health centers.......................................... 1,734,311 2,037,871 1,834,311 1,839,311 +105,000 -198,560 +5,000
Free Clinics Medical Malpractice.................................. 99 ................ ................ 99 ................ +99 +99
Radiation Exposure Compensation Act............................... 1,958 1,936 1,900 1,958 ................ +22 +58
Healthy Community Access Program.................................. 82,993 ................ ................ 60,000 -22,993 +60,000 +60,000
Hansen's Disease Services......................................... 17,251 16,066 16,066 17,066 -185 +1,000 +1,000
Buildings and Facilities.......................................... 247 222 222 222 -25 ................ ................
Payment to Hawaii, treatment of Hansen's.......................... 2,017 2,016 2,016 2,017 ................ +1 +1
Black lung clinics................................................ 5,951 5,912 5,912 5,975 +24 +63 +63
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Bureau of Primary Health Care..................... 1,844,827 2,064,023 1,860,427 1,926,648 +81,821 -137,375 +66,221
BUREAU OF HEALTH PROFESSIONS
National Health Service Corps:
Field placements.............................................. 45,068 40,705 40,705 40,705 -4,363 ................ ................
Recruitment................................................... 86,380 86,091 86,091 86,091 -289 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, National Health Service Corps..................... 131,448 126,796 126,796 126,796 -4,652 ................ ................
Health Professions
Training for Diversity:
Centers of excellence......................................... 33,609 ................ 12,000 33,609 ................ +33,609 +21,609
Health careers opportunity program............................ 35,647 ................ ................ 35,647 ................ +35,647 +35,647
Faculty loan repayment........................................ 1,302 ................ ................ 1,302 ................ +1,302 +1,302
Scholarships for disadvantaged students....................... 47,128 9,831 35,128 47,128 ................ +37,297 +12,000
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Training for Diversity............................ 117,686 9,831 47,128 117,686 ................ +107,855 +70,558
Training in Primary Care Medicine and Dentistry................... 88,816 ................ ................ 90,000 +1,184 +90,000 +90,000
Interdisciplinary Community-Based Linkages:
Area health education centers................................. 28,971 ................ ................ 28,971 ................ +28,971 +28,971
Health education and training centers......................... 3,819 ................ ................ 3,819 ................ +3,819 +3,819
Allied health and other disciplines........................... 11,753 ................ ................ 11,753 ................ +11,753 +11,753
Geriatric programs............................................ 31,548 ................ ................ 29,548 -2,000 +29,548 +29,548
Quentin N. Burdick program for rural training................. 6,076 ................ ................ 6,076 ................ +6,076 +6,076
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Comm. Linkages.................. 82,167 ................ ................ 80,167 -2,000 +80,167 +80,167
Health Professions Workforce Info & Analysis...................... 716 712 ................ 712 -4 ................ +712
Public Health Workforce Development:
Public health, preventive med. and dental programs............ 9,097 ................ ................ 9,097 ................ +9,097 +9,097
Health administration programs................................ 1,070 ................ ................ 1,070 ................ +1,070 +1,070
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Public Health Workforce Development............... 10,167 ................ ................ 10,167 ................ +10,167 +10,167
Nursing Programs:
Advanced Education Nursing.................................... 58,160 42,806 57,637 58,160 ................ +15,354 +523
Nurse education, practice, and retention...................... 36,468 46,325 36,468 40,468 +4,000 -5,857 +4,000
Nursing workforce diversity................................... 16,270 21,244 16,270 17,270 +1,000 -3,974 +1,000
Loan repayment and scholarship program........................ 31,482 31,369 31,369 31,482 ................ +113 +113
Comprehensive geriatric education............................. 3,450 3,426 3,426 3,450 ................ +24 +24
Nursing faculty loan program.................................. 4,831 4,821 4,821 4,831 ................ +10 +10
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Nursing programs.................................. 150,661 149,991 149,991 155,661 +5,000 +5,670 +5,670
=============================================================================================================================
Subtotal, Health Professions................................ 450,213 160,534 197,119 454,393 +4,180 +293,859 +257,274
Children's Hospitals Graduate Medical Education................... 300,730 200,000 300,000 300,000 -730 +100,000 ................
National Practitioner Data Bank................................... 15,700 15,700 15,700 15,700 ................ ................ ................
User Fees..................................................... -15,700 -15,700 -15,700 -15,700 ................ ................ ................
Health Care Integrity and Protection Data Bank.................... 4,000 4,000 4,000 4,000 ................ ................ ................
User Fees..................................................... -4,000 -4,000 -4,000 -4,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Bureau of Health Professions...................... 882,391 487,330 623,915 881,189 -1,202 +393,859 +257,274
MATERNAL AND CHILD HEALTH BUREAU
Maternal and Child Health Block Grant............................. 723,928 723,928 700,000 710,000 -13,928 -13,928 +10,000
Sickle cell service demonstration program......................... 198 ................ ................ 500 +302 +500 +500
Traumatic Brain Injury............................................ 9,297 ................ 9,000 9,297 ................ +9,297 +297
Healthy Start..................................................... 102,543 97,747 97,747 104,000 +1,457 +6,253 +6,253
Universal Newborn Hearing......................................... 9,792 ................ 10,000 9,792 ................ +9,792 -208
Emergency medical services for children........................... 19,830 ................ 19,000 20,000 +170 +20,000 +1,000
Poison control.................................................... 23,499 23,301 23,301 23,301 -198 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Maternal and Child Health Bureau.................. 889,087 844,976 859,048 876,890 -12,197 +31,914 +17,842
HIV/AIDS BUREAU
Ryan White AIDS Programs:
Emergency Assistance.......................................... 610,094 610,094 610,094 610,094 ................ ................ ................
Comprehensive Care Programs................................... 1,121,836 1,131,836 1,131,836 1,131,836 +10,000 ................ ................
AIDS Drug Assistance Program (ADAP) (NA).................. (787,521) (797,521) (797,521) (797,521) (+10,000) ................ ................
Early Intervention Program.................................... 195,578 195,578 195,578 195,578 ................ ................ ................
Pediatric HIV/AIDS............................................ 72,519 72,519 72,519 72,519 ................ ................ ................
AIDS Dental Services.......................................... 13,218 13,218 13,218 13,218 ................ ................ ................
Education and Training Centers................................ 35,051 35,051 35,051 35,051 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Ryan White AIDS programs.......................... 2,048,296 2,058,296 2,058,296 2,058,296 +10,000 ................ ................
Evaluation Tap Funding (NA)................................... (25,000) (25,000) (25,000) (25,000) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Ryan White AIDs program level..................... (2,073,296) (2,083,296) (2,083,296) (2,083,296) (+10,000) ................ ................
Telehealth.................................................... 3,916 3,888 3,888 3,888 -28 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, HIV/AIDS Bureau................................... 2,052,212 2,062,184 2,062,184 2,062,184 +9,972 ................ ................
SPECIAL PROGRAMS BUREAU
Organ Transplantation............................................. 24,413 23,282 23,282 24,413 ................ +1,131 +1,131
Cord Blood Stem Cell Bank......................................... 9,859 ................ ................ 9,859 ................ +9,859 +9,859
Bone Marrow Program............................................... 25,416 22,916 25,416 22,916 -2,500 ................ -2,500
Trauma Care....................................................... 3,418 ................ ................ 3,418 ................ +3,418 +3,418
State Planning Grants for Health Care Access...................... 10,910 ................ ................ ................ -10,910 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Special programs bureau........................... 74,016 46,198 48,698 60,606 -13,410 +14,408 +11,908
RURAL HEALTH PROGRAMS
Rural outreach grants............................................. 39,278 10,767 10,767 39,278 ................ +28,511 +28,511
Rural Health Research............................................. 8,825 8,528 ................ 8,825 ................ +297 +8,825
Rural Hospital Flexibility Grants................................. 39,180 ................ 39,180 64,180 +25,000 +64,180 +25,000
Rural and community access to emergency devices................... 8,927 1,960 1,960 8,927 ................ +6,967 +6,967
Rural EMS......................................................... 496 ................ ................ 500 +4 +500 +500
State Offices of Rural Health..................................... 8,321 8,223 8,223 8,321 ................ +98 +98
Denali Commission................................................. 39,680 ................ ................ 39,680 ................ +39,680 +39,680
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Rural health programs............................. 144,707 29,478 60,130 169,711 +25,004 +140,233 +109,581
Bioterrorism preparedness \3\..................................... ................ ................ 500,000 510,500 +510,500 +510,500 +10,500
Family Planning................................................... 285,963 285,963 285,963 285,963 ................ ................ ................
Health Care-related Facilities and activities..................... 482,729 ................ ................ 480,751 -1,978 +480,751 +480,751
Program Management................................................ 147,080 145,992 143,072 143,992 -3,088 -2,000 +920
=============================================================================================================================
Total, Health resources and services........................ 6,803,012 5,966,144 6,443,437 7,398,434 +595,422 +1,432,290 +954,997
Total, Health resources & services program level............ (6,828,012) (5,991,144) (6,468,437) (7,423,434) (+595,422) (+1,432,290) (+954,997)
Evaluation tap funding.................................. (25,000) (25,000) (25,000) (25,000) ................ ................ ................
HEALTH EDUCATION ASSISTANCE LOANS (HEAL) PROGRAM:
Liquidating account........................................... (4,000) (4,000) (4,000) (4,000) ................ ................ ................
Program management............................................ 3,244 2,916 2,916 2,916 -328 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, HEAL................................................. 3,244 2,916 2,916 2,916 -328 ................ ................
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:
Post-Fiscal Year 1988 claims.................................. 66,000 70,884 70,884 70,884 +4,884 ................ ................
HRSA administration........................................... 3,151 2,832 3,500 3,600 +449 +768 +100
-----------------------------------------------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund............... 69,151 73,716 74,384 74,484 +5,333 +768 +100
=============================================================================================================================
Total, Health Resources and Services Admin.................. 6,875,407 6,042,776 6,520,737 7,475,834 +600,427 +1,433,058 +955,097
Total, HRSA program level................................... (6,904,407) (6,071,776) (6,549,737) (7,504,834) (+600,427) (+1,433,058) (+955,097)
CENTERS FOR DISEASE CONTROL AND PREVENTION
Infectious Diseases............................................... 1,667,095 1,696,964 1,704,529 1,696,567 +29,472 -397 -7,962
Evaluation Tap Funding........................................ (12,794) (12,794) (12,794) (12,794) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (1,679,889) (1,709,758) (1,717,323) (1,709,361) (+29,472) (-397) (-7,962)
Health Promotion.................................................. 1,021,709 964,421 983,647 974,080 -47,629 +9,659 -9,567
Health Information and Service.................................... 94,438 89,564 195,069 89,564 -4,874 ................ -105,505
Evaluation Tap Funding........................................ (134,235) (134,235) (28,730) (134,235) ................ ................ (+105,505)
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (228,673) (223,799) (223,799) (223,799) (-4,874) ................ ................
Environmental health and injury................................... 285,721 284,820 285,721 288,982 +3,261 +4,162 +3,261
Occupational safety and health \4\................................ 198,970 198,859 164,170 170,050 -28,920 -28,809 +5,880
Evaluation Tap Funding........................................ (87,071) (87,071) (87,071) (87,071) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level \4\................................. (286,041) (285,930) (251,241) (257,121) (-28,920) (-28,809) (+5,880)
Global health..................................................... 293,863 306,079 309,076 313,227 +19,364 +7,148 +4,151
Supplemental (Public Law 109-13) (emergency).................. 15,000 ................ ................ ................ -15,000 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (308,863) (306,079) (309,076) (313,227) (+4,364) (+7,148) (+4,151)
Terrorism preparedness and response \3\........................... ................ ................ 1,616,723 1,566,471 +1,566,471 +1,566,471 -50,252
Public Health research:
Evaluation Tap Funding........................................ (31,000) (31,000) (31,000) (31,000) ................ ................ ................
Public health improvement and leadership.......................... 266,842 206,541 258,541 269,055 +2,213 +62,514 +10,514
Preventive health and health services block grant................. 118,526 ................ 100,000 100,000 -18,526 +100,000 ................
Buildings and Facilities.......................................... 269,708 30,000 30,000 225,000 -44,708 +195,000 +195,000
Business services................................................. 278,838 263,715 298,515 296,119 +17,281 +32,404 -2,396
-----------------------------------------------------------------------------------------------------------------------------
Total, Centers for Disease Control.......................... 4,510,710 4,040,963 5,945,991 5,989,115 +1,478,405 +1,948,152 +43,124
Evaluation Tap Funding (NA)............................. (265,100) (265,100) (159,595) (265,100) ................ ................ (+105,505)
Total, Centers for Disease Control program level............ (4,775,810) (4,306,063) (6,105,586) (6,254,215) (+1,478,405) (+1,948,152) (+148,629)
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute......................................... 4,825,259 4,841,774 4,841,774 4,960,828 +135,569 +119,054 +119,054
National Heart, Lung, and Blood Institute......................... 2,941,201 2,951,270 2,951,270 3,023,381 +82,180 +72,111 +72,111
National Institute of Dental & Craniofacial Research.............. 391,829 393,269 393,269 405,269 +13,440 +12,000 +12,000
National Institute of Diabetes and Digestive and Kidney Diseases.. 1,713,584 1,722,146 1,722,146 1,767,919 +54,335 +45,773 +45,773
Juvenile diabetes (mandatory)................................. (150,000) (150,000) (150,000) (150,000) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, NIDDK............................................. (1,863,584) (1,872,146) (1,872,146) (1,917,919) (+54,335) (+45,773) (+45,773)
National Institute of Neurological Disorders & Stroke............. 1,539,448 1,550,260 1,550,260 1,591,924 +52,476 +41,664 +41,664
National Institute of Allergy and Infectious Diseases............. 4,303,640 4,359,395 4,359,395 4,447,136 +143,496 +87,741 +87,741
Global HIV/AIDS Fund Transfer................................. 99,200 100,000 ................ 100,000 +800 ................ +100,000
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, NIAID............................................. 4,402,840 4,459,395 4,359,395 4,547,136 +144,296 +87,741 +187,741
National Institute of General Medical Sciences.................... 1,944,067 1,955,170 1,955,170 2,002,622 +58,555 +47,452 +47,452
National Institute of Child Health & Human Development............ 1,270,321 1,277,544 1,277,544 1,310,989 +40,668 +33,445 +33,445
National Eye Institute............................................ 669,070 673,491 673,491 693,559 +24,489 +20,068 +20,068
National Institute of Environmental Health Sciences............... 644,505 647,608 647,608 667,372 +22,867 +19,764 +19,764
National Institute on Aging....................................... 1,051,990 1,057,203 1,057,203 1,090,600 +38,610 +33,397 +33,397
National Institute of Arthritis and Musculoskeletal and Skin Dis- 511,157 513,063 513,063 525,758 +14,601 +12,695 +12,695
eases............................................................
National Institute on Deafness and Other Communication Dis- 394,259 397,432 397,432 409,432 +15,173 +12,000 +12,000
orders...........................................................
National Institute of Nursing Research............................ 138,072 138,729 138,729 142,549 +4,477 +3,820 +3,820
National Institute on Alcohol Abuse and Alcoholism................ 438,277 440,333 440,333 452,271 +13,994 +11,938 +11,938
National Institute on Drug Abuse.................................. 1,006,419 1,010,130 1,010,130 1,035,167 +28,748 +25,037 +25,037
National Institute of Mental Health............................... 1,411,933 1,417,692 1,417,692 1,460,393 +48,460 +42,701 +42,701
National Human Genome Research Institute.......................... 488,608 490,959 490,959 502,804 +14,196 +11,845 +11,845
National Institute of Biomedical Imaging and Bioengineering....... 298,209 299,808 299,808 309,091 +10,882 +9,283 +9,283
National Center for Research Resources............................ 1,115,090 1,100,203 1,100,203 1,188,079 +72,989 +87,876 +87,876
National Center for Complementary and Alternative Medicine........ 122,105 122,692 122,692 126,978 +4,873 +4,286 +4,286
National Center on Minority Health and Health Disparities......... 196,159 197,379 197,379 203,367 +7,208 +5,988 +5,988
John E. Fogarty International Center.............................. 66,632 67,048 67,048 68,745 +2,113 +1,697 +1,697
National Library of Medicine...................................... 315,146 318,091 318,091 327,222 +12,076 +9,131 +9,131
Evaluation Tap Funding........................................ (8,200) (8,200) (8,200) (8,200) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, NLM............................................... 323,346 326,291 326,291 335,422 +12,076 +9,131 +9,131
Office of the Director \3\........................................ 358,047 385,195 482,216 487,434 +129,387 +102,239 +5,218
Biodefense countermeasures.................................... ................ ................ (97,021) (97,021) (+97,021) (+97,021) ................
Buildings and Facilities.......................................... 110,288 81,900 81,900 113,626 +3,338 +31,726 +31,726
=============================================================================================================================
Total, National Institutes of Health (NIH).................. 28,364,515 28,509,784 28,506,805 29,414,515 +1,050,000 +904,731 +907,710
Global HIV/AIDS Fund Transfer........................... -99,200 -100,000 ................ -100,000 -800 ................ -100,000
Evaluation Tap Funding.................................. (8,200) (8,200) (8,200) (8,200) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, NIH, Program Level................................... (28,273,515) (28,417,984) (28,515,005) (29,322,715) (+1,049,200) (+904,731) (+807,710)
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA)
Mental Health:
Programs of Regional and National Significance................ 274,297 210,213 253,257 274,297 ................ +64,084 +21,040
Mental Health block grant..................................... 410,953 410,953 410,953 410,953 ................ ................ ................
Evaluation Tap Funding.................................... (21,803) (21,803) (21,803) (21,803) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. (432,756) (432,756) (432,756) (432,756) ................ ................ ................
Children's Mental Health...................................... 105,112 105,129 105,129 105,129 +17 ................ ................
Grants to States for the Homeless (PATH)...................... 54,809 54,809 54,809 54,809 ................ ................ ................
Protection and Advocacy....................................... 34,343 34,343 34,343 34,343 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Mental Health..................................... 879,514 815,447 858,491 879,531 +17 +64,084 +21,040
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (901,317) (837,250) (880,294) (901,334) (+17) (+64,084) (+21,040)
Substance Abuse Treatment:
Programs of Regional and National Significance................ 418,066 442,752 405,131 407,791 -10,275 -34,961 +2,660
Evaluation Tap Funding.................................... (4,300) (4,300) (4,300) (4,300) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. (422,366) (447,052) (409,431) (412,091) (-10,275) (-34,961) (+2,660)
Substance Abuse block grant................................... 1,696,355 1,696,355 1,696,355 1,696,355 ................ ................ ................
Evaluation Tap Funding.................................... (79,200) (79,200) (79,200) (79,200) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. (1,775,555) (1,775,555) (1,775,555) (1,775,555) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment..................... 2,114,421 2,139,107 2,101,486 2,104,146 -10,275 -34,961 +2,660
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. (2,197,921) (2,222,607) (2,184,986) (2,187,646) (-10,275) (-34,961) (+2,660)
Substance Abuse Prevention:
Programs of Regional and National Significance................ 198,725 184,349 194,950 202,289 +3,564 +17,940 +7,339
Program Management............................................ 75,806 75,817 75,817 75,817 +11 ................ ................
Evaluation Tap funding (NA)............................... (18,000) (16,000) (16,000) (18,000) ................ (+2,000) (+2,000)
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. 93,806 91,817 91,817 93,817 +11 +2,000 +2,000
=============================================================================================================================
Total, SAMHSA........................................... 3,268,466 3,214,720 3,230,744 3,261,783 -6,683 +47,063 +31,039
Evaluation Tap funding.............................. (123,303) (121,303) (121,303) (123,303) ................ (+2,000) (+2,000)
Total, SAMHSA program level............................. (3,391,769) (3,336,023) (3,352,047) (3,385,086) (-6,683) (+49,063) (+33,039)
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
Research on Health Costs, Quality, and Outcomes:
Federal Funds................................................. ................ ................ 318,695 ................ ................ ................ -318,695
Evaluation Tap funding (NA)................................... (260,695) (260,695) ................ (265,695) (+5,000) (+5,000) (+265,695)
Clinial effectiveness research (NA)....................... (15,000) (15,000) ................ (20,000) (+5,000) (+5,000) (+20,000)
Reducing medical errors (NA).............................. (84,000) (84,000) ................ (84,000) ................ ................ (+84,000)
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level................................. (260,695) (260,695) (318,695) (265,695) (+5,000) (+5,000) (-53,000)
Health Insurance and Expenditure Surveys:
Evaluation Tap funding (NA)................................... (55,300) (55,300) ................ (55,300) ................ ................ (+55,300)
Program Support:
Evaluation Tap funding (NA)................................... (2,700) (2,700) ................ (2,700) ................ ................ (+2,700)
=============================================================================================================================
Total, AHRQ................................................. ................ ................ 318,695 ................ ................ ................ -318,695
Evaluation Tap funding (NA)............................. (318,695) (318,695) ................ (323,695) (+5,000) (+5,000) (+323,695)
Total, AHRQ program level................................... (318,695) (318,695) (318,695) (323,695) (+5,000) (+5,000) (+5,000)
=============================================================================================================================
Total, Public Health Service appropriation.................. 43,019,098 41,808,243 44,522,972 46,141,247 +3,122,149 +4,333,004 +1,618,275
Total, Public Health Service program level.................. (43,664,196) (42,450,541) (44,841,070) (46,790,545) (+3,126,349) (+4,340,004) (+1,949,475)
CENTERS FOR MEDICARE AND MEDICAID SERVICES GRANTS TO STATES FOR
MEDICAID
Medicaid current law benefits..................................... 171,407,893 204,166,276 204,166,276 204,166,276 +32,758,383 ................ ................
State and local administration.................................... 9,318,602 9,803,100 9,803,100 9,803,100 +484,498 ................ ................
Vaccines for Children............................................. 1,468,799 1,502,333 1,502,333 1,502,333 +33,534 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Medicaid program level............................ 182,195,294 215,471,709 215,471,709 215,471,709 +33,276,415 ................ ................
Less funds advanced in prior year....................... -58,416,275 -58,517,290 -58,517,290 -58,517,290 -101,015 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Grants to States for medicaid........................ 123,779,019 156,954,419 156,954,419 156,954,419 +33,175,400 ................ ................
New advance, 1st quarter................................ 58,517,290 62,783,825 62,783,825 62,783,825 +4,266,535 ................ ................
PAYMENTS TO HEALTH CARE TRUST FUNDS
Supplemental medical insurance.................................... 114,002,000 128,015,000 128,015,000 128,015,000 +14,013,000 ................ ................
Hospital insurance for the uninsured.............................. 87,000 202,000 202,000 202,000 +115,000 ................ ................
Federal uninsured payment......................................... 199,000 206,000 206,000 206,000 +7,000 ................ ................
Program management................................................ 215,000 164,000 164,000 164,000 -51,000 ................ ................
General revenue for Part D benefit................................ ................ 53,596,000 53,596,000 53,596,000 +53,596,000 ................ ................
General revenue for Part D administration (CMS)................... ................ 357,000 357,000 357,000 +357,000 ................ ................
General revenue for Part D administration (SSA)................... ................ 320,000 320,000 320,000 +320,000 ................ ................
HCFAC reimbursement............................................... ................ 80,000 ................ 80,000 +80,000 ................ +80,000
Prescription drug eligibility determinations...................... 105,900 99,100 99,100 99,100 -6,800 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Payments to Trust Funds, current law.............. 114,608,900 183,039,100 182,959,100 183,039,100 +68,430,200 ................ +80,000
Less funds advanced in prior year....................... ................ -5,216,900 -5,216,900 -5,216,900 -5,216,900 ................ ................
New Advance Fiscal Year 2007............................ 5,216,900 ................ ................ ................ -5,216,900 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Payments to Trust Funds, current law................. 119,825,800 177,822,200 177,742,200 177,822,200 +57,996,400 ................ +80,000
PROGRAM MANAGEMENT
Medicare reform funding \5\ \6\ \7\ (NA).......................... (250,000) (250,000) (250,000) (250,000) ................ ................ ................
Research, Demonstration, Evaluation............................... 77,494 45,194 65,000 78,494 +1,000 +33,300 +13,494
Medicare Operations............................................... 1,722,984 2,189,987 2,172,987 2,184,984 +462,000 -5,003 +11,997
H.R. 3103 funding (NA)........................................ (720,000) (720,000) (720,000) (720,000) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Medicare Operations program level................. (2,442,984) (2,909,987) (2,892,987) (2,904,984) (+462,000) (-5,003) (+11,997)
Revitalization plan............................................... 24,205 24,205 24,205 24,205 ................ ................ ................
State Survey and Certification.................................... 258,735 260,735 260,735 260,735 +2,000 ................ ................
Federal Administration............................................ 581,493 657,357 657,357 655,000 +73,507 -2,357 -2,357
=============================================================================================================================
Total, Program management, Limitation on new BA............. 2,664,911 3,177,478 3,180,284 3,203,418 +538,507 +25,940 +23,134
Total, Program management, program level.................... (3,384,911) (3,897,478) (3,900,284) (3,923,418) (+538,507) (+25,940) (+23,134)
Health Care Fraud and Abuse Control:
Part D drug benefit/medicare advantage (MIP).................. ................ 75,000 ................ 75,000 +75,000 ................ +75,000
Medicaid and SCHIP financial management....................... ................ 5,000 ................ 5,000 +5,000 ................ +5,000
-----------------------------------------------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control.................. ................ 80,000 ................ 80,000 +80,000 ................ +80,000
=============================================================================================================================
Total, Center for Medicare and Medicaid Services............ 304,787,020 400,817,922 400,660,728 400,843,862 +96,056,842 +25,940 +183,134
Federal funds........................................... 302,122,109 397,560,444 397,480,444 397,560,444 +95,438,335 ................ +80,000
Current year........................................ (238,387,919) (334,776,619) (334,696,619) (334,776,619) (+96,388,700) ................ (+80,000)
New advance, fiscal year 2007....................... (63,734,190) (62,783,825) (62,783,825) (62,783,825) (-950,365) ................ ................
Trust Funds............................................. 2,664,911 3,257,478 3,180,284 3,283,418 +618,507 +25,940 +103,134
ADMINISTRATION FOR CHILDREN AND FAMILIES
FAMILY SUPPORT PAYMENTS TO STATES
Payments to territories........................................... 23,000 33,000 33,000 33,000 +10,000 ................ ................
Repatriation...................................................... 1,000 1,300 1,300 1,000 ................ -300 -300
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Welfare payments.................................. 24,000 34,300 34,300 34,000 +10,000 -300 -300
Child Support Enforcement:
State and local administration................................ 3,610,465 3,715,816 3,715,816 3,767,816 +157,351 +52,000 +52,000
Federal incentive payments.................................... 446,000 458,000 458,000 458,000 +12,000 ................ ................
Access and visitation......................................... 10,000 12,000 12,000 10,000 ................ -2,000 -2,000
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement......................... 4,066,465 4,185,816 4,185,816 4,235,816 +169,351 +50,000 +50,000
=============================================================================================================================
Total, Family support payments program level................ 4,090,465 4,220,116 4,220,116 4,269,816 +179,351 +49,700 +49,700
Less funds advanced in previous years................... -1,200,000 -1,200,000 -1,200,000 -1,200,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Family support payments, current request............. 2,890,465 3,020,116 3,020,116 3,069,816 +179,351 +49,700 +49,700
New advance, 1st quarter, fiscal year 2007.............. 1,200,000 1,200,000 1,200,000 1,200,000 ................ ................ ................
=============================================================================================================================
Total, Family support payments.............................. 4,090,465 4,220,116 4,220,116 4,269,816 +179,351 +49,700 +49,700
LOW INCOME HOME ENERGY ASSISTANCE PROGRAM
Formula grants.................................................... 1,884,799 1,800,000 2,006,799 1,883,000 -1,799 +83,000 -123,799
Emergency allocation:
Contingent emergency allocation............................... ................ 200,000 ................ ................ ................ -200,000 ................
Emergency allocation.......................................... 297,600 ................ ................ 300,000 +2,400 +300,000 +300,000
-----------------------------------------------------------------------------------------------------------------------------
Total, Low income home energy assistance.................... 2,182,399 2,000,000 2,006,799 2,183,000 +601 +183,000 +176,201
REFUGEE AND ENTRANT ASSISTANCE
Transitional and Medical Services................................. 192,028 264,129 264,129 264,129 +72,101 ................ ................
Victims of Trafficking............................................ 9,915 9,915 9,915 9,915 ................ ................ ................
Social Services................................................... 164,888 151,121 160,000 151,121 -13,767 ................ -8,879
Preventive Health................................................. 4,796 4,796 4,796 4,796 ................ ................ ................
Targeted Assistance............................................... 49,081 49,081 49,081 49,081 ................ ................ ................
Unaccompanied minors.............................................. 53,771 63,083 63,083 63,083 +9,312 ................ ................
Emergency appropriations...................................... ................ ................ ................ 19,100 +19,100 +19,100 +19,100
Victims of Torture................................................ 9,915 9,915 9,915 9,915 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Refugee and entrant assistance....................... 484,394 552,040 560,919 571,140 +86,746 +19,100 +10,221
CHILD CARE AND DEVELOPMENT BLOCK GRANT............................ 2,082,921 2,082,910 2,082,910 2,082,910 -11 ................ ................
SOCIAL SERVICES BLOCK GRANT (TITLE XX)............................ 1,700,000 1,700,000 1,700,000 1,700,000 ................ ................ ................
CHILDREN AND FAMILIES SERVICES PROGRAMS
Programs for Children, Youth and Families:
Head Start, current funded.................................... 5,454,314 5,499,336 5,499,000 5,474,314 +20,000 -25,022 -24,686
Advance from prior year................................... (1,388,800) (1,400,000) (1,400,000) (1,400,000) (+11,200) ................ ................
Fiscal year 2007.......................................... 1,400,000 1,388,800 1,400,000 1,388,800 -11,200 ................ -11,200
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Head Start, program level..................... 6,843,114 6,899,336 6,899,000 6,874,314 +31,200 -25,022 -24,686
Consolidated Runaway, Homeless Youth Program.................. 88,724 88,728 88,728 88,724 ................ -4 -4
Maternity Group Homes......................................... ................ 10,000 ................ ................ ................ -10,000 ................
Prevention grants to reduce abuse of runaway youth............ 15,178 15,179 15,179 15,179 +1 ................ ................
Child Abuse State Grants...................................... 27,280 27,280 27,280 27,280 ................ ................ ................
Child Abuse Discretionary Activities.......................... 31,640 31,645 31,645 31,640 ................ -5 -5
Community based child abuse prevention........................ 42,858 42,859 42,859 42,859 +1 ................ ................
Abandoned Infants Assistance.................................. 11,955 11,955 11,955 11,955 ................ ................ ................
Child Welfare Services........................................ 289,650 289,650 289,650 289,650 ................ ................ ................
Child Welfare Training........................................ 7,409 7,409 7,409 7,409 ................ ................ ................
Adoption Opportunities........................................ 27,116 27,119 27,119 27,119 +3 ................ ................
Adoption Incentive (no cap adjustment)........................ 31,846 31,846 31,846 22,846 -9,000 -9,000 -9,000
Adoption Awareness............................................ 12,802 12,802 12,802 12,802 ................ ................ ................
Compassion Capital Fund....................................... 54,549 100,000 75,000 95,000 +40,451 -5,000 +20,000
Social Services and Income Maintenance Research................... 26,012 ................ 2,621 26,012 ................ +26,012 +23,391
Evaluation tap funding........................................ (6,000) (6,000) (8,000) (6,000) ................ ................ (-2,000)
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (32,012) (6,000) (10,621) (32,012) ................ (+26,012) (+21,391)
Developmental Disabilities Programs:
State Councils................................................ 72,496 72,496 72,496 72,496 ................ ................ ................
Protection and Advocacy....................................... 38,109 38,109 38,109 39,109 +1,000 +1,000 +1,000
Voting access for individuals with disabilities............... 14,879 14,879 14,879 14,879 ................ ................ ................
Developmental Disabilities Projects of National Significance.. 11,542 11,529 11,529 11,529 -13 ................ ................
University Centers for Excellence in Developmental 31,549 31,548 33,548 33,548 +1,999 +2,000 ................
Disabilities.................................................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Developmental disabilities programs............... 168,575 168,561 170,561 171,561 +2,986 +3,000 +1,000
Native American Programs.......................................... 44,786 44,780 44,780 44,780 -6 ................ ................
Community Services:
Grants to States for Community Services....................... 636,793 ................ 320,000 636,793 ................ +636,793 +316,793
Community Initiative Program:
Economic Development...................................... 32,731 ................ 32,731 32,731 ................ +32,731 ................
Individual Development Account Initiative................. 24,704 24,699 24,699 24,699 -5 ................ ................
Rural Community Facilities................................ 7,242 ................ 7,242 7,492 +250 +7,492 +250
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Community Initiative Program.................. 64,677 24,699 64,672 64,922 +245 +40,223 +250
National Youth Sports............................................. 17,856 ................ ................ ................ -17,856 ................ ................
Community Food and Nutrition...................................... 7,180 ................ ................ 7,180 ................ +7,180 +7,180
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Community Services................................ 726,506 24,699 384,672 708,895 -17,611 +684,196 +324,223
Domestic Violence Hotline......................................... 3,224 3,000 3,000 3,000 -224 ................ ................
Family Violence/Battered Women's Shelters......................... 125,630 125,991 125,991 125,991 +361 ................ ................
Early Learning Fund............................................... 35,712 ................ ................ ................ -35,712 ................ ................
Mentoring Children of Prisoners................................... 49,598 49,993 49,993 49,993 +395 ................ ................
Independent Living Training Vouchers.............................. 46,623 59,999 50,000 46,623 ................ -13,376 -3,377
Abstinence Education.............................................. 99,198 138,045 110,000 101,000 +1,802 -37,045 -9,000
Evaluation Tap Funding........................................ (4,500) (4,500) (4,500) (4,500) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Program level..................................... (103,698) (142,545) (114,500) (105,500) (+1,802) (-37,045) (-9,000)
Faith-Based Center................................................ 1,375 1,400 1,400 1,400 +25 ................ ................
Program Direction................................................. 185,210 185,217 185,217 186,000 +790 +783 +783
=============================================================================================================================
Total, Children and Families Services Programs.............. 9,007,770 8,386,293 8,688,707 9,000,832 -6,938 +614,539 +312,125
Current Year............................................ (7,607,770) (6,997,493) (7,288,707) (7,612,032) (+4,262) (+614,539) (+323,325)
Fiscal year 2007........................................ (1,400,000) (1,388,800) (1,400,000) (1,388,800) (-11,200) ................ (-11,200)
Evaluation Tap funding.................................. (10,500) (10,500) (12,500) (10,500) ................ ................ (-2,000)
=============================================================================================================================
Total, Program level........................................ 9,018,270 8,396,793 8,701,207 9,011,332 -6,938 +614,539 +310,125
PROMOTING SAFE AND STABLE FAMILIES................................ 305,000 305,000 305,000 305,000 ................ ................ ................
Discretionary Funds........................................... 98,586 105,000 99,000 90,000 -8,586 -15,000 -9,000
PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION
Foster Care....................................................... 4,895,500 4,685,000 4,685,000 4,685,000 -210,500 ................ ................
Adoption Assistance............................................... 1,770,100 1,795,000 1,795,000 1,795,000 +24,900 ................ ................
Independent living................................................ 140,000 140,000 140,000 140,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Payments to States................................... 6,805,600 6,620,000 6,620,000 6,620,000 -185,600 ................ ................
Less Advances from Prior Year........................... -1,767,700 -1,767,200 -1,767,200 -1,767,200 +500 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, payments, current year............................... 5,037,900 4,852,800 4,852,800 4,852,800 -185,100 ................ ................
New Advance, 1st quarter................................ 1,767,200 1,730,000 1,730,000 1,730,000 -37,200 ................ ................
=============================================================================================================================
Total, Administration for Children & Families............... 26,756,635 25,934,159 26,246,251 26,785,498 +28,863 +851,339 +539,247
Current year............................................ (22,389,435) (21,615,359) (21,916,251) (22,466,698) (+77,263) (+851,339) (+550,447)
Fiscal year 2007........................................ (4,367,200) (4,318,800) (4,330,000) (4,318,800) (-48,400) ................ (-11,200)
Evaluation Tap funding.................................. (10,500) (10,500) (12,500) (10,500) ................ ................ (-2,000)
=============================================================================================================================
Total, Administration for Children & Families............... 26,767,135 25,944,659 26,258,751 26,795,998 +28,863 +851,339 +537,247
ADMINISTRATION ON AGING
Grants to States:
Supportive Services and Centers............................... 354,136 354,136 354,136 354,136 ................ ................ ................
Preventive Health............................................. 21,616 21,616 21,616 21,616 ................ ................ ................
Protection of vulnerable older americans-Title VII............ 19,288 19,360 19,360 20,360 +1,072 +1,000 +1,000
Family Caregivers............................................. 155,744 155,744 155,744 160,744 +5,000 +5,000 +5,000
Native American Caregivers Support............................ 6,304 6,304 6,304 6,304 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Caregivers........................................ 162,048 162,048 162,048 167,048 +5,000 +5,000 +5,000
Nutrition:
Congregate Meals.......................................... 387,274 387,274 391,147 387,274 ................ ................ -3,873
Home Delivered Meals...................................... 182,827 182,826 184,656 182,827 ................ +1 -1,829
Nutrition Services Incentive Program...................... 148,596 148,596 150,082 148,596 ................ ................ -1,486
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Nutrition..................................... 718,697 718,696 725,885 718,697 ................ +1 -7,188
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Grants to States.............................. 1,275,785 1,275,856 1,283,045 1,281,857 +6,072 +6,001 -1,188
Grants for Native Americans....................................... 26,398 26,398 26,398 26,398 ................ ................ ................
Program Innovations............................................... 43,286 23,843 23,843 40,513 -2,773 +16,670 +16,670
Aging Network Support Activities.................................. 13,266 13,266 13,266 13,266 ................ ................ ................
Alzheimer's Disease Demonstrations................................ 11,786 11,786 11,786 11,786 ................ ................ ................
White House Conference on Aging................................... 4,520 ................ ................ ................ -4,520 ................ ................
Program Administration............................................ 18,301 17,879 17,879 17,879 -422 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Administration on Aging.............................. 1,393,342 1,369,028 1,376,217 1,391,699 -1,643 +22,671 +15,482
OFFICE OF THE SECRETARY
GENERAL DEPARTMENTAL MANAGEMENT:
Federal Funds................................................. 179,837 172,643 172,643 182,810 +2,973 +10,167 +10,167
Trust Funds................................................... 5,804 5,851 5,851 5,851 +47 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal.................................................... 185,641 178,494 178,494 188,661 +3,020 +10,167 +10,167
Adolescent Family Life (Title XX)............................. 30,900 30,742 30,742 30,742 -158 ................ ................
Minority health............................................... 50,518 47,236 47,236 50,980 +462 +3,744 +3,744
Office of Women's Health...................................... 28,818 28,715 28,715 28,715 -103 ................ ................
Minority HIV/AIDS............................................. 52,415 52,415 52,415 52,415 ................ ................ ................
Afghanistan................................................... 5,952 5,952 5,952 5,952 ................ ................ ................
Embryo adoption awareness campaign............................ 992 992 992 2,000 +1,008 +1,008 +1,008
IT Security and Innovation Fund............................... 14,695 14,630 ................ ................ -14,695 -14,630 ................
Evaluation tap funding (ASPE) (NA)............................ (39,552) (39,552) (39,552) (39,552) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, General Departmental Management...................... 369,931 359,176 344,546 359,465 -10,466 +289 +14,919
Federal Funds........................................... 364,127 353,325 338,695 353,614 -10,513 +289 +14,919
Trust Funds............................................. 5,804 5,851 5,851 5,851 +47 ................ ................
Evaluation tap funding.................................. (39,552) (39,552) (39,552) (39,552) ................ ................ ................
OFFICE OF MEDICARE HEARINGS AND APPEALS........................... 57,536 80,000 60,000 75,000 +17,464 -5,000 +15,000
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 4,318 75,000 46,100 32,800 +28,482 -42,200 -13,300
TECHNOLOGY \6\...................................................
Evaluation tap funding........................................ (19,693) (2,750) (28,900) (12,350) (-7,343) (+9,600) (-16,550)
-----------------------------------------------------------------------------------------------------------------------------
Total, Health Information Tech. program level............... (24,011) (77,750) (75,000) (45,150) (+21,139) (-32,600) (-29,850)
OFFICE OF THE INSPECTOR GENERAL:
Federal Funds................................................. 39,930 39,813 39,813 39,813 -117 ................ ................
HIPAA funding (NA)........................................ (160,000) (160,000) (160,000) (160,000) ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Inspector General program level.................. (199,930) (199,813) (199,813) (199,813) (-117) ................ ................
OFFICE FOR CIVIL RIGHTS:
Federal Funds................................................. 31,726 31,682 31,682 31,682 -44 ................ ................
Trust Funds................................................... 3,287 3,314 3,314 3,314 +27 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Office for Civil Rights.............................. 35,013 34,996 34,996 34,996 -17 ................ ................
MEDICAL BENEFITS FOR COMMISSIONED OFFICERS:
Retirement payments........................................... 241,294 256,193 256,193 256,193 +14,899 ................ ................
Survivors benefits............................................ 14,750 15,600 15,600 15,600 +850 ................ ................
Dependents' medical care...................................... 74,592 56,759 56,759 56,759 -17,833 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Medical benefits for Commissioned Officers........... 330,636 328,552 328,552 328,552 -2,084 ................ ................
PUBLIC HEALTH AND SOCIAL SERVICE EMERGENCY FUND
HRSA homeland security activities \3\............................. 514,618 510,500 ................ ................ -514,618 -510,500 ................
CDC homeland security activities \3\.............................. 1,622,757 1,616,723 ................ ................ -1,622,757 -1,616,723 ................
NIH homeland security activities \3\.............................. 47,021 97,021 ................ ................ -47,021 -97,021 ................
Office of the Secretary homeland sercurity activities............. 63,821 83,589 63,589 63,589 -232 -20,000 ................
Other PHSSEF homeland security activities......................... 109,198 120,000 120,000 120,000 +10,802 ................ ................
Supplemental (Public Law 108-234) (emergency)................. 50,000 ................ ................ ................ -50,000 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, PHSSEF............................................... 2,407,415 2,427,833 183,589 183,589 -2,223,826 -2,244,244 ................
=============================================================================================================================
Total, Office of the Secretary.............................. 3,244,779 3,345,370 1,037,596 1,054,215 -2,190,564 -2,291,155 +16,619
Federal Funds........................................... 3,178,152 3,256,205 968,431 970,050 -2,208,102 -2,286,155 +1,619
Trust Funds............................................. 66,627 89,165 69,165 84,165 +17,538 -5,000 +15,000
=============================================================================================================================
Total, Title II, Dept of Health & Human Services............ 379,200,874 473,274,722 473,843,764 476,216,521 +97,015,647 +2,941,799 +2,372,757
Federal Funds........................................... 376,469,336 469,928,079 470,594,315 472,848,938 +96,379,602 +2,920,859 +2,254,623
Current year........................................ (308,367,946) (402,825,454) (403,480,490) (405,746,313) (+97,378,367) (+2,920,859) (+2,265,823)
Fiscal year 2007.................................... (68,101,390) (67,102,625) (67,113,825) (67,102,625) (-998,765) ................ (-11,200)
Trust Funds............................................. 2,731,538 3,346,643 3,249,449 3,367,583 +636,045 +20,940 +118,134
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Grants to Local Educational Agencies (LEAs):
Basic Grants:
Advance from prior year................................... (1,883,584) (1,383,584) (1,383,584) (1,383,584) (-500,000) ................ ................
Forward funded............................................ 5,547,798 5,955,508 5,452,798 5,452,798 -95,000 -502,710 ................
Current funded............................................ 3,472 3,500 3,472 3,472 ................ -28 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Basic grants current year approp.............. 5,551,270 5,959,008 5,456,270 5,456,270 -95,000 -502,738 ................
Subtotal, Basic grants total funds available............ (7,434,854) (7,342,592) (6,839,854) (6,839,854) (-595,000) (-502,738) ................
Basic Grants Fiscal Year 2007 Advance......................... 1,383,584 975,846 1,478,584 1,478,584 +95,000 +502,738 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Basic grants, program level....................... 6,934,854 6,934,854 6,934,854 6,934,854 ................ ................ ................
Concentration Grants:
Advance from prior year................................... (1,365,031) (1,365,031) (1,365,031) (1,365,031) ................ ................ ................
Fiscal Year 2007 Advance.................................. 1,365,031 1,365,031 1,365,031 1,365,031 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Concentration Grants program level............ 1,365,031 1,365,031 1,365,031 1,365,031 ................ ................ ................
Targeted Grants:
Advance from prior year................................... (1,969,843) (2,219,843) (2,219,843) (2,219,843) (+250,000) ................ ................
Fiscal Year 2007 Advance.................................. 2,219,843 2,822,581 2,269,843 2,269,843 +50,000 -552,738 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Targeted Grants program level................. 2,219,843 2,822,581 2,269,843 2,269,843 +50,000 -552,738 ................
Education Finance Incentive Grants:
Advance from prior year................................... (1,969,843) (2,219,843) (2,219,843) (2,219,843) (+250,000) ................ ................
Fiscal Year 2007 Advance.................................. 2,219,843 2,219,843 2,269,843 2,269,843 +50,000 +50,000 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Education Finance Incentive Grants............ 2,219,843 2,219,843 2,269,843 2,269,843 +50,000 +50,000 ................
=============================================================================================================================
Subtotal, Grants to LEAs, program level................. 12,739,571 13,342,309 12,839,571 12,839,571 +100,000 -502,738 ................
Even Start........................................................ 225,095 ................ 200,000 ................ -225,095 ................ -200,000
Reading First:
State Grants (forward funded)................................. 846,600 1,041,600 1,041,600 1,041,600 +195,000 ................ ................
Advance from prior year....................................... (195,000) (195,000) (195,000) (195,000) ................ ................ ................
Fiscal Year 2007 Advance...................................... 195,000 ................ ................ ................ -195,000 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Reading First State Grants........................ 1,041,600 1,041,600 1,041,600 1,041,600 ................ ................ ................
Early Reading First............................................... 104,160 104,160 104,160 104,160 ................ ................ ................
Striving readers.................................................. 24,800 200,000 30,000 35,000 +10,200 -165,000 +5,000
Literacy through School Libraries................................. 19,683 19,683 19,683 19,683 ................ ................ ................
High School Intervention.......................................... ................ 1,240,000 ................ ................ ................ -1,240,000 ................
State Agency Programs:
Migrant....................................................... 390,428 390,428 390,428 390,428 ................ ................ ................
Neglected and Delinquent/High Risk Youth...................... 49,600 49,600 49,600 51,000 +1,400 +1,400 +1,400
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, State Agency programs............................. 440,028 440,028 440,028 441,428 +1,400 +1,400 +1,400
Evaluation........................................................ 9,424 9,424 9,424 9,424 ................ ................ ................
Comprehensive School Reform Demonstration......................... 205,344 ................ 10,000 ................ -205,344 ................ -10,000
Migrant Education:
High School Equivalency Program............................... 18,737 18,737 18,737 18,737 ................ ................ ................
College Assistance Migrant Program............................ 15,532 15,532 15,532 15,532 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Migrant Education................................. 34,269 34,269 34,269 34,269 ................ ................ ................
=============================================================================================================================
Total, Education for the disadvantaged...................... 14,843,974 16,431,473 14,728,735 14,525,135 -318,839 -1,906,338 -203,600
Current Year............................................ (7,460,673) (9,048,172) (7,345,434) (7,141,834) (-318,839) (-1,906,338) (-203,600)
Fiscal Year 2007........................................ (7,383,301) (7,383,301) (7,383,301) (7,383,301) ................ ................ ................
Subtotal, forward funded.................................... (7,264,865) (8,677,136) (7,144,426) (6,935,826) (-329,039) (-1,741,310) (-208,600)
IMPACT AID
Basic Support Payments............................................ 1,075,018 1,075,018 1,102,896 1,102,896 +27,878 +27,878 ................
Payments for Children with Disabilities........................... 49,966 49,966 49,966 49,966 ................ ................ ................
Facilities Maintenance (Sec. 8008)................................ 7,838 7,838 5,000 5,000 -2,838 -2,838 ................
Construction (Sec. 8007).......................................... 48,544 45,544 18,000 18,000 -30,544 -27,544 ................
Payments for Federal Property (Sec. 8002)......................... 62,496 62,496 65,000 65,000 +2,504 +2,504 ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Impact aid........................................... 1,243,862 1,240,862 1,240,862 1,240,862 -3,000 ................ ................
SCHOOL IMPROVEMENT PROGRAMS
State Grants for Improving Teacher Quality........................ 1,481,605 1,481,605 1,481,605 1,481,605 ................ ................ ................
Advance from prior year....................................... (1,435,000) (1,435,000) (1,435,000) (1,435,000) ................ ................ ................
Fiscal Year 2007.............................................. 1,435,000 1,435,000 1,435,000 1,435,000 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, State Grants for Improving Teacher Quality, (2,916,605) (2,916,605) (2,916,605) (2,916,605) ................ ................ ................
program level..............................................
Early Childhood Educator Professional Development................. 14,696 14,696 14,696 14,696 ................ ................ ................
Mathematics and Science Partnerships.............................. 178,560 269,000 190,000 178,560 ................ -90,440 -11,440
State Grants for Innovative Education (Education Block Grant)..... 198,400 100,000 198,400 100,000 -98,400 ................ -98,400
Educational Technology State Grants............................... 496,000 ................ 300,000 425,000 -71,000 +425,000 +125,000
Supplemental Education Grants..................................... 18,183 18,183 18,183 18,183 ................ ................ ................
21st Century Community Learning Centers........................... 991,077 991,077 991,077 991,077 ................ ................ ................
State Assessments/Enhanced Assessment Instruments................. 411,680 411,680 411,680 411,680 ................ ................ ................
High school assessments........................................... ................ 250,000 ................ ................ ................ -250,000 ................
Javits gifted and talented education.............................. 11,022 ................ ................ 11,022 ................ +11,022 +11,022
Foreign language assistance....................................... 17,856 ................ ................ 25,000 +7,144 +25,000 +25,000
Education for Homeless Children and Youth......................... 62,496 62,496 62,496 62,496 ................ ................ ................
Training and Advisory Services (Civil Rights)..................... 7,185 7,185 7,185 7,185 ................ ................ ................
Education for Native Hawaiians.................................... 34,224 32,624 24,770 34,500 +276 +1,876 +9,730
Alaska Native Education Equity.................................... 34,224 31,224 31,224 34,500 +276 +3,276 +3,276
Rural Education................................................... 170,624 170,624 170,624 170,624 ................ ................ ................
Comprehensive Centers............................................. 56,825 56,825 56,825 56,825 ................ ................ ................
=============================================================================================================================
Total, School improvement programs.......................... 5,619,657 5,332,219 5,393,765 5,457,953 -161,704 +125,734 +64,188
Current Year............................................ (4,184,657) (3,897,219) (3,958,765) (4,022,953) (-161,704) (+125,734) (+64,188)
Fiscal Year 2007........................................ (1,435,000) (1,435,000) (1,435,000) (1,435,000) ................ ................ ................
Subtotal, forward funded.................................... (3,990,442) (3,736,482) (3,805,882) (3,821,042) (-169,400) (+84,560) (+15,160)
INDIAN EDUCATION
Grants to Local Educational Agencies.............................. 95,165 96,294 96,294 96,294 +1,129 ................ ................
Federal Programs:
Special Programs for Indian Children.......................... 19,595 19,595 19,595 19,595 ................ ................ ................
National Activities........................................... 5,129 4,000 4,000 4,000 -1,129 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Federal Programs.................................. 24,724 23,595 23,595 23,595 -1,129 ................ ................
=============================================================================================================================
Total, Indian Education..................................... 119,889 119,889 119,889 119,889 ................ ................ ................
INNOVATION AND IMPROVEMENT
Troops-to-Teachers................................................ 14,793 14,793 14,793 14,793 ................ ................ ................
Transition to Teaching............................................ 44,933 44,933 44,933 44,933 ................ ................ ................
National Writing Project.......................................... 20,336 ................ 20,336 23,000 +2,664 +23,000 +2,664
Teaching of Traditional American History.......................... 119,040 119,040 50,000 121,000 +1,960 +1,960 +71,000
School Leadership................................................. 14,880 ................ 14,880 15,000 +120 +15,000 +120
Advanced Credentialing............................................ 16,864 8,000 16,864 10,000 -6,864 +2,000 -6,864
Charter Schools Grants............................................ 216,952 218,702 216,952 216,952 ................ -1,750 ................
Credit Enhancement for Charter School Facilities.................. 36,981 36,981 36,981 ................ -36,981 -36,981 -36,981
Voluntary Public School Choice.................................... 26,543 26,543 26,543 26,543 ................ ................ ................
Magnet Schools Assistance......................................... 107,771 107,771 107,771 107,771 ................ ................ ................
Choice Incentive fund............................................. ................ 50,000 ................ ................ ................ -50,000 ................
Fund for the Improvement of Education (FIE)....................... 414,078 106,296 27,000 417,924 +3,846 +311,628 +390,924
Teacher Incentive Fund............................................ ................ 500,000 100,000 ................ ................ -500,000 -100,000
Ready to Learn television......................................... 23,312 23,312 ................ 25,000 +1,688 +1,688 +25,000
Dropout Prevention Programs....................................... 4,930 ................ ................ ................ -4,930 ................ ................
Close Up Fellowships.............................................. 1,469 ................ 1,469 1,469 ................ +1,469 ................
Advanced Placement................................................ 29,760 51,500 30,000 33,000 +3,240 -18,500 +3,000
=============================================================================================================================
Total, Innovation and Improvement........................... 1,092,642 1,307,871 708,522 1,057,385 -35,257 -250,486 +348,863
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Safe and Drug Free Schools and Communities: State Grants, forward 437,381 ................ 400,000 300,000 -137,381 +300,000 -100,000
funded...........................................................
National Programs................................................. 152,537 267,967 152,537 150,000 -2,537 -117,967 -2,537
Alcohol Abuse Reduction........................................... 32,736 ................ ................ 33,500 +764 +33,500 +33,500
Mentoring Programs................................................ 49,307 49,307 49,307 49,307 ................ ................ ................
Character education............................................... 24,493 24,493 24,493 24,493 ................ ................ ................
Elementary and Secondary School Counseling........................ 34,720 ................ 34,720 36,000 +1,280 +36,000 +1,280
Carol M. White Physical Education Program......................... 73,408 55,000 73,408 74,000 +592 +19,000 +592
Civic Education................................................... 29,405 ................ 29,405 30,000 +595 +30,000 +595
=============================================================================================================================
Total, Safe Schools and Citizenship Education............... 833,987 396,767 763,870 697,300 -136,687 +300,533 -66,570
Current Year............................................ (833,987) (396,767) (763,870) (697,300) (-136,687) (+300,533) (-66,570)
Subtotal, forward funded.................................... (437,381) ................ (400,000) (300,000) (-137,381) (+300,000) (-100,000)
ENGLISH LANGUAGE ACQUISITION
Current funded.................................................... 84,816 43,925 ................ 43,925 -40,891 ................ +43,925
Forward funded.................................................... 590,949 631,840 675,765 631,840 +40,891 ................ -43,925
-----------------------------------------------------------------------------------------------------------------------------
Total, English Language Acquisition......................... 675,765 675,765 675,765 675,765 ................ ................ ................
SPECIAL EDUCATION
State Grants:
Grants to States Part B current year.......................... 5,176,746 4,893,746 5,326,746 5,265,546 +88,800 +371,800 -61,200
Part B advance from prior year............................ (5,413,000) (5,413,000) (5,413,000) (5,413,000) ................ ................ ................
Grants to States Part B (Fiscal Year 2007).................... 5,413,000 6,204,000 5,413,000 5,424,200 +11,200 -779,800 +11,200
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Grants to States, program level................... 10,589,746 11,097,746 10,739,746 10,689,746 +100,000 -408,000 -50,000
Preschool Grants.............................................. 384,597 384,597 384,597 384,597 ................ ................ ................
Grants for Infants and Families............................... 440,808 440,808 440,808 444,308 +3,500 +3,500 +3,500
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, State grants, program level....................... 11,415,151 11,923,151 11,565,151 11,518,651 +103,500 -404,500 -46,500
IDEA National Activities (current funded):
State Personnel Development................................... 50,653 ................ 50,653 50,653 ................ +50,653 ................
Special Education-Voc Rehab transition initiative............. ................ 5,000 ................ ................ ................ -5,000 ................
Technical Assistance and Dissemination........................ 52,396 49,397 49,397 49,397 -2,999 ................ ................
Personnel Preparation......................................... 90,626 90,626 90,626 90,626 ................ ................ ................
Parent Information Centers.................................... 25,964 25,964 25,964 25,964 ................ ................ ................
Technology and Media Services................................. 38,816 31,992 31,992 38,816 ................ +6,824 +6,824
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, IDEA special programs............................. 258,455 202,979 248,632 255,456 -2,999 +52,477 +6,824
=============================================================================================================================
Total, Special education.................................... 11,673,606 12,126,130 11,813,783 11,774,107 +100,501 -352,023 -39,676
Current Year............................................ (6,260,606) (5,922,130) (6,400,783) (6,349,907) (+89,301) (+427,777) (-50,876)
Fiscal Year 2007........................................ (5,413,000) (6,204,000) (5,413,000) (5,424,200) (+11,200) (-779,800) (+11,200)
Subtotal, Forward funded.................................... (6,052,804) (5,719,151) (6,202,804) (6,145,104) (+92,300) (+425,953) (-57,700)
REHABILITATION SERVICES AND DISABILITY RESEARCH
Vocational Rehabilitation State Grants............................ 2,635,845 2,720,192 2,720,192 2,720,192 +84,347 ................ ................
Client Assistance State grants.................................... 11,901 11,901 11,901 11,901 ................ ................ ................
Training.......................................................... 38,826 38,826 38,826 38,826 ................ ................ ................
Demonstration and training programs............................... 25,607 6,577 6,577 6,577 -19,030 ................ ................
Migrant and seasonal farmworkers.................................. 2,302 ................ 2,302 2,302 ................ +2,302 ................
Recreational programs............................................. 2,543 ................ 2,543 2,543 ................ +2,543 ................
Protection and advocacy of individual rights (PAIR)............... 16,656 16,656 16,656 16,656 ................ ................ ................
Projects with industry............................................ 21,625 ................ 19,735 19,735 -1,890 +19,735 ................
Supported employment State grants................................. 37,379 ................ 30,000 30,000 -7,379 +30,000 ................
Independent living:
State grants.................................................. 22,816 22,816 22,816 22,816 ................ ................ ................
Centers....................................................... 75,392 75,392 75,392 75,392 ................ ................ ................
Services for older blind individuals.......................... 33,227 33,227 33,227 33,227 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Independent living................................ 131,435 131,435 131,435 131,435 ................ ................ ................
Program Improvement............................................... 843 843 843 843 ................ ................ ................
Evaluation........................................................ 1,488 1,488 1,488 1,488 ................ ................ ................
Helen Keller National Center for Deaf/Blind Youth and Adults...... 10,581 8,597 8,597 8,597 -1,984 ................ ................
National Inst. Disability and Rehab. Research (NIDRR)............. 107,783 107,783 107,783 107,783 ................ ................ ................
Assistive Technology.............................................. 29,760 15,000 29,760 34,760 +5,000 +19,760 +5,000
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, discretionary programs............................ 438,729 339,106 408,446 413,446 -25,283 +74,340 +5,000
=============================================================================================================================
Total, Rehabilitation services.............................. 3,074,574 3,059,298 3,128,638 3,133,638 +59,064 +74,340 +5,000
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
AMERICAN PRINTING HOUSE FOR THE BLIND............................. 16,864 16,864 17,000 18,500 +1,636 +1,636 +1,500
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF (NTID):
Operations.................................................... 53,672 53,672 55,337 56,479 +2,807 +2,807 +1,142
Construction.................................................. 1,672 800 800 800 -872 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, NTID................................................. 55,344 54,472 56,137 57,279 +1,935 +2,807 +1,142
GALLAUDET UNIVERSITY.............................................. 104,557 104,557 107,657 108,500 +3,943 +3,943 +843
=============================================================================================================================
Total, Special Institutions for Persons with Disabilities... 176,765 175,893 180,794 184,279 +7,514 +8,386 +3,485
VOCATIONAL AND ADULT EDUCATION
Vocational Education:
Basic State Grants/Secondary & Technical Education:
State Grants.............................................. 403,331 ................ 403,331 403,331 ................ +403,331 ................
Advance from prior year................................... (791,000) (791,000) (791,000) (791,000) ................ ................ ................
Fiscal Year 2007.......................................... 791,000 ................ 791,000 791,000 ................ +791,000 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Basic State Grants, program level............. 1,194,331 ................ 1,194,331 1,194,331 ................ +1,194,331 ................
Tech-Prep Education State Grants.............................. 105,812 ................ 105,812 105,812 ................ +105,812 ................
National Programs............................................. 11,757 ................ 11,757 9,257 -2,500 +9,257 -2,500
Tech-Prep Education Demonstration............................. 4,900 ................ ................ ................ -4,900 ................ ................
Occupational and Employment Information Program............... 9,307 ................ ................ ................ -9,307 ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Vocational Education.............................. 1,326,107 ................ 1,311,900 1,309,400 -16,707 +1,309,400 -2,500
Adult Education:
State Grants/Adult basic and literacy education: State Grants, 569,672 200,000 569,672 569,672 ................ +369,672 ................
current funded...............................................
National Programs:
National Leadership Activities............................ 9,096 9,096 9,096 9,096 ................ ................ ................
National Institute for Literacy........................... 6,638 6,638 6,638 6,638 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, National programs............................. 15,734 15,734 15,734 15,734 ................ ................ ................
=============================================================================================================================
Subtotal, Adult education............................... 585,406 215,734 585,406 585,406 ................ +369,672 ................
Smaller Learning Communities, current funded...................... 4,724 ................ 4,724 ................ -4,724 ................ -4,724
Smaller Learning Communities, forward funded...................... 89,752 ................ 89,752 ................ -89,752 ................ -89,752
Community Technology Centers...................................... 4,960 ................ ................ 4,960 ................ +4,960 +4,960
State Grants for Incarcerated Youth Offenders..................... 21,824 ................ ................ 24,000 +2,176 +24,000 +24,000
Literacy programs for prisoners................................... 4,960 ................ ................ ................ -4,960 ................ ................
=============================================================================================================================
Total, Vocational and adult education....................... 2,037,733 215,734 1,991,782 1,923,766 -113,967 +1,708,032 -68,016
Current Year............................................ (1,246,733) (215,734) (1,200,782) (1,132,766) (-113,967) (+917,032) (-68,016)
Fiscal Year 2007........................................ (791,000) ................ (791,000) (791,000) ................ (+791,000) ................
Subtotal, forward funded.................................... (1,232,089) (215,734) (1,196,058) (1,127,806) (-104,283) (+912,072) (-68,252)
STUDENT FINANCIAL ASSISTANCE
Pell Grants--maximum grant (NA)................................... (4,050) (4,050) (4,100) (4,050) ................ ................ (-50)
Pell Grants:
Regular Program............................................... 12,364,997 13,199,000 13,383,000 13,177,000 +812,003 -22,000 -206,000
Enhanced Pell grants for State scholars....................... ................ 33,000 ................ ................ ................ -33,000 ................
Federal Supplemental Educational Opportunity Grants............... 778,720 778,720 778,720 804,763 +26,043 +26,043 +26,043
Federal Work Study................................................ 990,257 990,257 990,257 990,257 ................ ................ ................
Federal Perkins Loans: Loan Cancellations......................... 66,132 ................ 66,132 66,132 ................ +66,132 ................
Presidential math and science scholars............................ ................ 50,000 ................ ................ ................ -50,000 ................
LEAP program...................................................... 65,643 ................ 65,643 65,643 ................ +65,643 ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, discretionary programs............................ 14,265,749 15,050,977 15,283,752 15,103,795 +838,046 +52,818 -179,957
=============================================================================================================================
Total, Student Financial Assistance......................... 14,265,749 15,050,977 15,283,752 15,103,795 +838,046 +52,818 -179,957
STUDENT AID ADMINISTRATION
Administrative Costs.............................................. 119,084 939,285 124,084 120,000 +916 -819,285 -4,084
Fed Direct Student Loan Reclassification (Leg prop)............... ................ -625,000 ................ ................ ................ +625,000 ................
LOANS FOR SHORT-TERM TRAINING..................................... ................ 11,000 ................ ................ ................ -11,000 ................
HIGHER EDUCATION
Aid for Institutional Development:
Strengthening Institutions.................................... 80,338 80,338 80,338 80,338 ................ ................ ................
Hispanic Serving Institutions................................. 95,106 95,873 95,873 95,873 +767 ................ ................
Strengthening Historically Black Colleges (HBCUs)............. 238,576 240,500 240,500 240,500 +1,924 ................ ................
Strengthening historically black graduate insts............... 58,032 58,500 58,500 58,500 +468 ................ ................
Strengthening Alaska Native and Native Hawaiian-Serving 11,904 6,500 6,500 11,904 ................ +5,404 +5,404
Institutions.................................................
Strengthening Tribal Colleges................................. 23,808 23,808 23,808 23,808 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, Aid for Institutional development................. 507,764 505,519 505,519 510,923 +3,159 +5,404 +5,404
International Education and Foreign Language:
Domestic Programs............................................. 92,465 92,466 92,466 92,466 +1 ................ ................
Overseas Programs............................................. 12,737 12,737 12,737 12,737 ................ ................ ................
Institute for International Public Policy..................... 1,616 1,616 1,616 1,616 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Subtotal, International Education & Foreign Lang............ 106,818 106,819 106,819 106,819 +1 ................ ................
Fund for the Improvement of Postsec. Ed. (FIPSE).................. 162,108 22,211 49,211 162,211 +103 +140,000 +113,000
Minority Science and Engineering Improvement...................... 8,818 8,818 8,818 8,818 ................ ................ ................
Interest Subsidy Grants........................................... 1,488 ................ ................ ................ -1,488 ................ ................
Tribally Controlled Postsec Voc/Tech Institutions................. 7,440 7,440 7,440 7,440 ................ ................ ................
Federal TRIO Programs............................................. 836,543 369,390 836,543 836,543 ................ +467,153 ................
GEAR UP........................................................... 306,488 ................ 306,488 306,488 ................ +306,488 ................
Byrd Honors Scholarships.......................................... 40,672 ................ ................ 41,000 +328 +41,000 +41,000
Javits Fellowships................................................ 9,797 9,797 9,797 9,797 ................ ................ ................
Graduate Assistance in Areas of National Need..................... 30,371 30,371 30,371 30,371 ................ ................ ................
Teacher Quality Enhancement Grants................................ 68,337 ................ 58,000 58,000 -10,337 +58,000 ................
Child Care Access Means Parents in School......................... 15,970 15,970 15,970 15,970 ................ ................ ................
Community college access.......................................... ................ 125,000 ................ ................ ................ -125,000 ................
Demonstration in Disabilities/Higher Education.................... 6,944 ................ ................ 6,944 ................ +6,944 +6,944
Underground Railroad Program...................................... 2,204 ................ ................ 2,204 ................ +2,204 +2,204
GPRA data/HEA program evaluation.................................. 980 980 980 980 ................ ................ ................
B.J. Stupak Olympic Scholarships.................................. 980 ................ 980 ................ -980 ................ -980
Thurgood Marshall legal education opportunity program............. 2,976 ................ ................ ................ -2,976 ................ ................
=============================================================================================================================
Total, Higher education..................................... 2,116,698 1,202,315 1,936,936 2,104,508 -12,190 +902,193 +167,572
HOWARD UNIVERSITY
Academic Program.................................................. 205,507 205,430 207,507 205,430 -77 ................ -2,077
Endowment Program................................................. 3,524 3,600 3,524 3,600 +76 ................ +76
Howard University Hospital........................................ 29,759 29,759 29,759 29,759 ................ ................ ................
-----------------------------------------------------------------------------------------------------------------------------
Total, Howard University.................................... 238,790 238,789 240,790 238,789 -1 ................ -2,001
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM: (CHAFL).... 573 573 573 573 ................ ................ ................
HBCU CAPITAL FINANCING PROGRAM--Federal Adm....................... 210 210 210 210 ................ ................ ................
INSTITUTE OF EDUCATION SCIENCES
Research, development and dissemination........................... 164,194 164,194 164,194 164,194 ................ ................ ................
Statistics........................................................ 90,931 90,931 90,931 90,931 ................ ................ ................
Regional Educational Laboratories................................. 66,132 ................ 66,132 66,131 -1 +66,131 -1
Research in special education..................................... 83,104 72,566 72,566 72,566 -10,538 ................ ................
Special education studies and evaluations......................... ................ 10,000 10,000 10,000 +10,000 ................ ................
Statewide data systems............................................ 24,800 24,800 24,800 24,800 ................ ................ ................
Assessment:
National Assessment........................................... 88,985 111,485 88,985 88,985 ................ -22,500 ................
National Assessment Governing Board........................... 5,088 5,088 5,088 5,088 ................ ................ ................
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Subtotal, Assessment........................................ 94,073 116,573 94,073 94,073 ................ -22,500 ................
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Total, IES.................................................. 523,234 479,064 522,696 522,695 -539 +43,631 -1
DEPARTMENTAL MANAGEMENT
PROGRAM ADMINISTRATION............................................ 419,280 418,992 410,612 418,992 -288 ................ +8,380
OFFICE FOR CIVIL RIGHTS........................................... 89,375 91,526 91,526 91,526 +2,151 ................ ................
OFFICE OF THE INSPECTOR GENERAL................................... 47,327 49,408 49,000 49,408 +2,081 ................ +408
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Total, Departmental management.............................. 555,982 559,926 551,138 559,926 +3,944 ................ +8,788
Total: Elementary and Secondary Education Act programs...... 24,529,212 25,504,846 23,725,884 23,779,249 -749,963 -1,725,597 +53,365
TITLE III GENERAL PROVISIONS
Pell grant shortfall payoff \9\................................... ................ 4,300,000 4,300,000 4,300,000 +4,300,000 ................ ................
=============================================================================================================================
Total, Title III, Department of Education................... 59,212,774 63,239,040 63,706,584 63,740,575 +4,527,801 +501,535 +33,991
Current Year............................................ (44,190,473) (48,216,739) (48,684,283) (48,707,074) (+4,516,601) (+490,335) (+22,791)
Fiscal Year 2007........................................ (15,022,301) (15,022,301) (15,022,301) (15,033,501) (+11,200) (+11,200) (+11,200)
TITLE IV--RELATED AGENCIES
COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY 4,669 4,669 4,669 4,669 ................ ................ ................
DISABLED.........................................................
CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
DOMESTIC VOLUNTEER SERVICE PROGRAMS
Volunteers in Service to America (VISTA).......................... 94,240 96,428 96,428 96,428 +2,188 ................ ................
Volunteers in Homeland Security................................... 4,960 ................ ................ ................ -4,960 ................ ................
Teach for America................................................. ................ 4,000 2,000 ................ ................ -4,000 -2,000
National Senior Volunteer Corps:
Foster Grandparents Program................................... 111,424 112,058 112,058 112,058 +634 ................ ................
Senior Companion Program...................................... 45,905 47,438 47,438 47,438 +1,533 ................ ................
Retired Senior Volunteer Program.............................. 58,528 60,288 60,288 60,288 +1,760 ................ ................
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Subtotal, Senior Volunteers................................. 215,857 219,784 219,784 219,784 +3,927 ................ ................
Program Administration............................................ 38,688 39,750 39,750 ................ -38,688 -39,750 -39,750
=============================================================================================================================
Total, Domestic Volunteer Service Programs.................. 353,745 359,962 357,962 316,212 -37,533 -43,750 -41,750
National and Community Service Programs: \10\
National service trust........................................ 142,848 146,000 146,000 149,000 +6,152 +3,000 +3,000
AmeriCorps grants............................................. 287,680 275,000 267,500 280,000 -7,680 +5,000 +12,500
Innovation, assistance, and other activities.................. 13,227 9,945 9,945 15,945 +2,718 +6,000 +6,000
Evaluation.................................................... 3,522 4,000 4,000 4,000 +478 ................ ................
National Civilian Community Corps............................. 25,296 25,500 25,500 27,000 +1,704 +1,500 +1,500
Learn and Serve America: K-12 and Higher Ed................... 42,656 40,000 37,500 42,656 ................ +2,656 +5,156
State Commission Administrative Grants........................ 11,904 12,642 12,642 12,642 +738 ................ ................
Points of Light Foundation.................................... 9,920 10,000 10,000 10,000 +80 ................ ................
America's Promise............................................. 4,464 5,000 5,000 5,000 +536 ................ ................
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Subtotal, National and Community Service Programs........... 541,517 528,087 518,087 546,243 +4,726 +18,156 +28,156
National and Community Service, Salaries and expenses \10\........ 25,792 27,000 27,000 66,750 +40,958 +39,750 +39,750
Office of Inspector General \10\.................................. 5,952 6,000 6,000 6,000 +48 ................ ................
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Total, Corp. for National and Community Service............. 927,006 921,049 909,049 935,205 +8,199 +14,156 +26,156
CORPORATION FOR PUBLIC BROADCASTING:
Fiscal year 2008 (current) with fiscal year 2007 comparable... 400,000 ................ 400,000 400,000 ................ +400,000 ................
Fiscal year 2007 advance with fiscal year 2006 comparable (400,000) (400,000) (400,000) (400,000) ................ ................ ................
(NA).........................................................
Fiscal year 2006 advance with fiscal year 2005 comparable (386,880) (400,000) (400,000) (400,000) (+13,120) ................ ................
(NA).........................................................
Rescission of fiscal year 2006 funds (NA)................. ................ (-10,000) ................ ................ ................ (+10,000) ................
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Subtotal, fiscal year 2006 program level................ 386,880 390,000 400,000 400,000 +13,120 +10,000 ................
Digitalization program, current funded \11\................... 39,387 ................ ................ 35,000 -4,387 +35,000 +35,000
Previous appropriated funds (NA) \12\..................... ................ (30,000) (30,000) ................ ................ (-30,000) (-30,000)
Interconnection, current funded \11\.......................... 39,680 ................ ................ 40,000 +320 +40,000 +40,000
Previous appropriated funds (NA) \12\..................... (75,000) (52,000) (52,000) ................ (-75,000) (-52,000) (-52,000)
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Subtotal, fiscal year 2006 appropriation................ 79,067 ................ ................ 75,000 -4,067 +75,000 +75,000
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Subtotal, fiscal year 2006 comparable................... (154,067) (82,000) (82,000) (75,000) (-79,067) (-7,000) (-7,000)
FEDERAL MEDIATION AND CONCILIATION SERVICE........................ 44,439 42,331 42,331 43,439 -1,000 +1,108 +1,108
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION.................. 7,809 7,809 7,809 7,809 ................ ................ ................
INSTITUTE OF MUSEUM AND LIBRARY SERVICES.......................... 280,564 262,240 249,640 290,129 +9,565 +27,889 +40,489
MEDICARE PAYMENT ADVISORY COMMISSION.............................. 9,899 10,168 10,168 10,168 +269 ................ ................
NATIONAL COMMISSION ON LIBRARIES AND INFO SCIENCE................. 993 993 993 993 ................ ................ ................
NATIONAL COUNCIL ON DISABILITY.................................... 3,344 2,800 2,800 3,344 ................ +544 +544
NATIONAL LABOR RELATIONS BOARD.................................... 249,860 252,268 252,268 252,268 +2,408 ................ ................
NATIONAL MEDIATION BOARD.......................................... 11,628 11,628 11,628 11,628 ................ ................ ................
OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION.................. 10,510 10,510 10,510 10,510 ................ ................ ................
RAILROAD RETIREMENT BOARD
Dual Benefits Payments Account.................................... 107,136 97,000 97,000 97,000 -10,136 ................ ................
Less Income Tax Receipts on Dual Benefits......................... -7,936 -7,000 -7,000 -7,000 +936 ................ ................
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Subtotal, Dual Benefits..................................... 99,200 90,000 90,000 90,000 -9,200 ................ ................
Federal Payment to the RR Retirement Account...................... 150 150 150 150 ................ ................ ................
Limitation on Administration...................................... 102,543 102,543 102,543 102,543 ................ ................ ................
Inspector General............................................. 7,196 7,196 7,196 7,196 ................ ................ ................
SOCIAL SECURITY ADMINISTRATION
Payments to Social Security Trust Funds........................... 20,454 20,470 20,470 20,470 +16 ................ ................
SUPPLEMENTAL SECURITY INCOME
Federal benefit payments.......................................... 38,109,000 37,487,174 37,487,174 37,487,174 -621,826 ................ ................
Beneficiary services.............................................. 45,929 52,000 52,000 52,000 +6,071 ................ ................
Research and demonstration........................................ 35,000 27,000 27,000 27,000 -8,000 ................ ................
Administration.................................................... 2,986,900 2,733,000 2,897,000 2,710,400 -276,500 -22,600 -186,600
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Subtotal, SSI program level................................. 41,176,829 40,299,174 40,463,174 40,276,574 -900,255 -22,600 -186,600
Less funds advanced in prior year....................... -12,590,000 -10,930,000 -10,930,000 -10,930,000 +1,660,000 ................ ................
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Subtotal, regular SSI current year.......................... 28,586,829 29,369,174 29,533,174 29,346,574 +759,745 -22,600 -186,600
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Total, SSI, current request................................. 28,586,829 29,369,174 29,533,174 29,346,574 +759,745 -22,600 -186,600
New advance, 1st quarter, fiscal year 2007.............. 10,930,000 11,110,000 11,110,000 11,110,000 +180,000 ................ ................
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Total, SSI program.......................................... 39,516,829 40,479,174 40,643,174 40,456,574 +939,745 -22,600 -186,600
LIMITATION ON ADMINISTRATIVE EXPENSES
OASDI Trust Funds................................................. 4,359,033 4,640,400 4,617,600 4,604,000 +244,967 -36,400 -13,600
HI/SMI Trust Funds................................................ 1,256,968 1,704,000 1,643,100 1,704,000 +447,032 ................ +60,900
Social Security Advisory Board.................................... 2,000 2,000 2,000 2,000 ................ ................ ................
SSI............................................................... 2,986,900 2,733,000 2,897,000 2,710,400 -276,500 -22,600 -186,600
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Subtotal, regular LAE....................................... 8,604,901 9,079,400 9,159,700 9,020,400 +415,499 -59,000 -139,300
Additional CDR Funding:
OASDI......................................................... ................ 25,000 ................ 25,000 +25,000 ................ +25,000
SSI........................................................... ................ 164,000 ................ 164,000 +164,000 ................ +164,000
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Subtotal, CDR Funding....................................... ................ 189,000 ................ 189,000 +189,000 ................ +189,000
SSI User Fee activities........................................... 124,000 119,000 119,000 119,000 -5,000 ................ ................
SSPA User Fee Activities.......................................... 1,000 1,000 1,000 1,000 ................ ................ ................
=============================================================================================================================
Total, Limitation on Administrative Expenses................ 8,729,901 9,388,400 9,279,700 9,329,400 +599,499 -59,000 +49,700
MEDICARE REFORM FUNDING
Medicare reform funding \13\ \14\................................. (446,054) ................ ................ ................ (-446,054) ................ ................
OFFICE OF INSPECTOR GENERAL
Federal Funds..................................................... 25,542 26,000 26,000 26,000 +458 ................ ................
Trust Funds....................................................... 64,836 67,000 66,805 67,000 +2,164 ................ +195
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Total, Office of Inspector General.......................... 90,378 93,000 92,805 93,000 +2,622 ................ +195
Adjustment: Trust fund transfers from general revenues............ -2,986,900 -2,733,000 -2,897,000 -2,710,400 +276,500 +22,600 +186,600
=============================================================================================================================
Total, Social Security Administration....................... 45,370,662 47,248,044 47,139,149 47,189,044 +1,818,382 -59,000 +49,895
Federal funds........................................... 39,687,825 40,834,644 40,809,644 40,812,044 +1,124,219 -22,600 +2,400
Current year........................................ (28,757,825) (29,724,644) (29,699,644) (29,702,044) (+944,219) (-22,600) (+2,400)
New advances, 1st quarter........................... (10,930,000) (11,110,000) (11,110,000) (11,110,000) (+180,000) ................ ................
Trust funds............................................. 5,682,837 6,413,400 6,329,505 6,377,000 +694,163 -36,400 +47,495
=============================================================================================================================
Total, Title IV, Related Agencies........................... 47,609,539 48,974,398 49,240,903 49,434,095 +1,824,556 +459,697 +193,192
Federal Funds........................................... 41,807,064 42,441,091 42,791,491 42,937,188 +1,130,124 +496,097 +145,697
Current Year........................................ (30,477,064) (31,331,091) (31,281,491) (31,427,188) (+950,124) (+96,097) (+145,697)
Fiscal Year 2007 Advance............................ (10,930,000) (11,110,000) (11,110,000) (11,110,000) (+180,000) ................ ................
Fiscal Year 2008 Advance............................ (400,000) ................ (400,000) (400,000) ................ (+400,000) ................
Trust Funds............................................. 5,802,475 6,533,307 6,449,412 6,496,907 +694,432 -36,400 +47,495
SUMMARY
Federal Funds..................................................... 488,978,652 586,624,660 588,183,697 590,841,346 +101,862,694 +4,216,686 +2,657,649
Current year.................................................. (391,980,961) (490,877,734) (492,000,571) (494,658,220) (+102,677,259) (+3,780,486) (+2,657,649)
2007 advance.................................................. (96,597,691) (95,746,926) (95,783,126) (95,783,126) (-814,565) (+36,200) ................
2008 advance.................................................. (400,000) ................ (400,000) (400,000) ................ (+400,000) ................
Trust Funds....................................................... 12,366,339 13,587,965 13,408,876 13,594,967 +1,228,628 +7,002 +186,091
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Grand Total................................................. 501,344,991 600,212,625 601,592,573 604,436,313 +103,091,322 +4,223,688 +2,843,740
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\1\ Funding from the Dislocated Worker National Reserve.
\2\ Two year availability.
\3\ Funds provided for biodefense activities are reflected within HRSA, CDC, and NIH respectively.
\4\ Includes Mine Safety and Health.
\5\ Funds provided in Public Law 108-173, the 2003 Medicare Prescription Drug, Improvement and Modernization Act.
\6\ $1 billion available for fiscal years 2004-2005.
\7\ $250 million available for fiscal years 2005-2008.
\8\ An additional $50 million for Health IT within AHRQ.
\9\ Part of the HEA reauthorization budget request.
\10\ Fiscal year 2006 House jurisdiction change account moved from former VA-HUD Appropriations.
\11\ Current funded.
\12\ Requested funds for these activities are from previously appropriated funds.
\13\ Funds provided in Public Law 108-173, the 2003 Medicare Prescription Drug, Improvement and Modernization Act and are available in fiscal year 2004 and 2005.
\14\ Funds required to continue implementing this Act are provided under the regular LAE account.