Senate Report 112-176 - DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2013

[Senate Report 112-176]
[From the U.S. Government Publishing Office]

Calendar No. 428
112th Congress Report
SENATE
2d Session 112-176

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

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2013
_______

June 14, 2012.--Ordered to be printed

_______

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

REPORT

[To accompany S. 3295]

The Committee on Appropriations reports the bill (S. 3295)
making appropriations for Departments of Labor, Health and
Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2013, and for other purposes,
reports favorably thereon and recommends that the bill do pass.

Amount of budget authority
Total of bill as reported to the Senate............. $777,568,714,000
Amount of 2012 appropriations....................... 741,495,738,000
Amount of 2013 budget estimate...................... 777,624,610,000
Bill as recommended to Senate compared to--
2012 appropriations............................. +36,072,976,000
2013 budget estimate............................ -55,896,000

CONTENTS

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Page

List of Abbreviations............................................ 4
Summary of Budget Estimates and Committee Recommendations........ 8
Overview..................................................... 8
Fiscal Accountability........................................ 8
Promoting Innovation......................................... 9
Early Childhood Education.................................... 11
Prevention................................................... 12
Assisting People With Disabilities........................... 12
Other Highlights of the Bill................................. 13
Title I: Department of Labor:
Employment and Training Administration....................... 15
Employee Benefits Security Administration.................... 26
Pension Benefit Guaranty Corporation......................... 27
Wage and Hour Division....................................... 28
Office of Labor-Management Standards......................... 28
Office of Federal Contract Compliance Programs............... 29
Office of Workers' Compensation Programs..................... 29
Occupational Safety and Health Administration................ 32
Mine Safety and Health Administration........................ 33
Bureau of Labor Statistics................................... 34
Office of Disability Employment Policy....................... 36
Departmental Management...................................... 36
General Provisions........................................... 39
Title II: Department of Health and Human Services:
Health Resources and Services Administration................. 41
Centers for Disease Control and Prevention................... 58
National Institutes of Health................................ 77
Substance Abuse and Mental Health Services Administration.... 108
Agency for Healthcare Research and Quality................... 117
Centers for Medicare and Medicaid Services................... 120
Administration for Children and Families..................... 125
Administration for Community Living.......................... 139
Office of the Secretary...................................... 145
General Provisions........................................... 156
Title III: Department of Education:
Education for the Disadvantaged.............................. 158
Impact Aid................................................... 162
School Improvement Programs.................................. 163
Indian Education............................................. 169
Innovation and Improvement................................... 170
Safe Schools and Citizenship Education....................... 176
English Language Acquisition................................. 177
Special Education............................................ 178
Rehabilitation Services and Disability Research.............. 181
Special Institutions for Persons With Disabilities:
American Printing House for the Blind.................... 185
National Technical Institute for the Deaf................ 186
Gallaudet University..................................... 186
Career, Technical, and Adult Education....................... 186
Student Financial Assistance................................. 188
Student Aid Administration................................... 192
Higher Education............................................. 193
Howard University............................................ 201
College Housing and Academic Facilities Loans Program........ 201
Historically Black College and University Capital Financing
Program Account............................................ 201
Institute of Education Sciences.............................. 202
Departmental Management:
Program Administration................................... 204
Office for Civil Rights.................................. 205
Office of the Inspector General.......................... 206
General Provisions........................................... 206
Title IV: Related Agencies:
Committee for Purchase From People Who Are Blind or Severely
Disabled................................................... 208
Corporation for National and Community Service............... 208
Corporation for Public Broadcasting.......................... 213
Federal Mediation and Conciliation Service................... 213
Federal Mine Safety and Health Review Commission............. 213
Institute of Museum and Library Services..................... 214
Medicaid and CHIP Payment and Access Commission.............. 215
Medicare Payment Advisory Commission......................... 215
National Council on Disability............................... 215
National Health Care Workforce Commission.................... 216
National Labor Relations Board............................... 216
National Mediation Board..................................... 216
Occupational Safety and Health Review Commission............. 217
Railroad Retirement Board.................................... 217
Social Security Administration............................... 218
Title V: General Provisions...................................... 223
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the
Senate......................................................... 225
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules
of the Senate.................................................. 225
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 226
Budgetary Impact of Bill......................................... 239
Comparative Statement of New Budget Authority.................... 240

LIST OF ABBREVIATIONS

ACL--Administration for Community Living
ADAP--AIDS Drug Assistance Program
AHEC--area health education center
AHRQ--Agency for Healthcare Research and Quality
ALS--amyotrophic lateral sclerosis
AoA--Administration on Aging
AP--Advanced Placement
APH--American Printing House for the Blind
ARRA--American Recovery and Reinvestment Act of 2009
ASH--Assistant Secretary for Health
ASPR--Assistant Secretary for Preparedness and Response
ATSDR--Agency for Toxic Substances and Disease Registry
BARDA--Biomedical Advanced Research and Development
Authority
BCA--Budget Control Act of 2011
BLS--Bureau of Labor Statistics
CAN--Cures Acceleration Network
CCAMPIS--Child Care Access Means Parents in School
CCDBG--Child Care and Development Block Grant
CDC--Centers for Disease Control and Prevention
CHAFL--College Housing and Academic Facilities Loans
CHC--community health center
CHGME--Children's Hospitals Graduate Medical Education
CMHS--Center for Mental Health Services
CMS--Centers for Medicare and Medicaid Services
CNCS--Corporation for National and Community Service
CPB--Corporation for Public Broadcasting
CSAP--Center for Substance Abuse Prevention
CSAT--Center for Substance Abuse Treatment
CSBG--Community Services Block Grant
CSEOA--Community Service Employment for Older Americans
DOD--Department of Defense
DOE--Department of Energy
DOL--Department of Labor
EBSA--Employee Benefits Security Administration
EEOICPA--Energy Employees Occupational Illness Compensation
Program Act
ERISA--Employee Retirement Income Security Act of 1974
ESEA--Elementary and Secondary Education Act
ETA--Employment and Training Administration
FDA--Food and Drug Administration
FEMA--Federal Emergency Management Agency
FIC--Fogarty International Center
FIE--Fund for the Improvement of Education
FIPSE--Fund for the Improvement of Postsecondary Education
FMCS--Federal Mediation and Coalition Service
FMSHRC--Federal Mine Safety and Health Review Commission
FTE--full time equivalent
FWS--Federal Work Study
GAANN--Graduate Assistance in Areas of National Need
GAO--Government Accountability Office
GEAR UP--Gaining Early Awareness and Readiness for
Undergraduate Programs
HBCUs--Historically Black Colleges and Universities
HCERA--Health Care and Education Reconciliation Act of 2010
HCFAC--Health Care Fraud and Abuse Control
HEA--Higher Education Act
HELP--Health, Education, Labor and Pensions
HFFI--Healthy Foods Financing Initiative
HHS--Health and Human Services
HITECH--Health Information Technology for Economic and
Clinical Health
HRSA--Health Resources and Services Administration
IC--Institute and Center
IDeA--Institutional Development Award
IDEA--Individuals with Disabilities Education Act
IES--Institute of Education Sciences
IMLS--Institute of Museum and Library Services
IOM--Institute of Medicine
LEA--local educational agency
LIHEAP--Low Income Home Energy Assistance Program
MACPAC--Medicaid and CHIP Payment and Access Commission
MCH--maternal and child health
MedPAC--Medicare Payment Advisory Commission
MIECHV--Maternal, Infant, and Early Childhood Home Visiting
MSHA--Mine Safety and Health Administration
NAEP--National Assessment of Educational Progress
NAGB--National Assessment Governing Board
NCATS--National Center for Advancing Transitional Sciences
NCBDDD--National Center on Birth Defects and Developmental
Disabilities
NCES--National Center for Education Statistics
NCHS--National Center for Health Statistics
NCI--National Cancer Institute
NCRR--National Center for Research Resources
NEI--National Eye Institute
NHGRI--National Human Genome Research Institute
NHLBI--National Heart, Lung, and Blood Institute
NIA--National Institute on Aging
NIAAA--National Institute on Alcohol Abuse and Alcoholism
NIAID--National Institute of Allergy and Infectious Disease
NIAMS--National Institute of Arthritis and Musculoskeletal
and Skin Diseases
NIBIB--National Institute of Biomedical Imaging and
Bioengineering
NICHD--Eunice Kennedy Shriver National Institute of Child
Health and Human Development
NIDA--National Institute on Drug Abuse
NIDCD--National Institute on Deafness and Other
Communication Disorders
NIDCR--National Institute of Dental and Craniofacial
Research
NIDDK--National Institute of Diabetes and Digestive and
Kidney Disease
NIDRR--National Institute on Disability and Rehabilitation
Research
NIEHS--National Institute of Environmental Health Sciences
NIGMS--National Institute of General Medical Sciences
NIH--National Institutes of Health
NIMH--National Institute on Mental Health
NIMHD--National Institute on Minority Health and Health
Disparities
NINDS--National Institute of Neurological Disorders and
Stroke
NINR--National Institute of Nursing Research
NLM--National Library of Medicine
NLRB--National Labor Relations Board
NSF--National Science Foundation
NSIP--Nutrition Services Incentives Program
NTID--National Technical Institute for the Deaf
OAR--Office of AIDS Research
OBSSR--Office of Behavioral and Social Sciences Research
OCR--Office for Civil Rights
ODEP--Office of Disability Employment Policy
OFCCP--Office of Federal Contract Compliance Programs
OIG--Office of the Inspector General
OLMS--Office of Labor-Management Standards
OMB--Office of Management and Budget
OMH--Office of Minority Health
OMHA--Office of Medicare Hearings and Appeals
ONC--Office of the National Coordinator for Health
Information Technology
ORR--Office of Refugee Resettlement
ORWH--Office of Research on Women's Health
OSEP--Office of Special Education Programs
OSHA--Occupational Safety and Health Administration
OWCP--Office of Workers' Compensation Programs
OWH--Office of Women's Health
PAIMI--protection and advocacy for individuals with mental
illness
PATH--Projects for Assistance in Transition From
Homelessness
PBGC--Pension Benefit Guaranty Corporation
PHS--Public Health Service
PPACA--Patient Protection and Affordable Care Act
PPH Fund--Prevention and Public Health Fund
PRNS--Programs of Regional and National Significance
PROMISE--Promoting School Readiness of Minors in SSI
RSA--Rehabilitation Services Administration
SAMHSA--Substance Abuse and Mental Health Services
Administration
SAPT--Substance abuse prevention and treatment
SCHIP--State Children's Health Insurance Program
SEA--State educational agency
SEOG--Supplemental Educational Opportunity Grant
SIG--School Improvement Grants
SPORE--Specialized Program of Research Excellence
SPRANS--Special Projects of Regional and National
Significance
SSA--Social Security Administration
SSBG--Social Services Block Grant
SSI--Supplemental Security Income
STEM--science, technology, engineering, and mathematics
TANF--Temporary Assistance for Needy Families
TB--tuberculosis
TBI--traumatic brain injury
TIF--Teacher Incentive Fund
TRND--Therapeutics for Rare and Neglected Diseases
UAC--unaccompanied alien children
UCEDD--University Center for Excellence in Developmental
Disabilities
UI--unemployment insurance
USAID--U.S. Agency for International Development
USDA--U.S. Department of Agriculture
USPSTF--U.S. Preventive Services Task Force
VETS--Veterans' Employment and Training Services
VISTA--Volunteers in Service to America
VR--Vocational Rehabilitation
WANTO--Women in Apprenticeship and Non-Traditional
Occupations
WHD--Wage and Hour Division
WIA--Workforce Investment Act
WIF--Workforce Innovation Fund
WISEWOMAN--Well-Integrated Screening and Evaluation for
Women Across the Nation

SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS

For fiscal year 2013, the Committee recommends total budget
authority of $777,568,714,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
Of this amount, $158,772,000,000 is current year discretionary
funding, including offsets and $1,050,000,000 in cap
adjustments for healthcare fraud and abuse and for program
integrity at the SSA, in accordance with the 302(b) allocation
for this bill.
The Committee recommendation reflects a program level of
$166,011,337,000 for fiscal year 2013. (Program level is
current year discretionary funding plus additional spending
that is offset by savings in mandatory programs and other
adjustments to discretionary funding.)
The bill provides discretionary program level funding of
$12,341,781,000 for the Department of Labor, $70,999,718,000
for the Department of HHS, $68,520,153,000 for the Department
of Education and $14,149,685,000 for related agencies. The
comparable fiscal year 2012 levels were $12,552,758,000 for
Labor, $69,620,175,000 for HHS, $68,112,288,000 for Education
and $13,831,731,000 for related agencies.

Overview

The Labor, HHS, and Education, and Related Agencies
appropriations bill constitutes the largest of the non-defense
Federal appropriations bills being considered by Congress this
year. But even more noteworthy than the size of the bill is the
breadth of the critical services that are funded by this
legislation, which range from medical research to job training,
from home energy assistance to mental health, from student
financial assistance to the management of SSA.
Weighing the relative merits of such a wide range of
priorities is difficult, especially when funding is tight. The
Committee has tried to strike a balance between investing in
the future prosperity of the Nation, providing a safety net for
people who are most vulnerable in today's struggling economy,
and increasing the fiscal accountability and effective use of
taxpayer dollars.
Several themes permeate the Committee's recommendation,
described below.

Fiscal Accountability

The Committee recommendation provides funding for several
activities that reduce fraud, waste, and abuse of Federal
funding.
Healthcare Program Integrity.--Fraud committed against
Federal healthcare programs diverts critical resources from
services to some of the Nation's most vulnerable populations.
The Committee includes $610,000,000 for HCFAC activities at
CMS, nearly double the fiscal year 2012 level of $310,378,000.
The historical return on investment for the Medicare Integrity
program has been about $14 for every $1 spent. For fraud and
abuse activities throughout Medicare and Medicaid, the Federal
Government saves or recovers $6 for every $1 spent.
Social Security Program Integrity.--The Committee
recommendation includes $1,024,000,000, an increase of
$268,000,000 over the fiscal year 2012 level, for the SSA to
conduct continuing disability reviews and redeterminations of
nonmedical eligibility under the SSI program. This investment
will save approximately $8,100,000,000 over 10 years for the
Social Security, Medicare, and Medicaid programs, a return on
investment of $8 for every $1 spent.
Unemployment Insurance Program Integrity.--The Committee
recommendation includes $75,000,000, an increase of $15,000,000
over the fiscal year 2012 level, to conduct re-employment and
eligibility assessments and UI improper payment reviews. This
funding will save State UI Trust funds by helping claimants
exit the UI program faster and avoid exhausting benefits. The
Committee recommendation also includes $30,000,000 to support
intensive reemployment services for UI claimants, which shorten
the length of time people receive unemployment insurance, as
well as boost employment and earnings for claimants. No funds
were provided in fiscal year 2012 for these services.
Spending on Conferences and Other Administrative
Expenses.--The Committee bill includes new provisions intended
to prevent excessive spending on conferences and other
administrative expenses. The provisions require departments,
agencies, boards, and commissions funded in this act to submit
quarterly reports to their OIG or senior ethics official on the
costs and contracting procedures involved in any conference
that costs more than $20,000. The provisions also limit the
amount of Federal funding that may be spent on any single
international conference and the number of Federal employees
who may attend it. The provisions codify the May 2012 OMB
memorandum related to planning for and spending on conferences,
travel, real property, and fleet management.
340B User Fee.--The Committee includes a provision to
institute a new 0.1 percent user fee on 340B discount drugs.
The fee is expected to generate $6,000,000 in fiscal year 2013,
which will be used to implement program integrity work
recommended by GAO and mandated by PPACA.

Promoting Innovation

Just because times are lean doesn't mean that innovation
should cease. This bill launches or continues several
initiatives that will leverage reform and transform key Federal
services.
Pay for Success.--The Committee recommendation creates a
new model, called Pay for Success, for financing and delivering
effective services under government programs. Federal funding
typically pays for services with the expectation, but no
absolute guarantee that they will have positive results. Under
Pay for Success, the Federal Government will make available
funds to pay for defined outcomes, such as employment or
graduation. Philanthropic groups and social impact investors
will finance the services and would earn payments if those
services lead to the agreed-upon outcomes. The Committee
recommendation includes up to $10,000,000 within WIF, up to
$9,000,000 within the Social Innovation Fund, and up to
$25,000,000 within the PROMISE program for this new approach.
Performance Partnerships for Disconnected Youth.--The
Committee recommendation creates a new authority called
Performance Partnerships that will provide States and local
communities with unprecedented flexibility to achieve defined
outcomes for disconnected youth. Up to 13 States and/or local
communities will be allowed to combine funding that they
receive through various programs within this bill, even if the
programs are funded in different departments, for these pilot
projects. Grantees will receive waivers to reduce bureaucratic
obstacles to the smooth functioning of these performance
partnerships; for example, they could be allowed to provide a
single set of outcome data to the Departments of Education,
HHS, and Labor, rather than slightly different data to each
agency.
Investing in Innovation.--The Committee bill creates a new
organization in the Department of Education called ARPA-ED that
will identify and promote advances in fundamental and applied
sciences and engineering that could be translated into new
learning technologies; develop, test, and evaluate novel
learning technologies and related processes; and accelerate
transformational technological advances. Modeled after the
Defense Advanced Research Projects Agency, the entity that
helped create the Internet, ARPA-ED will be funded as a set-
aside of up to $44,825,000 within the Investing in Innovation
[i3] program. The Committee bill provides $149,417,000 for i3,
which provides grants to replicate education programs that have
high levels of effectiveness and to develop and test promising
new ideas.
First in the World.--The Committee bill includes
$40,000,000 to create the First in the World Initiative in the
Department of Education. Modeled after the Investing in
Innovation program, the initiative will provide grants to
colleges and universities to implement innovative and effective
strategies that improve educational outcomes and significantly
reduce the net price paid by students.
Strategic Investor.--The Committee bill includes
$20,000,000 to create a Strategic Investor initiative at BARDA.
This new program will allow the Federal Government to partner
with small biotechnology companies in order to foster and
accelerate the generation of novel medical countermeasures and
technologies. This initiative will address gaps in the
Government's capability to respond to emerging infections,
bioterrorism, and other public health threats.
Promise Neighborhoods.--The Committee recommends
$80,000,000--a more than $20,000,000 increase over the fiscal
year 2012 level--for the Promise Neighborhoods program.
Inspired by the successful Harlem Children's Zone program,
Promise Neighborhoods supports local efforts to establish
cradle-to-career services designed to improve educational
outcomes for students in distressed neighborhoods.
Accelerating Cures.--The Committee bill includes
$40,000,000, four times the fiscal year 2012 level, for CAN, an
NIH initiative to help speed the translation and application of
discoveries that have shown signs of success at the laboratory
level but have not advanced far enough to attract significant
investments from the private sector. CAN will make grants to
biotech companies, universities, and patient advocacy groups,
and will also help facilitate FDA review for the high-need
cures that are funded by this initiative.
Workforce Innovation Fund.--The Committee includes
$49,906,000 to continue WIF, which will help reform the
Nation's workforce investment system and improve the delivery
of training programs to workers.
Social Innovation Fund.--The Committee recommendation
provides $45,000,000, the same as the fiscal year 2012 level,
for the Social Innovation Fund at CNCS. This fund mobilizes
public and private resources to expand and evaluate promising,
innovative community-based solutions in three areas: economic
opportunity, healthy futures, and youth development.

Early Childhood Education

Quality early childhood education has proven to have
lasting effects for low-income children and their families.
Investments in early childhood education not only improve
outcomes for children and families, but save taxpayer dollars
in the long run through lower welfare, special education, and
criminal justice costs.
Child Care and Development Block Grant.--The Committee
recommendation includes $2,438,313,000, a $160,000,000 increase
over the fiscal year 2012 level, for the CCDBG. Of this
increase, $90,000,000 is targeted to improving the quality of
the early childhood care and education workforce and will
support training, education, and other professional development
opportunities. The remaining $70,000,000 will be used to
improve low-income families' access to quality child care by
increasing the number of families served, subsidy rates, and
reimbursement rates to providers.
Head Start.--The Committee recommendation includes
$8,038,544,000, a $70,000,000 increase over the fiscal year
2012 level, for Head Start. In fiscal year 2012, HHS began
implementing new regulations that will require Head Start
grantees that do not meet certain performance standards to re-
compete for funding. This year, over $1,200,000,000 in Head
Start grants will be re-competed, providing additional
assurances that children in Head Start are receiving quality
services. The Committee recommendation supports the
implementation of this new re-competition process as well as an
increase for each existing grantee to help defray rising
operational costs.
Race to the Top.--The Committee includes $600,000,000, a
$51,040,000 increase over the fiscal year 2012 level, for the
administration's signature education reform program. A
significant portion of fiscal year 2013 funds will be used for
Race to the Top--Early Learning Challenge, which will offer
additional opportunities to States for enhancing early care and
education.

Prevention

Nearly three-quarters of all healthcare costs are
attributable to chronic diseases, the majority of which are
preventable. This bill promotes prevention efforts through
discretionary funding as well as through $1,000,000,000 in
mandatory funding that will be transferred from the PPH Fund.
The PPH Fund was appropriated in PPACA, but PPACA gives
Congress the authority to allocate it through the
appropriations process.
Community Transformation Grants.--The Committee recommends
dedicating $280,000,000 of the PPH Fund, an increase of
$54,000,000 over the fiscal year 2012 level, for implementing
evidence-based public health interventions to reduce obesity
and smoking and make preventive services more accessible.
Childhood Immunizations.--The Committee recommends
$557,870,000 for immunization programs authorized under section
317 of the PHS Act, including a $190,000,000 transfer from the
PPH Fund. This funding is sufficient to purchase an estimated
3.5 million doses of vaccine. Immunization saves $10.20 in
direct medical costs for every child vaccinated.
Smoking Prevention.--Tobacco kills 440,000 people in the
Nation each year, costing $96,000,000,000 per year in medical
expenses. The Committee bill provides $203,117,000, including
$95,000,000 in transfers from the PPH Fund, for the Office of
Smoking and Health at CDC. This funding, an increase of
$12,000,000 over the fiscal year 2012 level, will continue the
successful media campaign ``Tips From a Former Smoker'' and
expand State quit-lines.
Diabetes Prevention Program [DPP].--The Committee bill
includes $20,000,000, double the fiscal year 2012 level, for
replicating the Diabetes Prevention Program, a set of lifestyle
interventions that has been proven to reduce the risk of
developing diabetes by 58 percent in individuals at high risk.
This amount includes $10,000,000 in transfers from the PPH
Fund.
Elder Falls.--One out of three adults age 65 and older
falls each year, with 20 to 30 percent of falls resulting in
moderate to severe injury. The direct medical costs total
$19,000,000,000 a year. Many of the falls are preventable with
lifestyle interventions and appropriate physical supports. In a
new initiative, the Committee bill transfers $10,000,000 from
the PPH Fund to CDC and ACL to research and implement evidence-
based approaches to preventing elderly falls.

Assisting People With Disabilities

Promoting School Readiness for Minors in SSI.--In fiscal
year 2012, Congress created PROMISE, an unprecedented
interagency effort to improve outcomes for children, and the
families of children, receiving SSI benefits. This program will
improve services for these transition-aged youth by encouraging
State-level innovation and facilitating better coordination
that can help young people with disabilities enter and succeed
in competitive, integrated employment. In fiscal year 2013, the
Committee includes $11,996,000 and the authority to allocate
unspent vocational rehabilitation State grant funds within the
Department of Education for this effort, in addition to
$7,200,000 at SSA.
Education for Individuals With Disabilities.--The Committee
bill provides $11,677,855,000, an increase of $100,000,000 over
the fiscal year 2012 level, under section 611 of part B grants
to States for educating students with disabilities between the
age of 3 and 21. The bill also includes $462,710,000, an
increase of $20,000,000 over the fiscal year 2012 level, to
support statewide systems of coordinated and early intervention
services for children with disabilities 2 years old and
younger, as well as their families.
Special Education Research.--The bill includes $59,905,000,
an increase of $10,000,000 over the fiscal year 2012 level, to
support research on how children and adults with disabilities
learn and how best to meet their learning needs.
Assistive Technology.--The Committee bill provides
$37,500,000, an increase of $4,664,000 over the fiscal year
2012 level, for State assistive technology programs. These
programs support a range of activities to serve people with
disabilities, including State financing programs, device
reutilization and loan programs, and device demonstrations. The
Committee recommendation will ensure all 50 statewide assistive
technology programs receive the minimum grant authorized under
statute for the first time.
Disability Hearings at the Social Security
Administration.--The Committee recommendation includes
$11,735,544,000, a $290,352,000 increase over the fiscal year
2012 funding level, for SSA's administrative expenses. This
increase will support SSA's efforts to eliminate the disability
hearings backlog by the end of fiscal year 2013. In 2008, the
average processing time for a disability hearing reached an
all-time high of 532 days. As of April 2012, the average
processing time is 354 days. The Committee recommendation will
allow SSA to stay on target to eliminate the backlog and reduce
the average processing time to 270 days by the end of fiscal
year 2013.

Other Highlights of the Bill

Pell Grants.--The Committee bill maintains the
discretionary portion of the maximum Pell Grant award level at
$4,860 for the 2013-2014 school year. Combined with mandatory
funding, the total maximum award will rise by $85 to $5,635.
Centers for Medicare and Medicaid Services.--The Committee
recommends $3,156,045,000 for operations of CMS. The fiscal
year 2012 level is $2,608,785,000. Additional funding is needed
to continue implementation of PPACA and to accommodate a
dramatic increase in the Medicare population, as the baby boom
generation ages.
National Institutes of Health.--The bill provides
$30,723,259,000, an increase of $100,000,000, to fund
biomedical research at the 27 Institutes and Centers that
comprise the NIH.
Community Health Centers.--The Committee bill includes
$1,566,892,000 for CHCs. Combined with mandatory funding
provided in the health reform law, the fiscal year 2013 program
level for CHCs is $3,066,892,000--an increase of $300,000,000
over the fiscal year 2012 level. The bill includes a statutory
provision requiring that all fiscal year 2013 funds be awarded
in that fiscal year, rather than delayed for future years, to
allow for base grant adjustments for all existing CHCs and the
expansion of the national network of clinics.
Title I (Education for the Disadvantaged).--The Committee
bill includes $14,616,457,000, an increase of $100,000,000 over
the fiscal year 2012 level, for title I grants to local
education agencies for improving education for low-income
students. These funds support more than 90 percent of the
15,000 school districts across the Nation.
Children's Hospitals Graduate Medical Education.--The
Committee recommendation includes $265,171,000 for CHGME, the
same level as in fiscal year 2012. The Committee rejects the 67
percent cut to this program proposed by the administration.
Low Income Home Energy Assistance.--The Committee
recommendation includes $3,471,672,000, the same as the fiscal
year 2012 level, for LIHEAP. The administration proposes a
decrease of $451,672,000.
Community Services Block Grant.--The Committee
recommendation includes $677,358,000, the same as the fiscal
year 2012 funding level, for the CSBG. The administration
proposes a decrease of $327,358,000.
AIDS Drug Assistance Program.--The Committee recommends
$963,299,000 for ADAP, an increase of $30,000,000 over the
fiscal year 2012 level.
Food Safety.--The Committee recommendation includes
$43,848,000 for food safety activities at CDC, an increase of
$16,075,000 over the fiscal year 2012 level. This funding will
support food-based outbreak investigations and develop new
laboratory and epidemiological tools.
National Public Health Institutes.--The Committee
recommends $10,000,000 to create a new initiative to assist
other nations in setting up and strengthening NPHIs similar to
America's CDC. NPHIs are science-based organizations that
provide leadership and coordination for public health at the
national level. Increasing the number of NPHIs worldwide will
improve global health and enhance the U.S. capability to detect
infectious diseases that could threaten the U.S. population.
Misclassification of Workers.--The Committee recommendation
includes an increase of $14,000,000 at DOL to address the
misclassification of workers as independent contractors.
Misclassifications deny workers their rights to unemployment
benefits, overtime pay, and other benefits, and also reduce
revenue to the Unemployment, Social Security, and Medicare
trust funds, as well as to the Treasury.
Substance Abuse and Mental Health.--The Committee
recommendation includes a combined increase of $40,000,000 for
the Community Mental Health Services Block Grant and the
Substance Abuse Prevention and Treatment Block Grant, in
recognition of the severe budget cuts taking place to public
mental health and substance abuse treatment systems nationwide.
Domestic Violence and Sexual Exploitation.--The Committee
recommendation includes a $5,000,000 increase, for a total of
$137,774,000 for family violence prevention and related
services, which include emergency shelters and services for
victims of domestic violence. In addition, the Committee
recommendation includes $5,000,000 for a new program to improve
services for child victims of sex trafficking.

TITLE I

DEPARTMENT OF LABOR

Employment and Training Administration

TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2012.................................... $3,192,692,000
Budget estimate, 2013................................... 3,231,812,000
Committee recommendation................................ 3,176,063,000

The Committee recommends $3,176,063,000 for the Training
and Employment Services account, which provides funding
primarily for activities under WIA.
This account 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. Funds provided for fiscal
year 2013 will support the program from July 1, 2013, through
June 30, 2014. A portion of this account's funding,
$1,772,000,000, is available on October 1, 2013, for the 2013
program year.
Any reference in this title of the report to the
``Secretary'' or the ``Department'' shall be interpreted to
mean the Secretary of Labor or the Department of Labor,
respectively, unless otherwise noted.
In 1986, the United States entered into a Compact of Free
Association with the Federated States of Micronesia and the
Republic of the Marshall Islands. In 1994, the United States
entered into a similar relationship with the Republic of Palau.
The Compacts set forth the bilateral terms for the government,
economic, and security relations between the United States and
the FAS and the laws approving the Compacts set forth the U.S.
policy context and interpretation for Compacts. Section 141 of
the Compacts provides that certain FAS citizens ``may be
admitted to, lawfully engage in occupations, and its
territories.'' However, the Congress also stated, in section
104(e)(1), that ``it is not the intent of Congress to cause any
adverse consequences for an affected jurisdiction.''
At present, it is estimated that affected areas of the
United States are spending upwards of $200,000,000 annually for
education, healthcare, and other services for FAS migrants,
including high-cost treatments such as dialysis and
chemotherapy. There is also a high-unemployment rate among the
FAS citizens currently located in the affected areas. Employers
in the affected areas report that there is a significant need
for language and cultural education and job training, which
often complicates providing FAS citizens with employment
opportunities. The need for job training and technical
assistance in the affected areas is critical and would help to
alleviate some of the escalating social tensions. The Committee
believes the National Security Council Interagency Policy
Committee on Freely Associated State Affairs that was
established in Senate Report 112-74 would benefit from the
input of the Department on employment and training issues.
Therefore, the Committee requests the Department become a
member of the interagency group and asks for a report no later
than 180 days after enactment of this act on its involvement.
The Committee recognizes that there are opportunities for
the further alignment and streamlining of employment and
training services. The Committee encourages the Department to
continue to work with other Federal agencies to increase
administrative efficiencies.

Grants to States

The Committee recommends $2,603,315,000, the same as the
fiscal year 2012 level, for Training and Employment Services
Grants to States. The budget request is $2,600,344,000.
As proposed in the budget request, the Committee retains
bill language that allows a local workforce board to transfer
up to 30 percent between the adult and dislocated worker
assistance State grant programs, if such transfer is approved
by the Governor. In addition, a local board may award a
contract to an institution of higher education or other
eligible training provider if the board determines that it
would facilitate the training of multiple individuals in high-
demand occupations, if such contract does not limit customer
choice.
Adult Employment and Training.--For adult employment and
training activities, the Committee recommends $770,811,000, the
same amount provided in fiscal year 2012. The budget request
includes $769,465,000.
This program is funded by formula to States and further
distributed to local workforce investment areas. Three types of
services for adults are provided through the one-stop system:
core services, intensive services, and job training. Core
services are available to all adults with no eligibility
requirements. Intensive services are provided to unemployed
individuals who are not able to find jobs through core services
alone. Training services may be available to adults who have
been determined unable to obtain or retain employment through
intensive services.
Funds made available in this bill support program year 2013
activities that occur from July 1, 2013, through June 30, 2014.
The bill provides that $58,811,000 is available for obligation
on July 1, 2013, and that $712,000,000 is available on October
1, 2013. Both categories of funding are available for
obligation through June 30, 2014.
Youth Training.--For youth training programs, the Committee
recommends $824,353,000, the same as both the fiscal year 2012
comparable amount and the budget request.
The purpose of this program is to provide eligible youth
with assistance in achieving academic and employment success
through improved education and skill competencies, connections
to employers, mentoring, training, and supportive services. The
program also supports summer employment directly linked to
academic and occupational learning, incentives for recognition
and achievement, and activities related to leadership
development, citizenship, and community service. Funds made
available for youth training support program year 2013
activities, which occur from April 1, 2013, through June 30,
2014.
Dislocated Worker Assistance.--For dislocated worker
assistance, the Committee recommends $1,008,151,000, the same
as the fiscal year 2012 amount. The budget request includes
$1,006,526,000.
This program is a State-operated effort that provides core
and intensive services, training, and support to help
permanently separated workers return to productive,
unsubsidized employment. In addition, States must use statewide
reserve funds for rapid response assistance to help workers
affected by mass layoffs and plant closures. States must also
use these funds to carry out additional statewide employment
and training activities such as providing technical assistance
to certain low-performing local areas, evaluating State
programs, and assisting with the operation of one-stop delivery
systems. States may also use funds for implementing innovative
incumbent and dislocated worker training programs.
Funds made available in this bill support program year 2013
activities, which occur from July 1, 2013, through June 30,
2014. The bill provides that $148,151,000 is available for
obligation on July 1, 2013, and that $860,000,000 is available
on October 1, 2013. Both categories of funding are available
for obligation through June 30, 2014.

Governor's Reserve Fund

The Committee recommendation modifies current law regarding
the amount of WIA State grant funding that may be set aside by
Governors. As requested by the administration, the Committee
continues bill language authorizing the Governor of a State to
reserve not more than 5 percent of the funds allotted to a
State through the WIA State grant programs for statewide
workforce investment activities. The percentage was lowered
from 15 percent to 5 percent in fiscal year 2011, and then
maintained at that level in fiscal year 2012. The Committee
adds new bill language allowing Governors to reserve up to 10
percent of WIA State grant program funding if half of the total
set-aside is used to support on-the-job and incumbent training
to improve the skills of workers, avert layoffs, or lead to
employment, and is delivered on a local or regional basis for
in-demand occupations or industries.

Federally Administered Programs

Dislocated Worker Assistance National Reserve.--The
Committee recommends $224,066,000 for the Dislocated Worker
Assistance National Reserve, which is available to the
Secretary for activities such as responding to mass layoffs,
plant and/or military base closings, and natural disasters that
cannot be otherwise anticipated as well as for technical
assistance, training, and demonstration projects. This amount
is the same as the fiscal year 2012 level. The budget request
includes $223,688,000.
Funds made available in this bill support activities in
program year 2013, which occurs from July 1, 2013, through June
30, 2014. The bill provides that $24,066,000 is available for
obligation on July 1, 2013, and that $200,000,000 is available
on October 1, 2013. Both categories of funding are available
for obligation through June 30, 2014.
As proposed in the budget request, the Committee continues
bill language from previous years authorizing the use of funds
under the dislocated workers program for projects that provide
assistance to new entrants in the workforce or incumbent
workers and assistance where there have been dislocations
across multiple sectors or local areas of a State.
Native American Programs.--The Committee recommends
$47,562,000, the same amount provided in fiscal year 2012, for
Native American programs. The budget request is $52,562,000.
These programs are 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 in securing permanent,
unsubsidized employment.
Migrant and Seasonal Farmworker Programs.--The Committee
recommends $84,291,000, the same as the fiscal year 2012 level
and the budget request, for migrant and seasonal farmworkers
programs, which serve members of economically disadvantaged
families whose principal livelihood is derived from migratory
and other forms of seasonal farmwork, fishing, or logging
activities. Enrollees and their families are provided with
employment, training, and related services intended to prepare
them for stable, year-round employment within and outside of
the agriculture industry.
The Committee recommendation provides that $78,104,742 be
used for State service area grants. The Committee
recommendation also includes bill language directing that
$5,678,222 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 recommendation also includes
$508,036 to be used for section 167 training, technical
assistance, and related activities, including funds for migrant
rest center activities.
Women in Apprenticeship.--The Committee recommends $996,000
for activities authorized under the WANTO Act of 1992. This
amount is the same as the fiscal year 2012 level. The budget
request eliminates this program. These funds provide for
technical assistance to employers and unions to assist them in
training, placing, and retraining women in nontraditional jobs
and occupations.
YouthBuild.--The Committee recommends $79,689,000, the same
as the fiscal year 2012 level and the budget request, for the
YouthBuild program. YouthBuild targets at-risk, high-school
dropouts and prepares them with the skills and knowledge they
need to succeed in a knowledge-based economy.
Workforce Innovation Fund.--The Committee recommends
$49,906,000, the same as the fiscal year 2012 level, for WIF, a
program that provides competitive awards for workforce
innovation activities. The Committee recommendation does not
set aside $10,000,000, as requested by the administration, for
a new initiative to improve services for disconnected youth.
The Committee recommendation includes new bill language, as
requested by the administration, that allows a portion of the
funds for WIF to be used for Pay for Success pilots, which will
provide performance-based awards to States or local governments
and nonprofit organizations providing or arranging services
that improve employment and education outcomes for individuals,
including those with barriers to employment. The Committee
expects that funds for Pay for Success pilots will only be set
aside if it has been determined that such pilots could improve
outcomes and eligible entities show interest. The Committee
also expects to be notified prior to the issuance of any notice
related to Pay for Success activity.
The budget request includes $100,000,000 for WIF through
the Department and an additional $25,000,000 through the
Department of Education's VR State Grants and Adult Basic State
Grants programs.
The Committee is reluctant to provide an increase for WIF
until it can gauge the program's success. The Committee notes
that although the program was created in fiscal year 2011, with
additional funding appropriated in fiscal year 2012, the
Department does not plan to award the first WIF grants before
mid- to late June 2012.
WIF grants are intended to test innovative strategies;
replicate and expand effective, evidence-based strategies and
activities, including sector strategies, career pathways,
incumbent worker training, and on-the-job training; and align
programs and strengthen the workforce system in a State or
region in order to substantially improve the education and
employment outcomes for job seekers and workers, youth, and
employers. The Committee expects activities for youth will
improve services for individuals up to age 24.
WIF awards will be made either to States, in partnership
with local workforce investment boards, or to local workforce
investment boards or consortia of such boards that serve a
regional labor market. Priority will be given to applicants
that demonstrate significant alignment, strategic planning, and
coordination across the workforce development system and
supportive services at the State, regional, or local level, and
that support economic development goals and improved employment
outcomes for participants, particularly those who are hardest
to serve.
The Committee commends ETA for its collaborative work with
IMLS to integrate the education, employment, and training
services provided by public libraries into the workforce
development system. The Committee encourages ETA to continue to
invest in building and strengthening partnerships between the
one-stop system and public libraries and recommends that the
ETA encourage applicants for grants under WIF to collaborate
with public libraries.
The budget request includes a general provision that
provides the Secretary with the authority to waive statutes and
regulations relating to title I of WIA and the Wagner-Peyser
Act when the Secretary believes waivers would substantially
improve employment and education outcomes. The Committee does
not include this general provision.

National Activities

The Committee remains greatly concerned about the low level
of literacy and numeracy skills among adult workers. The
Committee continues to encourage the Department to work with
the Department of Education to examine and share best practices
to help adults with the lowest literacy levels improve their
overall skills and employment opportunities. The Committee
requests the Department report on its progress in educating the
workforce system on the effectiveness of adult literacy and
basic skills programs that have successfully implemented
strategies for delivering basic literacy instruction together
with occupational training no later than 120 days after
enactment of this act. Further, the Committee recommends that
these best practices be widely disseminated to maximize
outreach to programs that would be able to implement improved
approaches.
As proposed in the budget request, the Committee recommends
eliminating funding designated for two programs: pilots,
demonstrations, and research; and evaluation. These activities
will instead be funded through a 0.5 percent tap on the
Department's training and employment programs, including WIA,
Job Corps, and the Employment Service. The new set-aside
approach will ensure that sufficient funding is available to
carry out comprehensive research and evaluations, including
random assignment studies, and promote greater stability of
funding for these efforts.
The ETA will conduct evaluation and applied research
activities in consultation with the Department's chief
evaluation officer who oversees the evaluation program. Results
will inform policy, advance the Department's mission, and
improve its performance-based management initiatives.
Pilots, Demonstrations, and Research.--As explained above,
the Committee recommends eliminating funding designated for
this program. The fiscal year 2012 funding level is $6,603,000.
In recent years, funding levels have been sufficient only to
carry out research activities and not pilots and
demonstrations.
The Committee directs the Secretary to use the authority in
sections 170 and 171 of WIA to set aside up to $10,000,000 to
support technical assistance, research, and demonstration
activities by making competitive grants to nonprofit entities
with demonstrated effectiveness in aligning education,
workforce, and economic development programming to advance the
quality and effectiveness of the workforce development system
and to support innovative collaborations at the local level
that enhance the employment and training opportunities for
workers. This recommendation is intended to highlight the need
to build capacity in the workforce system in a way that
maximizes returns for job seekers, incumbent workers, and
employers. Grant awards should support integration of the
successful approaches identified in GAO Report 12-97, dated
January 19, 2012, to help local workforce boards react swiftly
to changing labor market demands and ensure workers have the
required skills to meet those demands. Awards should also
support capacity building or demonstration projects in local
communities to address chronic unemployment and skills
mismatches by disseminating information, providing technical
assistance, or serving as an intermediary to develop and
monitor projects that increase the alignment of education and
training investments.
Reintegration of Ex-Offenders.--The Committee recommends
$80,238,000, the same as the fiscal year 2012 level, for the
Reintegration of Ex-Offenders program. The budget request
includes $85,238,000. This program helps prepare and assist ex-
offenders return to their communities through pre-release
services, mentoring, and case management. The program also
provides support, opportunities, education, and training to
youth who are involved in court and on probation, in aftercare,
or on parole, or who would benefit from alternatives to
incarceration or diversion from formal judicial proceedings.
Programs are carried out directly through State and local
governmental entities and community-based organizations, as
well as indirectly through intermediary organizations.
Within the funds provided, the Committee recommendation
includes $20,000,000, the same as fiscal year 2012 and the
budget request, for competitive grants to national or regional
intermediaries for activities that prepare young ex-offenders
and school dropouts for employment. Priority should be given to
projects that serve high-crime, high-poverty areas.
Evaluation.--As explained above, the Committee recommends
eliminating funding designated for evaluation. The fiscal year
2012 funding level is $9,563,000.
Workforce Data Quality Initiative.--The Committee
recommends $6,000,000 for the Workforce Data Quality
Initiative, the same as the budget request. The comparable
fiscal year 2012 level is $6,463,000. Funds are used to assist
States with incorporating comprehensive workforce information
into longitudinal data systems being developed in part with the
support of funding provided by the Department of Education. The
initiative is also intended to help improve the quality and
accessibility of performance data being produced by training
providers. Twenty-five States have been awarded grants through
this program. This funding will expand the initiative to
approximately six additional States.

OFFICE OF JOB CORPS

Appropriations, 2012.................................... $1,702,947,000
Budget estimate, 2013................................... 1,650,004,000
Committee recommendation................................ 1,673,210,000

For Job Corps, the Committee recommends $1,673,210,000.
The recommendation for operations of Job Corps centers is
$1,569,078,000, the same as the fiscal year 2012 level. The
budget request includes $1,545,872,000.
The budget request for operations is based on a new reform
effort that will close a small number of chronically low-
performing Job Corps centers based on their educational and
employment outcomes. Some of these centers have remained in the
bottom cohort of center performance rankings for many years and
are failing at-risk youth in need of high-quality education and
training services. The Committee supports the Department's
reform effort and agrees that it is not beneficial to such
youth or a wise use of taxpayer dollars to continue to invest
in centers that have historically not served students well.
However, even if a few chronically low-performing centers
are closed, the Committee does not believe the budget request
is sufficient to support several new centers that have opened
in recent years and another center that is expected to open
during program year 2013. Therefore, the Committee recommends
no reduction to funding for operations.
The Committee is very concerned about the Department's
mismanagement of Job Corps funds that led to the funding
shortfall recently announced for the remainder of program year
2011 and the disruptions it has caused new, current, and
transfer students. In order to conduct proper oversight, it is
important for the Committee to understand the circumstances
that led to the shortfall. Therefore, the Committee requests a
detailed report that provides a timeline of when the Department
became aware of the shortfall; the specific steps the
Department is taking to address it; and a description of the
impact on students and services provided to them. The report
should also include a description of the impact on the budget
for program year 2012 and steps the Department is taking to
ensure that students do not face similar disruptions in the
coming year. The report shall be submitted to the Committee no
later than 30 days after enactment of this act. The Committee
expects to be notified in advance of announcements made to Job
Corps centers related to funding shortfalls.
The Committee urges the Department to ensure that any
center proposed for closure has exhausted all available options
to improve, including being placed on a corrective action plan
or performance improvement plan. The Committee also expects the
Department to use its existing performance measures as the key
component for developing its methodology for identifying
centers for closure and to adhere to the process for closing a
Job Corps center as described in section 159 of WIA, which
includes advance announcement to the general public of the
proposed closure; establishment of a reasonable comment period
for interested parties to submit written comments to the
Secretary; and notification to the Members of Congress who
represent the district or State in which such center is
located.
The Committee strongly encourages the Department to provide
Job Corps students enrolled in a closing low-performing center
the opportunity to transfer to another higher-performing Job
Corps center.
The Committee requests a detailed description of the
Department's plan for identifying centers for closure,
including a definition of a ``low-performing center,'' the
methodology used for identifying those centers, and a timeline
for the closure process. The Committee expects to receive this
information no later than 180 days after the enactment of this
act or at least 30 days prior to any public notice published in
the Federal Register.
The Committee recommendation for administrative costs is
$29,132,000, the same as the budget request. The comparable
fiscal year 2012 level is $29,077,000.
The Committee also recommends a total of $75,000,000 in
construction, renovation, and acquisition funds. This amount,
which is the same as the budget request, is available from July
1, 2013, to June 30, 2016. The comparable fiscal year 2012
level is $104,792,000.
As requested by the administration, the Committee again
includes bill language allowing the Secretary to transfer up to
15 percent of construction, renovation, and acquisition funds,
if necessary, to meet the operational needs of Job Corps
centers or to achieve administrative efficiencies.
The Committee notes that the Department recently took
disciplinary action against a Job Corps contractor for repeated
safety and protocol violations. The Committee believes that the
Job Corps program, its students, and the taxpayers would be
better served if the Department strengthened its oversight of
the program and its contractors.

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2012.................................... $448,251,000
Budget estimate, 2013...................................................
Committee recommendation................................ 448,251,000

The Committee recommends $448,251,000 for the CSEOA
program. As in fiscal year 2012, the budget request includes a
proposal to transfer the program to ACL in HHS. The Committee
again recommends keeping the program in DOL.
CSEOA provides part-time employment in community service
activities for unemployed, low-income persons aged 55 and
older.

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2012.................................... $1,100,100,000
Budget estimate, 2013................................... 1,421,000,000
Committee recommendation................................ 1,421,000,000

The Committee recommends $1,421,000,000 in mandatory funds
for Federal unemployment benefits and allowances.
This program assists trade-impacted workers with services
including: training, income support, employment, case
management, and assistance with health insurance coverage. The
program also includes a wage insurance option for certain
workers at least 50 years old. These benefits and services are
designed to help trade-impacted participants find a path back
into middle-class jobs, improve earnings, and increase
credential and education rates.

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Appropriations, 2012.................................... $4,071,058,000
Budget estimate, 2013................................... 3,949,240,000
Committee recommendation................................ 3,896,993,000

The Committee recommends $3,896,993,000 for this account.
The recommendation includes $3,810,882,000 authorized to be
drawn from the Employment Security Administration account of
the unemployment trust fund and $86,111,000 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 that
administer Federal and State unemployment compensation laws and
operate the public employment service.
The Committee bill retains language from previous years
that enables States to use funds appropriated under this
account to assist other States if they are impacted by a major
disaster declared by the President and that permits the
Secretary to use funds to make payments on behalf of States for
the use of the National Directory of New Hires. At the request
of one or more States, the Secretary may reallot funds for
States to carry out activities that benefit the administration
of unemployment compensation laws of a requesting State.
The Committee recommends a total of $3,016,209,000, the
same as the budget request, for UI activities. The comparable
fiscal year 2012 level is $3,220,438,000. The decrease in
funding is due to an expected reduction in UI administrative
workload. For UI State operations, the Committee recommends
$3,004,912,000. These funds are available for obligation by
States through December 31, 2013. Funds used for automation
acquisitions or for competitive grants awarded to States to
address worker misclassification, system improvements, or
improper payments are available for obligation by States
through September 30, 2015.
The Committee recommendation includes $75,000,000, the same
as the budget request, to conduct in-person re-employment and
eligibility assessments and UI improper payment reviews and
continues bill language allowing the Secretary to provide
additional funding to support these activities if funds become
available as the result of a decrease in UI workload activity.
Congress appropriated no less than $60,000,000 for this
activity in fiscal year 2012. This important program integrity
initiative has been shown to help claimants exit the UI program
faster and avoid exhausting UI benefits. The Committee intends
for a portion of these or other administrative funds to be used
for additional technology-based overpayment prevention,
detection, and collection activities. The budget request
includes a proposal for a discretionary cap adjustment
amendment to the Balanced Budget and Emergency Deficit Control
Act of 1985, which would provide an adjustment for $15,000,000
of the $75,000,000 included in the budget request. The
Committee recommendation does not use the cap adjustment, which
has yet to be enacted.
The Committee recommendation includes new bill language
that provides $10,000,000, as proposed in the budget request,
for an award program designed to incentivize States to improve
misclassification efforts. States that are most successful will
be able to use these incentive funds to upgrade their
misclassification detection and enforcement programs.
The Committee recommendation provides for a contingency
reserve amount should the unemployment workload exceed an
average weekly insured claims volume of 3,908,000, as proposed
in the budget request. This contingency amount would fund the
administrative costs of the UI workload over the level of
3,908,000 insured unemployed persons per week at a rate of
$28,600,000 per 100,000 insured unemployed persons, with a pro
rata amount granted for amounts of less than 100,000 insured
unemployed persons.
For UI national activities, the Committee recommends
$11,297,000, the same as the budget request. The comparable
fiscal year 2012 level is $11,266,000. These funds are directed
to activities that benefit the State/Federal UI program
including helping States adopt common technology-based
solutions to improve efficiency and performance and supporting
training and contracting for actuarial support for State trust
fund management.
For the Employment Service allotments to States, the
Committee recommends $730,842,000, the same as the budget
request. This amount includes $22,638,000 in general funds
together with an authorization to spend $708,204,000 from the
Employment Security Administration account of the unemployment
trust fund. The comparable fiscal year 2012 level is
$700,842,000. The Committee includes new bill language
requiring that no less than $30,000,000 be used to provide
reemployment services to UI beneficiaries. Congress last
appropriated funding for reemployment services in ARRA. A
recent study found that reemployment services coupled with re-
employment and eligibility assessments not only shorten UI
duration, but also boost employment and earnings for UI
claimants. The Committee recommendation continues to support
States' efforts in providing these critical workforce services
to UI claimants.
The Committee also recommends $20,952,000, the same as the
budget request, for Employment Service national activities. The
fiscal year 2012 level is $20,912,000. The administration of
the work opportunity tax credit accounts for $18,520,000 of the
recommended amount and the balance is for technical assistance,
training, and the Federal share of State Workforce Agencies
Retirement System payments.
For carrying out the Department's responsibilities related
to foreign labor certification activities, the Committee
recommends $65,517,000, the same as the budget request. The
comparable fiscal year 2012 level is $65,393,000. In addition,
5 percent of the revenue from H-1B fees is available to the
Department for costs associated with processing H-1B alien
labor certification applications.
For one-stop career centers and labor market information,
the Committee recommends $63,473,000, the same as the fiscal
year 2012 level. The budget request provides $115,720,000 and
includes a proposal to co-brand and increase public awareness
of the one-stop career center system. The Committee does not
recommend funding for this initiative due to funding
constraints.
The Committee recommendation includes $12,000,000 for the
ETA, in collaboration with ODEP, to continue to implement their
joint plan for improving effective and meaningful participation
of persons with disabilities in the workforce. The Committee
expects that these funds, in combination with funding available
to ODEP, will continue to improve the accessibility and
accountability of the public workforce development system for
individuals with disabilities. The budget request and fiscal
year 2012 level is $11,976,120.
The Committee recommendation includes new bill language, as
proposed in the budget request, authorizing the Secretary to
collect fees for costs associated with additional data
collection requested by States and local governments,
institutions of higher education, or nonprofit organizations
under the National Agricultural Workers Survey, and to retain
the proceeds to cover such costs.

STATE PAID LEAVE FUND

Appropriations, 2012....................................................
Budget estimate, 2013................................... $5,000,000
Committee recommendation................................................

Because of budget constraints, the Committee does not
recommend funding to create a new State Paid Leave Fund, which
would help States establish paid leave programs.

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2012.................................... $171,000,000
Budget estimate, 2013...................................................
Committee recommendation................................................

The Committee recommends and the budget requests such sums
as are necessary in mandatory funds for this account. The
budget estimates that there will be no net costs in fiscal year
2013 because of expected repaid advances to the trust fund. 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 Committee bill includes language proposed in the budget
request to allow the Department additional flexibility to
access funds as needed for covered programs.

PROGRAM ADMINISTRATION

Appropriations, 2012.................................... $147,081,000
Budget estimate, 2013................................... 147,611,000
Committee recommendation................................ 147,081,000

The Committee recommendation of $147,081,000 for program
administration includes $97,137,000 in general funds and
$49,944,000 from the Employment Security Administration account
of the unemployment trust fund.
General funds in this account pay for the Federal staff
needed to administer employment and training programs under
WIA, OAA, the Trade Act of 1974, WANTO, and the National
Apprenticeship Act. Trust funds provide for the Federal
administration of employment security functions under title III
of the Social Security Act.

Employee Benefits Security Administration

SALARIES AND EXPENSES

Appropriations, 2012.................................... $183,153,000
Budget estimate, 2013................................... 183,153,000
Committee recommendation................................ 183,153,000

The Committee recommends $183,153,000 for EBSA.
EBSA plays a critical role in improving health benefits and
retirement security for American workers and their families.
EBSA is responsible for the enforcement of title I of ERISA in
both civil and criminal areas and for enforcement of sections
8477 and 8478 of the Federal Employees' Retirement Security Act
of 1986. EBSA administers an integrated program of regulation,
compliance assistance and education, civil and criminal
enforcement, and research and analysis.
Benefits under EBSA's jurisdiction consist of approximately
$6,500,000,000,000 in assets covering approximately 150 million
participants and beneficiaries. EBSA oversees benefit security
for an estimated 718,000 private retirement plans, 2.6 million
health plans, and similar numbers of other welfare benefit
plans, such as those providing life or disability insurance.

Pension Benefit Guaranty Corporation

PBGC's estimated obligations for fiscal year 2013 include
single-employer benefit payments of $6,534,000,000, multi-
employer financial assistance of $118,000,000, and
administrative expenses of $479,013,000. Administrative
expenses are comprised of three activities: (1) pension
insurance activities, $75,943,000; (2) pension plan termination
expenses, $240,611,000; and (3) operational support,
$162,459,000. These expenditures are financed by permanent
authority.
The PBGC is a wholly owned Government corporation
established by ERISA. The law places it within DOL and makes
the Secretary 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. 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 President's budget proposes to continue authority for a
contingency fund for the PBGC that provides additional
administrative resources when the number of participants in
terminated plans exceeds 100,000. When the trigger is reached,
an additional $9,200,000 becomes available for every 20,000
participants in terminated plans. A trigger also is included
for additional investment management fees for plan terminations
or asset growth. These additional funds would be available for
obligation through September 30, 2014. The Committee bill
continues these provisions to ensure that the PBGC can take
immediate, uninterrupted action to protect participants'
pension benefits. The Committee expects to be notified
immediately of the availability of any funds provided by these
provisions.
As requested by the President's budget, the Committee bill
also continues authority allowing the PBGC additional
obligation authority for unforeseen and extraordinary pre-
termination expenses, after approval by the Office of
Management and Budget and notification of the Committees on
Appropriations of the House of Representatives and the Senate.
The Committee is very concerned by findings of the May 2012
PBGC IG Management Advisory report that found errors and
inconsistencies in both the multi-employer and single-employer
sections that were caused by a lack of quality control or
quality review process to ensure the integrity of reported
actuarial estimates. The Committee directs the PBGC Board of
Directors to designate a capable agency or organization that is
independent from the PBGC, such as the SSA, to conduct an
annual peer review of the Single-Employer Pension Insurance
Modeling System and Multi-Employer Pension Insurance Modeling
System, the first of which shall be initiated no later than 3
months after the date of enactment of this act. The Committee
also directs PBGC to develop written quality review policies
and procedures for all modeling and actuarial work performed by
the Policy, Research, and Analysis Department and to conduct a
record management review of the Policy, Research and Analysis
Department to determine what records must be retained as
Federal records. The PBGC shall, no later than 2 months after
the date of enactment, submit to Congress a report, approved by
the Board of Directors, setting forth a timetable for
addressing the outstanding recommendations of the Office of the
Inspector General relating to the Policy, Research and Analysis
Department and the Benefits Administration and Payment
Department.
PBGC's single-employer program protects nearly 34 million
participants in approximately 25,000 defined benefit pension
plans. The multi-employer insurance program protects about 10
million participants in roughly 1,500 plans.

Wage and Hour Division

SALARIES AND EXPENSES

Appropriations, 2012.................................... $227,061,000
Budget estimate, 2013................................... 237,730,000
Committee recommendation................................ 237,730,000

The Committee recommends $237,730,000 for WHD.
The WHD is responsible for administering and enforcing laws
that provide minimum standards for wages and working conditions
in the United States. The Fair Labor Standards Act [FLSA],
employment rights under the Family and Medical Leave Act, and
the Migrant and Seasonal Agricultural Worker Protection Act are
several of the important laws the WHD is charged with
administering and/or enforcing.
The Committee recommendation includes additional funds over
the fiscal year 2012 level to address the misclassification of
employees as independent contractors and to provide enhanced
enforcement of overtime pay regulations. In addition, as
proposed in the budget request, the Committee recommendation
includes funds reallocated from the Women's Bureau for WHD
efforts on Family and Medical Leave Act issues.
The Committee also supports the President's request to
provide additional resources for the WHD to increase its
oversight of organizations participating in the special minimum
wage program for individuals with disabilities authorized under
section 14(c) of the FLSA, in order to protect the rights of
workers with disabilities. The Committee also urges the WHD to
continue exploring and implementing strategies with ODEP and
other Federal agencies to provide additional opportunities for
such workers to participate in competitive integrated
employment.

Office of Labor-Management Standards

SALARIES AND EXPENSES

Appropriations, 2012.................................... $41,289,000
Budget estimate, 2013................................... 41,771,000
Committee recommendation................................ 41,289,000

The Committee recommends $41,289,000 for OLMS.
OLMS administers the Labor-Management Reporting and
Disclosure Act of 1959 and related laws. These laws establish
safeguards for union democracy and financial integrity. They
also require public disclosure by unions, union officers,
employers, and others. In addition, the office administers
employee protections under federally sponsored transportation
programs.

Office of Federal Contract Compliance Programs

SALARIES AND EXPENSES

Appropriations, 2012.................................... $105,187,000
Budget estimate, 2013................................... 106,415,000
Committee recommendation................................ 105,187,000

The Committee recommends $105,187,000 for OFCCP.
This office protects workers and potential employees of
Federal contractors from employment discrimination prohibited
under Executive Order 11246, section 503 of the Rehabilitation
Act of 1973, and the Vietnam Era Veterans' Readjustment
Assistance Act of 1974.
The Committee notes that almost 2 years ago the Department
issued an advance notice of proposed rulemaking regarding
regulations for implementing section 503 of the Rehabilitation
Act. The Committee strongly supports the administration's plan
to issue a final rule by October of this year, as these
regulations have not been updated in over 40 years. Changes
included in the proposed rule would make important improvements
in reducing barriers to employment opportunities for
individuals with disabilities. The Committee encourages the
Department to make technical assistance available to Federal
contractors regarding the rule, and to increase Federal
contractor employment opportunities for individuals with
disabilities.

Office of Workers' Compensation Programs

SALARIES AND EXPENSES

Appropriations, 2012.................................... $117,840,000
Budget estimate, 2013................................... 122,190,000
Committee recommendation................................ 117,840,000

The Committee recommends $117,840,000 for OWCP. The bill
provides authority to expend $2,120,000 from the special fund
established by the Longshore and Harbor Workers' Compensation
Act.
OWCP administers four distinct compensation programs: the
Federal Employees' Compensation Act, the Longshore and Harbor
Workers' Compensation Act, the Black Lung Benefits programs,
and the Energy Employees Occupational Illness Compensation
Program. In addition, OWCP houses the Division of Information
Technology Management and Services.

SPECIAL BENEFITS

Appropriations, 2012.................................... $350,000,000
Budget estimate, 2013................................... 396,000,000
Committee recommendation................................ 396,000,000

The Committee recommends $396,000,000 for this account.
This mandatory appropriation, which is administered by OWCP,
primarily provides benefits under the Federal Employees'
Compensation Act [FECA].
The Committee recommends continuation of appropriations
language to provide authority to require disclosure of Social
Security account numbers by individuals filing claims under
FECA or the Longshore and Harbor Workers' Compensation Act and
its extensions.
The Committee recommends continuation of appropriations
language that provides authority to use FECA funds to reimburse
a new employer for a portion of the salary of a newly re-
employed injured Federal worker. 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,
and declining thereafter.
The Committee recommendation also continues language that
allows carryover of unobligated balances to be used in the
following year and that provides authority to draw such sums as
are needed after August 15 to pay current beneficiaries. Such
funds are charged to the subsequent year appropriation.
The Committee also recommends continuation of
appropriations 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. Finally, the Committee continues
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, 2012.................................... $182,227,000
Budget estimate, 2013................................... 163,220,000
Committee recommendation................................ 163,220,000

The Committee recommends a mandatory appropriation of
$123,220,000 in fiscal year 2013 for special benefits for
disabled coal miners. This is in addition to the $40,000,000
appropriated last year as an advance for the first quarter of
fiscal year 2013, for a total program level of $163,220,000 in
fiscal year 2013. The decrease in this account below the fiscal
year 2012 level reflects a declining beneficiary population.
These mandatory funds are used to provide monthly benefits
to coal miners disabled by black lung disease and their widows
and certain other dependents, as well as to pay related
administrative costs.
The Committee also recommends an advance appropriation of
$35,000,000 for the first quarter of fiscal year 2014. This
amount is the same as the budget request. These funds will
ensure uninterrupted benefit payments to coal miners, their
widows, and dependents.

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

SALARIES AND EXPENSES

Appropriations, 2012.................................... $52,147,000
Budget estimate, 2013................................... 54,962,000
Committee recommendation................................ 54,962,000

The Committee recommends $54,962,000 for the Division of
Energy Employees Occupational Illness Compensation. This is a
mandatory appropriation.
The Division administers EEIOCPA, which provides benefits
to eligible employees and former employees of DOE, its
contractors and subcontractors, or to certain survivors of such
individuals. The mission also includes delivering benefits to
certain beneficiaries of the Radiation Exposure Compensation
Act. The Division is part of OWCP.
In fiscal year 2013, the volume of incoming claims under
part B of EEOICPA is estimated at about 7,300 from 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.
Under part E, approximately 6,400 new claims will be
received during fiscal year 2013. Under this authority, the
Department provides benefits to eligible DOE contractor
employees who were found to have work-related occupational
illnesses due to exposure to a toxic substance at a DOE
facility, or to the employees' survivors.

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2012.................................... $301,415,000
Budget estimate, 2013................................... 308,849,000
Committee recommendation................................ 308,849,000

The Committee bill provides an estimated $308,849,000 for
this mandatory appropriations account. This estimate is
comprised of $58,806,000 for administrative expenses and an
estimated $250,043,000 for benefit payment and interest costs.
The Committee bill continues to provide indefinite
authority for the Black Lung Disability Trust Fund to provide
for benefit payments. In addition, the bill provides for
transfers from the trust fund for administrative expenses for
the following DOL agencies: up to $32,906,000 for the part C
costs of the Division of Coal Mine Workers' Compensation
Programs, up to $25,217,000 for Departmental Management,
Salaries and Expenses, and up to $327,000 for Departmental
Management, Inspector General. The bill also allows a transfer
of up to $356,000 for the Department of the Treasury.
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 that are incurred in administering the benefits program
and operating the trust fund.

Occupational Safety and Health Administration

SALARIES AND EXPENSES

Appropriations, 2012.................................... $564,788,000
Budget estimate, 2013................................... 565,468,000
Committee recommendation................................ 565,468,000

The Committee recommends $565,468,000 for OSHA, which is
responsible for enforcing the Occupational Safety and Health
Act of 1970 in the Nation's workplaces.
The Committee continues bill language to allow OSHA to
retain up to $200,000 per fiscal year of tuition fees for
training institute courses to be used for occupational safety
and health training and education grants in the private sector.
The Committee bill retains language that continues to
effectively exempt farms employing 10 or fewer people from the
provisions of the act with the exception of those farms having
a temporary labor camp. The bill 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.
The Committee supports the important mission carried out by
OSHA. BLS data reveal that on average during calendar year 2010
one worker died of a work-related injury every 2 hours.
Millions more were seriously hurt or contracted a fatal illness
or disease in their workplace. These deaths and injuries take a
massive toll on our economy and society, decreasing
productivity and increasing the costs of medical care.
GAO recently reported that between 1981 and 2010, the time
it took OSHA to develop and issue safety and health standards
ranged widely, from 15 months to 19 years, and averaged more
than 7 years. OSHA's rulemaking on silica illustrates some of
the challenges identified by GAO.
According to CDC, as many as 1.7 million workers are
exposed to dangerous levels of silica in the workplace each
year; researchers estimate that 3,600 to 7,300 of them develop
silicosis and approximately 200 workers die of this condition
each year. Despite the mandate in Executive Order 12866 that
the Office of Information and Regulatory Affairs [OIRA]
complete its review of any proposed rule within 90 days (with a
possible extension of another 30 days), the silica rule has
languished at OIRA for more than 15 months. Therefore, the
Committee directs the Department to issue a notice of proposed
rulemaking on silica not later than 30 days after the end of
fiscal year 2012.
The Committee recommends $104,196,000, the same amount as
the budget request, for grants to States under section 203(g)
of the Occupational Safety and Health Act. These funds
primarily are provided to States that have taken responsibility
for administering their own occupational safety and health
programs for the private sector and/or the public sector. State
plans must be at least as effective as the Federal program and
are monitored by OSHA. The Committee bill continues language
that allows OSHA to provide grants of up to 50 percent for the
costs of State plans approved by the agency. The Committee
believes that, given the continuing fiscal pressures facing
State budgets, OSHA should continue its practice of allowing
States an extra year to match the appropriation provided by
this bill for support of their State plans, and also should
extend the period of expenditure for these funds for an
additional quarter.
The Committee also 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. Under the program,
grants are made to various types of organizations representing
employers and labor organizations for direct training of
workers on occupational safety and health. The Committee
recommendation includes $11,000,000 for the OSHA Susan Harwood
Training Grant Program. The budget request and the fiscal year
2012 level are both $10,709,000.

Mine Safety and Health Administration

SALARIES AND EXPENSES

Appropriations, 2012.................................... $372,523,000
Budget estimate, 2013................................... 371,896,000
Committee recommendation................................ 376,270,000

The Committee recommendation includes $376,270,000 for
MSHA.
MSHA insures the safety and health of the Nation's miners
by conducting inspections and special investigations of mine
operations, promulgating mandatory safety and health standards,
cooperating with the States in developing effective State
programs, and improving training in conjunction with States and
the mining industry.
The Committee bill continues language authorizing MSHA to
use up to $2,000,000 for mine rescue and recovery activities.
It also retains the provision allowing the Secretary 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. In order to prepare properly for an actual emergency,
the Committee also directs MSHA to continue to devote resources
toward a competitive grant activity for effective emergency
response and recovery training in various types of mine
conditions.
In addition, bill language is included to allow the
National Mine Health and Safety Academy to collect not more
than $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 $2,499,000 from fees collected for the
approval and certification of equipment, materials, and
explosives for use in mines, and to utilize such sums for such
activities. The Committee bill also provides new authority
requested in the President's budget to allow MSHA to establish,
collect, and retain fees for services related to the analysis
of rock dust samples.
The Committee continues to place a high priority on
reducing the backlog of contested safety and health violations.
This bill includes $2,233,000 more than the budget request to
expand that effort. In recent years, some mine operators have
challenged an increasing share of their mine safety violations,
preventing enhanced accountability provisions from taking
effect. As in last year's act, the bill provides the authority
to transfer a portion of these funds to support related
activities in the Office of the Solicitor. The Committee notes
that this effort has resulted in the targeted backlog being
reduced by over 80 percent in just less than 2 years.
The Committee notes that the current respirable coal dust
regulation dates back to 1980 and does not reflect changes in
technology or work schedules of miners that have occurred in
the decades since it was promulgated. In October 2010, MSHA
published a proposed rule on this issue. Congress included
language in last year's appropriations act that prohibited the
issuance of a final rule on the issue until GAO issues a report
related to the rulemaking or until after 240 days have passed
after enactment of the act. In either case, MSHA is expected to
promulgate the rule before the end of fiscal year 2012. In
addition, the statement of the managers accompanying the act
clarifies that MSHA could ``address any compliance assistance
or training needs'' before beginning to implement the rule.
The timely issuance of a final rule will help in the effort
to end black lung disease in the Nation's miners. Within this
account, the Committee provides resources needed to support the
rule's continued implementation in fiscal year 2013.
As requested by the administration, the Committee includes
new bill language allowing the Secretary to reallocate up to
$3,000,000 within MSHA's program lines. The Committee expects
to be notified prior to any such reallocation. The Committee
also expects that any reallocations will not prevent MSHA from
addressing important issues that are proposed in the budget
request or identified in this report. In addition to items
identified previously, the list of priority items include:
effective implementation of corrective actions related to the
Upper Big Branch internal review; purchase of additional
continuous personal dust monitors; adequate support for MSHA's
instructional capacity for training of mine safety and health
inspectors and other mine safety professionals; and
continuation of the spot inspection initiative related to
respirable coal dust.

Bureau of Labor Statistics

SALARIES AND EXPENSES

Appropriations, 2012.................................... $609,071,000
Budget estimate, 2013................................... 618,207,000
Committee recommendation................................ 619,043,000

The Committee recommends $619,043,000 for BLS. This amount
includes $67,176,000 from the Employment Security
Administration account of the unemployment trust fund and
$551,867,000 in Federal funds. The Committee retains bill
language providing that up to $1,500,000 may be used to support
the Mass Layoff Statistics Program.
The BLS is the principal fact-finding agency in the Federal
Government in the broad field of labor economics.
The Committee recognizes that the Nation requires current,
accurate, detailed labor statistics for Federal and non-Federal
data users. The Nation also requires Government programs to be
administered as cost-effectively as possible. However, the
current ability of the cooperative statistics system to meet
those needs is in question. Any weaknesses of this system could
reduce the ability of State and local regions to effectively
plan for recovery, anticipate industry demand for workforce
needs, and meet other labor market information challenges.
Therefore, the Committee directs the Secretary to
commission a study of and report on a comprehensive assessment
of the proper purpose, structure, methods, and operations of
the Federal-State cooperative statistics system, particularly
regarding the appropriate roles and responsibilities of the
BLS, the ETA, the State labor market information agencies, and
the system's relationship with the Census Bureau, the NCES,
State workforce agencies, State education agencies, and private
vendors.
The Committee believes the National Academies of Science
(Committee on National Statistics) and the National Academy of
Public Administration are very well-qualified to produce such a
report. The Committee requests the release of an interim report
within 12 months of the enactment of this act and a final
report within 24 months of the enactment of this act. The
interim report shall contain, at minimum, a rigorous assessment
of the Current Employment Statistics Program [CES], including
an evaluation of the accuracies of past and present methods for
producing initial State and metro area CES estimates,
identification of the methods most likely to produce accurate
initial estimates, and recommendations for appropriate BLS and
State roles and responsibilities in preparing such accurate
estimates. The report also should consider recommendations for
how to improve the collection of this large volume of
information, including through the use of technology;
coordinate the Federal and State data systems to provide
timely, accurate, and geographically detailed information on
employment, education and training, occupations, and worker
skills, as well as ease of access and technical assistance; and
improve responsiveness to the data needs of labor market
participants and policymakers at the Federal, State, and local
levels.
The Committee directs the Secretary to use such sums as may
be necessary for this study, allocated equally from funds
available to the Secretary, BLS, ETA, and the States. The State
contribution should be made through a set-aside from BLS
cooperative system grants to States.
The Committee commends the BLS for its roughly 4-decade
commitment to gather, extrapolate, and disseminate critical
information about the experiences of youth, women, and men in
the labor market through the National Longitudinal Surveys
[NLS]. These data have informed the development of public
policy and provided the basis for both historic and predictive
analysis of market trends across decades and generations
related to job creation, employment training, joblessness,
education, housing, health, and the economy. The Committee
recognizes that these longitudinal surveys serve as an
essential national data source for long-term and ongoing
analysis of the economic health of America and are an
invaluable resource for Congress, as well as the public and
private sectors, especially during times of economic
uncertainty. As such, the Committee continues to support the
NLS and recommends that the frequency of NLS data collection
should not be less than biennially.
The Committee recommendation includes sufficient funds to
initiate a pilot input price index that would track price
changes as establishments shift from domestic to foreign
sources. Within this pilot project, the Committee directs BLS
to develop a competitiveness audit that would compare the price
of selected imports with comparable domestically produced goods
and services.
Within available resources, the Committee encourages BLS to
prioritize work on the Contingent Work Supplement to the
Current Population Survey.

Office of Disability Employment Policy

Appropriations, 2012.................................... $38,879,000
Budget estimate, 2013................................... 38,953,000
Committee recommendation................................ 38,953,000

The Committee recommends $38,953,000 for ODEP. The
Committee intends that at least 80 percent of these funds shall
be used to design and implement research and technical
assistance grants and contracts to develop policy that reduces
barriers to competitive, integrated employment for youth and
adults with disabilities.
The mission of ODEP is to provide leadership, develop
policy and initiatives, and award grants furthering the
objective of eliminating physical and programmatic barriers to
the training and employment of people with disabilities. The
Committee strongly supports each of the components of ODEP's
mission and, in particular, urges the Secretary to ensure that
ODEP carries out its leadership role with respect to
governmentwide policies related to the training and employment
of individuals with disabilities. The Committee believes that
ODEP should put a high priority on providing support and
technical assistance to Federal agencies for the implementation
of Executive Order 13548 regarding hiring of persons with
disabilities. The Committee also encourages ODEP to provide any
support necessary for OFCCP to provide technical assistance to
Federal contractors in meeting their obligations under section
503 of the Rehabilitation Act.
The Committee looks forward to the findings from the
government-wide review involving ODEP that is intended to lead
to better program outcomes for individuals with disabilities
through improved coordination and alignment of disability
programs, including better sharing of data, goal setting, and
measuring of progress.
The Committee recommendation includes $12,000,000 for ODEP,
in collaboration with the ETA, to continue to implement their
joint plan for improving effective and meaningful participation
of persons with disabilities in the workforce. The Committee
expects that these funds, in combination with funding available
to the ETA, will continue to improve the accessibility and
accountability of the public workforce development system for
individuals with disabilities.

Departmental Management

SALARIES AND EXPENSES

Appropriations, 2012.................................... $362,999,000
Budget estimate, 2013................................... 348,927,000
Committee recommendation................................ 348,927,000

The Committee recommendation includes $348,927,000 for the
departmental management account. An amount of $326,000 is
available by transfer from the Black Lung Disability Trust
Fund.
The primary goal of the Department is to protect and
promote the interests of American workers. The departmental
management appropriation pays the salaries and related expenses
of 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 appropriations for salaries and expenses are not
suitable.
The Committee recommendation includes $12,000,000 within
the legal services activity to continue support of the
Department's efforts to reduce the backlog of mine safety cases
before FMSHRC. Additionally, up to $2,000,000 provided to MSHA
are available by transfer to legal services to support an
increased capacity of the Commission to process caseloads
pending before it. The Committee notes that this effort has
resulted in the targeted backlog being reduced by over 80
percent in fewer than 2 years. The Committee also continues to
expect the Department to make every effort to support the
timely processing of contested citations, particularly for
operators that have the highest proportion of significant and
substantial citations or other evidence of unacceptable health
and safety records, as well as other efforts that reduce the
number of contested citations.
The Committee recommendation includes $94,984,000 for the
Bureau of International Labor Affairs [ILAB]. These funds are
available to help improve working conditions and labor
standards for workers around the world and carry out ILAB's
statutory mandates and international responsibilities. The
Committee bill continues language from last year's act
regarding the authority to fund microfinance activities, and
funding levels for programs to combat exploitative child labor
and model worker rights programs in countries with which the
United States has trade preference programs or free trade
agreements. The Committee expects ILAB to maintain its current
effort on programs to combat exploitative child labor.
The bill continues to provide an extra quarter for
obligation of $66,500,000 of ILAB's appropriation as requested
in the budget.
The Committee recommendation provides $9,000,000, the same
amount as the budget request, for program evaluation and allows
these funds to be available for obligation through September
30, 2014. The Committee bill also continues the authority of
the Secretary to transfer these funds to any other account in
the Department for evaluation purposes. The Committee bill
includes requested authority to use up to 0.5 percent of
certain Department appropriations for evaluation activities
identified by the chief evaluation officer. The bill language
differs slightly from last year's bill by including the
Training and Employment Services in the list of accounts
covered by this authority, as proposed in the budget request.
The Committee expects to be notified of the planned uses of
funds derived from this authority.
The Committee recommendation provides $9,081,000 for the
Women's Bureau as proposed in the budget request. While this
amount is less than last year's level of $11,559,000, the
Committee expects that additional resources provided to the WHD
will allow the Department to strengthen its activities related
to family and medical leave issues. In addition, funds
available to the Bureau will enable it to undertake critical
work, including in collaboration with other Federal agencies,
in addressing the pay gap. The Committee continues bill
language allowing the Bureau to award grants.
The Committee is aware that, on April 10, 2012, the
Department announced a significant change in the manner in
which sensitive economic data are released to the news media
and public. Members of Congress, the news media, and public
interest groups have raised substantial concerns regarding this
proposed policy change. The Committee understands that the
Department and news organizations have been discussing
significant modifications to the proposal, and that the
Department has delayed implementation of all aspects that do
not deal with the process of issuing credentials. The Committee
directs the Department to collaborate with the news media in
developing a revised policy that responds to the reasonable
concerns of both the Department and the news media.
The Committee directs the Department to issue a report to
both the House and Senate Committees on Appropriations no later
than 30 days after enactment of this act outlining all the
Department's considerations, processes, and decision points
related to the Department's concerns about the prior policy and
justification of the initial April 10, 2012 policy. This report
also shall include a statement of any concerns the Bureau of
Labor Statistics may have regarding the Department's policy.

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2012.................................... $264,437,000
Budget estimate, 2013................................... 258,870,000
Committee recommendation................................ 262,821,000

The Committee recommends $262,821,000 for VETS, including
$38,185,000 in general revenue funding and $224,636,000 to be
expended from the Employment Security Administration account of
the unemployment trust fund.
This account provides resources for VETS to maximize
employment opportunities for veterans and transitioning
servicemembers, including protecting their employment rights.
VETS carries out its mission through a combination of grants to
States, competitive grants, and Federal enforcement and
oversight.
The Committee provides $14,000,000 for the transition
assistance program [TAP]. The budget request proposes
$12,000,000 and the fiscal year 2012 funding level is
$8,983,000. The additional resources provided above the budget
request are needed to meet updated projections developed after
the President's budget was proposed. The budget request assumes
that 160,000 transitioning servicemembers will use TAP in
fiscal year 2013, while the latest projections put the figure
at approximately 201,000 members.
The Committee recognizes the valuable work of VETS in
providing assistance to veterans seeking employment through the
Jobs for Veterans State Grants Program. Under this program,
grants are used to fund Disabled Veterans' Outreach Program
[DVOP] specialists and Local Veterans' Employment
Representatives [LVERs]. However, the Committee recognizes that
the current funding formula for DVOPs and LVERs poses
challenges for larger rural States because it is strictly
population-based and does not take service delivery area into
account. As a result, the very few DVOPs and LVERs in these
States have too much area to cover to provide personalized
assistance to veterans or to build relationships with local
employers. Therefore, the Committee provides funds above the
budget request to be used to address the service challenges of
such States and directs the Department to use the additional
funds to establish innovative access points and/or service
arrangements to help build the capacity of DVOPs and LVERs with
larger service delivery areas and proportions of rural
population. In addition, the Committee urges VETS to use any
funds available from fiscal year 2012's end-of-year
reallocation process to begin this effort.

INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2012.................................... $19,814,000
Budget estimate, 2013................................... 21,852,000
Committee recommendation................................ 19,814,000

The Committee recommends $19,814,000 for the IT
Modernization account.
Funds available in this account are used for two primary
activities. The first is departmental support systems for which
$7,985,000 is provided. These funds help align IT investments
with the Department's strategic objectives. The second budget
activity, for which $11,829,000 is provided, assists the
Department in consolidating and optimizing common IT
infrastructure services, protecting privacy, and improving
timely and efficient services to the public.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012.................................... $83,688,000
Budget estimate, 2013................................... 85,108,000
Committee recommendation................................ 83,688,000

The Committee recommends $83,688,000 for the DOL OIG. The
bill includes $77,790,000 in general funds and authority to
transfer $5,898,000 from the Employment Security Administration
account of the unemployment trust fund. In addition, an amount
of $327,000 is available by transfer from the Black Lung
Disability Trust Fund.
OIG was created 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, 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:
Limit the use of Job Corps funding for compensation of an
individual that is not a Federal employee at a rate not to
exceed Executive Level II (section 101).
Provide for general transfer authority (section 102).
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 (section 103).
Require that funds available under section 414(c) of the
American Competitiveness and Workforce Improvement Act of 1998
may only be used for competitive grants for training in
occupations and industries for which employers are using H-1B
visas to hire foreign workers (section 104).
Limit the use of ETA funds by a recipient or subrecipient
for compensation of an individual at a rate not to exceed
Executive Level II (section 105).
Prohibit the Secretary from taking any action to alter the
procedure for redesignating local areas under subtitle B of
title I of WIA (section 106).
Provide the ETA with authority to transfer funds provided
for technical assistance services to grantees to program
administration when it is determined that those services will
be more efficiently performed by Federal employees (section
107).
Allow up to 0.5 percent of discretionary appropriations
provided in this act for all DOL agencies to be used by the
Office of the Chief Evaluation Officer for evaluation purposes
consistent with the terms and conditions in this act applicable
to such office (section 108).
Allow the Secretary to reserve up to 3 percent of funds
available under section 272(b) of the Trade Act of 1974 to
conduct evaluations and provide technical assistance relating
to the activities carried out under the Community College and
Career Training Grant program (section 109).
Prohibit funding to promulgate, administer, enforce, or
otherwise implement the final rules entitled ``Wage Methodology
for the Temporary Non-Agricultural Employment H-2B Program''
(76 Fed. Reg. 3452 (January 19, 2011)) and ``Temporary Non-
Agricultural Employment of H-2B Aliens in the United States''
(77 Fed. Reg. 10038 (February 21, 2012)) (section 110).
Transfer the claims function under several Federal statutes
currently performed by GAO to DOL (section 111).

TITLE II

DEPARTMENT OF HEALTH AND HUMAN SERVICES

The administration request for HHS reflects a proposal to
increase program evaluation transfers under section 241 of the
PHS Act from 2.5 percent to 3.2 percent. Through these
transfers, PHS agencies contribute a percentage of their budget
authority to fund program evaluation activities throughout the
Department. The percentage is specified in section 205 of the
title II general provisions.
The Committee rejects the proposed increase to 3.2 percent
because of concern about the effect of this proposal on PHS Act
agencies that are used as a source of evaluation transfers,
most notably NIH. Increasing the total amount of funding that
is available for transfers makes it easier to provide increases
to selected programs that fund evaluation activities or to
supplant discretionary budget authority. For example, the
administration proposes in fiscal year 2013 to begin funding
the Minority HIV/AIDS Initiative entirely with program
evaluation transfers; that program is currently funded with
budget authority. But to programs that are the source of the
transfers, an increase in the evaluation tap, as proposed by
the administration, would be a de facto funding cut. With
regard to NIH, which the administration proposes to level fund
at $30,623,259,000, increasing the tap to 3.2 percent would
result in a net reduction of more than $200,000,000. For this
reason, the Committee maintains the evaluation transfer amount
at 2.5 percent, the same level as in fiscal year 2012.
Any references in this title of the report to the
``Secretary'' or the ``Department'' shall be interpreted to
mean the Secretary of HHS or the Department of HHS,
respectively, unless otherwise noted.

Health Resources and Services Administration

The Committee recommendation provides $6,517,188,000 in
this bill for HRSA, including $25,000,000 in transfers under
section 241 of the PHS Act. In addition, the Committee
recommends $25,000,000 in transfers from the PPH Fund.
The total program level for HRSA in fiscal year 2013 is
$6,542,188,000.
The fiscal year 2012 comparable program level is
$6,510,035,000 and the budget request is $6,382,146,000. The
budget request includes $60,000,000 in transfers under section
241 of the PHS Act and $10,000,000 in transfers from the PPH
Fund.
HRSA activities support programs to provide healthcare
services for mothers and infants; the underserved, elderly, and
homeless; rural residents; and disadvantaged minorities. This
agency supports cooperative programs in community health, AIDS
care, healthcare provider training, and healthcare delivery
systems and facilities.

BUREAU OF PRIMARY HEALTH CARE

Appropriations, 2012.................................... $1,585,064,000
Budget estimate, 2013................................... 1,579,975,000
Committee recommendation................................ 1,585,064,000

The Committee recommendation for the activities of the
Bureau of Primary Health Care is $1,585,064,000.

Community Health Centers

The Committee provides $1,566,892,000 in this bill, the
same as the fiscal year 2012 level, for the community health
centers program. The budget request is $1,561,803,000.
Combined with the $1,500,000,000 in mandatory funding
appropriated for fiscal year 2013 in PPACA, the Committee's
recommended program level totals $3,066,892,000.
This group of programs includes community health centers,
migrant health centers, healthcare for the homeless, and public
housing health service grants. The Committee continues to
support the ongoing effort to increase the number of people who
have access to medical services at health centers.
The administration proposes obligating only $1,220,000,000
of the fiscal year 2013 mandatory funding for this program in
fiscal year 2013, leaving $280,000,000 to be awarded in later
years. The Committee feels strongly that the congressional
intent of the PPACA funding for community health centers was to
enable individuals possessing affordable health insurance for
the first time in 2014 to have as many entry points to the
healthcare system as possible. For that reason, the Committee
includes a new statutory provision requiring HRSA to award all
fiscal year 2013 funds by September 30, 2013. Such awards shall
include $48,000,000 in base grant adjustments to ensure that
existing centers are surviving and thriving, even as new
centers come online.
Within the amount provided, the Committee provides up to
$94,893,000 under the Federal Tort Claims Act [FTCA], available
until expended. These funds are used to pay judgments and
settlements, occasional witness fees and expenses, and related
administrative costs. The Committee intends FTCA coverage
funded through this bill to be inclusive of all providers,
activities, and services included within the health centers'
federally approved scope of project.
Health Care for the Homeless [HCH].--The Committee is aware
of HRSA's intention to issue guidelines on permanent supportive
housing. The Committee remains strongly supportive of HCH
programs providing comprehensive healthcare services to
residents of permanent supportive housing or other housing
programs that are targeted to homeless populations but do not
limit tenant length of stay.
Hepatitis Data Collection.--The Committee commends HRSA for
initiating data collection on hepatitis B and C testing and
chronic hepatitis diagnoses in the Bureau of Primary Care
Uniform Data Sets. The Committee requests a status report on
the new hepatitis data to demonstrate disease burden and
diagnosis rates among community health center providers in the
fiscal year 2014 budget justification.
Native Hawaiian Health Care.--The Committee includes
sufficient funding in the community health centers program to
support healthcare activities funded under the Native Hawaiian
Health Care Program, which is specifically cited in the bill.
The Committee expects that not less than the fiscal year 2012
level be provided for these activities in fiscal year 2013.

Free Clinics Medical Malpractice Coverage

The Committee provides $40,000 for payments of claims under
the FTCA to be made available for free clinic health
professionals as authorized by section 224(o) of the PHS Act.
The fiscal year 2012 comparable level and the budget request
both include $40,000 for this program. This appropriation
extends FTCA coverage to medical volunteers in free clinics in
order to expand access to healthcare services to low-income
individuals in medically underserved areas.

National Hansen's Disease Program

The Committee includes $16,045,000 for the National
Hansen's Disease Program. This amount is the same as the fiscal
year 2012 comparable level and the budget request. The program
consists of inpatient, outpatient, and long-term care and
training and research in Baton Rouge, Louisiana; a residential
facility at Carville, Louisiana; and 11 outpatient clinic sites
in the continental United States and Puerto Rico.

National Hansen's Disease Program Buildings and Facilities

The Committee provides $127,000 for the repair and
maintenance of buildings at the Gillis W. Long Hansen's Disease
Center. This amount is the same as the fiscal year 2012
comparable level and the budget request.

Payment to Hawaii for Hansen's Disease Treatment

The Committee provides $1,960,000, the same amount as the
fiscal year 2012 level and the budget request, for Hansen's
disease services. Payments are made to the State of Hawaii for
the medical care and treatment of persons with Hansen's disease
in hospital and clinic facilities at Kalaupapa, Molokai, and
Honolulu. Expenses above the level of appropriated funds are
borne by the State of Hawaii.

BUREAU OF HEALTH PROFESSIONS

Appropriations, 2012.................................... $725,684,000
Budget estimate, 2013................................... 557,187,000
Committee recommendation................................ 727,862,000

The Committee recommendation for the activities of the
Bureau of Health Professions is $727,862,000. The budget
estimate includes $35,000,000 in transfers available under
section 241 of the PHS Act; the Committee recommendation does
not include those transfers. In addition, the Committee
recommends transferring $25,000,000 to the Bureau from the PPH
Fund.
The total program level assumed in this bill for the Bureau
is $752,862,000.
The Bureau of Health Professions provides policy leadership
and grant support for health professions workforce development.
The mission of the Bureau is to identify shortage areas while
working to make them obsolete. Its programs are intended to
ensure that the Nation has the right clinicians, with the right
skills, working where they are needed.

Training for Diversity

Centers of Excellence
The Committee provides $22,909,000, the same as the fiscal
year 2012 comparable level and the budget request, for the
Centers of Excellence Program.
Institutions that are designated as centers of excellence
are private institutions whose mission is to train
disadvantaged minority health professionals for service in
underserved areas. Funds are used for the recruitment and
retention of students, faculty training, and institutional
improvements.
Health Careers Opportunity Program
The Committee does not provide funding for the Health
Careers Opportunity Program. The fiscal year 2012 comparable
level is $14,822,000. The budget request eliminates funding for
this program.
The purpose of this program is to create an educational
pipeline to increase the number of individuals from
educationally or economically disadvantaged backgrounds who
enter the health and allied health professions. The program
provides activities for disadvantaged students through formal
academic and research training and programming and student
enhancement services.
The Committee notes that the Department of Education
provides academic and other support services to students from
disadvantaged backgrounds. Federally funded health workforce
development programs will also continue to promote training of
individuals from disadvantaged backgrounds. In addition, all
grantees under the Primary Care Training and Enhancement
program must have recruitment and retention strategies in place
to increase the representation of disadvantaged minority
trainees.
Faculty Loan Repayment
The Committee provides $1,243,000 for the Faculty Loan
Repayment Program. This amount is the same as the fiscal year
2012 comparable level and the budget request.
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 at least 2 years as a faculty member of a health
professions school.
Scholarships for Disadvantaged Students
The Committee provides $47,452,000 for the Scholarships for
Disadvantaged Students Program. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
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.

Primary Care Training and Enhancement

The Committee provides $48,962,000 for Primary Care
Training and Enhancement programs. The fiscal year 2012
comparable level is $38,962,000 and the budget request is
$50,962,000.
This program supports the expansion of training in internal
medicine, family medicine, pediatrics, and physician
assistance. Funds may be used for developing training programs
or providing direct financial assistance to students and
residents. The Committee once again urges HRSA to prioritize
the training of physician assistants and includes bill language
allowing HRSA to determine the funding amount for this
activity.
The Committee is troubled that the HRSA guidance for this
program currently prevents schools from applying for a grant
unless they are fully accredited. Training programs cannot gain
full accreditation until they are already up and running. By
restricting the grant competition to training programs with
full accreditation, HRSA is precluding one of two major goals
of this grant program--increasing the number of new primary
care training programs. The Committee directs HRSA to change
its guidance in fiscal year 2013 to allow funds to be used to
develop a training program and apply for accreditation.

Pediatric Loan Repayment

The Committee does not include funding, requested in the
President's budget, to create a new loan repayment program for
pediatricians authorized in section 523 of PPACA. The budget
request includes $5,000,000 for this initiative.

Training in Oral Health Care

The Committee recommends $32,392,000 for Training in Oral
Health Care programs, the same as the fiscal year 2012
comparable level and the budget request.
These programs support a variety of training opportunities
in the field of oral health. Funds may be used to expand
training in general dentistry, pediatric dentistry, public
health dentistry, dental hygiene, and other oral health
programs. Funds may be used to plan and operate training
programs, as well as to provide financial assistance to
students and residents.
The Committee notes that there are over 200 dental faculty
vacancies in the United States. Therefore, the Committee
intends that the general and the pediatric dentistry loan
repayment programs should receive $8,000,000 each.

Interdisciplinary, Community-Based Linkages

Area Health Education Centers
The Committee provides $27,220,000, the same as the fiscal
year 2012 comparable level, for AHECs. The budget request
eliminates funding for this program.
AHECs link 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 AHEC grants; and model programs to extend
AHEC programs with 50 percent Federal funding.
The Committee recognizes the importance of community health
workers in addressing the health needs of individuals who may
not have access to regular healthcare services. The AHEC
community training model provides a uniquely appropriate
opportunity to bring the training of community health workers
to scale. HRSA is encouraged to provide technical assistance on
and disseminate best practices for training community health
workers to existing AHECs.
Mental and Behavioral Health
The Committee provides $2,892,000, the same as the fiscal
year 2012 comparable level, for Mental and Behavioral Health
programs. The budget request for fiscal year 2013 is
$7,892,000, including $5,000,000 in transfers available under
section 241 of the PHS Act.
These programs provide grants to higher education
institutions and accredited training programs to recruit and
train professionals and faculty in the fields of social work,
psychology, psychiatry, marriage and family therapy, substance
abuse prevention and treatment, and other areas of mental and
behavioral health.
Graduate Psychology Education grants train psychology
graduate students to provide supervised behavioral and mental
health services to underserved populations. With significant
numbers of returning war veterans and a rapidly growing
generation of elderly, the Nation's mental health
infrastructure is certain to experience increased strain for
years to come as individuals and their families increasingly
turn to behavioral healthcare professionals in local
communities. The Committee supports efforts to help integrate
psychology trainees at Federally Qualified Health Centers to
provide behavioral and mental health services to underserved
populations, particularly those in rural America.
Geriatric Education
The Committee provides $30,629,000 for geriatric education
programs. This amount is the same as the fiscal year 2012
comparable level and the budget request.
Geriatric programs include: geriatric education centers,
the Geriatric Academic Career Awards program, and the Geriatric
Training for Physicians, Dentists, and Behavioral and Mental
Health Professionals program.
The Committee commends HRSA for recognizing the immediacy
of the eldercare workforce crisis by identifying ``enhancing
geriatric/elder care training and expertise'' as a top priority
in the fiscal year 2013 budget justification. The Nation's
health professions must be prepared to meet the unique and
often complex health needs of America's older adults. This is
especially critical in primary care settings. The Committee
requests that HRSA provide a report detailing how geriatric
training content is being integrated into primary care training
in HRSA-supported institutions.
Health Professions Workforce Information and Analysis
The Committee recommends $7,782,000 for health professions
workforce information and analysis. The fiscal year 2012
comparable level is $2,782,000. The budget request does not
include new budget authority but proposes $10,000,000 in
transfers available under section 241 of the PHS Act.
The program provides for the collection and analysis of
targeted information on the Nation's healthcare workforce,
research on high-priority workforce questions, the development
of analytic and research infrastructure, and program evaluation
and assessment.

Public Health and Preventive Medicine Training Programs

The Committee provides $35,111,000 for public health and
preventive medicine training programs, including $10,111,000 in
budget authority and $25,000,000 in transfers from the PPH
Fund. The fiscal year 2012 comparable level is $8,111,000 in
budget authority and $25,000,000 in funding from the PPH Fund.
The budget request includes $9,609,000 in budget authority and
$10,000,000 from the PPH Fund.
The Committee recommendation includes $5,420,000 for
preventive medicine residencies and $5,000,000 for integrative
medicine residencies. The fiscal year 2012 level for
integrative medicine residencies is $3,000,000. The increase
provided in the Committee recommendation is intended to expand
the national technical assistance and evaluation activities.
These programs support awards to schools of medicine,
osteopathic medicine, and public health to provide for
residency training programs in preventive medicine and public
health, and for financial assistance to trainees enrolled in
such programs.

Nursing Workforce Development Programs

The Committee provides $231,099,000, the same amount as the
fiscal year 2012 level, for nursing workforce development
programs. The budget request is $231,099,000 in budget
authority and an additional $20,000,000 in transfers available
under section 241 of the PHS Act.
The Committee recommendation includes the following
programs at the following amounts:

Within funds available for the Nursing Education and
Retention program, the Committee intends that no less than
$5,000,000 be awarded to nurse-managed health centers.
The Committee is concerned that many nursing education and
training programs are unable to guarantee required clinical
placements to students who have completed the appropriate
classroom work. These individuals remain full-time students
longer than otherwise necessary, accumulating more student loan
debt, while they await placement for their required clinical
rotation. The Committee directs HRSA to prioritize applications
for nursing education and training programs that provide
incoming freshman students with a guarantee of high-quality
clinical placements in hospitals, nursing homes, visiting nurse
programs, and other care settings during their junior and
senior years of study.

Children's Hospitals Graduate Medical Education

The Committee provides $265,171,000, the same as the fiscal
year 2012 level, for the CHGME program. The budget request is
$88,000,000.
The program provides support for graduate medical education
training programs in both ambulatory and in-patient settings
within freestanding children's teaching hospitals. CHGME
payments are determined by a per-resident formula that includes
an amount for direct training costs added to a payment for
indirect costs. Payments support training of resident
physicians as defined by Medicare in both ambulatory and
inpatient settings.
The Committee recognizes the program's contributions to the
future pediatric workforce and children's healthcare. The 56
freestanding children's hospitals receiving CHGME funding train
40 percent of all general pediatric residents and 43 percent of
all pediatric specialty residents.

National Practitioner Data Bank

The Committee provides $28,016,000 for the National
Practitioner Data Bank. This amount is the same as the fiscal
year 2012 comparable level and the budget request. As in
previous years, 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.
The National Practitioner Data Bank collects certain
adverse information, medical malpractice payment history, and
information related to healthcare fraud and abuse. The data
bank is open to healthcare agencies and organizations that make
licensing and employment decisions.

MATERNAL AND CHILD HEALTH BUREAU

Appropriations, 2012.................................... $853,355,000
Budget estimate, 2013................................... 854,807,000
Committee recommendation................................ 854,807,000

The Committee recommendation for the MCH Bureau is
$854,807,000.
The mission of the Bureau is to improve the physical and
mental health, safety, and well-being of the Nation's women,
infants, children, adolescents, and their families. This
population includes fathers and children with special
healthcare needs.

Maternal and Child Health Block Grant

The Committee provides $640,098,000, the same as the budget
request, for the MCH block grant. The fiscal year 2012
comparable level is $638,646,000.
The MCH block grant program provides a flexible source of
funding that allows States to target their most urgent maternal
and child health needs. The program supports a broad range of
activities including providing prenatal care, well child
services, and immunizations; reducing infant mortality;
preventing injury and violence; expanding access to oral
healthcare; addressing racial and ethnic disparities; and
providing comprehensive care through clinics, home visits, and
school-based health programs.
The Committee includes bill language requiring that the
State grant portion of the block grant be funded at no less
than $556,333,000. The fiscal year 2012 comparable level is
$549,729,000 and the budget request is $551,181,000.
The Committee includes bill language identifying
$62,634,000 for the Title V SPRANS set-aside. Within that
total, the Committee recommendation includes sufficient funding
to continue the set-asides for oral health, epilepsy, sickle
cell anemia, and fetal alcohol syndrome at no less than fiscal
year 2012 levels.
Healthy Homes Activities.--The Committee is encouraged by
recent meetings between HRSA and CDC to expand healthy homes
activities within maternal and child health programs that have
a home visiting focus. The Committee urges HRSA and CDC to
continue to work collaboratively on this effort and requests an
update on progress within 90 days of enactment of this act.
Perinatal Hepatitis B.--The Committee is concerned by high
rates of mother-to-child transmission of hepatitis B in the
United States. Given the large number of at-risk women being
seen in HRSA-funded health settings, the Committee requests a
report within 6 months of enactment of this act that includes
best practices for how to eliminate perinatal hepatitis B
transmission.
Pregnancy Risk Prevention.--The Committee strongly supports
efforts to provide women and healthcare providers with
information about prenatal exposures to medications, chemicals,
radiation, infections, and other substances. Access to this
information can reduce the incidence of preventable birth
defects, prematurity, or complications of pregnancy that limit
quality of life and increase costs in our healthcare system.
Vision and Eye Health.--The Committee is concerned that 1
in 4 school-aged children has a vision problem significant
enough to affect learning. Many serious ocular conditions in
children are treatable if diagnosed at an early stage. The
Committee encourages HRSA to continue to support the
development of a public health infrastructure to promote a
comprehensive continuum of vision care for children through
strong partnerships, sound science, and targeted policy
initiatives.

Sickle Cell Anemia

The Committee provides $4,665,000 for the sickle cell
anemia demonstration program. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
This program provides grants and contracts to help
coordinate service delivery for individuals with sickle cell
disease, including genetic counseling and testing; training of
health professionals; and coordination of education, treatment,
and continuity of care programs for individuals with sickle
cell disease.

Traumatic Brain Injury

The Committee provides $9,760,000 for the Traumatic Brain
Injury program. This amount is the same as the fiscal year 2012
comparable level and the budget request.
The program supports implementation and planning grants to
States for coordination and improvement of services to
individuals and families with traumatic brain injuries. Such
services can include: pre-hospital care, emergency department
care, hospital care, rehabilitation, transitional services,
education, employment, long-term support, and protection and
advocacy services.
The Committee includes no less than the fiscal year 2012
funding level for protection and advocacy services, as
authorized under section 1305 of Public Law 106-310.

Autism and Other Developmental Disorders

The Committee provides $47,142,000 for the Autism and Other
Developmental Disorders initiative. This amount is the same as
the fiscal year 2012 comparable level and the budget request.
The program supports surveillance, early detection,
education, and intervention activities on autism and other
developmental disorders, as authorized in the Combating Autism
Act of 2006.
The Committee directs HRSA to fund research on evidence-
based practices for interventions for individuals with autism
and other developmental disabilities, for development of
guidelines for those interventions, and for information
dissemination at no less than fiscal year 2012 levels.

Newborn Screening for Heritable Disorders

The Committee provides $9,834,000 for the newborn heritable
disorders screening program, as described in section 1109 of
the Newborn Screening Saves Lives Act of 2008. The fiscal year
2012 comparable level and the budget request are also
$9,834,000.
This program provides funding to improve States' ability to
provide newborn and child screening for heritable disorders.
Newborn screening provides early identification and follow-up
for treatment of infants affected by certain genetic,
metabolic, hormonal, and/or functional conditions.
The Committee encourages HRSA to collaborate with and
support non-governmental entities that help educate and support
States as they consider expanding their screening panels. The
Committee believes that this activity is beneficial to the
existing efforts of HRSA.

Healthy Start

The Committee provides $103,532,000 for the Healthy Start
infant mortality initiative. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
The primary purpose of Healthy Start is to reduce infant
mortality by 50 percent and generally improve maternal and
infant health in at-risk communities. Grants are awarded to
State and local health departments and nonprofit organizations
to conduct an infant mortality review, develop a package of
innovative health and social services for pregnant women and
infants, and evaluate these efforts.
The Committee continues to encourage HRSA to support
efforts to evaluate and address racial disparities in
stillbirth and sudden unexpected infant deaths.
The Committee expects HRSA to give full and fair
consideration to all applicants, including grantees with
expiring or recently expired project periods.

Universal Newborn Hearing Screening and Early Intervention

The Committee provides $18,660,000 for universal newborn
hearing screening and early intervention activities. This
amount is the same as the fiscal year 2012 comparable level and
the budget request.
This program awards grants to 53 States and territories
that support statewide systems of newborn hearing screening,
audiologic diagnostic testing before 3 months of age, and
enrollment in early intervention programs before the age of 6
months.

Emergency Medical Services for Children

The Committee provides $21,116,000 for the Emergency
Medical Services for Children [EMSC] program. This amount is
the same as the fiscal year 2012 comparable level and the
budget request.
The EMSC program makes funding available to every State EMS
office to improve emergency care for children and to pay for
research and dissemination of best practices.
The Committee is particularly concerned by the low
availability of pediatric emergency medical services in rural
and remote areas and urges HRSA to give priority to applicants
who propose a focus on populations in these areas. To the
extent possible, HRSA should work with other Federal agencies
that have an interest in expanding emergency systems in rural
and remote areas.

HIV/AIDS BUREAU

Appropriations, 2012.................................... $2,392,178,000
Budget estimate, 2013................................... 2,471,772,000
Committee recommendation................................ 2,422,178,000

The Committee recommendation includes $2,422,178,000 for
the HIV/AIDS Bureau, including $25,000,000 in transfers under
section 241 of the PHS Act.
The mission of the Bureau is to address the unmet care and
treatment needs of persons living with HIV/AIDS who are
uninsured or underinsured. The Bureau administers the Ryan
White Care Act, which provides a wide range of community-based
services, including primary and home healthcare, case
management, substance abuse treatment, mental health services,
and nutritional services.

Emergency Assistance

The Committee provides $666,071,000, the same as the fiscal
year 2012 level, for emergency assistance grants to eligible
metropolitan areas disproportionately affected by the HIV/AIDS
epidemic. The budget request is $671,258,000.
Grants are provided to metropolitan areas meeting certain
criteria. Two-thirds of the funds are awarded by formula, and
the remainder is awarded through supplemental competitive
grants.

Comprehensive Care Programs

The Committee provides $1,390,827,000 for HIV healthcare
and support services. The fiscal year 2012 comparable level is
$1,360,827,000 and the budget request is $1,422,341,000.
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.
The Committee includes bill language providing $963,299,000
for AIDS medications in ADAP. The fiscal year 2012 comparable
level is $933,299,000 and the budget request is $1,000,000,000.
The Committee intends that the increase provided for ADAP be
awarded according the statutory formula. The Committee
encourages HRSA to engage in a process with States to determine
the best allocation for the past emergency funds based upon the
growth of the program and cost containment measures in place as
of January 1, 2013.

Early Intervention Services

The Committee provides $215,086,000, the same as the fiscal
year 2012 level, for early intervention grants. The budget
request is $235,564,000.
Funds are awarded competitively to primary healthcare
providers to enhance healthcare services available to people at
risk of HIV and AIDS. Funds are used for comprehensive primary
care, including counseling, testing, diagnostic, and
therapeutic services.

Children, Youth, Women, and Families

The Committee provides $77,167,000, the same as the fiscal
year 2012 level, for grants for coordinated services and access
to research for women, infants, children, and youth. The budget
request is $69,582,000.
Funds are awarded to community health centers, family
planning agencies, comprehensive hemophilia centers, county and
municipal health departments, and other nonprofit community-
based programs that provide comprehensive primary healthcare
services to populations with or at risk for HIV.

AIDS Dental Services

The Committee provides $13,485,000 for AIDS Dental
Services. This amount is the same as the fiscal year 2012
comparable level and the budget request.
This program provides grants to dental schools, dental
hygiene schools, and postdoctoral dental education programs to
assist with the cost of providing unreimbursed oral healthcare
to patients with HIV.

AIDS Education and Training Centers

The Committee provides $34,542,000 for the AIDS Education
and Training Centers [AETCs]. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
AETCs train healthcare practitioners, faculty, and students
who care for AIDS patients outside of the traditional health
professions education venues and support curriculum development
on the diagnosis and treatment of HIV infection for health
professions schools and training organizations.

HEALTH CARE SYSTEMS BUREAU

Appropriations, 2012.................................... $82,534,000
Budget estimate, 2013................................... 82,534,000
Committee recommendation................................ 82,534,000

The Committee recommendation for the Health Care Systems
Bureau is $82,534,000.
The Health Care Systems Bureau protects the public health
and improves the health of individuals through efforts to
support and enhance the systems by which healthcare is
delivered in America.

Organ Donation and Transplantation

The Committee provides $24,015,000 for organ donation and
transplantation activities. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
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 to educate the public and health professionals about
organ donations and transplants and to support agency staff
providing clearinghouse and technical assistance functions.
The Committee encourages the Division of Transplantation
and the United Network for Organ Sharing to continue their
dialogue with experts regarding the methodology used to
determine lung transplantation eligibility for pulmonary
hypertension patients.

National Cord Blood Inventory

The Committee provides $11,887,000 for the National Cord
Blood Inventory. This amount is the same as the fiscal year
2012 comparable level and the budget request.
The purpose of this program is to provide funds to cord
blood banks to build an inventory of the highest-quality cord
blood units for transplantation.

C.W. Bill Young Cell Transplantation Program

The Committee provides $23,330,000 for the C.W. Bill Young
Cell Transplantation Program. This amount is the same as the
fiscal year 2012 comparable level and the budget request.
The Committee continues to strongly support cell
transplantation through the use of cord blood, bone marrow,
peripheral blood stem cells, and other sources of adult stem
cells that may be available in the future. The Committee
appreciates HRSA's efforts to increase the diversity of the
registry and the program's research efforts to improve the
availability, efficiency, safety, and cost of transplants and
the effectiveness of program operations.

Office of Pharmacy Affairs

The Committee provides $4,472,000 for the Office of
Pharmacy Affairs. This amount is the same as the fiscal year
2012 comparable level and the budget request.
The Office of Pharmacy Affairs administers the 340B Drug
Pricing program, which requires drug manufacturers to provide
discounts or rebates to a set of programs and hospitals that
serve a disproportionate share of low-income patients.
The Committee remains strongly committed to the Office's
plans to develop a transparent system to verify the accuracy of
the 340B ceiling price. Therefore, the Committee includes a
statutory provision, requested by the administration, to allow
a nominal cost recovery fee to fund the implementation of
program integrity provisions recommended by the Inspector
General and included in PPACA. The fee will be set at 0.1
percent for covered entities and is expected to generate
$6,000,000 in fiscal year 2013. The Committee expects HRSA to
report the expected and actual amounts generated by the fee in
HRSA's annual budget justification.
Audit Procedure.--The Committee commends HRSA for
conducting audits of covered entities and recertifying
eligibility for all program participants in an effort to ensure
340B program integrity. The Committee is aware that HRSA
recently published a program notice that referenced an audit
protocol to be made public at a later date. Given that the
audit process is well underway, the Committee urges HRSA to
make public information on the general audit process, including
areas of review, as soon as possible and consider suspending
audits until this information is publicly available.

Poison Control Centers

The Committee provides $18,830,000 for poison control
center activities. This is the same amount as the fiscal year
2012 comparable level and the budget request.
The Poison Control Centers program currently supports a mix
of grantees. Most serve States; a few serve multistate regions;
and, in a handful of cases, more than one grantee serves a
single State.
The Committee notes that poisoning is now the leading cause
of injury death, with rates higher than that of car accidents.
Treatment guidance for over 70 percent of poison exposures can
be provided over the phone. Providing services over the phone
reduces emergency department visits, ambulance use, and
hospital admissions, resulting in a savings of $7 for every $1
spent on poison control centers. For that reason, the Committee
is strongly supportive of ensuring that all citizens have
access to poison control hotlines.

RURAL HEALTH

Appropriations, 2012.................................... $138,172,000
Budget estimate, 2013................................... 122,232,000
Committee recommendation................................ 144,072,000

The Committee recommendation for rural health programs is
$144,072,000.
The Office of Rural Health Policy [ORHP] administers HHS
rural health programs, coordinates activities related to rural
healthcare within HHS, and analyzes the possible effects of
policy on 62 million residents of rural communities. ORHP
advises the Secretary on the effects of Medicare and Medicaid
on rural citizens' access to care, the viability of rural
hospitals, and the availability of physicians and other health
professionals.

Rural Healthcare Services Outreach Grants

The Committee provides $57,553,000 for rural health
outreach grants. The fiscal year 2012 comparable level and the
budget request are $55,553,000. 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 recommendation includes $2,000,000 to
replicate successful models of oral healthcare delivery. Such
models should focus on diverting care from emergency rooms,
disease management, and prevention of early childhood caries.

Rural Health Research

The Committee provides $9,866,000 for the Rural Health
Research program. This amount is the same as the fiscal year
2012 comparable level and the budget request.
Funds are used for rural health research centers, the
National Advisory Committee on Rural Health, and a reference
and information service. Supported activities focus on
improving the delivery of health services to rural communities
and populations.

Rural Hospital Flexibility Grants

The Committee provides $41,040,000, the same as the fiscal
year 2012 level, for rural hospital flexibility grants. The
budget request is $26,200,000.
Under this program, HRSA works with States to provide
support and technical assistance to critical access hospitals
to focus on quality and performance improvement and to
integrate emergency medical services.
The Committee commends HRSA for its work on telehealth and
electronic health records in rural hospitals, with a focus on
mental healthcare for veterans. The Committee understands that
the grant cycle is completed, and has modified the bill
language to give HRSA flexibility to determine future needs in
this area.

Rural Access to Emergency Devices

The Committee provides $5,000,000 for rural access to
emergency devices. The fiscal year 2012 comparable level is
$1,100,000. The budget request eliminates funding for this
program.
Funding is used to purchase automated external
defibrillators, place them in public areas where cardiac
arrests are likely to occur, and train lay rescuers and first
responders in their use.

State Offices of Rural Health

The Committee provides $10,036,000 for State Offices of
Rural Health. This amount is the same as the fiscal year 2012
comparable level and the budget request.
These offices help States strengthen rural healthcare
delivery systems by enabling them to coordinate care and
improve support and outreach in rural areas.

Black Lung Clinics

The Committee provides $7,140,000 for black lung clinics.
This amount is the same as the fiscal year 2012 comparable
level and the budget request.
This program funds clinics that treat respiratory and
pulmonary diseases of active and retired coal miners, steel
mill workers, agricultural workers, and others with
occupationally related respiratory and pulmonary impairments.
These clinics reduce the incidence of high-cost inpatient
treatment for these conditions.

Radiation and Exposure Screening and Education Program

The Committee provides $1,935,000 for activities authorized
by the Radiation Exposure Compensation Act. This amount is the
same as the fiscal year 2012 comparable level and the budget
request.
This program provides grants for the education, prevention,
and early detection of radiogenic cancers and diseases
resulting from exposure to uranium during mining and milling at
nuclear test sites.

Telehealth

The Committee provides $11,502,000 for telehealth
activities. This amount is the same as the fiscal year 2012
comparable level and the budget request.
The Telehealth program promotes the effective use of
technologies to improve access to health services for people
who are isolated from healthcare and to provide distance
education for health professionals.

FAMILY PLANNING

Appropriations, 2012.................................... $293,870,000
Budget estimate, 2013................................... 296,838,000
Committee recommendation................................ 293,870,000

The Committee provides $293,870,000 for the title X family
planning program.
The title X program supports preventive and primary
healthcare services at clinics nationwide through four key
functions: (1) providing individuals with comprehensive family
planning and related preventive health services, including all
FDA-approved methods of contraception; (2) training for family
planning clinic personnel; (3) data collection and research
aimed at improving the delivery of services; and (4)
information dissemination and community-based education and
outreach activities.
Comprehensive Services.--The Committee is aware that title
X clinics have been denied designation as National Health
Service Corps sites, under the reasoning that they do not
provide referral to comprehensive primary care services.
However, the Committee notes that all title X grantees are
required to certify that they provide, or provide referral to,
a full range of primary care services. If HRSA is sufficiently
satisfied that a title X clinic provides ``comprehensive
primary care services'', the Committee believes that that
should satisfy the identical requirement in other HRSA
programs. The Committee directs HRSA to align the definition of
``comprehensive primary care services'' in title X and the
National Health Service Corps. In addition, the Committee
directs the Secretary to provide guidance to title X-only
funded grantees about how to meet the requirements to receive
assignment of National Health Service Corps personnel.
Program Guidance.--The Committee supports efforts to review
and update the title X program guidance and administrative
directives. In particular, the Committee requests that the
guidance clarify that title X funds may be used for clinic
training on and implementation of information technology
systems, including electronic medical records. The Secretary is
encouraged to complete the guideline revisions in 2012 to
enable the publicly supported family planning network to
sufficiently prepare for the changing healthcare delivery
system.

PROGRAM MANAGEMENT

Appropriations, 2012.................................... $159,894,000
Budget estimate, 2013................................... 162,517,000
Committee recommendation................................ 162,517,000

The Committee provides $162,517,000 for program management
activities.

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

Appropriations, 2012.................................... $2,807,000
Budget estimate, 2013................................... 2,807,000
Committee recommendation................................ 2,807,000

The Committee recommends $2,807,000 for the Health
Education Assistance Loan [HEAL] program.
The Committee includes a general provision (section 522) to
transfer the administration of the HEAL program to the
Department of Education, as requested by the administration.

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2012.................................... $241,477,000
Budget estimate, 2013................................... 241,477,000
Committee recommendation................................ 241,477,000

The Committee provides that $241,477,000 be released from
the vaccine injury compensation trust fund in fiscal year 2013.
Of that amount, $6,477,000 is for administrative costs.
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 death
benefits. The vaccine injury compensation trust fund is funded
by excise taxes on certain childhood vaccines.

Centers for Disease Control and Prevention

The Committee recommendation provides $6,140,413,000 in
this bill for CDC, including $371,357,000 in transfers under
section 241 of the PHS Act and $55,358,000 in mandatory funds
under the terms of EEOICPA. In addition, the Committee
recommends $858,000,000 in transfers from the PPH Fund.
The total program level for CDC in fiscal year 2013 is
$6,998,413,000.
The fiscal year 2012 comparable program level is
$6,937,385,000 and the budget request is $6,715,419,000. The
budget request includes $667,503,000 in transfers under section
241 of the PHS Act and $903,210,000 in transfers from the PPH
Fund.
The activities of CDC focus on several major priorities:
providing core public health functions; responding to urgent
health threats; monitoring the Nation's health using sound
scientific methods; building the Nation's health
infrastructure; assuring the Nation's preparedness for emerging
infectious diseases and potential pandemics; and providing
leadership in the implementation of nationwide prevention
strategies that are conducive to good health.

IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2012.................................... $588,947,000
Budget estimate, 2013................................... 597,620,000
Committee recommendation................................ 588,947,000

The Committee recommendation for the activities of the
National Center for Immunization and Respiratory Diseases is
$588,947,000; this amount includes $12,864,000 in transfers
available under section 241 of the PHS Act. In addition, the
Committee recommends transferring $190,000,000 to the Center
from the PPH Fund.
The total program level recommended for the Center is
$778,947,000.
The mission of the National Center for Immunization and
Respiratory Diseases is the prevention of disease, disability,
and death through immunization and by control of respiratory
and related diseases.
The Committee recommendation includes funding for the
following activities in the following amounts:

Healthcare Workers.--The Committee is aware that healthcare
workers are at high risk during seasonal influenza epidemics
and periodic influenza pandemics. Yet, this is when their work
is most needed. The Committee recommends that CDC work in
partnership with CMS to ensure that all healthcare workers
receive the annual influenza vaccination.
Immunization Infrastructure.--The Committee strongly
supports investments in strengthening the systems around
immunization delivery, and encourages CDC to develop further
strategies to (1) modernize immunization information systems;
(2) prepare public health departments for changes in the
healthcare delivery system, including new billing procedures
related to privately insured patients; and (3) strengthen the
evidence base to inform immunization policy and program
monitoring.
Immunization Registries.--The Committee remains concerned
about the low rate of adult immunizations. The Committee urges
CDC to continue supporting States that wish to establish and
expand their use of immunization registries, with a particular
focus on improving information sharing about patients'
vaccination histories across different providers and generating
reminders to providers and patients about recommended
vaccinations, especially for adults.
Section 317 Immunization Program.--The Committee recognizes
that high rates of childhood immunization coverage are
important for reducing child mortality and saving costs over a
lifetime. For every $1 spent on the childhood series of
vaccines, $10.20 is saved. Therefore, the Committee transfers
$190,000,000 from the PPH Fund for the section 317 immunization
program. The additional funding will allow more recommended
immunizations to be available through the existing network of
private and public immunization providers, and support and
expand the network as needed.
The Committee requests an updated report on the section 317
program no later than February 1, 2013, to reflect fiscal year
2014 cost estimates for the program, optimum funding to support
State and local operations, and a discussion of the evolving
role of the program as expanded coverage for vaccination
becomes more available from private and public sources.
Vaccine Adverse Event Reporting System [VAERS].--The
Committee understands that a strong vaccine safety monitoring
system is essential to ensure that our Nation's vaccines are
safe, and to ensure the success of the national immunization
program and a low incidence of vaccine-preventable diseases.
VAERS, a national spontaneous reporting system co-administered
by CDC and FDA, requires healthcare providers and vaccine
manufacturers to voluntarily report certain vaccine adverse
events to VAERS, accepts voluntary reports from the public, and
requires this information be made available to the public. The
Committee directs CDC and FDA to communicate with physicians
about the importance of reporting vaccine adverse events,
regardless of whether those events are already part of the
Vaccine Injury Table.

HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS
PREVENTION

Appropriations, 2012.................................... $1,099,934,000
Budget estimate, 2013................................... 1,145,678,000
Committee recommendation................................ 1,101,934,000

The Committee recommendation for the activities of the
National Center for HIV, Viral Hepatitis, Sexually Transmitted
Diseases [STDs], and TB Prevention is $1,101,934,000. In
addition, the Committee recommends transferring $10,000,000 to
the Center from the PPH Fund.
The total program level recommended for the Center is
$1,111,934,000.
Established in 1994, the Center brings together the CDC's
work on HIV/AIDS, viral hepatitis, STDs, and TB, with the
exception of the Global AIDS program, which is housed in the
Center on Global Health.
The Committee includes a modified version of a provision
requested by the administration to give flexibility for CDC and
the States to support cross-program coordination activities
with 10 percent of the HIV prevention, TB, STI, and viral
hepatitis funding streams. The Committee provision limits the
flexibility to HIV prevention and TB funds for two reasons:
first, there is a drastically smaller amount of funding
available in viral hepatitis; and second, the Committee
believes that STI funding is already authorized to support
cross-cutting activities across a variety of sexually
transmitted infections.
The Committee recommends funding for the following
activities in the following amounts:

Within funds provided for national activities in HIV
prevention, the Committee intends that CDC spend no less than
last year's level on surveillance activities.
The Committee urges CDC to use the additional flexibility
provided by the Committee in health department prevention
funding to increase testing rates across the country.
Division of Viral Hepatitis.--The Committee intends that
funding be used to continue CDC's viral hepatitis screening and
testing initiatives, in support of the HHS goal to identify 65
percent to 75 percent of chronically infected persons who do
not know their status. The Committee acknowledges the need to
build an evidence base of effectiveness, and encourages the
Division to ensure that outcomes continuously inform activities
undertaken in the field. The Committee encourages CDC to focus
on best practices that can be replicated in various
jurisdictions with varying levels of resources.
Hepatitis Screening Guidelines.--The Committee notes that
hepatitis B and hepatitis C testing guidelines are not aligned
across HHS operating divisions, and expects CDC to work
expeditiously with ASH, AHRQ, and the USPSTF to develop
consistent national testing guidelines by January 1, 2013, to
improve testing rates. In particular, hepatitis B guidelines
should focus on the dramatic health disparity impacting the
U.S. Asian and Pacific Islander populations and hepatitis C
guidelines should address the prevalence of the disease in the
baby boomer population.
Infertility Prevention Program.--The Committee bill
provides a $2,000,000 increase in the Infertility Prevention
Program. Chlamydia is the most commonly reported STD in the
United States, yet remains under-reported due to a lack of
symptoms in most cases. It is entirely curable with simple
antibiotics. Left untreated, chlamydia damages reproductive
organs and can lead to infertility, ectopic pregnancies, and
increased risk of acquiring HIV. Routine screening is critical
for preventing the spread of this silent disease. The Committee
strongly supports the partnership between State departments of
public health and clinics that have a strong focus on
reproductive health.
Rapid Testing.--The Committee notes that the use of rapid
tests significantly increases the percentage of persons with
newly identified HIV who receive their testing results. The
Committee encourages CDC to continue expanding the use of rapid
HIV tests.

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2012.................................... $252,476,000
Budget estimate, 2013................................... 279,477,000
Committee recommendation................................ 269,274,000

The Committee recommendation for the activities of the
National Center for Emerging and Zoonotic Diseases is
$269,274,000. In addition, the Committee recommends
transferring $51,750,000 to the Center from the PPH Fund.
The total program level recommended for the Center is
$321,024,000.
The National Center for Emerging and Zoonotic Infectious
Diseases aims to detect, prevent, and control infectious
diseases from spreading, whether they are naturally occurring,
unintentional, or the result of terrorism.
The Committee recommendation includes funding for the
following activities in the following amounts:

Antibiotic Resistance.--The Committee commends CDC's
antimicrobial stewardship efforts, such as the GetSmart
program, but remains concerned about the lack of available data
on both resistance trends and antibiotic use in the United
States for both humans and animals. The Committee requests a
report from CDC, in coordination with its partners on the
Interagency Task Force on Antimicrobial Resistance, regarding
the type and scope of data collected in the United States on
antibiotic consumption and resistance trends. The report should
compare this level of data with the level and scope of data
collected around the world and the benefits or drawbacks of
collecting such data. In addition, the report should identify
what statutory and other obstacles exist in the United States
that might prevent the collection of more comprehensive data.
Emerging Infection Surveillance.--The Committee urges CDC
to create strong partnership opportunities between this Center
and the Center on Global Health in order to coordinate better
the Nation's surveillance of emerging infections and monitoring
activities at home and abroad.
Food Safety.--The Committee remains strongly supportive of
CDC's system of surveillance and outbreak response on food-
borne illness. The Committee is very concerned about changes in
private lab testing that reduce the ability of State labs to
identify quickly the fingerprint of a particular outbreak. The
Committee intends that the recommended funding increase be used
to support upgrades to PulseNet and develop new laboratory
tools. In addition, CDC should enhance and integrate
surveillance of disease, improve outbreak and response
timeliness, and help address deficits in local capacity to
prevent and stop illness. The Committee supports the expansion
of the number of Foodborne Diseases Centers for Outbreak
Response Enhancement [FoodCORE] and Food Safety Centers of
Excellence. These centers will serve a critical role through
the development and dissemination of best practices and tools
for food safety surveillance and outbreak response.

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2012.................................... $756,377,000
Budget estimate, 2013................................... 633,019,000
Committee recommendation................................ 798,445,000

The Committee recommendation for the activities of the
National Center for Chronic Disease Prevention and Health
Promotion is $798,445,000. In addition, the Committee
recommends transferring $457,050,000 to the Center from the PPH
Fund.
The total program level assumed in this bill for the Center
is $1,255,495,000.
The mission of the National Center for Chronic Disease
Prevention is to provide national leadership in promoting
health and well-being through prevention and control of chronic
diseases. Nearly one-half of all American adults have at least
one chronic illness; such diseases account for nearly 70
percent of all U.S. deaths and three-quarters of all healthcare
costs in the United States.
The budget proposes a consolidation of five programs within
the Center including: arthritis; comprehensive cancer; heart
disease and stroke; diabetes; and nutrition, physical activity,
and obesity. This consolidation proposal is the latest in a
series of efforts by the administration and this Committee to
coordinate better the obesity-related chronic disease
prevention programs in the Center. The Committee rejects the
proposed consolidation, not because the need to improve
coordination has gone away but because budget constraints make
it impossible to achieve without cutting funding to numerous
States. Yet, the Committee remains concerned by the lack of
coordination in the four State grant programs that address
obesity-related chronic disease: Diabetes; Heart Disease and
Stroke; Community Health Promotion; and Nutrition, Physical
Activity, and Obesity.
The Committee is aware that the target populations for
these four State grant programs, and the interventions
recommended by these four programs, are identical. Therefore,
the Committee recommends that CDC provide flexibility to States
to use up to 5 percent of their funds in any of these four
grant programs to address cross-cutting issues among them. The
Committee intends this flexibility be used to support
activities that align the goals, eligibility, evaluation, and
performance metrics of these programs.
Within the total provided for the National Center for
Chronic Disease Prevention and Health Promotion, the following
amounts are available for the following categories of funding:

[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2012 Fiscal year Committee
comparable 2013 request recommendation
----------------------------------------------------------------------------------------------------------------
Chronic Disease Block Grant..................................... .............. 378,607 ..............
Office of Smoking and Health--PPH Fund.......................... 83,000 89,000 95,000
Office of Smoking and Health.................................... 108,077 108,117 108,117
Environmental Health Lab (non-add).......................... 1,963 .............. 1,963
Nutrition, Physical Activity, and Obesity....................... 33,998 .............. 43,998
Nutrition, Physical Activity, and Obesity--PPH Fund............. 10,000 .............. ..............
School Health................................................... 13,522 .............. 13,522
Food Allergies (non-add).................................... 487 .............. 487
Community Health Promotion...................................... 6,106 .............. 6,106
Glaucoma........................................................ 3,319 .............. 3,319
Visual Screening Education...................................... 508 .............. 508
Alzheimer's Disease............................................. 1,802 .............. 11,802
Inflammatory Bowel Disease...................................... 677 .............. 677
Interstitial Cystitis........................................... 651 .............. 651
Excessive Alcohol Use........................................... 2,440 .............. 2,440
Chronic Kidney Disease.......................................... 2,081 .............. 2,081
Prevention Research Centers..................................... 17,900 .............. 17,900
Prevention Research Centers--PPH Fund........................... 10,000 .............. 10,000
Prevention Research Centers--Section 241 transfer............... .............. 25,000 ..............
Heart Disease and Stroke........................................ 54,975 .............. 54,975
Diabetes........................................................ 64,434 .............. 64,434
Cancer Prevention and Control--PPH Fund......................... .............. 260,871 ..............
Cancer Prevention and Control (total)........................... 348,304 62,794 346,332
Breast and Cervical Cancer.................................. 204,779 .............. 204,779
WISEWOMAN (non-add)..................................... 20,629 .............. 20,629
Breast Cancer Awareness for Young Women..................... 4,881 .............. 4,881
Cancer Registries........................................... 50,014 .............. 50,014
Colorectal Cancer........................................... 42,830 .............. 42,830
Comprehensive Cancer........................................ 20,199 .............. 20,199
Johanna's Law............................................... 4,972 .............. 3,000
Ovarian Cancer.............................................. 4,882 .............. 4,882
Prostate Cancer............................................. 13,114 .............. 13,114
Skin Cancer................................................. 2,138 .............. 2,138
Cancer Survivorship Resource Center......................... 495 .............. 495
Oral Health..................................................... 14,644 14,653 18,644
Safe Motherhood/Infant Health................................... 43,803 43,848 43,803
Arthritis....................................................... 13,001 .............. 13,001
Epilepsy........................................................ 7,757 .............. 7,757
National Lupus Patient Registry................................. 4,438 .............. 2,000
Racial and Ethnic Approaches to Community Health................ 13,940 .............. 23,940
Racial and Ethnic Approaches to Community Health--PPH Fund...... 40,000 .............. 40,000
Community Transformation Grants--PPH Fund....................... 226,000 146,340 280,000
Diabetes Prevention Program..................................... .............. .............. 10,000
Diabetes Prevention Program--PPH Fund........................... 10,000 .............. 10,000
Million Hearts Initiative--PPH Fund............................. .............. 5,000 5,000
Workplace Wellness--PPH Fund.................................... 10,000 4,000 10,000
Let's Move--PPH Fund............................................ 5,000 4,000 ..............
Breastfeeding Promotion and Support Grants--PPH Fund............ 7,050 2,500 7,050
----------------------------------------------------------------------------------------------------------------

Alzheimer's and Healthy Aging.--The Committee commends the
Healthy Brain Initiative [HBI] for its leadership in bringing
attention to the public health crisis of Alzheimer's disease
and for its work on cognitive impairment surveillance in 38
States. The Committee notes that developing a population-based
surveillance system with longitudinal follow-up is a key
recommendation in the National Public Health Road Map to
Maintaining Cognitive Health. The increase provided in the
Committee recommendation is intended to further develop this
system and to develop effective public health messages to
promote cognitive health in older adults, as recommended in the
recent progress report on the HBI.
Cancer Registries.--The Committee commends CDC for its work
to improve the ability of the cancer registries to support
enhanced access for researchers and the early capture of
particularly aggressive cancers.
Cardiomyopathy.--The Committee is aware of CDC estimates
that sudden cardiac arrest [SCA] is the leading cause of death
on school property, with one student athlete falling victim to
SCA every 3 to 4 days. The risk of SCA is highest among those
with undiagnosed cardiomyopathy. The Committee is pleased with
the information that CDC has developed for schools, coaches,
and parents on prevention of concussion in student athletes,
and encourages CDC to augment this effort with information
about how to identify children with cardiomyopathy and how to
respond appropriately and quickly to SCA. CDC is further
encouraged to disseminate this information through the CDC Web
site and the Division on Adolescent School Health.
Chronic Kidney Disease [CKD].--The Committee continues to
support early detection of CKD, particularly among high-
incidence minority populations. The Committee urges CDC to
continue early detection activities and the CKD Health
Evaluation and Risk Information Sharing project.
Chronic Obstructive Pulmonary Disease [COPD].--The
Committee applauds CDC for partnering with NHLBI to develop a
national action plan to address COPD. The Committee is pleased
to note that CDC is updating its COPD surveillance summary,
maximizing use of the currently available research data.
Community Transformation Grants [CTG].--The Committee
commends CDC for the recent announcement of a community grant
competition within the CTG program. The funding announcement
for this competition assumed that funds would be awarded for a
2-year period and the budget request did not anticipate another
funding announcement in fiscal year 2013. The Committee
recommendation includes an additional $54,000,000 above the
fiscal year 2012 level for CTG. The Committee directs CDC to
award this funding in another round of community grants in
fiscal year 2013.
Diabetes in Native Americans/Native Hawaiians.--The
Committee commends CDC for its focus on the high incidence of
diabetes and kidney disease among Native American, Alaska
Native, Native Hawaiian, and Filipino populations. The
Committee strongly supports the Native Diabetes Wellness
Program.
Glaucoma.--The Committee continues to believe that
education and screening programs for glaucoma and other age-
related eye diseases are a low-cost means of preventing and
reducing the risk of blindness, especially in minority
populations.
Heart Disease and Stroke.--The Committee is pleased that
the Center is developing a cardiovascular disease surveillance
system and continues to provide support for the Sodium
Reduction Communities program. The Committee recommends
$5,000,000 in transfers from the PPH Fund to support the
Million Hearts initiative.
Lupus.--The Committee applauds the completed development of
five lupus patient registries across the country meant to
identify reliable epidemiological and burden of illness data on
lupus. The Committee recommendation is sufficient to conduct
cohort studies of registry patients to study further long-term
outcomes, socioeconomic burdens, and mortality associated with
the disease. Studies should be designed to follow an
established, population-based cohort with lupus to determine
over time the treatment, healthcare access, and natural history
(severity, morbidity, mortality, etc.) of cohort members and
the factors (including genetic and other biological factors
such as antibody levels) associated with these outcomes.
Maternal Mortality Reviews.--State-based maternal mortality
reviews identify deaths, review associated factors, and take
action to institute changes to decrease pregnancy-related
mortality. A uniform pregnancy mortality dataset tool, which
includes an electronic comprehensive case abstraction form,
would ensure that the information needed for review and action
would be consistent for public health purposes. The Committee
encourages CDC, in consultation with relevant State and
national stakeholders, to develop a uniform pregnancy mortality
dataset tool for guidance to States on data collection, review,
and analysis, and make such a tool available to State maternal
mortality review committees.
Obesity.--The Committee is aware of the importance of diet
and nutrition in reducing obesity rates among targeted
populations, from school-aged children to seniors. Critical to
the success of this effort is training individuals how to
prepare foods that are healthful, flavorful, and delivered in
the most cost-effective manner. In accomplishing these
objectives, the Committee encourages CDC to support strategies
that engage institutions with demonstrated culinary training
expertise in the areas of ingredient selection, culinary
technique, flavor development, and menu development across a
wide range of volume food service operations, including
institutional foodservice. The Committee encourages the Center
to support strategies that engage such institutions throughout
its nutrition and health promotion programs.
Office on Smoking and Health [OSH].--The Committee includes
$203,177,000 for OSH, including $95,000,000 in transfers from
the PPH Fund. While much progress has been made in reducing
tobacco use, the Committee continues to believe that tobacco
prevention and cessation must be a priority. As noted in the
U.S. Surgeon General Report issued in March, tobacco use
remains a ``pediatric epidemic''; more than 3.6 million middle
and high school children actively smoke, with an additional 1.4
million trying their first cigarette each year. Funding from
OSH is particularly important in fiscal year 2013 because,
despite clear evidence of cost-effectiveness, States have cut
funding for tobacco prevention programs by a total of 36
percent in the last 4 years.
The Committee is pleased with the initial reported results
of the OSH media campaign. In the first 2 weeks of this
campaign, calls to State quitlines more than doubled and the
number of hits to www.smokefree.gov, the Government's Web site
offering quit assistance, more than tripled. In addition,
previous experience from State and local media campaigns
promoting quitlines shows at least 5 to 6 smokers try to quit
on their own for every one person who calls a quitline. The
Committee expects OSH to commit at least the same amount in
fiscal year 2013 for a media campaign and quitlines as it did
in fiscal year 2012.
The Committee commends the Environmental Health Laboratory
for its ongoing work on tobacco products, including its
successful partnership with the FDA in implementing the Family
Smoking Prevention and Tobacco Control Act. The Committee
expects OSH to transfer the same amount it did in fiscal year
2012 to the Environmental Health Laboratory. The Committee
notes that this transfer is to be provided to the lab in a
manner that supplements and in no way replaces existing funding
for tobacco-related activities.
Oral Health.--The Committee is greatly encouraged by pilot
programs across the country demonstrating new disease
management interventions, public health media campaigns, and
prevention strategies that can reduce the rate of dental
caries. The Committee intends that no less than $150,000 be
available for CDC to engage in planning and technical
assistance to improve and expand joint public-private media
campaigns at the national, State, and local levels. This may
include an oral health literacy program in response to a report
from the IOM which noted that ``individuals and many healthcare
professionals remain unaware of the risk factors and preventive
approaches for many oral diseases, and they do not fully
appreciate how oral health affects well being.''
In addition, the Committee has included sufficient funding
for CDC to convene a conference examining innovative strategies
to address early childhood caries [ECC] and to update the
agency's previous work on an ECC consensus statement. Through
this conference, CDC in collaboration with leading researchers,
clinicians, payors, and consumer groups will identify the most
recent science and research advancing ECC disease management.
Johanna's Law.--The Committee recognizes that fiscal year
2012 was the fifth year of Federal funding for the
gynecological awareness campaign authorized in Johanna's Law.
Over the last 5 years, CDC has developed and distributed
gynecologic cancer-specific fact sheets, Web sites, public
service announcements and other public education materials. The
Committee recommendation includes $1,500,000 for an evaluation
of Johanna's Law to determine the effectiveness of this
awareness campaign on gynecological cancer detection rates.
In addition, the Committee is concerned that the mortality
rate for ovarian cancer has remained relatively unchanged over
the last 40 years, while overall U.S. cancer mortality rates
have declined dramatically. The Committee recommendation for
Johanna's Law includes $1,500,000 for a review of the state of
the science on ovarian cancer, to be submitted no later than 1
year after enactment of this act. The review should be
conducted by a workgroup of both public and private sector
stakeholders, and it should identify a national plan of action
for improved prevention efforts, detection methods, care and
treatment for the full continuum of life, and basic and public
health research. The report and plan that follow should include
at least: an evaluation and summary of the existing state of
the science; an assessment of existing government initiatives;
and an identification of and recommendations for other public
and private sector efforts that would help the Nation make
progress in reducing the incidence and mortality of ovarian
cancer.
The Committee understands that women with the BRCA1 and
BRCA2 genetic mutations are at elevated risk for both breast
and ovarian cancers. Therefore, the Committee encourages CDC to
explore ways in which the risk of ovarian cancer can be
integrated into the larger public health system in cancer
prevention and treatment, particularly in public health
programs aimed at women at risk for breast cancer.
Racial and Ethnic Approaches to Community Health [REACH].--
The Committee is aware of the tremendous success of the REACH
program. From 2001 to 2009, physical activity rates among
minority populations in REACH communities increased from 7 to
12 percent, compared to a U.S. average in the general
population of 2 to 5 percent. These outcomes are all the more
impressive considering the high rates of obesity and obesity-
related illness in REACH communities. The Committee strongly
supports the REACH model of partnering with communities that
are underserved and often disaffected, both to identify health
disparities of concern to the community and then to implement
community-based, evidence-based, and culturally competent
approaches to reduce or eliminate those disparities.
Preterm Birth.--The Committee commends CDC for funding
State-based perinatal collaboratives that focus on improving
birth outcomes using known prevention strategies such as
reducing early elective deliveries.
Sleep Disorders.--Evidence is growing that chronic
circadian disruptions and disorders can cause significant
safety and health issues such as increased risk of
cardiovascular disease, breast cancer, diabetes, obesity, motor
vehicle crashes, and difficulty adhering to school and work
schedules. CDC is encouraged to continue current surveillance
efforts on sleep patterns that assist researchers in this area.
Well-Integrated Screening and Evaluation for Women Across
the Nation.--The Committee once again includes bill language
requiring CDC to make competitively awarded grants under
section 1509 of the PHS Act available to not less than 21
States, tribes, or tribal organizations. WISEWOMAN helps
uninsured and under-insured low-income women avoid heart
disease and stroke by providing preventive health services;
referrals to local healthcare providers, as needed; and
lifestyle counseling and interventions tailored to identify
risk factors to promote lasting, healthy behavior change.

NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES,
DISABILITY AND HEALTH

Appropriations, 2012.................................... $137,287,000
Budget estimate, 2013................................... 18,476,000
Committee recommendation................................ 134,500,000

The Committee recommendation for the activities of the
National Center on Birth Defects and Developmental Disabilities
[NCBDDD] is $134,500,000. The budget request transfers an
additional $107,089,000 from the PPH Fund; the Committee
rejects that proposed transfer.
This Center improves the health of children and adults by
preventing birth defects, developmental disabilities, and
complications of heredity blood disorders and by promoting
optimal child development and health and wellness among
children and adults living with disabilities.
For the second consecutive fiscal year, the budget request
includes a proposal to consolidate 14 programs in the Center
into a broadly defined program on disability and health. For
the second time, the Committee rejects the consolidation
proposal. The Committee notes with dismay that the proposal was
submitted to Congress without the accompanying information that
the fiscal year 2012 statement of the managers specifically
stated would be a requirement for consideration of any such
proposal in fiscal year 2013. The Committee reiterates that no
consolidation will be considered without an assessment of the
needs of the populations currently served and an analysis of
the impact of a consolidation on those populations.
Within the total provided, the following amounts are
provided for the following categories of funding:

Cerebral Palsy [CP].--The Committee commends CDC for
releasing the first multisite, population-based study on the CP
population in the country. In addition to updating prevalence
estimates, this report provided estimates of co-occurring
developmental disabilities, gross motor function, and walking
ability among children with CP. The Committee encourages the
CDC to update these figures regularly.
Fragile X--Fragile X-Associated Disorders [FXD].--The
Committee encourages CDC to continue to focus its efforts on
data collection to identify and define the population impacted
by FXD and the public health impact of these conditions. CDC is
further encouraged to support epidemiological research,
surveillance, screening, and the promotion of early
interventions and supports.
Hemophilia Treatment Centers [HTCs].--The Committee intends
that funds provided for HTCs be used to continue surveillance
and research at an expanded number of hemophilia treatment
centers.
Public Health Approach to Blood Disorders.--The Committee
includes sufficient funding to continue and expand work on
bleeding and clotting disorders, as well as hemoglobinopathies.
The Committee remains supportive of the blood safety
surveillance program focused on thalassemia. Because
thalassemia patients are transfused every 2 weeks and thus are
the largest users of red blood cells, closely monitoring their
health effectively protects all transfused patients, whether
due to surgery, childbirth, trauma, or any other cause.
Spina Bifida.--The Committee intends the funding provided
for the National Spina Bifida Program [NSBP] to be used to
support the continuation of a data collection initiative to
improve the efficacy and quality of care. Further, the
Committee intends the NSBP to serve as a model for programs
assisting other individuals living with similar complex
conditions.
Tourette Syndrome.--The Committee intends that CDC continue
to educate health professionals, educators, and the general
public about Tourette syndrome and to expand the scientific
knowledge base on prevalence, risk factors, and co-morbidities
of this disorder.

PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2012.................................... $391,741,000
Budget estimate, 2013................................... 415,069,000
Committee recommendation................................ 391,741,000

The Committee recommendation for Public Health Scientific
Services is $391,741,000; this amount includes $247,769,000 in
transfers available under section 241 of the PHS Act. In
addition, the Committee recommends transferring $70,000,000 to
these activities from the PPH Fund.
The total program level assumed in this bill for these
services is $461,741,000.
This funding supports the work of all of the CDC Centers by
compiling statistical information to inform public health
policy. In particular, these activities assure the accuracy and
reliability of laboratory tests; apply digital information
technology to help detect and manage diseases, injuries, and
syndromes; and develop and inform the public health community
on sound public health surveillance, laboratory protocols, and
epidemiological practices.
The Committee recommendation includes funding for the
following activities in the following amounts:

The Committee requests that CDC include in the fiscal year
2014 congressional budget justification a listing of all
internal laboratories with a description of their
responsibilities and their annual funding and staffing levels.
The laboratories should be categorized by biosafety level.
Seminal Surveys.--The Committee continues to support strong
data quality and accessibility within the ongoing seminal
health surveys, in particular the National Health Interview
Survey and National Health and Nutrition Examination Survey.
Sexual and Gender Identity Inclusion in Health Data
Collection.--The Committee recognizes the steps CDC has taken
to include questions relating to sexual orientation in the
National Health Interview Survey. The Committee remains
supportive of inclusion of gender identity questions. The
Committee urges CDC to ensure that milestones established in
the July 2011 national data progression plan are met.
Vital Statistics.--The Committee recommendation includes
sufficient funding to collect 12 months of vital statistics
data within the calendar year.

ENVIRONMENTAL HEALTH

Appropriations, 2012.................................... $104,998,000
Budget estimate, 2013................................... 103,672,000
Committee recommendation................................ 114,667,000

The Committee recommendation for the National Center for
Environmental Health is $114,667,000. In addition, the
Committee recommends transferring $35,000,000 to the Center
from the PPH Fund.
The total program level assumed in the bill for this Center
is $149,667,000.
The National Center for Environmental Health addresses
emerging pathogens and environmental toxins that pose
significant challenges to public health. The Center conducts
surveillance and data collection to determine which substances
in the environment are getting into people and to what degree.
The Center also determines whether these substances are harmful
to humans and at what level of exposure.
The Committee recommendation includes funding for the
following activities:

ALS.--The Committee commends the Center for launching a
tool within the ALS registry to promote clinical trial
enrollment and for exploring the addition of a biorepository.
The Committee encourages CDC to work with stakeholders and
researchers to help raise awareness of the registry in both the
patient community and the research community, and to ensure
that the registry collects information that is useful for ALS
research and treatment development. The Committee further
encourages CDC to work with CMS to explore how the registry may
help improve care and promote standards of care for those
living with the disease as well as other opportunities to
advance ALS research.
Asthma.--The budget request again proposes to consolidate
CDC's National Asthma Control program with the Healthy Homes/
Childhood Lead Poisoning program. The Committee notes that this
proposal contains few details on how the consolidated program
would bridge the different models and settings currently
employed by the two individual programs. For that reason, the
Committee again rejects the administration's proposal. The
Committee directs CDC to continue its support of the asthma
program, its approach to asthma control, its community
partners, and its successful interventions.
Blood Lead Reference Value.--The Committee applauds CDC for
doing away with the use of the ``blood lead level of concern''
methodology. The Committee encourages CDC to raise awareness of
the new blood lead reference value. The Committee is interested
in the potential for point-of-care screening devices,
particularly in at-risk communities.
Healthy Homes and Lead Poisoning Prevention Program.--The
Committee recommendation includes sufficient funding for
national surveillance efforts that can better target HUD lead
poisoning prevention efforts, technical assistance to local
public health officials, and national leadership on the science
of lead poisoning.
National Environmental Public Health Tracking Network.--The
Committee commends CDC for providing technical support to
States and cities that have demonstrated interest in conducting
public health tracking activities with their own resources.

INJURY PREVENTION AND CONTROL

Appropriations, 2012.................................... $137,693,000
Budget estimate, 2013................................... 137,754,000
Committee recommendation................................ 137,693,000

The Committee recommendation for the National Center for
Injury Prevention and Control is $137,693,000. In addition, the
Committee recommends transferring $3,000,000 to the Center from
the PPH Fund.
The total program level assumed in this bill for the Center
is $140,693,000.
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, and traffic
accidents. The national injury control program at CDC
encompasses nonoccupational injury and applied research in
acute care and rehabilitation of the injured.
The Committee recommendation includes funding for the
following activities:

Falls Prevention Interventions.--The Committee includes
$3,000,000 from the PPH Fund to expand older adult falls
prevention activities at CDC, in coordination with ACL. The
Committee intends that CDC use the funding to conduct research
to evaluate and disseminate the most effective fall prevention
interventions and that ACL use the funding provided that agency
to conduct outreach and demonstration programs to expand the
implementation of effective interventions.

OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2012.................................... $292,588,000
Budget estimate, 2013................................... 249,364,000
Committee recommendation................................ 292,588,000

The Committee recommendation for occupational safety and
health programs is $292,588,000; this amount includes
$110,724,000 in transfers available under section 241 of the
PHS Act, the same as was transferred in fiscal year 2012. The
budget request assumes $249,364,000 in transfers.
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 is implemented by
conducting scientific 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 recommendation includes funding for the
following activities at the following amounts:

Education and Research Centers.--The Committee directs CDC
to spend no less than last year for this program.
Mining Research.--The Committee requests that the fiscal
year 2014 congressional budget justification include a 5-year
history of mining research funding and FTE by type of mine
research, in particular the proportion of resources dedicated
to coal and metal/nonmetal research.
Other Occupational Safety and Health Research.--The
Committee requests that the fiscal year 2014 congressional
budget justification include a 5-year history of the funding
and FTE supported by this program, broken down by industry and
location.
Regional Proximity to Industry.--The Committee strongly
supports NIOSH's regional distribution of research facilities.
NIOSH is a leader in applied research and the Committee
believes that interaction with a wide variety of industries is
key to NIOSH's success. The Committee requests a staffing plan
for all facilities owned and leased by NIOSH over the coming 5
fiscal years, to be submitted no later than March 1, 2013. The
plan should include on-site contractors, any notable
projections for retirement, and site-specific plans for
recruitment.
National Occupational Research Agenda.--The Committee
directs CDC to spend no less than last year for the
Agriculture, Forestry, and Fishing Program within the National
Occupational Research Agenda.

ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATIONSATION ACT

Appropriations, 2012.................................... $55,358,000
Budget estimate, 2013................................... 55,358,000
Committee recommendation................................ 55,358,000

The Committee recommendation for EEOICPA is $55,358,000.
This mandatory funding supports NIOSH scientists who
reconstruct radiation dose levels to inform compensation
decisions.

GLOBAL HEALTH

Appropriations, 2012.................................... $347,594,000
Budget estimate, 2013................................... 362,889,000
Committee recommendation................................ 362,594,000

The Committee recommends $362,594,000 for global health-
related activities at CDC.
The Center for Global Health leads international programs
and coordinates CDC's global efforts with the goal of promoting
health and preventing disease in the United States and abroad.
The Center has a particular focus on ensuring rapid detection
and response to emerging health threats.
The Committee recommendation includes funding for the
following activities in the following amounts:

National Public Health Institutes [NPHIs].--In many
countries around the world, public health functions are spread
across the ministries of health. Laboratory work, surveillance,
outbreak response, and budget are often disconnected and
fragmented, making public health efforts less efficient and
less effective. This fragmentation is a barrier to
collaboration among nations on preventing the spread of
infectious disease and setting common health research goals.
NPHIs are science-based organizations that bring together the
public health functions of a government. They use evidence to
inform health practice and policies, determine the
effectiveness of health investments and practices, and provide
a locus of coordination for donor resources in developing
nations.
The Committee is aware that the International Association
of National Public Health Institutes has begun to transfer its
technical assistance functions to CDC, making CDC the global
leader on building NHPI capacity around the world.
In recognition of the leadership role that CDC plays in
global public health, the Committee has included a new
initiative to support the creation of NPHIs in developing
countries. The Committee has provided $10,000,000 to be
available over a 2-year period for CDC to work in at least five
countries. The Committee expects CDC's engagement to be time-
limited, extending from 3 to 5 years. The Committee further
expects this initiative to engage countries in all regions of
the world; however, the Committee understands that any country
engaged must show a high level of commitment to reorganize its
ministry of health in this manner.

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2012.................................... $1,299,479,000
Budget estimate, 2013................................... 1,228,360,000
Committee recommendation................................ 1,299,479,000

The Committee recommendation for the Office of Public
Health Preparedness and Response [OPHR] is $1,299,479,000.
The Committee does not support transferring any balances
from Public Law 111-32, the Supplemental Appropriations Act,
2009, in fiscal year 2013. In fiscal year 2012, $30,000,000 was
transferred from such balances for an additional amount for the
Strategic National Stockpile and the budget request proposes
transferring an additional $46,776,000. The Committee feels
strongly that additional transfers would impair the HHS flu
plan that the supplemental appropriations bill was designed to
implement.
The mission of OPHR is to build and strengthen national
preparedness for public health emergencies including natural,
biological, chemical, radiological, and nuclear incidents. OPHR
administers national response programs and assets, as well as
grants to States and localities to enhance preparedness efforts
across the country.
The Committee recommendation includes funding for the
following activities in the following amounts:

Public Health Emergency Preparedness Cooperative
Agreement.--The Committee directs that CDC award no less than
last year's level through the cooperative agreement with State
and local public health departments.

CDC-WIDE ACTIVITIES

Appropriations, 2012.................................... $617,913,000
Budget estimate, 2013................................... 487,648,000
Committee recommendation................................ 593,193,000

The Committee provides $593,193,000 for public health
leadership and support activities at CDC. In addition, the
Committee includes $41,200,000 in transfers from the PPH Fund,
the same as was transferred in fiscal year 2012 and the budget
request.
The Committee recommendation includes funding for the
following activities in the following amounts:

The Committee is pleased with the progress CDC made on
improving its congressional budget justification in fiscal year
2013 and appreciates the detailed information on programs,
grant awards, and staffing levels. The Committee continues to
urge CDC to give a clear accounting of how funds are being
spent in this annual budget document. The budget justification
should not only be an accounting of how funds will be spent in
the coming year, but also how funds have been spent in the
past. Therefore, the Committee directs that the fiscal year
2014 justification include information on programs as they
existed in fiscal year 2013, as well as any new structure the
budget may propose for the funding in fiscal year 2014. The
Committee expects progress on transparency to continue as CDC
seeks additional funding flexibility.
Chief Disability and Health Officer.--The Committee
commends CDC for appointing a chief disability and health
officer, as well as establishing a disability and health work
group that recently prepared its 1-year progress report. The
Committee encourages CDC to continue to support and strengthen
public health research activities focused on people with
disabilities. Specifically, CDC is encouraged to: recognize
disability as a key determinant in national surveys and
surveillance systems; address health disparities among people
with disabilities; enhance health promotion and prevention and
access to healthcare for people with disabilities; foster
knowledge translation and communication efforts to bring
persons with disabilities reliable health information; develop
new disability research initiatives through partnerships across
CDC centers and other Federal agencies; and develop public and
private partnerships to support and advance disability issues.
Extramural Research.--In last year's Senate report, the
Committee requested a report from CDC by March 1 of each year
that details the breakdown of intramural and extramural funding
for each program. CDC has yet to produce such a report. The
Committee directs CDC to comply with this request either in a
stand-alone report or in the annual budget justification.
Preventive Health and Health Services Block Grant.--The
committee recommends $79,545,000, the same as the fiscal year
2012 level, for the Preventive Health and Health Services Block
Grant. The budget request eliminates all funding for this
program.
Repairs and Improvements.--The Committee is dismayed by the
lack of clear information about CDC's building repair needs.
The Committee directs CDC to devise a system to categorize
needed repairs into security, life/safety repairs, condition
index, and other repairs. CDC is further directed to print the
number of repairs in the annual congressional budget
justification each year, with cost estimates. The Committee
understands that such a list is ever-changing and suggests that
CDC print an ``as of'' date in the justification.
Working Capital Fund [WCF].--The Committee is pleased with
the progress CDC has made to set up and create a strong
auditing system for a new WCF. The Committee hopes to see the
WCF begin operations in fiscal year 2014 to achieve greater
cost efficiencies across the administrative operations of the
agency.
The WCF is a revolving fund that pays for consolidated
business services for CDC. The Centers of CDC will pay into the
fund according to the amount of services they use. CDC is in
the process of setting up an audited and transparent system, in
which the Center directors participate in decisionmaking, to
determine those amounts.

National Institutes of Health

The Committee provides $30,731,459,000 for NIH activities
within the jurisdiction of this bill, including $8,200,000 in
transfers available under section 241 of the PHS Act. The
budget request is $30,631,459,000, the same as the fiscal year
2012 level.
The Committee notes that the net amount for NIH in the
budget request would actually be a cut of more than
$200,000,000 below the fiscal year 2012 level following
implementation of the administration's proposal to increase the
program evaluation tap on PHS agencies from 2.5 percent to 3.2
percent. As explained in the introduction to the HHS title in
this report, the Committee rejects that proposed increase and
maintains the tap at 2.5 percent.
The Institute and Center appropriation levels listed below
for fiscal year 2012 reflect the transfers announced by HHS in
April to increase funding for Alzheimer's disease research.
Recommended funding levels for some ICs are slightly below
the fiscal year 2012 levels, or increase less than others, due
to small reallocations or changes in scientific opportunity
reflected in the administration's budget request. For example,
the Committee agrees with the administration that all of the
funding for public access activities and the National Center
for Biotechnology Information should be provided directly to
NLM beginning in fiscal year 2013 instead of partly through
direct funding to NLM and partly through contributions from
other ICs. This change accounts for the relatively large
apparent increase for NLM and some minor reductions to other
ICs. In addition, as in prior years, the recommended levels for
the ICs reflect a redistribution of funding for AIDS research,
as some ICs increase their work in this area and others do
less.
Other than these reallocations, funding for most of the ICs
is increased over the fiscal year 2012 levels by the same
percentage.

NATIONAL CANCER INSTITUTE

Appropriations, 2012.................................... $5,067,396,000
Budget estimate, 2013................................... 5,068,864,000
Committee recommendation................................ 5,084,227,000

The Committee recommends an appropriation of $5,084,227,000
for NCI. Of this amount, $8,000,000 is available for repairs
and improvements to the NCI facility in Frederick, Maryland.
Angiogenesis.--The Committee commends NCI for planning a
scientific workshop to explore the effect of medication, diet,
and lifestyle on angiogenic levels. The Committee encourages
NIH to use this workshop to engage with the Trans-Institute
Angiogenesis Research Program on implementing a vigorous agenda
that examines current angiogenesis therapies in order to
improve outcomes. The Committee also encourages NCI to examine
angiogenic levels in the body prior, during, and after
treatments. In addition, all relevant Institutes are urged to
coordinate efforts to study the correlation of platelet
proteomes to angiogenesis with the goal of developing a health
marker.
Breast Cancer.--The Committee remains concerned about the
toll of triple negative breast cancer and urges NCI to
collaborate with ORWH, NIMHD, OMH, and OWH to help improve
treatment and survival rates.
Cancer Disparities.--The Committee urges NCI to fund basic,
translational, and clinical research on cancer disparities in
regions of the country that have a high predominance of
economically disadvantaged African Americans. Specifically, the
Committee urges further research on novel immune therapeutics
intervention in cancer areas relevant to human papilloma virus
and genomics etiologies in cancer areas relevant to smoking and
obesity.
Liver Cancer.--The Committee recognizes NCI's efforts in
the area of liver cancer, but encourages a stronger effort to
include funding of a specialized program of research excellence
on this disease as well as liver cancer program projects
focusing on pathogenesis, detection, and/or therapeutics.
Lung Cancer.--The Committee commends NCI for its National
Lung Screening Trial and urges the Institute and partner
agencies to move forward in translating these findings into
public health recommendations. The Committee requests an update
in the fiscal year 2014 congressional budget justification
about the benefits of screening among high-risk groups
including women, African-American men, and those with other co-
morbidities.
Melanoma.--The Committee continues to encourage NCI to
support research directed at the biology of tumor initiation
including UV radiation as a carcinogen, the immunologic and
addictive effects of UV radiation, host risk factors, and risk
reduction strategies. Research into the relative utility of
novel early detection strategies is encouraged, including
leveraging recent advances in imaging technology. Despite two
recent drug approvals for advanced melanoma, cures are rare.
Research strategies with curative potential that build on these
advances should be supported, including examining mechanisms of
drug resistance to molecularly targeted therapies such as BRAF
gene inhibitors. The Committee also urges more research on
treatment strategies for the 50 percent of patients without
BRAF mutations, as well as on predictive biomarkers that
correlate with immune response to ipilimumab. Finally, the
Committee urges NCI to promote collaborations between industry,
the extramural program, and foundations that will accelerate
translational and clinical research.
Minority Communities.--The Committee continues to remain
concerned at the disproportionately high rate at which minority
populations suffer from virtually every form of cancer. The
Committee requests that NCI and NIMHD prepare a joint report on
efforts to end this disparity and effective ways to communicate
with minorities on this important issue.
Neuroblastoma.--The Committee encourages NCI to expand its
research portfolio on this deadly pediatric cancer, including
the development of new treatment options for children suffering
from central nervous system [CNS] relapses. The Committee
requests an update on this research, including the potential
utilization of chimeric antibody immunotherapy for CNS-relapsed
neuroblastoma, in the fiscal year 2014 congressional budget
justification.
Pancreatic Cancer.--While survival rates for many types of
cancer have steadily improved, the rate for pancreatic cancer
has remained in the single digits for over 40 years. With the
number of new cases of pancreatic cancer projected to increase
55 percent between 2010 and 2030, the Committee urges NCI to
create a comprehensive, long-term research strategy for this
disease that focuses on increasing survival. The plan should
not be simply a summary of recent and ongoing research
activities. Rather, it should set out concrete goals for the
future. The Committee requests an update in the fiscal year
2014 congressional budget justification on the steps NCI is
taking to create such a plan.
Pediatric Cancer.--The Committee continues to urge NCI to
devote more of its funding specifically for research on
pediatric cancer, including pediatric low-grade astrocytoma.
The Committee requests an update in the fiscal year 2014
congressional budget justification, including efforts that
could result in more effective, less toxic treatments.
Robotic Biorepository Technology.--In order to determine
the genetic differences in the development, progression, and
response to treatment of individuals with cancer, biospecimens
(e.g. blood, urine, tumor tissue) must be collected and
evaluated. Under some circumstances, high throughput, robotic
instruments for the processing and storage of biospecimens can
improve the efficiency and consistency of handling and
distribution of these samples. In an effort to adequately
address the increasing demand for these specimens, an automated
approach should be considered when appropriate. Robotic
biorepositories may also allow researchers to expand the
collection of tissue specimens. A related goal is to ensure an
adequate supply of high-quality human biospecimens from
multiethnic communities for research to understand and overcome
cancer health disparities. The Committee encourages NCI to
explore the applicability of robotic biospecimen collection
technologies and the establishment of regional robotic
biorepositories in an effort to advance cancer research.
Shared Medical Decisionmaking.--The Committee encourages
NCI's collaboration with OBSRR to study shared medical
decisionmaking and to identify ways to improve communications
between healthcare providers and their patients.
Tumor Lysis Syndrome [TLS].--The Committee understands that
identifying high-risk patients, taking preventive measures, and
closely monitoring patients are all key in fighting TLS, a
life-threatening oncologic emergency that is frequently
encountered during and/or after the treatment of a variety of
cancers. The Committee encourages NCI to convene an expert
panel or working group to evaluate current risk assessment
models, recommend a standardized assessment tool, and develop a
plan of action to validate and disseminate the tools in
clinical practice.

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2012.................................... $3,076,115,000
Budget estimate, 2013................................... 3,076,067,000
Committee recommendation................................ 3,085,390,000

The Committee recommendation includes $3,085,390,000 for
NHLBI.
Asthma.--The Committee continues to urge NHLBI to increase
research on and awareness of asthma, and to collaborate with
the FDA, NIAID, NICHD, NIMHD, and OMH in this regard.
Basic Behavioral Research Translation.--NHLBI is encouraged
to speed the translation of basic research results in the
behavioral and social sciences to clinical or other
applications.
Cardiovascular Disease.--The Committee continues to believe
that research on heart disease, stroke, and other forms of
cardiovascular disease should be a top priority for NIH. Given
promising cardiovascular scientific opportunities and projected
escalating costs and prevalence, the Committee strongly urges
NHLBI to boost funding for its cardiovascular portfolio to
further support studies that will build on past accomplishments
and enhance prevention and treatment efforts. In particular,
the Institute should aggressively focus on and expand current
cardiovascular research and actively invest in novel areas,
including initiatives highlighted in its Division of
Cardiovascular Diseases Strategic Plan.
Chronic Obstructive Pulmonary Disease [COPD].--The
Committee applauds NHLBI for its plans to host a forum of
stakeholders and representatives from Federal agencies to share
information about current activities related to COPD and
discuss the development of a national action plan to address
this disease, the third highest cause of death in the United
States. The Committee requests an update in the fiscal year
2014 congressional budget justification.
Jackson Heart Study.--The Committee recognizes that the
Jackson Heart Study in Jackson, Mississippi, as authorized in
the PHS Act, is the largest investigation of cardiovascular
disease in the African-American population. The Committee
acknowledges the continued need for comprehensive research at
NHLBI and NIMHD to address this disease in African Americans
and the important implications for such research to all persons
threatened by cardiovascular disease.
Lymphangioleiomyomatosis [LAM].--The Committee remains very
interested in efforts to find a cure for LAM, a progressive and
often fatal lung disease in women. The Committee supports both
intramural and extramural means of expanding research on LAM
and urges NHLBI to use all available mechanisms as appropriate,
including Translational Program Project Grants, to stimulate a
broad range of clinical and basic research. The Committee
commends NIH for supporting multicenter LAM trials and
encourages additional support of such trials.
Marfan Syndrome.--The Committee commends NHLBI for its
leadership of the Genetically Triggered Thoracic Aortic
Aneurysms and Cardiovascular Conditions Registry [GenTac]. The
Committee encourages the Institute to use GenTac to advance
research on surgical outcomes for Marfan syndrome patients who
undergo different procedures to repair compromised aortas and
valves.
Pediatric Cardiomyopathy.--The Committee commends NHLBI for
its commitment to pediatric cardiomyopathy research and urges
the Institute to maintain support of the Pediatric
Cardiomyopathy Registry and Pediatric Cardiomyopathy Specimen
Repository. The Committee encourages NHLBI to establish a
pediatric cardiomyopathy task force that will focus on defining
standards of care, identifying gaps in basic and clinical
research, developing a research agenda, and working towards
better genetic screening methods.
Pulmonary Fibrosis.--The Committee supports ongoing efforts
to study pulmonary fibrosis and notes the promising strategy of
researching fibrosis across organs. The Committee encourages
NHLBI to develop a strategy for enhancing research on this
disease.
Scleroderma.--The Committee encourages NHLBI to support
additional research on the impact of connective tissue
diseases, such as scleroderma, on the pulmonary system.
Sickle Cell Trait.--The Committee commends NHLBI for its
efforts to develop a research agenda on sickle cell trait and
its relation to exertion-related illness and other conditions.
The Committee encourages the Institute to reach out to medical
societies in hematology and sports medicine, as well as
athletic associations, to collaboratively develop and undertake
research that can inform current policies related to sickle
cell trait screening and participation in athletic activities.
Sleep Disorders.--The Committee applauds NIH's Sleep
Disorders Research Plan, published by the National Center on
Sleep Disorders Research. The Committee urges the Institute to
work with other ICs to implement the plan's recommendations for
improving sleep research and training, and for advancing multi-
Institute collaborations.
Stem Cell Biology.--The Committee encourages NHLBI to
support additional research in the development of blood stem
cells from induced pluripotent stem [iPS] cells and to address
barriers to the clinical translation of iPS cell technology.

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2012.................................... $410,322,000
Budget estimate, 2013................................... 408,212,000
Committee recommendation................................ 409,449,000

The Committee recommendation includes $409,449,000 for
NIDCR.
Temporomandibular Disorders [TMD].--The Committee
recognizes the advances that have been made as a result of
NIDCR funding toward understanding the pain associated with TMD
and encourages the Institute to continue basic and clinical
research in this area. The Committee also encourages NIDCR to
collaborate with other ICs regarding the etiology and
pathogenesis of TMD as well as the co-morbid chronic pain
conditions and disorders that solely or predominately affect
women. An under-researched aspect of these disorders is the jaw
joint. NIDCR should work with NIAMS and NIBIB to develop
research opportunities in the area of joint pain and
dysfunction. Topics that need further research include: the
kinematics and biomechanics of the jaw in normal and disease
states; the development of biomarkers in bone, muscle, and
cartilage that are predictive of temporomandibular disease
progression; the interactions of the temporomandibular joint
musculoskeletal system with the nervous system; and the
development of non-invasive measures of temporomandibular joint
bone, cartilage, and muscle structure, degradation, and repair.
The Committee urges NIDCR, NIAMS, NIBIB, and other relevant ICs
to organize a workshop to assess the state of the science and
identify research gaps and future scientific directions to
advance understanding of the temporomandibular joint.

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2012.................................... $1,795,348,000
Budget estimate, 2013................................... 1,792,107,000
Committee recommendation................................ 1,797,539,000

The Committee recommendation includes $1,797,539,000 in
this bill for NIDDK.
Burden of Digestive Diseases.--Due to advancements in
diagnosis and greater understanding of many digestive
conditions, the Committee requests that NIDDK update its report
on the burden of digestive diseases in the United States to
provide more accurate information on the current economic and
health impacts of these conditions.
Chronic Pelvic Pain.--Interstitial cystitis often coexists
with several poorly understood and neglected chronic pain
conditions. The Committee applauds the progress made by the
Institute to understand the overlapping nature of these
disorders through the Multidisciplinary Approach to the Study
of Chronic Pelvic Pain [MAPP] Research Network. NIDDK is
encouraged to continue its focus on understanding co-morbidity
in the second phase of the MAPP project.
Diabetes Prevention.--The Committee applauds NIDDK for its
continued efforts to build on the successes of the Diabetes
Prevention Program and encourages the use of additional
resources to improve prevention and treatment of diabetes in
order to bring the Nation closer to a cure.
Fecal Incontinence.--The Committee commends NIDDK for its
launch of the Bowel Control Awareness Campaign and recognizes
that fecal incontinence significantly hinders the work and
social lives of those affected. The Committee prioritizes
research addressing this condition to improve patient quality
of life and to meet the research goals indicated in the NIDDK
report ``Opportunities and Challenges in Digestive Diseases
Research: Recommendations of the National Commission on
Digestive Diseases.''
Functional Gastrointestinal Disorders [FGIDs].--The
Committee understands that FGIDs can dramatically impact
children's social and educational development, and encourages
NIDDK to work with NICHD to support research addressing FGIDs
in children.
Inflammatory Bowel Disease.--The Committee commends NIH for
its support of the Human Microbiome Project and notes the
significance of this groundbreaking research in advancing the
understanding of inflammatory bowel disease and its impact on
pediatric patients. The Committee requests an update on this
program in the fiscal year 2014 congressional budget
justification.
Interstitial Cystitis.--The Committee continues to
encourage a focus on research and treatment relating to
interstitial cystitis, which impacts individuals of all ages.
The Committee encourages the inclusion of research focused on
this disease in children as a part of these activities.
Polycystic Kidney Disease [PKD].--The Committee continues
to urge NIDDK to collaborate with other Institutes and leverage
discoveries from its portfolio of PKD grants for the purpose of
developing a comprehensive strategic plan for PKD and other
related neoplastic diseases. For example, the Committee
understands that Pioglitazone, a drug that may have potential
for treating PKD, is being studied in Parkinson's patients and
is partially funded through NINDS.

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2012.................................... $1,624,830,000
Budget estimate, 2013................................... 1,624,707,000
Committee recommendation................................ 1,629,631,000

The Committee recommendation includes $1,629,631,000 for
NINDS.
ALS.--The Committee is aware that basic research on ALS and
a reservoir of pre-approved FDA drugs may provide the basis for
drug development that could offer meaningful therapy for those
with the disease. The Committee encourages NINDS to support
clinical trials on ALS that are scientifically well-founded and
have the opportunity to advance to ``bedside'' quickly.
Dystonia.--The Committee recognizes the advancements that
dystonia research has contributed towards an understanding of
neuromuscular disorders and neurotrauma and encourages NINDS to
continue to prioritize dystonia research.
Epilepsy.--The Committee applauds the establishment and
work of the Interagency Collaborative to Advance Research in
Epilepsy, led by NINDS, as a means to focus Federal agencies
and voluntary organizations on epilepsy research. The Committee
also commends NINDS for announcing the next conference on
curing epilepsy, to be held in March 2013, and for starting a
new initiative to develop ways to manage epilepsy with no
seizures and no therapeutic side effects. These new grants, the
EUREKA grants and the Epilepsy Centers without Walls grants,
are supporting creative and collaborative research that could
lead to advances in prevention, diagnosis, or treatment of
epilepsy and related co-morbidities. Additionally, the
Committee commends NINDS for supporting the Partners Against
Mortality in Epilepsy conference on sudden unexplained death in
epilepsy. Finally, the Committee urges NINDS to heed the
recommendations of the 2012 IOM report ``Epilepsy Across the
Spectrum: Promoting Health and Understanding''.
Headache Disorders.--The Committee encourages NINDS to put
a higher priority on the causes of headache disorders as well
as innovative treatments.
Network for Excellence in Neuroscience Clinical Trials.--
The Committee encourages NINDS to continue supporting the
Network for Excellence in Neuroscience Clinical Trials
[NeuroNEXT] program. The Committee urges NIH to increase the
efficiency of clinical trials conducted through NeuroNext,
facilitate patient recruitment and retention, and increase the
quality of the neuroscience trials. The Committee also
encourages NIH to work with other stakeholders to develop
surrogate endpoints to more efficiently determine the success
of a study.
Spinal Muscular Atrophy [SMA] Translational Research.--The
Committee commends NINDS for supporting SMA therapy development
projects through its Cooperative Program for Translational
Research. This collaborative program has proven highly
successful in accelerating the development of SMA therapies for
testing in the clinic and facilitating the submittal of
investigational new drug applications to the FDA. The Committee
urges NINDS to use this approach as a model as it shifts its
investment in SMA to the best opportunities based on current
science, and to use the Cooperative Program for Translational
Research to continue to advance and broaden the SMA drug
pipeline. The Committee also applauds NINDS for its work on
validating SMA biomarkers through the NeuroNEXT initiative.
Stroke.--The Committee remains concerned that NIH spends
only 1 percent of its budget on stroke research and strongly
urges NINDS to expand its stroke portfolio. The Committee
commends the leadership of NINDS in the decade-long work of the
Stroke Progress Review Group and requests another status
report, in the fiscal year 2014 congressional budget
justification, on its Phase 2 stroke planning process to
advance the most promising areas in prevention, treatment, and
recovery research.

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2012.................................... $4,486,473,000
Budget estimate, 2013................................... 4,495,307,000
Committee recommendation................................ 4,508,932,000

The Committee recommendation includes $4,508,932,000 for
NIAID.
Antibacterial Resistance.--The Committee applauds NIAID's
decision to target antibiotic-resistant bacterial infections as
the initial priority for the expansion of its clinical trials
networks beyond HIV/AIDS. To further support research on
antibacterial resistance, new antibacterial drugs, and new
diagnostics, the Committee recommends that NIAID form a blue
ribbon panel of experts including representatives from
infectious diseases professional societies, the pharmaceutical
and diagnostics industries, and others to create an
antibacterial resistance strategic plan to assist in
prioritizing research critical in this area.
Anti-Malarial Medications.--The Committee encourages NIAID
to increase its support for public-private partnerships focused
on developing anti-malarial medications and for research and
development of alternatives to artemisinin combination
therapies in response to the rapidly emerging threat of
artemisinin resistance.
Food Allergies.--The Committee is pleased with the support
and clinical advancement of promising food allergy research at
NIAID and NIDDK. NIH is currently evaluating potential
immunotherapy protocols for clinical implementation in children
and adults with food allergy. The Committee encourages NIAID to
continue its public-private partnerships in support of clinical
immunological, immunomodulator, and mechanistic studies, with
private donors and foundations as components of ongoing
clinical trials.
Hepatitis B.--The Committee is pleased with the emergence
of new and improved drugs to treat hepatitis B and the role
that NIAID continues to play in this effort. However, drugs are
effective in only half of the population, and for those
patients that can take these medications there is still only a
50 percent reduction in mortality over a 10-year period. The
Committee urges a more aggressive effort in this area.
Microbicides.--The Committee encourages NIAID to continue
coordination with USAID, the State Department, and others to
advance antiretroviral [ARV]-based microbicide development
efforts, with the goals of enabling regulatory approval of the
first safe and effective microbicide for women and supporting
product development and efficacy trials of alternative ARV-
based microbicides.
Neglected Tropical Diseases [NTDs].--The Committee urges
NIAID to continue its investment in neglected tropical disease
and malaria research, including translational research for
NTDs, and to work with other agencies as a part of the Global
Health Initiative to foster research and ensure that basic
discoveries are translated into solutions.
Nontuberculous Mycobacterial [NTM] Disease.--The Committee
urges NIAID to intensify research into NTM infections so that
more effective interventions can be developed for patients.
Regional Biocontainment Laboratories [RBLs].--NIAID
established 13 RBLs in response to the NIAID Strategic Plan for
Biodefense Research in 2002. Since their creation, the RBLs
have not received any additional Federal funding from NIAID
specifically for facility operations. The Committee asks NIAID
to provide a report by June 1, 2013, that details NIAID's plans
for the RBLs. The report shall include, at a minimum, projected
Federal funding needs, program goals, and a long-term plan for
the RBLs.
Specimen Collection.--Collecting specimens is critical to
research and development of diagnostic tests or other
activities intended to advance the treatment, detection,
identification, prevention, or control of antimicrobial-
resistant infections. The Committee urges NIAID, in conjunction
with CDC, ASPR, and the FDA, to consult with representatives
from diagnostics and pharmaceutical companies, academia, and
professional societies to explore the most effective way to
provide samples, including the feasibility of creating a
biorepository of prospectively collected specimens.
TB.--The Committee strongly urges NIAID to expand its
research into the development of new TB diagnostic tests,
drugs, and vaccines, particularly regarding drug-resistant TB
and totally drug-resistant TB.

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2012.................................... $2,427,742,000
Budget estimate, 2013................................... 2,378,835,000
Committee recommendation................................ 2,387,112,000

The Committee recommendation includes $2,387,112,000 for
NIGMS.
Institutional Development Awards [IDeA].--The Committee
provides $276,480,000 to continue increased support for the
IDeA program. The Committee recognizes the importance of the
Centers of Biomedical Research Excellence [COBRE] and the IDeA
Networks of Biomedical Research Excellence [INBRE] programs.
The Committee believes the IDeA program has made a significant
contribution to biomedical research and creating a skilled
workforce. Therefore, the Committee continues the $45,882,000
increase from fiscal year 2012 and recommends that one-half the
increase go toward new COBRE awards. The increase should be
paid for by a reduction in funding across NIH ICs.
The Committee encourages the NIH Director to expand the
program to support co-funding IDeA projects across NIH ICs to
foster the development of efforts in IDeA State programs.
Further, as an Office of Experimental Program to Stimulate
Competitive Research [EPSCoR] program, the focus of IDeA should
continue to be on improving the necessary infrastructure and
strengthening the biomedical research capacity and capability
of research institutions. Unfortunately, many institutions in
EPSCoR-qualifying States who could benefit from the IDeA
program are ineligible for funding. Therefore, the Committee
directs the IDeA Director to expand IDeA eligibility to all NSF
EPSCoR-eligible States.

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT

Appropriations, 2012.................................... $1,320,151,000
Budget estimate, 2013................................... 1,320,600,000
Committee recommendation................................ 1,324,603,000

The Committee recommendation includes $1,324,603,000 for
NICHD.
Children in Military Families.--Given that nearly 2 million
children live in military families and 700,000 children have
been affected by a recent or current deployment of a parent,
the Committee commends NICHD for supporting research on the
impact of these experiences on child health and well-being and
on the effectiveness of programs designed to address the
psychosocial and mental health needs of children and their
families. Studies are needed to examine the unique
developmental challenges of children when the mother or female
head of household is deployed to a combat zone, the process of
adjustment when military personnel return home, and the long-
term consequences of separation and reintegration on children's
development.
Chromosome Abnormalities.--The Committee continues to
support additional research on chromosome abnormalities and
urges NICHD to consider holding a state of the science meeting
focusing on strategies aimed at devising treatments for
recurring and nonrecurring copy number changes. The Committee
further urges new funding to support other independent
investigators whose work can provide pilot data or insight into
future directions for the study of more chromosome
abnormalities, particularly those involving chromosome 18. The
Committee requests an update on these activities, focusing on
non-Down syndrome research, in the fiscal year 2014
congressional budget justification.
Demographic Research.--The Committee commends NICHD for
supporting large-scale databases, such as the National
Longitudinal Survey of Youth, the Child Development Supplement
of the Panel Study of Income Dynamics, and the Fragile Families
and Child Well-Being Study, and demographic research
activities, such as the Population Research Infrastructure
Program. These investments have generated key scientific
findings, illuminating in particular the relationship between
socioeconomic status and individuals' health and well-being. As
NICHD implements its ambitious reorganization and scientific
visioning process in fiscal year 2013, the Committee urges the
Institute to continue its commitment to supporting demography
and population science.
Kidneys and Childhood Development.--The Committee urges
NICHD, in consultation with NIDDK, to undertake efforts to
examine the role of normal kidney development and/or function
in neonatal and child health. Specific areas to be addressed
should include: kidney function in low-birth weight infants;
how chronic acidosis, untreated hypertension, or recurrent
urinary tract infections affect child development; the impact
of childhood-onset hypertension on adult cardiovascular health;
and the identification of genetic and epigenetic factors that
may subsequently result in kidney injury and progression of
hypertension and chronic kidney disease.
Orthotics and Prosthetics.--As America's population ages,
the demand for orthotic and prosthetic care to address the
effects of stroke, diabetes, cardiovascular disease, and other
health issues continues to grow. To date, little comparative
effectiveness and outcomes research has been conducted to
establish which patients benefit most from which orthotic and
prosthetic services, supports, and devices. The Committee
supports evidence-based research in prosthetic and orthotic
care, and urges NICHD and the National Center for Medical
Rehabilitation Research to coordinate with DOD and the
Department of Veterans' Affairs to develop and pursue a
research agenda that responds to the most pressing needs of the
field.
Pediatric Functional Gastrointestinal Disorders [FGIDs].--
The Committee encourages NICHD to work with NIDDK to support
research addressing FGIDs in children.
Pheochromocytoma.--The Committee is concerned that the
current funding for the diagnosis, pathophysiology, and
molecular biology of pheochromocytoma is inadequate to meet the
rapidly expanding patient base and growing need for research
into pheochromocytoma and paraganglioma. The Committee
recommends NIH expand the funds available for this effort.
Preeclampsia.--The Committee is concerned by the lack of
progress made in understanding the causes of and risks
associated with preeclampsia and the related conditions of
eclampsia and HELLP syndrome, which can result in disability or
death for a mother and premature delivery or death for an
infant. The Committee encourages NICHD to work with other ICs
to share research findings and facilitate additional research
into ways to better prevent, manage, and identify interventions
for these conditions.
Preterm Births.--The Committee commends NICHD on its work
to prevent preterm births and encourages the Institute to take
into account that there are a number of conditions which
increase the risk of neurologic damage. The Committee urges
NICHD and NINDS to undertake studies into interventions during
pregnancy and/or labor to improve neonatal outcome,
particularly neurologic outcome. The Committee also requests
that NICHD identify the steps necessary to establish one or
more transdisciplinary research centers for prematurity as
recommended by the IOM.
Severe Maternal Morbidity.--The Committee understands that
NICHD is exploring the feasibility of holding a scientific
workshop to harmonize definitions for maternal morbidity. The
Committee urges NICHD to reach a positive decision, as uniform
definitions would help Federal, State, and local agencies and
research institutions establish standardized and interoperable
processes for surveillance, data collection, and research.
Spinal Muscular Atrophy [SMA] Care Protocols.--The
Committee is aware that clinical practice guidelines for SMA
are under preliminary development by advocacy groups in concert
with expert investigators and clinicians. In the absence of
evidence-based care protocols, the efficacy of the care
received by SMA patients depends largely upon geographic
proximity to experienced care centers and clinicians. Many SMA
patients receive care that is inconsistent with best practices,
and this variability negatively impacts individual patients as
well as clinical trial results for SMA therapies. The Committee
encourages NICHD to support natural history and care studies of
SMA to facilitate the development of clinical practice
guidelines that will bring uniformity to the medical care
received by SMA patients and significantly improve the
management of the disease. The Committee further encourages
NICHD to facilitate the sharing of data and data sources
between stakeholders involved in such studies.
Vulvodynia.--The Committee is pleased with the progress
that NICHD has made over the last fiscal year in expanding
extramural research support for vulvodynia, ensuring adequate
representation of vulvodynia experts on peer-review panels,
convening a vulvodynia workshop, and developing a research plan
on this condition. The Committee calls upon the Director to
build upon these initial efforts by carrying out the
recommendations from the strategic research plan and expects to
be updated on the Institute's progress in the fiscal year 2014
congressional budget justification. The Committee also notes
that vulvodynia frequently coexists with other persistent pain
conditions, including interstitial cystitis, fibromyalgia,
temporomandibular disorders, irritable bowel syndrome,
endometriosis, headache, and chronic fatigue syndrome. The
Committee is pleased with NICHD's participation in the trans-
NIH research initiative to support studies aimed at identifying
etiological and mechanistic pathways of these overlapping
conditions, and the Institute is encouraged to continue its
work in this area.

NATIONAL EYE INSTITUTE

Appropriations, 2012.................................... $702,049,000
Budget estimate, 2013................................... 693,015,000
Committee recommendation................................ 695,115,000

The Committee recommendation includes $695,115,000 for NEI.
Diabetic Eye Disease.--The Committee continues to support
the important work of the NEI Diabetic Retinopathy Clinical
Research Network.
Genetic Basis of Eye Disease.--The Committee commends NEI
for identifying more than 500 genes associated with both common
and rare eye diseases, enabling an understanding of disease
mechanisms and development of potential therapies for such
blinding eye conditions as age-related macular degeneration
[AMD], glaucoma, and retinitis pigmentosa [RP]. The Committee
is pleased that NEI's AMDGene Consortium has validated eight
previously known gene variants and identified 19 new gene
variants, and that the NEI Glaucoma Human Genetics
Collaboration [NEIGHBOR] has identified the first risk variant
in a gene thought to play a role in the development of the
optic nerve head, the degeneration of which leads to glaucoma
and loss of peripheral vision.
Translational Research.--The Committee recognizes NEI's
translational research initiatives and is pleased that the NEI-
led human gene therapy clinical trial for Leber congenital
amaurosis has resulted to date in 15 patients being treated and
experiencing visual improvement. The Committee applauds NEI's
pioneering work that is enabling further research into ocular
gene therapy through the launch of clinical trials for AMD,
choroideremia, Stargardt disease, and Usher syndrome, as well
as pre-clinical safety trials for RP, juvenile retinoschisis,
and achromatopsia.

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2012.................................... $684,923,000
Budget estimate, 2013................................... 684,030,000
Committee recommendation................................ 686,103,000

The Committee recommendation includes $686,103,000 for
NIEHS.
Endocrine Disruption and Women's Health.--The Committee
urges NIEHS to increase its research on the effects of
endocrine-disrupting chemicals on women's health outcomes. An
update is requested in the fiscal year 2014 congressional
budget justification.
Gulf Oil Spill.--The Committee commends NIEHS for the Gulf
Long-Term Follow-Up [GuLF] Study of 55,000 clean-up and
response workers whose activities have involved potential
exposures to oil, combustion by-products from burning oil, and
oil dispersants that may be associated with adverse health
consequences. In addition, the Committee commends the National
Toxicology Program for its assessment of the toxicological
effects of crude and weathered oil and dispersants, as well as
NIH for its grants to community-university consortia for
research on the effects of the oil spill on the health of the
people of the gulf coast. The Committee urges NIEHS and other
Institutes to continue their support of these important
studies.
Women's Health and the Environment.--The Committee urges
NIEHS to increase its research in several areas of special
importance to women's health: exposures that may initiate or
promote autoimmune diseases; exposures associated with risk of
uterine fibroids; the effects of engineered nanomaterials in
consumer products, especially cosmetics and personal care
products; and environmental exposures that are associated with
increased time to pregnancy.

NATIONAL INSTITUTE ON AGING

Appropriations, 2012.................................... $1,121,400,000
Budget estimate, 2013................................... 1,102,650,000
Committee recommendation................................ 1,124,265,000

The Committee recommendation includes $1,124,265,000 for
NIA.
Alzheimer's Disease.--In order to build upon the strong
body of work already being done in NIH-funded Alzheimer's
Disease Research Centers, the Committee urges NIH to take
advantage of existing well-characterized, longitudinal,
population-based cohort studies and the existing research
infrastructure these large-scale cohort studies have already
established to provide new insights into risk factors and
protective factors related to cognitive decline and dementia.
The Committee feels strongly that additional research is needed
in minority populations that are at particularly high risk for
cognitive decline and dementia.
Biology of Aging.--The Committee applauds NIA's leadership
role in the Geroscience Interest Group, which will promote
coordinated discussion and action across NIH on research to
reduce the burden of age-related disease.
Cognitive Interventions.--The Committee encourages NIA to
continue support of studies to identify environmental,
behavioral, and social factors that could protect against age-
related cognitive decline as well as randomized studies to test
the efficacy of behavioral and social interventions to slow or
reverse age-related cognitive decline.
Demographic Research.--The Committee recognizes NIA for
supporting research on the demographic, economic, and social
consequences of an aging population in the United States and
worldwide. A premier example of this research is the Health and
Retirement Study, a longitudinal survey of more than 26,000
Americans that is now being replicated in over 30 other
countries.
Measurement of Well-Being.--The Committee commends NIA for
working with the Economic and Social Research Council in Great
Britain to develop subjective measures of well-being as a
complement to objective health measures and traditional
economic indicators of progress. The Committee encourages the
continued development of these metrics and their incorporation
into national surveys.
Neuropsychology and Alzheimer's.--Recognizing that
neuropsychological assessment can provide detailed information
about cognitive deficits related to dementia or trauma, the
Committee encourages NIA to continue research that links
neuropsychological markers with Alzheimer's biomarkers.

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2012.................................... $535,280,000
Budget estimate, 2013................................... 535,610,000
Committee recommendation................................ 537,233,000

The Committee recommendation includes $537,233,000 for
NIAMS.
Heritable Connective Tissue Disorders.--The Committee
encourages NIAMS to expand its collaborative efforts with other
Institutes to support clinical and translational research aimed
at identifying effective therapies for heritable connective
tissue disorders, particularly Marfan syndrome.
Osteogenesis Imperfecta [OI].--The Committee urges NIAMS to
support natural history studies of OI that will facilitate
efforts by advocacy groups and medical professional societies
to develop clinical practice guidelines for adults living with
OI and to increase research on emerging issues. The Committee
encourages NIAMS to work with relevant stakeholders from
government, medical professional societies, and advocacy groups
on this matter and to provide an update in the fiscal year 2014
congressional budget justification.
Scleroderma.--The Committee continues to be pleased with
the progress of the Institute as it relates to scleroderma. The
Committee encourages NIAMS to concentrate efforts on
identifying genetic components that increase the likelihood of
developing this disease.
Temporomandibular Disorders [TMD].--Many people who have
TMD suffer from conditions that routinely affect other joints
in the body, such as trauma, arthritis, and fibromyalgia.
Therefore, the Committee calls on NIAMS to collaborate with
NIDCR and NIBIB to bring the intellectual and scientific
resources within these Institutes to the study of the jaw
anatomy and physiology and the complex neural, endocrine, and
immune system interactions that orchestrate jaw function and
trigger jaw joint pathology. NIAMS should integrate findings
from studies of the structure, mechanical function, metabolism,
and blood flow of bone, joints, and muscles with studies of
central and peripheral neural pathways, as well as the
endocrine, paracrine, and cytokine factors that impact upon
craniofacial structures as a means to understanding the
underlying causes of jaw pain and dysfunction.

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2012.................................... $415,880,000
Budget estimate, 2013................................... 417,297,000
Committee recommendation................................ 418,562,000

The Committee recommendation includes $418,562,000 for
NIDCD.
Clinical Trials for Human Communication Disorders.--The
Committee encourages NIDCD to expand its clinical trials
program and commends the Institute for a funding opportunity
announcement that encourages industry collaboration and
requires both clinical and basic scientists to be a part of
research teams.
Dementia and Hearing Loss.--The Committee recognizes the
association of unaddressed hearing loss with pre-dementia and
dementia and advocates investigating whether hearing loss is a
cause for dementia, whether hearing-loss interventions will
slow or halt dementia, and how rehabilitative interventions for
hearing loss can be delivered in communities.
Early Detection, Diagnosis, and Intervention.--The
Committee urges NIDCD to continue research on the auditory,
speech, language, voice, and psychosocial outcomes of children
identified with hearing loss through newborn screening.
Additionally, the Committee is aware of data that show a higher
prevalence of hearing loss than thought among school-age
children who passed newborn screening. Therefore, the Committee
recommends more research on methods of screening for both mild
hearing loss in infancy and for late-onset hearing loss. The
Committee also encourages NIDCD to continue studying optimal
sound amplification strategies for children's hearing aids,
particularly to enhance speech recognition in noisy classrooms,
and the effects of services and parental engagement on the
emotional well-being of the hearing-impaired child.
Hair Cell Regeneration and Replacement.--The Committee
continues to place a high priority on research involving
cellular regeneration of the inner ear. The Committee advocates
the goals to identify genes and factors that promote
regeneration cited in the 2012-2016 NIDCD Strategic Plan for
Research.
Hearing Aids and Cochlear Implants.--The Committee
encourages additional research that compares the benefits of
high- and lower-cost hearing aids, creates screening protocols
for hearing loss in primary care settings, and continues
collaborations between industry, scientists, clinicians, and
consumers in the area of low-cost hearing aids. The Committee
recommends further studies of the relationship between the
success of hearing aid fittings and the cognitive capabilities
of the hearing aid user, and supports further development of an
automated hearing-screening kiosk. The Committee is pleased
that NIDCD is funding cochlear implant research for those with
severe-to-profound hearing loss and recommends additional
studies on new electrode design and innovative approaches to
speech processing. The Committee further urges continued
research into studies evaluating and comparing the benefits of
the ``bimodal'' option of an implant in one ear and a hearing
aid in the other, and of a middle ear implantable device that
combines electromechanical and acoustical stimulation in the
same ear. The Committee encourages NIDCD to continue to monitor
cochlear-implanted children as they enter school, including
their development of higher-order cognitive and language
skills, speech production and recognition, and behavioral and
social adjustment.
Hearing Impairment Among Children and Young Adults.--The
Committee urges additional research on children and young
adults with mild and unilateral hearing loss from all modes of
injury. In particular, the Committee recommends further studies
on this group's diminished educational outcomes and development
of strategies to improve school achievement. The Committee
commends NIDCD for ``It's a Noisy Planet!'', a public education
effort in English and Spanish about the dangers of hearing loss
from noise exposure. The Committee also encourages NIDCD to
continue to explore new ways to engage and broaden audiences
through social media.
Hereditary Hearing Impairment.--The Committee encourages
additional efforts by NIDCD to identify and understand the
structure, function, and regulation of genes whose mutation
results in deafness and other communication disorders.
Noise-Induced and Environmental Hearing Loss.--The
Committee continues to encourage NIDCD to promote public
awareness of the importance of protecting hearing from noise,
through public service announcements or other means. The
Committee also encourages studies in normal-hearing children of
the impact of noisy classrooms on learning, continuation of a
study measuring hearing thresholds and noise exposure levels in
18- to 25-year-olds, and environmental and genetic research
into factors that predispose individuals to noise-induced
hearing loss.
Otitis Media.--The Committee supports continuing studies to
develop new treatments for chronic and recurrent otitis media
(ear infections), including treatment via a trans-tympanic
antibiotic gel and prevention through intranasal vaccines.
Presbycusis.--The Committee urges NIDCD to continue
multidisciplinary physiological and neurological studies of the
peripheral and central mechanisms of presbycusis, or age-
related hearing loss. It commends establishment of the NIDCD
Otopathology Research Collaboration Network and NIDCD's
National Temporal Bone, Hearing and Balance Pathology Resource
Registry to disseminate information about temporal bone
donation.
Salt Intake and Salt Substitute.--The Committee encourages
NIDCD to study whether taste perception will change following
reduced salt intake and to determine the biological mechanisms
of salt-taste transduction.
Synapses.--The Committee supports research on genetic and
cellular mechanisms of normal synapse function and on
approaches to prevent or reverse deafness-caused disruptions.
Tinnitus.--The Committee urges NIDCD to investigate
preventions, treatments, and cures for tinnitus, which remains
the most prevalent service-connected disorder for U.S. military
personnel. Continuing research on the specific neural
dysfunction responsible for tinnitus and on ways to suppress
hearing system hyperactivity is essential. The Committee urges
additional studies of the effect on tinnitus of stimulation of
the vagus nerve with an implantable electrode.

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2012.................................... $144,633,000
Budget estimate, 2013................................... 144,153,000
Committee recommendation................................ 144,590,000

The Committee recommendation includes $144,590,000 for
NINR.

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2012.................................... $459,085,000
Budget estimate, 2013................................... 457,104,000
Committee recommendation................................ 458,489,000

The Committee recommendation includes $458,489,000 for
NIAAA.
Prevention and Brief Intervention.--The Committee applauds
the release of NIAAA's new youth alcohol screening guide and
encourages the Institute to continue to promote alcohol
screening of children and adolescents. The Committee urges
NIAAA to pursue its plans to evaluate the guide both for
detecting risk of alcohol problems and as an initial screen for
other risky behaviors. The Committee also commends NIAAA's
efforts to develop a matrix of interventions for addressing
alcohol problems on college and university campuses and in the
surrounding communities. Providing information on the
effectiveness, cost, personnel requirements, and ease of
implementation of individual and environmental interventions
will assist college and university presidents and other
administrators as they work to reduce harmful alcohol use among
their students. The Committee recognizes the critical role of
psychological research in understanding and addressing underage
drinking.

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2012.................................... $1,052,373,000
Budget estimate, 2013................................... 1,054,001,000
Committee recommendation................................ 1,057,196,000

The Committee recommendation includes $1,057,196,000 for
NIDA.
Collaboration With the FDA.--The Committee applauds the
role NIDA is playing to facilitate the growth of regulatory
science at FDA's Center for Tobacco Products. The research NIDA
oversees will inform policies on regulating tobacco-product
advertising, labeling, marketing, constituents, ingredients,
and additives. As such, the Committee commends NIDA for helping
establish the science base for regulatory policies that are
expected to influence tobacco-product risk perceptions,
exposures, and use patterns in the short term, and to reduce
tobacco-related morbidity and mortality in the long term. In
particular, the Committee recognizes that large-scale research
on national, longitudinal cohorts like the Population
Assessment of Tobacco and Health study will be critical for
assessing the impact of FDA regulatory authority over tobacco
products and help to inform future activities.
Education.--The Committee recognizes and encourages the
educational efforts of NIDA to inform the public of the
deleterious effects of abused substances and the life-
threatening dangers of drug addiction. Adolescents and
returning veterans and their families are at a high risk for
drug abuse and therefore should be areas of focus.
Medications Development.--The Committee encourages NIDA to
continue its efforts to develop medications to treat diseases
of addiction.
Military Personnel, Veterans, and Their Families.--The
Committee commends NIDA for its efforts to coordinate and
support research with the Department of Veterans Affairs and
other NIH Institutes on substance abuse and associated problems
among U.S. military personnel, veterans, and their families.
The Committee encourages NIDA to continue work in this area.
Prescription Drug Abuse.--Prescription drug abuse has been
the focus of much work by NIDA and remains a high priority. The
Committee encourages NIDA to maintain its comprehensive
leadership role in the effort to halt this epidemic.
Translational Research.--The Committee encourages NIDA to
continue its efforts to understand how genetics, age,
environment, and other factors affect the use of experimental
drugs and the development of addiction.

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2012.................................... $1,478,868,000
Budget estimate, 2013................................... 1,479,204,000
Committee recommendation................................ 1,483,687,000

The Committee recommendation includes $1,483,687,000 for
NIMH.
Autism.--The Committee commends NIMH for its leadership on
autism research and encourages the Institute to ensure that
such research focuses on both genetic and environmental causes.
The Committee also encourages NIMH to collaborate with NIEHS
regarding environmental causation.
Combination HIV Prevention.--With recent scientific
advances demonstrating the promise of biomedical HIV prevention
interventions, behavioral research is needed more than ever to
bolster medication adherence and treatment uptake, document
real-world decisionmaking processes associated with biomedical
interventions, and better understand potential unintended and/
or undesired consequences of biomedical interventions. The
Committee urges NIMH to support a robust HIV/AIDS behavioral
prevention research agenda that examines these factors and
includes operations research to optimize combination HIV
prevention.
Mental Health Disparities.--Rural and minority individuals
can be vulnerable to emotional disorders for a number of
reasons. Greater rates of poverty among some ethnic and
minority groups and rural populations, relationships between
low socioeconomic status and some mental disorders, and greater
risk of poverty among people with certain mental illnesses can
create a vicious cycle. In addition, cultural differences in
symptom expression and attitudes toward mental illness can make
recognition and diagnosis of mental disorders in these
populations difficult. Further, minorities living in rural
areas are particularly likely to be medically underserved,
facing significant barriers to getting needed mental
healthcare. The Committee encourages NIMH to fund research
efforts to find innovative ways to address mental health
disparities in underserved populations, especially in
designated Psychiatric Manpower Shortage Areas.
Premature Mortality.--The Committee continues to be
concerned about premature mortality and lower life expectancy
experienced by adults living with serious mental illness as a
result of treatable medical conditions such as cardiovascular,
pulmonary, endocrine, and infectious diseases. The Committee
urges NIMH to continue its collaborations with other
Institutes, including NIDDK and NHLBI, to pursue research to
better understand the causes and interventions needed to
address this crisis. The Committee requests an update in the
fiscal year 2014 congressional budget justification.
Psychotropic Drugs and Children.--In a November 2011 letter
to State Medicaid directors, HHS officials noted that children
in foster care are prescribed antipsychotic medications at
nearly nine times the rate of other children receiving
Medicaid. A December 2011 study by GAO reported similar
findings, noting that prescriptions to foster children in the
States GAO analyzed were more likely to have indicators of
potential health risks. The Committee is pleased that NICHD, in
collaboration with NIMH, is working to better understand the
impact of medications on the growth and development of
children. In light of the clinical vulnerability of many
children in foster care, the Committee encourages both
Institutes to assign this research a high priority as well as
to examine evidence-based, nonpharmaceutical interventions to
treat children with behavioral and mental health issues.

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2012.................................... $512,727,000
Budget estimate, 2013................................... 511,370,000
Committee recommendation................................ 512,920,000

The Committee recommendation includes $512,920,000 for
NHGRI.

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2012.................................... $338,038,000
Budget estimate, 2013................................... 336,896,000
Committee recommendation................................ 337,917,000

The Committee recommendation includes $337,917,000 for
NIBIB.

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

Appropriations, 2012.................................... $127,937,000
Budget estimate, 2013................................... 127,930,000
Committee recommendation................................ 128,318,000

The Committee recommendation includes $128,318,000 for
NCCAM.
Access to Natural Product Collections.--The Committee
continues to applaud NCCAM's efforts to increase access to
comprehensive and professionally organized natural product
libraries, which are a major source of pharmaceutical leads and
therapeutic agents.

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2012.................................... $276,179,000
Budget estimate, 2013................................... 279,389,000
Committee recommendation................................ 280,236,000

The Committee recommendation includes $280,236,000 for
NIMHD.
Diabetes.--The Committee recognizes that more research and
education are needed on the disparate effects of diabetes on
minority populations. The Committee urges NIMHD to expand its
research on pre-diabetes and diabetes, particularly type 2
diabetes in minority populations. This research should identify
clinical, socioeconomic, geographical, cultural, and
organizational factors that contribute to diabetes in such
populations. Specifically, the Committee encourages NIMHD to
analyze behavior and obesity.
Obesity.--The Strategic Plan for NIH Obesity Research
emphasizes the need for a transdisciplinary, multifaceted
approach to address the complex factors that have resulted in
the growing obesity problem in the United States. The Committee
supports NIH's actions to date and the findings of the task
force, but remains concerned that while the essential plan and
direction may be in place, a better mechanism is needed to
coordinate a trans-NIH, multidisciplinary effort to address the
complicated nature of the obesity problem. The Committee urges
NIH to intensify its investment in obesity research, in
particular in populations that are most affected--racial and
ethnic minorities, low-income populations, and rural
populations. The Committee again strongly recommends that NIH
review the benefits of establishing a Comprehensive Center of
Excellence for Obesity Research and Prevention within NIMHD to
better coordinate efforts within NIH and with other Federal
agencies. The Committee believes that a comprehensive center
could serve to capitalize on the health disparities efforts
already underway at NIMHD and leverage both intramural and
extramural research programs across NIH.

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

Appropriations, 2012.................................... $69,556,000
Budget estimate, 2013................................... 69,758,000
Committee recommendation................................ 69,969,000

The Committee recommendation includes $69,969,000 for FIC.
The Committee continues to support FIC's efforts to foster
long-term research and training partnerships between U.S.
research institutions and those in developing countries.

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2012.................................... $574,823,000
Budget estimate, 2013................................... 639,033,000
Committee recommendation................................ 631,346,000

The Committee recommendation includes $631,346,000 for
NCATS. The Committee includes bill language allowing up to
$40,000,000 of this amount to be used for the Cures
Acceleration Network [CAN]. The fiscal year 2012 funding level
for CAN is $9,981,000 and the budget request includes bill
language allowing up to $50,000,000 for this purpose.
The Committee is encouraged by the direction of this new
Center. In particular, the Committee applauds the recent launch
of a collaborative program that will match researchers with a
selection of pharmaceutical industry compounds to help
scientists explore new treatments for patients. NCATS has
partnered initially with three pharmaceutical companies that
have agreed to make dozens of their compounds available for a
new initiative called Discovering New Therapeutic Uses for
Existing Molecules. These are compounds that have already
cleared several key steps in the development process, but were
abandoned by the companies because they were not
therapeutically effective on the targeted diseases. Researchers
will test these compounds for their effectiveness against other
diseases and conditions. The companies will provide the
researchers with access to the compounds and all related
research data. Participating industry partners will retain the
ownership of their compounds, while academic research partners
will own any intellectual property they discover through the
research project with the right to publish the results of their
work. This initiative encapsulates the kind of collaboration
between NIH and the pharmaceutical industry that the Committee
envisioned when creating NCATS.
Congenital Diaphragmatic Hernia [CDH].--The Committee
encourages ORDR to support dedicated research funding directed
for CDH, which affects approximately 1,600 babies in the United
States every year. The Committee urges ORDR to put a high
priority on research related to finding the causes of CDH and
requests an update in the fiscal year 2014 congressional budget
justification.
Clinical and Translational Science Awards [CTSAs].--The
Committee encourages NCATS to continue the focus of the CTSA
program on the full spectrum of translational research.
Dystonia.--The Committee commends ORDR's support of the
Dystonia Coalition Patient Registry.
Hereditary Angioedema [HAE].--The Committee recognizes that
few treatment options are available for HAE and that they are
not effective for all patients. The Committee encourages ORDR
to continue to reinvigorate HAE research at NIH and help
identify new pathways for interventions.
Rehabilitation Research.--The Committee encourages NCATS to
include rehabilitation research as a priority area of
investigation.
Therapeutics for Rare and Neglected Diseases [TRND]
Program.--The Committee commends NIH for establishing and
growing the TRND program, and encourages NIH to fund the
projects with the highest likelihood of success, regardless of
disease state. In particular, the Committee commends TRND for
supporting a Fragile X partnership to accelerate potential new
treatments that benefit patients with this rare and neglected
disease. The Committee also encourages TRND to continue
supporting development of treatments for Duchenne muscular
dystrophy to bridge the gap between a basic research discovery
and the testing of drugs in humans.

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2012.................................... $345,522,000
Budget estimate, 2013................................... 380,851,000
Committee recommendation................................ 381,981,000

The Committee recommends $381,981,000 for NLM. This amount
includes $8,200,000 from transfers available under section 241
of the PHS Act. Of the funds provided, $4,000,000 is for the
improvement of information systems, to remain available until
September 30, 2014.
Disaster Information Management.--The Committee applauds
NLM's support of the Disaster Information Management Research
Center [DIMRC], which has made important contributions to the
Nation's disaster preparedness and response efforts through the
rapid creation of information resources for specific events;
development of innovative information tools to aid in disaster
preparedness, response, and recovery; the establishment of a
disaster information specialty among librarians; and its
participation in the Bethesda Hospital Emergency Preparedness
Partnership. The Committee encourages NLM to continue to work
through DIMRC with Federal and non-Federal partners, including
the library community, to identify and implement best practices
for maintaining access to health information before, during,
and after disasters; develop innovative resources and tools to
aid emergency responders and managers; collect, organize, and
disseminate disaster health information; promote the
development of disaster information specialists; engage the
library community in disaster information management; conduct
research into disaster health informatics; and develop and
export community-based models of health resiliency during
disasters.

OFFICE OF THE DIRECTOR

Appropriations, 2012.................................... $1,458,501,000
Budget estimate, 2013................................... 1,429,161,000
Committee recommendation................................ 1,431,341,000

The Committee recommendation includes $1,431,341,000 for
the Office of the Director [OD].
The Committee includes bill language allowing up to
$165,000,000 to be used for continuation of the National
Children's Study. The budget request includes $165,000,000, but
does not specify this amount in bill language. The fiscal year
2012 level is $193,098,000.
The Committee recommendation includes $544,930,000 for the
Common Fund. This is the same amount as the budget request and
the fiscal year 2012 level.
Alzheimer's Disease.--The long-term costs of Alzheimer's
disease, both in terms of lives and resources, are enormous.
The Committee strongly urges the Director and all relevant ICs
to increase funding for research on Alzheimer's disease to the
greatest extent possible within their budgets. However, the
Committee strongly disagrees with the President's budget
request to allocate $80,000,000 of the PPH Fund for Alzheimer's
disease research at NIH. NIH research is not an appropriate use
of the PPH Fund. Additionally, the Committee believes it would
set a dangerous precedent to provide specific amounts of NIH
funding for individual diseases. The Committee notes that it
took the same position in fiscal year 2010 when the
administration proposed allocating specific levels of funding
for cancer and autism research. The Committee also notes that
NIH has flexibility to prioritize funding for individual
diseases when the scientific opportunities and the number of
high-quality applications warrant an increase. HHS took this
very approach in April when it announced a transfer of
$18,300,000 of fiscal year 2012 funds within NIH, as part of an
overall strategy to increase NIH's investment in Alzheimer's
research by $50,000,000.
The Committee recommends that NIH allocate resources for
Alzheimer's research according to the priority research
recommendations included in the National Alzheimer's Plan
required under the National Alzheimer's Project Act. NIH is
also encouraged to consider entering into public-private
partnerships to accelerate the discovery and development of
small molecule therapeutics that could potentially improve the
symptoms and modify the course of Alzheimer's disease.
Career Development Awards for Clinical Researchers.--The
Committee is encouraged by the Director's efforts to strengthen
the biomedical research workforce and recommends the continued
awarding of NIH Career Development Awards, or ``K'' Awards, to
train clinical researchers.
Cerebral Palsy.--The Committee notes that NIH funding for
research on cerebral palsy has long been disproportionately low
compared with that of similar diseases that affect fewer
people. The Committee urges NIH to put a higher priority on
cerebral palsy in fiscal year 2013.
Chimpanzees.--The Committee commends NIH for adopting the
IOM's recommendations regarding research involving chimpanzees
in the December 2011 report ``Chimpanzees in Biomedical and
Behavioral Research: Assessing the Necessity.'' The IOM found
that chimpanzees are ``largely unnecessary'' for current
research. One possible exception cited by the IOM is efficacy
testing of a prophylactic hepatitis C vaccine, but the report
pointed to several alternatives which are currently in
development that could eliminate any need for chimpanzees in
this type of research. The Committee urges NIH to put a
priority on developing these alternatives.
Class B Animal Dealers.--The Committee commends NIH for
moving to end the use of Class B random source dealers as
suppliers of dogs and cats to its grant recipients by recently
announcing a ban, effective October 1, 2012, on the acquisition
of cats from Class B random source dealers. The Committee urges
NIH to implement the ban on the acquisition of dogs from Class
B random source dealers no later than 2015 and requests an
update on this matter in the fiscal year 2014 congressional
budget justification.
Collaboration With DOE.--The Committee commends NIH and
DOE's national laboratories for their collaboration on research
and development projects, which have resulted in advances in
bioinformatics and breakthroughs in atomic resolution
structural biology. The Committee encourages the Director and
ICs to continue these collaborations.
Collaboration With the FDA.--The Committee commends NIH for
its participation in a NIH-FDA Joint Leadership Council to help
ensure that regulatory considerations form an increasing
component of biomedical research planning and that the latest
science is integrated into the regulatory review process. The
Director is urged to continue this joint effort to advance the
translation of biomedical research discoveries into approved
diagnostics and therapies as well as promote science to enhance
the evaluation tools used for regulatory review.
Congenital Muscular Dystrophy.--The Committee applauds NIH
for its growing support of congenital muscle disease research,
particularly in congenital muscular dystrophy and congenital
myopathy, which will yield returns across the muscular
disorders. The Committee also commends NINDS and NIAMS for its
financial support of scientific conferences to identify common
therapeutic targets and action plans toward clinical trial
readiness. The Committee urges NIH to continue supporting
grants and other funding mechanisms to advance key congenital
muscle disease initiatives for clinical trial readiness and
requests an update in the fiscal year 2014 congressional budget
justification on total dollars spent on congenital muscular
dystrophy and congenital myopathy research.
Cystic Fibrosis [CF].--While the life expectancy of CF
patients has slowly improved, the Committee remains concerned
regarding the severe morbidity and early mortality associated
with the condition. The Committee supports further research
regarding treatments that target the underlying cause of CF,
building upon the success of the recently approved new drug
Kalydeco. The Committee encourages support for protein
structural studies that may advance the understanding of
mechanisms of action of CF drugs in clinical development and
also encourages the use of new technologies to discover,
develop, and characterize the effect of new treatments,
including the use of airway imaging to characterize the
function of the airways. The Committee also notes the potential
for research in CF to have applications on a wide array of
human diseases, and urges continued work to identify the
applications of CF treatments to other disease states.
Doctors of Veterinary Medicine [DVMs] and Loan Repayment
Programs.--The Committee recognizes the important role that
DVMs play in the biomedical research enterprise because of
their background and training in disease processes across all
animals, including cross-species virus transmission, and animal
models. As with other medical professionals, large debt upon
graduation influences their choice to pursue careers in
biomedical research. DVMs participate on clinical research
teams and are eligible in that capacity for loan repayments
under the Clinical Research and Clinical Research for
Individuals from Disadvantaged Backgrounds loan repayment
programs. NIH is encouraged to make this information more
widely known to potential applicants, ICs, and reviewers.
Down Syndrome.--The Committee commends NIH for its ongoing
efforts to implement the NIH Down Syndrome Research Plan and
for establishing the NIH Down Syndrome Consortium, which is
focused on facilitating a dialogue between trans-NIH Institutes
and the Down syndrome patient community. Increased Federal
funding for translational research is important, and investing
in Down syndrome-centered research has the potential for
benefiting many other diseases and conditions such as
Alzheimer's disease. The Committee encourages NIH to increase
the amount invested in investigator-driven research grants and
plan for the development of the Down syndrome clinical
database, research registry, and biobank. NIH is also urged to
establish workshops and mentoring programs to encourage young
researchers and scientists to successfully pursue NIH grants
for Down syndrome research.
Drug Allergy.--The Committee is concerned about the
incidence of allergic reactions to drugs for debilitating and
potentially fatal diseases including cancer, HIV/AIDS, cystic
fibrosis, and rheumatoid arthritis. The Committee requests an
update in the fiscal year 2014 congressional budget
justification regarding ways in which NCI, NHLBI, NIAMS, and
other relevant Institutes can collaborate with NIAID to support
research on desensitization of patients who have allergic
reactions to potentially life-saving medications.
Duchenne Muscular Dystrophy.--The Committee is aware of
multiple governmental and nongovernmental efforts to develop
patient registries containing valuable data from patients with
Duchenne muscular dystrophy. Such registries are critically
important to continue advancing Duchenne public health and
research projects, but the Committee is concerned about the
lack of coordination and potential duplication of efforts. The
Committee encourages NIH, working through the Muscular
Dystrophy Coordinating Committee and with the private
organizations that predominantly fund these registries, to
convene a meeting to discuss coordination of all the Duchenne
patient registries to the extent possible. The Committee
requests an update on this topic in the fiscal year 2014
congressional budget justification.
Eating Disorders.--The Committee continues to be concerned
about the alarming effects of eating disorders on women's
health including elevated mortality rates and associated health
consequences, such as serious cardiac conditions, kidney
failure, gastrointestinal disorders, and osteoporosis. The
Committee urges NIH to expand, intensify, and coordinate its
activities with respect to research on eating disorders and to
examine the possibility of creating collaborative consortia on
eating disorders research with a specific emphasis on basic and
clinical investigations into the causes, diagnosis, and
treatment of these conditions. The Committee requests an update
on this topic in the fiscal year 2014 congressional budget
justification.
Eosinophil-Associated Disorders.--The Committee is pleased
that a NIAID working group is developing a research agenda on
eosinophilic disorders. The Committee requests an update in the
fiscal year 2014 congressional budget justification regarding
programmatic initiatives being undertaken based on the working
group's recommendations. In addition to NIAID and NIDDK, the
Committee urges NHLBI, NICHD, NIMH, and other relevant
Institutes to participate in these efforts. Further, NIH should
seek opportunities to collaborate with private sector
organizations on this initiative.
False Positives and Replications.--The Committee supports
NIH's effort to develop a consensus on the issues of false-
positive research results. This effort will encourage policies
on the publishing of replications (and nonreplications) of
previous research and advance scientific knowledge.
Fragile X-Associated Disorders.--The Committee commends NIH
for the NICHD-led effort to update the NIH Research Plan on
Fragile X Syndrome and Associated Disorders in light of the
significant progress made toward targeted drug treatments since
the plan was published. The Committee urges NIH to fully
implement and prioritize the updated goals and objectives. In
particular, NIH is encouraged to support translational research
that shows significant promise of safer and more effective
treatments for Fragile X-associated disorders. The Committee
also encourages NIH to work with CDC to support and coordinate
Federal investments in data collection efforts related to
Fragile X.
Glomerular Disease.--The Committee continues to be
concerned about the impact of idiopathic nephrotic syndrome
[NS] and primary focal segmental glomerulosclerosis [FSGS]
within the minority community, particularly given the
increasing body of research linking FSGS to gene variants
predominately expressed in African Americans. The Committee
urges NIMHD to collaborate with NIDDK on NS and FSGS research.
The Committee commends ORDR for its support of the Nephrotic
Syndrome Rare Diseases Clinical Research Network and recognizes
the potential impact of this study for patients with NS and
FSGS and their families. Finally, the Committee urges NIDDK to
continue to support research on NS and FSGS in order to develop
treatments and cures that could ultimately prevent end-stage
renal disease.
Human Tissue Supply.--The Committee remains committed to
matching the increased needs of NIH-funded researchers, both
intramural and extramural, who rely upon human tissues and
organs to study human diseases, both common and rare, and who
strive to translate research advances and discoveries into
treatments and cures. Furthermore, the Committee recognizes
that the national demand for high-quality human biospecimens
will continue to grow, as will its importance to advancing
translational research across NIH. Therefore, the Committee
urges the Director to expand core and trans-NIH support for its
nationwide human tissue and organ procurement program.
Interstitial Cystitis [IC].--The Committee commends ORWH
for its support of research on IC. The Committee understands
that IC disproportionately affects women and encourages ORWH to
continue to work with NIDDK to support specialized centers of
research that serve as a valuable source of IC research.
Lupus.--Given the scope and impact lupus has on virtually
every organ system in the body, advances in lupus research
require studies that transcend multiple disciplines, including
genetics, basic and applied immunology, proteomics, and
therapeutics. Therefore, the Committee urges the establishment
of a trans-NIH coordinating committee on lupus that could focus
on developing a comprehensive NIH research strategy and
identifying gaps in lupus research.
Lymphatic Research and Lymphatic Disease.--The Committee
commends the trans-NIH Coordinating Committee for Lymphatic
Research [CCLR] for its efforts. As the Committee has
previously requested, more oversight and engagement are needed
by the Director and ICs to help make meaningful advances in
research of the lymphatic system and medical care for lymphatic
diseases. Furthermore, in keeping with the 2007 CCLR Working
Group recommendations, the Committee urges the CCLR to work
cooperatively to create interdisciplinary programs to train new
investigators, such as an annual primer course for doctoral and
postdoctoral candidates. The Committee also expects greater
involvement by NIBIB, especially in carrying forth the CCLR
Working Group quantitative and molecular imaging
recommendations. Finally, the Committee urges NCATS to provide
representation to the CCLR.
mHealth.--New mobile and wireless health technologies,
known as mHealth, are likely to have a profound impact on
biomedical research and the delivery of healthcare. The
Committee applauds OBSSR for leading efforts to systematically
evaluate the impact of new technologies. The Committee is
pleased that virtually all of the NIH Institutes and NSF are
collaborating in this area.
Minority Researchers.--The Committee is deeply concerned by
the findings of the recent study ``Race, Ethnicity, and NIH
Research Awards,'' which shows a disparity in the rates at
which African Americans received NIH R01 grants. The Committee
looks forward to the findings of the blue ribbon panel
examining this matter.
Mitochondrial Disease.--The Committee applauds the progress
that NIH has made to advance research on mitochondrial disease
and dysfunction. Among other activities, NICHD has worked to
cultivate new researchers in the field and, in collaboration
with ORDR and NINDS, continued support for the North American
Mitochondrial Disease Consortium. ORDR also convened a major
workshop with the participation of numerous ICs to identify
scientific opportunities and barriers to research advances. The
Committee requests that a strategy to implement the workshop
recommendations be developed.
Mucopolysaccharidoses [MPS].--The Committee encourages
NINDS, NICHD, NIDDK, NIAMS, and ORDR to continue to expand
research efforts in the development of effective treatments for
MPS. The Committee also urges all relevant ICs and ORDR to
continue funding research consortia and conferences on MPS and
other lysosomal diseases, such as the annual Lysosomal Disease
Network WORLD meeting and the Gordon research conference
scheduled for 2013. Finally, the Committee encourages NIAMS to
continue to support investigator-initiated research focused on
the skeletal complications associated with MPS.
National Children's Study.--The Committee is troubled that
after appropriating nearly $1,000,000,000 for the NCS since the
first work on it began in fiscal year 2000, only a few thousand
children have been enrolled and fundamental questions about the
project's implementation still remain, particularly regarding
the methods that will be used to recruit participants. The
Committee hopes that the budget request, a 15-percent reduction
below the fiscal year 2012 level, represents a positive sign
that NIH intends to bring the costs of the NCS under control
and spend its appropriation more efficiently.
NIH's recently announced plan to switch to a provider-based
rather than a household-based recruitment strategy will help
achieve some of the necessary savings and may offer scientific
benefits as well. At the same time, special efforts must be
made to ensure that the new strategy will not leave out
disadvantaged or underrepresented groups that are most
negatively affected by health disparities. Plans to collect
environmental as well as biological samples also should not be
sacrificed.
Most important, it remains unclear whether a provider-based
approach can accommodate the original goal of constructing a
national probability sample that could be generalized to the
entire U.S. population. The Committee believes NIH should make
every possible effort to fulfill that goal within a sustainable
long-term budget.
The Committee directs the Secretary to enter into an
agreement within 90 days of enactment of this act with the
National Academy of Sciences to review the NCS' sampling
strategy.
The Committee is also aware of the confusion and disruption
caused by NIH's decision to let the Vanguard Study contracts
expire--a decision that caught many academic institutions by
surprise. The Committee strongly urges NIH to improve its level
of communication with the research community about any future
changes to the project.
National Primate Research Centers.--The Committee supports
the NPRCs and expects they will receive the same level of
attention in the OD that they received in the now-dissolved
National Center for Research Resources.
Neurofibromatosis [NF].--The Committee continues to support
efforts to increase funding and resources for NF research and
treatment at multiple NIH Institutes, including NCI, NHLBI,
NINDS, NICHD, NIMH, NIDCD, NIAMS, NEI, and NHGRI. The Committee
requests brief updates on NF-related activities at these ICs in
the fiscal year 2014 congressional budget justification.
Overlapping Chronic Pain Conditions.--The Committee
recognizes that NIH has taken seriously its repeated calls for
an improved and expanded research effort to better understand
overlapping chronic pain conditions including chronic fatigue
syndrome, endometriosis, fibromyalgia, interstitial cystitis,
irritable bowel syndrome, chronic headache, temporomandibular
disorders, and vulvodynia. The Committee is aware that initial
progress is being made toward the development and
implementation of a trans-NIH research initiative to support
studies aimed at identifying etiological and mechanistic
pathways of these overlapping conditions, with a state of the
science meeting scheduled for summer 2012. The Committee hopes
that the meeting will lay out a clear and concrete set of
recommendations for an aggressive trans-NIH research agenda.
The Committee notes that the chronic pain conditions listed
above are also ideal candidates for inclusion in the Patient-
Reported Outcomes Measurement Information System, as many
chronic pain patients use multiple individualized approaches to
manage pain symptoms.
Pain.--The Committee commends NIH for its efforts so far to
respond to the IOM report ``Relieving Pain in America: A
Blueprint for Transforming Prevention, Care, Education and
Research.'' For example, NIH has designated NINDS as the lead
Institute for coordinating pain research efforts across the
organization; selected a cadre of 11 Centers of Excellence for
Pain Education; begun to develop new informational material for
the public and medical professionals on pain conditions; and
instituted more frequent meetings of the NIH Pain Consortium.
The Committee strongly urges NIH to expand on such efforts
while giving appropriate attention to overlapping chronic pain
conditions that solely or disproportionately impact women. The
Committee believes that pain research would be an appropriate
subject for inclusion in the Common Fund, as advances in this
area would benefit all Institutes. Finally, the Committee
agrees with the IOM report recommendation that NIH increase
financial resources and staffing support for the Pain
Consortium.
Pediatric Low Grade Astrocytoma [PLGA].--The Committee is
encouraged by advancements in research on slow-growing
children's brain tumors but remains concerned by the long-term
physical and cognitive disabilities caused by surgery,
chemotherapy, and radiation treatments for PLGA children. The
Committee urges NIH to establish a special emphasis panel with
a focus on identifying and validating new therapeutic targets
in these tumors. Research should emphasize the development of
novel preclinical models of pediatric brain tumors (both mouse
and other nonmammalian models), novel drug development and
testing, target identification and validation, and improved
drug delivery modalities. The Committee requests an update on
these topics in the fiscal year 2014 congressional budget
justification.
Pregnancy Health Status.--Epidemiologic studies have shown
that a woman's health status during pregnancy is associated
with her health after pregnancy, suggesting that findings in
pregnancy may be a better indicator for determining a woman's
future health status than traditional risk factors. The
Committee encourages NICHD, NHLBI, and NIDDK to work together
to more closely study these epidemiologic findings in an effort
to identify predictive markers during pregnancy for subsequent
heart disease and diabetes; develop tests to evaluate health
after pregnancy; and test interventions both during and after
pregnancy that may mitigate risk.
Rehabilitation Research.--The Committee recognizes and
supports efforts of the Blue Ribbon Panel on Medical
Rehabilitation Research to identify gaps in rehabilitation
research. The Committee believes that the panel's findings
warrant meaningful steps by the Director to enhance the stature
of, and emphasis is on, medical rehabilitation and disability
research at NIH.
Sex-Based Biology.--It is now more than 10 years since the
IOM report ``Exploring the Biological Contributions to Human
Health: Does Sex Matter?'' confirmed that biological
differences between males and females affect health, burden of
disease, healthcare, and health outcomes, but significant
disparities continue to exist. Understanding the basic biology
of the impact of sex/gender in development, diagnosis, and
treatment of disease could help improve the health of women.
Therefore, the Committee urges NIH to analyze sex at all levels
of biomedical research, including the basic animal and cellular
levels, and to form interdisciplinary teams of basic and
clinical investigators interested in unraveling the biology of
sex differences.
Sleep Disorders.--The Committee recognizes that sleep or
circadian disorders impact conditions such as hypertension,
diabetes, obesity, heart attack, and stroke. The Committee
urges implementation of the National Sleep Disorders Research
Plan's recommendations for the continuation of multi-Institute
research collaborations to address such conditions.
Tox21 Program.--The Committee supports NIH's leadership
role in the Tox21 program, a collaborative effort with the EPA
and the FDA to adopt advanced molecular biological and
computational methods in lieu of animal toxicity tests for
conducting chemical risk assessments. The Committee encourages
NIH to continue to expand its extramural support for the use of
human biology-based experimental and computational approaches
in health research to further define toxicity and disease
pathways and develop tools for their integration into
evaluation strategies. Extramural and intramural funding should
be made available for the evaluation of the relevance and
reliability of Tox21 methods and prediction tools to assure
readiness and utility for regulatory purposes, including pilot
studies of pathway-based risk assessments. The Committee asks
NIH to provide a report on fiscal year 2012 and 2013 funding
for these activities in the fiscal year 2014 congressional
budget justification.
Tuberous Sclerosis Complex [TSC].--The Committee
understands that TSC is the largest single genetic cause of
more prevalent neurological disorders such as autism and
epilepsy and therefore encourages NINDS to focus resources on
new drug targets for TSC and encourages NINDS and NIMH to focus
resources on clinical trials for TSC. Because TSC impacts tumor
growth and health of multiple organ systems, including skin,
lung, kidney, and brain, the Committee encourages NCI, NIAMS,
NHLBI, NIDDK, NINDS, NICHD, and ORDR to focus resources on
methods to detect and treat manifestations of TSC in these
organ systems.
Underrepresented Groups in Science.--The Committee commends
OBSSR for its work to establish a comprehensive and cohesive
process to track the efforts of government, universities,
private foundations, and associations to enhance minority
participation in the sciences.

OFFICE OF AIDS RESEARCH

OAR coordinates the scientific, budgetary, legislative, and
policy elements of the NIH AIDS research program. The Committee
recommendation does not include a direct appropriation for OAR.
Instead, the Director of OAR and the Director of NIH together
determine the total for AIDS research within the total NIH
appropriation, and the Director of OAR determines and allocates
distribution of those funds to the ICs and OAR. The
recommendation includes a general provision permitting the NIH
Director and 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 commends NIH for supporting the AIDS and non-
AIDS funding allocations at their current relative rates and
endorses the continuation of this policy. The Committee
recognizes that OAR's AIDS allocation to each IC is based on
scientific need and opportunity. Therefore, individual IC AIDS
budgets may not each grow at the same rate, but total AIDS and
non-AIDS funding will continue to grow at a comparable rate.
The Committee includes bill language permitting OAR to use
up to $8,000,000 for construction or renovation of National
Primate Research Centers. This amount is the same as the fiscal
year 2012 level and the budget request.

BUILDINGS AND FACILITIES

Appropriations, 2012.................................... $125,308,000
Budget estimate, 2013................................... 125,308,000
Committee recommendation................................ 125,308,000

The Committee recommendation includes $125,308,000 for NIH
buildings and facilities. This funding will remain available
for obligation for 5 years, as in the fiscal year 2012 bill.
The budget request proposes making the funding available until
expended.

Substance Abuse and Mental Health Services Administration

The Committee recommends $3,472,213,000 for SAMHSA. The
recommendation includes $129,667,000 in transfers available
under section 241 of the PHS Act. The comparable level for
fiscal year 2012 is $3,476,682,000 and the administration
request is $3,316,266,000. In addition, the Committee
recommends transferring $88,000,000 to SAMHSA from the PPH
Fund. The total program level assumed in this bill for SAMHSA
is $3,560,213,000.
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 continues to provide funding for Programs of
Regional and National Significance [PRNS] under each of
SAMHSA's statutorily created centers and directs that SAMHSA
shall account for all of its PRNS funding in this manner, which
shall include future budget requests. SAMHSA's authorization
states that the agency's work to improve the provision of
mental health and substance abuse services shall be established
and carried out by the agency's three centers. Therefore,
SAMHSA shall account for the funding for all of its programs,
contracts and activities through the accounts, budget line
items, and categories identified in this act and the
accompanying Senate report. The Committee requests that the
fiscal year 2014 congressional justification include budgetary
and programmatic information on programs as they existed in
fiscal year 2013, even if the budget request proposes a new
structure or consolidation in fiscal year 2014.
The Committee is extremely concerned that the increases
provided to the Community Mental Health Services Block Grant
[MHBG] and SAPT Block Grant in last year's conference report
were eroded by the administration's decision to tap 1.25
percent of both block grants for program evaluation transfers
pursuant to section 241 of the PHS Act. In prior years the
administration has exempted these block grants from being used
as a source for these evaluation transfers. The Committee
directs SAMHSA and the Department to exempt these two programs
from being used as a source for PHS evaluation transfers in
fiscal year 2013, as was done prior to fiscal year 2012.

CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2012.................................... $953,859,000
Budget estimate, 2013................................... 923,895,000
Committee recommendation................................ 968,497,000

The Committee recommends $968,497,000 for mental health
services. The recommendation includes $21,039,000 in transfers
available under section 241 of the PHS Act. In addition, the
Committee recommends transferring $45,000,000 to CMHS from the
PPH Fund. The total program level assumed in this bill for CMHS
is $1,013,497,000. Included in the recommendation is funding
for programs of regional and national significance, the MHBG,
children's mental health services, PATH, and PAIMI.

Programs of Regional and National Significance

The Committee recommends $270,394,000 for PRNS within CMHS.
The comparable level for fiscal year 2012 is $275,756,000 and
the administration request is $219,550,000. In addition, the
Committee recommends that $45,000,000 be transferred to PRNS
from the PPH Fund. The total program level assumed in this bill
for PRNS at CMHS is $315,394,000. These programs address
priority mental health needs through developing and applying
evidence-based practices, offering training and technical
assistance, providing targeted capacity expansion grants, and
changing the delivery system through family, client-oriented,
and consumer-run activities.
Within the total provided for PRNS, the Committee
recommendation includes funding for the following activities:

Child Trauma.--The Committee reiterates its strong support
for the National Child Traumatic Stress Initiative [NCTSI] and
its work on behalf of children, families, and communities
affected by a wide range of trauma, including physical and
sexual abuse, natural disasters, sudden death of a loved one,
and the impact of war on military families. The Committee
provides $48,713,000 under section 582 of the PHS Act to
support the continuance of the current model and mission of the
NCTSI by providing grants to the National Center for Child
Traumatic Stress [NCCTS] and academic, clinical, and community-
based centers for the purposes of developing knowledge of best
practices, offering trauma training to child-serving providers,
and providing mental health services to children and families
suffering from PTSD and other trauma-related disorders. The
Committee is aware that SAMHSA is developing a new definition
of trauma-informed services to be used by NCTSI grantees and
expects to be informed of any major changes before they are
implemented.
The Committee also recognizes the extraordinary value of
the core data set developed by the NCCTS. Within the total
provided, the Committee provides $1,500,000 to the NCCTS for
the targeted collection of new outcome data from selected NCTSI
centers and related analyses and reports.
Minority Fellowship Program.--The Committee continues to be
concerned that while minorities represent 30 percent of the
population and are projected to increase to 40 percent by 2025,
only 23 percent of recent doctorates in psychology, social
work, and nursing were awarded to minorities. The Committee
has, therefore, continued funding at last year's level for the
Minority Fellowship Program.
Primary and Behavioral Healthcare Integration.--The
Committee continues to direct SAMHSA to ensure that new
Integration grants awarded for fiscal year 2013, from both
discretionary and PPH funds, are funded under the authorities
in section 520K of the PHS Act.
Project LAUNCH.--The Committee intends that funds provided
to Project LAUNCH not duplicate activities eligible for funding
elsewhere in the Department. The Committee reiterates its
intention that funds provided to this program focus on mental
health promotion and promotion strategies for children aged 0
to 8.
Seclusion and Restraint.--The Committee recommends
$2,444,000 for seclusion and restraint activities at CMHS. The
Committee is deeply concerned that a recent Department of
Education report showed that tens of thousands of students with
disabilities are physically restrained in school systems across
the country. There are also widespread media reports of persons
with mental illnesses and developmental disabilities living in
congregate care facilities who are subject to excessive use of
seclusion and restraint causing psychological trauma, serious
physical injury, and even death. The Committee urges SAMHSA to
partner with other Federal agencies to reduce and ultimately
eliminate the use of seclusion and restraints in institutional,
community, and educational settings, and to promote evidence-
based alternatives to restraint and seclusion, including the
use of positive behavioral interventions and supports.
Suicide Prevention in Indian Populations.--The Committee
remains concerned about the high incidence of drug and alcohol
abuse and suicide in American Indian populations. SAMHSA is
encouraged to continue its efforts in providing culturally
competent suicide prevention training courses to selected
gatekeepers in Indian country. These courses should teach
community leaders, school personnel, and families how to
identify and talk with at-risk individuals to motivate them to
seek help. Courses should also include mental health support
services information tailored to the specific geographical
location of the participants in each program. The Committee
further urges SAMHSA to collaborate with the Indian Health
Service to identify priority communities and help ensure
sustainability within American Indian/Alaska Native
communities.

Community Mental Health Services Block Grant

The Committee recommends $479,756,000 for the MHBG. The
comparable fiscal year 2012 funding level and the
administration request is $459,756,000. The recommendation
includes $21,039,000 in transfers available under section 241
of the PHS Act.
The MHBG distributes funds to 59 eligible States and
territories through a formula based on specified economic and
demographic factors. Grant 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.
The Committee provides an increase to the MHBG in
recognition of the severe budget cuts taking place to State and
local mental health services and facilities nationwide. At the
same time, public mental health systems are reporting an
increase in demand for services. The MHBG is the primary source
of financial support for evidence-based, comprehensive services
for low-income and uninsured persons living with serious mental
illnesses. Increased funding for this safety net program is
needed to meet the growing demand for services resulting from
the economic downturn, as well as the mental healthcare needs
of returning Iraq and Afghan war veterans and their families.

Children's Mental Health Services

The Committee recommends $117,315,000 for the children's
mental health services program. This amount is the same as the
comparable fiscal year 2012 level. The administration request
is $88,557,000. This program provides grants and technical
assistance to support a network of community-based services for
children and adolescents with serious emotional, behavioral, or
mental disorders. Grantees must provide matching funds and
services must be coordinated with the educational, juvenile
justice, child welfare, and primary healthcare systems.
The Committee rejects the administration's proposed cut to
this important program. The Committee notes that in the United
States every year 5,000 young people between the ages of 14 and
24 commit suicide, and 600,000 make an attempt that is serious
enough to require an emergency room visit. Furthermore, the
Committee understands that 75 percent of psychiatric illness
occurs before the age of 24. This public health crisis is
exacerbated by the fact that there are only 7,500 child and
adolescent psychiatrists and 3,500 child psychologists
nationwide to treat this vulnerable population. The Committee
encourages SAMHSA to seek innovative means to increase the
number of children's mental health professionals, including
efforts to develop bachelor's degree and master's level
training curricula focusing on evidence-based interventions.

Projects for Assistance in Transition From Homelessness

The Committee recommends $64,794,000 for PATH. This amount
is the same as the comparable fiscal year 2012 level and the
administration request. PATH addresses the needs of individuals
with serious mental illness who are experiencing homelessness
or are at risk of homelessness. Funds are used to provide an
array of services, such as screening and diagnostic services,
emergency assistance, case management, and referrals to the
most appropriate housing environment.

Protection and Advocacy for Individuals With Mental Illness

The Committee recommends $36,238,000 for PAIMI. This amount
is the same as the comparable fiscal year 2012 funding level
and the administration request. This program helps ensure that
the rights of mentally ill individuals are protected while they
are patients in all public and private facilities, or while
they are living in the community, including in their own homes.
Funds are allocated to States according to a formula based on
population and relative per capita incomes.

Mental Health State Prevention Grants

The Committee recommendation does not include funding
requested by the administration to create the Mental Health
State Prevention Grant program. The administration requests
$55,000,000 for this program, which would promote the wellness
of children, youth, and young adults up to age 25. Rather than
create a new program, the Committee has provided increases to
the MHBG and to the SAPT Block Grant.

CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2012.................................... $2,200,574,000
Budget estimate, 2013................................... 2,187,270,000
Committee recommendation................................ 2,191,145,000

The Committee recommends $2,191,145,000 for substance abuse
treatment programs, including programs of regional and national
significance and the substance abuse prevention and treatment
block grant to the States. The recommendation includes
$81,200,000 in transfers available under section 241 of the PHS
Act. In addition, the Committee recommends transferring
$25,000,000 to CSAT from the PPH Fund. The total program level
assumed in this bill for CSAT in fiscal year 2013 is
$2,216,145,000.

Programs of Regional and National Significance

The Committee recommends $370,813,000 for PRNS within CSAT.
The comparable fiscal year 2012 level is $400,242,000 and the
administration request is $334,139,000. The recommendation
includes $2,000,000 in transfers available under section 241 of
the PHS Act. In addition, the Committee recommends transferring
$25,000,000 to PRNS from the PPH Fund. The total program level
assumed in this bill for PRNS in fiscal year 2013 is
$395,813,000.
Programs of regional and national significance include
activities to increase capacity by implementing service
improvements using proven evidence-based approaches as well as
science-to-services activities that promote the identification
of practices thought to have potential for broad service
improvement.
Within the total provided for PRNS, the Committee
recommendation includes funding for the following activities:

Addiction Technology Transfer Centers [ATTCs].--The
Committee continues to direct SAMHSA to ensure that ATTCs
maintain a primary focus on addiction treatment and recovery
services in order to strengthen the addiction workforce. As
more individuals become eligible for substance abuse services
through Medicaid and private insurance, the ATTC network is
critical to ensure there are enough skilled workers to meet the
demand in substance use disorder services.
Addiction Workforce.--As the provision of quality substance
use disorder services is dependent on an adequate, qualified
workforce and SAMHSA is the lead Federal agency charged with
improving these services, the Committee directs SAMHSA to
continue to focus on developing the addiction workforce and
identifying ways to address the current and future workforce
needs of the addiction prevention, treatment, and recovery
fields.
Drug Treatment Courts.--The Committee continues to direct
SAMHSA to ensure that all funding appropriated for drug
treatment courts is allocated to serve people diagnosed with a
substance use disorder as their primary condition. In addition,
the Committee urges CSAT to ensure that State substance abuse
agencies are eligible to apply for all drug treatment court
grant programs in its portfolio. The Committee expects CSAT to
ensure that non-State substance abuse agency applicants for any
drug treatment court grant in its portfolio continue to
demonstrate evidence of working directly and extensively with
the corresponding State substance abuse agency in the planning,
implementation, and evaluation of the grant.
Hepatitis Testing.--The Committee notes the high incidence
of hepatitis among injection drug users and urges SAMHSA to
implement viral hepatitis testing as a standard of care in
drug-treatment programs, consistent with the HHS Action Plan
for the Prevention, Care and Treatment of Viral Hepatitis. The
Committee encourages SAMHSA to use established best practices
for infectious disease testing, including rapid tests.
HIV Testing.--The Committee urges SAMHSA to expand
voluntary routine HIV-testing services at substance abuse and
mental health treatment clinics, consistent with the National
HIV/AIDS Strategy Implementation Plan. The Committee requests
an update on the implementation of these activities in SAMHSA's
fiscal year 2014 congressional budget justification.
Minority AIDS.--The Committee is concerned by SAMHSA's
proposal to transfer funds to CMHS from the Minority Aids
Initiative [MAI] administered by CSAT. According to NIDA, 1 in
4 of those living with HIV in 2009 reported use of alcohol or
drugs at a level that warranted treatment. In addition,
research shows alcohol and drug use are major risk factors for
HIV/AIDS. The Committee directs SAMHSA to maintain funding for
CSAT's MAI and to focus on building capacity and outreach
efforts to individuals with, or at risk of developing, a
primary substance use disorder and to improve efforts to
identify such individuals to prevent the spread of the disease.
Oral Fluid Testing.--The Committee commends SAMHSA for
updating its substance abuse testing guidelines to include oral
fluid and encourages the agency to continue to advance oral
fluid testing guidelines.
Screening, Brief Intervention, and Referral to Treatment
[SBIRT].--The Committee continues to direct SAMHSA to ensure
that funds provided for SBIRT are used for existing evidence-
based models of providing early intervention and treatment
services to those at risk of developing substance abuse
disorders.

Substance Abuse Prevention and Treatment Block Grant

The Committee recommends $1,820,332,000 for the SAPT block
grant. The comparable funding level for fiscal year 2012 is
$1,800,332,000. The administration request is $1,448,630,000.
The recommendation includes $79,200,000 in transfers available
under section 241 of the PHS Act. 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 a formula.
The Committee rejects, as it did last year, the
administration's request for a waiver of the statutory
requirement that 20 percent of the SAPT block grant be set
aside for substance abuse prevention. The administration
proposes to reallocate these set-aside funds to a new Substance
Abuse State Prevention Grant program. The Committee remains
concerned that creating another State grant program with new
requirements would represent an unnecessary and burdensome
approach and would not support services being delivered on a
continuum of prevention, treatment, and recovery support
services.

Substance Abuse State Prevention Grants

As explained above, the Committee recommendation does not
include funding to create Substance Abuse State Prevention
Grants. The administration request is $404,501,000 for this
program, which did not receive funding in fiscal year 2012.

CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2012.................................... $185,956,000
Budget estimate, 2013................................... 58,877,000
Committee recommendation................................ 184,433,000

The Committee recommends $184,433,000 for CSAP, the sole
Federal organization with responsibility for improving
accessibility and quality of substance abuse prevention
services.

Programs of Regional and National Significance

The Committee provides $184,433,000 for PRNS within CSAP.
Through these programs, 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.
Within the total provided for PRNS, the Committee
recommendation includes funding for the following activities:

The Committee recommendation includes funding for the
Strategic Prevention Framework State Incentive Grant/
Partnerships for Success [SPFSIG/PFS] programs at last year's
level. The Committee is disappointed that the agency did not
follow its direction in last year's statement of the managers
regarding these programs. Although Congress rejected the
administration's proposed cut for fiscal year 2012 and level-
funded the SPFSIG/PFS programs, SAMHSA did not use funding from
expiring grants to reinvest in new SPFSIG/PFS awards, as
envisioned by Congress. Rather, SAMHSA proposed a new 1-year
Prevention Achievement Grant program, which was not adequately
described and for which no funding was explicitly appropriated
by Congress. The Committee believes that by issuing 1-year
grants and making frequent changes to its prevention programs,
SAMHSA makes it difficult for States to plan and build
capacity. In addition, with youth drug use rates increasing and
perceptions of harm decreasing, especially for marijuana,
SAMHSA's lack of long-term vision for prevention funding is
deeply troubling.
The Committee reiterates its strong support for SPFSIG/PFS
programs, which are promising approaches to preventing the
onset and reducing the progression of substance abuse,
including childhood and underage drinking. The Committee
intends that continuation awards for SPFSIG/PFS grantees should
be made at amounts no less than what grantees received in
fiscal year 2012. Furthermore, SAMHSA shall use any additional
funding to provide new grants under SPFSIG/PFS. The Committee
intends that these new grants shall be awarded as the program
was originally designed prior to fiscal year 2011, with similar
eligible applicants, a multiyear project period, reliance on
epidemiological workgroups, and financial incentives for
grantees that meet performance targets. The Committee expects
SAMHSA to awards these multiyear grants on an annual,
incremental basis rather than fully funding them in fiscal year
2013.
The Committee recognizes substance abuse prevention as a
unique and distinct field and urges SAMHSA to promote
programming consistent with this finding. The Committee intends
that funds specifically appropriated for bona fide substance
abuse and underage drinking prevention purposes shall not be
consolidated with, reallocated to, or used for any other
programs or initiatives in SAMHSA which do not have youth drug
and underage alcohol abuse as a primary purpose, even if these
other programs may have secondary effects on these goals.
Underage Drinking.--The Committee provides a total of
$5,000,000 for Sober Truth on Preventing Underage Drinking
[STOP] Act Community Based Coalition Enhancement Grants. The
Committee understands that building on the infrastructure of
current and past Drug Free Communities grantees is the most
effective way to invest limited Federal dollars to deal with
underage drinking issues at the community level.

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2012.................................... $136,293,000
Budget estimate, 2013................................... 119,657,000
Committee recommendation................................ 128,138,000

The Committee recommends $128,138,000 for health
surveillance and program support activities. The recommendation
includes $27,428,000 in transfers available under section 241
of the PHS Act. In addition, the Committee recommends
transferring $18,000,000 to this account from the PPH Fund. The
total program level assumed in this bill for health
surveillance and support is $146,138,000.
This activity supports Federal staff and the administrative
functions of the agency. It also provides funding to SAMHSA's
surveillance and data collection activities, including national
surveys such as the National Survey on Drug Use and Health.
The Committee directs SAMHSA to provide within 90 days of
enactment of this act a report to Congress that describes:
SAMHSA's proposed plan for implementing its Behavioral Health
Quality Plan, including any proposed changes or additions to
current outcome data measures for both discretionary grants and
the SAPT Block Grant, including the use of dashboards; a
description of the extent to which SAMHSA is coordinating the
development of outcome measures with other HHS agencies,
specifically CMS; and the extent to which SAMHSA has sought and
received stakeholder input on changes to data collection and
outcome measures.

Agency for Healthcare Research and Quality

Appropriations, 2012.................................... $369,053,000
Budget estimate, 2013................................... 334,357,000
Committee recommendation................................ 364,053,000

The Committee provides $364,053,000 for AHRQ through
transfers available under section 241 of the PHS Act. In
addition, the Committee recommends transferring $12,000,000 to
AHRQ from the PPH Fund. The total program level assumed in this
bill for AHRQ is $376,053,000.
AHRQ was established in 1990 to enhance the quality,
appropriateness and effectiveness of health services, as well
as access to such services. In order to fulfill this mission,
AHRQ conducts, supports, and disseminates scientific and
policy-relevant research on topics such as reducing medical
errors, eliminating healthcare disparities, using information
technology, and comparing the effectiveness of drugs and
medical procedures. AHRQ-supported research provides valuable
information to researchers, policymakers, healthcare providers,
and patients on ways to improve our Nation's health system and
make healthcare more affordable.

HEALTH COSTS, QUALITY, AND OUTCOMES

The Committee provides $236,331,000 for research on health
costs, quality, and outcomes [HCQO]. The comparable funding
level for fiscal year 2012 is $235,768,000 and the
administration request is $206,635,000. In addition, the
Committee recommends that $12,000,000 be transferred to HCQO
from the PPH Fund. The total program level assumed in this bill
for HCQO is $248,331,000. The HCQO research activity is focused
upon improving clinical practice, improving the healthcare
system's capacity to deliver quality care, and tracking
progress toward health goals through monitoring and evaluation.
Within the total provided for HCQO, the Committee
recommendation includes funding for the following activities:

Within the Prevention portfolio, the Committee recommends
that $5,000,000 from the PPH Fund be transferred to support the
Research Centers for Excellence in Clinical Preventive
Services. The Committee also recommends $7,000,000 in PPH Fund
transfers to support the work of the USPSTF.
Broadening the Evidence Base.--AHRQ's research portfolio
focuses predominantly on patient safety and healthcare quality.
The Committee urges AHRQ to develop a more balanced research
agenda, supporting all aspects of healthcare research outlined
in its statutory mission, including: the cost and utilization
of, and access to, healthcare; and the ways in which healthcare
services are organized, delivered, and financed.
Healthcare Delivery Systems.--The Committee notes that
identifying and disseminating improvements to the design of
hospital rooms and healthcare facilities has the potential to
prevent medical errors, reduce associated costs, and save
lives. Within the Patient Safety portfolio, the Committee
includes $4,000,000 for research grants authorized by section
933 of the PHS Act. These grants will provide for the creation
of multi-disciplinary teams, consisting of patients and their
families, clinicians, technology experts, and engineers, to
develop and test interventions that improve the safety of
healthcare services as well as improve accountability and
value. This is a new activity that was not funded in fiscal
year 2012. The administration did not request funding for this
activity.
Investigator-Initiated Research.--The Committee continues
to prioritize investments in investigator-initiated research,
which forms the backbone of AHRQ's ability to improve
healthcare with creative and innovative approaches to ongoing
and emerging healthcare issues. Within the Crosscutting
Activities portfolio, the Committee provides $43,364,000, the
same amount as the fiscal year 2012 level, for investigator-
initiated research. The administration request is $29,259,000
for this research. The recommended funding level will allow
ARHQ to support new investigator-initiated research grants to
advance discovery and the free marketplace of ideas.
Maternal-Fetal Medicine.--The practice of maternal-fetal
medicine has made great strides. The Committee encourages AHRQ,
in collaboration with NICHD, to conduct clinical comparative
effectiveness research to guide best practices and clinical
management. Special emphasis should be placed on the use of
progesterone, when to use it and in whom, as well as on
research that will provide guidance on optimal timing of
delivery for maternal and fetal conditions.
Medication Therapy Management.--The Committee recognizes
the importance of medication therapy management [MTM] as a
critical component of primary care services. In order to
further integrate MTM services into primary care, the Committee
encourages AHRQ to perform a systematic review that includes:
the breadth and context of MTM services, a synthesis of what is
currently known about the comparative effectiveness of MTM
programs and program components, and a delineation of the gaps
in the existing evidence base.
Moving Research Into Practice.--Health services research
has great potential to improve health and healthcare when
widely disseminated and used. The Committee continues to
support AHRQ's research translation activities, including
practice-based research centers and learning networks that are
designed to better understand healthcare delivery and quickly
move the best available research and decisionmaking tools into
healthcare practice.
Quality Measure Development.--The Committee notes that
there are significant gaps in the quality measures that
determine whether Americans are receiving good healthcare.
Strong, patient-centered quality measures that fill in current
gaps will enable the evaluation and reduction of geographic
variations in care quality and health disparities while
improving the delivery of healthcare services, patient health
outcomes, and population health. For this reason, the Committee
recommendation includes $4,000,000 within the Crosscutting
portfolio for AHRQ, in consultation with CMS, to develop
quality measures as authorized under section 931 of the PHS
Act. This is a new activity that was not funded in fiscal year
2012. The administration did not request funding for this
activity.
Scientific Freedom in Contracted Research.--The Committee
continues to be concerned that contractual prior restraint
clauses on the publication of research may inadvertently stifle
scientific freedom and hinder the dissemination of findings
that can inform health policymaking. The Committee urges AHRQ
to ensure that researchers have the opportunity to publish
research findings in peer-reviewed journals without
unreasonable restrictions to allow greater review and input
from the scientific community.
Training Grants.--The Committee is concerned about declines
in the number of, and funding for, training grants for the next
generation of researchers. Within the Crosscutting Activities
portfolio, the Committee provides $2,250,000 for new, competing
pre- and post-doctoral training grants. The comparable funding
level for fiscal year 2012 is $1,500,000. The administration
request did not include funding for new training grants.

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $59,300,000, the same as the
administration request and the comparable funding level for
fiscal 2012, for Medical Expenditure Panel Surveys [MEPS].
These surveys collect detailed information annually from
households, healthcare providers, and employers regarding how
Americans use and pay for healthcare. The data from MEPS are
used to develop estimates of healthcare utilization,
expenditures, sources of payment, and the degree of health
insurance coverage of the U.S. population.

PROGRAM SUPPORT

The Committee recommends $68,422,000 for program support.
This amount is the same as the administration request. The
comparable funding level for fiscal year 2012 is $73,985,000.
This activity funds the overall management of AHRQ, including
salaries, benefits, and overhead costs such as rent. The
Committee recommendation will support 305 FTEs, the same level
as fiscal year 2012. The Committee recommendation does not
include funding for tenant improvement costs associated with
AHRQ's relocation. As requested by the administration, funding
associated with a new long-term lease for AHRQ is included in
the Office of the Secretary account.

Centers for Medicare and Medicaid Services

GRANTS TO STATES FOR MEDICAID

Appropriations, 2012

$184,279,110,000

Budget estimate, 2013

178,791,197,000
Committee recommendation
178,791,197,000

The Committee recommends $178,791,197,000 in mandatory
funding for grants to States for Medicaid.
The fiscal year 2013 recommendation excludes
$90,614,082,000 in fiscal year 2012 advance appropriations for
fiscal year 2013. As requested by the administration,
$106,335,631,000 is provided for the first quarter of fiscal
year 2014.
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 that determines
the appropriate Federal matching rate for State program costs.
This matching rate is based on the State's average per capita
income relative to the national average and cannot be less than
50 percent.

PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2012

$230,741,378,000

Budget estimate, 2013

251,718,000,000
Committee recommendation
251,718,000,000

The Committee recommends $251,718,000,000 in mandatory
funding for payments to healthcare trust funds.
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 provides $189,520,000,000 for the Federal
payment to the Supplementary Medical Insurance Trust Fund. This
payment provides matching funds for premiums paid by Medicare
part B enrollees. The Committee further provides
$60,744,000,000 for the general fund share of benefits paid
under Public Law 108-173, the Medicare Prescription Drug,
Improvement and Modernization Act of 2003. As in previous
years, 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 Committee recommendation also includes $424,000,000 to
be transferred to the Supplementary Insurance Trust Fund as the
general fund share of part D administrative expenses. The
Committee recommendation includes $610,000,000 in
reimbursements to the HCFAC fund.

PROGRAM MANAGEMENT

Appropriations, 2012.................................... $3,820,112,000
Budget estimate, 2013................................... 4,820,808,000
Committee recommendation................................ 4,370,112,000

The Committee recommends $4,370,112,000 for CMS program
management.

Research, Demonstrations, and Evaluations

The Committee recommends $23,900,000 for research,
demonstrations, and evaluation activities. The comparable level
for fiscal year 2012 is $21,160,000. The administration
requests $24,600,000, funded within program operations. The
Committee includes sufficient funding to fulfill the
President's request for the Medicare Current Beneficiaries
Survey, the Research Data Assistance Center, public use data
files, and Medicaid Analytic Data.
CMS research and demonstration activities expand efforts
that improve the efficiency of payment, delivery, access, and
quality of the Medicare and Medicaid programs.
Food Allergies.--In the United States, a patient visits an
emergency department every 3 minutes for the treatment of a
food-related allergic reaction. The Committee believes that
proper management of food allergies could improve patient
outcomes, reduce costs, and decrease the incidence of
preventable death. The Committee encourages CMS to consider
food allergy patients in other disease management pilot
programs.

Program Operations

The Committee recommends $3,156,045,000 for program
operations. The comparable funding level for fiscal year 2012
is $2,608,785,000 and the budget request is $3,618,487,000.
The program operations account 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.
The Committee includes additional funding for program
operations above the fiscal year 2012 level to help support the
work required of CMS to implement PPACA.
PPACA requires CMS in fiscal year 2013 to support States as
they attempt to meet the January 1, 2014, deadline for a viable
State-based health insurance exchange. The Committee
recommendation includes funding to provide technical assistance
to States, design and build the Federal fall-back exchange,
educate Americans on the availability of subsidies, and develop
systems to determine eligibility and protect the private health
information of those who apply for health insurance through an
exchange.
The Committee recommendation also includes increased
funding for the National Medicare Education program. This
funding supports beneficiary materials, Internet sites, contact
centers and support services. The Committee notes that as the
baby boom generation ages into Medicare, the population of
Medicare beneficiaries will grow by 36 percent by the end of
this decade, according to Census estimates. With a record
number of Americans signing up for Medicare benefits, the
Committee recognizes the need to help them set up their
Medicare benefit plans and to modify beneficiary materials and
support systems according to the ways baby boomers are most
accustomed to accessing information.
Community First Choice Option.--The Committee commends CMS
on the completion of the final rule for the implementation of
the Community First Choice Option. The Committee directs CMS to
provide information to State Medicaid Directors about the
availability of the Community First Choice Option as a way to
help States meet their obligations to expand opportunities for
home and community based services for people with disabilities
under the Supreme Court's decision in Olmstead v. L.C. and the
Americans with Disabilities Act.
Continuous Oxygen Therapy.--The Committee continues to
encourage innovative and more cost-effective methods for
treating hard-to-heal wounds. The Committee appreciates CMS'
interest in commissioning a technology assessment through AHRQ
to review evidence on continuous oxygen delivery.
Health Insurance Literacy.--The Committee recognizes that
to most effectively implement PPACA in medically underserved
and at-risk communities, individuals with limited literacy and
numeracy skills will need special attention. The Committee
encourages CMS to work with experts to develop effective
programs to educate these consumers on their rights and the
resources available to help them access insurance coverage.
Healthcare Integrated General Ledger and Accounting System
[HIGLAS].--The Committee is pleased with the continued progress
being made to develop and fully implement HIGLAS using ongoing
funding from this appropriation. Over the past 7 years, at
least $467,000,000 in additional interest has been earned in
the Medicare Trust Funds as a result of HIGLAS implementation.
With deployment to 14 fee-for-service Medicare contractors and
19 Medicare administrative contractor sites, the program is on
schedule and within its budget. The Committee expects
deployment to continue as the remaining contractor sites are
brought onto the system, achieving 100 percent compliance. The
Committee requests that the fiscal year 2014 budget
justification include lessons learned in the implementation of
this program that may serve as a guide for other similar
efforts to implement automated systems using commercially
available software in the Federal Government.
Hepatitis Screening.--An estimated two-thirds of chronic
hepatitis C cases are baby boomers who are currently beginning
to enroll in Medicare in large numbers. Viral hepatitis is very
costly to treat when diagnosed in the later stages of the
disease. The Committee believes that opt-out hepatitis B and C
screenings at the Welcome to Medicare physical exam would
identify a significant number of beneficiaries with
asymptomatic liver disease and reduce Medicare costs overall.
The Committee encourages CMS to work with CDC to determine the
prevalence of viral hepatitis in the soon-to-enroll Medicare
population and to develop a cost-benefit analysis on this type
of screening.
Pediatric Dental Services.--Although virtually all dental
disease is fully preventable, tooth decay remains the most
common chronic illness among children and oral healthcare is
the most prevalent unmet healthcare need among children.
Currently, 34 States allow dental hygienists to provide dental
care outside of a dental office without a prior exam or pre-
authorization by a dentist. The Committee urges CMS to update
Medicaid dental regulations to reflect how dental services are
currently delivered in the majority of the country.
Rural Hospital Flexibility.--In 1997, Congress created the
Medicare Rural Hospital Flexibility Program for the purposes of
improving access to hospital and other health services for
rural residents. For those hospitals that did not meet the
requirement for a minimum distance to another hospital or
critical access hospital [CAH] of more than a 35-mile drive, or
a 15-mile drive based on mountainous terrain or areas with only
secondary roads, the program allowed a State to waive the
distance requirement for one or more facilities designated as a
necessary provider. The Committee requests a list of all CAH
facilities grandfathered into the program through the State
waiver system.
Vaccinations.--The Committee is concerned that the majority
of healthcare workers, who are at high risk of contracting
infectious disease, do not get regularly recommended
vaccinations. In addition, adult vaccination rates are
particularly low for minority groups. The Committee supports
efforts by CMS to incorporate seasonal influenza vaccination
rates into hospital payment updates and performance metrics and
urges CMS to require Medicare-certified hospitals to offer the
seasonal influenza vaccine to healthcare workers.

State Survey and Certification

The Committee recommends $375,203,000, the same as the
fiscal year 2012 level, for State survey and certification
activities. The administration's request is $387,353,000.
Survey and certification activities ensure that
institutions and agencies providing care to Medicare and
Medicaid beneficiaries meet Federal health, safety, and program
standards. On-site surveys are conducted by State survey
agencies, with a pool of Federal surveyors performing random
monitoring surveys.
The Committee encourages CMS to complete its efforts to
collect uniform staffing data based on payroll extracts from
skilled nursing facilities and nursing facilities reimbursed by
Medicare and Medicaid. The Committee requests an update from
CMS on its progress in the fiscal year 2014 budget
justification.

High-Risk Insurance Pools

The Committee includes $44,000,000, the same as the fiscal
year 2012 level, for high-risk insurance pools. The budget
request is $22,004,000.

Federal Administration

The Committee recommends $770,964,000, the same as the
fiscal year 2012 level, for Federal administration costs. The
budget request is $792,964,000.

HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2012.................................... $309,790,000
Budget estimate, 2013................................... 610,000,000
Committee recommendation................................ 610,000,000

The Committee recommends $610,000,000, to be transferred
from the Medicare trust funds, for health care fraud and abuse
control [HCFAC] activities.
The Committee recommendation includes a base amount of
$311,000,000 and an additional $299,000,000 through a budget
cap adjustment authorized by section 251(b) of the Balanced
Budget and Emergency Deficit Control Act of 1985.
This amount, in addition to the $1,296,665,000 in mandatory
monies for these activities, will provide a total of
$1,906,665,000 for HCFAC activities in fiscal year 2013.
Improper Payments.--The Committee is encouraged by the work
of the Medicare fee-for-service [FFS] Recovery Audit Contractor
[RAC] program. While there is clear value in rectifying
improper payments, the Committee feels strongly that a larger
benefit of the Medicare FFS RAC program lies in its ability to
help identify potential vulnerabilities in the payment system.
The list of potential vulnerabilities, which CMS identifies
from RAC reports, allows CMS to make system changes that can
prevent improper payments in the future. Unfortunately, in
2010, a GAO report found that CMS has no formal process in
place to ensure that RAC-identified vulnerabilities are
addressed. The Committee directs CMS to include in its annual
report to Congress an accounting of reported vulnerabilities
each fiscal year broken down by type of improper payment,
including the number of vulnerabilities identified; the
financial cost of the vulnerabilities reported; the number that
have been addressed with a change to the system; the number
that have a system change identified but are waiting for the
change to be made; the number that CMS has decided a system
change is unfeasible; and the number that are waiting CMS
review.
Senior Medicare Patrol [SMP].--The Committee strongly
supports the SMP, administered by ACL with historical financial
assistance from CMS. The Committee is concerned that the return
on investment [ROI] calculation included in the performance
metrics of the program does not adequately reflect outcome data
on SMP fraud referrals. The Committee requests that a more
accurate ROI calculation be developed for this important
program. The Committee further directs CMS, ACL, DOJ, and HHS
OIG to work to improve the process of informing beneficiaries
and volunteers when their tips result in a conviction, a
recovery, or a change to Medicare policies.
Transparency Reporting.--The Committee urges CMS to ensure
transparency and accountability through the accurate reporting
of transfers of value from drug, device, and group purchasing
industries to physicians and teaching hospitals. The Committee
encourages CMS to finalize procedures to comply with section
6002 of PPACA in time to require data collection in 2013. The
Committee supports the statutory goal of posting payment
reports information on a public Web site no later than
September 30, 2014.

Administration for Children and Families

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS

Appropriations, 2012.................................... $2,847,514,000
Budget estimate, 2013................................... 2,756,485,000
Committee recommendation................................ 2,756,485,000

The Committee recommends $2,756,485,000 in fiscal year 2013
mandatory funds for payments to States for child support
enforcement and family support programs. In addition, the
Committee recommends $1,100,000,000 in advance funding for the
first quarter of fiscal year 2014, the same as the budget
request and the comparable advance provided last year for the
first quarter of fiscal year 2013.
These funds support States' efforts to promote the self-
sufficiency and economic security of low-income families,
including administrative expenses matching funds and incentive
payments to States for child support enforcement; grants to
States to help establish and administer access and visitation
programs between non-custodial parents and their children;
payments to territories for benefits to certain aged, blind, or
disabled individuals; and temporary benefits for certain
repatriated citizens.

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2012.................................... $3,471,672,000
Budget estimate, 2013................................... 3,020,000,000
Committee recommendation................................ 3,471,672,000

The Committee recommends $3,471,672,000 for LIHEAP. LIHEAP
provides home heating and cooling assistance to low-income
households, generally in the form of payments to energy vendors
on behalf of the recipient. The Committee recommendation
represents a 50-percent increase over the fiscal year 2008 non-
emergency funding level.

State Formula Block Grant

The Committee recommendation includes $3,371,672,000 for
the State formula block grant. The comparable fiscal year 2012
funding level is $3,471,672,000 and the budget request is
$2,820,000,000. The Committee maintains bill language that
allocates these funds to States based on the same formula
distribution that has been used since fiscal year 2009.
Within this amount, the Committee recommendation includes
up to $3,000,000, the same as the comparable fiscal year 2012
funding level and the budget request, for program integrity and
oversight efforts.

Contingency Fund

The Committee recommendation includes $100,000,000 for the
contingency fund. This program was not funded in fiscal year
2012; the budget request is $200,000,000. The contingency fund
supports grants to States that are adversely affected by
extreme heat or cold, energy prices, or other energy-related
emergencies. While average home energy costs for many
households decreased this past year, the costs for households
dependent on home fuel oil and other home-delivered fuels
remain at record levels. Low-income households dependent on
home-delivered fuels are also generally not protected by State
laws that prohibit utility companies from shutting off service
during the winter. Therefore, the Committee encourages HHS to
direct these funds to those States hit hardest by increases in
home energy costs and facing other energy-related emergencies.

REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2012.................................... $768,334,000
Budget estimate, 2013................................... 805,358,000
Committee recommendation................................ 805,358,000

The Committee recommends $805,358,000 for refugee and
entrant assistance programs. These programs provide a variety
of benefits and services to refugees, asylees, Cuban and
Haitian entrants, trafficking victims, and torture victims
(referred to below as ``refugees''). The programs also fund
temporary shelter and services for unaccompanied alien children
apprehended by law enforcement who are in Federal custody
awaiting adjudication of their immigration status.

Transitional and Medical Services

The Committee recommendation includes $343,000,000 for
Transitional and Medical Services [TAMS]. The comparable fiscal
year 2012 funding level is $323,195,000 and the budget request
is $403,000,000. TAMS provides grants to States and nonprofit
organizations to provide up to 8 months of cash and medical
assistance to incoming refugees as well as foster care services
to unaccompanied minors.
In fiscal year 2012 HHS reprogrammed $49,100,000 from TAMS
to the UAC program in response to a significant increase in the
number of unaccompanied alien children placed into HHS' care
through the first half of the year. This reprogramming will not
impact the TAMS program because the number of refugees arriving
in the United States has been significantly less than the
amount allowed under law, and assumed in the fiscal year 2012
appropriation. The Committee recommendation assumes current
trends will continue in fiscal year 2013 and the number of
refugees actually arriving in the United States will continue
to be less than the amount allowed under law. The Committee
will continue to work with HHS and revisit these estimates as
necessary.
Within the total, the Committee recommendation includes not
less than $65,000,000 for the voluntary agency matching grant
program, which provides grants to resettlement agencies to
support comprehensive services for arriving refugees, including
case management, job development, job placement, and interim
housing and cash assistance, with the goal of refugees becoming
self-sufficient within their first 4 months in the United
States. Refugees enrolled in this program are not eligible for
regular transitional and medical assistance. The Committee
continues to support the voluntary agency matching grant
program and encourages HHS to explore the continued expansion
of this program.

Victims of Trafficking

The Committee recommendation includes $9,775,000, the same
as the comparable fiscal year 2012 funding level and the budget
request, for the Victims of Trafficking program. This program
supports a national network for identifying, certifying, and
providing comprehensive services to international victims of
trafficking.

Social Services

The Committee recommendation includes $153,407,000, the
same amount as the budget request, for social services
programs. The comparable fiscal year 2012 funding level is
$115,107,000. These funds include formula and discretionary
grants to States and nonprofit organizations to provide a
variety of employment and support services to recently arrived
refugees.
In fiscal year 2012 HHS reprogrammed $38,300,000 from
social services to the UAC program in response to a significant
increase in the number of children placed into HHS' care
through the first half of the year. Discretionary social
services grants are typically awarded for a 12-month budget
period at the end of the fiscal year. Under this reprogramming,
discretionary grants will be awarded at the end of fiscal year
2012 but for a shorter budget period. This effectively shifts
the budget period for these grants from starting at the end of
the fiscal year to the middle of the fiscal year. The Committee
recommendation will allow eligible grants to be fully funded in
fiscal year 2013 for a 12-month budget period starting in the
middle of the fiscal year.
The Committee strongly encourages ORR to explore the use of
existing discretionary funds for case management services for
particularly vulnerable refugee populations. Refugees enrolled
in the matching grant program, which generally include those
refugees easiest to place in employment, have access to such
services but other refugees generally do not beyond their first
30 to 90 days in the United States. Intensive case management
services can help connect refugees to other support services
and provide a comprehensive approach to integration for those
that need it most.

Preventive Health

The Committee recommendation includes $4,730,000, the same
as the comparable fiscal year 2012 funding level and the budget
request, for preventive health services for refugees. This
program funds grants to coordinate and promote refugees' access
to health screening, treatment, and follow-up services.

Targeted Assistance

The Committee recommendation includes $48,401,000, the same
as the budget request, for targeted assistance for refugees.
The comparable fiscal year 2012 funding level is $20,201,000.
This program provides additional funds to States with an influx
of refugee arrivals and a high concentration of refugees facing
difficulties achieving self-sufficiency.
In fiscal year 2012 HHS reprogrammed $28,200,000 from the
targeted assistance program to the UAC program. As with social
services grants, targeted assistance grants are typically
awarded for a 12-month budget period at the end of the fiscal
year. Under this reprogramming, these grants will be awarded
for a shorter budget period, effectively shifting the budget
period from starting at the end of the fiscal year to the
middle of the fiscal year. The Committee recommendation will
allow eligible grants to be fully funded in fiscal year 2013
for a 12-month budget period beginning in the middle of the
fiscal year.

Unaccompanied Alien Children

The Committee recommendation includes $235,000,000 for the
UAC program. The comparable fiscal year 2012 funding level is
$284,281,000 and the budget request is $175,000,000. The UAC
program provides shelter and support services to unaccompanied
alien children apprehended in the United States by the
Department of Homeland Security or other law enforcement
agencies. Children are taken into HHS' care pending resolution
of their claims for relief under U.S. immigration law or
release to an adult family member or guardian.
If current trends continue, the number of children placed
into HHS' care could nearly double from around 8,000 in recent
years to over 14,000 in fiscal year 2012. To address this
increase, HHS reprogrammed a total of $115,600,000 to the UAC
program from other ORR programs in fiscal year 2012. A
significant amount of this increase was for emergency-related
costs associated with a sudden increase in children that
required HHS to quickly acquire shelter space. As HHS acquires
more permanent shelter space, these costs should decrease in
fiscal year 2013. The Committee recommendation provides an
increase over the budget request to support an increase in the
number of children being placed into HHS' care and will
continue to work with HHS to revise these estimates as
necessary.
Many of the children placed into HHS' care are victims of
abuse, neglect, or trafficking, or otherwise have physical or
mental health issues. The Committee is particularly concerned
about the impact this increase in children will have on the
availability of support services, including access to pro bono
legal representation, child advocates, social workers,
physicians, and psychologists. The Committee strongly supports
placing these children in areas where these vital services are
readily available. As HHS pursues additional shelter space, it
should provide assurances that children will have adequate
access to these services.
Within the total, the Committee provides $6,100,000 to
continue the pro bono legal services initiative to support
legal representation for both released and detained children.
These funds are to be used to train legal counsel to detect
abuse, mistreatment, labor exploitation, and trafficking of
these children.

Victims of Torture

The Committee recommendation includes $11,045,000 for the
Victims of Torture program. This amount is the same as the
comparable fiscal year 2012 funding level and the budget
request. This program provides treatment, social, and legal
services to victims of torture and training to healthcare
providers on treating the physical and psychological effects of
torture.

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2012.................................... $2,278,313,000
Budget estimate, 2013................................... 2,603,313,000
Committee recommendation................................ 2,438,313,000

The Committee recommends $2,438,313,000 for the CCDBG, a
State formula grant that provides financial assistance to low-
income families to help pay for child care and to improve the
quality of States' child care programs.
The Committee recommends that $90,000,000 of the increase
over the fiscal year 2012 level should be used for formula
grants to States, tribes, and territories to improve the
quality of the early childhood care and education workforce.
These funds should support activities such as training,
education, and other professional development (including
coaching, mentoring, and other on-site training and technical
assistance for staff) that are linked to a career pathway or
lattice; technical assistance to help providers become licensed
and comply with licensing and regulatory requirements;
scholarships for further education; and compensation
improvement (including rewards or bonuses) linked to increased
credential or degree completion. States should work with their
State Early Childhood Advisory Councils in coordinating these
activities. States should report on the number of providers and
staff, including by type of child care setting and age of
children served in the setting, that receive support through
these funds and the kind of support they receive. States
applying for these funds should also provide assurances that
funds will be prioritized first in areas with significant
concentrations of poverty and unemployment that lack access to
high-quality early care and education programs, or for
otherwise underserved populations such as children with
disabilities or special needs. Additionally, any use of child
assessments should conform to the recommendations of the
National Research Council's reports on early childhood and
assessment. Finally, these funds should be used to supplement
and not to supplant Federal, State, and local funds otherwise
used for these purposes.
The Committee recommends that the remaining $70,000,000
increase over the fiscal year 2012 level should be used for the
regular block grant. In recent years, many States have
struggled to maintain key child care policies and have
tightened eligibility requirements, added to waitlists,
increased family copayments, and left reimbursement rates for
providers stagnant. As a result, fewer families are receiving
assistance and many that do are struggling to find quality
affordable child care options. This increase will allow States
to increase the number of families served and generally improve
low-income families' access to quality affordable child care.
The Committee recommendation also maintains several
existing set-asides at their comparable fiscal year 2012
funding levels. The Committee recommendation includes
$19,396,000 for resource and referral programs and school-aged
child care activities. Of this amount $1,000,000 is specified
for a national toll-free referral line and Web site to provide
child care consumer education information to low-income
families, including information about the quality of child care
programs, such as information under a State or local quality
rating and improvement system, and information to help families
access available child care in their community through linkages
to State and local data sources. The Committee recommendation
also includes $9,871,000 for child care research and evaluation
activities. Finally, in addition to the funds specified above
for improving the quality of the early childhood workforce, the
Committee recommendation also maintains existing set-asides for
quality improvement activities. These quality improvement funds
are in addition to the 4-percent quality improvement set-aside
established in the authorizing legislation.
Tribes Participating in Public Law 102-477 Programs.--The
Committee appreciates the administration's response to concerns
raised in last year's Senate Committee report over the
imposition of additional reporting, auditing and accounting
requirements on ``477 tribes'', which includes the
administration of CCDBG funding. For 20 years tribes have
operated 477 programs and integrated employment, training, and
related services to improve the effectiveness of these services
and better serve tribal needs consistent with the policy of
self-determination. The Committee appreciates the importance of
ensuring appropriate transparency and accountability of Federal
funds but believes that requirements to separately report on
funding by CFDA numbers is contrary to the intent of section 14
of Public Law 102-477 and would impair the efficiency of the
477 initiative. The Committee appreciates that the
administration has accordingly suspended such requirements. The
Committee continues to believe that any reporting, accounting,
or auditing requirements to improve transparency and
accountability should be consistent with the intent of Public
Law 102-477 and should not impose unnecessary or burdensome
requirements on tribes and should be in response to specific
identified problems. The Committee expects the administration
to continue to work with the 477 Tribal Work Group so that any
new guidelines or requirements continue to promote tribal
flexibility in the administration of employment, training, and
related services under the 477 program. The Committee directs
HHS to provide a briefing to the Committees on Appropriations
of the House and the Senate by September 30, 2012 on the status
of the Tribal Work Group discussions.

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2012.................................... $1,700,000,000
Budget estimate, 2013................................... 1,700,000,000
Committee recommendation................................ 1,700,000,000

The Committee recommends $1,700,000,000 in mandatory funds
for the SSBG. This amount is the same as the comparable fiscal
year 2012 funding level and the budget request. The SSBG is a
flexible source of funding that allows States to provide a
diverse array of services to low-income children and families,
the disabled, and the elderly.
The Committee continues to regard the SSBG as a critical
source of funding for services that protect children from
neglect and abuse, including providing foster and respite care,
as well as related services for children and families, persons
with disabilities, and older adults. The Committee recognizes
the importance of this program, especially in providing mental
health and counseling services to underserved populations, and
recommends continued usage and flexibility of these funds for
such purposes.

CHILDREN AND FAMILY SERVICES PROGRAMS

Appropriations, 2012.................................... $9,734,982,000
Budget estimate, 2013................................... 9,515,657,000
Committee recommendation................................ 9,818,982,000

The Committee recommends $9,818,982,000 in budget authority
for children and families services programs. In addition, the
Committee recommends $5,762,000, the same as the comparable
fiscal year 2012 funding level and the budget request, in
transfers available under section 241 of the PHS Act. These
funds support a variety of programs for children, youth, and
families; the developmentally disabled; Native Americans;
victims of child abuse, neglect, and domestic violence; and
other vulnerable populations.

Head Start

The Committee recommendation includes $8,038,544,000 for
Head Start. The comparable fiscal year 2012 funding level is
$7,968,544,000 and the budget request is $8,054,000,000. Head
Start provides comprehensive early childhood education and
development services for low-income children and families,
focusing on cognitive and language development, socio-emotional
development, physical and mental health, and parental
involvement.
Within the total, the Committee recommendation includes up
to $25,000,000 for transition-related costs associated with the
Head Start Designation Renewal System [DRS]. The Committee
recommendation does not include bill language, requested by the
administration, making these funds available through fiscal
year 2014. In November 2011, carrying out provisions in the
Improving Head Start for School Readiness Act of 2007, ACF
published a final rule which requires grantees that do not meet
certain standards to re-compete for funding through the DRS. In
fiscal year 2012, over $1,200,000,000 in grants will be re-
competed, with new awards expected to be made in fiscal year
2013. These additional funds will support implementation of the
DRS and provide start-up related costs to new grantees to
minimize any disruption in services. In addition, the Committee
encourages HHS to consider the unique challenges faced by Head
Start grantees in remote and frontier areas when reviewing such
grantees' compliance with health and dental screening
requirements as part of the DRS.
The Committee recommendation also supports an approximately
0.6 percent cost-of-living adjustment for each grantee. This
will help defray rising operational costs so that grantees can
maintain services for the approximately 962,000 low-income
children and their families in Head Start programs.

Consolidated Runaway and Homeless Youth Program

The Committee recommendation includes $97,355,000, the same
as the fiscal year 2012 level and the budget request, for the
consolidated runaway and homeless youth program. This program
supports the Basic Centers program, which provides temporary
shelter, counseling, and after-care services to runaway and
homeless youth under age 18 and their families; the
Transitional Living Program, which provides longer-term shelter
and services for older youth; and a national toll-free runaway
and homeless youth crisis hotline.

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth

The Committee recommendation includes $17,901,000, the same
as the fiscal year 2012 level and the budget request, for
education and prevention grants to reduce sexual abuse of
runaway and homeless youth. This program provides competitive
grants for street-based outreach and education services for
runaway and homeless youth who are subjected to or are at risk
of being subjected to sexual abuse or exploitation.

Child Abuse Prevention and Treatment State Formula Grants

The Committee recommendation includes $26,432,000 for child
abuse prevention and treatment State formula grants. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request. This program provides formula
grants to States to improve their child protective service
systems.

Child Abuse Prevention and Treatment Discretionary Activities

The Committee recommendation includes $25,744,000 for child
abuse prevention and treatment discretionary activities. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request. This program supports
discretionary grants for research, demonstration, and technical
assistance to increase the knowledge base of evidence-based
practices and to disseminate information to State and local
child welfare programs.

Child Abuse Prevention and Treatment Community-Based Grants

The Committee recommendation includes $41,527,000 for child
abuse prevention and treatment community-based grants. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request. This program provides formula
grants to States that then disburse funds to local, community-
based organizations to improve local child abuse prevention and
treatment efforts, including providing direct services and
improving the coordination between State and community-based
organizations.

Abandoned Infants Assistance

The Committee recommendation includes $11,553,000 for the
Abandoned Infants Assistance program. This amount is the same
as the comparable fiscal year 2012 funding level and the budget
request. This program provides discretionary grants to public
and private community and faith-based organizations to develop,
implement, and operate demonstration projects that prevent the
abandonment of infants and young children impacted by substance
abuse and HIV. Funds may be used to provide respite care for
families and caregivers, allow abandoned infants and children
to reside with their natural families or in foster care, and
carry out residential care programs for abandoned infants and
children who are unable to reside with their families or be
placed in foster care.

Child Welfare Services

The Committee recommendation includes $280,650,000 for
child welfare services. This amount is the same as the
comparable fiscal year 2012 funding level and the budget
request. This formula grant program helps State and tribal
public welfare agencies improve their child welfare services
with the goal of keeping families together. States and tribes
provide a continuum of services that prevent child neglect,
abuse or exploitation; allow children to remain with their
families, when appropriate; promote the safety and permanence
of children in foster care and adoptive families; and provide
training and professional development to the child welfare
workforce.

Child Welfare Research, Training, and Demonstration

The Committee recommendation includes $31,092,000, the same
as the budget request, for child welfare research, training,
and demonstration projects. The comparable fiscal year 2012
funding level is $26,092,000. This program provides grants to
public and nonprofit organizations for demonstration projects
that encourage experimental and promising types of child
welfare services, as well as projects that improve education
and training programs for child welfare service providers.
The Committee recommends an increase of $5,000,000, as
requested by the administration, to enhance efforts to prevent
domestic child sex trafficking and improve services for child
victims of sex trafficking. These funds will be used to train
and build capacity in existing organizations that come into
contact with at-risk youth, such as child welfare agencies,
foster group homes, runaway and homeless youth programs, law
enforcement, and courts, to better identify and serve this very
vulnerable population.
The Committee has previously encouraged ACF to work with
ACL and other HHS agencies to evaluate intergenerational
approaches for improving outcomes for at-risk youth and
families. The Committee is particularly interested in
initiatives that are place-based and leverage the service of
older volunteers with supportive housing. Such initiatives have
demonstrated potential to reduce demand for social services
while improving the health and well-being of participating
seniors by increasing their civic and societal engagement. The
Committee strongly encourages HHS to use existing discretionary
resources for such initiatives to support intermediary and
community-based organizations developing projects that
demonstrate this approach.

Adoption Opportunities

The Committee recommends $39,179,000 for the Adoption
Opportunities program. This amount is the same as the
comparable fiscal year 2012 funding level and the budget
request. The Adoption Opportunities program funds discretionary
grants to help facilitate the elimination of barriers to
adoption and provide technical assistance to help States
increase the number of children adopted, particularly children
with special needs.
Consistent with the reauthorization of this program, the
Committee continues to expect that these funds will focus on
facilitating the adoption of older children, minority children,
and children with special needs. Specifically, the Committee
expects HHS to focus new grants on strengthening postadoption
services and the recruitment of adoptive parents for these
populations of children.

Adoption Incentives

The Committee recommends $39,346,000 for adoption
incentives. This amount is the same as the comparable fiscal
year 2012 funding level and the budget request. This program
provides incentive payments to States based on a formula in law
to encourage States to increase the number of adoptions of
children from the foster care system, with an emphasis on
children who are the hardest to place. If the payments due to
States are higher than the amount of funds available, the
payments are reduced on a pro rata basis based on the amount
available.

Social Services and Income Maintenance Research

The Committee recommends $5,762,000, the same as the fiscal
year 2012 level, for social services and income maintenance
research. This entire amount is funded through transfers
available under section 241 of the PHS Act, the same as in
fiscal year 2012. The budget request is $13,762,000, of which
$5,762,000 is funded through transfers available under the PHS
Act. These funds support research and evaluation of cost-
effective programs that increase the stability and economic
independence of American families, and contribute to the
healthy development of children and youth.
Due to budget constraints, the Committee recommendation
does not include a $3,000,000 increase requested by the
administration for an early childhood care and education
research and evaluation study. Similarly, the Committee
recommendation does not include a $5,000,000 increase requested
by the administration for a new initiative to improve services
for disconnected youth. However, the Committee does include a
new general provision on Performance Partnerships involving
disconnected youth. This new bill language provides the
Departments of HHS, Education, and Labor flexibility to
encourage local and State-level innovation among programs
serving disconnected youth.

Developmental Disabilities

In fiscal year 2012 HHS moved the administration of
developmental disabilities programs from ACF to the newly
established ACL. The Committee supports this administrative
change and funds these programs within ACL in fiscal year 2013.

Voting Access for Individuals With Disabilities

In fiscal year 2012 HHS moved the administration of the
voting access for individuals with disabilities program from
ACF to ACL. The Committee supports this administrative change
and funds this program within ACL in fiscal year 2013.

Native American Programs

The Committee recommends $48,583,000 for Native American
programs. This amount is the same as the comparable fiscal year
2012 funding level and the budget request. These funds support
a variety of programs to promote self-sufficiency and cultural
preservation activities among Native American, Native Hawaiian,
Alaska Native, and Pacific Islander organizations and
communities.
Within the total, the Committee recommendation includes
$12,000,000 for Native American language preservation
activities, including no less than $4,000,000 for language
immersion programs authorized by section 803C(b)(7)(A)-(C) of
the Native American Programs Act, as amended by the Esther
Martinez Native American Language Preservation Act of 2006. The
Committee continues to strongly encourage ACF to give priority
to grantees with rigorous immersion programs.

Community Services Block Grant

The Committee recommendation includes $677,358,000, the
same as the comparable fiscal year 2012 funding level, for the
Community Services Block Grant [CSBG]. The budget request is
$350,000,000. The CSBG is a formula grant 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. States are
required to pass on at least 90 percent of these funds to local
community-based organizations, the vast majority of which are
community action agencies.
The Committee continues to strongly support this program,
which provides critical flexible funding for local
organizations that serve as a central source of assistance for
low-income populations. These local organizations typically
administer larger Federal programs such as Head Start and
LIHEAP. The CSBG provides critical funding to support the
administration of these programs at the local level, as well as
flexible funding to fill in service gaps and meet the
particular needs of local communities.

Community Economic Development

The Committee recommendation includes $29,943,000 for the
community economic development program. This amount is the same
as the comparable fiscal year 2012 funding level and the budget
request. This program provides grants to community development
corporations to support employment and business development
opportunities for low-income individuals.
Within the total for community economic development, the
Committee recommendation includes up to $10,000,000 for the
Healthy Foods Financing Initiative [HFFI]. This amount is the
same as the comparable fiscal year 2012 funding level and the
budget request. The HFFI is a joint initiative with the
Department of Agriculture and Department of the Treasury to
provide financial and technical assistance to community
development financial institutions, nonprofit organizations,
and businesses to expand access to healthy foods in low-income
and underserved communities.

Rural Community Facilities

The Committee recommendation includes $5,981,000 for the
rural community facilities program. The comparable fiscal year
2012 funding level is $4,981,000; the budget request eliminates
funding for this program. The rural community facilities
program provides grants to regional nonprofit organizations to
provide training and technical assistance to low-income rural
communities in developing and managing safe and affordable
water and wastewater treatment facilities. These funds support
projects in communities that generally cannot access resources
and services through similar programs at the Department of
Agriculture and the Environmental Protection Agency.

Assets for Independence

The Committee recommendation includes $19,869,000 for the
Assets for Independences [AFI] program. This amount is the same
as the comparable fiscal year 2012 funding level and the budget
request. The AFI program provides discretionary grants to
organizations to support individual development accounts that
encourage low-income individuals to create savings accounts for
dedicated purposes, such as buying a home, paying for college,
or starting a business.
In addition, the Committee recommendation includes new bill
language requested by the administration that will allow HHS to
recapture unused funds by grantees and reallocate them to new
or existing projects. AFI grantees are required to match
individual savings with equal amounts of Federal and non-
Federal funds. Grantees have 5 years to expend funds but some
have struggled to encourage enough savings or to provide a
sufficient match to be able to expend their full grant during
that time. This new language will allow HHS to recapture after
3 years unused funds that HHS determines grantees will be
unable to spend within their grant period and award it to other
organizations.
The Committee also includes new bill language requested by
the administration providing for a $1,000,000 evaluation of
individual development account demonstration projects through
the AFI program.

Domestic Violence Hotline

The Committee recommendation includes $4,197,000 for the
national domestic violence hotline. The comparable fiscal year
2012 funding level is $3,197,000 and the budget request is
$4,500,000. This national, toll-free hotline provides
information and assistance to victims of domestic violence 24
hours a day.

Family Violence Prevention and Services

The Committee recommendation includes $133,547,000 for
family violence prevention and services programs. The
comparable fiscal year 2012 funding level is $129,547,000 and
the budget request is $135,000,000. These funds support
programs to prevent family violence and provide immediate
shelter and related assistance for victims of domestic violence
and their dependents. The Committee recommends an increase for
this program, as well as for the national domestic violence
hotline, to respond to an increase in demand for emergency
domestic violence shelter services over the last several years.
According to a 2011 survey of over 1,700 domestic violence
programs, on any given day 67,000 victims receive services but
an additional 10,000, including 6,700 requesting emergency or
transitional housing, are turned away because of a lack of
resources.

Education and Training Vouchers

The Committee recommendation includes $45,174,000 for
education and training vouchers for foster care youth. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request. This program supports vouchers of
up to $5,000 per year for expenses related to postsecondary
education and vocational training for foster care youth up to
21 years of age.

Disaster Human Services Case Management

The Committee recommends $1,992,000 for disaster human
services case management. This amount is the same as the
comparable fiscal year 2012 funding level and the budget
request. This program assists States in establishing the
capacity to provide case management services in a timely manner
in the event of a disaster. It ensures that States are able to
meet social service needs during disasters by helping disaster
victims prepare recovery plans, referring them to service
providers and FEMA contacts in order to identify needed
assistance, and providing ongoing support and tracking through
the recovery process.

Program Administration

The Committee recommendation includes $201,645,000 for ACF
program administration, which supports the administration of
all ACF programs. The comparable fiscal year 2012 funding level
is $198,645,000 and the budget request is $206,447,000. These
amounts have been adjusted to reflect the move of the
Administration on Developmental Disabilities to the new ACL.
The Committee recommends an increase for program
administration to support the implementation of the new Head
Start Designation Renewal System as described earlier under the
Head Start heading.

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2012.................................... $408,065,000
Budget estimate, 2013................................... 408,065,000
Committee recommendation................................ 408,065,000

The Committee recommends $408,065,000 for promoting safe
and stable families. The Committee recommendation includes
$345,000,000 in mandatory funds authorized by the Social
Security Act and $63,065,000 in discretionary appropriations.
This program supports activities that can prevent the
emergence of family crises that might require the temporary or
permanent removal of a child from his or her home. Grants allow
States to operate coordinated programs of family preservation
services, time-limited family reunification services,
community-based family support services, and adoption promotion
and support services.

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2012.................................... $5,153,000,000
Budget estimate, 2013................................... 4,810,000,000
Committee recommendation................................ 4,810,000,000

The Committee recommends $4,810,000,000 in mandatory funds
for payments for foster care and permanency. In addition, the
Committee recommends $2,200,000,000, the same as the budget
request, in advance mandatory funding for the first quarter of
fiscal year 2014. The comparable advance provided last year for
the first quarter of fiscal year 2013 is $2,100,000,000. These
funds support programs that assist States with the costs of
maintaining eligible children in foster care, prepare children
for living on their own, assist relatives with legal
guardianship of eligible children, and find and support
adoptive homes for children with special needs.
The Committee recommendation includes a program level of
$4,143,000,000, the same as the budget request, for foster care
programs. The comparable fiscal year 2012 program level is
$4,288,000,000. This program provides matching reimbursement
funds for State costs associated with operating and managing
their foster care programs.
The Committee recommendation includes a program level of
$2,537,000,000, the same as the budget request, for adoption
assistance. The comparable fiscal year 2012 program level is
$2,495,000,000. The adoption assistance program provides funds
to States for maintenance payments and the nonrecurring costs
of adoption for children with special needs. The goal of this
program is to facilitate the adoption of hard-to-place children
in permanent homes and thus prevent long, inappropriate stays
in foster care.
The Committee recommendation includes a program level of
$140,000,000 for the independent living program. This amount is
the same as the comparable fiscal year 2012 program level and
the budget request. The independent living program provides
services to foster children under 18 and foster youth ages 18
to 21 to help them make the transition to independent living by
engaging in a variety of services including educational
assistance, life skills training, and health services. States
are awarded grants based on their share of the number of
children in foster care, subject to a matching requirement.
The Committee recommendation includes a program level of
$90,000,000, the same as the budget request, for the
guardianship assistance program. The comparable fiscal year
2012 program level is $80,000,000. This program provides
assistance payments to relatives taking legal guardianship of
eligible children who have been in foster care.

Administration for Community Living

AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2012.................................... $1,697,264,000
Budget estimate, 2013................................... 2,152,712,000
Committee recommendation................................ 1,708,105,000

The Committee recommends an appropriation of $1,708,105,000
for ACL, which includes $52,115,000 in Medicare trust funds. In
addition, the Committee recommends that $17,000,000 be
transferred to ACL from the PPH Fund. The total program level
assumed in this bill for ACL is $1,725,105,000.
ACL was established by HHS in April 2012 with the goal of
increasing access to community supports for older Americans and
people with disabilities. This new agency was created by
combining the organizational components of AoA, the HHS Office
on Disability, and the Administration on Developmental
Disabilities. ACL is charged with administering programs
authorized under the Older Americans Act [OAA] and the
Developmental Disabilities Act, as well as promoting community
living policies throughout the Federal Government for older
Americans and people with disabilities.

Home and Community-Based Supportive Services

The Committee recommends an appropriation of $366,916,000
for home- and community-based supportive services program. This
amount is the same as the comparable funding level for fiscal
year 2012 and the administration request. This program provides
formula grants to States and territories to fund a wide range
of social services that enable seniors to remain independent
and in their homes for as long as possible. State agencies on
aging award funds to designated area agencies on aging that, in
turn, make awards to local service providers. This activity
supports services such as transportation, adult day care,
physical fitness programs, as well as in-home assistance such
as personal care and homemaker assistance.

Preventive Health Services

The Committee recommends $20,945,000 for preventive health
services. This amount is the same as the comparable funding
level for fiscal year 2012 and the administration request. This
program funds activities that help seniors stay healthy and
avoid chronic disease, thus reducing the need for costly
medical interventions. The Committee continues language from
the fiscal year 2012 bill requiring States to use these funds
for interventions that are evidence-based and effective, such
as enhanced fitness and wellness programs, depression
screening, and medication management programs. These evidence-
based prevention programs have been shown through randomized-
controlled trials to be effective at helping older adults
improve their health status and lower their use of healthcare
services.

Protection of Vulnerable Older Americans

The Committee recommends $21,797,000, the same as the
comparable level for fiscal year 2012 and the administration
request, for grants to States for protection of vulnerable
older Americans. This activity funds the long-term care
ombudsman program and 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 other long-term care facilities, while the elder
abuse prevention program targets the elderly community at
large.

National Family Caregiver Support Program

The Committee recommends $153,621,000 for the national
family caregiver support program. This amount is the same as
the comparable level for fiscal year 2012 and the
administration request. Funds appropriated for this activity
establish a multifaceted support system in each State for
family caregivers, allowing them to care for their loved ones
at home for as long as possible. States may use funding to
provide information to caregivers about available services,
assistance to caregivers in gaining access to services,
caregiver counseling and training, respite care to enable
caregivers to be temporarily relieved from their caregiving
responsibilities, and limited supplemental services that fill
remaining service gaps.

Native American Caregiver Support Program

The Committee recommendation includes $6,364,000 to carry
out the Native American caregiver support program. This amount
is the same as the comparable level for fiscal year 2012 and
the administration request. This program provides grants to
tribes for the support of American Indian, Alaskan Native, and
Native Hawaiian families caring for older relatives with
chronic illness or disability, as well as for grandparents
caring for grandchildren.

Congregate and Home-Delivered Nutrition Services

The Committee recommends an appropriation of $439,070,000
for congregate nutrition services and $216,831,000 for home-
delivered meals. Both amounts are the same as the comparable
funding levels for fiscal year 2012 and the administration
request.
These programs address the nutritional needs of older
individuals. Funded projects must make home-delivered and
congregate meals available at least once a day, 5 days a week,
and each meal must meet a minimum of one-third of daily dietary
requirements. While States receive separate allotments of funds
for congregate meals, home-delivered meals, and supportive
services, they have flexibility to transfer funds between these
programs.

Nutrition Services Incentives Program

The Committee recommendation includes $160,389,000 for the
nutrition services incentives program [NSIP]. This amount is
the same as the comparable funding level for fiscal year 2012
and the administration request. NSIP 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 $27,601,000 for grants to Native
Americans. This amount is the same as the comparable funding
level for fiscal year 2012 and the administration request.
Under this program, awards are made to eligible organizations
based on their share of Native Americans, Native Alaskans, and
Native Hawaiians aged 60 and over.

Aging Network Support Activities

The Committee recommends $7,873,000 for aging network
support activities. This amount is the same as the comparable
funding level for fiscal year 2012 and the administration
request. These funds support activities that 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, and provide technical assistance to agencies that
administer programs authorized by the OAA.
Within funding for aging network support activities, the
Committee provides $998,000 to continue the 24-hour call center
that provides Alzheimer's family caregivers with professional
care consultation and crisis intervention. This amount is the
same as the comparable funding level for fiscal year 2012 and
the administration request.
Mental Health.--The Committee notes that approximately 20
to 25 percent of older adults have a mental or behavioral
health problem, with White men aged 85 and older having the
highest rates of suicide of any group in the United States. The
Committee urges ACL to expand its efforts to address the mental
and behavioral health needs of older adults, including
implementation of the mental and behavioral health provisions
in the OAA. The Committee also urges ACL to designate an
officer responsible for administering mental health services
for older Americans.

Alzheimer's Disease Demonstration Grants to States

The Committee recommendation includes $4,011,000 for
Alzheimer's disease demonstration grants to States. This amount
is the same as the comparable funding level for fiscal year
2012. The administration request is $9,537,000. This program
funds competitive grants to States to test and implement new
models of care for individuals with Alzheimer's disease.

Lifespan Respite Care

The Committee recommends $4,990,000 for the Lifespan
Respite Care program. The comparable funding level for fiscal
year 2012 level and the administration request is $2,490,000.
The Lifespan Respite Care program provides grants to States to
expand respite care services to family caregivers, improve the
local coordination of respite care resources, and improve
access to and quality of respite care services, thereby
reducing family caregiver strain.
The Committee recognizes the essential role of family
caregivers who provide a significant proportion of our Nation's
health and long-term services and supports for the chronically
ill and aging. Respite care can provide family caregivers with
relief necessary to maintain their own health, bolster family
stability and well being, and avoid or delay more costly
nursing home or foster care placements. The Committee urges the
Secretary to ensure that State agencies, as well as aging and
disability research centers [ADRCs], use these funds to serve
all age groups, chronic conditions, and disability categories
equitably and without preference.

Chronic Disease Self-Management Program

The Committee recommends $10,000,000 be transferred from
the PPH Fund to ACL for the Chronic Disease Self-Management
Program [CDSMP]. This amount is the same as the comparable
funding level in fiscal year 2012 and the administration
request. This program assists those with chronic disease with
managing their conditions and improving their health status.
Topics covered by the program include nutrition, appropriate
use of medications, fitness, and effective communications with
healthcare providers. The Committee notes that the CDSMP has
been shown through multiple studies to result in significant
and measurable improvements in health and quality of life, as
well as reductions in hospitalizations and emergency room
visits.

Elder Falls Prevention

The Committee recommends that $7,000,000 in mandatory
funding be transferred from the PPH Fund for elder falls
prevention activities at ACL, in coordination with CDC. This is
a new activity that was not funded in fiscal year 2012. The
administration did not request funding for this program.
The Committee notes that falls are the leading cause of
fatal and nonfatal injuries for those 65 and older. Each year,
1-in-3 Americans aged 65 and older falls. Every 15 seconds, an
older adult is treated in the emergency room for a fall-related
injury. Preventing falls will help seniors stay independent and
in their homes, avoiding costly hospitalizations and hip
fractures, which frequently lead to nursing home placement. The
Committee intends that funds provided to ACL should be used for
public education about the risk of these falls, as well as
implementation and dissemination of community-based strategies
that have been proven to reduce the incidence of falls among
seniors.

Adult Protective Services Demonstrations

The Committee recommendation includes $8,000,000 for adult
protective services demonstrations. This amount is the same as
the administration request. This is a new program that did not
receive funding in fiscal year 2012. This program, as
established in the Elder Justice Act, will provide competitive
grants to States to test and evaluate innovative approaches to
preventing and responding to elder abuse.

Senior Medicare Patrol

The Committee recommends $9,402,000 for the Senior Medicare
Patrol [SMP] program. This amount is the same as the comparable
funding level for fiscal year 2012 and the administration
request. These funds support a network of retired senior
volunteers who educate older adults on preventing and
identifying healthcare fraud and abuse.
The Committee strongly supports the SMP program,
administered by ACL with historical financial assistance from
CMS. The Committee is concerned that the return on investment
[ROI] calculation included in the performance metrics of the
program does not adequately reflect outcome data on SMP fraud
referrals. The Committee requests that a more accurate ROI
calculation be developed for this important program. The
Committee requests that ACL, CMS, DOJ, and the HHS OIG work to
improve the process of informing beneficiaries when their tips
directly result in a conviction, a recovery, or a change to
Medicare policies.

Elder Rights Support Activities

The Committee recommends $4,088,000 for elder rights
support activities. This amount is the same as the comparable
funding level for fiscal year 2012 and the administration
request. This activity supports programs that provide
information, training, and technical assistance to legal and
aging services organizations in order to prevent and detect
elder abuse and neglect.

Aging and Disability Resource Centers

The Committee recommendation includes $6,457,000 for ADRCs.
This amount is the same as the comparable funding level for
fiscal year 2012. The administration did not request funding
for this program. ADRCs provide ``one stop shop'' entry points
into long-term care at the community level. The Committee
recommendation continues funding for this program in
recognition of the centers' role in providing access to a range
of home- and community-based resources that allow seniors and
individuals with disabilities to maintain their independence.

State Health Insurance Assistance Program

The Committee recommendation includes $52,115,000 for State
Health Insurance Assistance Programs [SHIPs], which provide
accurate and understandable health insurance information to
Medicare beneficiaries and their families. This is the same as
the comparable fiscal year 2012 level. The administration
request is $51,902,000. The Committee concurs with the
administration's proposal to transfer this grant program to ACL
from CMS and includes bill language that reflects this
transfer. The Committee notes that many SHIPs are already
housed in, or are partnered with, area agencies on aging.
Activities of the SHIPs are also aligned with ACL's mission to
develop a comprehensive system of home- and community-based
services to help seniors maintain their health and
independence.

Community Service Employment for Older Americans

The Committee recommendation does not include funding for
the CSEOA program in ACL, as proposed by the administration.
The administration request is $448,251,000 for this program.
The Committee continues to provide funding for this program in
the Department of Labor.

Developmental Disabilities State Councils

The Committee recommendation includes $74,774,000 for State
councils on development disabilities. This amount is the same
as the comparable fiscal year 2012 funding level and the budget
request. These State councils work to develop, improve, and
expand the system of services and supports for people with
developmental disabilities. By engaging in activities such as
training, educating the public, building capacity, and
advocating for change in State policies, these councils support
the inclusion and integration of individuals with developmental
disabilities in all aspects of community life.

Developmental Disabilities Protection and Advocacy

The Committee recommendation includes $40,865,000 for
protection and advocacy programs for people with developmental
disabilities. This amount is the same as the comparable fiscal
year 2012 funding level and the budget request. This formula
grant program provides funds to States to establish and
maintain protection and advocacy systems to protect the legal
and human rights of persons with developmental disabilities who
are receiving treatment, services, or rehabilitation.

Voting Access for Individuals With Disabilities

The Committee recommendation includes $5,235,000 for voting
access for individuals with disabilities. This amount is the
same as the comparable fiscal year 2012 funding level and the
budget request. This program provides grants to protection and
advocacy organizations to ensure that individuals with
disabilities have the opportunity to participate in every step
of the electoral process, including registering to vote,
accessing polling places, and casting a vote.

Developmental Disabilities Projects of National Significance

The Committee recommendation includes $8,317,000 for
projects of national significance to assist persons with
developmental disabilities. This amount is the same as the
comparable fiscal year 2012 funding level and the budget
request. This program funds grants and contracts that develop
new technologies and demonstrate innovative methods to support
the independence, productivity, and integration into the
community of persons with developmental disabilities.

University Centers for Excellence in Developmental Disabilities

The Committee recommendation includes $38,792,000 for
University Centers for Excellence in Developmental Disabilities
[UCEDDs]. This amount is the same as the comparable fiscal year
2012 funding level and the budget request. The UCEDD program
supports a network of 67 university-based centers that provide
interdisciplinary education, conduct research, and develop
model services for children and adults with disabilities. The
centers serve as the major vehicle to translate disability-
related research into community practice and to train the next
cohort of future professionals who will provide services and
supports to an increasingly diverse population of people with
disabilities.

Program Administration

The Committee recommends $29,652,000, the same as the
administration request, for program administration. The
comparable funding level for fiscal year 2012 is $29,311,000.
These levels have been adjusted for comparability to reflect
the administrative costs associated with the Administration for
Developmental Disabilities and the Office on Disability, which
are now part of ACL. These funds support salaries and related
expenses for program management and oversight activities.

Office of the Secretary

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2012.................................... $542,197,000
Budget estimate, 2013................................... 421,895,000
Committee recommendation................................ 535,639,000

The Committee recommends $535,639,000 for general
departmental management [GDM]. The recommendation includes
$69,211,000 in transfers available under section 241 of the PHS
Act. Funding levels have been adjusted to reflect the transfer
to ACL of the Office on Disability.
This appropriation supports activities that are associated
with the Secretary's role as policy officer and general manager
of the Department. It supports health activities performed by
the Office of the Assistant Secretary for Health [ASH],
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 Committee recommendation includes an increase of
$2,800,000, requested by the administration, for acquisition
reform activities. The Committee does not include funding for
abstinence-only education programs, consistent with the
administration request. The comparable fiscal year 2012 funding
level for abstinence-only education programs is $4,991,000.
The Committee recommendation includes $250,000 for
continued support of the Advisory Council on Alzheimer's
Research, Care, and Services.
Antimicrobial Resistance.--The Committee commends the work
of the Interagency Task Force on Antimicrobial Resistance
[ITFAR], particularly the final action plan, but is concerned
that the plan is missing measurable benchmarks and completion
deadlines. The Committee urges the Secretary to designate an
office and director within ASH or ASPR to lead the task force
and coordinate the Federal response. The Committee further
recommends that the task force work with non-government
antimicrobial resistance experts to help set priorities and
provide expert input on a routine basis.
Biovigilance Network.--The Committee recognizes the
leadership of ASH and the Office of Blood Safety and
Availability in coordinating efforts between CDC, FDA, NIH,
AHRQ, HRSA, and CMS, as well as experts in transfusion medicine
and blood banking, in the development and implementation of
surveillance systems to track medical errors and adverse events
occurring at any point in the collection, processing,
distribution, or transfusion of blood. The Committee urges ASH
to further these biovigilance efforts as a public/private
collaboration allowing for in-depth analysis of the data
collected as well as the development of interventions and best
practices that can be implemented to eliminate errors and
waste, thus improving patient health and safety and reducing
costs.
Drug Shortages.--The Committee urges the Secretary, in
consultation with FDA, to establish an interagency and intra-
agency task force to address drug shortages. The task force
should have stakeholder input, including an expert in how
shortages affect pediatric patients. The study should examine
whether other countries have experienced drug shortages, the
extent and effect of the shortages, as well as any steps these
countries are taking to mitigate or prevent such shortages.
Freely Associated States.--Pursuant to the Compact of Free
Association Act of 1985 (Public Law 99-239), and continued
under the Compact of Free Association Amendments Act of 2003
(Public Law 108-188), citizens of the FAS are accorded the
privilege of freely traveling and residing in the United States
without a set time limit. Upon arrival, FAS migrants often
arrive with serious medical needs, requiring acute care such as
dialysis and chemotherapy. As such, affected jurisdictions are
seeing an increase in the number of cases involving
tuberculosis, hepatitis, and sexually transmitted diseases
which is putting a further strain on already constrained public
health resources and education services. The Secretary is
directed to work within the National Security Council
Interagency Policy Committee on Freely Associated State Affairs
to implement an effective action plan that addresses some of
these issues. The Secretary should also provide effective
guidance and feedback to the island nations through the Joint
Economic Management Committee and Joint Economic Management
Financial Accountability Committee process by ensuring that
funds provided to the FAS nations are spent wisely to develop
capacity in the islands to promote economic development,
provide pre-health screenings, and to create an education
program to ensure that FAS migrants know what is expected of
them upon arrival to the affected jurisdictions.
Global Health Threats.--The Committee acknowledges the
urgent need for new technologies in the fight against global
health threats as well as the need to sustain and protect U.S.
investment in this important research. The Committee urges the
FDA, CDC, and NIH to each create metrics to measure progress
and to develop concrete plans to prioritize and incorporate
global health research, product development, and regulation
into the U.S. global health and development strategies, in line
with the new HHS Global Health Strategy.
Human Services Transportation.--The Committee
recommendation includes $1,000,000 for a competitive grant to
provide technical assistance to local government and nonprofit
transportation providers. This assistance should focus on the
most cost-effective ways to provide transportation assistance
and information to persons with disabilities. In addition,
because of rising fuel prices, such technical assistance should
include expanding the use of accessible, fuel-efficient taxi
service for persons with disabilities and those receiving
dialysis. Congress appropriated $998,000 for a similar purpose
in fiscal year 2012.
Overdose Prevention.--Accidental deaths from overdose,
particularly from prescription drugs such as opioids, are on
the rise and have become the leading cause of preventable death
for individuals under the age of 65 in the United States. The
Committee strongly encourages the Secretary to launch a public
awareness campaign to educate the public and health
professionals about the signs, symptoms, and risk factors for
overdose, as well as how individuals can make linkages to
recovery and treatment services. The Committee urges the
Secretary to develop the campaign with the participation of
Federal agencies including SAMHSA, NIDA, HRSA, FDA, and the
Office of National Drug Control Policy.
Pain Management.--A recent IOM report concluded that pain
represents a public health crisis that impacts more than 1 out
of every 3 adults, costs the American economy over
$560,000,000,000 in added healthcare costs and lost
productivity, and results in unnecessary human suffering. The
Committee requests that HHS develop a comprehensive plan with
specific goals, actions, and timeframes regarding reducing
barriers to pain management, educating the public, improving
professional education, and refocusing pain research efforts at
NIH. The Committee requests that this plan be submitted to the
House and Senate Committees on Appropriations by March 2013.
Traumatic Brain Injury [TBI].--The Committee notes that TBI
is a leading cause of death and disability worldwide,
especially in children and young adults ages 1 to 44. Due to
the high prevalence of TBI, the Committee believes there is a
need for multidisciplinary approaches to rapid evaluation and
diagnosis of injured patients who have the potential for the
development of TBI, as well as the development of early
intervention and treatment protocol for use in preventing TBI
and improving patient outcomes. The Secretary is encouraged to
support a competitively awarded program of academic centers
focused on developing and implementing multidisciplinary
approaches to the early diagnosis and innovative treatment
models for TBI victims.
Urban-Based Network.--The Committee continues to encourage
the Secretary and other agencies within the Department such as
HRSA, AHRQ, CDC, CMS, and OMH to partner with NIMHD in
supporting a network of urban-based institutions focused on,
and with demonstrated commitment and capacity to, addressing
recruitment and training needs of minority and urban
underserved populations and reducing health disparities in
these urban communities.

Teen Pregnancy Prevention

The Committee recommendation includes $113,047,000 for the
Teenage Pregnancy Prevention [TPP] program, which is the same
as the comparable funding level for fiscal year 2012. The
recommendation includes $8,455,000 in transfers available under
section 241 of the PHS Act. The administration requests
$109,022,000 for the TPP program, with $104,790,000 funded
through transfers from the PPH Fund.
This program supports competitive grants to public and
private entities to replicate evidence-based teen pregnancy
prevention approaches. The Committee recommendation includes
$4,000,000 to continue the Federal evaluation of the projects
funded by this program.

Office of Minority Health

The Committee recommends $55,782,000, the same as the
fiscal year 2012 funding level, for OMH. The administration
request is $41,100,000. OMH focuses on strategies designed to
decrease health 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. The Committee strongly urges continuation
of existing programs run by OMH to address health disparities
in rural and disadvantaged populations.
The Committee recommendation includes $1,000,000 to
continue the national health education program on lupus for
healthcare providers, with the goal of improving diagnosis for
those with lupus and reducing health disparities. This program
is intended to engage healthcare providers, educators, and
schools of health professions in working together to improve
lupus diagnosis and treatment through education.
Cancer in Asian/Pacific Islanders.--Asian and Pacific
Islanders [API] have a high incidence of stomach cancer and
liver cancers compared to Caucasians. The Committee continues
to urge the Department to focus on the unique and pressing
needs regarding cancer in the API population.
Chronic Kidney Disease [CKD].--The Committee continues to
prioritize early detection and treatment of CKD in minority
communities to improve health outcomes and eliminate health
disparities. In particular, the Committee urges the Department
to focus on the prevention of CKD in Filipino populations, who
have one of the highest rates of incidence per capita. The
Committee encourages OMH to partner with minority health
professions schools to educate providers on the benefits and
opportunities for early detection and treatment of CKD.
Health Disparities in Women.--Women of racial and ethnic
minorities face higher rates of obesity, cancer, diabetes,
heart disease, HIV/AIDS, and other diseases when compared with
white women. A disproportionately higher rate of preterm birth
exists among African-American women that cannot be accounted
for by known risk factors. The Committee encourages HHS to
conduct research into the causes of these health disparities
and develop and evaluate interventions to address these causes.
Hepatitis B.--The Committee urges OMH to expand hepatitis B
outreach and preventive programs specific to API and other
groups disproportionately affected by this disease.
Offices of Minority Health.--The Committee continues to be
encouraged by the Department's implementation of the Action
Plan to Reduce Racial and Ethnic Health Disparities, as well as
the National Stakeholder Strategy for Achieving Health Equity.
The Committee strongly supports the Offices of Minority Health
in the Office of the Secretary, AHRQ, CDC, CMS, FDA, HRSA, and
SAMHSA, which are charged with leading the strategy. The
Secretary is encouraged to work closely with communities, as
well as the public and private sectors, in this effort.

Office of Women's Health

The Committee recommends $29,120,000, the same as the
administration request, for OWH. The comparable level for
fiscal year 2012 is $33,682,000. OWH develops, stimulates, and
coordinates women's health research, healthcare services, and
public and healthcare professional education across the
Department. It advances important crosscutting initiatives and
develops public-private partnerships, providing leadership and
policy direction, and initiating and synthesizing program
activities to redress the disparities in women's health.
The Committee recommendation includes $3,010,000 to
continue the violence against women's initiative. This
initiative provides funding to public health programs that
integrate domestic and sexual violence assessment and
intervention into basic care, as well as encourages
collaborations between healthcare providers, public health
programs, and domestic and sexual violence programs.

HIV/AIDS in Minority Communities

The Committee recommends $53,681,000 for this program,
which addresses high-priority HIV prevention and treatment
needs of minority communities heavily impacted by HIV/AIDS. The
funding level provided is the same as the comparable level for
fiscal year 2012. The administration request is $53,891,000.
The Committee provides funding for this activity through budget
authority, rather than through transfers available under
section 241 of the PHS Act as requested by the administration.
These funds are available to key operating divisions of the
Department with expertise in HIV/AIDS services to assist
minority communities with education, community linkages, and
technical assistance.

Embryo Donation and Adoption

The Committee does not provide funding for embryo donation
and adoption awareness activities, consistent with the
administration request. The fiscal year 2012 funding level for
this program is $1,996,000. The Committee notes that this
program has had a limited number of applicants since its
inception and the administration has been unable to demonstrate
its effectiveness.

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2012.................................... $72,011,000
Budget estimate, 2013................................... 84,234,000
Committee recommendation................................ 79,908,000

The Committee provides $79,908,000 for OMHA. OMHA is
responsible for hearing Medicare appeals at the administrative
law judge level, which is the third level of Medicare claims
appeals. The Office ensures that Medicare beneficiaries who are
dissatisfied with the initial decisions about their benefits or
eligibility can appeal and exercise their right to a hearing in
front of an administrative law judge. The Committee
recommendation provides additional funding to OMHA to address
its growing backlog of cases and expand its capacity to
adjudicate Medicare appeals.

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2012.................................... $61,226,000
Budget estimate, 2013................................... 66,257,000
Committee recommendation................................ 66,257,000

The Committee makes available $66,257,000 to ONC, which
includes $49,842,000 in transfers available under section 241
of the PHS Act. ONC 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.

OFFICE OF INSPECTOR GENERAL

Appropriations, 2012.................................... $50,083,000
Budget estimate, 2013................................... 58,579,000
Committee recommendation................................ 55,483,000

The Committee recommends an appropriation of $55,483,000
for the HHS OIG. In addition to discretionary funds provided in
this act, the Health Insurance Portability and Accountability
Act of 1996 provides a permanent appropriation of $196,669,000
for OIG.
OIG conducts audits, investigations, and evaluations of the
programs administered by the Department's operating and staff
divisions, including the recipients of the Department's grant
and contract funds. In doing so, OIG addresses issues of waste,
fraud, and abuse and makes recommendations to improve the
efficiency and effectiveness of the Department's programs and
operations. The recommended increase over the fiscal year 2012
level should be used to support staff previously funded through
ARRA, who will be redirected toward other departmental
priorities.

OFFICE FOR CIVIL RIGHTS

Appropriations, 2012.................................... $40,938,000
Budget estimate, 2013................................... 38,966,000
Committee recommendation................................ 38,966,000

The Committee recommends $38,966,000 for OCR, which is
responsible for enforcing civil rights-related statutes in
healthcare 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.
OCR also has responsibility for implementing and enforcing
privacy protections under the HITECH Act.

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2012.................................... $497,350,000
Budget estimate, 2013................................... 527,151,000
Committee recommendation................................ 527,151,000

The Committee provides an estimated $527,151,000 in
mandatory funds for retirement pay and medical benefits for
commissioned officers of the U.S. Public Health Service [PHS].
This account provides for retirement payments to PHS officers
who are retired due to age, disability, or length of service;
payments to survivors of deceased officers; and medical care to
active duty and retired officers, as well as their dependents.

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2012.................................... $983,231,000
Budget estimate, 2013................................... 1,057,262,000
Committee recommendation................................ 1,020,220,000

The Committee recommends $1,020,220,000 for the Public
Health and Social Services Emergency Fund [PHSSEF]. This
appropriation supports the activities of ASPR and other
components within the Office of the Secretary to prepare for
the health consequences of bioterrorism and other public health
emergencies, including pandemic influenza. It also provides
funding for the Department's cybersecurity efforts.
The Committee does not support transferring additional
balances from Public Law 111-32, the Supplemental
Appropriations Act, 2009, to CDC as proposed by the
administration. The Committee believes that the remaining
supplemental funds should be used for the purposes for which
they were intended, namely increasing domestic influenza
vaccine production capacity, improving international pandemic
preparedness efforts, and developing better vaccines,
antivirals, and diagnostics. Specifically, the Committee
strongly supports BARDA's International Influenza Vaccine
Manufacturing Capacity Building Program. Through this program,
HHS helps developing countries build sustainable influenza
vaccine production capacity, which includes establishing
manufacturing facilities and ensuring a skilled in-country
workforce. So far, 12 developing countries have received
technical and financial support from BARDA to establish
influenza vaccine manufacturing capacity. In 2005, the capacity
to produce pandemic influenza vaccine in these countries was
less than 1 million doses. By 2016, continued financial support
from BARDA will enable manufacturers in these countries to
produce up to 300 million doses of vaccine to respond to a
pandemic. The Committee notes that the capability of developing
countries to produce influenza vaccine within their borders is
crucial to reducing the threat of a global pandemic. The
Committee strongly urges BARDA to continue this effort with
existing balances from the fiscal year 2009 supplemental.

Office of the Assistant Secretary for Preparedness and Response

The Committee recommendation includes $944,821,000 for
activities administered by ASPR. The administration request is
$981,863,000 and the comparable funding level for fiscal year
2012 is $925,612,000. ASPR was created by the Pandemic and All-
Hazards Preparedness Act to lead the Department's activities
regarding preventing, preparing for, and responding to public
health emergencies, including disasters and acts of terrorism.
Virtual Training.--The Committee notes the need,
particularly at the local level, to improve surge capacity and
enhance community and hospital preparedness for public health
emergencies using today's enabling training technologies.
Virtual training tools have the potential to revolutionize
medical emergency response training with a corresponding
reduction in costs. The Committee urges ASPR to develop and
standardize such hospital preparedness training using state-of-
the-art, 3D, medical response simulation technology with a goal
of exporting it to all States to preclude redundant efforts.
Hospital Preparedness Program
The Committee's recommendation includes $324,650,000 for
the Hospital Preparedness Program [HPP]. The administration
request for HPP is $254,500,000 and the comparable funding
level for fiscal year 2012 is $374,650,000. This program
provides grants to States and localities to enhance hospital
preparedness and improve overall surge capacity in public
health emergencies.
Funds will be used in fiscal year 2013 to transform HPP
toward an emphasis on healthcare coalitions at the regional and
community level rather than on individual hospitals. The
Committee requests a multiyear plan from the Department
describing this change. This plan should include the program's
framework for determining funding levels for coalitions,
strategies to improve coordination with public health
departments, inclusion of nonacute hospitals and ambulatory
care settings, and engagement with individual healthcare
providers.
Medical Surge Capacity.--The ability of our healthcare
system to quickly expand beyond normal capacity during a major
emergency is critical in securing preparedness for our Nation.
The Committee urges the Secretary to extend health system surge
capacity by creating a national framework to guide States and
local entities on developing crisis standards of care in the
event of a mass casualty event or crisis. The Secretary should
also clarify Federal law to implement uniform liability
applying to all volunteer health professionals during a
declared public health emergency.
Emergency System for Advance Registration of Volunteer
Health Professionals [ESAR VHP]
The Committee recommendation includes $4,989,000 for the
ESAR VHP program. This amount is the same as the comparable
funding level for fiscal year 2012. This program is a national
network of State-based registries that allows health
professionals to volunteer in public health emergencies and
disasters.
The administration requests $500,000 for this program and
proposes discontinuing these grants, noting that all 50 States
and the District of Columbia have developed ESAR VHP programs.
However, the Committee believes that ESAR VHP is a critical
component of providing workforce surge capacity in the event of
a public health emergency. For this reason, the Committee
provides continued funding for the ESAR VHP program and expects
grantees to use the funds to support volunteer recruitment and
retention, training and coordination, and integration of ESAR
VHP with the Medical Reserve Corps at the State and local
level.
Biomedical Advanced Research and Development
The Committee recommendation includes $465,000,000 for
advanced research and development. The administration request
is $546,671,000 for this activity and the comparable funding
level for fiscal year 2012 is $415,000,000. As in previous
years, the Committee includes bill language to transfer
$415,000,000 from the Project BioShield Special Reserve Fund
advance appropriation to fund advanced research and development
of medical countermeasures. This amount is the same as the
administration request and the comparable level from fiscal
year 2012.
Advanced Research and Development.--The fiscal year 2012
Senate Report included language encouraging ASPR to work with
NIAID to ensure that sufficient research is being conducted to
develop a bioagent detection and bioterrorism warning system
based on bioinformatics technology that would allow for the
direct identification and sample characterization of pathogens
in rapid fashion. The Committee requests an update on these
efforts within 60 days of enactment of this act.
Anthrax.--The Committee continues to be concerned about the
country's level of preparedness against biological threats,
most particularly anthrax. The Committee notes that BARDA is
moving forward with developing a variety of countermeasures to
anthrax, including antitoxins, enhancements to the current AVA
vaccine, and most importantly a next generation recombinant
vaccine. The Committee expects BARDA to keep it informed of its
progress in developing a recombinant anthrax vaccine for the
Strategic National Stockpile [SNS].
Antibiotic Research and Development.--The Committee
recognizes that the increasing failure of approved, life-saving
antibiotics, as well as the plummeting number of new
antibiotics in development, seriously threatens our Nation's
health and potentially our security. The Committee encourages
BARDA to continue awarding contracts for promising new
antibiotics that otherwise might not make it to market due to
existing challenges and particularly for new antibiotics
intended to treat multidrug-resistant pathogens.
Multiyear Planning Process.--The Committee notes that the
2010 review of the Public Health Emergency Medical
Countermeasure Enterprise endorsed a 5-year planning process to
enable the Department to forecast, plan for, and communicate
its long-range advanced development needs. The Committee
directs the Department to report on the implementation of such
a coordinated 5-year budgetary planning process based on
medical countermeasure priorities and goals not later than 180
days after the date of enactment of this act, and every year
thereafter. This report should include specific information on
the Department's planned investments for the next 5-year fiscal
period, including: the cost of procuring and maintaining all
materials placed in SNS, the costs associated with maintaining
existing research and development contracts for medical
countermeasures, and the costs associated with anticipated new
research and development contracts for medical countermeasures.
Strategic Investor
The Committee recommendation includes $20,000,000 to create
the Strategic Investor program. The purpose of this program is
to provide financial support and business expertise to emerging
biodefense companies that develop medical countermeasures for
the Federal stockpile. The administration requests $50,000,000
for this activity. Funding was not provided in fiscal year
2012.
Medical Countermeasure Dispensing
The Committee recommendation includes $5,000,000, the same
as the administration request, for the Medical Countermeasure
Dispensing program. Funding for this program was last provided
in fiscal year 2010.
Funding provided by the Committee will support the
continued implementation of the National Postal Model, which
provides for the delivery of medical countermeasures through
the U.S. Postal Service during a bioterrorist attack.
Other Activities
The Committee recommendation includes the following amounts
for the following activities within ASPR:
--Operations--$32,981,000;
--Preparedness and Emergency Operations--$24,647,000;
--National Disaster Medical System--$52,390,000; and
--Policy, Strategic Planning, and Communications--
$15,164,000.

Office of the Assistant Secretary for Administration

The Committee recommends $40,000,000 for information
technology cybersecurity in the Office of the Assistant
Secretary for Administration. This amount is the same as the
administration request. The comparable funding level for fiscal
year 2012 is $39,924,000. These funds provide for continuous
monitoring and security incident response coordination for the
Department's computer systems and networks.

Office of the Assistant Secretary for Health

The Committee recommendation includes $10,971,000, the same
as the administration request, for the medical reserve corps
program in ASH. This program is a national network of local
volunteers who work to strengthen the public health
infrastructure and preparedness capabilities of their
communities. The comparable funding level for fiscal year 2012
is $11,247,000.

Office of the Secretary

The Committee recommendation includes $24,428,000 for
activities within the Office of the Secretary. This amount is
the same as the administration request. The comparable fiscal
year 2012 funding level is $6,448,000.
Lease Replacement
The Committee recommendation includes $17,000,000, the same
as the administration request, for relocation and fit-out costs
associated with new long-term leases for HHS agencies. In
fiscal year 2012 funding for this activity was provided in the
accounts of each HHS agency.
Office of Security and Strategic Information
The Committee includes $7,428,000 for the Office of
Security and Strategic Information to secure and strengthen the
Department's critical assets. This amount is the same as the
administration request. The comparable level for fiscal year
2012 is $6,448,000.

PREVENTION AND PUBLIC HEALTH FUND

The PPH Fund was created in section 4002 of PPACA. The fund
provides $12,500,000,000 in mandatory funds over the next 10
years to supplement investments in public health and
prevention.
The Committee strongly believes that additional resources
for prevention will improve people's health and reduce
healthcare costs over the long term. Discretionary funding is
needed for these purposes because many of the health promotion
activities that reach the populations most in need take place
outside the reimbursement system, through community- and State-
based initiatives.
In recognition of the Committee's responsibility to
determine funding levels for community-based prevention and
public health programs, PPACA specifically gives the Committee
authority to transfer funds into Federal programs that support
the goal of making America healthier.
In fiscal year 2013, the level appropriated for the fund is
$1,000,000,000, the same as the fiscal year 2012 level. The
Committee includes bill language in section 220 of this act
that requires that funds be transferred within 45 days of
enactment of this act to the following accounts, for the
following activities, and in the following amounts:

----------------------------------------------------------------------------------------------------------------
Committee
Agency Account Program recommendation
----------------------------------------------------------------------------------------------------------------
CDC..................................... Chronic Disease Community Transformation $280,000,000
Prevention, Health Grants.
Promotion, and Genomics.
CDC..................................... Immunization and Section 317 Immunization 190,000,000
Respiratory Diseases. Grants.
CDC..................................... Chronic Disease Office of Smoking and 95,000,000
Prevention, Health Health.
Promotion, and Genomics.
CDC..................................... CDC-Wide Activities....... Public Health 40,200,000
Infrastructure grants.
CDC..................................... Emerging and Zoonotic Epidemiology and 40,000,000
Infectious Diseases. Laboratory Capacity
Grants.
CDC..................................... Chronic Disease Racial and Ethnic 40,000,000
Prevention, Health Approaches to Community
Promotion, and Genomics. Health.
CDC..................................... Environmental Health...... Environmental and Health 35,000,000
Outcome Tracking Network.
CDC..................................... Public Health Scientific Health Surveillance and 35,000,000
Services. Statistics.
SAMHSA.................................. Mental Health............. Primary and Behavioral 35,000,000
Healthcare Integration.
CDC..................................... CDC-Wide Activities....... Public Health Workforce... 25,000,000
HRSA.................................... Health Workforce.......... Public Health Training 25,000,000
Centers.
SAMHSA.................................. Substance Abuse Treatment. Screening, Brief 25,000,000
Intervention and Referral
to Treatment.
SAMHSA.................................. Health Surveillance and Surveillance activities... 18,000,000
Program Sup- port.
CDC..................................... Emerging and Zoonotic Healthcare Associated 11,750,000
Infectious Dis- eases. Infections.
ACL..................................... Aging and Disability Chronic Disease Self 10,000,000
Services. Management.
CDC..................................... Chronic Disease Diabetes Prevention 10,000,000
Prevention, Health Program.
Promotion, and Genomics.
CDC..................................... Public Health Scientific Guide to Community 10,000,000
Services. Preventive Services.
CDC..................................... Chronic Disease Prevention Research 10,000,000
Prevention, Health Centers.
Promotion, and Genomics.
CDC..................................... HIV/AIDS, Viral Hepatitis, Viral Hepatitis Screening. 10,000,000
STD, and TB Prevention.
CDC..................................... Chronic Disease Workplace Wellness grants. 10,000,000
Prevention, Health
Promotion, and Genomics.
SAMHSA.................................. Mental Health............. Suicide Prevention........ 10,000,000
CDC..................................... Chronic Disease Breast Feeding Promotion 7,050,000
Prevention, Health and Support Grants.
Promotion, and Genomics.
AHRQ.................................... Health Costs, Quality, and U.S. Preventive Services 7,000,000
Outcomes. Task Force.
ACL..................................... Aging and Disability Elderly Falls Prevention.. 7,000,000
Services.
AHRQ.................................... Health Costs, Quality, and Clinical Prevention 5,000,000
Outcomes. Research Centers for
Excellence.
CDC..................................... Chronic Disease Million Hearts Program.... 5,000,000
Prevention, Health
Promotion, and Genomics.
CDC..................................... Injury Prevention and Elderly Falls Prevention.. 3,000,000
Control.
CDC..................................... CDC-Wide Activities....... National Prevention, 1,000,000
Health Promotion, and
Public Health Council.
----------------------------------------------------------------------------------------------------------------

General Provisions

Section 201. The bill continues a provision placing a
$50,000 ceiling on official representation expenses.
Section 202. The bill continues a provision that limits the
assignment of certain public health personnel.
Section 203. The bill continues a provision limiting the
use of certain grant funds to pay individuals more than an
annual rate of executive level II.
Section 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 of the House and Senate on the
proposed use of funds.
Section 205. The Committee recommendation continues a
provision authorizing the transfer of up to 2.5 percent of PHS
Act funds for evaluation activities.
Section 206. The Committee recommendation continues a
provision restricting transfers of appropriated funds and
requires a 15-day notification to both the House and Senate
Appropriations Committees.
Section 207. The Committee recommendation continues a
provision permitting the transfer of up to 3 percent of AIDS
funds among ICs by the Director of NIH and the Director of the
Office of AIDS Research at NIH.
Section 208. The Committee recommendation retains language
which requires that the use of AIDS research funds be
determined jointly by the Director of NIH 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.
Section 209. The Committee recommendation continues a
provision regarding requirements for family planning
applicants.
Section 210. 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.
Section 211. 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.
Section 212. The Committee recommendation modifies a
provision which facilitates the expenditure of funds for
international health activities.
Section 213. The Committee recommendation continues a
provision authorizing the Director of NIH to enter into certain
transactions to carry out research in support of the NIH Common
Fund.
Section 214. The Committee continues a provision that
permits CDC 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''.
Section 215. The Committee recommendation includes bill
language allowing use of funds to continue operating the
Council on Graduate Medical Education.
Section 216. The Committee recommendation continues a
provision permitting NIH to use up to $3,500,000 per project
for improvements and repairs of facilities.
Section 217. The Committee recommendation includes a
provision that transfers funds from NIH to HRSA and AHRQ, to be
used for National Research Service Awards.
Section 218. The Committee recommendation modifies a
provision requiring a publicly available Web site that details
expenditures from the PPH Fund.
Section 219. The Committee recommendation includes a new
provision that rescinds unobligated mandatory funds from the
Abstinence Education program.
Section 220. The Committee recommendation includes a new
provision transferring mandatory funds from section 4002 of the
Patient Protection and Affordable Care Act to accounts within
the Department for activities outlined under the heading
``Prevention and Public Health Fund'' in this report.
Section 221. The Committee recommendation includes a new
provision that allows the Director of CDC to detail staff in
response to a public health emergency.
Section 222. The Committee recommendation includes a new
provision requiring fiscal year 2014 budget justifications to
include certain FTE information with respect to PPACA.
Section 223. The Committee includes a new provision
requiring the Secretary to respond to certain correspondence.

TITLE III

DEPARTMENT OF EDUCATION

Education for the Disadvantaged

Appropriations, 2012.................................... $15,741,703,000
Budget estimate, 2013................................... 15,530,002,000
Committee recommendation................................ 15,840,103,000

The Committee recommends an appropriation of
$15,840,103,000 for education for the disadvantaged.
The President's budget was based on the administration's
proposal to reauthorize the ESEA, but no such bill has passed
the Senate. As a result, the Committee bill is based on current
law for programs authorized under the ESEA.
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. Funds appropriated in this account
primarily support activities in the 2013-2014 school year.

Grants to Local Educational Agencies

Title I grants to 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 meet
challenging State academic standards.
The Committee recommends $14,616,457,000 for the title I
grants to LEAs program. The comparable fiscal year 2012 level
and budget request also are $14,516,457,000.
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 $3,984,000
transferred to the Census Bureau for poverty updates, the
Committee recommends an appropriation of $6,577,904,000, the
same amount as the fiscal year 2012 level and budget request.
For concentration grants, the Committee recommends
$1,362,301,000, the same amount as the fiscal year 2012 level
and budget request.
For grants through the targeted formula, the Committee
recommends $3,338,126,000. The comparable fiscal year 2012
level and budget request are $3,288,126,000.
For grants through the EFIG formula, the Committee
recommends $3,338,126,000. The comparable fiscal year 2012
level and budget request are $3,288,126,000.
Of the funds available for title I grants to LEAs, up to
$3,984,000 shall be available on October 1, 2012;
$3,771,296,000 will become available on July 1, 2013; and
$10,841,177,000 will become available on October 1, 2013. The
funds that become available on July 1, 2013, and October 1,
2013, will remain available for obligation through September
30, 2014.
The Committee notes that the biggest barrier for homeless
children and youth attempting to enroll in and attend school
regularly is the lack of transportation. The Committee bill
includes a new provision clarifying that title I funds may be
used to address this transportation issue, as well as support
homeless liaisons.
The Committee also notes that the ESEA allows title I funds
to be used to implement integrated student support services
that address both the academic and nonacademic needs of
students through partnerships of schools and nonprofit
providers. The Committee believes, at the discretion of schools
choosing to use funds for such activities, that such decisions
should be based on evidence that the activities implemented
will have a significant effect on student outcomes.

School Improvement Grants

The Committee recommendation includes $533,552,000, the
same amount as the fiscal year 2012 level and budget request,
for the SIG program.
The Committee continues authority provided by prior
appropriations acts that addresses several issues. First, it
continues the expansion of the number of schools that may
receive funds through the program. This language allows schools
to be eligible for SIG if they are eligible for title I and
have not made adequate yearly progress for at least 2 years or
are in the State's lowest quintile of performance based on
proficiency rates. Second, language also allows States to make
subgrants of not more than $2,000,000 to each participating
school. And, a set-aside of up to 5 percent of the SIG
appropriation may be used for national activities.
The Committee continues to believe that the SIG program
holds great promise for improving outcomes for students in our
Nation's lowest-achieving schools. At the request of three
Committee members, the GAO analyzed certain aspects of the SIG
program, focusing particularly on challenges for successful SIG
implementation, the Department's technical assistance and
oversight activities, and State administration of SIG. Interim
and final reports released during the past 12 months
identified, among other things, that local capacity--such as
the ability to attract and retain administrative staff with
school turnaround expertise or high-quality teachers--
influenced implementation, and that SIG interventions were
often challenging for low-capacity districts. Further, the GAO
found that third-party contractors rarely were reviewed for
contract performance. The Committee believes the Department
should implement effective strategies that address the GAO's
findings as soon as possible.
The Committee also notes that Federal and non-Federal
investments in school turnaround and comprehensive school
reform have identified, developed, or supported research-
proven, replicable models for struggling schools. Such schools
now have a growing number of options to match their needs.
Therefore, the Committee bill includes new language that will
allow schools that receive SIG funds the flexibility to choose
and implement a research-proven, whole-school reform model.
The Committee believes that the Department needs to take
additional steps to support parent engagement and family
support through SIG and other programs and activities. The
Committee notes that evidence-based parent education and family
support models have been shown to increase parent knowledge of
child development; provide early detection of developmental
delays; and increase children's school readiness and school
success. The Committee directs the Department to address this
issue through its national activities set-aside and other
appropriate actions.

Striving Readers

The Committee recommends $159,698,000, the same amount as
the comparable fiscal year 2012 level, to continue the Striving
Readers initiative. The budget request proposes to consolidate
this funding within a new Effective Teaching and Learning
program under the administration's reauthorization proposal.
The Committee bill includes language that continues the
competitive portion of the program as it was established in the
fiscal year 2010 appropriations act. This comprehensive
literacy program will advance literacy skills for all students,
including English language learners and students with
disabilities, from birth through grade 12.

Migrant Education Program

The Committee recommends $393,236,000, the same as the
fiscal year 2012 level and budget request, for the migrant
education program.
The title I migrant education program authorizes grants to
SEAs for programs to meet the special educational needs of the
children of migrant agricultural workers and fishermen. This
appropriation also supports activities to improve interstate
and intrastate coordination of migrant education programs, as
well as identify and improve services to the migrant student
population.

Neglected and Delinquent

The Committee recommends $50,231,000, the same amount as
the fiscal year 2012 level and budget request, for the title I
neglected and delinquent program.
This program provides financial assistance to SEAs for
education services to neglected and delinquent children and
youth in State-run institutions and for juveniles in adult
correctional institutions. 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 re-entry of youth
offenders who are age 20 or younger and have received a
secondary school diploma or its recognized equivalent.

Evaluation

The Committee recommends $1,594,000 for evaluation of title
I programs. The budget request proposes to fund evaluation
efforts through a comprehensive evaluation authority contained
in the administration's reauthorization proposal. The
comparable fiscal year 2012 amount is $3,194,000.
Evaluation funds are used to support large-scale national
surveys that examine how the title I program is 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.
The Committee bill also includes a new general provision in
this title that clarifies the Department's authority to reserve
up to 0.5 percent of each ESEA appropriation in the bill for
evaluation of ESEA programs funded in this act. These resources
are in addition to any funds specifically provided for
evaluation purposes. The Department shall provide the Senate
Committees on Appropriations and HELP with an evaluation plan
not later than 10 days before the initial obligation of funds
under the provision.

High School Graduation Initiative

The Committee recommends $48,809,000, the same amount as
the fiscal year 2012 level, for the High School Graduation
Initiative under title I, part H of the ESEA. The budget
request does not include any funding for this program but
proposes to fund related activities through a broader College
Pathways and Accelerated Learning program.
The High School Graduation Initiative provides competitive
grants to LEAs or SEAs to implement effective high school
graduation and re-entry strategies in schools and districts
that serve students in grades 6 through 12 and have annual
school dropout rates that are above their State's average.
Funds also are used for certain national activities, including
evaluation, technical assistance, and dissemination of
information on effective programs and best practices.

Special Programs for Migrant Students

The Committee recommends $36,526,000, the same amount as
the fiscal year 2012 level and budget request, for Special
Programs for Migrant Students.
The Higher Education Opportunity Act of 2008 reauthorized
the High School Equivalency Program [HEP] and College
Assistance Migrant Program [CAMP] within the Special Programs
for Migrant Students, and added a new provision allowing the
Department to reserve up to 0.5 percent of the funds
appropriated between the two programs for outreach, technical
assistance, and professional development activities. In
addition, under current law, if the total amount appropriated
is below $40,000,000, the remaining funds are to be distributed
between the two programs in the same proportion as the amounts
available for each program the previous year.
HEP projects are 5-year grants to institutions of higher
education and other nonprofit organizations to recruit migrant
students ages 16 and older 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 post-secondary institution or a job-training program, or join
the military.
CAMP projects are 5-year grants to institutions of higher
education and nonprofit organizations to provide tutoring,
counseling, and financial assistance to migrant students during
their first year of postsecondary education.

Impact Aid

Appropriations, 2012.................................... $1,291,186,000
Budget estimate, 2013................................... 1,224,239,000
Committee recommendation................................ 1,291,186,000

The Committee recommends $1,291,186,000 for impact aid.
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 retains 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 schools in the same school district.
Basic Support Payments.--The Committee recommends
$1,153,540,000, the same amount as the fiscal year 2012 level
and budget request, for basic support payments. 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 $48,413,000, the same amount as the fiscal year
2012 level and the budget request, for payments for children
with disabilities. Under this program, additional payments are
made for certain federally connected children eligible for
services under IDEA.
Facilities Maintenance.--The Committee recommends
$4,845,000, the same amount as the fiscal year 2012 level and
budget request, for facilities maintenance. This activity
provides funding for emergency repairs and comprehensive
capital improvements to certain school facilities owned by the
Department and used by LEAs to serve federally connected
military dependent students. Funds appropriated for this
purpose are available until expended.
Construction.--The Committee recommends $17,441,000, the
same amount as the fiscal year 2012 level and budget request,
for the construction program. Formula and competitive grants
are authorized to be awarded to eligible LEAs for emergency
repairs and modernization of school facilities.
The Committee recommendation includes bill language
allowing these funds to be awarded entirely through the
authorized formula. The budget request proposes to award funds
on a competitive basis. Last year's bill provided these funds
entirely through competitive allocations.
Payments for Federal Property.--The Committee recommends
$66,947,000, the same amount as the fiscal year 2012 level, for
payments for Federal property. The budget request eliminates
funding for this program. These payments compensate LEAs in
part for revenue lost due to the removal of Federal property
from local tax rolls.

School Improvement Programs

Appropriations, 2012.................................... $4,544,596,000
Budget estimate, 2013................................... 2,436,203,000
Committee recommendation................................ 4,544,596,000

The Committee recommendation includes $4,544,596,000 for
school improvement programs.
The President's budget was based on the administration's
proposal to reauthorize the ESEA, but no such bill has passed
the Senate. As a result, programs in this account are based
generally on current law, as authorized under the ESEA.

Effective Teaching and Learning: Literacy

The Committee recommends no funds for the proposed
Effective Teaching and Learning: Literacy program. The budget
request is $186,892,000. Activities supported under this
proposed program are instead funded under current law.
The Effective Teaching and Learning: Literacy program would
provide competitive grants to SEAs, or SEAs in partnership with
appropriate outside entities, to support development and
implementation of comprehensive, evidence-based State and local
efforts to provide high-quality literacy programs aligned with
college- and career-ready English language standards.

Effective Teaching and Learning: Science, Technology, Engineering, and
Mathematics

The Committee recommends no funds for the proposed
Effective Teaching and Learning: STEM program. The budget
request is $149,716,000. Activities supported under this
proposed program are instead funded under current law.
The Effective Teaching and Learning: STEM would provide
competitive grants to SEAs, or SEAs in partnership with
appropriate outside entities, to support State and local
efforts to implement a comprehensive strategy for the provision
of high-quality STEM instruction and support to students from
preschool through grade 12.

Effective Teaching and Learning for a Well-Rounded Education

The Committee recommends no funds for the proposed
Effective Teaching and Learning for a Well-Rounded Education
program. The budget request is $90,000,000. Activities
supported under this proposed program are instead funded under
current law.
The Effective Teaching and Learning for a Well-Rounded
Education program would provide competitive grants to high-need
LEAs, SEAs, and institutions of higher education or nonprofit
organizations in partnership with one or more high-need LEAs to
support the development and expansion of innovative practices
to improve teaching and learning across a well-rounded
curriculum that includes the arts, health education, physical
education, foreign languages, civics and government, history,
geography, environmental education, economics and financial
literacy, and other subjects.

College Pathways and Accelerated Learning

The Committee recommends no funds for the proposed College
Pathways and Accelerated Learning program. The budget request
is $81,282,000. Activities supported under this proposed
program are instead funded under current law.
The College Pathways and Accelerated Learning program would
support efforts to increase high school graduation rates and
preparation for college matriculation and success by providing
college-level and other accelerated courses and instruction in
middle and high schools with concentrations of students from
low-income families and in high schools with low graduation
rates.

State Grants for Improving Teacher Quality

The Committee recommends $2,466,567,000, the same amount as
the fiscal year 2012 level, for State grants for improving
teacher quality. The budget request does not include any
funding for this program but instead proposes $2,466,567,000
for a new Effective Teacher and Leaders State Grants program
within the Innovation and Improvement account.
The appropriation for this program primarily supports
activities associated with the 2013-2014 academic year. Of the
funds provided, $785,126,000 will become available on July 1,
2013, and $1,681,441,000 will become available on October 1,
2013. These funds will remain available for obligation through
September 30, 2014.
States and LEAs may use 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 bill modifies a set-aside included in prior
year bills for competitive awards to national not-for-profit
organizations for recruiting, training, or providing
professional enhancement activities for teachers or teachers
and school leaders, particularly for high-need schools most
likely to face shortages in these areas. The Committee
recommends that up to 5.5 percent of funds available for the
State grants for improving teacher quality program shall be
used for this purpose; in fiscal year 2012, the set-aside was
1.5 percent. The bill language also differs slightly from prior
years by allowing up to 10 percent of the set-aside funds to be
used for related research, development, evaluation,
dissemination, and technical assistance.

Mathematics and Science Partnerships

The Committee recommends $149,716,000, the same as the
comparable fiscal year 2012 level, for the mathematics and
science partnerships program. The budget request does not
include any funding for this program but instead proposes
$149,716,000 for a new Effective Teaching and Learning: STEM
program.
The ESEA requires that when the appropriation for this
program is higher than $100,000,000, the funds are to be
distributed to States by formula. The Committee has been
concerned that at recent appropriations levels, this funding
has been spread too thinly among the States to make a
significant impact.
At the recommended funding level, the ESEA requires the
Department to make competitive awards to eligible partnerships,
which must include an engineering, math, or science department
of an institution of higher learning and a high-need LEA.
Partnerships will seek to improve the performance of students
in the areas of math and science, including engineering, by
bringing math and science teachers in elementary and secondary
schools together with scientists, mathematicians, and engineers
to increase the teachers' subject-matter knowledge and improve
their teaching skills.
The Committee notes that it is including additional
resources under FIE to create a new, evidence-based grant
competition jointly administered by the Department and NSF that
will focus on developing, evaluating, and scaling-up effective
practices that can help increase student achievement in
mathematics, and for related activities.

Supplemental Education Grants

The Committee recommendation includes $17,619,000, the same
amount as the fiscal year 2012 level and budget request, for
supplemental education grants to the Republic of Marshall
Islands [RMI] and the Federated States of Micronesia [FSM].
This grant program was authorized by the Compact of Free
Association Amendments Act of 2003. These funds will be
transferred from the Department to the Secretary of the
Interior for grants to these entities. The Committee bill
continues 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 to the Departments of Labor,
HHS, and Education for such services.

21st Century Community Learning Centers

The Committee recommends an appropriation of
$1,151,673,000, the same amount as the fiscal year 2012 level
and budget request, for the 21st Century Community Learning
Centers program.
Funds are allocated to States by formula, which in turn,
award at least 95 percent of their allocations to LEAs,
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 afterschool programs, recreational activities, drug and
violence prevention, and family literacy programs for students
and related services to their families. Centers must target
their services to students who attend schools that are eligible
to operate a schoolwide program under title I of the ESEA or
serve high percentages of students from low-income families.
A growing body of evidence demonstrates that students
benefit academically from a longer school day, week, and year.
The Committee notes that some school districts have adopted
strategies to extend the school day without significant new
investments, such as through staggered school schedules and
innovative partnerships with community partners.
The Committee bill includes new language to expand the
design options for subgrants under the 21st CCLC program for
high-quality, afterschool, before school, summer learning, and
expanded learning time programs.
The Committee believes that SEAs should award grants to
high-quality programs that address individual student learning
needs and student well-being. Funded programs should deliver
services through a variety of high-quality and effective
strategies for boosting learning and enrichment including
afterschool, before school, summer school, or expanded day,
week, or year opportunities; align with and complement, rather
than replicate, the regular school day, by offering a range of
activities that capture student interest and support student
engagement to promote higher class attendance, reduce risk for
retention or dropping out, and foster good health; integrate
academics, enrichment, and skill development through hands-on
experiences that make learning relevant and engaging; and
actively address the specific learning needs and interests of
all types of students, especially those who may benefit from
approaches and experiences not offered in the traditional
classroom setting.
The Committee urges the Department to provide guidance and
technical assistance to States, schools, and community partners
on how to develop and maintain strong community-school
partnerships, implement continuous quality improvement
processes, and ensure that programs meet the needs of
individual students. The Committee also urges the Department to
consult with experts in the field, including State and local
intermediaries, in creating and providing such guidance and
technical assistance. The Committee directs the Department to
refrain from giving priority to, showing preference for, or
providing direction about whether communities should use these
funds for afterschool, before school, summer school, or
expanded school day programs, unless specifically requested by
SEAs or LEAs.
The Committee also directs the Secretary to report to
Congress on the progress of the ESEA--No Child Left Behind
waiver process initiated in the fall of 2011, specifically in
terms of the impact on the 21st Century Community Learning
Centers and student participation in, and access to,
afterschool, before school, and summer learning programs, as a
result of the flexibility provided to SEAs under waiver option
11. The Department should report on the number of children
served and the centers/sites offering expanded learning in the
3 years preceding the waiver approval and the 3 years following
waiver approval, as well as the number of hours of and
diversity of programming available to students through such
grants at each site and the average cost of the programs (per
student and per site) before and after waiver approval. All
data should be provided at the State level.

State Assessments and Enhanced Assessment Instruments

The Committee recommends $389,214,000, the same amount as
the fiscal year 2012 level and budget request, for State
assessments and enhanced assessment instruments.
This program has two components. The first provides formula
grants to States to pay the cost of developing and implementing
standards and assessments required by the ESEA. The Committee
provides $380,000,000 for this purpose.
Under the second component--grants for enhanced assessment
instruments--appropriations in excess of the State assessment
program are used for a competitive grant program designed to
support efforts by States to improve the quality and
reliability of their assessment systems. The Committee
recommendation for the second component is $9,214,000.
The Committee urges the Department to place a high priority
in the fiscal year 2013 enhanced instruments grant competition
on improving the quality of State assessments for students with
disabilities and students with limited English proficiency, and
to ensure the most accurate means of measuring their
performance on these assessments.

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 $65,173,000. This amount is the
same as the budget request and the comparable fiscal year 2012
level.
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 Youth
Program, 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.
The Committee bill also includes language under the
Education for the Disadvantaged account clarifying the
availability of title I funds for services to homeless children
and youths.

Training and Advisory Services

For training and advisory services authorized by title IV
of the Civil Rights Act, the Committee recommends $6,962,000.
This is the same amount as the budget request and the
comparable fiscal year 2012 level.
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 $34,181,000. This is the same amount as
the budget request and the comparable fiscal year 2012 amount.
The Committee bill continues a provision that allows
funding provided by this program to be used for construction.

Alaska Native Educational Equity

The Committee recommends $33,185,000, the same amount as
the fiscal year 2012 level and budget request, for the Alaska
Native educational equity assistance program.
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 continues language that
allows funding provided by this program to be used for
construction. The Committee bill also includes language
overriding the authorizing statute's requirement to make
noncompetitive awards to certain organizations.
The Committee is aware that the ESEA includes a priority
for funding under this program for applications from Alaska
Native regional nonprofit organizations, or consortia that
include at least one Alaska Native regional nonprofit
organization. Therefore, the Committee directs the Department
to distribute funding for new awards under this program based
only on the priority authorized under part C of title VII of
the ESEA. Within 180 days of enactment of this act, the
Committee also directs the Department to prepare and submit a
report on activities funded under this program, including how
such activities are achieving the purposes of the program as
authorized in the ESEA. The report should also include a plan
on how the Department will work to improve consultation with
and participation of Alaska Native organizations, Alaska Native
regional nonprofit organizations, or consortia that include at
least one Alaska Native regional nonprofit organizations in the
program.

Rural Education

The Committee recommends $179,193,000, the same amount as
the fiscal year 2012 level and budget request, for rural
education programs.
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 $51,113,000, the same amount as
the fiscal year 2012 level and budget request, for the
comprehensive centers program.
These funds provide support to a network of comprehensive
centers that are operated by research organizations, agencies,
institutions of higher education, or partnerships thereof, and
provide training and technical assistance on various issues to
States, LEAs, and schools as identified through needs
assessments undertaken in each region. The system currently
includes 16 regional centers, which are charged with providing
intensive technical assistance to SEAs to increase their
capacity to assist LEAs and schools with meeting the goals of
the ESEA, and content centers, which are organized by topic
area.
The Committee strongly supports the mission of the centers,
particularly with regard to their role in helping develop State
capacity to meet the needs of LEAs and schools. The Committee
also believes that the centers play an important part in the
Department's system of technical assistance and appreciates the
steps the Department has taken to align and coordinate its
various technical assistance activities. The Committee
encourages the Department to continue its efforts in
coordinating its technical assistance activities and requests
that the Department describe these efforts and future plans in
the fiscal year 2014 congressional budget justification.

Indian Education

Appropriations, 2012.................................... $130,779,000
Budget estimate, 2013................................... 130,779,000
Committee recommendation................................ 130,779,000

The Committee recommends $130,779,000 for Indian education
programs.

Grants to Local Educational Agencies

For grants to LEAs, the Committee recommends $105,921,000,
the same amount as the fiscal year 2012 level and budget
request.
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
LEAs, schools supported and operated by the Department of the
Interior/Bureau of Indian Education, and in some cases directly
to Indian tribes.

Special Programs for Indian Children

The Committee recommends $18,986,000, the same amount as
the fiscal year 2012 level and budget request, for special
programs for Indian children.
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 $5,872,000, the same amount as the
comparable fiscal year 2012 funding level and budget request,
for national activities.
Funds will be used to expand efforts to improve research,
evaluation, and data collection on the status and effectiveness
of Indian education programs, and to continue grants to tribal
educational departments for education administration and
planning.

Innovation and Improvement

Appropriations, 2012.................................... $1,527,536,000
Budget estimate, 2013................................... 4,332,166,000
Committee recommendation................................ 1,545,966,000

The Committee recommends $1,545,966,000 for programs within
the innovation and improvement account.
The President's budget was based on the administration's
proposal to reauthorize the ESEA, but no such bill has passed
the Senate. As a result, programs in this account are based
generally on current law.

Race to the Top

The Committee recommends $549,284,000 for the Race to the
Top [RTT] program. The budget request includes $850,000,000 for
this program. These funds are available for obligation through
December 31, 2013.
RTT, which was established in ARRA, has supported and
incentivized reforms that are designed to reduce achievement
gaps; improve student achievement, graduation rates, and
college enrollments; and encourage the broad replication of
effective practices. The Committee bill continues language
allowing local school districts to be eligible for RTT grants
and up to 5 percent of the appropriation for this program to be
used for evaluation and technical assistance.
Funds also may be used for Race to the Top-Early Learning
Challenge [RTT-ELC], a component that was added in the fiscal
year 2011 appropriations bill. The goal of RTT-ELC is to
improve the quality of early learning and development and close
the achievement gap for children with high needs. The RTT-ELC
grant competition focuses on improving early learning and
development for young children by supporting States' efforts to
increase the number and percentage of low-income and
disadvantaged children in each age group of infants, toddlers,
and preschoolers enrolled in high-quality early learning and
development programs; and designing and implementing an
integrated system of high-quality early learning and
development programs and services. Grants may be made to
States, or consortia thereof, which may make subgrants to
appropriate entities.
The Committee expects a significant portion of the fiscal
year 2013 appropriation to be used for RTT-ELC. In combination
with additional resources allocated for the CCDBG and Head
Start programs, the Committee expects these investments to help
improve early learning and development systems and
opportunities for young children. The Committee bill includes
language requiring the Departments of Education and HHS to
jointly administer RTT-ELC.
The Committee applauds the Department's efforts to ensure
that rural areas have a fair opportunity to compete in recent
grant competitions, including the LEA-level competition under
RTT. The Committee directs the Department in developing any
fiscal year 2013 notice under RTT to provide an absolute
priority for rural States or rural LEAs, as applicable.

Investing in Innovation

The Committee recommends $149,417,000, the same amount as
the fiscal year 2012 level, for the Investing in Innovation
program. The budget request is $150,000,000 for this purpose.
Investing in Innovation, which was established in ARRA, has
provided a source for replicating education programs that meet
the highest level of evidence; expanding those with significant
levels of evidence; and supporting promising practices for
which there is some level of appropriate research. The
Committee supports this three-tier evidentiary model and
believes that this feature of the program should continue to
guide future funding opportunities and decisions. The Committee
also appreciates the priority given to rural applicants in the
last two competitions and believes that this priority should
continue to be used in the fiscal year 2013 competition. The
Committee expects the Department to distribute grants equally
among the absolute priority categories unless there are an
insufficient number of qualified grants for a particular
category.
The Committee bill continues language from last year's bill
providing up to 5 percent of the appropriation for this program
to be used for evaluation and technical assistance. The
Committee expects to be notified in advance of the proposed
uses of these funds.
The Committee bill also includes new language allowing up
to 30 percent of the funds for this program to be used to
support ARPA-ED, a new organization that will be created to
identify and promote advances in fundamental and applied
sciences and engineering that could be translated into new
learning technologies; to develop, test, and evaluate novel
learning technologies and related processes; and to accelerate
transformational technological advances. Prior to obligating
any funds for ARPA-ED, the Committee directs the Department to
provide the Senate Committees on Appropriations and HELP with a
report describing the goals, planned activities, and
organization related to this new effort.

Effective Teachers and Leaders

The Committee recommends no funding to create the Effective
Teachers and Leaders State grant program. The budget request
includes $2,466,567,000 for this program based on the
administration's reauthorization proposal.
The Committee has provided $2,466,567,000 for State Grants
for Improving Teacher Quality within the school improvement
programs account. These funds may be used for similar purposes
as those proposed under this program.

Effective Teachers and Leaders Innovation Fund

The Committee recommends no funding to create the Effective
Teachers and Leaders Innovation Fund. The budget request
includes $400,000,000 for this program based on the
administration's reauthorization proposal.
The Committee provides $299,433,000 for the Teacher
Incentive Fund and additional funds for other current law
programs that may be used for similar purposes as those
proposed under this program.

Teacher and Leader Pathways

The Committee recommends no funding to create the Teacher
and Leader Pathways program. The budget request includes
$74,676,000 for this program based on the administration's
reauthorization proposal.
The Committee provides resources under current law programs
that may be used for similar purposes as those proposed under
this new program.

Expanding Educational Options

The Committee recommends no funding to create the Expanding
Educational Options program. The budget request includes
$255,036,000 for this program based on the administration's
reauthorization proposal.
The Committee provides resources under current law programs
that may be used for similar purposes as those proposed under
this new program.

Transition to Teaching

The Committee recommends $18,200,000 for the Transition to
Teaching program. The budget request proposes an Excellent
Instructional Teams initiative that could support activities
carried out under this program, but includes no funds
specifically for Transition to Teaching. The fiscal year 2012
level is $26,054,000 for this program.
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.

School Leadership

The Committee recommends $29,107,000, the same amount as
the fiscal year 2012 level, for the school leadership program.
The budget request proposes a Teacher and Leader Pathways
program that could support activities funded through this
program, but includes no funds specifically for school
leadership.
The 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. The Committee urges the
Department to put a high priority on grants that prepare,
place, and support school leaders in schools most in need of
improvement, as defined by status as persistently lowest-
achieving, priority, or focus schools.

Charter Schools

The Committee recommends a total of $254,836,000, the same
amount as the fiscal year 2012 level, for the support of
charter schools. The budget request proposes no dedicated
funding for the charter schools program, instead providing
support for such activities through a broader Expanding
Educational Options program.
The Committee allocates the recommended funding as follows:
$221,836,000 for charter school grants, up to $11,000,000 for
State facilities incentives, not less than $11,000,000 for the
credit enhancement for charter schools facilities program, and
up to $11,000,000 for national activities designed to support
local, State, and national efforts to increase the number of
high-quality charter schools.
The Charter Schools grants program supports the planning,
development, and initial implementation of charter schools.
SEAs 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.
Under the State facilities program, the Department awards
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.
The credit enhancement program provides assistance to help
charter schools meet their facility needs. Funds are provided
on a competitive basis to public and nonprofit entities, to
leverage non-Federal funds that help charter schools obtain
school facilities through purchase, lease, renovation, and
construction.
The Committee continues bill language that allows the
Secretary to reserve a portion of the charter school grant
funds to make multiple awards to charter management
organizations and other entities for the replication and
expansion of successful charter school models that have a track
record of success. This year's bill requires that not less than
$30,000,000 of funds available for charter school grants shall
be used for this purpose. Last year's bill caps this activity
at $55,000,000 but only roughly $29,000,000 is expected to be
used for this purpose.
The Committee urges the Department to continue using a
portion of the funds available for national activities to
address issues related to services to students with
disabilities enrolled in or interested in enrolling in charter
schools, as well as efforts to strengthen charter authorizing
practices that will result in a greater share of high-quality
charter schools.

Magnet Schools Assistance

The Committee recommends $96,733,000, the same amount as
the comparable fiscal year 2012 level, for the magnet schools
assistance program. The budget request includes $99,611,000 for
this purpose.
This program supports grants to LEAs 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,
salaries of instructional staff, and the purchase of
technology, educational materials, and equipment.

Fund for the Improvement of Education

The Committee recommends an appropriation of $85,735,000
for FIE. The fiscal year 2012 appropriation is $65,775,000 and
the budget request is $36,276,000 for this purpose.
Within programs of national significance, the Committee
includes $29,000,000 to continue the initiative funded in last
year's bill that provides competitive awards to national not-
for-profit organizations or school libraries for providing
books and childhood literacy activities to children and
families living in high-need communities. The Committee expects
no less than 50 percent of these funds to be made available to
applications from school libraries proposing high-quality
projects for increasing access to a wide range of print and
electronic resources that provide learning opportunities to all
students, but particularly those less likely to have access to
such materials at home.
The Committee recommendation also includes $19,235,000 for
a new STEM initiative. A portion of these funds will be used
jointly with funds provided to NSF for a program using a
tiered-evidence model, similar to the Investing in Innovation
program, that seeks to develop, evaluate, and scale-up proven
practices that can help improve teaching and learning in
mathematics. Another portion of the funds for this initiative
will be used for STEM-related activities at IES to improve the
evidence base for STEM programs across the Federal Government;
this portion may also be used for providing technical
assistance to other Federal agencies and the field to improve
evaluations.
Within programs of national significance, the Committee
also recommends $2,950,000 to support inter-agency strategies
to strengthen re-engagement activities and outcomes of Federal
programs serving disconnected youth, $5,424,000 to continue
awards for full-service community schools, $1,276,000 for data
quality and evaluation initiatives, and $350,000 for peer
review. It also includes $1,000,000 to support a new
competition for operation of a clearinghouse on educational
facilities, which will provide information on planning,
designing, financing, building, maintaining, and operating
safe, healthy, high-performance educational facilities,
including early learning centers.
Within the amount for FIE, the Committee also includes
$26,500,000 for the Arts in Education program. The budget
request includes funds for similar activities under its
proposed Effective Teaching and Learning for a Well-Rounded
Education program, but no funds specifically for arts in
education. The fiscal year 2012 appropriation is $24,935,000.
The funding is used for competitive awards for national
nonprofit organizations engaged in arts education, professional
development activities, and model arts education programs.
Funds also are used for evaluation and dissemination
activities, as well as a partnership with the National
Endowment for the Arts. The Committee appreciates the recent
release of the arts education report prepared by NCES. The
Committee believes that this survey should be conducted more
frequently than once every 10 years. The Committee also directs
the Department to take more effective steps in disseminating
what is being learned through the model and professional
development grants funded under the Arts in Education program.

Teacher Incentive Fund

The Committee recommendation includes $299,433,000, the
same amount as the fiscal year 2012 level, for TIF. The budget
proposal supports the program through a broader Teacher and
Leader Innovation Fund based on the administration's
reauthorization proposal but includes no funding specifically
for TIF.
The goals of TIF are to improve student achievement by
increasing teacher and principal effectiveness; reform
compensation systems to reward gains in student achievement;
increase the number of effective teachers teaching low-income,
minority, and disadvantaged students, and students in hard-to-
staff subjects; and other activities designed to increase the
effectiveness of teachers, principals, and other personnel in
high-need schools.

Ready-To-Learn Television

The Committee recommendation includes $27,194,000, the same
amount as the fiscal year 2012 level, for the Ready-to-Learn
Television program. The budget request proposes to fund similar
activities through its proposed Effective Teaching and
Learning: Literacy program, but includes no funding
specifically for Ready-to-Learn.
The Ready-to-Learn program is intended to use the power and
reach of public television to help prepare children, especially
disadvantaged children, enter and succeed in school. The ESEA
requires that all programming and digital content created under
Ready-to-Learn be specifically designed for nationwide
distribution over public television stations' digital
broadcasting channels and the Internet. The act also requires
funds to be made available to public telecommunications
entities to ensure that these programs and related educational
materials are disseminated and distributed to the widest
possible audience and are made accessible to all Americans.

Advanced Placement

The Committee recommends $36,027,000 for AP programs. The
comparable fiscal year 2012 level is $30,027,000. The budget
request proposes to fund similar activities through its College
Pathways and Accelerated Learning program, but does not include
funding specifically for AP.
These funds support two programs, the AP Test Fee program
and the AP Incentive [API] program. The purpose of both is to
aid State and local efforts to increase access to AP and
International Baccalaureate [IB] classes and tests for low-
income students. Under the test fee program, the Department
makes awards to SEAs to enable them to cover part or all of the
cost of test fees of low-income students who are enrolled in an
AP or IB class and plan to take an AP or IB test. Under the API
program, the Department makes 3-year competitive awards to
SEAs, LEAs, or national nonprofit educational entities to
expand access for low-income individuals to AP programs through
activities including teacher training; development of pre-
advanced placement courses; coordination and articulation
between grade levels to prepare students for academic
achievement in AP or IB courses; books and supplies; and
participation in online AP or IB courses. Under the authorizing
statute, the Department must give priority to funding the test
fee program.

Safe Schools and Citizenship Education

Appropriations, 2012.................................... $255,753,000
Budget estimate, 2013................................... 295,866,000
Committee recommendation................................ 259,589,000

The Committee recommends a total of $259,589,000 for
activities to promote safe schools, healthy students, and
citizenship education.
The President's budget was based on the administration's
proposal to reauthorize the ESEA, but no such bill has passed
the Senate. As a result, the Committee bill is based on current
law for programs authorized under the ESEA.

Promise Neighborhoods

The Committee recommends $80,000,000 for the Promise
Neighborhoods program. The comparable fiscal year 2012 funding
level is $59,887,000, and the budget request is $100,000,000.
Funds are available for obligation through December 31,
2013. By providing an extra quarter to obligate these funds,
the Committee gives fiscal year 2012 planning grantees
sufficient time to develop implementation plans that could be
funded by this bill and provides the Department ample time to
evaluate whether prior-year implementation grantees are making
significant progress required to justify the receipt of
continuation awards in fiscal year 2013.
Competitive grants are awarded to nonprofit, community-
based organizations for the development of comprehensive
neighborhood programs designed to combat the effects of poverty
and improve educational and life outcomes for children and
youth, from birth through college. Each Promise Neighborhood
grantee serves a high-poverty urban neighborhood or rural
community.
Two types of awards are made under this program, 1-year
planning grants and implementation grants. Funds for planning
grants are used by communities to develop a plan for providing
a continuum of services and supports for the children and youth
in a particular neighborhood. Implementation grants are awarded
to organizations with feasible plans for achieving the goals of
the program.
At the funding level recommended by the Committee, the
Department could use roughly $67,000,000 to support
implementation grants for prior planning grant recipients or
communities with high-quality plans for achieving the goals of
the program. Approximately $13,000,000 would be available for
another round of planning grants and for technical assistance
activities.

Successful, Safe, and Healthy Students

The Committee recommends no funds for this proposed new
program, which is based on the administration's reauthorization
plan. The Committee has allocated funds for related current law
programs, as described under the individual headings in this
account.
Under this program, the Department would award grants to
SEAs, title I-eligible LEAs, and their partners for programs
designed to improve the school culture and climate; improve
students' physical health and well-being; and improve students'
mental health and well-being.

Safe and Drug-Free National Activities

The Committee recommendation includes $48,600,000 for the
national activities portion of the Safe and Drug-Free Schools
and Communities program. The comparable fiscal year 2012
funding level is $64,877,000. The budget request proposes to
fund related activities within the proposed Successful, Safe,
and Healthy Students program.
The Committee recommendation includes funds for
continuation costs related to safe and supportive schools
grants and other activities.
The Committee is aware of the Department's work with
elementary and secondary schools and institutions of higher
education [IHEs] to support the successful adoption of the
National Incident Management System [NIMS]. Since all schools
and IHEs have a critical role in emergency management, it is
important that they adopt NIMS at the organizational and
operational levels as part of an integrated school and campus
emergency management plan. Therefore, the Committee encourages
the Department to continue to collaborate with the Department
of Homeland Security, make widely available the guidance on the
implementation of NIMS for schools and IHEs as part of all-
hazard emergency management planning, and provide training
resources on safety and security at large venues.

Elementary and Secondary School Counseling

The Committee recommends $52,296,000, the same amount as
the comparable fiscal year 2012 funding level, to establish or
expand counseling programs in elementary and secondary schools.
The budget request recommends consolidating this program into
its proposed Successful, Safe, and Healthy Students program,
but does not include any funding specifically for counseling.
As authorized, at least $40,000,000 must be used to support
elementary school counseling programs.

Carol M. White Physical Education for Progress Program

The Committee recommendation includes $78,693,000, the same
as the fiscal year 2012 level, to help LEAs and community-based
organizations initiate, expand, and improve physical education
programs for students in grades K-12. The budget request
recommends this program into its proposed Successful, Safe, and
Healthy Students program, but does not include any funding
specifically for physical education. This funding will help
schools and communities improve their structured physical
education programs for students and help children develop
healthy lifestyles to combat the national epidemic of obesity.

English Language Acquisition

Appropriations, 2012.................................... $732,144,000
Budget estimate, 2013................................... 732,144,000
Committee recommendation................................ 732,144,000

The Committee recommends an appropriation of $732,144,000
for English language acquisition.
The President's budget was based on the administration's
proposal to reauthorize the ESEA, but no such bill has passed
the Senate. As a result, the Committee bill is based on current
law for programs authorized under the ESEA.
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 authorizing statute requires
that 6.5 percent of the appropriation 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.
National activities funds shall be available for 2 years.
The Committee bill continues language that requires the
Secretary to use a 3-year average of the most recent data
available from the American Community Survey for calculating
allocations to all States under this program.

Special Education

Appropriations, 2012.................................... $12,640,709,000
Budget estimate, 2013................................... 12,687,307,000
Committee recommendation................................ 12,770,709,000

The Committee recommends an appropriation of
$12,770,709,000 for special education programs.

Grants to States

The Committee recommends $11,677,855,000, an increase of
$100,000,000 more than the fiscal year 2012 level and budget
request, for special education grants to States, authorized
under section 611 of part B of the IDEA.
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
LEAs, but may reserve some for program monitoring, enforcement,
technical assistance, and other activities.
The appropriation for this program primarily supports
activities associated with the 2013-2014 academic year. Of the
funds available for this program, $2,394,472,000 will become
available on July 1, 2013, and $9,283,383,000 will become
available on October 1, 2013. These funds will remain available
for obligation through September 30, 2014.
As requested by the administration, the Committee continues
bill language capping the Department of the Interior set-aside
at the prior year level, adjusted by the lower of the increase
in inflation or the change in the appropriation for grants to
States. This provision also would prevent a decrease in the
amount to be transferred in case the funding for this program
decreases or does not change.
The bill also includes new language clarifying provisions
of the IDEA. The first provision clarifies that penalties paid
by States for violating maintenance of effort under part B of
the IDEA shall be reallocated to States by formula to those
States that did not violate those requirements. The language
further clarifies that both the reduced State allocations due
to penalties paid and increased amounts under the reallocation
shall not be considered in fiscal year 2013 or future years for
allocations under the statutory formula. These provisions are
included in the administration's budget request.
The bill also includes new language clarifying that the
level of effort under part B that an LEA must meet in the year
after it fails to maintain its fiscal effort is the level that
it should have met in the prior year. This language clarifies
congressional intent and is consistent with OSEP's April 4,
2012, informal guidance letter on the issue. Finally, the bill
includes language clarifying that funds reserved under section
611(c) of the IDEA may be used to help improve State capacity
to meet data collection requirements under the IDEA and improve
data collection, quality, and use under the act.

Preschool Grants

The Committee recommends $372,646,000, the same amount as
the fiscal year 2012 level and budget request, for preschool
grants. The preschool grants program provides formula grants to
States to assist them in making available special education and
related services for children with disabilities aged 3 through
5. States distribute the bulk of the funds to LEAs. States must
serve all eligible children with disabilities aged 3 through 5
and have an approved application under the IDEA.

Grants for Infants and Families

The Committee recommends $462,710,000, the same amount as
the budget request, for the grants for infants and families
program under part C of the IDEA. The comparable fiscal year
2012 level is $442,710,000. Part C of the IDEA authorizes
formula grants to States, outlying areas, and other entities to
implement statewide systems for providing early intervention
services to all children with disabilities, ages 2 and younger,
and their families. The IDEA also gives States the option of
extending eligibility for part C services to children 3 and
older if they were previously served under part C and will
continue to be served until entrance to kindergarten.
As requested by the administration, the Committee bill
includes new language allowing the Department to use up to
$2,710,000 for incentive grants to States that choose to serve
children 3 years old until entrance into elementary school. The
IDEA currently allows up to 15 percent of the amount above
$460,000,000 to be used for this purpose, which would be too
small under the level of the Committee recommendation to
effectively serve potentially interested States.

State Personnel Development

The Committee recommends $45,011,000, the same amount as
the budget request, for the State personnel development
program. The comparable fiscal year 2012 amount is $43,917,000.
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 SEAs 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.

Technical Assistance and Dissemination

The Committee recommends $46,781,000, the same amount as
the budget request and fiscal year 2012 level, for technical
assistance and dissemination. 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 the IDEA.
The Committee continues to support activities that address
the need for high-quality, evidence-based technical assistance
activities that improve the services to and outcomes for
students with disabilities. Prior to issuing new notices for
fiscal year 2013 competitions, the Committee directs OSEP to
develop a long-term strategic plan for its technical assistance
activities that is aligned with its revised monitoring and data
reporting structures as well as the Department's other
technical assistance activities.

Personnel Preparation

The Committee recommends $86,205,000 for the personnel
preparation program. The budget request is $85,799,000 and the
comparable fiscal year 2012 amount is $88,299,000.
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 program is
required to fund several other broad areas, including training
leadership personnel and personnel who work with children with
low-incidence disabilities, and providing enhanced support for
beginning special educators.

Parent Information Centers

The Committee recommends $29,917,000 for parent information
centers. The budget request and comparable fiscal year 2012
amount are $28,917,000. 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 $29,588,000, the same amount as
the budget request and comparable fiscal year 2012 level, for
technology and media services. This program makes competitive
awards to support the development, demonstration, and use of
technology and educational media activities of value to
children with disabilities.

PROMISE: Promoting Readiness of Minors in SSI

The Committee recommendation includes $11,996,000 for
PROMISE and makes these funds available for obligation through
September 30, 2014. The budget request includes $30,000,000 for
this activity. Last year's bill provides $1,996,000 under this
account, as well as additional resources from unclaimed VR
State grant funds and funds provided to SSA.
The goal of PROMISE is to improve outcomes, such as
employment and completion of postsecondary education, of
children who receive SSI, as well as their families.
Competitive grants will be awarded to a small number of States
for a period of 5 years. States will use funds to improve the
coordination and increase the use of existing services for
which children receiving SSI and their families are already
eligible. The Committee includes new bill language requested by
the administration that slightly modifies the program as it was
initially created in last year's bill.
As requested by the administration, the Committee bill also
includes new bill language that allows a portion of the funds
provided to be used for Pay for Success awards, which are
described in the highlights section in the introduction to the
Committee report. The Committee expects to be notified prior to
the issuance of any notice related to the Pay for Success
activity.

Special Olympics

The Committee recommendation includes $8,000,000, the same
amount as the fiscal year 2012 level and budget request, for
Special Olympics education activities. Under the Special
Olympics Sport and Empowerment Act of 2004, the Secretary is
authorized to provide financial assistance to Special Olympics
for activities that promote its expansion and for the design
and implementation of education activities that can be
integrated into classroom instruction and are consistent with
academic content standards.
The Committee bill includes language requested by the
administration allowing funds to be used to support Special
Olympics National and World Games. This language was not
included in last year's bill, but has been included in bills
from prior years.

Rehabilitation Services and Disability Research

Appropriations, 2012.................................... $3,511,281,000
Budget estimate, 2013................................... 3,581,313,000
Committee recommendation................................ 3,626,380,000

The Committee recommends $3,626,380,000 for rehabilitation
services and disability research.

Vocational Rehabilitation State Grants

The Committee recommends $3,230,972,000 for VR grants to
States. The Committee recommends the full amount authorized by
the Rehabilitation Act of 1973 for this mandatory funding
stream. The comparable fiscal year 2012 level is
$3,121,712,000. The fiscal year 2013 budget request is
$3,167,369,000 and assumes several program consolidations and
eliminations as part of a proposal to reauthorize WIA. While
the Senate authorizing committee has made significant progress
on a WIA reauthorization, legislation has not yet passed the
Senate. As a result, the Committee recommendation follows
current law.
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.
The Rehabilitation Act requires that not less than 1
percent and not more than 1.5 percent of the appropriation in
fiscal year 2013 for VR State grants be set aside for grants
for Indians.
The Committee bill continues language, as requested by the
administration, allowing unmatched funds in excess of any funds
requested during the reallotment process to be available for
the PROMISE program described under the Special Education
account and SSA. Such funds used for the PROMISE program will
remain available for obligation through September 30, 2014.
As requested by the administration, the Committee bill also
includes new bill language that allows a portion of the funds
provided under the PROMISE program to be used for Pay for
Success awards, which are described in the highlights section
in the introduction to the Committee report. The Committee
expects to be notified prior to the issuance of any notice
related to Pay for Success activity.
The budget request also provides a $10,000,000 set-aside
for WIF. The Committee does not recommend any funds for WIF
from VR grants to States due to budget constraints, but instead
recommends funding through the Department of Labor to continue
this initiative.

Client Assistance State Grants

The Committee recommends $12,240,000 in discretionary
funds, the same amount provided in fiscal year 2012 and the
budget request, for the client assistance State grants program.
The client assistance program funds State formula grants to
help VR clients or client applicants understand the benefits
available to them and work with service providers. States must
operate client assistance programs in order to receive VR State
grant funds.

Training

The Committee recommends $35,515,000, the same as the
comparable fiscal year 2012 level, for training rehabilitation
personnel. The budget request provides $30,188,000.
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.

Demonstration and Training Programs

The Committee recommends $6,500,000 for demonstration and
training programs; this amount is an increase of $1,175,000
above the comparable fiscal year 2012 funding level. The budget
request includes $5,750,000.
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 recommendation includes $425,000 for new
technical assistance activities, as requested in the budget,
for RSA to direct program improvement resources to the areas of
greatest need and assist the field to improve outcomes for
individuals with disabilities.
The Committee recommendation includes $750,000 to support a
new competition for parent training and information centers,
which provide information and training on transition planning,
the adult service system, and strategies that prepare youth for
successful employment, postsecondary education, and independent
living outcomes. The Committee expects RSA to coordinate with
OSEP in carrying out this activity.

Migrant and Seasonal Farmworkers

The Committee recommends $1,262,000, the same as the
comparable fiscal year 2012 funding level, for migrant and
seasonal farmworkers. The budget request proposes consolidating
this program into the VR State Grants Program.
This program provides grants for comprehensive
rehabilitation services to migrant and seasonal farmworkers
with disabilities and their families.

Protection and Advocacy of Individual Rights

The Committee recommends $18,031,000, the same amount
provided in fiscal year 2012 and the budget request, for
protection and advocacy of individual rights.
This program provides grants to agencies to protect and
advocate for the legal and human rights of persons with
disabilities who are ineligible 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.

Supported Employment State Grants

The Committee recommends $29,068,000, the same as the
comparable fiscal year 2012 level, for the supported employment
State grant program. The budget request proposes consolidating
this program into the VR State Grants program.
This program assists the most severely disabled individuals
by providing ongoing support needed to obtain competitive
employment.

Independent Living State Grants

The Committee recommends $23,359,000, the same amount
provided in fiscal year 2012 and the budget request, for
independent living State grants.
This program provides formula grants to States to improve
independent living services, support the operation of centers
for independent living, conduct studies and analysis, and
provide training and outreach.

Centers for Independent Living

The Committee recommends $79,953,000, the same amount
provided in fiscal year 2012 and the budget request, for
independent living 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.
The Committee commends the work by these centers and
encourages them to continue their efforts to facilitate the
transition of individuals with significant disabilities from
institutional settings to home and community based residences,
and from school to postsecondary life, including employment.

Independent Living Services for Older Blind Individuals

The Committee provides $34,018,000, the same amount
provided in fiscal year 2012 and the budget request, for
independent living services to older blind individuals.
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 most commonly provided by this program
are daily living skills training, counseling, community
integration, information and referral, the provision of low-
vision devices and communication devices, and low-vision
screening.

Helen Keller National Center

The Committee recommends $9,145,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults. This is the
same amount as the budget request and fiscal year 2012 level.
The Helen Keller National Center consists of a national
headquarters in Sands Point, New York, with a residential
training and rehabilitation facility where deaf-blind persons
receive intensive specialized services; a network of 10
regional field offices that provide referral and counseling
assistance to deaf-blind persons; and an affiliate network of
agencies.

National Institute on Disability and Rehabilitation Research

The Committee recommends $108,817,000, the same as the
comparable fiscal year 2012 level, for NIDRR. The budget
request includes $106,817,000 for this purpose.
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 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 strongly supports the mission of NIDRR, which
includes research in the interrelated domains of health and
function, employment, and participation and community living.
NIDRR's resources should focus on each of these statutory
research priorities to ensure the advancement of economic and
social self-sufficiency and full community inclusion and
participation. The Committee urges the Secretary to embrace
NIDRR's mission and enhance its stature and visibility within
the Department. It also urges the NIDRR director to focus
attention on ensuring that the practical implications of
research outcomes are summarized and research activities and
findings are made publicly available in a timely manner.

Assistive Technology

The Committee recommends $37,500,000 for assistive
technology. The fiscal year 2012 funding level is $32,836,000.
The budget request includes $30,840,000 for this purpose.
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 supports various activities that help States develop
comprehensive, consumer-responsive statewide programs that
increase access to, and the availability of, assistive
technology devices and services.
The Committee recommendation will ensure all 50 Statewide
Assistive Technology programs, the District of Columbia, and
outlying areas will receive the minimum grant provided under
statute for the first time.
The Committee recommendation includes $31,000,000 for State
grant activities authorized under section 4 of the
Rehabilitation Act of 1973, $5,500,000 for protection and
advocacy systems authorized by section 5, and $1,000,000 for
technical assistance activities authorized under section 6. The
comparable fiscal year 2012 levels are $25,560,599, $4,282,890,
and $996,114, respectively.

Special Institutions for Persons With Disabilities

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2012.................................... $24,505,000
Budget estimate, 2013................................... 24,505,000
Committee recommendation................................ 24,505,000

The Committee recommends $24,505,000 to help support APH.
APH provides educational materials to students who are
legally blind and enrolled in programs below the college level.
The Federal subsidy provides approximately 70 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, recorded form, and computer 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.

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2012.................................... $65,422,000
Budget estimate, 2013................................... 65,037,000
Committee recommendation................................ 65,422,000

The Committee recommends $65,422,000 for NTID. This level
supports operational costs only, as in fiscal year 2012. The
budget request includes $2,000,000 for construction expenses in
addition to operational costs.
NTID, located on the campus of the Rochester Institute of
Technology in Rochester, New York, 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.

GALLAUDET UNIVERSITY

Appropriations, 2012.................................... $125,516,000
Budget estimate, 2013................................... 117,541,000
Committee recommendation................................ 125,000,000

The Committee recommends $125,000,000 for Gallaudet
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 and deaf. The
university conducts basic and applied research related to
hearing impairments and provides public service programs for
the deaf community.
Federal funding also supports the Model Secondary School
for the Deaf, which serves as a laboratory for educational
experimentation and development; disseminates curricula,
materials, and models of instruction for students who are deaf;
and prepares adolescents who are deaf for postsecondary
academic or vocational education or the workplace. The Kendall
Demonstration Elementary School develops and provides
instruction for children from infancy through age 15.
The Committee bill includes $7,000,000 for construction-
related activities at Gallaudet University. The administration
does not request funds specifically for construction, but
allows up to $7,000,000 to be set aside from operations for
construction-related activities.

Career, Technical, and Adult Education

Appropriations, 2012.................................... $1,737,154,000
Budget estimate, 2013................................... 1,737,154,000
Committee recommendation................................ 1,737,154,000

The Committee recommends a total of $1,737,154,000 for
career, technical, and adult education.

Career and Technical Education

The Committee recommends $1,130,859,000, the same as the
comparable fiscal year 2012 level and the budget request, for
career and technical education [CTE].
State Grants.--The Committee recommends $1,123,030,000, the
same as the comparable fiscal year 2012 level and budget
request, for CTE State grants.
Funds provided under the State grant program assist States,
localities, and outlying areas expand and improve their CTE
program and help ensure equal access to CTE 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 additional
to services received by these groups under other provisions of
the Perkins Act.
Of the funds available for this program, $332,030,000 will
become available July 1, 2013, and $791,000,000 will become
available on October 1, 2013. These funds will remain available
for obligation until September 30, 2014.
National Programs.--The Committee recommends $7,829,000 for
national research programs and other national activities. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request.
Funds are used to support the CTE national research center,
as well as activities designed to improve the quality of
performance data States collect and report to the Department.

Adult Education

The Committee recommends $606,295,000, the same as the
fiscal year 2012 level and the budget request, for adult
education.
Adult Education State Grant.--For adult basic and literacy
education State grants, the Committee recommends $594,993,000,
the same as the fiscal year 2012 level and the budget request.
Funds are used by States for programs to enable 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 grants appropriation. Within the total,
$74,709,000 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. This
set-aside is the same as the fiscal year 2012 level and the
budget request.
The budget request also provides a $15,000,000 set-aside
for WIF, to be jointly administered by the Department and DOL.
The Committee does not recommend any adult education funds for
WIF due to budget constraints. Instead, the Committee provides
WIF funding only through DOL.
The budget request includes a general provision that
provides the Secretary with the authority to waive statutes and
regulations relating to title II of WIA and title I of the
Rehabilitation Act of 1973 when the Secretary believes waivers
would substantially improve employment and education outcomes.
The Committee does not include the general provision.
National Leadership Activities.--The Committee recommends
$11,302,000, the same amount as the fiscal year 2012 level and
the budget request, for national leadership activities.
The Committee urges the Department to strengthen adult
education programs to increase the focus on adults with the
lowest literacy and numeracy skills. A vital component of
delivering these services to those individuals are community-
based organizations that have successfully implemented
strategies for delivering basic adult literacy instruction
together with employment training. The Committee encourages the
Department to work with DOL to identify promising approaches to
succeed in this effort, including approaches that support the
Department's career pathways and postsecondary transition
initiatives. In recognition of the critical role adult learners
play in advising on successful learner outcomes, the Committee
also requests that the Department work with national adult
literacy organizations to identify and promote new capacity
building initiatives on adult learner leadership and advisory
roles in local programs.

Student Financial Assistance

Appropriations, 2012.................................... $24,535,281,000
Budget estimate, 2013................................... 24,685,281,000
Committee recommendation................................ 24,535,281,000

The Committee recommends an appropriation of
$24,535,281,000 for programs under the student financial
assistance account.

Federal Pell Grant Program

The Committee recommends $22,824,000,000 in discretionary
funding, the same amount as the fiscal year 2012 level and the
budget request, for the Pell grant program. This amount will
support an increase in the maximum Pell grant award from $5,550
to $5,635--the first increase in the maximum award since fiscal
year 2010.
Pell Grants provide need-based financial assistance that
helps 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.
More than 9.6 million students are expected to receive a
Pell grant during the 2012-2013 academic year. Of the 9.3
million students who relied on Pell Grants during the 2010-2011
award year, 74 percent had incomes or came from families with
incomes less than or equal to $30,000.
The Pell grant program is funded partly through the
discretionary appropriations process and partly through
mandatory funding. The HCERA included additional mandatory
money for the program to increase the maximum grant by the
Consumer Price Index beginning in academic year 2013-2014 as
long as the discretionary portion of the funding is sufficient
to support $4,860 of the maximum award. The Committee
recommendation for fiscal year 2013 meets that requirement, so
it will trigger enough mandatory funding to add $775 ($85 more
than in fiscal year 2012) to the maximum award on top of the
discretionary portion, for a total maximum award of $5,635.
In fiscal year 2012, Congress made several programmatic
changes to the Pell grant program to close the $1,362,000,000
funding gap between the estimated cost of maintaining the
maximum award and the discretionary funding level provided the
previous year. These changes reduced program costs in fiscal
year 2012 and into the future, and helped improve the fiscal
sustainability of the Pell grant program.
Together with mandatory funding from the HCERA and BCA,
plus discretionary funding in the fiscal year 2012 Consolidated
Appropriations Act, as well as $2,087,000,000 in cumulative
surplus budget authority from previous fiscal years, the fiscal
year 2013 funding level will provide an estimated
$1,839,000,000 more than is needed to support the discretionary
base award of $4,860 and trigger the mandatory increase in the
maximum award. This surplus will carry over into fiscal year
2014.
While the Committee's recommendation ensures there will be
no funding gap in fiscal year 2013, the Committee is extremely
concerned about the funding cliff expected in fiscal year 2014.
If the discretionary funding for Pell grants were level funded
again in fiscal year 2014, it is estimated that an additional
$6,003,000,000 would be needed to continue supporting the
discretionary portion of the maximum award at $4,860.
Ignoring this looming crisis would be irresponsible.
Therefore, the Committee recommends three reforms to the
student financial aid programs that will provide offsets that
will not only put a down payment on the Pell grant program's
funding needs but also incentivize students to complete their
education, eliminate excessive payments to guaranty agencies,
and reduce fraud related to distance education programs.
Together, these changes will produce $3,517,000,000 in savings
in fiscal years 2013 and 2014, all of which will be put back
into the Pell grant program to further reduce the funding cliff
in fiscal year 2014. The remaining savings from these
provisions will be applied in later years.
First, the Committee recommendation includes bill language
that limits the duration of a student borrower's in-school
interest subsidy to 150 percent of the normal time required to
complete the educational program. For example, an undergraduate
student enrolled in a 4-year bachelor's degree program will be
eligible to receive the in-school interest subsidy for up to 6
years. Currently, subsidized Stafford student loan borrowers
receive the in-school interest subsidy the entire time they
remain enrolled. The proposal to limit the subsidy duration
will encourage borrowers to complete their educational program
in a timelier manner. The Committee recommendation will impact
new borrowers only. The administration included a similar
proposal in the budget request that would have applied to
current borrowers as well.
The second reform recommended by the Committee, and
requested by the administration, will reduce the amount of loan
rehabilitation funds that may be retained by guaranty agencies.
A student borrower who has defaulted on his or her loan has
the opportunity to rehabilitate it by making a series of nine
payments over a 10-month period. The guaranty agency then sells
the loan to an eligible lender, triggering the removal of the
default status. Guaranty agencies are compensated in two ways
through the rehabilitation process. First, they receive 18.5
percent of the original defaulted amount, plus an additional
18.5 percent collection fee that is charged to the borrower.
This means the guaranty agency retains 37 percent of each loan
rehabilitated.
The Committee recommendation includes bill language that
eliminates the guaranty agencies' retention of 18.5 percent of
the original balance and requires the guaranty agencies to
remit the original balance to the Department, as opposed to
selling the remaining 81.5 percent of the original balance to
an eligible lender. In addition, the fee charged to borrowers
will be capped at 16 percent as opposed to 18.5 percent. The
Department estimates this policy will reduce borrower fees by
$58,000,000 in fiscal year 2013.
The Committee notes that many guaranty agencies are
affiliated with not-for-profit servicers that will benefit from
new loan servicing contracts awarded under the HCERA. These new
contracts will reduce or even eliminate the financial impact of
the proposed reform to the guaranty agencies.
Third, the Committee recommendation includes a reform to
limit Pell Grants to cover only tuition, fees, books, and
supplies, and not room and board, for students enrolled in
programs provided exclusively by distance education. The
Committee notes that, with recent statutory changes that
removed the restrictions on the eligibility of distance
education programs for student financial aid, there has been a
significant increase in the number of education programs
offered solely online and in the number of students receiving
Pell Grants to enroll in such programs. In September 2011, the
Department's Inspector General [IG] issued an Investigative
Program Advisory Report alerting the Department about the
growth of fraud in distance education programs. Specifically,
the report noted that since 2005, 215 participants in 42 fraud
rings have been convicted and ordered to pay $7,500,000 in
restitution and fines and that 17 percent of the agency's open
cases are related to distance education fraud. The IG also
expressed concern that the cost of attendance [COA] for
distance education students includes an allowance for room and
board, which is in contrast to the requirement for students
enrolled in correspondence courses. The COA for those students
excludes room and board.
Therefore, the Committee includes new bill language that
will limit the COA calculation for purposes of determining Pell
grant award amounts. Only the costs of tuition, fees, books,
and supplies will be included in the COA used to determine the
Pell grant award amount for an individual enrolled in an
education program delivered exclusively online. Students
enrolled in programs that are taught in an on-campus location,
or taught using a mix of both on-campus instruction and
instruction through distance education, will be unaffected by
this reform.

Protecting Financial Aid for Students and Taxpayers

The Committee is disturbed by recent findings that some
colleges and universities are using Federal student financial
assistance funding for aggressive marketing, recruitment, and
advertising rather than for the programs' intended purpose--to
help low- and middle-income students pursue an academic degree.
At a time when Federal resources are scarce and students
and families across the Nation are struggling to afford a
college education, this practice should not be tolerated.
To that end, the Committee includes bill language that
prohibits all colleges and universities receiving funding
through the HEA from spending Federal educational program
dollars on advertising, marketing, and recruitment. Colleges
and universities will continue to be free to spend however much
they want on these activities; this provision simply stipulates
that they cannot use Federal tax dollars that are intended for
student aid and educational programs to do so. This reform will
target Federal resources at educating students, as opposed to
online advertisements and aggressive recruiters, and help
ensure that taxpayers are getting a good return on their
investment.

Federal Supplemental Educational Opportunity Grant Program

The Committee recommends $734,599,000 for the SEOG program.
This amount is the same as the fiscal year 2012 level and the
budget request.
The SEOG program provides funds to postsecondary
institutions for need-based grants to undergraduate students.
Institutions must contribute at least 25 percent toward SEOG
awards. Students qualify for grants of up to $4,000 by
demonstrating financial need. School financial aid officers
have flexibility to determine student awards, though they must
give priority to Pell grant recipients with exceptional need.
The budget request recommends reforming the SEOG allocation
formula and redirecting SEOG funding from higher-priced and
well-endowed institutions to lower-priced public and private
institutions that enroll and graduate higher numbers of Pell-
eligible students and restrain tuition increases. The budget
request does not include any specific recommendations or bill
language on how to accomplish these goals. The Committee
supports the proposals in principle but believes they deserve
more deliberation in Congress.

Federal Work-Study Program

The Committee bill provides $976,682,000 for the FWS
program. This is the same amount as the comparable fiscal year
2012 level. The budget request includes $1,126,682,000 and
directs the $150,000,000 in new funds to institutions opting to
participate in an enhanced work-study partnership with
prospective employers.
The budget request also recommends reforming the FWS
allocation formula to target and incentivize funding toward
institutions that enroll and graduate relatively high numbers
of Pell-eligible students as well as offer lower, net tuition
prices and fees and/or contain growth in tuition and fees. The
budget request does not include bill language on this proposal
and no hearings on the topic have been held in the Senate or
House. The Committee supports the administration's goals, but
believes the proposal deserves more deliberation in Congress.
This program provides grants to about 3,400 institutions to
help an estimated 700,000 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 recognizes that community service
opportunities allow students to gain work experience and
develop skills that they may be able to use in future careers
and encourages the Department to bolster these opportunities at
participating FWS institutions.
The Committee expects the Department to provide the same
funding from the FWS program appropriation in fiscal year 2013
as in the prior year for the Work Colleges program authorized
under section 448 of the HEA.

Federal Perkins Loans

The Federal Perkins loan program supports student loan
revolving funds built up with capital contributions to nearly
1,700 participating institutions. Institutions use these
revolving funds, which also include Federal capital
contributions [FCCs], institutional contributions equal to one-
third of the FCCs, and student repayments, to provide low-
interest, subsidized loans that help financially needy students
pay the costs of postsecondary education.
The Committee recommends no new funds for the Perkins Loans
program, as was the case in fiscal year 2012. The budget
request proposes to restructure the Perkins Loan program as a
mandatory credit program--and to expand institutional
participation by up to an additional 2,700 postsecondary
education institutions. The Committee bill does not include
this proposal.

Student Aid Administration

Appropriations, 2012.................................... $1,043,387,000
Budget estimate, 2013................................... 1,126,363,000
Committee recommendation................................ 1,126,363,000

The Committee recommends $1,126,363,000 for the Student Aid
Administration account. These funds are available until
September 30, 2014, and support the Department's student aid
management expenses.
The HCERA terminated the authority under the HEA to make
loans under the Federal Family Education Loan Program as of
June 2010. Beginning July 1, 2010, 100 percent of student loans
are now made through the William D. Ford Direct Loan Program
and are serviced by private for-profit and not-for-profit
servicers under contract with the Department.
The Committee recommendation includes $726,618,000 for
administrative costs and $399,745,000 for loan servicing
activities. The Committee recommendation for these two
activities represents a combined $82,976,000 increase over the
fiscal year 2012 level. The Committee recommendation reflects
the increased application, origination, and servicing costs
associated with the recent legislative changes. These increases
are necessary to manage the higher loan volume, ensure the
operational integrity of Federal student aid systems, and
provide high-quality service to student and parent borrowers.
The budget request includes a general provision
transferring the Health Education Assistance Loan program from
HHS to the Department. The Committee recommendation includes
new bill language authorizing the transfer and provides
$2,807,000 for the costs of managing and servicing outstanding
loans.
The Committee directs the Department to continue to provide
quarterly reports detailing its obligation plan by quarter for
spending mandatory and discretionary funding for student aid
administrative activities broken out by servicer, activity, and
funding source.

Higher Education

Appropriations, 2012.................................... $1,869,656,000
Budget estimate, 2013................................... 2,914,064,000
Committee recommendation................................ 1,911,348,000

The Committee recommends an appropriation of $1,911,348,000
for higher education programs.

Aid for Institutional Development

The Committee recommends $531,076,000 for Aid for
Institutional Development. This total and the recommended
levels for each of the individual programs below are the same
as the comparable levels for fiscal year 2012 and the budget
request.
Strengthening Institutions.--The Committee bill recommends
$80,623,000 to provide 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 these funds to develop
faculty, strengthen academic programs, improve institutional
management, and expand student services.
Hispanic-Serving Institutions [HSIs].--The Committee
recommends $100,432,000 for competitive grants to institutions
at which Hispanic students make up at least 25 percent of
enrollment. 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. In addition to the Committee-recommended
level, the HCERA provides $100,000,000 of mandatory funding in
each fiscal year through 2019 to support HSIs in the
development of STEM and articulation programs.
Promoting Postbaccalaureate Opportunities for Hispanic
Americans.--The Committee recommends $9,011,000 for competitive
5-year grants to HSIs to help Hispanic Americans gain entry
into and succeed in graduate study. Institutions may use
funding to support low-income students through outreach
programs; academic support services; mentoring and financial
assistance; acquisition, rental, or lease of scientific or
laboratory equipment; construction and other facilities
improvements; and purchase of educational materials.
Strengthening Historically Black Colleges and
Universities.--The Committee recommends $227,980,000 for the
strengthening HBCUs program. The 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. In addition to the Committee-
recommended level, this program will receive $85,000,000 of
mandatory funding through the HCERA in each fiscal year through
2019.
Strengthening Historically Black Graduate Institutions
[HBGIs].--The Committee recommends $58,958,000 for the
Strengthening HBGIs program. This program provides 5-year
grants to provide scholarships for low-income students and
academic and counseling services to improve student success.
Funds may also be used for construction, maintenance and
renovation activities, the purchase or lease of scientific and
laboratory equipment, and the establishment of an endowment.
Strengthening Predominately Black Institutions [PBIs].--The
Committee recommends $9,262,000 for the Strengthening PBIs
program. This program provides 5-year grants to PBIs to plan
and implement programs to enhance the institutions' capacity to
serve more low- and middle-income Black American students. In
addition to the Committee-recommended level, the HCERA provides
$15,000,000 of mandatory funding in each fiscal year through
2019 to support programs at PBIs in the areas of STEM, health
education, internationalization or globalization, teacher
preparation, and improving the educational outcomes of African-
American males.
Strengthening Asian American and Native American Pacific
Islander-Serving Institutions [AANAPISIs].--The Committee
recommends $3,119,000 for competitive grants to AANAPISIs that
have an enrollment of undergraduate students that is at least
10 percent Asian American or Native American Pacific Islander
students. Grants may be used to improve their capacity to serve
Asian American and Native American Pacific Islander students
and low-income individuals. In addition to the Committee-
recommended level, AANAPISIs will receive $5,000,000 of
mandatory funding through the HCERA in each fiscal year through
2019 to develop faculty, strengthen academic programs, improve
institutional management, and expand student services.
AANAPISIs may also use mandatory funds for construction of
classrooms, libraries, laboratories, and other instructional
facilities.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions.--The Committee recommends $12,859,000 for this
program. In addition to the Committee-recommended level, these
institutions receive $15,000,000 of mandatory funding through
the HCERA in each fiscal year through 2019.
The purpose of this program is to improve and expand the
capacity of institutions serving Alaska Native and Native
Hawaiian students and low-income individuals. Funds may be used
to plan, develop, and implement activities that encourage
faculty and curriculum development, better fund administrative
management, renovation, and improvement of educational
facilities, enhanced student services, the purchase of library
and other educational materials, and education or counseling
services designed to improve the financial and economic
literacy of students or their families.
Strengthening Native American-Serving Nontribal
Institutions.--The Committee recommends $3,119,000 for this
program, which serves institutions that enroll at least 10
percent Native American students and at least 50 percent low-
income students. In addition to the Committee-recommended
level, these institutions receive $5,000,000 of mandatory
funding through the HCERA in each fiscal year through 2019 to
help institutions plan, develop, and implement activities that
encourage faculty and curriculum development, better fund
administrative management, renovation, and improvement of
educational facilities, enhanced student services, and the
purchase of library and other educational materials.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $25,713,000 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. In
addition to the Committee-recommended level, this program
receives $30,000,000 of mandatory funding through the HCERA in
each fiscal year through 2019.

International Education and Foreign Language Studies

The bill includes a total of $75,729,000, the same as the
budget request, for international education and foreign
language programs. The comparable fiscal year 2012 level is
$74,037,000.
Funds are used to support visits and study in foreign
countries by individuals who plan to utilize their language
skills in areas vital to U.S. national security in the fields
of government, international development, and the professions.
Domestic Programs.--The Committee recommends $68,278,000
for domestic program activities related to international
education and foreign language studies under title VI of the
HEA. This amount is the same as the budget request. The fiscal
year 2012 level is $66,586,000. Funding will support
continuation awards in the national resource centers, foreign
language and area studies fellowships, international business
education projects and centers, language resource centers, and
American overseas research centers. The Committee urges the
Secretary to preserve the program's longstanding focus on
activities and institutions that address the Nation's need for
a strong training and research capacity in foreign languages
and international studies, including increasing the pool of
international experts in areas that are essential to national
security and economic competitiveness.
The increase in funds over the fiscal year 2012 level
should be used to support new awards in the Undergraduate
International Studies and Foreign Language program. The
Committee recognizes that study abroad helps prepare students
to function effectively in a global environment and recommends
funding to expand access to study abroad, as authorized by
section 604(b) of the HEA, particularly for underserved student
populations and to nontraditional destinations, especially in
developing countries.
Overseas Programs.--The Committee recommends $7,451,000 for
overseas programs authorized under the Mutual Educational and
Cultural Exchange Act of 1961, popularly known as the
Fulbright-Hays Act. This amount is the same as the comparable
fiscal year 2012 funding level and the budget request. Funding
is provided for group, faculty, or doctoral dissertation
research abroad as well as special bilateral projects. Grants
focus on training American instructors and students in order to
improve foreign language and area studies education in the
United States.

Fund for the Improvement of Postsecondary Education

The Committee recommends $43,494,000 for FIPSE. The
comparable fiscal year 2012 funding level is $3,494,000 and the
budget request for this program is $70,000,000.
The Committee includes $39,000,000 to create the First in
the World initiative, which will be modeled after the Investing
in Innovation program. The budget request includes $55,500,000
for this new program. The initiative will help ensure
institutions of higher education have access to and implement
innovative strategies and practices that have been shown to be
effective in improving educational outcomes and making college
more affordable for students and families. The Committee
recommends that up to $14,000,000 be set aside for minority-
serving institutions to improve their students' persistence and
completion rates while keeping costs under control. The
Committee is particularly interested in supporting programs
that target innovative strategies at low-income students.
Training for Realtime Writers.--Within the total for FIPSE,
the Committee recommendation includes $1,128,000 for the
Training for Realtime Writers program authorized by section 872
of the HEA. This amount is the same as the fiscal year 2012
level. The budget request does not include funding for this
program, which provides grants to institutions of higher
education to establish programs to train realtime writers.
Eligible activities include curriculum development, student
recruitment, distance learning, mentoring, and scholarships.
The program places a priority on encouraging individuals with
disabilities to pursue careers in realtime writing. More than
30 million Americans are considered deaf or hard of hearing,
and many require captioning services to participate in
mainstream activities and gain access to emergency broadcasts.
Federal law requires that all television broadcasts be closed
captioned, yet a shortage of trained captioners is contributing
to the barrier to full-quality captioning of realtime
television programming such as news, weather, and emergency
messaging.
Low-Income Single Parents.--The Committee recognizes the
importance of providing targeted, supportive services to low-
income, single-parent students, such as on-campus housing,
child care, counseling, advising, internship opportunities,
financial aid, and financial aid counseling and assistance. The
Committee continues to encourage the Department to promote
replication of best practices that have proven to successfully
provide postsecondary degree completion opportunities for low-
income single parents.
The Committee includes new bill language, as proposed in
the budget, allowing any funds from title III (Institutional
Aid), title V (Developing Institutions), and part AA of title
VIII (Masters and Postbaccalaureate Programs) of the HEA that
would otherwise lapse to carry out an initiative to improve
college completion rates at minority-serving institutions.
Analysis of Federal Regulations and Reporting Requirements
on Institutions of Higher Education.--The Committee directs
$1,000,000 for the Secretary to enter into an agreement with
the National Research Council of the National Academy of
Sciences to conduct a study on the impacts of Federal
regulations and reporting requirements on institutions of
higher education as authorized under section 1106 of the Higher
Education Opportunity Act of 2008. The study shall include
information describing, by agency, the number of Federal
regulations and reporting requirements affecting institutions
of higher education, the estimated time required and costs to
institutions of higher education (disaggregated by types of
institutions) to comply with the regulations and reporting
requirements affecting institutions of higher education, and
recommendations for consolidating, streamlining, and
eliminating redundant and burdensome Federal regulations and
reporting requirements affecting institutions of higher
education. The study shall be submitted to the Senate and House
Committees on Appropriations, as well as the Committee on HELP
and the Committee on Education and the Workforce not later than
1 year after the date of enactment of this act.

Model Comprehensive Transition and Postsecondary Programs for Students
With Intellectual Disabilities

The Committee recommendation includes $10,957,000 for this
program as authorized by section 769 of the HEA. This is the
same level that was provided in fiscal year 2012. The budget
request includes $10,978,000 for this purpose within FIPSE
rather than as a distinct program.
These funds provide competitive grants to postsecondary
institutions to establish model programs to help students with
intellectual disabilities transition to and complete college.
Funds may be used for student support services; academic
enrichment, socialization, or independent living; integrated
work experiences; and partnerships with LEAs to support
students with intellectual disabilities participating in the
model program who are still eligible for special education and
related services under the IDEA.
Funds also support a national coordinating center that is
charged with conducting and disseminating research on
strategies to promote positive academic, social, employment,
and independent living outcomes for students with intellectual
disabilities.
The Committee is aware that the national coordinating
center has been unable to collect data about the
characteristics of students served, course access, employment,
and costs associated with creating these services because its
evaluation system has yet to be approved. It is important for
the Committee to learn which supports are successful in
improving educational and employment outcomes for students with
intellectual disabilities. Therefore, the Committee urges the
Department, in coordination with OMB, to finalize the national
coordinating center's evaluation system, so that data can be
captured in a timely manner.

Minority Science and Engineering Improvement

The Committee recommends $9,466,000 for the Minority
Science and Engineering Improvement program. This amount is the
same as the comparable fiscal year 2012 funding level and the
budget request. 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.

Tribally Controlled Postsecondary Career and Technical Institutions

The Committee recommends $8,131,000 for tribally controlled
postsecondary vocational institutions. This amount is the same
as the comparable fiscal year 2012 funding level and the budget
request. This program provides grants for the operation and
improvement of tribally controlled postsecondary vocational
institutions to ensure continued and expanding opportunities
for Indian students.

Federal TRIO Programs

The Committee recommends $839,932,000, the same amount as
the fiscal year 2012 level and budget request, for Federal TRIO
programs.
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 pursue and complete
a postsecondary education; Student Support Services provides
developmental 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 doctoral
programs.
The Committee is aware that the Department plans to
reallocate fiscal year 2012 funds from the McNair
Postbaccalaureate Achievement program to the Upward Bound Math-
Science program. Recognizing the importance of increasing
attainment of doctoral degrees by students from disadvantaged
backgrounds, the Committee directs the Department to submit a
report, not later than 90 days after enactment of this act, on
the impact of any proposed reduction on preparing and assisting
students in the pursuit of doctoral degrees. Additionally, the
Committee expects to be notified in advance of the obligation
of any Federal TRIO funds for fiscal year 2013 and urges the
Department to restore any proposed reduction in funding to the
McNair Postbaccalaureate Achievement program within available
resources.

Gaining Early Awareness and Readiness for Undergraduate Programs

The Committee recommends $302,244,000 for GEAR UP. This
amount is the same as the comparable fiscal year 2012 funding
level and the budget request. GEAR UP funds are used by States
and partnerships of colleges, middle and high schools, and
community organizations to assist cohorts or students in middle
and high schools serving a high percentage of low-income
students. Services provided help students prepare for and
pursue a postsecondary education.

Graduate Assistance in Areas of National Need and Javits Fellowships

The Committee recommends $30,909,000, the same amount as
the fiscal year 2012 level and the budget request, to support
the GAANN and Javits Fellowships programs.
GAANN awards competitive grants to graduate academic
departments and programs for fellowship support in areas of
national need as determined by the Secretary. Javits
Fellowships are awarded to students of superior ability who are
pursuing doctoral degrees in the arts, humanities, and social
sciences. Each fellowship consists of a student stipend to
cover living costs and an institutional payment to cover each
fellow's tuition and other expenses.
In fiscal year 2012, Congress consolidated the GAANN and
Javits Fellowships programs, as proposed by the administration.
The Committee recommendation for fiscal year 2013 includes new
bill language allowing funds awarded under GAANN to be used to
fund continuation costs for the Javits Fellowships program.
The Committee urges the Department to ensure that the arts,
humanities, and social science disciplines supported by the
current Javits program are eligible fields for new and
continuing grant competitions under the consolidated GAANN and
Javits programs. The Committee requests that the Department
provide a plan for the implementation of the consolidation. The
report should be submitted to the Committee within 30 days of
the enactment of this act.

Teacher Quality Partnership Program

The Committee recommends $42,833,000, the same as the
fiscal year 2012 level, for the teacher quality partnership
program. The budget request consolidates this program into a
proposed new Teacher and Leader Pathways authority as part of
the administration's plan for reauthorizing the ESEA. The
Teacher Quality Partnership Program helps improve the quality
of teachers working in high-need schools and early childhood
education programs by creating model teacher preparation and
residency programs.

Child Care Access Means Parents in Schools

The Committee recommends an appropriation of $15,970,000
for CCAMPIS. This amount is the same as the comparable fiscal
year 2012 funding level and the budget request. CCAMPIS
supports the efforts of a growing number of nontraditional
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
child care program primarily serving the needs of low-income
students enrolled at the institution.

GPRA/Higher Education Act Program Evaluation

The Committee recommends $607,000 to collect data
associated with the Government Performance and Results Act and
to evaluate programs authorized by the HEA. This amount is the
same as the comparable fiscal year 2012 funding level and the
budget request.

Hawkins Centers of Excellence

Because of budget constraints, the Committee does not
recommend funding for the proposed new Hawkins Centers of
Excellence. The budget request includes $30,000,000 for this
program as a way to increase the talent pool of effective
minority educators by expanding and reforming teacher education
programs at minority-serving institutions.

Race to the Top: College Affordability and Completion

The budget request includes $1,000,000,000 to create the
proposed Race to the Top: College Affordability and Completion
initiative, which would provide competitive grants to States
with strong records of, and commitments to, increasing college
affordability, quality, and value. The Committee recognizes the
importance of addressing rapidly increasing college costs and
encouraging State-level reform of higher education policies,
but it does not include funding for this program because of
budget constraints. The Committee also notes that the Senate
and House authorizing committees have held no hearings on this
proposed initiative.
The Committee notes that the concerns the administration
has raised about rising college costs are very serious ones,
and agrees that action is needed to reduce burdens on families
and improve outcomes for students. The Committee bill funds the
First in the World competition requested in the President's
budget as a first step toward tackling the challenges of
college affordability and completion at the State and
institution level. While the administration's request for a new
Race to the Top cannot be accommodated in this year's bill, the
Committee believes it is important for States to adopt reforms
to higher education policies and practices that will reduce
college costs for students. The Committee will continue to
support these efforts and consider the Race to the Top proposal
in the future, after additional deliberation in Congress.

Howard University

Appropriations, 2012.................................... $234,064,000
Budget estimate, 2013................................... 234,064,000
Committee recommendation................................ 234,064,000

The Committee recommends an appropriation of $234,064,000
for Howard University. Howard 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. Federal funds from
this account support approximately 43 percent of the
university's projected educational and general expenditures,
excluding the hospital. The Committee recommends, within the
funds provided, not less than $3,593,000 for the endowment
program.
Howard University Hospital.--Within the funds provided, the
Committee recommends $28,834,000 for the Howard University
Hospital. The hospital provides inpatient and outpatient care,
as well as training in the health professions. It also 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 Program

Appropriations, 2012.................................... $459,000
Budget estimate, 2013................................... 459,000
Committee recommendation................................ 459,000

Federal Administration.--The Committee bill includes
$459,000 for Federal administration of the CHAFL program. These
funds will be used to reimburse the Department for expenses
incurred in managing the existing CHAFL loan portfolio during
fiscal year 2013. These expenses include salaries and benefits,
travel, printing, contracts, and other expenses directly
related to the administration of the CHAFL program.

Historically Black College and University Capital Financing Program
Account

Appropriations, 2012.................................... $20,502,000
Budget estimate, 2013................................... 20,502,000
Committee recommendation................................ 20,502,000

The Committee recommends $20,502,000 for the HBCU Capital
Financing Program.
The Committee recommendation includes $20,150,000 to pay
the loan subsidy costs in guaranteed loan authority under this
program. This amount will support $320,350,000 in new loan
volume in fiscal year 2013. The remaining $352,000 will be used
for administrative expenses.
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. As requested by the
administration, the Committee retains bill language allowing
the program to make loans to public and private HBCUs without
regard to the limitations within section 344(a) of the HEA.
The Committee recommendation includes new bill language, as
proposed in the budget request, that allows the loan subsidy
funding to be available for 2 fiscal years. The Department has
found that the 1-year timeframe to insure loans constrains the
planning process for new program loans, decreasing the number
of projects that can be considered for funding and limiting the
Department's ability to achieve the statutory mandate of
ensuring that loans are fairly allocated among as many eligible
institutions as possible.

Institute of Education Sciences

Appropriations, 2012.................................... $593,664,000
Budget estimate, 2013................................... 621,150,000
Committee recommendation................................ 618,661,000

The Committee recommends $618,661,000 for IES. This account
supports education research, development, dissemination, and
evaluation; data collection and analysis activities; and the
assessment of student progress.
The Committee commends IES's attempts to improve the rigor,
relevance, and utilization of education research that leads to
enhanced education policy and classroom practices. The
Committee urges IES to continue its efforts in these areas,
particularly through the regional educational laboratories and
the research, development, and dissemination program.

RESEARCH, DEVELOPMENT, AND DISSEMINATION

The Committee recommends $189,787,000, the same as the
fiscal year 2012 level, for education research, development,
and national dissemination activities. The budget request is
$202,273,000. Funds are available for obligation for 2 fiscal
years. These funds support 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 directs IES to continue support for research
and development activities related to gifted and talented
education that directly support learning and improve the
academic achievement of gifted and talented students, including
those who may not be formally identified as gifted and those
who are from underrepresented populations. The Committee also
directs IES to support a National Research Center on the Gifted
and Talented and to ensure that gifted and talented education
is reported in national reports produced by IES.
The Committee is particularly supportive of IES' research
partnership work, which seeks to leverage investments in
statewide, longitudinal data systems in supporting reform and
data-based decisionmaking. The Committee believes that this
work should include local partnerships that seek to integrate
these statewide systems with local and State health and human
service data systems for policy- and practice-relevant research
on educational risk and resilience among disadvantaged
students.
The Committee continues to support IES research
announcements that provide an opportunity for researchers to
explore how closed captions could be best used to increase
literacy and to evaluate whether changes to closed captions
might enhance their effect.

STATISTICS

The Committee recommends $114,745,000 for data gathering
and statistical analysis activities at NCES. The increase of
$5,997,000 provided above the fiscal year 2012 level will allow
NCES to provide partial support to States that would like to
benchmark their student performance against countries that
participate in the Program for International Student
Assessment. The budget request includes $114,745,000 for NCES.
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.
NCES also provides technical assistance to SEAs, LEAs, and
postsecondary institutions.

REGIONAL EDUCATIONAL LABORATORIES

The Committee recommends $57,426,000 to continue support
for the regional educational laboratories. This amount is the
same as the fiscal year 2012 level and the budget request.
Funds available in this bill will continue to support a network
of 10 laboratories. The laboratories are responsible for
promoting the use and development of knowledge and evidence in
broad-based systemic strategies to increase student learning
and further school improvement efforts. The Committee
appreciates the efforts of IES to strengthen the connections
between practitioners and the research community, so that
federally supported research is practical and meets the needs
of the field.

RESEARCH AND INNOVATION IN SPECIAL EDUCATION

The Committee recommends $59,905,000, an increase of
$10,000,000 over the fiscal year 2012 funding level and the
budget request, for research and innovation in special
education conducted by the National Center for Special
Education Research [NCSER]. At the Committee-recommended
funding level, NCSER should be able to fund roughly $20,000,000
in new awards in fiscal year 2013.
The Center addresses 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 are available for
obligation for 2 fiscal years.
Under the Individuals with Disabilities Education
Improvement Act of 2004, Congress established NCSER to improve
the overall quality and rigor of the special education research
conducted by the Department, and to ensure that the needs of
children with disabilities are included throughout other
research programs, data collection efforts, and related
activities conducted at IES, OSEP, and other offices of the
Department. The Committee therefore directs the Director to
submit a report within 90 days of enactment on the Institute's
plans for a comprehensive research agenda for special
education.

SPECIAL EDUCATION STUDIES AND EVALUATIONS

The Committee recommends $11,415,000 for special education
studies and evaluations. This amount is the same as the fiscal
year 2012 level and the budget request.
This program supports competitive grants, contracts, and
cooperative agreements to assess the implementation of IDEA.
Funds are also 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.

STATEWIDE DATA SYSTEMS

The Committee recommendation includes $53,077,000, the same
amount as the budget request, for statewide data systems. The
fiscal year 2012 level is $38,077,000.
This program supports competitive grants to SEAs to enable
such agencies to design, develop, and implement statewide,
longitudinal data systems to manage, analyze, disaggregate, and
use individual data for students of all ages. Early childhood,
postsecondary, and workforce information systems may be linked
to such systems or developed with program funds. The Committee
believes the Department should continue its efforts to ensure
every State has the base support necessary to develop effective
systems. Funds are available for obligation for 2 fiscal years.
The Committee bill allows up to $20,000,000 to be used for
awards to public or private agencies or organizations to
support activities to improve data coordination, quality, and
use at the local, State, and national levels. The Committee
requests that, prior to obligating any funds for this purpose,
the Department provide to the Committee an operating plan
describing the proposed purpose and use of such funds.

ASSESSMENT

The Committee recommends $132,306,000, the same amount as
the budget request, to provide support for NAEP, a
congressionally mandated assessment created to measure and
report the educational achievement of American students in a
range of subjects and analyze trends over time. The comparable
fiscal year 2012 amount is $138,306,000.
Within the funds appropriated, the Committee recommends
$7,690,000, the same amount as the budget request, for NAGB.
The comparable fiscal year 2012 level is $8,690,000. NAGB is
responsible for formulating policy for NAEP.

Departmental Management

PROGRAM ADMINISTRATION

Appropriations, 2012.................................... $446,259,000
Budget estimate, 2013................................... 463,815,000
Committee recommendation................................ 448,470,000

The Committee recommends $448,470,000 for program
administration.
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 Federal education
programs. Support for program evaluation and studies and
advisory councils also is provided under this account.
The Committee recommendation includes $2,211,000, the same
amount as the budget request, for building modernization
activities for the Department. The fiscal year 2012 bill did
not provide any resources for this purpose.
The Committee is concerned with deficiencies in geography
education at the elementary and secondary education levels and
geographic education research in the United States. The
Committee recognizes that a sound understanding of geography is
critical to ensuring that the American workforce is qualified
for jobs in geospatial technologies and other emerging
industries. The Committee directs GAO to conduct a study on the
status of geographic education and the ability of U.S.
graduates to fill and retain skilled jobs, particularly in
geospatial technologies. Additionally, recognizing fiscal
constraints on States and LEAs, the Committee requests GAO to
report on the challenges elementary and secondary schools face
in providing geographic education within limited resources.

OFFICE FOR CIVIL RIGHTS

Appropriations, 2012.................................... $102,624,000
Budget estimate, 2013................................... 105,318,000
Committee recommendation................................ 102,624,000

The Committee recommends $102,624,000 for OCR.
OCR 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 that receive financial assistance from the
Department. 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 these civil rights requirements.
The Committee finds troubling the continued high rates of
out-of-school suspension and expulsion evidenced in the Civil
Rights Data Collection [CRDC]. Research demonstrates that over-
reliance on suspension and expulsion does not improve school
safety, does little to correct misbehavior, is associated with
worse school-wide educational outcomes, and increases the
likelihood of a student dropping out and having contact with
the juvenile justice system. However, as the CRDC shows, some
schools have successfully lowered suspension and expulsion
rates and have demonstrated academic improvement in the
process.
The Committee applauds the Department for its recent
expansion of the CRDC to include more data related to school
discipline and climate. The Committee recommends further
expansion of the CRDC to include a comprehensive set of school
discipline data indicators such as: the grade level of students
subject to discipline, the length of time of any exclusionary
discipline action, and disaggregation by the general types of
incidents giving rise to disciplinary action. Adequate
collection and reporting of this information will engender the
implementation of the types of evidence-based approaches to
improving school discipline and climate that improve academic
performance, student attendance, and perceptions of school
safety while lowering disciplinary rates.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012.................................... $59,820,000
Budget estimate, 2013................................... 62,401,000
Committee recommendation................................ 59,820,000

The Committee recommends $59,820,000 for OIG.
OIG 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

Section 301. The bill continues a provision prohibiting the
use of funds for the transportation of students or teachers in
order to overcome racial imbalance.
Section 302. The bill continues a provision prohibiting the
involuntary transportation of students other than to the school
nearest to the student's home.
Section 303. The bill continues a provision prohibiting the
use of funds to prevent the implementation of programs of
voluntary prayer and meditation in public schools.
Section 304. The bill continues a provision giving the
Secretary authority to transfer up to 1 percent of any
discretionary funds between appropriations.
Section 305. The bill continues a provision that allows the
outlying areas to consolidate funds under title V of the ESEA.
Section 306. The bill continues a provision that allows the
Republic of Palau to receive certain Federal funds.
Section 307. The bill includes a new provision changing the
name of the Office of Vocational and Adult Education to the
Office of Career, Technical, and Adult Education.
Section 308. The bill contains a new provision that
clarifies the Department's authority to reserve up to 0.5
percent of each ESEA appropriation in the bill for evaluation
of ESEA programs funded in this act. These resources are in
addition to any funds specifically provided for evaluation
purposes. The Department shall provide the Committees on
Appropriations and HELP with an evaluation plan not later than
10 days before any funds are obligated under the provision.
Section 309. The bill includes a new provision prohibiting
all colleges and universities that receive funding through HEA
from spending Federal educational program dollars on
advertising, marketing, and recruitment.
Section 310. The bill includes a new provision that reforms
the student aid programs by eliminating the interest subsidy
for new borrowers who remain in-school beyond 150 percent of
their program length, reducing subsidies for guaranty agencies
that rehabilitate defaulted loans, and reducing fraud related
to distance education programs. The savings from these reforms
are reappropriated into the Pell grant program. The provision
will also allow certain students to become eligible for Pell
grants through the ability to benefit option and to limit the
number of not-for-profit student loan servicers.

TITLE IV

RELATED AGENCIES

Committee for Purchase From People Who Are Blind or Severely Disabled

SALARIES AND EXPENSES

Appropriations, 2012.................................... $5,375,000
Budget estimate, 2013................................... 5,396,000
Committee recommendation................................ 5,375,000

The Committee recommends $5,375,000 for the Committee for
Purchase from People Who Are Blind or Severely Disabled.
The primary purpose of this program 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

OPERATING EXPENSES

Appropriations, 2012.................................... $750,252,000
Budget estimate, 2013................................... 760,498,000
Committee recommendation................................ 760,498,000

The Committee recommends $760,498,000 for the operating
expenses of CNCS.
The Committee recommendation is sufficient to maintain the
number of AmeriCorps members at over 82,000.
The Committee bill includes a consolidation of the Training
and Technical Assistance grants into the State Commission
grants. The Committee believes that this consolidation will
create efficiencies at both the Federal and State levels of
government by combining two State grants with overlapping
purposes.
CNCS, a corporation owned by the Federal Government, was
established to enhance opportunities for national and community
service. 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.
CNCS administers programs authorized under the Domestic
Volunteer Service Act, the National and Community Service Trust
Act, and the SERVE America Act.

VISTA

The Committee recommends $95,300,000, the same as the
budget request, for VISTA. The fiscal year 2012 level is
$94,820,000.
VISTA provides capacity building for small, community-based
organizations with a mission of combating poverty. VISTA
members raise resources, recruit and organize volunteers, and
establish and expand programs in housing, employment, health,
and economic development activities.

NATIONAL SENIOR VOLUNTEER CORPS

The Committee recommends $208,883,000 for the National
Senior Volunteer Corps Programs. The fiscal year 2012
comparable level is $207,491,000 and the budget request is
$207,883,000.
Senior Corps is a collection of programs that connect
Americans older than the age of 55 with opportunities to
contribute their job skills and expertise to community projects
and organizations. Programs include the Retired Senior
Volunteer Program, the Foster Grandparent Program, and the
Senior Companion Program.
The Committee recommendation includes funding for the
following activities in the following amounts:

The Committee includes $1,000,000 above the request in the
Retired Senior Volunteer Program [RSVP] to provide training and
technical assistance to grantees as they begin to undergo the
grant competition process set out in the SERVE America Act,
scheduled to begin in fiscal year 2013.

AMERICORPS STATE AND NATIONAL GRANTS

The Committee recommends $346,368,000 for AmeriCorps State
and National Grants. The fiscal year 2012 level is
$344,348,000. The budget request is $345,000,000.
AmeriCorps State and National Grants provide funds to local
and national organizations and agencies to address community
needs in education, public safety, health, and the environment.
Each of these organizations and agencies, in turn, uses its
AmeriCorps funding to recruit, place, and supervise AmeriCorps
members. AmeriCorps members receive a modest living allowance
and other benefits proportional to their level of time
commitment.
In fiscal year 2009, Congress removed a long-standing
provision capping the amount of funding that could be awarded
as national direct grants. Fiscal year 2012 was the fourth year
in which CNCS determined the funding balance between State and
national direct awardees. The Committee requests a report, no
later than 60 days after the beginning of fiscal year 2013, on
the balance of awards between national direct grants, State
competitive grants, and State formula awards for the 4 years
prior to and the 4 years subsequent to the elimination of the
statutory cap. The report should include a State-by-State
analysis that includes number of members, number of grants, and
dollar amounts for each State.
The Committee is very supportive of the work being done by
members supported by the national direct program; however, the
Committee is concerned by the lack of support for rural America
in this program. The Committee directs CNCS to develop an
action plan for how to create a more appropriate balance
between urban and rural communities in the national direct
program. The Committee encourages CNCS to engage organizations
that specialize in addressing rural needs to determine the type
of technical assistance that might increase their participation
in this important program.

National Civilian Community Corps [NCCC]

The Committee recommendation includes $30,742,000 for NCCC.
The comparable fiscal year 2012 level is $31,882,000 and the
budget request is $30,110,000. The recommended reduction
reflects the completion of one-time relocation activities
related to the loss of the Perry Point campus.
NCCC is a full-time, team-based residential program for men
and women ages 18 to 24. Members are assigned to 1 of 5
campuses for a 10-month service commitment.
The Committee is pleased by the creation of FEMA Corps, a
new partnership between CNCS and the Federal Emergency
Management Agency [FEMA]. This partnership is a welcome
recognition of the significant contribution that NCCC teams
have made to communities hardest hit by natural disasters. FEMA
Corps will broaden this traditional mission of NCCC by creating
a new Corps with additional responsibilities and training.
Given that NCCC has routinely executed task orders from FEMA in
the past, the Committee believes that allowing FEMA to deploy
NCCC members directly will create sorely needed efficiencies in
times of crisis.

INNOVATION, DEMONSTRATION, AND ASSISTANCE ACTIVITIES

The Committee recommendation includes $54,215,000 for
Innovation, Demonstration, and Assistance Activities. The
comparable fiscal year 2012 level is $53,280,000. The budget
request is $53,215,000.
Within the funds provided for the Innovation account, the
Committee includes $45,000,000 for the Social Innovation fund
authorized under section 1807 of the SERVE America Act. The
fiscal year 2012 comparable level is $44,815,000. The budget
request is $50,000,000.
In addition, $5,000,000 is included for the Volunteer
Generation Fund authorized under section 198P of the SERVE
America Act, and $1,000,000 for MLK Service Day. The fiscal
year 2012 comparable levels are $3,984,000 and $992,000,
respectively. The budget request does not include funds for
either activity.

EVALUATION

The Committee recommendation includes $5,000,000, the same
as the budget request, for CNCS evaluation activities. The
fiscal year 2012 level is $2,994,000.
The Committee intends that part of the increase in
evaluation funds be used to continue the Civic Health
Assessment, which is funded in Training and Technical
Assistance in fiscal year 2012.

STATE COMMISSION GRANTS

The Committee includes $19,990,000 for State Commission
grants. The fiscal year 2012 level is $15,437,000 and the
budget request is $20,990,000.
The recommended increase over the budget request reflects
the Committee's intention to consolidate the training and
technical assistance grants into the State Commission Grants.
The Committee believes that this consolidation will create
efficiencies at both the Federal and State levels of government
by combining two State grants with overlapping purposes. The
Committee expects CNCS to develop measures to ensure that
States adequately train new applicants and newly awarded
grantees in accountability procedures.
The Committee does not continue a provision in the fiscal
year 2012 bill that lowered the State minimum award to $200,000
from the $250,000 level prescribed in the SERVE America Act.
The Committee is concerned that Commission grants are
awarded based on a formula that does not take into account
either the number of grants, the number of members, or the
dollar amounts administered by any of the State commissions. As
CNCS moves to consolidate training and technical assistance
into this funding stream, the Committee encourages CNCS to
consider linking the State Commission Grants more closely to
their federally mandated workload.

PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2012.................................... $211,797,000
Budget estimate, 2013................................... 208,744,000
Committee recommendation................................ 208,744,000

The Committee recommends an appropriation of $208,744,000
for making payments to the National Service Trust.
The National Service Trust makes payments of Segal
education awards, pays interest that accrues on qualified
student loans for AmeriCorps participants during terms of
service in approved national service positions, and makes other
payments entitled to members who serve in the programs of CNCS.
The recommended funding level is sufficient to support no
less than the same number of servicemembers as were enrolled in
fiscal year 2012.
The Committee is aware that some institutions of higher
education, in recognition and appreciation of members' service,
have agreed to match the Segal educational award either
financially or through some other inducement. This is a
practice that the Committee applauds and would like to
encourage due to the increasing costs of higher education and
limited resources for financial aid. To that end, the Committee
directs CNCS to include in members' end-of-service packet of
information a list of all institutions and programs in the
country that match the educational award. The Committee further
directs CNCS to make a current list available on its Web site
and in the AmeriCorps portal.

SALARIES AND EXPENSES

Appropriations, 2012.................................... $82,843,000
Budget estimate, 2013................................... 88,000,000
Committee recommendation................................ 88,000,000

The Committee recommends an appropriation of $88,000,000
for CNCS salaries and expenses.
The salaries and expenses appropriation provides funds for
staff salaries, benefits, travel, training, rent, equipment,
and other operating expenses necessary for management of CNCS
programs and activities.
The Committee strongly supports efforts to redesign the
outreach activities meant to recruit and support national
service members with disabilities. The program should build on
successful models of integration of persons with disabilities.
The Committee notes that section 129(k) of the National and
Community Service Act of 1990 requires CNCS to reserve 2
percent of funds for disability training and support
activities. Though flexibility exists to use excess funds in
other ways, the Congress clearly intended this effort to be
robust. Therefore, the Committee requests that CNCS begin to
report in the annual congressional budget justification the
amount for disability training and support activities proposed
for the current fiscal year and the amount obligated in the 5
prior fiscal years.
The Committee remains strongly supportive of service
learning. The Committee encourages CNCS to work with the heads
of State service commissions, former Learn and Serve America
grantees, SEAs, and other relevant stakeholders to formulate a
plan to advance service learning. The Committee further
encourages CNCS to become a national resource on service
learning by collecting and disseminating model curricula and
public information on school districts that provide service
learning opportunities for school-aged children.

OFFICE OF INSPECTOR GENERAL

Appropriations, 2012.................................... $3,992,000
Budget estimate, 2013................................... 5,400,000
Committee recommendation................................ 5,400,000

The Committee recommends an appropriation of $5,400,000 for
the CNCS OIG.
The OIG's goals are to increase organizational efficiency
and effectiveness within the Corporation and to prevent fraud,
waste, and abuse.
The recommended level of funding should allow the IG to
hire three new criminal investigators, one criminal analyst,
two auditors and an audit manager.

ADMINISTRATIVE PROVISIONS

The Committee retains language in previous bills concerning
four administrative provisions: requiring the Corporation to
make any significant changes to program requirements or policy
through rule-making (section 401), stipulating minimum share
requirements (section 402), requiring that donations supplement
and not supplant operations (section 403), and aligning
requirements regarding the use of Education Awards at GI bill-
eligible institutions (section 404). The Committee bill does
not include language requested by the administration to modify
the SERVE America Act with respect to the Senior Corps grant
award process.

Corporation for Public Broadcasting

Appropriations, 2012.................................... $444,159,000
Appropriations, 2013.................................... 445,000,000
Appropriations, 2014.................................... 445,000,000
Budget estimate, 2015................................... 445,000,000
Committee recommendation, 2015.......................... 445,000,000

The Committee recommends $445,000,000 for CPB as an advance
appropriation for fiscal year 2015. Two-year advance funding
has been in place since 1975 to ensure the independence of
public broadcasting programming.
The majority of these funds go directly to local public
television and radio stations to support their programming. CPB
funds also support the creation of content for radio,
television, and other platforms; system support activities that
benefit the entire public broadcasting community; and CPB's
administrative costs.

Federal Mediation and Conciliation Service

SALARIES AND EXPENSES

Appropriations, 2012.................................... $46,163,000
Budget estimate, 2013................................... 47,045,000
Committee recommendation................................ 46,163,000

The Committee recommends $46,163,000 for the Federal
Mediation and Conciliation Service [FMCS]. FMCS provides
mediation, conciliation, and arbitration services to labor and
management organizations to prevent and minimize work stoppages
and promote stable labor-management relationships. FMCS is also
authorized to provide dispute resolution consultation and
training to all Federal agencies.
Within the total, the Committee recommendation includes up
to $400,000, the same amount as the budget request, for labor-
management partnership grants. This program was not funded in
fiscal year 2012. These grants support innovative approaches to
collaborative labor-management relationships to resolve
potential problems, explore ways to improve productivity, and
avert serious work stoppages.

Federal Mine Safety and Health Review Commission

SALARIES AND EXPENSES

Appropriations, 2012.................................... $17,604,000
Budget estimate, 2013................................... 16,000,000
Committee recommendation................................ 17,000,000

The Committee recommends $17,000,000 for FMSHRC. FMSHRC
provides administrative trial and appellate review of legal
disputes under the Federal Mine Safety and Health Act of 1977.
Most cases involve civil penalties proposed by MSHA. FMSHRC's
administrative law judges [ALJs] decide cases at the trial
level and the five-member Commission provides review of the ALJ
decisions.
The comparable fiscal year 2012 funding level includes
$2,680,000 in one-time costs associated with developing an
electronic case management system and moving FMSHRC to new
office space. Excluding these one-time costs, the Committee
recommendation represents a $2,076,000 increase over the
comparable fiscal year 2012 operating level.
This increase in funding, and corresponding increases at
DOL, supports continued Federal efforts to reduce the backlog
of appealed cases up for review at FMSHRC. The rate of
contested MSHA citations has more than quadrupled since 2006,
resulting in a corresponding fourfold increase in the number of
cases appealed to FMSHRC annually. For many years FMSHRC's
funding did not keep up with this added workload resulting in a
significant increase in the number of backlogged cases awaiting
review and the time it takes to process cases. This has created
a dangerous incentive for mine operators to contest violations
solely to delay enforcement. Congress provided additional
resources over the last several years to increase capacity to
process contested cases but at current funding levels FMSRHC is
still only able to keep up with incoming cases. As a result,
pending cases and processing times are expected to remain at
approximately their current levels. The Committee
recommendation allows FMSHRC to decrease the number of pending
cases and the time it takes to process cases.

Institute of Museum and Library Services

OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2012.................................... $231,954,000
Budget estimate, 2013................................... 231,954,000
Committee recommendation................................ 231,954,000

The Committee recommends $231,954,000 for IMLS. IMLS
supports programs for museums and libraries that encourage
innovation, provide lifelong learning opportunities, promote
cultural and civic engagement, and improve access to a variety
of services and information.
The budget request proposes to consolidate the Conservation
Project Support program with the Museums for America program
and the 21st Century Museum Professionals program with the
National Leadership program, for the purpose of simplifying and
streamlining the grantee application process and IMLS'
management of these programs. The Committee supports these
consolidations.
The Committee encourages IMLS to consider allowing museums,
as appropriate, to be considered as organizations that
primarily serve and represent Native Hawaiians for eligibility
purposes under the Native American/Native Hawaiian Museum
Services program.
Within the total for IMLS, the Committee recommendation
includes the amounts below:

[in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Fiscal year Fiscal year 2013 Committee
Budget activity 2012 2013 budget
comparable request recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
Grants to States............................................ 156,365 156,365 156,365
Native American Library Services............................ 3,869 3,869 3,869
National Leadership: Libraries.............................. 11,946 12,000 12,000
Laura Bush 21st Century Librarian........................... 12,524 12,470 12,470
-----------------------------------------------
Subtotal, LSTA............................................ 184,704 184,704 184,704
-----------------------------------------------
Museums Services Act:
Museums for America......................................... 18,030 20,643 20,643
21st Century Museum Professionals........................... 1,969 .............. ..............
Conservation Project Support................................ 2,675 .............. ..............
Native American/Hawaiian Museum Services.................... 926 926 926
National Leadership: Museums................................ 5,911 7,880 7,880
-----------------------------------------------
Subtotal, MSA............................................. 29,449 29,449 29,449
-----------------------------------------------
African American History and Culture Act........................ 1,410 1,410 1,410
Administration.................................................. 14,505 14,505 14,505
Research, Analysis, and Data Collection......................... 1,886 1,886 1,886
----------------------------------------------------------------------------------------------------------------

Medicaid and CHIP Payment and Access Commission

SALARIES AND EXPENSES

Appropriations, 2012.................................... $5,989,000
Budget estimate, 2013................................... 11,000,000
Committee recommendation................................ 9,500,000

The Committee recommends $9,500,000 for MACPAC. MACPAC was
established in the Children's Health Insurance Program
Reauthorization Act of 2009 and is tasked with reviewing State
and Federal Medicaid and Children's Health Insurance Program
access and payment policies and making recommendations to
Congress, the Secretary of HHS, and the States on a wide range
of issues affecting those programs. The Committee
recommendation will allow MACPAC to continue to build capacity
to carry out these activities.

Medicare Payment Advisory Commission

SALARIES AND EXPENSES

Appropriations, 2012.................................... $11,778,000
Budget estimate, 2013................................... 12,210,000
Committee recommendation................................ 11,778,000

The Committee recommends $11,778,000 for MedPAC, which
provides independent policy and technical advice on issues
affecting the Medicare program.

National Council on Disability

SALARIES AND EXPENSES

Appropriations, 2012.................................... $3,258,000
Budget estimate, 2013................................... 3,258,000
Committee recommendation................................ 3,258,000

The Committee recommends $3,258,000 for the National
Council on Disability [NCD]. NCD is mandated to make
recommendations to the President, Congress, the RSA, and NIDRR
on issues of concern to individuals with disabilities. The
Council gathers information on the implementation,
effectiveness, and impact of the Americans with Disabilities
Act and examines emerging policy issues as they affect persons
with disabilities and their ability to enter or re-enter the
Nation's workforce and to live independently.

National Health Care Workforce Commission

SALARIES AND EXPENSES

Appropriations, 2012....................................................
Budget estimate, 2013................................... $3,000,000
Committee recommendation................................ 3,000,000

The Committee recommendation includes $3,000,000 for the
National Health Care Workforce Commission, which was authorized
in PPACA but has not yet been funded.
The Commission will serve as a resource to Congress, the
President, and State and local entities in evaluating
healthcare workforce needs, including assessing education and
training activities to determine to what extent the demand for
health workers is being met; identifying barriers to improved
coordination at the Federal, State and local levels; and
recommending changes to address those barriers.

National Labor Relations Board

SALARIES AND EXPENSES

Appropriations, 2012.................................... $278,306,000
Budget estimate, 2013................................... 292,800,000
Committee recommendation................................ 288,306,000

The Committee recommends $288,306,000 for NLRB, which
administers and enforces the National Labor Relations Act and
protects employee and employer rights provided under that act.
The Committee recommends an increase of $10,000,000 for
planned relocation costs in fiscal year 2013. The General
Services Administration has recommended that NLRB reduce its
headquarters space and estimates that $10,000,000 will be
needed for those associated costs. In future years this
reduction in space is expected to reduce NLRB's rent costs by
approximately 30 percent, or $4,600,000 annually.

National Mediation Board

SALARIES AND EXPENSES

Appropriations, 2012.................................... $13,411,000
Budget estimate, 2013................................... 13,530,000
Committee recommendation................................ 14,411,000

The Committee recommends $14,411,000 for the National
Mediation Board [NMB], which mediates labor-management
relations in the railroad and airline industries under the
Railway Labor Act. The NMB mediates collective bargaining
disputes, conducts elections to determine the choice of
employee bargaining representatives, and administers
arbitration of employee grievances. The Committee
recommendation includes an increase over the comparable fiscal
year 2012 funding level to prevent backlogs of key workloads
and to respond to oversight and reporting requirements included
in the FAA Modernization and Reform Act of 2012.

Occupational Safety and Health Review Commission

SALARIES AND EXPENSES

Appropriations, 2012.................................... $11,667,000
Budget estimate, 2013................................... 11,965,000
Committee recommendation................................ 11,667,000

The Committee recommends $11,667,000 for the Occupational
Safety and Health Review Commission [OSHRC]. OSHRC serves as a
court to resolve disputes between OSHA and employers charged
with violations of health and safety standards enforced by
OSHA.

Railroad Retirement Board

The Railroad Retirement Board [RRB] administers the
retirement/survivor and unemployment/sickness insurance benefit
programs for railroad workers and their families under the
Railroad Retirement Act and Railroad Unemployment Insurance
Act.

DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2012.................................... $50,904,000
Budget estimate, 2013................................... 45,000,000
Committee recommendation................................ 45,000,000

The Committee recommends $45,000,000 for the Dual Benefits
Payments Account. This amount includes an estimated $3,000,000
derived from income taxes on vested dual benefits. This
appropriation provides for vested dual benefit payments to
beneficiaries covered under both the railroad retirement and
Social Security systems.

FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2012.................................... $150,000
Budget estimate, 2013................................... 150,000
Committee recommendation................................ 150,000

The Committee recommends $150,000 for Federal payments to
the railroad retirement account. These funds reimburse the
railroad retirement trust funds for interest earned on non-
negotiated checks.

LIMITATION ON ADMINISTRATION

Appropriations, 2012.................................... $108,649,000
Budget estimate, 2013................................... 112,415,000
Committee recommendation................................ 111,649,000

The Committee recommends $111,649,000 for RRB's costs
associated with the administration of railroad retirement/
survivor and unemployment/sickness benefit programs. This
account limits the amount of funds in the railroad retirement
and railroad unemployment insurance trust funds that may be
used by the Board for administrative expenses. The Committee
recommendation includes an increase over the comparable fiscal
year 2012 funding level to support RRB's transition to a new
financial management system.

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012.................................... $8,155,000
Budget estimate, 2013................................... 8,820,000
Committee recommendation................................ 8,155,000

The Committee recommends $8,155,000 for the RRB OIG. This
Office conducts audits and investigations to protect the
integrity of the RRB trust funds and provides comprehensive
oversight of all RRB operations and programs.

Social Security Administration

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2012.................................... $20,404,000
Budget estimate, 2013................................... 20,402,000
Committee recommendation................................ 20,402,000

The Committee recommends $20,402,000 in mandatory funds for
payments to Social Security trust funds. This account
reimburses the Old Age and Survivors Insurance [OASI] and
Disability Insurance [DI] 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 and they were properly
charged to general revenues.

SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2012.................................... $37,823,550,000
Budget estimate, 2013................................... 40,043,000,000
Committee recommendation................................ 40,043,000,000

The Committee recommends $40,043,000,000 in fiscal year
2013 mandatory funds for the SSI program. In addition, the
Committee recommends $19,300,000,000, the same as the budget
request, in advance funding for the first quarter of fiscal
year 2014. The comparable advance provided last year for the
first quarter of fiscal year 2013 is $18,200,000,000. The SSI
program guarantees a minimum level of income to individuals who
are disabled, blind, or older than age 65, and meet certain
income and resource limitations.

Federal Benefit Payments

The Committee recommendation includes a fiscal year 2013
program level of $54,245,000,000, the same as the budget
request, for Federal benefit payments. This includes a regular
fiscal year 2013 mandatory appropriation of $36,045,000,000 and
a mandatory advance appropriation provided last year for the
first quarter of fiscal year 2013 of $18,200,000,000. The
comparable fiscal year 2012 program level is $47,557,000,000.
The increase in fiscal year 2013 is largely the result of
having 13 Federal monthly benefit payments compared with 11 in
fiscal year 2012. Monthly SSI benefit payments are typically
made on the first day of the month. But if the first day of the
month falls on a weekend or holiday, the payment is accelerated
to the previous business day. As a result, the number of
monthly payments in some fiscal years can vary. In fiscal year
2013 the SSI program will provide an average monthly benefit of
$544 to 8.2 million recipients.

Beneficiary Services

As in the budget request, the Committee recommendation does
not include new mandatory budget authority for beneficiary
services. The comparable fiscal year 2012 funding level is
$47,000,000. Carryover of prior year unobligated balances will
be sufficient to fund these activities in fiscal year 2013 and
will support a fiscal year 2013 program level of $59,000,000.
The comparable fiscal year 2012 program level is $52,000,000.
These funds reimburse VR agencies for successfully
rehabilitating disabled SSI recipients by helping them achieve
and sustain productive, self-supporting work activity. Funds
also support the Ticket to Work program that provides SSI
recipients with a ticket to offer employment networks [ENs],
including VR agencies, in exchange for employment and support
services. Instead of reimbursing ENs for specific services, the
Ticket to Work program pays ENs based on recipients achieving
certain milestones and outcomes.

Research and Demonstration

The Committee recommendation includes $48,000,000, the same
as the budget request, in mandatory funds for research and
demonstration projects conducted under sections 1110, 1115, and
1144 of the Social Security Act. The comparable fiscal year
2012 funding level is $7,998,000. Because of the availability
of unobligated balances, these funds will support a fiscal year
2013 program level of $57,270,000, compared to $51,422,000 in
fiscal year 2012.
These funds support a variety of research and demonstration
projects designed to improve the disability process, promote
self-sufficiency and assist individuals in returning to work,
encourage savings and retirement planning through financial
literacy, and generally provide analytical and data resources
for use in preparing and reviewing policy proposals.
Within the total for research and demonstration, the
Committee recommends $7,200,000, the same amount as the budget
request, for the PROMISE program. The comparable fiscal year
2012 funding level is $2,800,000. This demonstration program is
jointly administered by SSA and the Department of Education and
includes interagency collaboration with the Departments of HHS
and Labor. The goal of the PROMISE program is to test
interventions that improve health, education, postsecondary,
employment, and family outcomes for children receiving SSI by
encouraging innovation and improving coordination between
existing programs and services. In fiscal year 2013, the
Department of Education expects to award competitive grants to
a small number of States to test promising strategies. These
funds at SSA will support program design and evaluation
activities.
Within the total for research and demonstration the
Committee recommends $3,000,000 for a new demonstration program
to test the impact of providing financial literacy information
on the OASI, DI, and SSI programs to high school-aged youth.

Administrative Expenses

The Committee recommendation includes $3,950,000,000, the
same as the budget request, for SSI program administrative
expenses. The comparable fiscal year 2012 funding level is
$3,611,552,000. This appropriation funds the SSI program's
share of administrative expenses incurred through the
Limitation on Administrative Expenses [LAE] account.

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2012.................................... $11,445,192,000
Budget estimate, 2013................................... 11,755,000,000
Committee recommendation................................ 11,735,544,000

The Committee recommends $11,735,544,000 for SSA's LAE
account. This account provides resources for SSA to administer
the OASI, DI, and SSI programs, and to support CMS in
administering the Medicare program. The LAE account is funded
by the Social Security and Medicare trust funds for their share
of administrative expenses, the general fund for the SSI
program's share of administrative expenses, and applicable user
fees. The majority of these funds are used to process
retirement and disability claims, which SSA expects will stay
at near-record levels in fiscal year 2013.
The Committee applauds the work SSA has done in recent
years to reduce the disability hearings backlog and the time it
takes to process disability hearings. SSA has reduced the
average time it takes to process a disability hearing from 532
days in 2008 to 354 days in 2012, despite a record increase in
disability hearings over that period. SSA has also greatly
improved the parity of processing times across the country. In
fiscal year 2008 some hearing offices had average processing
times over 900 days but this year no hearing office has a
processing time over 475 days.
Work Incentives Planning and Assistance [WIPA] and
Protection and Advocacy for Beneficiaries of Social Security
[PABSS].--The WIPA and PABSS programs provide valuable services
to disabled beneficiaries, particularly in helping them return
to work. However, because of a delay in the reauthorization
process, WIPA grantees have been told they will have to shut
down at the end of June 2012 and PABSS grantees at the end of
September 2012. The Committee strongly encourages SSA to use
fiscal year 2012 funds, and the broad authority provided in
annual appropriations language, to continue these programs.
Specifically, the Committee encourages SSA to extend current
WIPA and PABSS grants as soon as possible for a short period of
time, up to 1 year, to prevent any disruption in services. If
there are subsequent changes to the programs, through
reauthorization or otherwise, this would give the Agency ample
time to run a new competition and make new awards without
unnecessarily creating a gap in services. In addition, the
Committee recommendation for fiscal year 2013 includes
$23,000,000 for WIPA and $7,000,000 for PABSS.
Representative Payee Oversight.--The Committee
recommendation includes not less than $2,500,000 for SSA to
continue to partner with outside organizations to improve
representative payee oversight. SSA assigns representative
payees when beneficiaries are unable to financially manage
their own benefit payments. These funds support activities to
identify and prevent fraud and abuse within the program.
Social Security Advisory Board.--The Committee
recommendation includes not less than $2,150,000, the same as
the budget request, for the Social Security Advisory Board. The
comparable fiscal year 2012 funding level is $2,146,000. The
Social Security Advisory Board advises the Commissioner of
Social Security and makes recommendations to Congress and the
President on policies relating to the OASI, DI, and SSI
programs.
Social Security Annual Statements.--The Committee believes
that Social Security Annual Statements, required by statute to
be provided to everyone older than age 25, provide valuable
information to workers on their benefits under the OASI and DI
programs. In addition, they allow workers to check their
earnings history and notify SSA of any errors in a timely
fashion. Earnings discrepancies identified years later can
often be complicated and time-consuming to resolve. Therefore,
the Committee directs SSA to resume the mailing of annual
Social Security Account Statements in accordance with section
1143(c)(2) of the Social Security Act.
Field Office Closings.--The Committee directs SSA to submit
a report to the Committee on Appropriations of the Senate
within 90 days of enactment of this act on its policies and
procedures for closing and consolidating field offices. The
report should include a detailed description of the process SSA
uses and the factors it considers when deciding which offices
to close, and its process for notifying the public of such
closures. It should also include an analysis of the offices
closed in fiscal year 2012 based on those factors. Finally, the
Committee directs SSA to provide a readily available public
notice of proposed field office closures. Such notice should be
provided not less than 90 days prior to closing any field
office.
Adminstrative Law Judge Disclosure Policy.--The Committee
is concerned about SSA's new policy to not disclose the name of
the ALJ who will preside over a disability appeal until the day
of the hearing. The Committee notes SSA's concern with the
possibility of claimant representatives abusing the process,
specifically as it relates to declining a video hearing or
postponing other hearings simply to search for judges they
believe are more likely to allow a case. This abuse challenges
the integrity of the process and can cause administrative
delays. However, such a broad policy change could have
unintended consequences. The Committee strongly encourages SSA
to consider policies more targeted at suspected abuse, such as
sanctions against individual representatives or changes to
regulations to prevent representatives from canceling a video
hearing close to the hearing date without due cause. The
Committee directs SSA to submit a report to the Committee on
Appropriations of the Senate no later than November 1, 2012,
detailing the type and scope of abuse under the previous policy
and alternative policies that were considered or could
otherwise be used to address the issue.

Program Integrity

Within the total for LAE, the Committee recommendation
includes $1,024,000,000, the same as the budget request, for
program integrity activities. This includes $273,000,000 in
base funding and $751,000,000 in cap adjustment funding allowed
under the Budget Control Act of 2011. The comparable fiscal
year 2012 funding level is $756,052,000. These funds support
program integrity activities such as continuing disability
reviews [CDRs] and redeterminations of nonmedical eligibility
under the SSI program. This increase in funding in fiscal year
2013 will allow SSA to conduct approximately 650,000 full
medical CDRs, 215,000 more than in fiscal year 2012, and
2,622,000 SSI redeterminations, the same amount as in fiscal
year 2012. In total, these activities are projected to save
approximately $8,100,000,000 over 10 years to the Social
Security, Medicare, and Medicaid programs.

User Fees

Within the total for LAE, the Committee recommendation
includes up to $166,500,000 for administrative activities
funded from user fees. This includes $166,000,000 in fees paid
to SSA by States that request SSA to administer State SSI
supplementary payments and up to $500,000 from a fee payment
process for nonattorney representatives of claimants.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012.................................... $102,283,000
Budget estimate, 2013................................... 107,600,000
Committee recommendation................................ 102,283,000

The Committee recommends $102,283,000, the same as the
comparable fiscal year 2012 funding level, for OIG. The budget
request is $107,600,000. The recommendation includes
$73,396,000 funded from the OASI and DI trust funds for those
programs' share of inspector general expenses and $28,887,000
funded from general revenues for the SSI program's share of
expenses.

TITLE V--GENERAL PROVISIONS

Section 501. The bill continues a provision authorizing
transfers of unexpended balances.
Section 502. The bill continues a provision limiting
funding to 1-year availability unless otherwise specified.
Section 503. The bill modifies a provision limiting
lobbying and related activities.
Section 504. The bill continues a provision limiting
official representation expenses.
Section 505. The bill continues a provision clarifying
Federal funding as a component of State and local grant funds.
Sections 506 and 507. The bill continues provisions
limiting the use of funds for abortion.
Section 508. The bill continues a provision restricting
human embryo research.
Section 509. The bill continues a provision limiting the
use of funds for promotion of legalization of controlled
substances.
Section 510. The bill continues a provision prohibiting the
use of funds to promulgate regulations regarding the individual
health identifier.
Section 511. The bill continues a provision limiting the
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.
Section 512. The bill continues a provision prohibiting the
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.
Section 513. The bill continues a provision prohibiting
Federal funding in this act for libraries unless they are in
compliance with the Children's Internet Protection Act.
Section 514. The bill continues a provision maintaining a
procedure for reprogramming of funds.
Section 515. The bill continues a provision prohibiting
candidates for scientific advisory committees from having to
disclose their political activities.
Section 516. The bill continues a provision requiring each
department and related agency to submit an operating plan.
Section 517. The bill continues a provision requiring the
Secretaries of Labor, Health and Human Services, and Education
to submit a report on the number and amounts of contracts,
grants, and cooperative agreements awarded by the Departments
on a noncompetitive basis.
Section 518. The bill continues a provision prohibiting the
use of funds for a grant or contract exceeding $5,000,000
unless the prospective contractor or grantee makes certain
certifications regarding Federal tax liability.
Section 519. The bill modifies a provision rescinding funds
from the State Children's Health Insurance Program performance
bonus fund.
Section 520. The bill modifies a provision regarding
funding for programs that carry out distribution of sterile
needles or syringes.
Section 521. The bill continues a provision requiring each
department and SSA to provide quarterly reports on the status
of balances of appropriations.
Section 522. The bill adds a new provision authorizing the
transfer of the Health Education Assistance Loan program from
the Department of Health and Human Services to the Department
of Education.
Section 523. The bill adds a new provision establishing
Performance Partnership Pilots related to discretionary funds
available in this act.
Section 524. The bill adds a new provision requiring
departments, agencies, boards, and commissions funded in this
act to submit quarterly reports regarding conferences.
Section 525. The bill adds a new provision limiting the
attendance of Federal employees at any single international
conference.

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

Paragraph 7 of rule XVI requires that Committee reports 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 Committee is filing an original bill, which is not
covered under this rule, but reports this information in the
spirit of full disclosure.
The Committee recommends funding for the following programs
and activities which currently lack authorization: Elementary
and Secondary Education Act; National Center for Special
Education Research; parts C and D of the Individuals with
Disabilities Education Act; Education Sciences Reform Act;
Special Olympics Sport and Empowerment Act of 2004; Workforce
Investment Act; Homeless Veterans Reintegration Program;
Universal Newborn Hearing Screening; Organ Transplantation;
Family Planning; Rural Health programs; Traumatic Brain Injury
programs; Combating Autism Act; Public Health Improvement Act;
Healthy Start; Telehealth; Health Professions Education
Partnership Act; Children's Health Act; Women's Health Research
and Prevention Amendments of 1998; Birth Defects Prevention,
Preventive Health Amendments of 1993; Substance Abuse and
Mental Health Services programs, except for Depression Centers
of Excellence and grants for Primary and Behavioral Healthcare
Integration; Low Income Home Energy Assistance Program; Refugee
and Entrant Assistance programs; Adoption Opportunities; Child
Welfare Services and Research; Child Care and Development Block
Grant; Developmental Disabilities programs; Voting Access for
Individuals with Disabilities; Native American Programs;
Community Services Block Grant; Rural Facilities; Individual
Development Accounts; Community Economic Development;
Alzheimer's Disease Demonstration Grants; Adolescent Family
Life; Office of Disease Prevention and Health Promotion;
Rehabilitation Services and Disability Research, except
sections 4, 5, and 6 of the Assistive Technology Program;
Institute of Education Sciences; Corporation for Public
Broadcasting; Museum and Library Services Act programs;
National Council on Disability; and Older Americans Act.

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

Pursuant to paragraph 7(c) of rule XXVI, on June 14, 2012,
the Committee ordered favorably reported favorably an original
bill (S. 3301) making appropriations for the Departments of
Labor, Health and Human Services, and Education, and related
agencies for the fiscal year ending September 30, 2013, subject
to amendment and subject to its spending allocations, by a
recorded vote of 16-14, a quorum being present. The vote was as
follows:
Yeas Nays
Chairman Inouye Mr. Cochran
Mr. Leahy Mr. McConnell
Mr. Harkin Mr. Shelby
Ms. Mikulski Mrs. Hutchison
Mr. Kohl Mr. Alexander
Mrs. Murray Ms. Collins
Mrs. Feinstein Ms. Murkowski
Mr. Durbin Mr. Graham
Mr. Johnson (SD) Mr. Kirk
Ms. Landrieu Mr. Coats
Mr. Reed Mr. Blunt
Mr. Lautenberg Mr. Moran
Mr. Nelson Mr. Hoeven
Mr. Pryor Mr. Johnson (WI)
Mr. Tester
Mr. Brown

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

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

TITLE 20--EDUCATION

CHAPTER 28--HIGHER EDUCATION RESOURCES AND STUDENT ASSISTANCE

SUBCHAPTER I--GENERAL PROVISIONS

Part A--Definitions

Sec. 1011m. Certification regarding the use of certain Federal funds
and restrictions on sources of funds for recruiting
and marketing activities

(a) Prohibition

* * * * * * *

(d) Certification

Each institution of higher education or other postsecondary
educational institution receiving Federal funding under the
Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) [and 42
U.S.C. 2751 et seq.], as a condition for receiving such
funding, shall annually certify to the Secretary of Education
that the requirements of [subsections (a) through (c)]
subsections (a), (b), (c), and (e) have been met.

(e) Restrictions on Sources of Funds for Recruiting and
Marketing Activities.--
(1) In general.--An institution of higher
education, or other postsecondary educational
institution, may not use revenues derived from Federal
educational assistance funds for recruiting or
marketing activities described in paragraph (2).
(2) Covered activities.--Except as provided in
paragraph (3), the recruiting and marketing activities
subject to paragraph (1) shall include the following:
(A) Advertising and promotion activities,
including paid announcements in newspapers,
magazines, radio, television, billboards,
electronic media, naming rights, or any other
public medium of communication, including
paying for displays or promotions at job fairs,
military installations, or college recruiting
events.
(B) Efforts to identify and attract
prospective students, either directly or
through a contractor or other third party,
including contact concerning a prospective
student's potential enrollment or application
for grant, loan, or work assistance under title
IV of the Higher Education Act of 1965 (20
U.S.C. 1070 et seq.) or participation in
preadmission or advising activities,
including--
(i) paying employees responsible
for overseeing enrollment and for
contacting potential students in-
person, by phone, by email, or by other
internet communications regarding
enrollment; and
(ii) soliciting an individual to
provide contact information to an
institution of higher education,
including websites established for such
purpose and funds paid to third parties
for such purpose.
(C) Such other activities as the Secretary
of Education may prescribe, including paying
for promotion or sponsorship of education or
military-related associations.
(3) Exceptions.--Any activity that is required as a
condition of receipt of funds by an institution under
title IV of the Higher Education Act of 1965 (20 U.S.C.
1070 et seq.), is specifically authorized under such
title, or is otherwise specified by the Secretary of
Education, shall not be considered to be a covered
activity under paragraph (2).
(4) Federal educational assistance funds.--In this
subsection, the term ``Federal educational assistance
funds'' means any Federal financial assistance provided
under any Federal law, through a grant, contract,
subsidy, loan, guarantee, insurance or other means,
including Federal financial assistance that is
disbursed or delivered to an institution on behalf of a
student or to a student to be used to attend the
institution.
(5) Rule of construction.--Nothing in this section
shall be construed as a limitation on the use by an
institution of revenues derived from sources other than
Federal educational assistance funds.
(6) Reporting.--Each institution of higher
education, or other postsecondary educational
institution, that receives revenues derived from
Federal educational assistance funds shall report
annually to the Secretary of Education and to Congress
the institution's expenditures on advertising,
marketing, and recruiting.

[(e)] (f) Actions to implement and enforce

The Secretary of Education shall take such actions as are
necessary to ensure that the provisions of this section are
implemented and enforced.

* * * * * * *

SUBCHAPTER IV--STUDENT ASSISTANCE

Part A--Grants To Students in Attendance at Institutions of Higher
Education

SUBPART 1--FEDERAL PELL GRANTS

Sec. 1070a. Federal Pell Grants: amount and determinations;
applications

(a) Program authority and method of distribution

* * * * * * *

(b) Purpose and amount of grants

(1) * * *

* * * * * * *

(7) Additional funds.--
(A) In general.-- * * *
(i) * * *

* * * * * * *

[(iv) to carry out this section-
[(I) $13,500,000,000 for
fiscal year 2011;
[(II) $13,795,000,000 for
fiscal year 2012;
[(III) $7,587,000,000 for
fiscal year 2013;
[(IV) $588,000,000 for
fiscal year 2014;
[(V) $0 for fiscal year
2015;
[(VI) $0 for fiscal year
2016;
[(VII) $1,574,000,000 for
fiscal year 2017;
[(VIII) $1,382,000,000 for
fiscal year 2018;
[(IX) $1,409,000,000 for
fiscal year 2019;
[(X) $1,430,000,000 for
fiscal year 2020; and
[(XI) $1,145,000,000 for
fiscal year 2021 and each
succeeding fiscal year.]
(iv) to carry out this section--
(I) $13,500,000,000 for
fiscal year 2011;
(II) $13,795,000,000 for
fiscal year 2012;
(III) $10,683,000,000 for
fiscal year 2013;
(IV) $1,009,000,000 for
fiscal year 2014;
(V) $0 for fiscal year
2015;
(VI) $0 for fiscal year
2016;
(VII) $1,574,000,000 for
fiscal year 2017;
(VIII) $1,595,000,000 for
fiscal year 2018;
(IX) $1,622,000,000 for
fiscal year 2019;
(X) $1,643,000,000 for
fiscal year 2020;
(XI) $1,358,000,000 for
fiscal year 2021 and each
succeeding fiscal year.

* * * * * * *

Part B--Federal Family Education Loan Program

Sec. 1078-6. Default reduction program

(a) Other repayment incentives

(1) Sale or assignment of loan

(A) In general

Each guaranty agency, upon securing 9
payments made within 20 days of the due date
during 10 consecutive months of amounts owed on
a loan for which the Secretary has made a
payment under paragraph (1) of section 1078(c)
of this title, shall--
(i) * * *
[(ii) on or before September 30,
2011, assignthe loan to the Secretary
if--]
(ii) on or after October 1, 2012,
assign the loan to the Secretary if the
guaranty agency has been unable to sell
the loan under clause (i).

* * * * * * *

(D) Duties upon sale

With respect to a loan sold under subparagraph
(A)(i)--
[(i) the guaranty agency--
[(I) shall repay the Secretary
81.5 percent of the amount of
the principal balance
outstanding at the time of such
sale, multiplied by the
reinsurance percentage in
effect when payment under the
guaranty agreement was made
with respect to the loan; and]
(i) the guaranty agency--
(I) shall, in the case of a
sale made on or after October
1, 2012, repay the Secretary
100 percent of the amount of
the principal balance
outstanding at the time of such
sale, multiplied by the
reinsurance percentage in
effect when payment under the
guaranty agreement was made
with respect to the loan; and
(II) may, in the case of a
sale made on or after October
1, 2012, in order to defray
collection costs--
(aa) charge to the
borrower an amount not
to exceed 16 percent of
the outstanding
principal and interest
at the time of the loan
sale; and
(bb) retain such
amount from the
proceeds of the loan
sale; and

* * * * * * *

Part C--William D. Ford Federal Direct Loan Program

Sec. 1087e. Terms and conditions of loans

(a) In general

* * * * * * *

(p) Disclosures

Each institution of higher education with which the
Secretary has an agreement under section 1087c of this title,
and each contractor with which the Secretary has a contract
under section 1087f of this title, shall, with respect to loans
under this part and in accordance with such regulations as the
Secretary shall prescribe, comply with each of the requirements
under section 1083 of this title that apply to a lender with
respect to a loan under part B.

(q) Eligibility for, and Interest Charges on, Federal
Direct Stafford Loans for New Borrowers on or After July 1,
2013.--
(1) In general.--Notwithstanding subsection (a) or
any other provision of this title, any borrower who was
a new borrower on or after July 1, 2013, shall not be
eligible for a Federal Direct Stafford Loan if the
period of time for which the borrower has received
Federal Direct Stafford loans, in the aggregate,
exceeds the period of enrollment described in paragraph
(3). Such borrower may still receive any Federal Direct
Unsubsidized Stafford Loan for which such borrower is
otherwise eligible.
(2) Payment of interest on federal direct stafford
loans.--Notwithstanding subsection (f)(1)(A) or any
other provision of this title and beginning on the date
upon which a borrower who is in school becomes
ineligible for a Federal Direct Stafford Loan as a
result of paragraph (1), interest on all Federal Direct
Stafford Loans that were disbursed to such borrower on
or after July 1, 2013, shall accrue. Such interest
shall be paid or capitalized in the same manner as
interest on a Federal Direct Unsubsidized Stafford Loan
is paid or capitalized under section 428H(e)(2).
(3) Period of enrollment.--
(A) In general.--The aggregate period of
enrollment referred to in paragraph (1) shall
not exceed the lesser of--
(i) a period equal to 150 percent
of the published length of the
educational program in which the
student is enrolled; or
(ii) in the case of a borrower who
was previously enrolled in one or more
other educational programs that began
after July 1, 2013, a period of time
equal to the difference between--
(I) 150 percent of the
published length of the longest
educational program in which
the borrower was, or is,
enrolled; and
(II) any periods of
enrollment in which the
borrower received a Federal
Direct Stafford Loan.
(B) Less than full-time basis.--The
Secretary shall specify in regulation how the
aggregate period described in subparagraph (A)
shall be calculated with respect to a borrower
who was or is enrolled on a less than full-time
basis.

* * * * * * *

Sec. 1087f. Contracts

(a) Contracts for supplies and services

(1) In general

* * * * * * *

(4) Servicing by eligible not-for-profit servicers

(A) Servicing contracts

(i) In general

The Secretary shall contract with
each eligible not-for-profit servicer
to service loans originated under this
part, if the servicer--''

* * * * * * *

(B) Allocations

(i) In general

The Secretary shall (except as
provided in clause (ii)) allocate to an
eligible not-for-profit servicer,
subject to the contract of such
servicer described in subparagraph (A),
the servicing rights for the loan
accounts of 100,000 borrowers
(including borrowers who borrowed loans
in a prior year that were serviced by
the servicer).

(ii) Servicer allocation

The Secretary may reallocate,
increase, reduce, or terminate an
eligible not-for-profit servicer's
allocation of servicing rights under
clause (i) based on the performance of
such servicer, on the same terms as
loan allocations provided by contracts
awarded pursuant to paragraph (1).
(5) Special rule for not-for-profit servicers with
affiliates.--Notwithstanding any other provision of
this section, only an eligible not-for-profit servicer
described in clause (i) or (ii) of subsection (c)(1)(B)
shall receive a contract with the Secretary under
paragraph (4)(A), and an allocation under paragraph
(4)(B), except that, if an eligible not-for-profit
servicer so described is also a corporation described
in subparagraphs (A) and (B) of section 150(d)(2) of
the Internal Revenue Code of 1986, then the affiliated
entity of that servicer (described in subsection
(c)(1)(B)(ii)) shall receive the contract with the
Secretary under paragraph (4)(A), and an allocation
under paragraph (4)(B), rather than the eligible not-
for-profit servicer described in clause (i) or (ii) of
subsection (c)(1)(B).
(6) Special rule for not-for-profit servicers with
shared management or common control.--Notwithstanding
any other provision of this section, in the case of
entities that otherwise meet the definition of an
eligible not-for-profit servicer under this section but
2 or more of the same individuals serve as part of the
management, board of directors, or other governing body
of more than one such entity, or the Secretary
determines that one entity controls, is controlled by,
or is under common control with, another such entity,
all such entities with that shared management or
control shall receive one aggregate allocation under
paragraph (4)(B) and be treated for purposes of
paragraph (4) as though all of such entities were a
single eligible not-for-profit servicer.

* * * * * * *

Part E--Need Analysis

Sec. 1087ll. Cost of attendance

For the purpose of this subchapter and part C of subchapter I
of chapter 34 of title 42, the term ``cost of attendance''
means--
(1) * * *

* * * * * * *

(3) except as provided in paragraph (10)(A)(i), an
allowance (as determined by the institution) for room
and board costs incurred by the student which--

* * * * * * *

[(10) for a student receiving all or part of the
student's instruction by means of telecommunications
technology, no distinction shall be made with respect
to the mode of instruction in determining costs;]
(10)(A) with respect to the determination of a
student's need for a Federal Pell Grant, in the case of
a student who is receiving--
(i) all instruction (excluding limited
periods in which the student is required to be
physically present at the institution for
noninstructional purposes, such as orientation
or the administration of examinations) by means
of telecommunications technology, only tuition
and fees, books and supplies; or
(ii) part of the student's instruction by
means of telecommunications technology, no
distinction shall be made with respect to the
mode of instruction in determining costs; and
(B) with respect to the determination of a
student's need for assistance under this title other
than a Federal Pell Grant, in the case of a student who
is receiving all or part of the student's instruction
by means of telecommunications technology, no
distinction shall be made with respect to the mode of
instruction in determining costs;

* * * * * * *

Part F--General Provisions Relating to Student Assistance Programs

Sec. 1091. Student eligibility

(a) * * *

* * * * * * *

[(d) Students who are not high school graduates

[In order for a student who does not have a certificate of
graduation from a school providing secondary education, or the
recognized equivalent of such certificate, to be eligible for
any assistance under subparts 1, 3, and 4 of part A and parts
B, C, and D of this subchapter and part C of subchapter I of
chapter 34 of title 42, the student shall have completed a
secondary school education in a home school setting that is
treated as a home school or private school under State law.]
(d) Students Who Are Not High School Graduates.--
(1) Student eligibility.--In order for a student
who does not have a certificate of graduation from a
school providing secondary education, or the recognized
equivalent of such certificate, to be eligible for any
assistance under subparts 1, 3, and 4 of part A and
parts B, C, D, and E of this title, the student shall
meet the requirements of one of the following
subparagraphs:
(A) The student is enrolled in an eligible
career pathway program and meets one of the
following standards:
(i) The student shall take an
independently administered examination
and shall achieve a score, specified by
the Secretary, demonstrating that such
student can benefit from the education
or training being offered. Such
examination shall be approved by the
Secretary on the basis of compliance
with such standards for development,
administration, and scoring as the
Secretary may prescribe in regulations.
(ii) The student shall be
determined as having the ability to
benefit from the education or training
in accordance with such process as the
State shall prescribe. Any such process
described or approved by a State for
the purposes of this section shall be
effective 6 months after the date of
submission to the Secretary unless the
Secretary disapproves such process. In
determining whether to approve or
disapprove such process, the Secretary
shall take into account the
effectiveness of such process in
enabling students without high school
diplomas or the equivalent thereof to
benefit from the instruction offered by
institutions utilizing such process,
and shall also take into account the
cultural diversity, economic
circumstances, and educational
preparation of the populations served
by the institutions.
(iii) The student shall be
determined by the institution of higher
education as having the ability to
benefit from the education or training
offered by the institution of higher
education upon satisfactory completion
of 6 credit hours or the equivalent
coursework that are applicable toward a
degree or certificate offered by the
institution of higher education.
(B) The student has completed a secondary
school education in a home school setting that
is treated as a home school or private school
under State law.
(2) Eligible career pathway program.--In this
subsection, the term ``eligible career pathway
program'' means a program that--
(A) concurrently enrolls participants in
connected adult education and eligible
postsecondary programs;
(B) provides counseling and supportive
services to identify and attain academic and
career goals;
(C) provides structured course sequences
that--
(i) are articulated and
contextualized; and
(ii) allow students to advance to
higher levels of education and
employment;
(D) provides opportunities for acceleration
to attain recognized postsecondary credentials,
including degrees, industry relevant
certifications, and certificates of completion
of apprenticeship programs;
(E) is organized to meet the needs of
adults;
(F) is aligned with the education and skill
needs of the regional economy; and
(G) has been developed and implemented in
collaboration with partners in business,
workforce development, and economic
development.

* * * * * * *

CHAPTER 44--CAREER AND TECHNICAL EDUCATION

SUBCHAPTER I--CAREER AND TECHNICAL EDUCATION ASSISTANCE TO THE STATES

Part A--Allotment and Allocation

Sec. 2324. National activities

(a) Program performance information

* * * * * * *

(b) Miscellaneous provisions

(1) Collection of information at reasonable cost

The Secretary shall take such action as may be
necessary to secure at reasonable cost the information
required by this subchapter. To ensure reasonable cost,
the Secretary, in consultation with the National Center
for Education Statistics, the [Office of Vocational and
Adult Education] Office of Career, Technical, and Adult
Education, and an entity assisted under section 2328 of
this title (if applicable), shall determine the
methodology to be used and the frequency with which
information is to be collected.

* * * * * * *

CHAPTER 48--DEPARTMENT OF EDUCATION

SUBCHAPTER II--ESTABLISHMENT OF THE DEPARTMENT

Sec. 3412. Principal officers

(a) Deputy Secretary of Education

* * * * * * *

(b) Assistant Secretaries and General Counsel

(1) There shall be in the Department--
(A) * * *

* * * * * * *

(C) an [Assistant Secretary for Vocational and
Adult Education] Assistant Secretary for
Career, Technical, and Adult Education;

* * * * * * *

(h) Coordination of literacy related functions by [Assistant
Secretary for Vocational and Adult Education]
Assistant Secretary for Career, Technical, and
Adult Education

The [Assistant Secretary for Vocational and Adult
Education] Assistant Secretary for Career, Technical, and Adult
Education, in addition to performing such functions as the
Secretary may prescribe, shall have responsibility for
coordination of all literacy related programs and policy
initiatives in the Department. The [Assistant Secretary for
Vocational and Adult Education] Assistant Secretary for Career,
Technical, and Adult Education shall assist in coordinating the
related activities and programs of other Federal departments
and agencies.

* * * * * * *

Sec. 3416. [Office of Vocational and Adult Education] Office of Career,
Technical, and Adult Education

There shall be in the Department an [Office of Vocational
and Adult Education] Office of Career, Technical, and Adult
Education, to be administered by the [Assistant Secretary for
Vocational and Adult Education] Assistant Secretary for Career,
Technical, and Adult Education appointed under section 3412(b)
of this title. The Assistant Secretary shall administer such
functions affecting [vocational and adult education] career,
technical, and adult education as the Secretary shall delegate,
and shall serve as principal adviser to the Secretary on
matters affecting [vocational and adult education] career,
technical, and adult education. The Secretary, through the
Assistant Secretary, shall also provide a unified approach to
rural education and rural family education through the
coordination of programs within the Department and shall work
with the Federal Interagency Committee on Education to
coordinate related activities and programs of other Federal
departments and agencies.
------

TITLE 40--PUBLIC BUILDINGS, PROPERTY, AND WORKS

Part A--General

CHAPTER 31--GENERAL

SUBCHAPTER IV--WAGE RATE REQUIREMENTS

Sec. 3144. Authority [of Comptroller General] to pay wages and list
contractors violating contracts

(a) Payment of Wages.--
(1) In general.--[The Comptroller General] The
Secretary of Labor shall pay directly to laborers and
mechanics from any accrued payments withheld under the
terms of a contract any wages found to be due laborers
and mechanics under this subchapter.

* * * * * * *

CHAPTER 37--CONTRACT WORK HOURS AND SAFETY STANDARDS

Sec. 3703. Report of violations and withholding of amounts for unpaid
wages and liquidated damages

(a) Reports of Inspectors.-- * * *

* * * * * * *

(b) Withholding Amounts.--
(1) Determining amount.-- * * *

* * * * * * *

(3) Payment.--[The Comptroller General] The
Secretary of Labor shall pay the amount
administratively determined to be due directly to the
laborers and mechanics from amounts withheld on account
of underpayments of wages if the amount withheld is
adequate. If the amount withheld is not adequate, [the
Comptroller General] the Secretary of Labor shall pay
an equitable proportion of the amount due.
------

TITLE 42--THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A--PUBLIC HEALTH SERVICE

SUBCHAPTER V--HEALTH PROFESSIONS EDUCATION

Part A--Student Loans

SUBPART I--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE
STUDENTS

Sec. 292o. Definitions

For purposes of this subpart:
(1) The term ``eligible institution'' means, with respect
to a fiscal year, a school of medicine, osteopathic medicine,
dentistry, veterinary medicine, optometry, podiatric medicine,
pharmacy, public health, allied health, or chiropractic, or a
graduate program in health administration or behavioral and
mental health practice, including clinical psychology.

* * * * * * *

(5)(A) The term ``default rate'', in the case of an
eligible entity, means the percentage constituted by
the ratio of--
(i) the principal amount of loans
insuredunder this subpart--
(I) that are made with respect to
the entity and that enter repayment
status after April 7, 1987; and
(II) for which amounts have been
paid under section 292f(a) of this
title to insurance beneficiaries,
exclusive of any loan for which amounts
have been so paid as a result of the
death or total and permanent disability
of the borrower; exclusive of any loan
for which the borrower begins payments
to the Secretary on the loan pursuant
to section 292f(b) of this title and
maintains payments for 12 consecutive
months in accordance with the agreement
involved (with the loan subsequently
being included or excluded, as the case
may be, as amounts paid under section
292f(a) of this title according to
whether further defaults occur and
whether with respect to the default
involved compliance with such
requirement regarding 12 consecutive
months occurs); and exclusive of any
loan on which payments may not be
recovered by reason of the obligation
under the loan being discharged in
bankruptcy under title 11; to
(ii) the total principal amount of loans
insured under this subpart that are made with
respect to the entity and that enter repayment
status after April 7, 1987.
(B) For purposes of subparagraph (A), a loan
insured under this subpart shall be considered to have
entered repayment status if the applicable period
described in subparagraph (B) of section 292d(a)(2) of
this title regarding the loan has expired (without
regard to whether any period described in subparagraph
(C) of such section is applicable regarding the loan).
(C) For purposes of subparagraph (A), the term
``eligible entity'' means an eligible institution, an
eligible lender, or a holder, as the case may be.
(D) For purposes of subparagraph (A), a loan is
made with respect to an eligible entity if--
(i) in the case of an eligible institution,
the loan was made to students of the
institution;
(ii) in the case of an eligible lender, the
loan was made by the lender; and
(iii) in the case of a holder, the loan was
purchased by the holder.
(6) The term ``Secretary'' means the Secretary of
Education.
------

TITLE 48--TERRITORIES AND INSULAR POSSESSIONS

CHAPTER 18--MICRONESIA, MARSHALL ISLANDS, AND PALAU

SUBCHAPTER I--MICRONESIA AND MARSHALL ISLANDS

Part B--Approval and Implementation of Compacts, as Amended

Sec. 1921d. Supplemental provisions

(a) Domestic program requirements

* * * * * * *

(f) Continuing programs and laws

(1) Federated States of Micronesia and Republic of the
Marshall Islands

* * * * * * *

(A) Emergency and disaster assistance

* * * * * * *

(B) Treatment of additional programs

(i) Consultation

* * * * * * *

(ix) Applicability

The government, institutions, and
people of Palau shall remain eligible
for appropriations and to receive
grants under the provisions of law
specified in clauses (ii) and (iii)
until the end of fiscal year [2009]
2013, to the extent the government,
institutions, and people of Palau were
so eligible under such provisions in
fiscal year 2003.
------

DEPARTMENT OF EDUCATION ORGANIZATION ACT, 1980, PUBLIC LAW 96-88

Section 1. This Act may be cited as the ``Department of
Education Organization Act''.

TABLE OF CONTENTS

TITLE II--ESTABLISHMENT OF THE DEPARTMENT

Sec. 201. Establishment.
* * * * * * *
[Sec. 206. Office of Vocational and Adult Education]
Sec. 206. Office of Career, Technical, and Adult Education

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 in Committee Amount in
allocation bill allocation bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
to its subcommittees of amounts in the Budget Resolution
for 2013: Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies:
Mandatory............................................... 594,910 594,910 594,481 \1\594,481
Discretionary........................................... 157,722 158,772 168,600 \1\165,542
Security............................................ ........... ........... NA NA
Nonsecurity......................................... 157,722 158,722 NA NA
Projections of outlays associated with the recommendation:
2013.................................................... ........... ........... ........... \2\663,774
2014.................................................... ........... ........... ........... 73,446
2015.................................................... ........... ........... ........... 17,804
2016.................................................... ........... ........... ........... 2,919
2017 and future years................................... ........... ........... ........... 642
Financial assistance to State and local governments for NA 323,132 NA 305,979
2013.......................................................

----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.

NA: Not applicable.

Note.--Consistent with the funding recommended in the bill for continuing disability reviews and
redeterminations and for healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C)
of section 251(b)(2) of the BBEDCA of 1985 and section 106 of the Deficit Control Act of 2011, the Committee
anticipates that the Budget Committee will file a revised section 302(a) allocation for the Committee on
Appropriations reflecting an upward adjustment of $1,050,000,000 in budget authority plus associated outlays.

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2012 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2013
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2011 Budget estimate Committee -----------------------------------
appropriation recommendation 2012
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I--DEPARTMENT OF LABOR

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Grants to States:
Adult Training, current year.............................. 58,811 57,465 58,811 ................ +1,346
Advance from prior year............................... (710,654) (712,000) (712,000) (+1,346) ................
Fiscal year 2014...................................... 712,000 712,000 712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 770,811 769,465 770,811 ................ +1,346

Youth Training............................................ 824,353 824,353 824,353 ................ ................

Dislocated Worker Assistance, current year................ 148,151 146,526 148,151 ................ +1,625
Advance from prior year............................... (858,375) (860,000) (860,000) (+1,625) ................
Fiscal year 2014...................................... 860,000 860,000 860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 1,008,151 1,006,526 1,008,151 ................ +1,625
=========================================================================================
Subtotal, Grants to States.......................... 2,603,315 2,600,344 2,603,315 ................ +2,971
Current Year...................................... (1,031,315) (1,028,344) (1,031,315) ................ (+2,971)
Fiscal year 2014.................................. (1,572,000) (1,572,000) (1,572,000) ................ ................

Federally Administered Programs:
Dislocated Worker Assistance National Reserve:
Current year.......................................... 24,066 23,688 24,066 ................ +378
Advance from prior year............................... (199,622) (200,000) (200,000) (+378) ................
Fiscal year 2014...................................... 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 224,066 223,688 224,066 ................ +378
-----------------------------------------------------------------------------------------
Subtotal, Dislocated Worker Assistance.............. 1,232,217 1,230,214 1,232,217 ................ +2,003

Native Americans.......................................... 47,562 52,562 47,562 ................ -5,000
Migrant and Seasonal Farmworker programs.................. 84,291 84,291 84,291 ................ ................
Women in Apprenticeship................................... 996 ................ 996 ................ +996
YouthBuild activities..................................... 79,689 79,689 79,689 ................ ................
Workforce Innovation Fund................................. 49,906 100,000 49,906 ................ -50,094
=========================================================================================
Subtotal, Federally Administered Programs [FAP]......... 486,510 540,230 486,510 ................ -53,720
Current Year........................................ (286,510) (340,230) (286,510) ................ (-53,720)
Fiscal year 2014.................................... (200,000) (200,000) (200,000) ................ ................

National Activities:
Pilots, Demonstrations, and Research.................. 6,603 ................ ................ -6,603 ................
Reintegration of Ex-Offenders......................... 80,238 85,238 80,238 ................ -5,000
Evaluation............................................ 9,563 ................ ................ -9,563 ................
Workforce Data Quality Initiative..................... 6,463 6,000 6,000 -463 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 102,867 91,238 86,238 -16,629 -5,000
=========================================================================================
Total, Training and Employment Services [TES]....... 3,192,692 3,231,812 3,176,063 -16,629 -55,749
Current Year...................................... (1,420,692) (1,459,812) (1,404,063) (-16,629) (-55,749)
Fiscal year 2014.................................. (1,772,000) (1,772,000) (1,772,000) ................ ................

OFFICE OF JOB CORPS

Administration................................................ 29,077 29,132 29,132 +55 ................
Operations.................................................... 1,569,078 1,545,872 1,569,078 ................ +23,206
Advance from prior year................................... (589,883) ................ ................ (-589,883) ................
Construction, Rehabilitation and Acquisition.................. 104,792 75,000 75,000 -29,792 ................
Advance from prior year................................... (99,811) ................ ................ (-99,811) ................
-----------------------------------------------------------------------------------------
Total, Office of Job Corps.............................. 1,702,947 1,650,004 1,673,210 -29,737 +23,206
Current Year........................................ (1,702,947) (1,650,004) (1,673,210) (-29,737) (+23,206)

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\........... 448,251 ................ 448,251 ................ +448,251
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES.................. 1,100,100 1,421,000 1,421,000 +320,900 ................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Unemployment Compensation [UI]:
State Operations.......................................... 3,209,172 3,004,912 3,004,912 -204,260 ................
National Activities....................................... 11,266 11,297 11,297 +31 ................
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation..................... 3,220,438 3,016,209 3,016,209 -204,229 ................

Employment Service [ES]:
Allotments to States:
Federal Funds......................................... 22,595 22,638 22,638 +43 ................
Trust Funds........................................... 678,247 708,204 708,204 +29,957 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 700,842 730,842 730,842 +30,000 ................

ES National Activities.................................... 20,912 20,952 20,952 +40 ................
-----------------------------------------------------------------------------------------
Subtotal, Employment Service............................ 721,754 751,794 751,794 +30,040 ................
Federal Funds....................................... (22,595) (22,638) (22,638) (+43) ................
Trust Funds......................................... (699,159) (729,156) (729,156) (+29,997) ................

Foreign Labor Certification:
Federal Administration.................................... 50,323 50,418 50,418 +95 ................
Grants to States.......................................... 15,070 15,099 15,099 +29 ................
-----------------------------------------------------------------------------------------
Subtotal, Foreign Labor Certification................... 65,393 65,517 65,517 +124 ................

One-Stop Career Centers/Labor Market Information.............. 63,473 115,720 63,473 ................ -52,247
=========================================================================================
Total, State UI and ES.................................. 4,071,058 3,949,240 3,896,993 -174,065 -52,247
Federal Funds....................................... (86,068) (138,358) (86,111) (+43) (-52,247)
Trust Funds......................................... (3,984,990) (3,810,882) (3,810,882) (-174,108) ................

STATE PAID LEAVE FUND......................................... ................ 5,000 ................ ................ -5,000

ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\................... 171,000 ................ ................ -171,000 ................

PROGRAM ADMINISTRATION

Adult Employment and Training................................. 46,677 47,015 46,677 ................ -338
Trust Funds............................................... 8,518 8,536 8,518 ................ -18
Youth Employment and Training................................. 12,260 12,283 12,260 ................ -23
Employment Security........................................... 3,476 3,483 3,476 ................ -7
Trust Funds............................................... 39,343 39,417 39,343 ................ -74
Apprenticeship Services....................................... 27,676 27,728 27,676 ................ -52
Executive Direction........................................... 7,048 7,062 7,048 ................ -14
Trust Funds............................................... 2,083 2,087 2,083 ................ -4
-----------------------------------------------------------------------------------------
Total, Program Administration........................... 147,081 147,611 147,081 ................ -530
Federal Funds....................................... (97,137) (97,571) (97,137) ................ (-434)
Trust Funds......................................... (49,944) (50,040) (49,944) ................ (-96)
=========================================================================================
Total, Employment and Training Admin. [ETA]............. 10,833,129 10,404,667 10,762,598 -70,531 +357,931
Federal Funds....................................... 6,798,195 6,543,745 6,901,772 +103,577 +358,027
Current Year.................................... (5,026,195) (4,771,745) (5,129,772) (+103,577) (+358,027)
Fiscal year 2014................................ (1,772,000) (1,772,000) (1,772,000) ................ ................
Trust Funds......................................... 4,034,934 3,860,922 3,860,826 -174,108 -96

EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]

SALARIES AND EXPENSES

Enforcement and Participant Assistance........................ 145,243 145,243 145,243 ................ ................
Policy and Compliance Assistance.............................. 31,205 31,205 31,205 ................ ................
Executive Leadership, Program Oversight and Admin............. 6,705 6,705 6,705 ................ ................
-----------------------------------------------------------------------------------------
Total, EBSA............................................. 183,153 183,153 183,153 ................ ................

PENSION BENEFIT GUARANTY CORPORATION [PBGC]

Pension Insurance Activities.................................. (84,219) (75,943) (75,943) (-8,276) ................
Pension Plan Termination...................................... (238,993) (240,611) (240,611) (+1,618) ................
Operational Support........................................... (153,689) (162,459) (162,459) (+8,770) ................
-----------------------------------------------------------------------------------------
Total, PBGC (program level)............................. (476,901) (479,013) (479,013) (+2,112) ................

Enforcement of Wage & Hour Standards.......................... 227,061 237,730 237,730 +10,669 ................
OFFICE OF LABOR-MANAGEMENT STANDARDS.......................... 41,289 41,771 41,289 ................ -482
Feeral Contractor EEO Standards Enforcement................... 105,187 106,415 105,187 ................ -1,228

FEDERAL PROGRAMS FOR WORKERS' COMPENSATION

Salaries and Expenses......................................... 115,720 120,056 115,720 ................ -4,336
Trust Funds............................................... 2,120 2,134 2,120 ................ -14
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses............................ 117,840 122,190 117,840 ................ -4,350
Federal Funds....................................... (115,720) (120,056) (115,720) ................ (-4,336)
Trust Funds......................................... (2,120) (2,134) (2,120) ................ (-14)

SPECIAL BENEFITS

Federal Employees' Compensation Benefits...................... 347,000 393,000 393,000 +46,000 ................
Longshore and Harbor Workers' Benefits........................ 3,000 3,000 3,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Benefits................................. 350,000 396,000 396,000 +46,000 ................

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Benefit Payments.............................................. 177,000 158,000 158,000 -19,000 ................
Administration................................................ 5,227 5,220 5,220 -7 ................
-----------------------------------------------------------------------------------------
Subtotal, fiscal year 2014 program level................ 182,227 163,220 163,220 -19,007 ................
Less funds advanced in prior year................... -41,000 -40,000 -40,000 +1,000 ................
-----------------------------------------------------------------------------------------
Total, Current Year, fiscal year 2014................... 141,227 123,220 123,220 -18,007 ................
New advances, 1st quarter fiscal year 2014.......... 40,000 35,000 35,000 -5,000 ................
-----------------------------------------------------------------------------------------
Total, Special Benefits for Disabled Coal Miners........ 181,227 158,220 158,220 -23,007 ................

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND

Part B Administrative Expenses................................ 52,147 54,962 54,962 +2,815 ................

BLACK LUNG DISABILITY TRUST FUND

Benefit Payments and Interest on Advances..................... 242,609 250,043 250,043 +7,434 ................
Workers' Compensation Programs, Salaries and Expenses......... 32,906 32,906 32,906 ................ ................
Departmental Management, Salaries and Expenses................ 25,217 25,217 25,217 ................ ................
Departmental Management, Inspector General.................... 327 327 327 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability......................... 301,059 308,493 308,493 +7,434 ................

Treasury Department Administrative Costs...................... 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................. 301,415 308,849 308,849 +7,434 ................
=========================================================================================
Total, Federal Programs for Workers' Compensation....... 1,002,629 1,040,221 1,035,871 +33,242 -4,350
Federal Funds....................................... 1,000,509 1,038,087 1,033,751 +33,242 -4,336
Current year.................................... (960,509) (1,003,087) (998,751) (+38,242) (-4,336)
Fiscal year 2014................................ (40,000) (35,000) (35,000) (-5,000) ................
Trust Funds......................................... 2,120 2,134 2,120 ................ -14

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA]

SALARIES AND EXPENSES

Safety and Health Standards................................... 19,962 21,008 20,964 +1,002 -44
Federal Enforcement........................................... 207,753 207,075 207,075 -678 ................
Whistleblower enforcement..................................... 15,873 20,739 18,650 +2,777 -2,089
State Programs................................................ 104,196 104,196 104,196 ................ ................
Technical Support............................................. 25,820 24,880 24,880 -940 ................

Compliance Assistance:
Federal Assistance........................................ 76,355 73,131 75,000 -1,355 +1,869
State Consultation Grants................................. 57,890 57,890 57,890 ................ ................
Training Grants........................................... 10,709 10,709 11,000 +291 +291
-----------------------------------------------------------------------------------------
Subtotal, Compliance Assistance......................... 144,954 141,730 143,890 -1,064 +2,160

Safety and Health Statistics.................................. 34,739 34,313 34,313 -426 ................
Executive Direction and Administration........................ 11,491 11,527 11,500 +9 -27
=========================================================================================
Total, OSHA............................................. 564,788 565,468 565,468 +680 ................

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Coal Enforcement.............................................. 164,500 167,859 167,859 +3,359 ................
Metal/Non-Metal Enforcement................................... 89,063 91,697 91,697 +2,634 ................
Standards Development......................................... 4,764 5,416 5,416 +652 ................
Assessments................................................... 7,103 6,732 7,000 -103 +268
Educational Policy and Development............................ 38,325 31,682 33,555 -4,770 +1,873
Technical Support............................................. 33,613 33,791 33,791 +178 ................
Program Evaluation and Information Resources [PEIR]........... 18,157 17,990 17,990 -167 ................
Program Administration........................................ 16,998 16,729 18,962 +1,964 +2,233
=========================================================================================
Total, Mine Safety and Health Administration............ 372,523 371,896 376,270 +3,747 +4,374
=========================================================================================
Total, Worker Protection Agencies....................... 1,611,841 1,628,623 1,626,937 +15,096 -1,686
Federal Funds....................................... (1,609,721) (1,626,489) (1,624,817) (+15,096) (-1,672)
Trust Funds......................................... (2,120) (2,134) (2,120) ................ (-14)

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Employment and Unemployment Statistics........................ 209,367 213,219 214,367 +5,000 +1,148
Labor Market Information...................................... 67,176 67,176 67,176 ................ ................
Prices and Cost of Living..................................... 205,888 211,084 210,860 +4,972 -224
Compensation and Working Conditions........................... 80,391 81,545 80,391 ................ -1,154
Productivity and Technology................................... 12,013 10,205 12,013 ................ +1,808
Executive Direction and Staff Services........................ 34,236 34,978 34,236 ................ -742
=========================================================================================
Total, Bureau of Labor Statistics....................... 609,071 618,207 619,043 +9,972 +836
Federal Funds....................................... 541,895 551,031 551,867 +9,972 +836
Trust Funds......................................... 67,176 67,176 67,176 ................ ................

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES......................................... 38,879 38,953 38,953 +74 ................

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Executive Direction........................................... 32,722 32,722 32,722 ................ ................
Departmental Program Evaluation............................... 24,360 9,000 9,000 -15,360 ................
Legal Services................................................ 129,647 130,938 130,938 +1,291 ................
Trust Funds............................................... 325 326 326 +1 ................
International Labor Affairs................................... 92,309 94,984 94,984 +2,675 ................
Administration and Management................................. 29,982 29,614 29,614 -368 ................
Adjudication.................................................. 29,495 29,639 29,639 +144 ................
Women's Bureau................................................ 11,559 9,081 9,081 -2,478 ................
Civil Rights Activities....................................... 7,260 7,273 7,273 +13 ................
Chief Financial Officer....................................... 5,340 5,350 5,350 +10 ................
-----------------------------------------------------------------------------------------
Total, Salaries and expenses............................ 362,999 348,927 348,927 -14,072 ................
Federal Funds....................................... (362,674) (348,601) (348,601) (-14,073) ................
Trust Funds......................................... (325) (326) (326) (+1) ................

VETERANS EMPLOYMENT AND TRAINING

State Administration, Grants.................................. 165,081 170,049 172,000 +6,919 +1,951
Transition Assistance Program................................. 8,983 12,000 14,000 +5,017 +2,000
Federal Administration........................................ 35,155 35,222 35,222 +67 ................
National Veterans Training Institute.......................... 2,439 3,414 3,414 +975 ................
Homeless Veterans Program..................................... 38,185 38,185 38,185 ................ ................
Veterans Workforce Investment Programs........................ 14,594 ................ ................ -14,594 ................
-----------------------------------------------------------------------------------------
Total, Veterans Employment and Training................. 264,437 258,870 262,821 -1,616 +3,951
Federal Funds....................................... 52,779 38,185 38,185 -14,594 ................
Trust Funds......................................... 211,658 220,685 224,636 +12,978 +3,951

INFRASTRUCTURE TECHNOLOGY MODERNIZATION

Departmental support systems.................................. 11,829 8,000 7,985 -3,844 -15
Infrastructure technology modernization....................... 7,985 13,852 11,829 +3,844 -2,023
-----------------------------------------------------------------------------------------
Total, IT Modernization................................. 19,814 21,852 19,814 ................ -2,038

OFFICE OF INSPECTOR GENERAL

Program Activities............................................ 77,790 79,199 77,790 ................ -1,409
Trust Funds............................................... 5,898 5,909 5,898 ................ -11
-----------------------------------------------------------------------------------------
Total, Office of Inspector General...................... 83,688 85,108 83,688 ................ -1,420
=========================================================================================
Total, Departmental Management.......................... 730,938 714,757 715,250 -15,688 +493
Federal Funds....................................... 513,057 487,837 484,390 -28,667 -3,447
Current Year.................................... (513,057) (487,837) (484,390) (-28,667) (-3,447)
Trust Funds......................................... 217,881 226,920 230,860 +12,979 +3,940
=========================================================================================
Total, Title I, Department of Labor..................... 14,708,647 14,323,238 14,680,812 -27,835 +357,574
Federal Funds....................................... 10,386,536 10,166,086 10,519,830 +133,294 +353,744
Current Year.................................... (8,574,536) (8,359,086) (8,712,830) (+138,294) (+353,744)
Fiscal year 2014................................ (1,812,000) (1,807,000) (1,807,000) (-5,000) ................
Trust Funds......................................... 4,322,111 4,157,152 4,160,982 -161,129 +3,830

TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]

HEALTH RESOURCES AND SERVICES

Primary Health Care

Community Health Centers...................................... 1,566,892 1,561,803 1,566,892 ................ +5,089
Free Clinics Medical Malpractice.............................. 40 40 40 ................ ................
National Hansen's Disease Program............................. 16,045 16,045 16,045 ................ ................
Hansen's Disease Program Buildings and Facilities............. 127 127 127 ................ ................
Payment to Hawaii, Treatment of Hansen's...................... 1,960 1,960 1,960 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Primary Health Care........................... 1,585,064 1,579,975 1,585,064 ................ +5,089

Bureau of Health Professions [BHP]

Health Workforce

Health Professions, Training for Diversity:
Centers of Excellence..................................... 22,909 22,909 22,909 ................ ................
Health Careers Opportunity Program........................ 14,822 ................ ................ -14,822 ................
Faculty Loan Repayment.................................... 1,243 1,243 1,243 ................ ................
Scholarships for Disadvantaged Students................... 47,452 47,452 47,452 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Training for Diversity........................ 86,426 71,604 71,604 -14,822 ................

Training in Primary Care Medicine............................. 38,962 50,962 48,962 +10,000 -2,000
Pediatric Loan Repayment...................................... ................ 5,000 ................ ................ -5,000
Oral Health Training.......................................... 32,392 32,392 32,392 ................ ................

Interdisciplinary Community-Based Linkages:
Area Health Education Centers............................. 27,220 ................ 27,220 ................ +27,220
Geriatric Programs........................................ 30,629 30,629 30,629 ................ ................
Mental and Behavorial Health.............................. 2,892 2,892 2,892 ................ ................
Evaluation Tap Funding................................ ................ (5,000) ................ ................ (-5,000)
Prevention and Public Health Fund\3\.................. (10,000) ................ ................ (-10,000) ................
-----------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Community Linkages...... 60,741 33,521 60,741 ................ +27,220
Subtotal, Evaluation Tap Funding................ ................ 5,000 ................ ................ -5,000
Subtotal, Prevention and Public Health Fund\3\.. 10,000 ................ ................ -10,000 ................
-----------------------------------------------------------------------------------------
Total, Interdisciplinary Community Linkages......... 70,741 38,521 60,741 -10,000 +22,220

Workforce Information and Analysis............................ 2,782 ................ 7,782 +5,000 +7,782
Evaluation Tap Funding.................................... ................ (10,000) ................ ................ (-10,000)

Public Health and Preventive Medicine programs................ 8,111 9,609 10,111 +2,000 +502
Prevention and Public Health Fund\3\...................... (25,000) (10,000) (25,000) ................ (+15,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 33,111 19,609 35,111 +2,000 +15,502

Nursing Programs:
Advanced Education Nursing................................ 63,925 63,925 63,925 ................ ................
Evaluation Tap Funding................................ ................ (20,000) ................ ................ (-20,000)
Nurse Education, Practice, and Retention.................. 39,182 39,182 39,182 ................ ................
Nursing Workforce Diversity............................... 15,819 15,819 15,819 ................ ................
Loan Repayment and Scholarship Program.................... 83,135 83,135 83,135 ................ ................
Comprehensive Geriatric Education......................... 4,485 4,485 4,485 ................ ................
Nursing Faculty Loan Program.............................. 24,553 24,553 24,553 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Nursing programs.............................. 231,099 231,099 231,099 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Evaluation Tap Funding........................ ................ (20,000) ................ ................ (-20,000)

Children's Hospitals Graduate Medical Education............... 265,171 88,000 265,171 ................ +177,171
National Practitioner Data Bank............................... 28,016 28,016 28,016 ................ ................
User Fees................................................. -28,016 -28,016 -28,016 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Bureau of Health Professions.................. 725,684 522,187 727,862 +2,178 +205,675
-----------------------------------------------------------------------------------------
Subtotal, Evaluation Tap Funding........................ ................ (35,000) ................ ................ (-35,000)
-----------------------------------------------------------------------------------------
Subtotal, Prevention and Public Health Fund............. (35,000) (10,000) (25,000) (-10,000) (+15,000)
-----------------------------------------------------------------------------------------
Total, Health Professions Program Level................. 760,684 567,187 752,862 -7,822 +185,675

Maternal and Child Health

Maternal and Child Health Block Grant......................... 638,646 640,098 640,098 +1,452 ................
Sickle Cell Anemia Demonstration Program...................... 4,665 4,665 4,665 ................ ................
Traumatic Brain Injury........................................ 9,760 9,760 9,760 ................ ................
Autism and Other Developmental Disorders...................... 47,142 47,142 47,142 ................ ................
Heritable Disorders........................................... 9,834 9,834 9,834 ................ ................
Healthy Start................................................. 103,532 103,532 103,532 ................ ................
Universal Newborn Hearing..................................... 18,660 18,660 18,660 ................ ................
Emergency Medical Services for Children....................... 21,116 21,116 21,116 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Maternal and Child Health..................... 853,355 854,807 854,807 +1,452 ................

Ryan White HIV/AIDS Program

Ryan White AIDS Programs:
Emergency Assistance...................................... 666,071 671,258 666,071 ................ -5,187
Comprehensive Care Programs............................... 1,360,827 1,422,341 1,390,827 +30,000 -31,514
AIDS Drug Assistance Program [ADAP] (NA).............. (933,299) (1,000,000) (963,299) (+30,000) (-36,701)
Early Intervention Program................................ 215,086 235,564 215,086 ................ -20,478
Children, Youth, Women, and Families...................... 77,167 69,582 77,167 ................ +7,585
AIDS Dental Services...................................... 13,485 13,485 13,485 ................ ................
Education and Training Centers............................ 34,542 34,542 34,542 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDS programs...................... 2,367,178 2,446,772 2,397,178 +30,000 -49,594
Evaluation Tap Funding (NA)............................... (25,000) (25,000) (25,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDs program level................. (2,392,178) (2,471,772) (2,422,178) (+30,000) (-49,594)

Health Care Systems

Organ Transplantation......................................... 24,015 24,015 24,015 ................ ................
National Cord Blood Inventory................................. 11,887 11,887 11,887 ................ ................
Bone Marrow Program........................................... 23,330 23,330 23,330 ................ ................
Office of Pharmacy Affairs.................................... 4,472 4,472 4,472 ................ ................
340B Drug Pricing User Fees................................... ................ 6,000 6,000 +6,000 ................
User Fees................................................. ................ -6,000 -6,000 -6,000 ................
Poison Control................................................ 18,830 18,830 18,830 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Health Care Systems........................... 82,534 82,534 82,534 ................ ................

Rural Health

Rural Outreach Grants......................................... 55,553 55,553 57,553 +2,000 +2,000
Rural Health Research/Policy Development...................... 9,866 9,866 9,866 ................ ................
Rural Hospital Flexibility Grants............................. 41,040 26,200 41,040 ................ +14,840
Rural and Community Access to Emergency Devices............... 1,100 ................ 5,000 +3,900 +5,000
State Offices of Rural Health................................. 10,036 10,036 10,036 ................ ................
Black Lung Clinics............................................ 7,140 7,140 7,140 ................ ................
Radiation Exposure Screening and Education Program............ 1,935 1,935 1,935 ................ ................
Telehealth.................................................... 11,502 11,502 11,502 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Rural Health.................................. 138,172 122,232 144,072 +5,900 +21,840

Family Planning............................................... 293,870 296,838 293,870 ................ -2,968
Program Management............................................ 159,894 162,517 162,517 +2,623 ................
Total, Health resources & services program level........ (6,265,751) (6,137,862) (6,297,904) (+32,153) (+160,042)

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT

HEAL Liquidating Account...................................... (1,000) (1,000) (1,000) ................ ................
HEAL Program Management....................................... 2,807 2,807 2,807 ................ ................
-----------------------------------------------------------------------------------------
Total, HEAL............................................. 2,807 2,807 2,807 ................ ................

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Post-fiscal year 1988 Claims.................................. 235,000 235,000 235,000 ................ ................
HRSA Administration........................................... 6,477 6,477 6,477 ................ ................
-----------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund........... 241,477 241,477 241,477 ................ ................
=========================================================================================
Total, Health Resources & Services Administration....... 6,450,035 6,312,146 6,492,188 +42,153 +180,042
Total, Evaluation tap funding....................... (25,000) (60,000) (25,000) ................ (-35,000)

Prevention and Public Health Fund\3\...................... (35,000) (10,000) (25,000) (-10,000) (+15,000)
Total, HRSA program level............................... (6,510,035) (6,382,146) (6,542,188) (+32,153) (+160,042)

CENTERS FOR DISEASE CONTROL AND PREVENTION

DISEASE CONTROL, RESEARCH, AND TRAINING

Immunization and Respiratory Diseases......................... 576,083 583,855 576,083 ................ -7,772
Evaluation Tap Funding.................................... (12,864) (13,765) (12,864) ................ (-901)
Pandemic Flu balances (Public Law 111-32)................. ................ (51,049) ................ ................ (-51,049)
Prevention and Public Health Fund\3\...................... (190,000) (72,460) (190,000) ................ (+117,540)
-----------------------------------------------------------------------------------------
Subtotal................................................ (778,947) (721,129) (778,947) ................ (+57,818)

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention............. 1,099,934 1,145,678 1,101,934 +2,000 -43,744
Prevention and Public Health Fund\3\...................... (10,000) ................ (10,000) ................ (+10,000)
-----------------------------------------------------------------------------------------
Subtotal, HIV/AIDS, Viral Hepathitis, STD & TB.......... 1,109,934 1,145,678 1,111,934 +2,000 -33,744

Emerging and Zoonotic Infectious Diseases..................... 252,476 279,477 269,274 +16,798 -10,203
Prevention and Public Health Fund\3\...................... (51,750) (51,750) (51,750) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Emerging and Zoonotic Infectious.............. 304,226 331,227 321,024 +16,798 -10,203

Chronic Disease Prevention and Health Promotion............... 756,377 608,019 798,445 +42,068 +190,426
Evaluation Tap Funding.................................... ................ (25,000) ................ ................ (-25,000)
Prevention and Public Health Fund\3\...................... (427,050) (511,711) (457,050) (+30,000) (-54,661)
-----------------------------------------------------------------------------------------
Subtotal, Chronic Disiease Prevention................... (1,183,427) (1,144,730) (1,255,495) (+72,068) (+110,765)

Birth Defects and Developmental Disabilities.................. 137,287 18,476 134,500 -2,787 +116,024
Prevention and Public Health Fund\3\...................... ................ (107,089) ................ ................ (-107,089)
-----------------------------------------------------------------------------------------
Subtotal, Birth Defects................................. (137,287) (125,565) (134,500) (-2,787) (+8,935)

Public Health Scientific Services............................. 143,972 35,695 143,972 ................ +108,277
Evaluation Tap Funding.................................... (247,769) (379,374) (247,769) ................ (-131,605)
Prevention and Public Health Fund\3\...................... (70,000) (90,000) (70,000) ................ (-20,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ (461,741) (505,069) (461,741) ................ (-43,328)

Environmental Health.......................................... 104,998 103,672 114,667 +9,669 +10,995
Prevention and Public Health Fund\3\...................... (35,000) (29,000) (35,000) ................ (+6,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ (139,998) (132,672) (149,667) (+9,669) (+16,995)

Injury Prevention and Control................................. 137,693 137,754 137,693 ................ -61
Prevention and Public Health Fund\3\...................... ................ ................ (3,000) (+3,000) (+3,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ (137,693) (137,754) (140,693) (+3,000) (+2,939)

National Institute for Occupational Safety & Health\3\........ 181,864 ................ 181,864 ................ +181,864
Evaluation Tap Funding.................................... (110,724) (249,364) (110,724) ................ (-138,640)
-----------------------------------------------------------------------------------------
Subtotal................................................ (292,588) (249,364) (292,588) ................ (+43,224)

Energy Employees Occupational Illness Compensation Program.... 55,358 55,358 55,358 ................ ................
Global Health................................................. 347,594 362,889 362,594 +15,000 -295
Public Health Preparedness and Response....................... 1,299,479 1,228,360 1,299,479 ................ +71,119
Pandemic Flu balances (Public Law 111-32)................. (30,000) (46,776) ................ (-30,000) (-46,776)
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,329,479 1,275,136 1,299,479 -30,000 +24,343

CDC-Wide Activities........................................... 617,913 487,648 593,193 -24,720 +105,545
Prevention and Public Health Fund\3\.......................... (41,200) (41,200) (41,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, CDC-Wide Activities........................... (659,113) (528,848) (634,393) (-24,720) (+105,545)

Total, Centers for Disease Control...................... 6,536,028 5,950,091 6,627,056 +91,028 +676,965
Discretionary....................................... 5,655,670 4,991,523 5,713,698 +58,028 +722,175
Evaluation Tap Funding (NA)......................... (371,357) (667,503) (371,357) ................ (-296,146)
Pandemic Flu balances (Public Law 111-32)........... (30,000) (97,825) ................ (-30,000) (-97,825)
-----------------------------------------------------------------------------------------
Prevention and Public Health Fund\3\................ (825,000) (903,210) (858,000) (+33,000) (-45,210)
=========================================================================================
Total, Centers for Disease Control Program Level........ (6,937,385) (6,715,419) (6,998,413) (+61,028) (+282,994)

NATIONAL INSTITUTES OF HEALTH

National Cancer Institute..................................... 5,067,396 5,068,864 5,084,227 +16,831 +15,363
National Heart, Lung, and Blood Institute..................... 3,076,115 3,076,067 3,085,390 +9,275 +9,323
National Institute of Dental & Craniofacial Research.......... 410,322 408,212 409,449 -873 +1,237
National Institute of Diabetes and Digestive and Kidney 1,795,348 1,792,107 1,797,539 +2,191 +5,432
Diseases [NIDDK].............................................
National Institute of Neurological Disorders & Stroke......... 1,624,830 1,624,707 1,629,631 +4,801 +4,924
National Institute of Allergy and Infectious Diseases......... 4,486,473 4,495,307 4,508,932 +22,459 +13,625
Global HIV/AIDS Fund Transfer............................. ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal, NIAID program level........................... 4,486,473 4,495,307 4,508,932 +22,459 +13,625

National Institute of General Medical Sciences................ 2,427,742 2,378,835 2,387,112 -40,630 +8,277
National Institute of Child Health & Human Development........ 1,320,151 1,320,600 1,324,603 +4,452 +4,003
National Eye Institute........................................ 702,049 693,015 695,115 -6,934 +2,100
National Institute of Environmental Health Sciences........... 684,923 684,030 686,103 +1,180 +2,073
National Institute on Aging................................... 1,121,400 1,102,650 1,124,265 +2,865 +21,615
National Institute of Arthritis and Musculoskeletal and Skin 535,280 535,610 537,233 +1,953 +1,623
Diseases.....................................................
National Institute on Deafness and Other Communication 415,880 417,297 418,562 +2,682 +1,265
Disorders....................................................
National Institute of Nursing Research........................ 144,633 144,153 144,590 -43 +437
National Institute on Alcohol Abuse and Alcoholism............ 459,085 457,104 458,489 -596 +1,385
National Institute on Drug Abuse.............................. 1,052,373 1,054,001 1,057,196 +4,823 +3,195
National Institute of Mental Health........................... 1,478,868 1,479,204 1,483,687 +4,819 +4,483
National Human Genome Research Institute...................... 512,727 511,370 512,920 +193 +1,550
National Institute of Biomedical Imaging and Bioengineering... 338,038 336,896 337,917 -121 +1,021
National Center for Complementary and Alternative Medicine.... 127,937 127,930 128,318 +381 +388
National Institute on Minority Health and Health Disparities.. 276,179 279,389 280,236 +4,057 +847
John E. Fogarty International Center.......................... 69,556 69,758 69,969 +413 +211
National Center for Advancing Translation Sciences............ 574,823 639,033 631,346 +56,523 -7,687
National Library of Medicine [NLM]............................ 337,322 372,651 373,781 +36,459 +1,130
Evaluation Tap Funding.................................... (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 345,522 380,851 381,981 +36,459 +1,130

Office of the Director........................................ 1,458,501 1,429,161 1,431,341 -27,160 +2,180
Common fund............................................... (544,930) (544,930) (544,930) ................ ................
Buildings and Facilities...................................... 125,308 125,308 125,308 ................ ................
=========================================================================================
Total, National Institutes of Health [NIH].............. 30,623,259 30,623,259 30,723,259 +100,000 +100,000
Evaluation Tap Funding.............................. (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Total, NIH Program Level................................ (30,631,459) (30,631,459) (30,731,459) (+100,000) (+100,000)

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
[SAMHSA]

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Mental Health:
Programs of Regional and National Significance............ 275,756 219,550 270,394 -5,362 +50,844
Prevention and Public Health Fund\3\...................... (45,000) (28,000) (45,000) ................ (+17,000)
-----------------------------------------------------------------------------------------
Subtotal, PRNS.......................................... (320,756) (247,550) (315,394) (-5,362) (+67,844)

Mental Health block grant................................. 438,717 438,717 458,717 +20,000 +20,000
Evaluation Tap Funding................................ (21,039) (21,039) (21,039) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, MHBG Program level........................ (459,756) (459,756) (479,756) (+20,000) (+20,000)

Children's Mental Health.................................. 117,315 88,557 117,315 ................ +28,758
Grants to States for the Homeless (PATH).................. 64,794 64,794 64,794 ................ ................
Protection and Advocacy................................... 36,238 36,238 36,238 ................ ................
State prevention grants................................... ................ 55,000 ................ ................ -55,000
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................. 932,820 902,856 947,458 +14,638 +44,602
-----------------------------------------------------------------------------------------
Subtotal, Mental health program level................... (998,859) (951,895) (1,013,497) (+14,638) (+61,602)

Substance Abuse Treatment:
Programs of Regional and National Significance............ 398,242 334,139 368,813 -29,429 +34,674
Prevention and Public Health Fund\3\...................... (25,000) (30,000) (25,000) ................ (-5,000)
Evaluation Tap Funding................................ (2,000) ................ (2,000) ................ (+2,000)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (425,242) (364,139) (395,813) (-29,429) (+31,674)

Substance Abuse block grant............................... 1,721,132 1,376,906 1,741,132 +20,000 +364,226
Evaluation Tap Funding................................ (79,200) (71,724) (79,200) ................ (+7,476)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (1,800,332) (1,448,630) (1,820,332) (+20,000) (+371,702)

Substance abuse prevention grants......................... ................ 404,501 ................ ................ -404,501
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment..................... 2,119,374 2,115,546 2,109,945 -9,429 -5,601
-----------------------------------------------------------------------------------------
Subtotal, Program level................................. (2,225,574) (2,217,270) (2,216,145) (-9,429) (-1,125)

Substance Abuse Prevention:
Programs of Regional and National Significance............ 185,956 58,877 184,433 -1,523 +125,556
Prevention and Public Health Fund\3\...................... ................ (7,000) ................ ................ (-7,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 185,956 58,877 184,433 -1,523 +125,556
-----------------------------------------------------------------------------------------
Subtotal, Program Level................................. (185,956) (65,877) (184,433) (-1,523) (+118,556)

Health Surveillance and Program Support:
Program Management........................................ 76,891 72,229 72,229 -4,662 ................
Health Surveillance....................................... 1,996 2,000 1,996 ................ -4
Prevention and Public Health Fund\3\.................. (18,000) ................ (18,000) ................ (+18,000)
Evaluation Tap Funding................................ (27,428) (45,428) (27,428) ................ (-18,000)
-----------------------------------------------------------------------------------------
Surveillance, Program level......................... (47,424) (47,428) (47,424) ................ (-4)

Military Families............................................. 3,493 ................ ................ -3,493 ................
Data Requests and Publications................................ ................ 1,500 1,500 +1,500 ................
User Fees................................................. ................ -1,500 -1,500 -1,500 ................
Public Awareness and Support.................................. 13,545 ................ 13,545 ................ +13,545
Evaluation Tap Funding.................................... ................ (13,571) ................ ................ (-13,571)
Performance and Quality Information Systems................... 12,940 ................ 12,940 ................ +12,940
Evaluation Tap Funding.................................... ................ (12,996) ................ ................ (-12,996)
Tribal Prevention Grants [PPHF]............................... ................ (40,000) ................ ................ (-40,000)
-----------------------------------------------------------------------------------------
Total, Health Surveillance.............................. 108,865 74,229 100,710 -8,155 +26,481
-----------------------------------------------------------------------------------------
Total, Health Surveillance Program Level................ 154,293 186,224 146,138 -8,155 -40,086
=========================================================================================
Total, SAMHSA........................................... 3,347,015 3,151,508 3,342,546 -4,469 +191,038
Evaluation Tap Funding.............................. (129,667) (164,758) (129,667) ................ (-35,091)
Prevention and Public Health Fund\3\................ (88,000) (105,000) (88,000) ................ (-17,000)
-----------------------------------------------------------------------------------------
Total, SAMHSA Program Level............................. (3,564,682) (3,421,266) (3,560,213) (-4,469) (+138,947)

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]

HEALTHCARE RESEARCH AND QUALITY

Research on Health Costs, Quality, and Outcomes:
Evaluation Tap funding.................................... (235,768) (206,635) (236,331) (+563) (+29,696)
Prevention and Public Health Fund\3\...................... (12,000) (12,000) (12,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Health Costs, Quality, and Outcomes........... (247,768) (218,635) (248,331) (+563) (+29,696)

Medical Expenditures Panel Surveys:
Evaluation Tap Funding (NA)............................... (59,300) (59,300) (59,300) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Medical Expenditures Panel Surveys............ (59,300) (59,300) (59,300) ................ ................

Program Support:
Evaluation Tap Funding (NA)............................... (73,985) (68,422) (68,422) (-5,563) ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (73,985) (68,422) (68,422) (-5,563) ................
Evaluation Tap Funding (NA)......................... (369,053) (334,357) (364,053) (-5,000) (+29,696)
AHRQ, Prevention and Public Health Fund\3\.......... (12,000) (12,000) (12,000) ................ ................
-----------------------------------------------------------------------------------------
Total, AHRQ Program Level............................... (381,053) (346,357) (376,053) (-5,000) (+29,696)
=========================================================================================
Total, Public Health Service (PHS) appropriation........ 46,131,337 45,133,794 46,327,049 +195,712 +1,193,255
Total, Public Health Service Program Level.............. (48,148,614) (47,612,647) (48,322,326) (+173,712) (+709,679)

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Medicaid Current Law Benefits................................. 253,884,907 250,398,918 250,398,918 -3,485,989 ................
State and Local Administration................................ 12,808,496 14,735,346 14,735,346 +1,926,850 ................
Vaccines for Children......................................... 4,030,996 4,271,015 4,271,015 +240,019 ................
-----------------------------------------------------------------------------------------
Subtotal, Medicaid Program Level........................ 270,724,399 269,405,279 269,405,279 -1,319,120 ................
Less funds advanced in prior year................... -86,445,289 -90,614,082 -90,614,082 -4,168,793 ................
-----------------------------------------------------------------------------------------
Total, Grants to States for Medicaid.................... 184,279,110 178,791,197 178,791,197 -5,487,913 ................
New advance, 1st quarter............................ 90,614,082 106,335,631 106,335,631 +15,721,549 ................

PAYMENTS TO HEALTH CARE TRUST FUNDS

Supplemental Medical Insurance................................ 178,041,000 189,520,000 189,520,000 +11,479,000 ................
Federal Uninsured Payment..................................... 262,000 228,000 228,000 -34,000 ................
Program Management............................................ 222,000 192,000 192,000 -30,000 ................
General Revenue for Part D Benefit............................ 51,431,000 60,744,000 60,744,000 +9,313,000 ................
General Revenue for Part D Administration..................... 475,000 424,000 424,000 -51,000 ................
HCFAC Reimbursement........................................... 310,378 610,000 610,000 +299,622 ................
-----------------------------------------------------------------------------------------
Total, Payments to Trust Funds, Program Level........... 230,741,378 251,718,000 251,718,000 +20,976,622 ................

PROGRAM MANAGEMENT

Research, Demonstration, Evaluation........................... 21,160 ................ 23,900 +2,740 +23,900
Program operations............................................ 2,608,785 3,618,487 3,156,045 +547,260 -462,442
State Survey and Certification................................ 375,203 387,353 375,203 ................ -12,150
High Risk Insurance Pools..................................... 44,000 22,004 44,000 ................ +21,996
Federal Administration........................................ 770,964 792,964 770,964 ................ -22,000
=========================================================================================
Total, Program management, Limitation on new BA......... 3,820,112 4,820,808 4,370,112 +550,000 -450,696

HEALTH CARE FRAUD AND ABUSE CONTROL

Part D Drug Benefit/Medicare Advantage [MIP].................. 219,463 362,792 362,792 +143,329 ................
HHS Office of Inspector General............................... 29,674 102,500 102,500 +72,826 ................
Medicaid/CHIP................................................. 30,979 46,906 46,906 +15,927 ................
Department of Justice......................................... 29,674 97,802 97,802 +68,128 ................
-----------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control.............. 309,790 610,000 610,000 +300,210 ................
=========================================================================================
Total, Centers for Medicare and Medicaid Services....... 509,764,472 542,275,636 541,824,940 +32,060,468 -450,696
Federal funds....................................... 505,634,570 536,844,828 536,844,828 +31,210,258 ................
Current year.................................... (415,020,488) (430,509,197) (430,509,197) (+15,488,709) ................
New advance, fiscal year 2014................... (90,614,082) (106,335,631) (106,335,631) (+15,721,549) ................
Trust Funds......................................... 4,129,902 5,430,808 4,980,112 +850,210 -450,696

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY
SUPPORT PROGRAMS

Payments to Territories....................................... 33,000 33,000 33,000 ................ ................
Repatriation.................................................. 1,000 1,000 1,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Welfare payments.............................. 34,000 34,000 34,000 ................ ................

Child Support Enforcement:
State and Local Administration............................ 3,484,514 3,272,647 3,272,647 -211,867 ................
Federal Incentive Payments................................ 519,000 539,838 539,838 +20,838 ................
Access and Visitation..................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement..................... 4,013,514 3,822,485 3,822,485 -191,029 ................
=========================================================================================
Total, Family Support Payments Program Level............ 4,047,514 3,856,485 3,856,485 -191,029 ................
Less funds advanced in previous years............... -1,200,000 -1,100,000 -1,100,000 +100,000 ................
-----------------------------------------------------------------------------------------
Total, Family Support Payments, current year............ 2,847,514 2,756,485 2,756,485 -91,029 ................
New advance, 1st quarter, fiscal year 2014.......... 1,100,000 1,100,000 1,100,000 ................ ................
=========================================================================================
LOW-INCOME HOME ENERGY ASSISTANCE [LIHEAP]

Formula Grants................................................ 3,471,672 2,820,000 3,371,672 -100,000 +551,672
Contingency Fund.............................................. ................ 200,000 100,000 +100,000 -100,000
-----------------------------------------------------------------------------------------
Total, LIHEAP, Program Level............................ 3,471,672 3,020,000 3,471,672 ................ +451,672

REFUGEE AND ENTRANT ASSISTANCE

Transitional and Medical Services............................. 323,195 403,000 343,000 +19,805 -60,000
Victims of Trafficking........................................ 9,775 9,775 9,775 ................ ................
Social Services............................................... 115,107 153,407 153,407 +38,300 ................
Preventive Health............................................. 4,730 4,730 4,730 ................ ................
Targeted Assistance........................................... 20,201 48,401 48,401 +28,200 ................
Unaccompanied Minors.......................................... 284,281 175,000 235,000 -49,281 +60,000
Victims of Torture............................................ 11,045 11,045 11,045 ................ ................
-----------------------------------------------------------------------------------------
Total, Refugee and Entrant Assistance................... 768,334 805,358 805,358 +37,024 ................

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
GRANT

Child Care and Development Block Grant........................ 2,278,313 2,603,313 2,438,313 +160,000 -165,000

SOCIAL SERVICES BLOCK GRANT (TITLE XX)........................ 1,700,000 1,700,000 1,700,000 ................ ................

CHILDREN AND FAMILIES SERVICES PROGRAMS

Programs for Children, Youth and Families:
Head Start, current funded................................ 7,968,544 8,054,000 8,038,544 +70,000 -15,456
Consolidated Runaway, Homeless Youth Program.............. 97,355 97,355 97,355 ................ ................
Prevention Grants to Reduce Abuse of Runaway Youth........ 17,901 17,901 17,901 ................ ................
Child Abuse State Grants.................................. 26,432 26,432 26,432 ................ ................
Child Abuse Discretionary Activities...................... 25,744 25,744 25,744 ................ ................
Community Based Child Abuse Prevention.................... 41,527 41,527 41,527 ................ ................
Abandoned Infants Assistance.............................. 11,553 11,553 11,553 ................ ................
Child Welfare Services.................................... 280,650 280,650 280,650 ................ ................
Child Welfare Training/Innovative Approaches to Foster 26,092 31,092 31,092 +5,000 ................
Care.....................................................
Adoption Opportunities.................................... 39,179 39,179 39,179 ................ ................
Adoption Incentive........................................ 39,346 39,346 39,346 ................ ................

Social Services and Income Maintenance Research............... ................ 8,000 ................ ................ -8,000
Evaluation Tap Funding.................................... (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Program Level................................. (5,762) (13,762) (5,762) ................ (-8,000)

Native American Programs...................................... 48,583 48,583 48,583 ................ ................

Community Services:
Community Services Block Grant Act programs:
Grants to States for Community Services............... 677,358 350,000 677,358 ................ +327,358
Economic Development.................................. 29,943 29,943 29,943 ................ ................
Rural Community Facilities............................ 4,981 ................ 5,981 +1,000 +5,981
-----------------------------------------------------------------------------------------
Subtotal............................................ 712,282 379,943 713,282 +1,000 +333,339

Individual Development Account Initiative............. 19,869 19,869 19,869 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Community Services........................ 732,151 399,812 733,151 +1,000 +333,339

Domestic Violence Hotline..................................... 3,197 4,500 4,197 +1,000 -303
Family Violence/Battered Women's Shelters..................... 129,547 135,000 133,547 +4,000 -1,453
Independent Living Training Vouchers.......................... 45,174 45,174 45,174 ................ ................
Faith-Based Center............................................ 1,370 1,370 1,370 ................ ................
Disaster Human Services Case Management....................... 1,992 1,992 1,992 ................ ................
Program Direction............................................. 198,645 206,447 201,645 +3,000 -4,802
=========================================================================================
Total, Children and Families Services Programs.......... 9,734,982 9,515,657 9,818,982 +84,000 +303,325
Current Year........................................ (9,734,982) (9,515,657) (9,818,982) (+84,000) (+303,325)
Evaluation Tap Funding.............................. (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Total, Program Level.................................... (9,740,744) (9,521,419) (9,824,744) (+84,000) (+303,325)

PROMOTING SAFE AND STABLE FAMILIES............................ 345,000 345,000 345,000 ................ ................
Discretionary Funds....................................... 63,065 63,065 63,065 ................ ................

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Foster Care................................................... 4,288,000 4,143,000 4,143,000 -145,000 ................
Adoption Assistance........................................... 2,495,000 2,537,000 2,537,000 +42,000 ................
Kinship Guardianship.......................................... 80,000 90,000 90,000 +10,000 ................
Independent Living............................................ 140,000 140,000 140,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States............................... 7,003,000 6,910,000 6,910,000 -93,000 ................
Less Advances from Prior Year....................... -1,850,000 -2,100,000 -2,100,000 -250,000 ................
-----------------------------------------------------------------------------------------
Total, payments, current year................... 5,153,000 4,810,000 4,810,000 -343,000 ................
New Advance, 1st quarter........................ 2,100,000 2,200,000 2,200,000 +100,000 ................
=========================================================================================
Total, Administration for Children & Families........... 29,561,880 28,918,878 29,508,875 -53,005 +589,997
Current year........................................ (26,361,880) (25,618,878) (26,208,875) (-153,005) (+589,997)
Fiscal year 2014.................................... (3,200,000) (3,300,000) (3,300,000) (+100,000) ................
Evaluation Tap Funding.............................. (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Total, ACF Program Level................................ 29,567,642 28,924,640 29,514,637 -53,005 +589,997

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

Grants to States:
Home and Community-based Supportive Services.............. 366,916 366,916 366,916 ................ ................
Preventive Health......................................... 20,945 20,945 20,945 ................ ................
Protection of Vulnerable Older Americans--Title VII....... 21,797 21,797 21,797 ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 409,658 409,658 409,658 ................ ................

Family Caregivers......................................... 153,621 153,621 153,621 ................ ................
Native American Caregivers Support........................ 6,364 6,364 6,364 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Caregivers.................................... 159,985 159,985 159,985 ................ ................

Nutrition:
Congregate Meals...................................... 439,070 439,070 439,070 ................ ................
Home Delivered Meals.................................. 216,831 216,831 216,831 ................ ................
Nutrition Services Incentive Program.................. 160,389 160,389 160,389 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 816,290 816,290 816,290 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Grants to States.......................... 1,385,933 1,385,933 1,385,933 ................ ................

Grants for Native Americans................................... 27,601 27,601 27,601 ................ ................
Aging Network Support Activities.............................. 7,873 7,873 7,873 ................ ................
Alzheimer's Disease Demonstrations............................ 4,011 9,537 4,011 ................ -5,526
Lifespan Respite Care......................................... 2,490 2,490 4,990 +2,500 +2,500
Chronic Disease Self-Management Program....................... ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\...................... (10,000) (10,000) (10,000) ................ ................
Elder Falls................................................... ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\...................... ................ ................ (7,000) (+7,000) (+7,000)
Adult Protective Services Demonstration....................... ................ 8,000 8,000 +8,000 ................
Senior Medicare Patrol Program................................ 9,402 9,402 9,402 ................ ................
Elder Rights Support Activities............................... 4,088 4,088 4,088 ................ ................
Aging and Disability Resources................................ 6,457 ................ 6,457 ................ +6,457
State Health Insurance Program................................ 52,115 51,902 52,115 ................ +213
Community Service Employment for Older Americans.............. ................ 448,251 ................ ................ -448,251

Developmental Disabilities Programs:
State Councils............................................ 74,774 74,774 74,774 ................ ................
Protection and Advocacy................................... 40,865 40,865 40,865 ................ ................
Voting Access for Individuals with Disabilities........... 5,235 5,235 5,235 ................ ................
Developmental Disabilities Projects of National 8,317 8,317 8,317 ................ ................
Significance.............................................
Universtiy Centers of Excellence.......................... 38,792 38,792 38,792 ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 167,983 167,983 167,983 ................ ................

Program Administration........................................ 29,311 29,652 29,652 +341 ................
-----------------------------------------------------------------------------------------
Total, Administration for Community Living.............. 1,697,264 2,152,712 1,708,105 +10,841 -444,607
Federal funds....................................... 1,645,149 2,100,810 1,655,990 +10,841 -444,820
Trust Funds......................................... (52,115) (51,902) (52,115) ................ (+213)
-----------------------------------------------------------------------------------------
Total, ACL Program Level................................ 1,707,264 2,162,712 1,725,105 +17,841 -437,607

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

General Departmental Management:
Federal Funds............................................. 223,253 234,834 223,253 ................ -11,581
Prevention and Public Health Fund\3\...................... (30,000) (105,000) ................ (-30,000) (-105,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 253,253 339,834 223,253 -30,000 -116,581

Teen Pregnancy Prevention Community Grants.................... 104,592 ................ 104,592 ................ +104,592
Prevention and Public Health Fund\3\...................... ................ (104,790) ................ ................ (-104,790)
Teen Pregnancy Prevention approaches Evaluation Tap Funding... (8,455) (4,232) (8,455) ................ (+4,223)
-----------------------------------------------------------------------------------------
Subtotal, Pregnancy Grants.............................. (113,047) (109,022) (113,047) ................ (+4,025)

Minority Health............................................... 55,782 41,100 55,782 ................ +14,682
Office of Women's Health...................................... 33,682 29,120 29,120 -4,562 ................
Minority HIV/AIDS............................................. 53,681 ................ 53,681 ................ +53,681
Evaluation Tap Funding.................................... ................ (53,891) ................ ................ (-53,891)
Embryo Adoption Awareness Campaign............................ 1,996 ................ ................ -1,996 ................
Planning and Evaluation, Evaluation Tap Funding............... (60,756) (58,718) (60,756) ................ (+2,038)
-----------------------------------------------------------------------------------------
Total, General Departmental Management.................. 542,197 421,895 535,639 -6,558 +113,744
Federal Funds....................................... (472,986) (305,054) (466,428) (-6,558) (+161,374)
Evaluation Tap Funding (NA)......................... (69,211) (116,841) (69,211) ................ (-47,630)
Prevention and Public Health Fund\3\................ (30,000) (209,790) ................ (-30,000) (-209,790)
Total, General Departmental Management Program.......... 572,197 631,685 535,639 -36,558 -96,046

OFFICE OF MEDICARE HEARINGS AND APPEALS....................... 72,011 84,234 79,908 +7,897 -4,326

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 16,415 26,246 16,415 ................ -9,831
TECHNOLOGY...................................................
Evaluation Tap Funding.................................... (44,811) (40,011) (49,842) (+5,031) (+9,831)
-----------------------------------------------------------------------------------------
Total, Program Level.................................... (61,226) (66,257) (66,257) (+5,031) ................

OFFICE OF INSPECTOR GENERAL

Inspector General Federal Funds............................... 50,083 58,579 55,483 +5,400 -3,096
HIPAA/HCFAC funding (NA).................................. (196,090) (196,669) (196,669) (+579) ................
-----------------------------------------------------------------------------------------
Total, Inspector General Program Level.................. (246,173) (255,248) (252,152) (+5,979) (-3,096)

OFFICE FOR CIVIL RIGHTS:
Federal Funds............................................. 40,938 38,966 38,966 -1,972 ................
-----------------------------------------------------------------------------------------
Total, Office for Civil Rights.......................... 40,938 38,966 38,966 -1,972 ................

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Retirement Payments........................................... 375,016 395,452 395,452 +20,436 ................
Survivors Benefits............................................ 28,350 31,043 31,043 +2,693 ................
Dependents' Medical Care...................................... 93,984 100,656 100,656 +6,672 ................
-----------------------------------------------------------------------------------------
Total, Medical Benefits for Commissioned Officers....... 497,350 527,151 527,151 +29,801 ................

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Assistant Secretary for Preparedness and Response

Operations.................................................... 32,981 32,991 32,981 ................ -10
Preparedness and Emergency Operations......................... 29,583 24,647 24,647 -4,936 ................
National Disaster Medical System.............................. 52,735 52,390 52,390 -345 ................
Hospital Preparedness Cooperative Agreement Grants............ 374,650 254,500 324,650 -50,000 +70,150
Emergency Systems for Advanced Registration of Volunteer 4,989 500 4,989 ................ +4,489
Health Professionals [ESAR-VHP]..............................
Biomedical Advanced Research and Development Authority [BARDA] 415,000 546,671 465,000 +50,000 -81,671
Medical Countermeasure Strategic Investment Corp.............. ................ 50,000 20,000 +20,000 -30,000
Medical Countermeasure Dispensing............................. ................ 5,000 5,000 +5,000 ................
Policy and Planning........................................... 15,674 15,164 15,164 -510 ................
-----------------------------------------------------------------------------------------
Subtotal, AS for Preparedness and Response.............. 925,612 981,863 944,821 +19,209 -37,042

Assistant Secretary for Administration

Cybersecurity................................................. 39,924 40,000 40,000 +76 ................

Assistant Secretary for Health

Medical Reserve Corps......................................... 11,247 10,971 10,971 -276 ................

Office of the Secretary

Office of Security and Strategic Information.................. 6,448 7,428 7,428 +980 ................
HHS Lease Replacements........................................ ................ 17,000 17,000 +17,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Office of the Secretary....................... 6,448 24,428 24,428 +17,980 ................
=========================================================================================
Subtotal, Non-pandemic flu/BARDA/BioShield/Parklawn..... 568,231 642,262 605,220 +36,989 -37,042
=========================================================================================
Total, PHSSEF........................................... 983,231 1,057,262 1,020,220 +36,989 -37,042
=========================================================================================
Total, Office of the Secretary.......................... 2,133,014 2,097,492 2,204,571 +71,557 +107,079
Federal Funds....................................... 2,061,003 2,013,258 2,124,663 +63,660 +111,405
Trust Funds......................................... 72,011 84,234 79,908 +7,897 -4,326
Evaluation Tap Funding (NA)......................... (114,022) (156,852) (119,053) (+5,031) (-37,799)
-----------------------------------------------------------------------------------------
Total, Office of the Secretary Program Level............ 2,277,036 2,464,134 2,323,624 +46,588 -140,510
=========================================================================================
Total, Title II, Dept of Health & Human Services........ 589,287,967 620,578,512 621,573,540 +32,285,573 +995,028
Federal Funds....................................... 585,033,939 615,011,568 616,461,405 +31,427,466 +1,449,837
Current year.................................... (491,219,857) (505,375,937) (506,825,774) (+15,605,917) (+1,449,837)
Fiscal year 2014................................ (93,814,082) (109,635,631) (109,635,631) (+15,821,549) ................
Trust Funds......................................... 4,254,028 5,566,944 5,112,135 +858,107 -454,809
Pandemic Flu balances (Public Law 111-32)........... (30,000) (97,825) ................ (-30,000) (-97,825)

TITLE III--DEPARTMENT OF EDUCATION

EDUCATION FOR THE DISADVANTAGED

Grants to Local Educational Agencies [LEAs]:
Basic Grants:
Advance from prior year............................... (2,956,911) (2,962,510) (2,962,510) (+5,599) ................
Forward funded........................................ 3,611,410 2,830,559 3,611,410 ................ +780,851
Current funded........................................ 3,984 4,000 3,984 ................ -16
-----------------------------------------------------------------------------------------
Subtotal, Basic grants current year approp.......... 3,615,394 2,834,559 3,615,394 ................ +780,835
Subtotal, Basic grants total funds available........ (6,572,305) (5,797,069) (6,577,904) (+5,599) (+780,835)

Basic Grants fiscal year 2014 Advance..................... 2,962,510 3,743,345 2,962,510 ................ -780,835
-----------------------------------------------------------------------------------------
Subtotal, Basic grants, program level................... 6,577,904 6,577,904 6,577,904 ................ ................

Concentration Grants:
Advance from prior year............................... (1,359,726) (1,362,301) (1,362,301) (+2,575) ................
Fiscal year 2014 Advance.............................. 1,362,301 1,362,301 1,362,301 ................ ................

Targeted Grants:
Forward funded........................................ 29,943 ................ 79,943 +50,000 +79,943
Advance from prior year............................... (3,252,025) (3,258,183) (3,258,183) (+6,158) ................
Fiscal year 2014 Advance.............................. 3,258,183 3,288,126 3,258,183 ................ -29,943
-----------------------------------------------------------------------------------------
Subtotal (excluding emergencies).................... 3,288,126 3,288,126 3,338,126 +50,000 +50,000

Education Finance Incentive Grants:
Forward Funded........................................ 29,943 ................ 79,943 +50,000 +79,943
Advance from prior year............................... (3,252,025) (3,258,183) (3,258,183) (+6,158) ................
Fiscal year 2014 Advance.............................. 3,258,183 3,288,126 3,258,183 ................ -29,943
-----------------------------------------------------------------------------------------
Subtotal............................................ 3,288,126 3,288,126 3,338,126 +50,000 +50,000
=========================================================================================
Subtotal, Grants to LEAs, program level............. 14,516,457 14,516,457 14,616,457 +100,000 +100,000
=========================================================================================
Subtotal, Grants to LEAs, program level............. 14,516,457 14,516,457 14,616,457 +100,000 +100,000

School Improvement Grants..................................... 533,552 533,552 533,552 ................ ................
Striving Readers.............................................. 159,698 ................ 159,698 ................ +159,698

State Agency Programs:
Migrant................................................... 393,236 393,236 393,236 ................ ................
Neglected and Delinquent/High Risk Youth.................. 50,231 50,231 50,231 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, State Agency programs......................... 443,467 443,467 443,467 ................ ................

Evaluation.................................................... 3,194 ................ 1,594 -1,600 +1,594
High School Graduation Initiative............................. 48,809 ................ 48,809 ................ +48,809
Migrant Education:
High School Equivalency Program........................... 36,526 36,526 36,526 ................ ................
=========================================================================================
Total, Education for the disadvantaged.................. 15,741,703 15,530,002 15,840,103 +98,400 +310,101
Current Year........................................ (4,900,526) (3,848,104) (4,998,926) (+98,400) (+1,150,822)
Fiscal year 2014.................................... (10,841,177) (11,681,898) (10,841,177) ................ (-840,721)
Subtotal, Forward Funded................................ (4,808,013) (3,807,578) (4,908,013) (+100,000) (+1,100,435)

IMPACT AID

Basic Support Payments........................................ 1,153,540 1,153,540 1,153,540 ................ ................
Payments for Children with Disabilities....................... 48,413 48,413 48,413 ................ ................
Facilities Maintenance (Sec. 8008)............................ 4,845 4,845 4,845 ................ ................
Construction (Sec. 8007)...................................... 17,441 17,441 17,441 ................ ................
Payments for Federal Property (Sec. 8002)..................... 66,947 ................ 66,947 ................ +66,947
-----------------------------------------------------------------------------------------
Total, Impact aid....................................... 1,291,186 1,224,239 1,291,186 ................ +66,947

SCHOOL IMPROVEMENT PROGRAMS

Effective Teaching and Learning: Literacy..................... ................ 186,892 ................ ................ -186,892
Effective Teaching and Learning: STEM......................... ................ 149,716 ................ ................ -149,716
Effective Teaching and Learning for Well-Rounded Educ......... ................ 90,000 ................ ................ -90,000
College Pathways.............................................. ................ 81,282 ................ ................ -81,282
State Grants for Improving Teacher Quality.................... 785,126 ................ 785,126 ................ +785,126
Advance from prior year................................... (1,678,263) (1,681,441) (1,681,441) (+3,178) ................
Fiscal year 2014.......................................... 1,681,441 ................ 1,681,441 ................ +1,681,441
-----------------------------------------------------------------------------------------
Subtotal, State Grants for Improving Teacher Quality, 2,466,567 ................ 2,466,567 ................ +2,466,567
program level..........................................

Mathematics and Science Partnerships.......................... 149,716 ................ 149,716 ................ +149,716
Supplemental Education Grants................................. 17,619 17,619 17,619 ................ ................
21st Century Community Learning Centers....................... 1,151,673 1,151,673 1,151,673 ................ ................
State Assessments/Enhanced Assessment Instruments............. 389,214 389,214 389,214 ................ ................
Consolidated Runaway and Homeless Youth programs.............. 65,173 65,173 65,173 ................ ................
Training and Advisory Services (Civil Rights)................. 6,962 6,962 6,962 ................ ................
Education for Native Hawaiians................................ 34,181 34,181 34,181 ................ ................
Alaska Native Education Equity................................ 33,185 33,185 33,185 ................ ................
Rural Education............................................... 179,193 179,193 179,193 ................ ................
Comprehensive Centers......................................... 51,113 51,113 51,113 ................ ................
=========================================================================================
Total, School improvement programs...................... 4,544,596 2,436,203 4,544,596 ................ +2,108,393
Current Year........................................ (2,863,155) (2,436,203) (2,863,155) ................ (+426,952)
Fiscal year 2014.................................... (1,681,441) ................ (1,681,441) ................ (+1,681,441)
Subtotal, Forward Funded................................ (2,720,095) (1,785,253) (2,720,095) ................ (+934,842)

INDIAN EDUCATION

Grants to Local Educational Agencies.......................... 105,921 105,921 105,921 ................ ................

Federal Programs:
Special Programs for Indian Children...................... 18,986 18,986 18,986 ................ ................
National Activities....................................... 5,872 5,872 5,872 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Federal Programs.............................. 24,858 24,858 24,858 ................ ................
=========================================================================================
Total, Indian Education................................. 130,779 130,779 130,779 ................ ................

INNOVATION AND IMPROVEMENT

Race to the Top............................................... 548,960 850,000 549,284 +324 -300,716
Investing in Innovation Fund.................................. 149,417 150,000 149,417 ................ -583
Effective Teachers and Leaders State Grants................... ................ 2,466,567 ................ ................ -2,466,567
Teacher and Leader Innovation Fund............................ ................ 400,000 ................ ................ -400,000
Teacher and Leader Pathways................................... ................ 74,676 ................ ................ -74,676
Expanding Educational Options................................. ................ 255,036 ................ ................ -255,036

Transition to Teaching........................................ 26,054 ................ 18,200 -7,854 +18,200
School Leadership............................................. 29,107 ................ 29,107 ................ +29,107
Charter Schools Grants........................................ 254,836 ................ 254,836 ................ +254,836
Magnet Schools Assistance..................................... 96,733 99,611 96,733 ................ -2,878
Fund for the Improvement of Education [FIE]................... 65,775 36,276 85,735 +19,960 +49,459
Teacher Incentive Fund........................................ 299,433 ................ 299,433 ................ +299,433
Ready-to-Learn television..................................... 27,194 ................ 27,194 ................ +27,194
Advanced Placement............................................ 30,027 ................ 36,027 +6,000 +36,027
=========================================================================================
Total, Innovation and Improvement....................... 1,527,536 4,332,166 1,545,966 +18,430 -2,786,200
Current Year........................................ (1,527,536) (4,332,166) (1,545,966) (+18,430) (-2,786,200)

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Safe and Healthy Students..................................... ................ 195,866 ................ ................ -195,866
Promise Neighborhoods......................................... 59,887 100,000 80,000 +20,113 -20,000
National Programs............................................. 64,877 ................ 48,600 -16,277 +48,600
Elementary and Secondary School Counseling.................... 52,296 ................ 52,296 ................ +52,296
Carol M. White Physical Education Program..................... 78,693 ................ 78,693 ................ +78,693
=========================================================================================
Total, Safe Schools and Citizenship Education........... 255,753 295,866 259,589 +3,836 -36,277

ENGLISH LANGUAGE ACQUISITION

Current funded................................................ 47,589 47,589 47,589 ................ ................
Forward funded................................................ 684,555 684,555 684,555 ................ ................
=========================================================================================
Total, English Language Acquisition..................... 732,144 732,144 732,144 ................ ................

SPECIAL EDUCATION

State Grants:
Grants to States Part B current year...................... 2,294,472 1,453,752 2,394,472 +100,000 +940,720
Part B advance from prior year........................ (8,576,143) (9,283,383) (9,283,383) (+707,240) ................
Grants to States Part B (fiscal year 2014)................ 9,283,383 10,124,103 9,283,383 ................ -840,720
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 11,577,855 11,577,855 11,677,855 +100,000 +100,000

Preschool Grants.......................................... 372,646 372,646 372,646 ................ ................
Grants for Infants and Families........................... 442,710 462,710 462,710 +20,000 ................
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 12,393,211 12,413,211 12,513,211 +120,000 +100,000

IDEA National Activities (current funded):
State Personnel Development............................... 43,917 45,011 45,011 +1,094 ................
Technical Assistance and Dissemination.................... 46,781 46,781 46,781 ................ ................
Personnel Preparation..................................... 88,299 85,799 86,205 -2,094 +406
Parent Information Centers................................ 28,917 28,917 29,917 +1,000 +1,000
Technology and Media Services............................. 29,588 29,588 29,588 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, IDEA special programs......................... 237,502 236,096 237,502 ................ +1,406

Special Olympics Education Programs........................... 8,000 8,000 8,000 ................ ................
PROMISE....................................................... 1,996 30,000 11,996 +10,000 -18,004
=========================================================================================
Total, Special education................................ 12,640,709 12,687,307 12,770,709 +130,000 +83,402
Current Year........................................ (3,357,326) (2,563,204) (3,487,326) (+130,000) (+924,122)
Fiscal year 2014.................................... (9,283,383) (10,124,103) (9,283,383) ................ (-840,720)
Subtotal, Forward Funded................................ (3,109,828) (2,289,108) (3,229,828) (+120,000) (+940,720)

REHABILITATION SERVICES AND DISABILITY RESEARCH

Vocational Rehabilitation State Grants........................ 3,121,712 3,230,972 3,230,972 +109,260 ................
Discretionary modification (NA)........................... ................ (-63,603) ................ ................ (+63,603)
-----------------------------------------------------------------------------------------
Subtotal, VR State grants program level................. 3,121,712 3,167,369 3,230,972 +109,260 +63,603

Client Assistance State grants................................ 12,240 12,240 12,240 ................ ................
Training...................................................... 35,515 30,188 35,515 ................ +5,327
Demonstration and Training programs........................... 5,325 5,750 6,500 +1,175 +750
Migrant and Seasonal Farmworkers.............................. 1,262 ................ 1,262 ................ +1,262
Protection and Advocacy of Individual Rights [PAIR]........... 18,031 18,031 18,031 ................ ................
Supported Employment State grants............................. 29,068 ................ 29,068 ................ +29,068

Independent Living:
State Grants.............................................. 23,359 23,359 23,359 ................ ................
Centers................................................... 79,953 79,953 79,953 ................ ................
Services for Older Blind Individuals...................... 34,018 34,018 34,018 ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 137,330 137,330 137,330 ................ ................

Helen Keller National Center for Deaf/Blind Youth and Adults.. 9,145 9,145 9,145 ................ ................
National Inst. Disability and Rehab. Research [NIDRR]......... 108,817 106,817 108,817 ................ +2,000
Assistive Technology.......................................... 32,836 30,840 37,500 +4,664 +6,660
-----------------------------------------------------------------------------------------
Subtotal, Discretionary programs........................ 389,569 350,341 395,408 +5,839 +45,067
=========================================================================================
Total, Rehabilitation services.......................... 3,511,281 3,581,313 3,626,380 +115,099 +45,067

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND......................... 24,505 24,505 24,505 ................ ................

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF [NTID]:
Operations................................................ 65,422 63,037 65,422 ................ +2,385
Construction.............................................. ................ 2,000 ................ ................ -2,000
-----------------------------------------------------------------------------------------
Total, NTID............................................. 65,422 65,037 65,422 ................ +385

GALLAUDET UNIVERSITY:
Operations................................................ 117,541 117,541 118,000 +459 +459
Construction.............................................. 7,975 ................ 7,000 -975 +7,000
-----------------------------------------------------------------------------------------
Total, Gallaudet University............................. 125,516 117,541 125,000 -516 +7,459
=========================================================================================
Total, Special Institutions for Persons with 215,443 207,083 214,927 -516 +7,844
Disabilities...........................................

CAREER, TECHNICAL AND ADULT EDUCATION

Career Education:
Basic State Grants/Secondary & Technical Education State 332,030 332,030 332,030 ................ ................
Grants, current funded...................................
Advance from prior year............................... (789,505) (791,000) (791,000) (+1,495) ................
Fiscal year 2014...................................... 791,000 791,000 791,000 ................ ................
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Subtotal, Basic State Grants, program level......... 1,123,030 1,123,030 1,123,030 ................ ................

National Programs......................................... 7,829 7,829 7,829 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Career Education.............................. 1,130,859 1,130,859 1,130,859 ................ ................

Adult Education:
State Grants/Adult Basic and Literacy Education:
State Grants, current funded.......................... 594,993 594,993 594,993 ................ ................
National Leadership Activities................................ 11,302 11,302 11,302 ................ ................
=========================================================================================
Subtotal, Adult education............................... 606,295 606,295 606,295 ................ ................
=========================================================================================
Total, Career and adult education....................... 1,737,154 1,737,154 1,737,154 ................ ................
Current Year........................................ (946,154) (946,154) (946,154) ................ ................
Fiscal year 2014.................................... (791,000) (791,000) (791,000) ................ ................
Subtotal, Forward Funded................................ (946,154) (946,154) (946,154) ................ ................

STUDENT FINANCIAL ASSISTANCE

Pell Grants--maximum grant (NA)............................... (4,860) (4,860) (4,860) ................ ................
Pell Grants................................................... 22,824,000 22,824,000 22,824,000 ................ ................
Federal Supplemental Educational Opportunity Grants........... 734,599 734,599 734,599 ................ ................
Federal Work Study............................................ 976,682 1,126,682 976,682 ................ -150,000
=========================================================================================
Total, Student Financial Assistance [SFA]............... 24,535,281 24,685,281 24,535,281 ................ -150,000

STUDENT AID ADMINISTRATION

Salaries and Expenses......................................... 675,750 726,618 726,618 +50,868 ................
Servicing Activities.......................................... 367,637 399,745 399,745 +32,108 ................
=========================================================================================
Total, Student Aid Administration....................... 1,043,387 1,126,363 1,126,363 +82,976 ................

HIGHER EDUCATION

Aid for Institutional Development:
Strengthening Institutions................................ 80,623 80,623 80,623 ................ ................
Hispanic Serving Institutions............................. 100,432 100,432 100,432 ................ ................
Promoting Post-Baccalaureate Opportunities for Hispanic 9,011 9,011 9,011 ................ ................
Americans................................................
Strengthening Historically Black Colleges (HBCUs)......... 227,980 227,980 227,980 ................ ................
Strengthening Historically Black Graduate Institutions.... 58,958 58,958 58,958 ................ ................
Strengthening Predominantly Black Institutions............ 9,262 9,262 9,262 ................ ................
Asian American Pacific Islander........................... 3,119 3,119 3,119 ................ ................
Strengthening Alaska Native and Native Hawaiian-Serving 12,859 12,859 12,859 ................ ................
Institutions.............................................
Strengthening Native American-Serving Nontribal 3,119 3,119 3,119 ................ ................
Institutions.............................................
Strengthening Tribal Colleges............................. 25,713 25,713 25,713 ................ ................
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Subtotal, Aid for Institutional development............. 531,076 531,076 531,076 ................ ................

International Education and Foreign Language:
Domestic Programs......................................... 66,586 68,278 68,278 +1,692 ................
Overseas Programs......................................... 7,451 7,451 7,451 ................ ................
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Subtotal, International Education & Foreign Lang........ 74,037 75,729 75,729 +1,692 ................

Fund for the Improvement of Postsec. Ed. [FIPSE].............. 3,494 70,000 43,494 +40,000 -26,506
Postsecondary Program for Students with Intellectual 10,957 ................ 10,957 ................ +10,957
Disabilities.................................................
Minority Science and Engineering Improvement.................. 9,466 9,466 9,466 ................ ................
Tribally Controlled Postsec Voc/Tech Institutions............. 8,131 8,131 8,131 ................ ................
Federal TRIO Programs......................................... 839,932 839,932 839,932 ................ ................
GEAR UP....................................................... 302,244 302,244 302,244 ................ ................
Graduate Assistance in Areas of National Need................. 30,909 30,909 30,909 ................ ................
Teacher Quality Partnerships.................................. 42,833 ................ 42,833 ................ +42,833
Child Care Access Means Parents in School..................... 15,970 15,970 15,970 ................ ................
GPRA Data/HEA Program Evaluation.............................. 607 607 607 ................ ................
Hawkins Centers of Excellence................................. ................ 30,000 ................ ................ -30,000
Race to the Top: College Affordability and Completion......... ................ 1,000,000 ................ ................ -1,000,000
=========================================================================================
Total, Higher Education................................. 1,869,656 2,914,064 1,911,348 +41,692 -1,002,716

HOWARD UNIVERSITY

Academic Program.............................................. 201,637 201,637 201,637 ................ ................
Endowment Program............................................. 3,593 3,593 3,593 ................ ................
Howard University Hospital.................................... 28,834 28,834 28,834 ................ ................
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Total, Howard University................................ 234,064 234,064 234,064 ................ ................

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS [CHAFL]......... 459 459 459 ................ ................

HBCU CAPITAL FINANCING PROGRAM

HBCU Federal Administration................................... 352 352 352 ................ ................
HBCU Loan Subsidies........................................... 20,150 20,150 20,150 ................ ................
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Total, HBCU Capital Financing Program................... 20,502 20,502 20,502 ................ ................

INSTITUTE OF EDUCATION SCIENCES [IES]

Research, Development and Dissemination....................... 189,787 202,273 189,787 ................ -12,486
Statistics.................................................... 108,748 114,748 114,745 +5,997 -3
Regional Educational Laboratories............................. 57,426 57,426 57,426 ................ ................
Research in Special Education................................. 49,905 49,905 59,905 +10,000 +10,000
Special Education Studies and Evaluations..................... 11,415 11,415 11,415 ................ ................
Statewide Data Systems........................................ 38,077 53,077 53,077 +15,000 ................

Assessment:
National Assessment....................................... 129,616 124,616 124,616 -5,000 ................
National Assessment Governing Board....................... 8,690 7,690 7,690 -1,000 ................
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Subtotal, Assessment.................................... 138,306 132,306 132,306 -6,000 ................
=========================================================================================
Total, IES.............................................. 593,664 621,150 618,661 +24,997 -2,489

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION:
Salaries and Expenses..................................... 446,259 461,604 446,259 ................ -15,345
Building Modernization.................................... ................ 2,211 2,211 +2,211 ................
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Total, Program administration........................... 446,259 463,815 448,470 +2,211 -15,345

OFFICE FOR CIVIL RIGHTS....................................... 102,624 105,318 102,624 ................ -2,694

OFFICE OF THE INSPECTOR GENERAL............................... 59,820 62,401 59,820 ................ -2,581
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Total, Departmental management.......................... 608,703 631,534 610,914 +2,211 -20,620
=========================================================================================
Total, Title III, Department of Education............... 71,234,000 73,127,673 71,751,125 +517,125 -1,376,548
Current Year........................................ (48,636,999) (50,530,672) (49,154,124) (+517,125) (-1,376,548)
Fiscal year 2014.................................... (22,597,001) (22,597,001) (22,597,001) ................ ................

TITLE IV--RELATED AGENCIES

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY 5,375 5,396 5,375 ................ -21
DISABLED.....................................................

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

OPERATING EXPENSES

Domestic Volunteer Service Programs:
Volunteers in Service to America [VISTA].................. 94,820 95,300 95,300 +480 ................

National Senior Volunteer Corps:
Foster Grandparents Program........................... 110,565 110,774 110,774 +209 ................
Senior Companion Program.............................. 46,722 46,810 46,810 +88 ................
Retired Senior Volunteer Program...................... 50,204 50,299 51,299 +1,095 +1,000
-----------------------------------------------------------------------------------------
Subtotal, Senior Volunteers......................... 207,491 207,883 208,883 +1,392 +1,000
=========================================================================================
Subtotal, Domestic Volunteer Service Programs....... 302,311 303,183 304,183 +1,872 +1,000

National and Community Service Programs:
AmeriCorps State and National Grants...................... 344,348 345,000 346,368 +2,020 +1,368
Disability Placement Funds................................ ................ 3,000 ................ ................ -3,000
Innovation, Assistance, and Other Activities.............. 53,280 53,215 54,215 +935 +1,000
Evaluation................................................ 2,994 5,000 5,000 +2,006 ................
National Civilian Community Corps......................... 31,882 30,110 30,742 -1,140 +632
State Commission Grants................................... 15,437 20,990 19,990 +4,553 -1,000
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Subtotal, National & Community Service Programs......... 447,941 457,315 456,315 +8,374 -1,000
-----------------------------------------------------------------------------------------
Total, Operating expenses............................... 750,252 760,498 760,498 +10,246 ................

Payment to the National Service Trust......................... 211,797 208,744 208,744 -3,053 ................
Salaries and Expenses......................................... 82,843 88,000 88,000 +5,157 ................
Office of Inspector General................................... 3,992 5,400 5,400 +1,408 ................
=========================================================================================
Total, Corp. for National and Community Service......... 1,048,884 1,062,642 1,062,642 +13,758 ................

CORPORATION FOR PUBLIC BROADCASTING:
Fiscal year 2015 (current) with fiscal year 2014 445,000 445,000 445,000 ................ ................
comparable...............................................
Fiscal year 2014 advance with fiscal year 2013 comparable (445,000) (445,000) (445,000) ................ ................
(NA).....................................................
Fiscal year 2013 advance with fiscal year 2012 comparable (444,159) (445,000) (445,000) (+841) ................
(NA).....................................................
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Subtotal, fiscal year 2013 appropriation................ ................ ................ ................ ................ ................

FEDERAL MEDIATION AND CONCILIATION SERVICE.................... 46,163 47,045 46,163 ................ -882
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION.............. 17,604 16,000 17,000 -604 +1,000
INSTITUTE OF MUSEUM AND LIBRARY SERVICES...................... 231,954 231,954 231,954 ................ ................
MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION............... 5,989 11,000 9,500 +3,511 -1,500
MEDICARE PAYMENT ADVISORY COMMISSION.......................... 11,778 12,210 11,778 ................ -432
NATIONAL COUNCIL ON DISABILITY................................ 3,258 3,258 3,258 ................ ................
NATIONAL HEALTH CARE WORKFORCE COMMISSION..................... ................ 3,000 3,000 +3,000 ................
NATIONAL LABOR RELATIONS BOARD................................ 278,306 292,800 288,306 +10,000 -4,494
NATIONAL MEDIATION BOARD...................................... 13,411 13,530 14,411 +1,000 +881
OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION.............. 11,667 11,965 11,667 ................ -298

RAILROAD RETIREMENT BOARD

Dual Benefits Payments Account................................ 50,904 45,000 45,000 -5,904 ................
Less Income Tax Receipts on Dual Benefits..................... -2,000 -3,000 -3,000 -1,000 ................
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Subtotal, Dual Benefits................................. 48,904 42,000 42,000 -6,904 ................

Federal Payment to the RR Retirement Account.................. 150 150 150 ................ ................
Limitation on Administration.................................. 108,649 112,415 111,649 +3,000 -766
Inspector General......................................... 8,155 8,820 8,155 ................ -665

SOCIAL SECURITY ADMINISTRATION

Payments to Social Security Trust Funds....................... 20,404 20,402 20,402 -2 ................

SUPPLEMENTAL SECURITY INCOME

Federal Benefit Payments...................................... 47,557,000 54,245,000 54,245,000 +6,688,000 ................
Beneficiary Services.......................................... 47,000 ................ ................ -47,000 ................
Research and Demonstration.................................... 7,998 48,000 48,000 +40,002 ................
Administration................................................ 3,611,552 3,950,000 3,950,000 +338,448 ................
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Subtotal, SSI program level............................. 51,223,550 58,243,000 58,243,000 +7,019,450 ................
Less funds advanced in prior year................... -13,400,000 -18,200,000 -18,200,000 -4,800,000 ................
-----------------------------------------------------------------------------------------
Subtotal, regular SSI current year...................... 37,823,550 40,043,000 40,043,000 +2,219,450 ................
New advance, 1st quarter, fiscal year 2014.......... 18,200,000 19,300,000 19,300,000 +1,100,000 ................
-----------------------------------------------------------------------------------------
Total, SSI program...................................... 56,023,550 59,343,000 59,343,000 +3,319,450 ................

LIMITATION ON ADMINISTRATIVE EXPENSES

OASDI Trust Funds............................................. 5,320,028 5,275,463 5,256,007 -64,021 -19,456
HI/SMI Trust Funds............................................ 2,089,794 1,901,313 1,901,313 -188,481 ................
Social Security Advisory Board................................ 2,146 2,150 2,150 +4 ................
SSI........................................................... 3,123,576 3,386,074 3,386,074 +262,498 ................
-----------------------------------------------------------------------------------------
Subtotal, regular LAE................................... 10,535,544 10,565,000 10,545,544 +10,000 -19,456

User Fees:
SSI User Fee activities................................... 153,596 166,000 166,000 +12,404 ................
SSPA User Fee Activities.................................. ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal, User fees..................................... 153,596 166,000 166,000 +12,404 ................
-----------------------------------------------------------------------------------------
Subtotal, Limitation on administrative expenses......... 10,689,140 10,731,000 10,711,544 +22,404 -19,456

Program Integrity Funding:
OASDI Trust Funds......................................... 268,076 460,074 460,074 +191,998 ................
SSI....................................................... 487,976 563,926 563,926 +75,950 ................
-----------------------------------------------------------------------------------------
Subtotal, Program integrity funding..................... 756,052 1,024,000 1,024,000 +267,948 ................
=========================================================================================
Total, Limitation on Administrative Expenses............ 11,445,192 11,755,000 11,735,544 +290,352 -19,456

OFFICE OF THE INSPECTOR GENERAL

Federal Funds................................................. 28,887 30,000 28,887 ................ -1,113
Trust Funds................................................... 73,396 77,600 73,396 ................ -4,204
-----------------------------------------------------------------------------------------
Total, Office of the Inspector General.................. 102,283 107,600 102,283 ................ -5,317

Adjustment: Trust fund transfers from general revenues........ -3,611,552 -3,950,000 -3,950,000 -338,448 ................
=========================================================================================
Total, Social Security Administration................... 63,979,877 67,276,002 67,251,229 +3,271,352 -24,773
Federal funds....................................... 56,226,437 59,559,402 59,558,289 +3,331,852 -1,113
Current year.................................... (38,026,437) (40,259,402) (40,258,289) (+2,231,852) (-1,113)
New advances, 1st quarter....................... (18,200,000) (19,300,000) (19,300,000) (+1,100,000) ................
Trust funds......................................... 7,753,440 7,716,600 7,692,940 -60,500 -23,660
=========================================================================================
Total, Title IV, Related Agencies....................... 66,265,124 69,595,187 69,563,237 +3,298,113 -31,950
Federal Funds....................................... 58,383,102 61,745,142 61,738,715 +3,355,613 -6,427
Current Year.................................... (39,738,102) (42,000,142) (41,993,715) (+2,255,613) (-6,427)
Current Year (emergency)........................ ................ ................ ................ ................ ................
Fiscal year 2014 Advance........................ (18,200,000) (19,300,000) (19,300,000) (+1,100,000) ................
Fiscal year 2014 Advance........................ (445,000) (445,000) (445,000) ................ ................
Trust Funds......................................... 7,882,022 7,850,045 7,824,522 -57,500 -25,523
=========================================================================================
Grand Total............................................. 741,495,738 777,624,610 777,568,714 +36,072,976 -55,896
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\1\President's budget request these funds in the Admin for Community living at HHS.
\2\Two year availability
\3\Section 4002 of Public Law 111-148.