[Senate Report 113-71]
[From the U.S. Government Publishing Office]
Calendar No. 128
113th Congress Report
SENATE
1st Session 113-71
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2014
_______
July 11, 2013.--Ordered to be printed
_______
Mr. Harkin, from the Committee on Appropriations,
submitted the following
REPORT
[To accompany S. 1284]
The Committee on Appropriations reports the bill (S. 1284)
making appropriations for Departments of Labor, Health and
Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2014, and for other purposes,
reports favorably thereon and recommends that the bill do pass.
Amounts in new budget authority
Total of bill as reported to the Senate............. $783,365,379,000
Amount of 2013 appropriations\1\\2\................. 757,440,498,000
Amount of 2014 budget estimate...................... 787,803,163,000
Bill as recommended to Senate compared to--
2013 appropriations............................. +25,924,881,000
2014 budget estimate............................ -4,437,784,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25.
\2\Includes emergency funding of $825,000,000 in the Disaster Relief
Appropriations Act, 2013 (division A of Public Law 113-2).
CONTENTS
----------
Page
List of Abbreviations............................................ 4
Summary of Budget Estimates and Committee Recommendations........ 8
Overview..................................................... 8
Reducing Healthcare Costs.................................... 8
Early Childhood Care and Education........................... 9
Improving Fiscal Accountability.............................. 10
Promoting Policy Reform...................................... 11
Prevention................................................... 11
Reducing Violence--Now is the Time........................... 12
Assisting People With Disabilities........................... 13
Helping America's Workers.................................... 13
Other Highlights of the Bill................................. 14
Title I: Department of Labor:
Employment and Training Administration....................... 16
Employee Benefits Security Administration.................... 27
Pension Benefit Guaranty Corporation......................... 27
Wage and Hour Division....................................... 28
Office of Labor-Management Standards......................... 29
Office of Federal Contract Compliance Programs............... 29
Office of Workers' Compensation Programs..................... 30
Occupational Safety and Health Administration................ 32
Mine Safety and Health Administration........................ 33
Bureau of Labor Statistics................................... 34
Office of Disability Employment Policy....................... 35
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................................ 83
Substance Abuse and Mental Health Services Administration.... 111
Agency for Healthcare Research and Quality................... 119
Centers for Medicare and Medicaid Services................... 122
Administration for Children and Families..................... 128
Administration for Community Living.......................... 140
Office of the Secretary...................................... 145
General Provisions........................................... 155
Title III: Department of Education:
Education for the Disadvantaged.............................. 158
School Readiness............................................. 161
Impact Aid................................................... 162
School Improvement Programs.................................. 163
Indian Education............................................. 168
Innovation and Improvement................................... 169
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................ 185
Gallaudet University..................................... 186
Career, Technical, and Adult Education....................... 186
Student Financial Assistance................................. 188
Student Aid Administration................................... 191
Higher Education............................................. 192
Howard University............................................ 199
College Housing and Academic Facilities Loans Program........ 200
Historically Black College and University Capital Financing
Program Account............................................ 200
Institute of Education Sciences.............................. 201
Departmental Management:
Program Administration................................... 203
Office for Civil Rights.................................. 204
Office of the Inspector General.......................... 205
General Provisions........................................... 205
Title IV: Related Agencies:
Committee for Purchase From People Who Are Blind or Severely
Disabled................................................... 207
Corporation for National and Community Service............... 207
Corporation for Public Broadcasting.......................... 212
Federal Mediation and Conciliation Service................... 212
Federal Mine Safety and Health Review Commission............. 212
Institute of Museum and Library Services..................... 213
Medicaid and CHIP Payment and Access Commission.............. 214
Medicare Payment Advisory Commission......................... 214
National Council on Disability............................... 214
National Health Care Workforce Commission.................... 215
National Labor Relations Board............................... 215
National Mediation Board..................................... 215
Occupational Safety and Health Review Commission............. 216
Railroad Retirement Board.................................... 216
Social Security Administration............................... 217
Title V: General Provisions...................................... 222
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the
Senate......................................................... 224
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..................................................... 225
Budgetary Impact of Bill......................................... 232
Comparative Statement of New Budget Authority.................... 233
LIST OF ABBREVIATIONS
ACA--Patient Protection and Affordable Care Act
ACL--Administration for Community Living
ADAP--AIDS Drug Assistance Program
AHEC--area health education center
AHRQ--Agency for Healthcare Research and Quality
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
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
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
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
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
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
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
SEA--State educational agency
SEOG--Supplemental Educational Opportunity Grant
SIG--School Improvement Grants
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
TB--tuberculosis
TBI--traumatic brain injury
TIF--Teacher Incentive Fund
UAC--unaccompanied alien children
UCEDD--University Center for Excellence in Developmental
Disabilities
UI--unemployment insurance
USAID--U.S. Agency for International Development
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 2014, the Committee recommends total budget
authority of $783,365,379,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
This amount includes $164,330,000,000 in current year
discretionary funding and $1,253,000,000 in cap adjustments for
healthcare fraud and abuse and for program integrity at the
Social Security Administration, in accordance with the
allocation for this bill.
Fiscal year 2013 levels cited in this report reflect the
enacted amounts in Public Law 113-6, the Consolidated and
Further Continuing Appropriations Act, 2013. They do not
reflect the March 1, 2013, sequester of funds required under
Public Law 112-25 (the Budget Control Act of 2011) or agency
transfers and reprogrammings that are allowed in Public Law
113-6 and that have occurred since that law's enactment. Where
applicable, the fiscal year 2013 levels include emergency
funding in the Disaster Relief Appropriations Act, 2013.
OVERVIEW
The Labor, Health and Human Services, and Education, and
Related Agencies appropriations bill constitutes the largest of
the nondefense Federal appropriations bills. 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 early childhood care and
education to the operations of the Social Security
Administration.
Balancing the competing priorities in this bill is always
difficult, but especially so at a time when discretionary
spending as a share of the overall economy has dropped to
historically low levels. The Committee has examined all of the
programs in this bill and recommended what it believes is an
appropriate level for each of them, within the limits of the
bill's allocation. Details are included in the report.
Several themes permeate the Committee's recommendation,
described below. All funding comparisons are to fiscal year
2013 levels.
REDUCING HEALTHCARE COSTS
The Nation's fiscal health is inextricably linked to our
ability to curb the cost of healthcare. The Affordable Care
Act, enacted in 2010, is vital to that effort. But this
appropriations bill also plays a critical role--by supporting
the ACA's implementation, promoting efforts to prevent chronic
diseases, and increasing funding for medical research.
Implementing the Affordable Care Act.--The ACA has already
resulted in historic savings for the Federal Government and for
American families. More than 6.3 million Medicare beneficiaries
have saved more than $6,100,000,000 on prescription drugs. In
2012 alone, consumers also saved $2,000,000,000 because of
provisions to review premium rates and to require insurers to
provide rebates if they do not spend at least 80 percent of
premiums on care, rather than overhead. In 2013, some 8.5
million Americans with health coverage will receive rebates,
averaging $100 per family. And the law's provisions have
extended the life of the Medicare Trust Fund by 8 years.
Fiscal year 2014 begins on the same day the ACA will open
enrollment for new health coverage in the Health Insurance
Marketplace, which will for the first time offer people a
single place where they can compare the costs and benefits of
different health insurance plans and choose the one that fits
their needs.
The Committee includes $5,217,357,000 for Program
Management at the Centers for Medicare and Medicaid Services,
the lead agency with responsibility for overseeing the ACA. CMS
will use this funding to run the Marketplace, ensure compliance
with the Patient's Bill of Rights and other insurance market
rules, and implement additional quality measures to improve
healthcare services for all Americans.
Alzheimer's Disease.--The total payments for healthcare,
long-term care, and hospice for people with Alzheimer's and
other dementias are projected to increase from $203,000,000,000
in 2013 to a staggering $1,200,000,000,000 in 2050.
Without a medical breakthrough to prevent, slow, or stop
the disease, Medicare and Medicaid costs related to Alzheimer's
could rise an estimated 500 percent. Research is desperately
needed to bring those costs under control. Therefore, the bill
includes a significant increase for the National Institute on
Aging, the NIH Institute with the primary responsibility for
preventing, treating, and curing Alzheimer's disease.
The Committee recommendation also includes $20,000,000 for
a new Alzheimer's Disease Initiative consisting of $10,500,000
to strengthen dementia-capable long-term services and supports,
$4,200,000 for an outreach campaign to assist caregivers of
individuals with Alzheimer's disease, and $5,300,000 to train
healthcare providers on how to recognize the signs and symptoms
of Alzheimer's and manage the disease.
EARLY CHILDHOOD CARE AND EDUCATION
High-quality early childhood care and education has been
proven to have positive, lasting effects for children and
families. It also supports the Nation's long-term economic
security by preparing our next generation of workers,
entrepreneurs, and business leaders. The Committee provides a
combined increase of $2,561,394,000 for the key early childhood
care and education programs in this bill: Head Start, the Child
Care and Development Block Grant, and Preschool Development
Grants. Together, they address the entire age range of birth
through 5.
Head Start.--The Committee recommendation includes
$9,621,070,000, a $1,635,030,000 increase, for Head Start. This
includes a $1,430,376,000 increase to expand Early Head Start,
including the creation of new Early Head Start-Child Care
Partnerships, to serve children and families from before birth
through age 3.
Child Care and Development Block Grant.--The Committee
recommendation includes $2,500,000,000, a $176,344,000
increase, for CCDBG. This includes a $110,000,000 increase to
improve the quality of the child care workforce and health and
safety standards.
Preschool Development Grants.--The Committee bill includes
$750,000,000 for a new program to support States' efforts to
expand or create high-quality preschool systems for 4-year-olds
from low- and moderate-income families.
IMPROVING FISCAL ACCOUNTABILITY
The Committee has an obligation to promote the fiscal
accountability and effective use of taxpayer dollars. This bill
provides funding for several efforts to combat fraud, waste,
and abuse within Federal programs.
Healthcare Program Integrity.--Fraud committed against
Federal healthcare programs diverts critical resources from
services that are intended for some of the Nation's most
vulnerable populations. The Committee includes $640,000,000 for
HCFAC activities at CMS, more than double the fiscal year 2013
level of $309,170,000. Every $1 spent on these activities
returns approximately $7.90 to the Treasury. At that rate, the
level in this bill would return more than $5,000,000,000.
Social Security Program Integrity.--The Committee includes
$1,197,000,000, a $440,948,000 increase, for Social Security
program integrity activities, including continuing disability
reviews [CDRs] and SSI redeterminations. CDRs and
redeterminations save $9 and $5, respectively, for each $1
spent by reducing waste, fraud, abuse, and improper payments in
the Social Security, Medicare, and Medicaid programs. Combined,
the Committee recommendation for Social Security program
integrity activities is estimated to save $9,600,000,000 over
10 years.
Unemployment Insurance Program Integrity.--The Committee
recommendation includes $80,000,000, an increase of
approximately $20,000,000, to conduct reemployment and
eligibility assessments [REAs] and UI improper payment reviews.
This level is projected to save State UI trust funds an
estimated $315,000,000 through REAs by helping claimants exit
the UI program faster and avoid exhausting their benefits.
Protecting Students and Taxpayers.--The Committee bill
includes a new provision prohibiting colleges and universities
from spending Federal educational funding on marketing,
recruitment, and advertising. This reform will ensure that
Federal resources are targeted at educating students as opposed
to online advertisements and aggressive recruiting activities,
so that both students and taxpayers receive a good return on
their investment.
Spending on Conferences.--The Committee helps prevent
excessive spending on conferences and other administrative
expenses by requiring departments, agencies, boards, and
commissions funded in this bill to report to Inspectors General
or senior ethics officials on the costs and contracting
procedures involved in any conference that costs more than
$100,000.
PROMOTING POLICY REFORM
This bill launches or continues several initiatives that
will leverage policy reform and transform key Federal services.
Race to the Top--College Affordability and Completion.--The
Committee includes $250,000,000 to support a new Race to the
Top program focused on college affordability and completion.
Funding will incentivize States to reduce costs for students
and families and improve academic outcomes.
Public Access to Federally Funded Research.--In fiscal year
2009, Congress required NIH to improve the public's ability to
access taxpayer-funded research by means of an online NIH
repository. This effort has been highly successful. The
Committee includes a new general provision that extends the
requirement to other agencies funded in this bill.
Investing in Innovation.--The Committee bill provides
$170,000,000 for the Investing in Innovation education program,
which allows grantees to develop and test promising new ideas
and replicate programs that are successful.
Accelerating Cures.--The Committee bill includes
$50,000,000, five times the fiscal year 2013 level, for the
Cures Acceleration Network, an NIH initiative intended 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.
Performance Partnerships for Disconnected Youth.--The
Committee bill includes a new authority called Performance
Partnerships that will provide States and local communities
with unprecedented flexibility to improve services 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 for these pilot projects.
PREVENTION
Nearly three-quarters of all healthcare costs are
attributable to chronic diseases, the majority of which are
preventable. This bill promotes prevention efforts by
supporting implementation of the ACA, which will enable
millions of newly insured Americans to receive preventive
screenings; providing discretionary funding for programs such
as childhood immunizations and cancer screenings; and
allocating the Prevention and Public Health Fund, which will
total $1,000,000,000 in fiscal year 2014.
Key prevention programs listed below are either funded in
this bill or through transfers from the PPH Fund.
Community Transformation Grants.--The Committee includes
$290,000,000, an increase of $143,660,000, for evidence-based
public health interventions to reduce obesity and smoking and
make preventive services more accessible.
Childhood Immunizations.--The Committee includes
$579,457,000 for immunization programs. Immunization saves
$10.20 in direct medical costs for every $1 invested.
Smoking Prevention.--The Committee includes $202,892,000
for the Office of Smoking and Health at CDC. This funding, an
increase of $34,698,000, will continue the successful media
campaign, ``Tips From a Former Smoker,'' and expand State quit-
lines.
Diabetes Prevention Program [DPP].--The Committee includes
$10,000,000 for the DPP, a set of lifestyle interventions that
has been proven to reduce the risk of developing diabetes by 58
percent in individuals at high risk.
Elder Falls.--In 2010, 2.3 million older adults were
treated in emergency departments after a fall, with more than
662,000 of these patients being hospitalized. Many of these
falls are preventable with lifestyle interventions and
appropriate physical supports. In a new initiative, the
Committee includes $10,000,000 to research and implement
evidence-based approaches to preventing elderly falls.
REDUCING VIOLENCE--NOW IS THE TIME
The mass shootings last year at an Aurora, Colorado, movie
theater and at Sandy Hook Elementary School in Newtown,
Connecticut, raised public awareness about the problems of
violence and mental illness in our communities as perhaps never
before.
There are approximately 30,000 firearm-related homicides
and suicides in the United States each year, and almost one-
quarter of 14- to 17-year-olds have witnessed a shooting in
their lifetime. Research shows that exposure to community
violence can impact children's mental health and development
and can substantially increase the likelihood that these
children will later commit violent acts themselves.
Unfortunately, less than half of children and adults with
diagnosable mental health problems receive the treatment they
need.
Addressing these challenges will require complex,
comprehensive solutions that are beyond the scope of any single
school, community, State, or set of laws. But funding provided
in this bill to prevent violence, increase access to mental
health treatment, and improve school safety can play an
important role.
Mental Health Services.--The Committee bill includes
$119,000,000 in new funding to increase access to mental health
services. This includes: $95,000,000 for the administration's
Now Is the Time initiative; $15,000,000 for Mental Health First
Aid programs that help identify and respond to individuals
showing signs of mental illness; $40,000,000 for grants to
States to reduce violence in schools and increase the number of
students receiving mental health services; and $40,000,000 to
address shortages in the behavioral health workforce. The
Committee also includes $24,187,000 for a new Mental Health
Block Grant set-aside for evidence-based programs that serve
individuals with early serious mental illness.
Safe and Healthy Schools.--Research shows that safe,
positive school environments can help reduce unhealthy student
behavior, increase academic achievement, and counter the
effects that violence can have on students. The Committee bill
includes $195,191,000 for specific activities to improve
learning conditions in the Nation's schools. This amount
includes $50,000,000 for a new School Climate Transformation
Grants program, which will train school staff to implement
evidence-based strategies to improve school climate;
$25,000,000 to help school districts develop, implement, and
improve their emergency management plans; $25,000,000 for
Project Prevent, which will help schools in troubled
communities break the cycle of violence; and up to $8,000,000
for Project SERV, which offers education-related services
following a violent or traumatic event.
Tracking Violent Deaths.--The National Violent Death
Reporting System [NVDRS] is an 18-State surveillance system
that pulls together information on violent deaths with the aim
of developing effective interventions and preventive measures.
The Committee bill includes $18,465,000, an increase of
$15,000,000, to expand NVDRS to additional States and
communities.
Public Health Research.--Behind motor vehicle injuries,
firearm injuries are the second leading cause of injury and
mortality in the United States. The Committee bill includes
$10,000,000 to build the public health research base on how to
reduce the threat of firearm-related violence.
ASSISTING PEOPLE WITH DISABILITIES
Special Education.--The Committee bill provides
$11,722,946,000, an increase of $168,246,000, under section 611
of part B Grants to States for educating students with
disabilities between the ages of 3 and 21. The bill also
includes $462,710,000, an increase of $20,886,000, to support
statewide systems of coordinated and early intervention
services for children with disabilities 2 years old and
younger, as well as their families.
Promoting Readiness of Minors in SSI.--The Committee bill
continues the PROMISE program, an interagency effort to improve
outcomes for children, and the families of children, receiving
SSI benefits. This program, which will award its first grants
in late fiscal year 2013, 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.
Special Education Research.--The bill includes $69,905,000,
an increase of $20,099,000, to support research on how children
and adults with disabilities learn and how best to meet their
educational needs.
Assistive Technology.--The Committee bill provides
$37,500,000, an increase of $4,730,000, for activities to
improve occupational and educational opportunities and the
quality of life for people with disabilities through assistive
technology.
HELPING AMERICA'S WORKERS
Job Training.--The Committee recommendation includes
$2,683,766,000, an increase of $85,658,000, for Workforce
Investment Act Grants to States to provide job training skills
and assistance to low-skilled adults, dislocated workers, and
low-income youth with barriers to employment.
Paid Leave for Workers.--The Committee bill includes
$5,000,000 to support a new State Paid Leave Fund. The Fund
will provide planning and implementation grants to States that
wish to establish paid leave programs and provide benefits to
workers who need to take time off for reasons covered under the
Family and Medical Leave Act.
Veterans Employment and Training.--The Committee
recommendation includes $300,518,000, an increase of
$36,611,000, to expand employment services to transitioning
servicemembers, veterans with disabilities, and their spouses
and caregivers.
Protecting Whistleblowers.--The Committee recommendation
includes $567,012,000 for OSHA and targets a $6,042,000
increase for its enforcement of whistleblower laws. These laws
provide important protections for workers who raise issues in
their workplace about practices that could impact fellow
employees or the public.
Preventing Misclassifications.--The Committee
recommendation includes an increase of $14,000,000 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.
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 2014-2015 school year. Combined with mandatory
funding, the total maximum award will rise by $140 to $5,785.
National Institutes of Health.--The Committee bill provides
$30,946,776,000, an increase of $307,127,000, to fund
biomedical research at the 27 Institutes and Centers that
comprise NIH.
This level will allow NIH to allocate $40,000,000 for the
proposed new Brain Research through Application of Innovative
Neurotechnologies [BRAIN] Initiative.
Community Health Centers.--The Committee bill includes
$1,574,606,000 for CHCs. Combined with mandatory funding
provided in the ACA, the fiscal year 2014 program level for
CHCs is $3,774,606,000, an increase of $700,000,000.
Title I (Education for the Disadvantaged).--The Committee
includes $14,612,425,000, an increase of $125,000,000, for
title I grants to LEAs for improving education for low-income
students. These funds support 90 percent of the 14,000 school
districts across the Nation.
Children's Hospitals Graduate Medical Education.--The
Committee recommendation includes $267,313,000 for CHGME, the
same level as in fiscal year 2013. The Committee rejects the 67
percent cut to this program proposed by the administration.
Low Income Home Energy Assistance.--The Committee
recommendation includes $3,614,729,000 for LIHEAP and rejects
the administration's proposed cut to the program.
Community Services Block Grant.--The Committee
recommendation rejects the administration's proposed cut to the
CSBG and includes $676,003,000 for this program, the same as
the fiscal year 2013 funding level.
AIDS Drug Assistance Program.--The Committee recommends
$943,299,000 for ADAP, an increase of $46,797,000.
Promise Neighborhoods.--Inspired by the Harlem Children's
Zone program, Promise Neighborhoods supports cradle-to-career
services designed to improve educational outcomes for students
in distressed neighborhoods. The Committee includes $56,754,000
for this program.
Unaccompanied Alien Children.--The Committee includes
$494,597,000, a $119,509,000 increase, to provide care and
services for unaccompanied alien children while they await
placement with a sponsor and adjudication of their immigration
status. Such children are often fleeing abuse, trafficking, or
other dangerous situations in their home country,
Social Security Administration.--The Committee
recommendation includes $11,965,473,000, a $533,578,000
increase, for SSA's administrative expenses. This includes a
$440,948,000 increase for program integrity activities and a
$92,630,000 increase in core administrative expenses for SSA to
keep pace with an aging population and persistently record-high
workloads.
TRIO.--The bill includes $849,932,000, an increase of
$11,680,000, to help low-income and first generation college
students plan, prepare for, and succeed in college through the
TRIO programs.
TITLE I
DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
Appropriations, 2013\1\\2\.............................. $3,211,756,000
Budget estimate, 2014................................... 3,387,405,000
Committee recommendation................................ 3,264,213,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Includes emergency funding of $25,000,000 in the Disaster Relief
Appropriations Act, 2013 (division A of Public Law 113-2).
The Training and Employment Services account provides
funding primarily for activities under WIA, and 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 2014 will support the
program from July 1, 2014, through June 30, 2015. A portion of
this account's funding, $1,772,000,000, is available on October
1, 2014, for the 2014 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.
The Committee encourages the Department to continue to work
with other Federal agencies to align and streamline employment
and training services.
The Committee encourages the Department to use grant funds
and training programs to facilitate solutions to address the
shortage in the STEM workforce, such as laboratory
professionals. STEM fields are central to U.S. economic
competitiveness and growth, and the Committee urges the
Department to continue to address gaps in the Nation's approach
to strengthening the STEM pipeline.
Grants to States
The Committee recommends $2,683,766,000 for Training and
Employment Services Grants to States.
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.
The Committee recommendation modifies current law regarding
the amount of WIA State grant funding that may be set aside by
Governors. As proposed in the budget request, the Committee
includes bill language authorizing the Governor of a State to
reserve not more than 7.5 percent of the funds allotted to a
State through the WIA State grant programs for statewide
workforce investment activities. The current maximum set-aside
in each State is 5 percent. The funding increase provided for
the WIA State grant programs in this bill will allow the set-
aside to grow without reducing funds provided to local areas.
The Committee notes that GAO Report 12-97, dated January
19, 2012, found that one of the six identified characteristics
of effective local public and private workforce partnerships
was leadership. The Committee encourages the Department to
support States, in cooperation with local elected officials and
local workforce board chairs, in the development of high-
quality standards for workforce development leaders and to
support professional development of such leaders based on the
standards.
Adult Employment and Training.--For adult employment and
training activities, the Committee recommends $791,644,000.
This program is funded by formula to States and further
distributed to local workforce investment areas through one-
stop centers. 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.
The Committee commends the Department for employment
outcomes among adult exiters who receive on-the-job training
and encourages the Department to continue supporting these
efforts and increase participation.
Funds made available in this bill for adult employment and
training support activities in program year 2014, which occurs
from July 1, 2014, through June 30, 2015. The bill provides
that $79,644,000 is available for obligation on July 1, 2014,
and that $712,000,000 is available on October 1, 2014. Both
categories of funding are available for obligation through June
30, 2015.
Youth Training.--For youth training activities, the
Committee recommends $846,632,000.
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 activities in program year
2014, which occurs from April 1, 2014, through June 30, 2015.
Dislocated Worker Assistance.--For dislocated worker
assistance, the Committee recommends $1,045,490,000.
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 activities in
program year 2014, which occurs from July 1, 2014, through June
30, 2015. The bill provides that $185,490,000 is available for
obligation on July 1, 2014, and that $860,000,000 is available
on October 1, 2014. Both categories of funding are available
for obligation through June 30, 2015.
Federally Administered Programs
Dislocated Worker Assistance National Reserve.--The
Committee recommends $220,859,000 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.
Funds made available in this bill support activities in
program year 2014, which occurs from July 1, 2014, through June
30, 2015. The bill provides that $20,859,000 is available for
obligation on July 1, 2014, and that $200,000,000 is available
on October 1, 2014. Both categories of funding are available
for obligation through June 30, 2015.
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
$47,467,000 for Native American programs. These programs are
designed to improve the economic well-being of Native Americans
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 $84,123,000 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 $77,949,000 be
used for State service area grants. The Committee
recommendation also includes bill language directing that
$5,667,000 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
$507,000 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 $994,000
for activities authorized under the WANTO Act of 1992. 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 $84,530,000 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
$49,806,000 for WIF, a program that provides competitive grants
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, including individuals up to age 24, and
employers. WIF awards are 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.
The Committee recommendation includes a set-aside of
$5,000,000 to support a new, interagency initiative to improve
services for disconnected youth and the development of
performance partnership pilots; the budget request includes
$10,000,000 for this purpose.
The budget request also includes a $50,000,000 set-aside
for projects that address the employment needs of veterans. The
Committee does not recommend a set-aside for this purpose
within WIF, but provides a significant increase for the
Veterans' Employment and Training Service account.
The Committee notes that although the program was created
in fiscal year 2011, with additional funding appropriated in
fiscal years 2012 and 2013, the Department did not award the
first WIF grants until June 2012. The Committee is awaiting the
results of the initial grants.
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 not-for-profit organizations providing or arranging
services that improve employment and education outcomes for
individuals, including those with barriers to employment. The
Committee understands that these pilots will be funded only if
the Department determines that they could improve outcomes and
eligible entities show interest. The Committee directs the
Department to provide at least 15 days' notice to the Committee
before issuing any announcements related to Pay for Success
activity.
The Committee recommendation includes new bill language, as
requested by the administration, that allows the Secretary to
authorize WIF awardees to use a portion of grant funds for
evaluation purposes if the Department's chief evaluation
officer approves the evaluation plan. This is in addition to
the 5 percent set-aside made available to the Secretary for
technical assistance and evaluations.
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 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 WIA, the Wagner-Peyser Act, and title I
of the Rehabilitation 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 a report on the Department's 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; the report should be provided to
the Committee no later than March 1, 2014. Further, the
Committee recommends that these best practices be widely
disseminated to maximize outreach to programs that would be
able to implement improved approaches.
Pilots, Demonstrations, and Research.--The Committee
recommends $6,590,000 for pilots, demonstrations, and research
authorized by section 171 of WIA to support grants or contracts
to conduct research, pilots, or demonstrations that foster
promising practices for national policy application.
Reintegration of Ex-Offenders.--The Committee recommends
$80,078,000 for the Reintegration of Ex-Offenders program. The
budget request includes a $10,000,000 set-aside for Pay for
Success projects. The Committee recommendation does not include
the set-aside. The Reintegration of Ex-Offenders program helps
prepare and assist adult 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 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 proposed in the budget request, the
Committee recommends using a set-aside funding mechanism to
support the evaluation of employment and training programs.
Instead of directly providing funds for evaluation, the
Committee recommendation will support these activities through
a 0.5 percent tap on all training and employment programs,
including the Training and Employment Services, Office of Job
Corps, Community Service Employment for Older Americans, and
State Unemployment Insurance and Employment Service Operations.
The new set-aside approach will ensure that sufficient funding
is available to carry out comprehensive evaluation and applied
research activities, including continued support of the WIA
Adult and Dislocated Worker Programs Gold Standard Evaluation.
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.
Workforce Data Quality Initiative.--The Committee
recommends $6,000,000 for the Workforce Data Quality
Initiative. 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. Thirty-
one States have been awarded grants through this program. This
funding will expand the initiative to approximately six
additional States.
OFFICE OF JOB CORPS
Appropriations, 2013\1\................................. $1,699,541,000
Budget estimate, 2014................................... 1,691,923,000
Committee recommendation................................ 1,706,923,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The recommendation for operations of Job Corps centers is
$1,586,776,000. The Committee understands that construction on
the new Job Corps center in Manchester, New Hampshire, will be
substantially completed in December 2014. The Committee's
recommended level for operations includes funds to ensure that
competitively awarded contracts will be in place to keep the
process of opening the Manchester center on course.
The Committee remains concerned about the Department's
mismanagement of Job Corps, which resulted in projected costs
exceeding the funding provided for the operations account and,
most recently, a 12-week freeze on new student enrollment. An
OIG audit dated May 31, 2013, found that programmatic,
budgetary, and managerial problems as well as a lack of proper
program integrity controls contributed to the shortfalls in
program years 2011 and 2012. The Committee directs the
Secretary to provide a report no later than December 1, 2013,
on the progress of the Department's implementation of the OIG
recommendations, in addition to the new on-board strength
model's impact on projecting program costs.
The Committee understands that the Department is
undertaking a full review of the Job Corps Policy and
Requirements Handbook to improve and update program management
and identify potential areas for additional cost savings. The
Committee supports the Department's effort in this area and
encourages the Department to seek input from all stakeholders
in Job Corps. The Committee directs the Department to provide a
report no later than March 1, 2014, on the Department's
progress in reviewing and updating the handbook.
The Committee recommendation for administrative costs is
$30,147,000. This funding will support additional staff to
conduct financial oversight and monitoring of the Job Corps
program.
The Committee also recommends a total of $90,000,000 in
construction, renovation, and acquisition funds. This amount is
available from July 1, 2014, to June 30, 2017. The budget
request is $75,000,000. The Committee notes that an OIG audit
report dated December 7, 2012, found Job Corps did not address
maintenance deficiencies in a timely manner and did not
sufficiently track and monitor obligated funds. The Committee
directs the Secretary to provide a report no later than June
30, 2014, on the Department's progress in implementing the OIG
recommendations to ensure the health and safety of students,
staff, and visitors as well as making improvements to the
Funded-not-Corrected system, which center contractors use to
track and monitor repair deficiencies.
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 includes new bill language requiring the Secretary to
notify the House and Senate Committees on Appropriations at
least 15 days in advance of any transfer and expects the
notification to include a justification.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriations, 2013\1\................................. $447,355,000
Budget estimate, 2014................................... 380,000,000
Committee recommendation................................ 447,355,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
As in fiscal years 2012 and 2013, the budget request
includes a proposal to transfer the CSEOA 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, 2013\1\................................. $797,000,000
Budget estimate, 2014................................... 656,000,000
Committee recommendation................................ 656,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes mandatory funds for
the Federal unemployment benefits and allowances program that
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, 2013\1\................................. $4,018,879,000
Budget estimate, 2014................................... 3,825,699,000
Committee recommendation................................ 3,848,094,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $3,762,198,000
authorized to be drawn from the Employment Security
Administration account of the Unemployment Trust Fund and
$85,896,000 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 $2,967,818,000 for UI
activities. The budget request is $2,917,872,000. For UI State
operations, the Committee recommends $2,931,575,000. These
funds are available for obligation by States through December
31, 2014. The Committee includes new bill language, as proposed
by the administration, that allows the Department to make funds
used for automation acquisitions and for competitive grants
awarded to States for system improvements, reemployment and
eligibility assessments, improper payments and activities to
address misclassification of workers available for obligation
through December 31, 2014. The Committee includes bill language
allowing States to obligate funds for these activities through
September 30, 2016, as requested by the administration.
The Committee recommendation supports investments in UI
program integrity activities, including technology-based
programs that identify and reclaim overpayments. The Committee
requests a report no later than March 1, 2014, on the
Department's plan to address the detection and recovery of
improper payments, including desired outcomes and steps it will
take to help States improve their performance. The Committee
also expects the Secretary to submit a report by June 30, 2015,
providing the status of the outcomes identified in the March 1,
2014, plan.
As proposed in the budget request, the Committee includes
new bill language allowing States awarded grants for improved
operations or to carry out national activities of the Federal-
State UI system to award subgrants to other States. This
authority provides States more flexibility in improving
operations and national activities of the UI system.
The Committee recommendation includes $80,000,000 to
conduct in-person reemployment 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. This important program
integrity initiative has been shown to help claimants exit the
UI program faster and avoid exhausting UI benefits. The
Committee recommendation will fund an estimated 1,352,000
reemployment and eligibility assessments, saving State UI Trust
Funds an estimated $315,000,000 and expanding the initiative
from 42 to 45-50 States. 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 an amendment to the Balanced
Budget and Emergency Deficit Control Act of 1985 that would
provide a discretionary cap adjustment for $20,000,000 of the
proposed $80,000,000. 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 for an award program designed to
incentivize States to improve misclassification efforts, as
requested by the administration. States that are most
successful in addressing worker misclassification, which denies
the Federal and State UI Trust Funds hundreds of millions of
dollars a year, will be able to use these incentive funds to
upgrade their misclassification detection and enforcement
programs.
The Committee recommendation includes $3,000,000 for
continued support of the UI Integrity Center of Excellence. The
Center's mission is to develop, implement, and promote
innovative integrity strategies in the UI program, focusing on
the prevention and detection of fraud.
The Committee includes new bill language, as requested by
the administration, providing $25,000,000 to assist States in
carrying out UI demonstration projects as authorized by the
Middle Class Tax Relief and Job Creation Act of 2012. The
authorizing statute allows the Secretary to enter into
agreements with up to 10 States to conduct demonstration
projects that test and evaluate measures designed to expedite
reemployment of individuals receiving UI benefits.
The Committee recommendation provides for a contingency
reserve amount should the unemployment workload exceed an
average weekly insured claims volume of 3,357,000, as proposed
in the budget request.
For UI national activities, the Committee recommends
$11,243,000. These funds are directed to activities that
benefit the Federal-State UI system, 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 $730,797,000. This amount includes
$22,550,000 in general funds together with an authorization to
spend $708,247,000 from the Employment Security Administration
account of the Unemployment Trust Fund. The Committee includes
new bill language requiring that no less than $30,000,000 be
used to provide targeted reemployment services to UI
beneficiaries, as requested by the administration. Congress
last appropriated funding for reemployment services in ARRA. A
recent DOL report to Congress found that reemployment services
coupled with reemployment 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 $20,871,000 for Employment
Service national activities. The administration of the work
opportunity tax credit accounts for $18,485,000 of the
recommended amount; 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 $65,262,000. 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 $63,346,000. The Committee does not
include any funding for the administration's proposal to co-
brand and increase public awareness of the one-stop career
center system.
The Committee recommendation includes $8,976,000 for 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 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, 2013....................................................
Budget estimate, 2014................................... $5,000,000
Committee recommendation................................ 5,000,000
The Committee recommendation includes $5,000,000 to create
a new State Paid Leave Fund. Paid leave programs are financed
by employer and/or employee contributions and offer benefits to
workers who must take time off to care for an ill child,
spouse, or parent, or to bond with a newborn or recently
adopted child. Competitive grants will be awarded to States to
support pre-implementation planning, such as research and
analysis and financial modeling, as well as to support
implementation costs, including information technology,
outreach to eligible workers and employers, project management,
and the development of reporting and performance accountability
processes.
In determining eligibility for funding, the Committee
strongly urges the Secretary to include States that have passed
State paid leave laws but have yet to implement programs due to
funding constraints, as well as States that have yet to pass
paid leave laws but are in the planning phase.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
Appropriations, 2013....................................................
Budget estimate, 2014................................... $600,000,000
Committee recommendation................................ 600,000,000
The Committee recommends and the budget requests such sums
as are necessary in mandatory funds for this account. The
appropriation is available to provide advances to several
accounts for purposes authorized under various Federal and
State unemployment compensation laws and the Black Lung
Disability Trust Fund, whenever balances in such accounts prove
insufficient.
The Committee bill includes new language proposed in the
budget request to provide advances from this account to the
Employment Security Administration account of the Unemployment
Trust Fund. The language will ensure the Unemployment Trust
Fund has enough funding to provide loans to States to
administer the UI and Employment Service programs and Veterans
Employment and Training programs.
PROGRAM ADMINISTRATION
Appropriations, 2013\1\................................. $146,787,000
Budget estimate, 2014................................... 149,617,000
Committee recommendation................................ 151,602,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation of $151,602,000 for program
administration includes $100,994,000 in general funds and
$50,608,000 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, 2013\1\................................. $182,787,000
Budget estimate, 2014................................... 179,104,000
Committee recommendation................................ 176,472,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $176,472,000 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
$7,000,000,000,000 in assets covering approximately 140 million
participants and beneficiaries. EBSA oversees benefit security
for an estimated 700,000 private retirement plans, 2.3 million
health plans, and similar numbers of other welfare benefit
plans, such as those providing life or disability insurance.
The Committee directs the Department to work with HHS and
the Department of the Treasury to revise their joint FAQ
regarding section 2706 of the ACA, as explained in the HHS
title of this report.
Pension Benefit Guaranty Corporation
PBGC's estimated obligations for fiscal year 2014 include
single-employer benefit payments of $6,358,000,000, multi-
employer financial assistance of $115,000,000, and
administrative expenses of $505,441,000. Administrative
expenses are comprised of three activities: (1) pension
insurance activities, $80,000,000; (2) pension plan termination
expenses, $268,230,000; and (3) operational support,
$157,211,000. 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 through September
30, 2015, for every 20,000 participants in terminated plans. A
trigger also is included for additional investment management
fees for plan terminations or asset growth. The bill does not
revise this trigger to allow additional resources for
investment management fees incurred in carrying out the PBGC's
Board-approved investment policy, as proposed in the budget.
The Committee bill includes current law 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.
The Committee bill also continues authority allowing the
PBGC additional obligation authority for unforeseen and
extraordinary pre-termination expenses, after approval by OMB
and notification of the Committees on Appropriations of the
House of Representatives and the Senate.
The Committee is very concerned by the lack of progress in
selecting a participant and plan sponsor advocate, a position
required by Public Law 112-141, which was signed by President
Obama on July 6, 2012. Among other things, the advocate is
expected to act as a liaison between PBGC and participants in
terminated pension plans, ensure that participants receive
everything they are entitled to under law, and provide plan
sponsors with assistance in resolving disputes with PBGC. The
Committee expects the PBGC Board to move expeditiously in
selecting a candidate for this position, which should occur as
soon as possible but no later than 90 days after enactment of
this act. The Committee also believes that the advocate must be
a full-time position reporting directly to the PBGC Board given
the significant duties required.
PBGC's single-employer program protects about 33 million
workers and retirees in approximately 24,000 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, 2013\1\................................. $226,607,000
Budget estimate, 2014................................... 243,254,000
Committee recommendation................................ 243,254,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $243,254,000 for WHD.
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
[FMLA], and the Migrant and Seasonal Agricultural Worker
Protection Act are several of the important laws that WHD is
charged with administering and/or enforcing.
The Committee recommendation includes additional funds over
the fiscal year 2013 level to address the misclassification of
employees as independent contractors and to enforce the FMLA
and FLSA.
The Committee also supports the President's request to
provide additional resources for 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 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, 2013\1\................................. $41,206,000
Budget estimate, 2014................................... 46,891,000
Committee recommendation................................ 41,206,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $41,206,000 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, 2013\1\................................. $104,976,000
Budget estimate, 2014................................... 108,467,000
Committee recommendation................................ 106,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $106,000,000 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.
Almost 3 years ago, the Department issued an advance notice
of proposed rulemaking regarding regulations for implementing
section 503 of the Rehabilitation Act. The proposal would
strengthen affirmative action provisions for workers with
disabilities under section 503, and details specific actions
that a contractor must take to satisfy its obligations. The
Committee strongly supports the administration's plan to issue
a final rule during fiscal year 2013. The Committee encourages
the Department to make technical assistance regarding the rule
available to Federal contractors.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $117,604,000
Budget estimate, 2014................................... 120,600,000
Committee recommendation................................ 117,604,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $117,604,000 for OWCP. The bill
provides authority to expend $2,116,000 from the special fund
established by the Longshore and Harbor Workers' Compensation
Act.
OWCP administers four distinct compensation programs: the
Federal Employees' Compensation Act [FECA], 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, 2013.................................... $350,000,000
Budget estimate, 2014................................... 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 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
reemployed 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 bill
includes slightly revised language that allows fair share
collections to be used to pay for capital investment projects
and specific initiatives to strengthen compensation fund
control and oversight.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriations, 2013\1\................................. $182,227,000
Budget estimate, 2014................................... 133,235,000
Committee recommendation................................ 133,235,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends a mandatory appropriation of
$98,235,000 in fiscal year 2014 for special benefits for
disabled coal miners. This is in addition to the $35,000,000
appropriated last year as an advance for the first quarter of
fiscal year 2014, for a total program level of $133,235,000 in
fiscal year 2014. The decrease in this account below the fiscal
year 2013 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
$24,000,000 for the first quarter of fiscal year 2015. 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, 2013\1\................................. $52,147,000
Budget estimate, 2014................................... 55,176,000
Committee recommendation................................ 55,176,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $55,176,000 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 2014, the volume of incoming claims under
part B of EEOICPA is estimated at about 6,500 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 5,900 new claims will be
received during fiscal year 2014. 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, 2013\1\................................. $301,006,000
Budget estimate, 2014................................... 316,559,000
Committee recommendation................................ 316,559,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee bill provides an estimated $316,559,000 for
this mandatory appropriations account. This estimate is
comprised of $59,081,000 for administrative expenses and an
estimated $257,478,000 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 Department agencies: up to $33,033,000 for the
part C costs of the Division of Coal Mine Workers' Compensation
Programs; up to $25,365,000 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, 2013\1\................................. $563,658,000
Budget estimate, 2014................................... 570,519,000
Committee recommendation................................ 567,012,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $567,012,000 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 is extremely disappointed by the Department's
continued delays in issuing a rule for occupational exposure to
silica. The silica rulemaking process is almost a decade old.
The administration's most recent regulatory agenda stated that
a notice of proposed rulemaking would be issued in May 2013--
another in a series of deadlines that the Department has failed
to meet. The Committee directs the Department to issue a notice
of proposed rulemaking on silica not later than 30 days after
enactment of this act. The Committee also supports rulemaking
for the Injury and Prevention Program and the timetable for
actions outlined in the Department's January 8, 2013,
regulatory agenda.
The Committee recommends $103,987,000 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 $10,709,000 for the OSHA Susan Harwood
Training Grant Program.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $372,547,000
Budget estimate, 2014................................... 380,721,000
Committee recommendation................................ 380,721,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $380,721,000 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 these
activities. Bill language also allows MSHA to establish,
collect, and retain fees for services related to the analysis
of rock dust samples.
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 to support inspections
or investigations. 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
priorities include: effective implementation of corrective
actions related to the Upper Big Branch internal review;
adequate support for MSHA's instructional capacity for training
of mine safety and health inspectors and other mine safety
professionals; and sufficient support for MSHA's Accountability
Program.
Finally, the bill includes new language intended to support
the relocation of MSHA's headquarters by authorizing the
transfer of necessary funds to the Office of the Solicitor.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $607,852,000
Budget estimate, 2014................................... 613,794,000
Committee recommendation................................ 609,852,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $609,852,000 for BLS. This amount
includes $67,041,000 from the Employment Security
Administration account of the Unemployment Trust Fund and
$542,811,000 in Federal funds.
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 BLS,
ETA, the State labor market information agencies, and the
system's relationship with the Census Bureau, 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 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.
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, 2013\1\................................. $38,802,000
Budget estimate, 2014................................... 42,432,000
Committee recommendation................................ 42,432,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $42,432,000 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 component 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 the hiring of persons with disabilities.
The Committee recommendation includes $9,000,000 for ODEP,
in collaboration with 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 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, 2013\1\................................. $345,661,000
Budget estimate, 2014................................... 347,956,000
Committee recommendation................................ 346,685,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $346,685,000 for the
Departmental Management account. Of this amount, $346,359,000
is available from general funds and $326,000 is available by
transfer from the Employment Security account of the
Unemployment Trust Fund. In addition, $25,365,000 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 continues its support of the Department's
efforts to reduce the backlog of mine safety cases before the
Federal Mine Safety and Health Review Commission [FMSHRC] and
to assure that the timely processing of cases occurs in the
future.
The Committee directs the Secretary, in conjunction with
FMSHRC, to provide a joint report to the Committees on
Appropriations of the House of Representatives and Senate for
reducing the number of pending cases and average case
processing time to appropriate levels by the end of fiscal year
2015. The report should fully explain how such levels were
determined. It also should establish goals and metrics for
determining when the levels will be achieved and how they will
be maintained in the future.
The Committee recommendation includes $95,425,000 for the
Bureau of International Labor Affairs [ILAB], of which
$66,375,000 is available for obligation through December 31,
2014. ILAB's appropriation is available to help improve working
conditions and labor standards for workers around the world and
carry out ILAB's statutory mandates and international
responsibilities. Funding for international programming to
eliminate the worst forms of child labor should prioritize
comprehensive and sustainable initiatives that address the root
causes of the problem, including lack of education and
vocational training opportunities; household poverty; lack of
data and awareness of the scope and impact of the worst forms
of child labor; gaps in social protection services; and weak
enforcement of labor laws, which increase the vulnerability of
households to the worst forms of child labor.
The Committee expects ILAB to maintain its current effort
on programs to combat exploitative child labor. The Committee
also expects that the integrated child labor and worker rights
projects proposed in the budget request will have a significant
and direct child labor component. The bill requires ILAB to
spend not more than $59,887,000 for programs to combat
exploitative child labor internationally and not less than
$6,488,000 to implement model worker rights programs in
countries with which the United States has trade preference
programs or free trade agreements. The bill also continues
language from last year's act regarding the authority to fund
microfinance activities.
Additionally, the Committee commends the Department for
annually completing the country assessments on commitments to
eliminate the worst forms of child labor, consistent with the
requirements of 19 U.S.C. 2464.
The Committee recommendation provides $8,467,000 for
program evaluation and allows these funds to be available for
obligation through September 30, 2015. 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 $11,536,000 for the
Women's Bureau. These funds will enable the Bureau to undertake
critical work in addressing the pay gap. The Committee
continues bill language allowing the Bureau to award grants.
The Committee is very supportive of Executive Order 13548
and the Department's goal to raise the representation of
individuals with disabilities in its workforce from 7.24
percent in fiscal year 2010 to 11.3 percent by fiscal year
2016. However, fiscal year 2011 results suggest the Department
is not on pace to meet its goals. The Committee encourages the
Department to accelerate its efforts in this area.
VETERANS EMPLOYMENT AND TRAINING
Appropriations, 2013\1\................................. $263,907,000
Budget estimate, 2014................................... 300,518,000
Committee recommendation................................ 300,518,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation of $300,518,000 for VETS
includes $38,185,000 in general revenue funding and
$262,333,000 to be expended from the Employment Security
Administration account of the Unemployment Trust Fund. The
Committee recommendation supports a significant expansion of
services to veterans, transitioning servicemembers, and family
members.
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 recommendation includes new bill language, as
proposed in the budget request, specifying funding levels for
particular activities, as opposed to providing a lump sum
appropriation. The new bill language also allows the Secretary
to reallocate funds among activities in an amount not to exceed
3 percent of the funding from which any reallocation is made.
The Committee provides $203,081,000 for the Jobs for
Veterans State Grants [JSVG] program. This funding level will
enable the Department to increase the level of intensive
services provided to veterans by Disabled Veterans' Outreach
Program [DVOP] specialists as well as to reach new populations
of servicemembers and their families in need of employment
services. As proposed by the administration, the Committee
includes new bill language specifying that JSVG funds may be
used to provide DVOP and Local Veterans' Employment
Representatives [LVER] services to transitioning servicemembers
early in their separation from military service; wounded
warriors recuperating in military treatment facilities or
transition units; and, spouses and family caregivers to help
ensure the family has income to provide sufficient support.
The Committee provides $14,000,000 for the Transition
Assistance Program [TAP]. This funding will support an
estimated 5,444 employment workshops at military installations
and in virtual classrooms worldwide for exiting servicemembers
and spouses. The VOW to Hire Heroes Act of 2011 requires TAP
services for most transitioning servicemembers.
The Committee recommendation includes $41,838,000 for
Federal administration costs. This funding level will support
outreach to major private-sector companies to generate interest
in hiring veterans and improve oversight and strengthen
protection of veterans' employment rights, among other
activities.
The Committee recommends $38,185,000 for the Homeless
Veterans' Reintegration Program [HVRP] to help homeless
veterans attain the skills they need to gain meaningful
employment. HVRP is the only Federal program that focuses
exclusively on the employment of veterans who are homeless.
The Committee recommendation includes $3,414,000 for the
National Veterans' Training Service Institute [NTVI], which
provides training to Federal staff and veteran service
providers. At this recommended level, NTVI will be able to
train an estimated 2,210 veteran service providers and meet the
new training requirements of the Veterans' Benefits Act of
2010.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriations, 2013\1\................................. $19,775,000
Budget estimate, 2014................................... 20,587,000
Committee recommendation................................ 19,775,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $19,775,000 for the IT
Modernization account. Funds available in this account are used
for two primary activities. The first is departmental support
systems, for which $4,898,000 is provided. These funds help
align IT investments with the Department's strategic
objectives. The second budget activity, for which $14,877,000
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, 2013\1\................................. $83,520,000
Budget estimate, 2014................................... 85,714,000
Committee recommendation................................ 83,520,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $83,520,000 for the DOL OIG. The
bill includes $77,634,000 in general funds and authority to
transfer $5,886,000 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.
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
Section 101. The bill continues a provision limiting 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 102. The bill continues a provision providing for
general transfer authority.
Section 103. The bill continues a provision prohibiting
funding for the procurement of goods and services utilizing
forced or indentured child labor in industries and host
countries already identified by the Department in accordance
with Executive Order 13126.
Section 104. The bill continues a provision requiring 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 105. The bill continues a provision limiting 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 106. The bill continues a provision prohibiting the
Secretary from taking any action to alter the procedure for
redesignating local areas under subtitle B of title I of WIA.
Section 107. The bill modifies a provision providing 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. The provision does not apply to
section 173A(f)(2) of the WIA.
Section 108. The bill modifies a provision allowing up to
0.5 percent of discretionary appropriations provided in this
act for all Department 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 109. The bill includes a new provision allowing 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 and to allow grantees to award subgrants.
Section 110. The bill includes a new provision transferring
the claims function under several Federal statutes currently
performed by GAO to DOL.
Section 111. The bill includes a new provision adjusting
the salary cap for the Administrator of the Wage and Hour
Division from Executive Level V to Executive Level IV.
Section 112. The bill includes a new provision that
provides flexibility with respect to the crossing of H-2B
nonimmigrants working in the seafood industry and clarifies the
Department's regulatory authority with respect to the H-2B visa
program.
Section 113. The bill includes a new provision related to
the H-2A program.
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 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 percent
because of the effect on PHS Act agencies that are used as a
source of evaluation transfers, most notably NIH. The Committee
also believes that raising the tap would reduce the
transparency of its recommended funding levels.
For programs that are the source of the transfers, an
increase in the evaluation tap would effectively cut their
funding. With regard to NIH, the administration presents its
request as an increase of approximately $471,000,000 over the
fiscal year 2012 level; the effective increase for NIH, after
factoring in the proposed tap increase, would actually be
approximately $147,000,000 less. There are many other examples
where the budget request touts significant increases for
particular programs without noting that its tap proposal would
undercut a portion of those increases. For these reasons, the
Committee maintains the evaluation transfer amount at 2.5
percent, the same level as in fiscal year 2013.
This is the fourth year that the administration has
proposed an increase in the section 241 tap percentage. The
Committee strongly discourages a similar increase in the fiscal
year 2015 request.
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
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 maternal and child
health, AIDS care, healthcare provider training, and healthcare
delivery systems and facilities.
BUREAU OF PRIMARY HEALTH CARE
Appropriations, 2013\1\................................. $1,574,646,000
Budget estimate, 2014................................... 1,566,932,000
Committee recommendation................................ 1,574,646,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation for the activities of the
Bureau of Primary Health Care is $1,574,646,000.
Community Health Centers
The Committee provides $1,574,606,000 in this bill for the
Community Health Centers program. Combined with the
$2,200,000,000 in mandatory funding appropriated for fiscal
year 2014 in the ACA, the Committee's recommended program level
totals $3,774,606,000.
Programs supported by this funding include 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 Committee includes bill language, modified from last
year, requiring the administration to award all fiscal year
2014 funds by September 30, 2014. Such awards shall include
$142,000,000 in base grant adjustments and not less than
$700,000,000 in new access point awards and expanded service
awards. These levels assume that funds made available for
outreach and enrollment in health exchanges in fiscal year 2013
will be awarded as base grant adjustments in fiscal year 2014.
In addition, 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.
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 2013
level be provided for these activities in fiscal year 2014.
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.
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.
BUREAU OF HEALTH PROFESSIONS
Appropriations, 2013\1\................................. $731,548,000
Budget estimate, 2014................................... 540,804,000
Committee recommendation................................ 773,190,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation for the activities of the
Bureau of Health Professions is $773,190,000. In addition, the
Committee recommends transferring $30,300,000 to the Bureau
from the PPH Fund.
The total program level assumed in this bill for the Bureau
is $803,490,000.
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.
The Committee notes that section 223 of this act modifies
the rules governing National Health Service Corps contracts,
which are administered in the Bureau of Health Professions. The
authorization for this program allows contract cancellations up
to 45 days prior to the end of the current fiscal year, which
was intended to give HHS time to redirect those funds to new
contracts before the available funding expired. NHSC now makes
contracts on a rolling basis throughout the year with funds
that do not expire. Under the rolling award system, Corps
members who sign contracts in January have 7 months to cancel,
while Corps members who sign up in September are not given the
opportunity to cancel. Section 223 will allow every Corps
member 60 days to cancel their contract.
Training for Diversity
Centers of Excellence
The Committee provides $22,863,000 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.
The Committee continues to support the Centers of
Excellence program and the financial stability it has provided
for the schools that participate. However, the Committee is
concerned by reports that recent award amounts were based in
large part on the amount of funding requested by each school,
resulting in large, unexpected cuts for some of the schools and
large increases for others. The Committee directs HRSA to
institute an award review process that focuses more fully on
the merits of the requested activities. The Committee expects
HRSA to report back to the Committees on Appropriations of the
House of Representatives and the Senate on the implementation
of this process in the fiscal year 2015 budget justification.
Health Careers Opportunity Program
The Committee provides $14,942,000 for the Health Careers
Opportunity Program [HCOP]. 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.
HCOP supports activities for disadvantaged students through
formal academic and research training and student enhancement
services.
The Committee encourages HRSA to refocus the program on
reaching undergraduate and post-baccalaureate students.
Faculty Loan Repayment
The Committee provides $1,253,000 for the Faculty Loan
Repayment program. 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 $47,357,000 for the Scholarships for
Disadvantaged Students program. 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 $50,962,000 for Primary Care
Training and Enhancement programs, which support 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 increase funding for this activity.
Pediatric Loan Repayment
The Committee recommends $5,000,000 to create a new loan
repayment program for pediatric specialties, as authorized in
section 775 of the PHS Act.
The Committee is concerned that shortages of child mental
health providers and pediatric subspecialists are more severe
than the shortages that exist for general pediatricians.
Available fellowship positions are left unfilled because of the
burden of student loans for specialty training. The Committee
recommendation in this bill will fund 64 initial 2-year loan
repayment awards for eligible providers working in underserved
areas. The Committee urges HRSA to prioritize pediatric
specialties aimed at mental and behavioral health services in
implementing this program.
Training in Oral Health Care
The Committee recommends $32,654,000 for Training in Oral
Health Care programs. Funds may be used to expand training in
general dentistry, pediatric dentistry, public health
dentistry, dental hygiene, and other oral health access
programs. Funds may also be used to plan and operate training
programs, as well as to provide financial assistance to
students and residents.
The Committee recommendation includes not less than
$8,000,000 each for general and pediatric dentistry. The
Committee encourages HRSA to focus on training programs that
target vulnerable populations in risk-based clinical disease
management of all populations.
The Committee urges HRSA to work with CMS on the evaluation
of additional models for expanding access to oral healthcare.
Such models should include emergency room diversion programs
and efforts under State law to deploy and evaluate new provider
types.
Interdisciplinary, Community-Based Linkages
Area Health Education Centers
The Committee provides $30,025,000 for AHECs, which 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 is pleased by HRSA's collaboration with
SAMHSA to develop and replicate community health worker
programs that integrate primary care and behavioral health.
HRSA should include in the fiscal year 2015 budget
justification a report on progress made in this initiative.
Geriatric Education
The Committee provides $30,629,000 for Geriatric Education
programs. 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 reiterates its support for geriatric
education and the effort to ensure that the wider primary care
provider community has the skills and training to provide high-
quality and coordinated care to older adults. The Committee
looks forward to receiving the report HRSA is compiling to
detail the ways in which geriatric training content is being
integrated into primary care training in HRSA-supported
institutions.
In addition, the Committee recommendation transfers
$5,300,000 from the PPH Fund to train health professionals on
issues related to Alzheimer's disease. These funds are awarded
to Geriatric Education Centers for outreach and education
efforts to enhance healthcare providers' knowledge of the
disease, improve detection and early intervention, and improve
care for people with Alzheimer's disease and their caregivers.
Mental and Behavioral Health
The Committee provides $3,916,000 for Mental and Behavioral
Health programs. 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.--The Committee supports the
Secretary's initiative to increase the number of psychologists
pursuing clinical work with high-need and high-demand
populations. These populations are defined as rural,
vulnerable, and/or underserved populations, as well as
veterans, military personnel, and their families. While the
Committee commends the emphasis on programs targeting veteran
and military personnel population centers, the Committee is
concerned that many servicemembers reintegrate into civilian
life in communities that are rural and far from military and
veteran facilities. As such, the Committee encourages HRSA to
maintain a strong commitment to underserved areas generally.
Social Work Training Program.--The Committee recognizes the
importance of social workers and their contribution to family
planning and maternal and child health outcomes, particularly
in low-income communities. The Committee intends the increase
in this program to be used to continue and expand the
Leadership Training in Social Work program, formerly funded in
the Maternal Child Health Bureau of HRSA. This program annually
funds three centers of excellence at schools of social work to
help develop the next generation of social workers and provide
critical leadership, resources, and training. The Leadership
Training in Social Work program has successfully recruited many
qualified minority candidates for long-term training, and
graduates have taken faculty positions in schools of social
work, pursued careers in policy and research, and become local
leaders in direct service. The Committee directs the Bureau of
Health Professions to work with the Maternal Child Health
Bureau to ensure a smooth transition for grantees.
Health Professions Workforce Information and Analysis
The Committee recommends $5,000,000 for health professions
workforce information and analysis. 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 Workforce Development
The Committee provides $35,177,000 for Public Health
Workforce Development, including $10,177,000 in budget
authority and $25,000,000 in transfers from the PPH Fund.
This program line, also called Public Health and Preventive
Medicine, funds programs that are authorized in titles III and
VII of the PHS Act and support awards to schools of medicine,
osteopathic medicine, public health, and integrative medicine
programs. Funds are used to expand and improve residency
training programs, and provide financial assistance to trainees
enrolled in such programs.
The Committee recommendation includes $3,813,000 for
preventive medicine residencies.
Integrative Medicine.--The Committee includes $3,502,000
for existing programs related to integrative medicine and
$2,000,000 for a new competitive opportunity to improve
residency programs in integrative medicine. The Committee
intends the new funding to be used to award a national center
of excellence on integrative primary care for the purpose of
developing and disseminating best practices for integrative
medicine training for physicians and nurses. HRSA should select
a nonprofit entity with a strong record of leadership in the
field of integrative medicine curriculum development, with
experience in both publishing and working with residency
programs.
Nursing Workforce Development Programs
The Committee provides $251,099,000 for Nursing Workforce
Development programs. The Committee recommendation is
sufficient to fund all nursing programs at the level requested
in the budget, which provides an increase of $19,672,000 for
Advanced Education Nursing.
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 remains concerned that waiting lists for
admission to nursing school are limiting our Nation's ability
to address the nursing shortage. For that reason, the Committee
continues to place a strong priority on filling vacant nursing
faculty positions, the majority of which require either a Ph.D.
or a doctorate of nursing practice. The Committee encourages
the Division of Nursing to prioritize this level of training
and create incentives for students to pursue teaching as a
career.
Children's Hospitals Graduate Medical Education
The Committee provides $267,313,000 for the CHGME program.
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.
National Practitioner Data Bank
The Committee provides $28,016,000 for the National
Practitioner Data Bank. 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, 2013\1\................................. $860,252,000
Budget estimate, 2014................................... 824,861,000
Committee recommendation................................ 858,600,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation for the MCH Bureau is
$858,600,000. The President's request includes an additional
$28,494,000 in transfers from the PPH Fund; the Committee
recommendation for this account does not include any such
transfers.
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 $643,807,000 for the MCH Block
Grant, which 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 $554,890,000. The fiscal year 2013 level is $554,171,000.
The budget request is $549,729,000.
The Committee also includes bill language identifying
$78,641,000 for the Title V SPRANS set-aside. Within that
total, the Committee recommendation includes sufficient funding
to fully fund the set-asides for oral health, epilepsy, sickle
cell anemia, and fetal alcohol syndrome at the level requested
in the budget.
Hemophilia.--The Committee commends HRSA on its work to
establish models of hemophilia care in a culturally sensitive,
family-centered coordinated manner. The National Hemophilia
Program is a model system for caring for high-cost, chronic
conditions. The Committee encourages HRSA to share best
practices with CMS, particularly those regarding transitioning
care from adolescence to adulthood.
Oral Health.--The Committee recognizes the key role that
Maternal and Child Health Centers in Pediatric Dentistry
provide in preparing dentists with dual training in pediatric
dentistry and dental public health, fostering academic
leadership, and developing expertise in the treatment of
children with special healthcare needs. The Committee
encourages HRSA to provide incentives for these centers to
leverage resources to strengthen and expand their activities.
Perinatal Hepatitis B.--The Committee is pleased at the
progress that has been made in reducing perinatal hepatitis B
transmission and commends HRSA for the ongoing review of best
practices. The Committee notes that the 2010 rate of
transmission was the lowest on record and well below the
Healthy People 2010 goal. However, given the availability of an
effective post-exposure prophylaxis protocol, the Committee
believes that the elimination of all perinatal transmission is
a goal worth pursuing. In view of the large number of at-risk
women being seen in HRSA-funded settings, the Committee urges
HRSA to move expeditiously to integrate the best practices
identified in the review into routine practice. In addition,
HRSA is encouraged to validate further best practices to
prevent perinatal hepatitis B transmission, particularly in
high-risk ethnic communities disproportionately impacted by
chronic hepatitis B.
Social Work Training Program.--The Committee recognizes the
importance of social workers and their contribution to family
planning and maternal and child health outcomes, particularly
in low-income communities. The Committee has included funding
in the Bureau of Health Professions to continue and expand the
Leadership Training Program in Social Work, which annually
funds three centers of excellence at schools of social work to
help develop the next generation of social workers and to
provide critical leadership, resources, and training. The
Committee directs the MCH Bureau to work with the Bureau of
Health Professions to ensure a smooth transition for the
program's grantees.
Sickle Cell Anemia
The Committee provides $4,770,000 for 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.
Traumatic Brain Injury
The Committee provides $9,760,000 for the Traumatic Brain
Injury program. 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 2013
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. 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 2013 levels.
Leadership Education in Neurodevelopmental and Related
Disabilities [LEND].--The Committee directs that HRSA provide
no less than the fiscal year 2013 level for LEND programs to
maintain their capacity to train professionals to diagnose,
treat, and provide interventions to individuals with autism
spectrum disorders.
Newborn Screening for Heritable Disorders
The Committee provides $9,913,000 in budget authority for
the Newborn Heritable Disorders Screening program, as described
in section 1109 of the Newborn Screening Saves Lives Act of
2008. The budget request is funded entirely through transfers
from the PPH Fund.
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.
Healthy Start
The Committee provides $103,532,000 for the Healthy Start
infant mortality initiative. The primary purpose of Healthy
Start is to reduce infant mortality 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.
Public-Private Partnerships.--The Committee commends
Healthy Start for engaging in public-private partnerships that
identify best practices and lead to continuous quality
improvement within the program. The Committee encourages HRSA
to continue to evaluate rigorously the Healthy Start program
and these partnerships.
Stillbirth and Sudden Unexpected Infant Deaths [SUIDs].--
The Committee notes that racial disparities in stillbirth and
SUIDs persist and significantly contribute to the more than
25,000 stillbirths and over 4,000 SUIDs each year. HRSA is
encouraged to support training and assistance that will enhance
cooperative partnerships among local community health
professionals, public health officers, community advocates, and
consumers to address racial disparities in SUIDs and
stillbirth. In addition, the Committee continues to support
HRSA's efforts to review cases of stillbirth and SUIDs at a
local level, especially to identify better ways to address
racial disparities.
Universal Newborn Hearing Screening and Early Intervention
The Committee provides $18,660,000 for universal newborn
hearing screening and early intervention activities. 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 which focuses on
improving the pediatric components of the emergency medical
services system and improving the quality of care provided to
children in the pre-hospital setting. Funding is available to
every State emergency medical services office to improve the
quality of emergency care for children and to pay for research
and dissemination of best practices.
The Committee commends HRSA for initiating a demonstration
project in fiscal year 2012 to support innovative models to
increase pediatric care in rural and tribal communities. The
Committee also applauds the EMSC program for its collaboration
with other Federal agencies in order to achieve EMS systemwide
improvements. Finally, the Committee remains strongly
supportive of the Pediatric Emergency Care Applied Research
Network.
HIV/AIDS BUREAU
Appropriations, 2013\1\................................. $2,342,623,000
Budget estimate, 2014................................... 2,412,178,000
Committee recommendation................................ 2,393,951,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $2,393,951,000 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. 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, and nutritional services.
HIV Testing, Linkage, and Adherence.--The Committee is
aware that, despite the demonstrated success of treatment-as-
prevention programs, less than half of all Americans with HIV
are on antiretroviral treatment. The Committee believes that
the key steps to ending the HIV/AIDS epidemic include finding
those people who are unaware of their HIV-positive status,
linking all Americans with HIV/AIDS to care and treatment, and
retaining them in that care and treatment. The Committee urges
HRSA within its Ryan White SPRANS portfolio to focus on the
development of systemic approaches aimed at ensuring viral load
suppression.
Emergency Assistance
The Committee provides $669,915,000 for emergency
assistance grants to eligible metropolitan areas
disproportionately affected by the HIV/AIDS epidemic.
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.
The Committee notes that the provision requiring HRSA to
transfer funds from part A to part B of the Ryan White Care Act
as a result of the four transitional grant areas that changed
status in fiscal year 2011 has expired. Therefore, the
Committee expects HRSA to transfer no funds in fiscal year 2014
related to transitional grant areas.
Comprehensive Care Programs
The Committee provides $1,369,327,000 for HIV healthcare
and support services.
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 $943,299,000
for AIDS medications in ADAP. This funding level is sufficient
to continue the activities funded through HHS transfers in the
previous 2 fiscal years and provide an increase of $11,797,000.
The Committee intends that the increase provided for ADAP be
awarded according to the statutory formula.
Early Intervention Services
The Committee provides $204,765,000 for early intervention
grants. These 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 $77,013,000 for grants for
coordinated services to women, infants, children, and youth.
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 $13,458,000 for the AIDS Dental
Services program. 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 $34,473,000 for AIDS Education and
Training Centers [AETCs]. 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, 2013\1\................................. $101,299,000
Budget estimate, 2014................................... 83,836,000
Committee recommendation................................ 103,515,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation for the Health Care Systems
Bureau is $103,515,000.
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 $26,015,000 for organ donation and
transplantation activities. 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.
National Cord Blood Inventory
The Committee provides $11,864,000 for the National Cord
Blood Inventory. 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 $23,283,000 for the C.W. Bill Young
Cell Transplantation Program.
The Committee continues to strongly support cell
transplantation through the use of cord blood, bone marrow,
peripheral blood stem cells, and other sources of 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 $4,463,000 for the Office of
Pharmacy Affairs [OPA]. OPA 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 OPA's plans to
develop a transparent system to verify the accuracy of the 340B
ceiling price. Therefore, the Committee again 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 the ACA. The fee will be set at 0.1
percent for covered entities and is expected to generate
$6,000,000 in fiscal year 2014. The Committee expects HRSA to
report the expected and actual amounts generated by the fee in
HRSA's annual budget justification.
More than simply an individual discount program, the 340B
program was designed to help safety net providers maintain,
improve, and expand patient access to healthcare services
generally. In establishing the program in 1992, Congress
explicitly stated that the 340B program was intended to
``enable entities to stretch scarce Federal resources as far as
possible.'' As OPA continues to improve and enhance oversight
of the 340B program, the Committee urges OPA to implement
policies that maximize the healthcare safety net and expand
patient access to healthcare.
The Committee continues to note that there is currently no
way for eligible entities to know if they are paying
manufacturers the correct prices for 340B drugs. The ACA
requires HRSA to make 340B ceiling prices available to covered
entities through a secure Web site. Given that the new cost
recovery fee is being paid by 340B participating entities, the
Committee directs HRSA to make this Web site the first activity
funded by the fee.
The Committee commends HRSA for delaying the enforcement of
the group purchasing exclusion guidance promulgated on February
7, 2013, but remains concerned by HRSA's broad interpretation
of the term ``covered outpatient drug.'' The Committee urges
HRSA to create an understanding of the term that is more
specific to the 340B program. This would allow 340B-
participating entities to use other available purchasing
methods to obtain access to non-340B drugs at a lower cost.
Poison Control Centers
The Committee provides $19,793,000 for poison control
activities. 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.
Poison control centers respond to nearly 4 million public
and healthcare professional poisoning, toxic exposure, and
adverse drug event emergency calls annually. It is estimated
that the avoidance of these unnecessary hospitalizations save
more than $1,200,000,000 in healthcare costs annually, of which
nearly $700,000,000 of these savings accrue to the benefit of
the Federal Medicare and Medicaid programs. The Committee
believes these savings can be substantially increased through
enhanced awareness of poison control centers by all Medicare
and Medicaid participants. The Committee encourages the
Secretary to engage in discussions with the Nation's poison
control centers to develop a plan to achieve these possible
additional Medicare and Medicaid cost savings.
National Hansen's Disease Program
The Committee includes $16,013,000 for the National
Hansen's Disease program. 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 $128,000 for the repair and
maintenance of buildings at the Gillis W. Long Hansen's Disease
Center.
Payment to Hawaii for Hansen's Disease Treatment
The Committee provides $1,956,000 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.
RURAL HEALTH
Appropriations, 2013\1\................................. $139,288,000
Budget estimate, 2014................................... 122,232,000
Committee recommendation................................ 141,798,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation for Rural Health programs is
$141,798,000.
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.
The Committee commends ORHP for its increased collaboration
with the Department of Veterans Affairs and other agencies of
the Federal Government. ORHP has significant experience in the
areas of information technology, workforce recruitment and
retention, and improved access to care. The Committee urges
ORHP to continue providing its expertise across the government
in ways that improve healthcare delivery in rural areas. The
Committee directs the Administrator to report to Congress in
the fiscal year 2015 budget justification on ORHP's efforts in
this area.
Rural Health Outreach
The Committee provides $55,442,000 for the Rural Health
Outreach program.
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 sufficient funding to
continue the five key program areas identified in the
President's budget: outreach services grants, rural network
development grants, network planning grants, small healthcare
provider quality improvement grants, and the Delta States
network grant program.
The Committee commends HRSA on its work to develop a
generalizable formula to allow rural communities to measure the
economic impact of their health investment. The Committee is
gratified to learn that $1.50 is generated in the community for
every $1 invested by HRSA in rural health outreach.
Frontier Extended Stay Clinics.--The Committee is aware
that the Frontier Extended Stay Clinic demonstration concluded
in April 2013. The Committee urges HRSA to assist clinics in
maintaining their infrastructure while they wait for CMS'
evaluation of data from the demonstration.
Native American Graduate Education.--The Committee is aware
of significant needs in rural areas of the country for health
professionals and in particular those areas that have
significant populations of Native Americans. The Committee
encourages HRSA to work with institutions in these areas to
help them identify appropriate graduate health professions
training programs for the need.
Oral Health.--The Committee remains concerned about the
unnecessary use of hospital emergency rooms [ERs] for relief
but not resolution of oral health maladies. The 2012 report ``A
Costly Dental Destination'' estimates that 830,590 emergency
room visits were made across the country in 2009 because of
preventable dental problems. The Committee is aware of several
successful community-wide programs that have effectively
reduced ER visits for oral health patients. The Committee urges
HRSA to compile best practices related to reductions in
emergency dental care and disseminate that information to small
and rural hospitals. In addition, HRSA is encouraged to work
with CMS and AHRQ to identify gaps in knowledge related to
these prevention initiatives.
Rural Health Research
The Committee provides $9,847,000 for the Rural Health
Research program. 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 $40,958,000 for Rural Hospital
Flexibility grants and the Small Hospital Improvement Program.
Under these grant programs, 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 recommendation rejects the proposed
elimination of the Small Hospital Improvement Program.
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 modifies previous
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 the Rural Access to
Emergency Devices 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.
The Committee intends this appropriation to fund the rural
program authorized in section 413 of the PHS Act and the
community access demonstration authorized in section 313.
Funding will be used to buy automated external defibrillators,
put 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 $10,016,000 for State Offices of
Rural Health. 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 $7,125,000 for the Black Lung
Clinics program. 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 $1,931,000 for activities authorized
by the Radiation Exposure Compensation Act. 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 $11,479,000 for the Office for the
Advancement of Telehealth [OAT], which 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.
The Committee commends OAT for expanding adult mental
health services to 204 communities and pediatric/adolescent
mental health services to 239 communities where access to such
services did not exist prior to receiving Federal telehealth
funding. The Committee remains strongly supportive of the
emphasis OAT has placed on expanding access to mental health
services.
FAMILY PLANNING
Appropriations, 2013\1\................................. $296,244,000
Budget estimate, 2014................................... 327,402,000
Committee recommendation................................ 327,402,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee provides $327,402,000 for the Title X Family
Planning program. This 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.
The Committee recognizes the ongoing need to support
publicly funded family planning services and supplies during
and after implementation of the ACA. Although health reform
will result in the expansion of insurance coverage, patients
seeking family planning and reproductive health services often
have privacy concerns that inhibit the full use of coverage.
Many of these patients will turn to safety-net settings, such
as title X-funded health centers, for care. Public funding for
family planning remains a cost-effective means of providing
essential health services and will be important to Federal and
State efforts to implement the ACA.
Infrastructure.--As essential community providers, title X
clinics provide primary and preventive care services, including
cancer screenings and family planning services, to nearly 5
million women and men each year. The Committee supports the use
of title X program funds for infrastructure investments,
including for health information technology, to ensure women's
health providers can keep pace with the increased demand for
reproductive health services.
Tiered Subgranting.--The Committee is aware that some
traditional grantees of the title X program are implementing
newly tiered approaches which base subgranting decisions on
criteria that are unrelated to the performance outcomes of the
program. The Committee directs HRSA to give funding preference
to applicants with plans that show that a wide range of
providers are eligible for subgrants and that funding decisions
will be made solely on the ability of a clinic to achieve the
best possible outcomes for the population served.
PROGRAM MANAGEMENT
Appropriations, 2013\1\................................. $161,186,000
Budget estimate, 2014................................... 161,794,000
Committee recommendation................................ 161,794,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee provides $161,794,000 for program management
activities.
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM
Appropriations, 2013\1\................................. $2,830,000
Budget estimate, 2014................................... 2,807,000
Committee recommendation................................ 2,807,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $2,807,000 for the Health
Education Assistance Loan [HEAL] program.
The Committee bill 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, 2013\1\................................. $241,464,000
Budget estimate, 2014................................... 241,477,000
Committee recommendation................................ 241,464,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee provides that $241,464,000 be released from
the Vaccine Injury Compensation Trust Fund in fiscal year 2014.
Of that amount, $6,464,000 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 $6,183,769,000 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 $839,000,000 in transfers from the PPH Fund.
The total program level recommended for CDC is
$7,022,769,000.
The fiscal year 2013 program level is $6,547,169,000 and
the budget request is $6,644,640,000. The budget request
includes $617,664,000 in transfers under section 241 of the PHS
Act and $755,110,000 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 improving and maintaining
health. The Committee has deleted references to title VII of
the PHS Act throughout CDC's appropriation, as requested by the
President's budget, in recognition of the fact that activities
authorized in title VII are outside the scope of CDC's mission.
The funding levels for the fiscal year 2014 budget request
are not easily comparable to the fiscal year 2013 and
Committee-recommended levels. The President proposes to
implement the Working Capital Fund [WCF] through each
individual program line. The Committee rejects that approach
and recommends implementing the WCF through a transfer of funds
in the first quarter of fiscal year 2014, in accordance with
statutory transfer provisions provided in the fiscal year 2013
continuing resolution and this bill. For that reason, prior
year and Committee-recommended funding levels for each activity
reflect the programmatic costs of such activities, and the
total business service costs for CDC are appropriated
separately in the CDC-wide appropriation. In contrast, the
President's request assumes business service costs are built
into each funded activity at the level of that activity's
business service consumption in fiscal year 2011. In many
cases, a proposed increase for an activity in the budget
request simply reflects the addition of the existing business
service cost.
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriations, 2013\1\................................. $587,959,000
Budget estimate, 2014\2\................................ 681,560,000
Committee recommendation................................ 587,959,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $35,915,000 in business service funding.
The Committee recommendation for the activities of the
National Center for Immunization and Respiratory Diseases is
$587,959,000; this amount includes $12,864,000 in transfers
available under section 241 of the PHS Act.
In addition, the Committee recommends transferring
$150,000,000 to the Center from the PPH Fund. The President's
budget proposed transferring $72,460,000 from the PPH Fund;
$90,883,000 was transferred from the PPH Fund in fiscal year
2013.
The total program level recommended for the Center is
$737,959,000.
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 request\2\ Committee
appropriation\1\ recommendation
----------------------------------------------------------------------------------------------------------------
Immunization............................................... 520,340 580,959 579,457
National Immunization Survey (non-add)................. (12,864) (12,864) (12,864)
Influenza Planning and Response............................ 158,502 173,061 158,502
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $35,915 in funds from the Working Capital Fund realignment.
Cost Estimates.--The Committee requests an updated report
on Federal immunization programs no later than February 1,
2014, to reflect fiscal year 2015 cost estimates, optimum
funding to support State and local operations, and a continued
discussion of the evolving role of Federal programs as expanded
coverage for vaccination becomes more available from private
and public sources.
Exemption Rates.--The Committee urges CDC to continue
working with State and local governments to ensure that the
universal immunization recommendations, as defined by the
Advisory Committee on Immunization Practices, are implemented.
The Committee encourages CDC to work with States to track
exemption rates and assess the impact that exemptions may have
on vaccine-preventable disease rates. CDC should provide to
State and local health officials, the provider community, and
the public, scientifically accurate information on vaccines and
vaccine-preventable diseases that is presented in culturally
and linguistically appropriate manners.
Public Health Role.--As more individuals have access to
vaccines through health insurance coverage, the Committee
believes that the public health role in vaccination will shift
but not diminish. The Nation's public health immunization
infrastructure will be called upon to ensure the quality and
safety of our vaccines, monitor increasing vaccination rates
and remaining gaps, provide science-based education on vaccine
risks and benefits, and respond to outbreaks. The Committee has
combined the funding amounts for section 317 vaccine purchase
with funding for program implementation and accountability to
allow CDC maximum flexibility to increase quality and safety
activities as insurance coverage rates change over time. The
Committee urges CDC to use this flexibility to shift resources
to better reflect the changing public health role.
Specifically, the Committee recommends that CDC increase
resources 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; (3) strengthen the
evidence base to inform immunization policy; and (4) improve
program monitoring, including vaccine-preventable disease
surveillance, vaccine coverage assessment, adverse event
reporting, and laboratory training. The Committee directs that
intramural costs within the immunization be funded at the
fiscal year 2013 level.
Vaccine Purchase Formula Change.--The Committee supports
CDC's policy decision to limit the conditions under which fully
insured individuals may receive vaccines purchased through
section 317 funds. The Committee believes that section 317
should be the payer of last resort for vaccination. However,
the Committee has some concerns about the administration's plan
to change from a vaccine purchase allocation formula that is
based strictly on each State's total population to a formula
based on Census estimates of each State's uninsured population.
The Committee notes that this change would inadvertently
penalize uninsured and underinsured individuals in States that
are using all available tools to insure their populace. The
Committee urges CDC to develop a component in the formula that
would provide an incentive to States to administer section 317-
funded vaccines in a way that addresses coverage gaps which
cannot be filled with other available Federal programs.
HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS
PREVENTION
Appropriations, 2013\1\................................. $1,097,823,000
Budget estimate, 2014\2\................................ 1,176,942,000
Committee recommendation................................ 1,097,823,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $53,030,000 in business service funding.
The Committee recommendation for the activities of the
National Center for HIV, Viral Hepatitis, Sexually Transmitted
Diseases [STDs], and TB Prevention is $1,097,823,000.
In addition, the Committee recommends transferring
$10,000,000 to the Center from the PPH Fund. The President's
budget did not recommend transferring funds from the PPH Fund;
however, the budget request did propose a transfer of
$3,000,000 under section 241 of the PHS Act.
The total program level recommended for the Center is
$1,107,823,000.
The Center administers CDC's activities 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 recommends funding for the following
activities in the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year Fiscal year
Budget activity 2013 2014 Committee
comparable\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
HIV Prevention by Health Department............................. 334,422 399,744 392,636
National Programs To Identify and Reach High Risk Populations... .............. 400,985 362,189
HIV School Health............................................... 29,778 35,395 29,778
HIV Surveillance................................................ 116,797 .............. ..............
Enhanced HIV Testing Initiative................................. 64,918 .............. ..............
Improving HIV Program Effectiveness............................. 101,649 .............. ..............
National, Regional, Local, Community and Other Organizations.... 137,039 .............. ..............
Viral Hepatitis................................................. 19,640 31,410 29,640
Sexually Transmitted Infections................................. 153,523 161,710 153,523
Tuberculosis.................................................... 140,057 147,698 140,057
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $53,030 in funds from the Working Capital Fund realignment.
Hepatitis C Prevention.--The Committee is concerned by
increasing rates of new hepatitis C infections that are
associated with the injection of prescription opioids and
heroin, particularly among young people. The Committee
encourages the Division of Viral Hepatitis to continue
coordinating efforts with the Assistant Secretary for Health,
SAMHSA, and NIDA to address these outbreaks by disseminating
timely information on evidence-based prevention strategies and
providing technical assistance to health departments and
community-based organizations.
HIV Prevention.--The Committee accepts the administration
proposal to realign and consolidate the various funding streams
that are awarded to State health departments for the
surveillance and prevention of HIV. The Committee believes this
consolidation will allow needed flexibility while the public
health system adapts to the expansion of preventive services
brought about by the implementation of the ACA. The Committee
requests that CDC provide an accurate picture of how States are
using this additional flexibility in future budget
justifications.
Liver Disease.--Liver diseases of all kinds have a
significant impact on the health and well-being of Americans.
The Committee notes that liver diseases are addressed by
several Centers of CDC. For example, public health efforts
around hepatitis are housed in this Center, but fatty liver
disease is associated with obesity, the prevention of which is
led by the Center on Chronic Diseases. The Committee encourages
CDC to consider ways to coordinate public health efforts on
liver diseases across Centers.
Viral Hepatitis Screening.--The Committee urges CDC to
prioritize testing activities and initiatives to identify
people infected with asymptomatic forms of hepatitis. The
Committee further encourages CDC to conduct prevention research
to identify and disseminate best practices for implementing
viral hepatitis screening, including new tests and testing
procedures, standards of preventive care, and prompt linkage of
persons testing positive for viral hepatitis to needed medical
management and treatment. CDC should investigate opportunities
to make purchasing options for hepatitis testing supplies more
streamlined and efficient.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriations, 2013\1\................................. $252,043,000
Budget estimate, 2014\2\................................ 380,664,000
Committee recommendation................................ 283,237,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $57,917,000 in business service funding.
The Committee recommendation for the activities of the
National Center for Emerging and Zoonotic Diseases is
$283,237,000. In addition, the Committee recommends
transferring $52,000,000 to the Center from the PPH Fund. The
President's budget proposed transferring $51,750,000 from the
PPH Fund; $44,174,000 was transferred from the PPH Fund in
fiscal year 2013.
The total program level recommended for the Center is
$335,237,000.
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Infectious Disease Core Funding.............................. 19,789 24,339 19,789
Vector-borne Diseases........................................ 23,044 28,326 23,044
Lyme Disease................................................. 8,702 10,701 9,702
Prion Disease................................................ 4,960 6,089 4,960
Chronic Fatigue Syndrome..................................... 4,699 5,778 4,699
Emerging Infectious Diseases................................. 123,147 151,521 123,147
Food Safety.................................................. 27,067 49,223 35,067
National HealthCare Safety Network........................... 14,814 31,562 16,814
Quarantine................................................... 25,821 33,125 26,015
Advanced Molecular Detection................................. ................. 40,000 20,000
Epidemiology and Laboratory Improvement program.............. 32,424 40,000 40,000
Healthcare-Associated Infections............................. 11,750 11,750 12,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $57,917 in funds from the Working Capital Fund realignment.
Advanced Molecular Detection.--The Committee strongly
supports CDC's mission to improve our Nation's capability to
detect and treat infectious diseases and food-borne illnesses.
Therefore, the Committee recommendation includes the full
amount requested for improving pathogen identification,
enhancing sustainable laboratory information systems, and
improving modeling and early recognition of pathogens, as the
first investment in CDC's proposed 5-year initiative. The
Committee recommends that CDC use the first year of funding to
begin building the science base of this initiative before
funding the coordination of States. In starting this
initiative, the Committee notes that this is a focused, time-
limited effort on a particular genetic sequencing capability
that has implications across many of CDC's program areas. To
the extent that this capability reveals a potential advance
that is limited to an issue area covered by other programs and
Centers of CDC, the Committee expects CDC to transition the
research and implementation of that new technique to the
relevant condition-specific and laboratory support programs of
CDC. The Committee strongly supports ongoing innovation in all
programs of CDC and intends this initiative to strengthen that
commitment across the agency.
Antibiotic Resistance.--The Committee commends CDC for
committing to develop the report requested in fiscal year 2013
on the available data on antibiotic consumption and resistance
trends. The Committee recognizes that the report requires
substantial effort and looks forward to receiving it on CDC's
proposed timetable.
Antimicrobial Resistance.--The Committee urges CDC to work
with State health departments to expand the work of prevention
collaboratives, which seek to interrupt and prevent the
transmission of significant antibiotic-resistant pathogens
across healthcare settings. CDC, with the collaboratives,
should evaluate the impact of possible interventions on
hospital readmissions, healthcare-associated infection rates,
or other measures relevant to health or economic activity. CDC
and the Prevention Epicenters are encouraged to continue
evaluating interventions to prevent or limit the development of
antimicrobial resistance, facilitating public health research
on the prevention and control of resistant organisms, and
assessing the appropriateness of current surveillance and
prevention programs in healthcare and institutional settings.
Epidemiology Laboratory Capacity [ELC] Cooperative
Agreement.--The Committee is aware that some confusion exists
between the ELC program funding and the ELC cooperative
agreement. The ELC cooperative agreement is a flexible funding
mechanism that is used to award ELC program funds to States,
and is also used to award funds that are appropriated for a
variety of condition-specific activities in this report. To
eliminate this unnecessary and unhelpful confusion, the
Committee has renamed the ELC program ``the Epidemiology and
Laboratory Improvement program''. The Committee intends this to
be a clarifying change only. CDC should maintain the prior
purpose, award mechanism, and allocation of this funding.
Food Safety.--The Committee recommendation includes
additional funding to maintain appropriate staffing levels and
enhance laboratory capacity in States to identify food-borne
illnesses and effectively confine outbreaks. Further, the
Committee continues to support the integrated Food Safety
Centers of Excellence. These Centers, housed within State
health departments, serve a critical role in developing and
disseminating best practices and tools in food safety
surveillance and outbreak response.
Healthcare-Associated Infections [HAIs].--Researchers
estimate that excess medical costs from HAIs in U.S. hospitals
range from $28,000,000,000 to $33,000,000,000 every year. The
Committee continues to support the monitoring, response, and
prevention efforts that have led to promising reductions in
HAIs in recent years. The Committee recommendation is
sufficient to expand the National Healthcare Safety Network, an
HAI surveillance system used by over 5,000 facilities,
including hospitals in all 50 States and nonhospital settings
throughout the country.
Infectious Diseases.--The core Infectious Disease program
provides funding to States to identify and monitor the
occurrence of known infectious diseases, identify newly
emerging infectious diseases, and identify and respond to
outbreaks. The Committee notes that this funding has supported
the public health response in virtually every major infectious
disease outbreak in recent years.
Quarantine.--The Committee recommendation includes a new
provision, requested by the administration, to reimburse States
for the cost of isolation and quarantine. The Committee
modifies the requested statutory language to limit
reimbursement to the costs States incur following a Federal
quarantine order, rather than reimburse States for quarantines
that originate under State laws.
Unsafe Injection Practices.--The Committee remains troubled
by outbreaks of and ongoing public exposure to life-threatening
infections and bacteria caused by unsafe injection practices in
healthcare facilities, including the misuse of vials and
syringes. Outbreaks are entirely preventable when evidence-
based infection control practices are followed. CDC is
encouraged to continue its injection safety activities,
including provider education and awareness, detection,
tracking, and response. The Committee encourages broader
outreach to healthcare providers and State and local health
departments to disseminate the standards-based resources and
toolkits that were created through previous investments of this
Committee and through the PPH Fund. The Committee is aware that
CMS is collecting additional data on infection control
procedures of ambulatory surgical centers, beginning in fiscal
year 2013, and encourages CDC to collaborate with CMS to
analyze this data and use it to target prevention resources
more effectively.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriations, 2013\1\................................. $755,079,000
Budget estimate, 2014\2\................................ 620,189,000
Committee recommendation................................ 774,831,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $43,939,000 in business service funding.
The Committee recommendation for the activities of the
National Center for Chronic Disease Prevention and Health
Promotion is $774,831,000. In addition, the Committee
recommends transferring $485,700,000 to the Center from the PPH
Fund. The President's budget proposed transferring $415,904,000
from the PPH Fund; $233,033,000 was transferred from the PPH
Fund in fiscal year 2013.
The total program level recommended in this bill for the
Center is $1,260,531,000.
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.
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 Fiscal year 2013 2014 request\2\ Committee
appropriation\1\ recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco.................................................... 168,194 212,360 202,892
Chronic Disease State Grants:
Heart Disease and Stroke............................... 54,881 58,870 54,881
Diabetes............................................... 64,323 69,260 64,323
School Health.......................................... 13,499 14,703 17,199
Food Allergy (non-add)............................. (486) ............... (486)
National School Food Marketing Assessment (non-add) ................. ............... (1,700)
Nutrition, Physical Activity and Obesity............... 42,763 47,400 51,311
National Diabetes Prevention Program....................... ................. 10,000 10,000
Community Health Promotion................................. 6,096 6,636 6,096
Glaucoma................................................... 3,313 3,591 3,313
Visual Screening Education................................. 507 551 507
Alzheimer's Disease........................................ 1,799 1,949 1,799
Inflammatory Bowel Disease................................. 676 733 676
Interstitial Cystitis...................................... 650 704 650
Excessive Alcohol Use...................................... 2,436 2,647 2,436
Chronic Kidney Disease..................................... 2,078 2,251 2,078
Oral Health................................................ 14,619 15,921 15,000
Safe Motherhood/Infant Health.............................. 43,727 49,322 43,727
Prevention Research Centers................................ 24,325 25,041 27,869
Breast and Cervical Cancer................................. 204,427 184,560 204,427
WISEWOMAN (non-add).................................... (20,594) (21,413) (20,594)
Breast Cancer Awareness for Young Women.................... 4,872 5,067 4,872
Cancer Registries.......................................... 49,928 51,915 49,928
Colorectal Cancer.......................................... 42,756 40,577 42,756
Comprehensive Cancer State Grants.......................... 20,165 20,967 20,165
Johanna's Law.............................................. 4,962 5,161 4,962
Ovarian Cancer............................................. 4,873 5,068 4,873
Prostate Cancer............................................ 13,092 13,612 13,092
Skin Cancer................................................ 2,135 2,219 2,135
Cancer Survivorship Resource Center........................ 494 514 494
Arthritis and Other Chronic Diseases....................... 25,152 26,654 25,152
Arthritis.............................................. 12,979 ............... 12,979
Epilepsy............................................... 7,743 ............... 7,743
National Lupus Patient Registry........................ 4,430 ............... 4,430
Racial and Ethnic Approach to Community Health............. 13,916 ............... 53,916
Community Transformation Grants............................ 146,340 146,340 290,000
Obesity Prevention in High-Obesity Regions................. ................. ............... 5,000
Million Hearts............................................. 4,612 5,000 5,000
Workplace Wellness......................................... ................. ............... 10,000
Let's Move--National Early Child Care Collaboratives....... 4,000 4,000 4,000
Breastfeeding Promotion and Support........................ 2,500 2,500 15,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $43,939 in funds from the Working Capital Fund realignment.
Breast and Cervical Cancer Screening.--While the Committee
understands that more women will have insurance in fiscal year
2014 and thus more women will have access to breast and
cervical cancer screening through their coverage, this program
remains vitally important for the outreach and education it
provides on the need for screening. Such efforts will be
critical to ensuring that newly insured women actually receive
these life-saving services. For that reason, the Committee
includes the provision requested by the administration to
eliminate the cap on State outreach activities; however, while
the administration proposed giving this needed flexibility to
just 10 States, the Committee recommends that it should be
provided to all States.
Cardiomyopathy.--The Committee continues to support CDC's
efforts to track the rates of sudden cardiac arrest [SCA],
develop evidence-based prevention strategies for SCA deaths in
youth, and disseminate information to schools, coaches, and
parents.
Coordinated Chronic Disease Funding.--The Committee
commends CDC on the release of the February 2013 funding
opportunity announcement [FOA] ``State Public Health Actions to
Prevention and Control Diabetes, Heart Disease, Obesity and
Associated Risk Factors and Promote School Health.'' This
announcement implements an approach requested by the Committee
for the past 3 years.
The Committee is aware that ensuring some level of chronic
disease funding to all States, combined with the implementation
of overall funding cuts in fiscal year 2013, resulted in
drastic reductions for some States. The Committee
recommendation includes additional funding in the Nutrition,
Physical Activity, and Obesity, and School Health programs to
increase the base grant component of the coordinated FOA. This
investment, when combined with the $6,000,000 CDC awarded to
all States in fiscal year 2013 to align the timing of these
four grants, should increase each State's annual award by an
average of $440,000. This level is sufficient to reduce by over
two-thirds the number of States funded below the level they
were awarded in fiscal year 2012.
The Committee believes this approach will achieve three
important goals: better align the distribution of CDC funding
to chronic disease rates in the States, increase the ability of
State health officials to move beyond planning activities into
implementation of prevention strategies, and improve health
outcomes for all Americans. CDC is expected to demonstrate that
funds are spent in the amounts allocated and for the purposes
specified in this report.
Colorectal Cancer.--The Committee requests a report
detailing CDC's activities in each State regarding colorectal
cancer.
Community Transformation Grants [CTGs].--The Committee
recommendation includes an additional $143,660,000 above the
fiscal year 2013 level for CTGs. The Committee directs CDC to
award this funding in another round of community grants in
fiscal year 2014. The Committee directs CDC to give a priority
to communities that request funding to implement ``Blue Zone''
goals and strategies, in particular multi-sector approaches to
public health interventions in areas such as transportation,
agriculture, and housing. Blue Zones implement evidence-based
practices identified in groups and cultures from around the
world where people live measurably longer lives. In addition,
priority should be given to communities and clusters of
contiguous communities that are economically disadvantaged and
whose residents have disproportionately poor health outcomes.
Diabetes.--The Committee remains impressed by the
implementation of the evidence-based National Diabetes
Prevention Program [DPP] and includes $10,000,000 to expand the
use of this model. The Committee notes that approximately one-
third of people with diabetes do not know that they have it,
while another 57 million have pre-diabetes and are at high risk
for developing this deadly disease. The Committee directs CDC
to ensure that diabetes prevention activities are conducted by
all States within the coordinated chronic disease efforts.
Diet and Nutrition.--The Committee believes that attention
to the flavor of food is critical to inspiring the consumption
of healthy and nutritious food. For that reason, the Committee
continues to strongly support CDC's initiatives to develop
training resources for foodservice professionals and employees
on the preparation of foods that are healthful, flavorful, and
delivered in the most cost-effective manner. In particular, CDC
is encouraged to produce and disseminate digital media
instruction on best practices for delivering healthy meals in
large volume settings.
Epilepsy.--The Committee applauds the CDC epilepsy program
for the progress it has made in advancing a public health
agenda that seeks to improve the lives of people living with
this disease. The Committee encourages CDC to continue
expanding collaborations and addressing the recommendations of
the 2012 IOM report ``Epilepsy Across the Spectrum: Promoting
Health and Understanding.''
Heart Disease and Stroke.--The Committee continues to
support strongly the Paul Coverdell National Acute Stroke
Registry. In addition, the Committee eagerly anticipates the
upcoming release of data from the NCHS heart attack follow-up
study, funded with PPH funding beginning in fiscal year 2011.
Through this study, CDC is reviewing past medical records of
individuals who are treated for heart attack in emergency
rooms, to determine if patterns exist for earlier intervention.
CDC is directed to move expeditiously to incorporate any
lessons learned into the State programs.
Inflammatory Bowel Disease.--The Committee continues to
prioritize CDC's inflammatory bowel disease epidemiology study,
and requests a report on the ongoing activities in this
important area.
Interstitial Cystitis.--The Committee commends CDC's work
to raise awareness of interstitial cystitis, particularly as
emerging epidemiology data indicates that this condition is
underdiagnosed in the male population. The Committee continues
to prioritize the Interstitial Cystitis Education and Awareness
Program and encourages CDC to partner with the advocacy
community on this issue.
Lupus Patient Registry.--The Committee applauds the efforts
of the National Lupus Patient Registry. The Committee
recommendation includes funding to conduct cohort and burden of
illness studies to help study long-term outcomes, socioeconomic
burdens, and mortality associated with lupus. Given the
complexity of and difficulty in diagnosing the disease, the
Committee is concerned that individuals with lupus could be
missing from the registries. To address this concern, the
Committee urges CDC to develop a national campaign focused on
healthcare provider education and improved public understanding
of lupus. The Committee directs CDC to work with the Office of
Minority Health to ensure that all provider education efforts
are coordinated and not duplicative.
Maternal Mortality Reviews.--The Committee continues to
support CDC's work to standardize core data sets for State-
based maternal mortality reviews, which identify deaths, review
associated factors, and take action to institute changes to
decrease pregnancy-related and pregnancy-associated mortality.
The Committee looks forward to the dissemination of the final
case abstraction form in the coming year.
National Early Care and Education Collaboratives.--
According to statistics published in the Journal of American
Medical Association, over a quarter of children aged 2 to 5 are
overweight or obese. An estimated 12 million children spend
time in early care and education [ECE] settings on a regular
basis. The Committee recommendation includes $4,000,000 to
continue the highly successful collaboratives, which assist ECE
providers in six States adopt policies and practices related to
nutrition, breastfeeding support, physical activity, and screen
time.
National School Food Marketing Assessment.--The Committee
continues to be concerned that more than one-third of children
and adolescents in the United States are overweight or obese.
The Committee commends CDC for expanding the 2014 School Health
Policies and Practices Study [SHPPS] to include additional
questions related to food and beverage marketing. In support of
this effort, the Committee recommendation for School Health
includes an additional $1,700,000 in transfers from the PPH
Fund for a SHPPS follow-up observational study related to food
marketing.
The primary objective of this follow-up component to the
study shall be to assess the extent and types of marketing in
elementary and secondary schools and on school grounds related
to food and beverages. Coupled with the 2014 SHPPS
questionnaire, this component shall assess ways through which
foods and beverages are marketed to children in schools,
including but not limited to brand and product logos, names, or
information on educational materials, school supplies,
displays, signage, equipment, buses, and other school property;
educational incentive programs; label redemption programs; in-
school media; free samples and coupons; branded fundraising
activities; market research activities; and product displays
and placements. The Committee further directs CDC to integrate
the observational data into the 2014 SHPPS fact sheets and make
publicly available a fact sheet on food marketing. The
Committee encourages CDC to make the observational data
available to external researchers to the greatest extent
possible.
Obesity Outreach.--While some indicators show slight drops
in obesity rates recently, the Committee remains concerned that
there has been little change in the areas where the problem is
worst, particularly in rural areas. The Committee
recommendation includes $5,000,000 in PPH Fund competitive
funding to conduct pilot programs that focus on the use of
existing extension and outreach services in the counties with
the highest prevalence of obesity. All counties with an obesity
prevalence of over 40 percent, as determined by CDC's latest
county level data in the Behavioral Risk Factor Surveillance
System, shall be eligible to participate in this extension and
outreach program.
Office on Smoking and Health [OSH].--The Committee expects
OSH to transfer at least the same amount it did in fiscal year
2013 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. The Committee is pleased with
the reported results of the OSH media campaign, ``Tips from
Former Smokers.'' In its first year, the Tips campaign
generated more than 207,000 additional calls to State quitlines
and more than 510,000 hits to www.smokefree.gov, the
Government's Web site offering quit assistance. Research has
shown that at least five to six 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
2014 for a media campaign and quitlines as it did in fiscal
year 2013.
Oral Health.--The Committee recommendation includes funding
for States to strengthen their capacities to assess the
prevalence of oral diseases and to target resources and
interventions, such as community prevention and school-linked
sealant programs, to the underserved. The Committee is pleased
with CDC's work on the new communications plan related to
prevention initiatives, and includes additional funding to
implement the plan. The Committee continues to support the
development of an oral health literacy program in response to
recommendations from the IOM.
Ovarian Cancer.--Within the funds provided for Johanna's
Law, up to $1,000,000 shall be used for a review of the state
of the science on ovarian cancer. To conduct this review, CDC
should engage all relevant operating divisions of HHS, as well
as stakeholders and experts from the private and nonprofit
sectors. The review should include: an evaluation and summary
of the existing state of the science; an assessment of existing
government initiatives; and 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. In addition, the
Committee requests an update in the fiscal year 2015 budget
justification on CDC's effort to integrate ovarian cancer into
other related programs at the CDC.
Psoriasis.--The Committee commends CDC on the release of
the report ``Developing and Addressing the Public Health Agenda
for Psoriasis and Psoriatic Arthritis,'' funded under the
jurisdiction of this Committee in fiscal year 2010 and released
in February 2013. The Committee encourages the Center on
Chronic Disease Prevention and Health Promotion to collaborate
with the National Center for Health Statistics to identify
survey instruments that could be used to implement this agenda.
Racial and Ethnic Approaches to Community Health [REACH].--
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. The Committee believes that REACH complements the
CTG program by providing a more intense partnership with the
leadership of communities that suffer from marked health
disparities. Due to the relative lack of resources and
organizing capacity, these communities need a longer
engagement, with more intense community planning, smaller match
requirements, and more significant technical assistance. For
that reason, the Committee directs CDC to implement the model
of REACH that existed prior to 2012, when CDC began supporting
shorter commitments with a smaller level of funding.
Safe Motherhood Initiative.--Although nearly 50 percent of
all premature births have no known cause, there are prevention
strategies that work, such as reducing early elective
deliveries. Funding is provided to maintain current preterm
birth research and prevention initiatives.
School-Based Food Allergy Guidelines.--Deaths from
anaphylactic reactions to food allergens are entirely
preventable. Nevertheless, these tragedies continue to occur
when epinephrine is not readily accessible for prompt
administration or bystanders are not adequately prepared to
respond. Many State legislatures have passed or are considering
legislation to require or allow schools to stock epinephrine.
The Committee recommendation includes funding to support the
dissemination and implementation of the food allergy school
guidelines, which CDC is expected to issue this fall. CDC is
encouraged to consider making epinephrine purchase an allowable
use of School Health funds, subject to terms and conditions
related to storage and appropriate use.
WISEWOMAN.--The Committee is aware that CDC is undertaking
an open competition for WISEWOMAN, allowing new States to apply
for the first time since 2008 and requiring all 20 funded
States to recompete. WISEWOMAN helps uninsured and underinsured
low-income women avoid heart disease and stroke by providing
preventive health services, referrals to local healthcare
providers, and lifestyle counseling and behavioral
interventions tailored to particular factors.
NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES,
DISABILITY AND HEALTH
Appropriations, 2013\1\................................. $137,051,000
Budget estimate, 2014\2\................................ 67,148,000
Committee recommendation................................ 123,483,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $11,205,000 in business service funding.
The Committee recommendation for the activities of the
National Center on Birth Defects and Developmental Disabilities
[NCBDDD] is $123,483,000. The budget requests an additional
$74,796,000 in transfers from the PPH Fund.
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.
Within the total provided, the following amounts are
provided for the following categories of funding:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Birth Defects............................................... 20,157 21,798 18,352
Fetal Death (non-add)................................... (806) .............. (806)
Fetal Alcohol Syndrome...................................... 9,845 10,789 9,845
Folic Acid.................................................. 2,774 3,160 2,774
Infant Health............................................... 7,854 8,899 7,854
Autism...................................................... 21,228 23,098 21,228
Disability, Development, and Health......................... 17,748 18,941 17,748
Limb Loss................................................... 2,815 3,095 2,600
Tourette Syndrome........................................... 1,695 1,842 1,695
Early Hearing Detection and Intervention.................... 10,612 11,253 10,612
Muscular Dystrophy.......................................... 5,818 6,364 5,818
Paralysis Resource Center................................... 6,689 .............. ...............
Attention Deficit Hyperactivity Disorder.................... 1,712 1,828 1,712
Fragile X................................................... 1,678 1,802 1,678
Spina Bifida................................................ 5,725 6,265 5,725
Congenital Heart Failure.................................... 1,986 2,138 2,986
Thallasemia................................................. 1,856 .............. 1,856
Public Health Approach to Blood Disorders................... 226 20,672 4,000
Hemophilia.................................................. 16,633 .............. 7,000
CDC Activities.......................................... ................. .............. 2,000
Hemophilia Treatment Centers............................ ................. .............. 5,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $11,205 in funds from the Working Capital Fund realignment.
Congenital Heart Defects [CHDs].--CHDs continue to be the
most common birth defect and leading cause of infant mortality
in the United States. Even those who receive successful
intervention will need lifelong, costly, specialized cardiac
care. Estimates suggest there are over 2 million people alive
today with CHDs. The Committee commends CDC for its increasing
efforts to address the lifelong needs of this growing
population, particularly in collaboration with other Federal
agencies and private organizations. However, the Committee is
concerned that there continues to be a lack of rigorous
epidemiological and longitudinal data on individuals of all
ages with CHDs and includes funding to continue initial efforts
to compile this information. The Committee provides $3,000,000
to collect and analyze nationally representative, population-
based epidemiological and longitudinal data on infants,
children, and adults, with the goal of improving estimates of
CHD incidence, prevalence, and disease burden, which can be
used to better assess the public health impact of this
condition.
Duchenne Care Considerations.--The Committee recognizes the
value the Duchenne ``Care Considerations'' guidelines have had
in improving the standardization of care and quality of life
for patients with Duchenne muscular dystrophy and in extending
the lifespan of Duchenne patients. The Committee encourages
CDC, in collaboration with other Federal health agencies, to
issue updated care recommendations and to develop new adult
care recommendations expeditiously. Further, the Committee
encourages CDC to evaluate whether outcomes are improved by
care that is consistent with the existing guidelines.
Fragile X and Fragile X-Associated Disorders [FXD].--The
Committee continues to support CDC's efforts to identify and
define the population impacted by FXD, with the goal of
understanding the public health impact of these conditions.
Given the connection between fragile X syndrome and autism, the
prospect of targeted treatments for both conditions, and
current budgetary constraints, the Committee urges CDC to
explore ways to create greater efficiency and synergy between
programs addressing each condition.
Hemophilia Treatment Centers.--The Committee is
disappointed that funds appropriated specifically to address
hemophilia have been used to develop public health approaches
to other blood disorders. The Committee recommendation for
hemophilia more closely aligns to a true accounting of funds
spent on hemophilia and the Committee expects no further
diversion of funds. The Committee includes sufficient funding
to maintain and expand the surveillance and research activities
of the national network of hemophilia treatment centers and
CDC's national outreach and prevention programs on hemophilia.
The CDC hemophilia programs provide critical information to
better understand risk factors for complications and identify
high-risk populations for prevention measures.
Limb Loss Resource Center.--The Committee is disappointed
to learn that $1,000,000 appropriated for outreach and
education on limb loss has been diverted to support broad
activities that may not be of benefit to individuals who have
lost a limb. The Committee directs that CDC allocate the full
$2,600,000 provided herein for a limb loss resource center to
that activity in fiscal year 2014.
Paralysis Resource Center.--The Committee has transferred
funding for the Paralysis Resource Center program to ACL, as
requested by the administration. The Committee expects CDC to
work with ACL to ensure a smooth transition for grantees and
those served by this program.
Public Health Approach to Blood Disorders.--The Committee
includes $4,000,000 to support broad public health approaches
to blood disorders.
Spina Bifida.--The Committee recommendation includes
sufficient funding to continue the patient registry on spina
bifida to improve the efficacy and quality of care for people
with this disease.
Tourette Syndrome.--The Committee commends CDC for its
national public health education and research program on
Tourette syndrome. The Committee intends that funds be used to
continue to educate physicians, educators, clinicians, allied
professionals, and the general public about the disorder and to
improve scientific knowledge on prevalence, risk factors and
co-morbidities of Tourette syndrome.
Tuberous Sclerosis Complex [TSC].-- Because TSC is a
leading genetic cause of more prevalent neurological disorders
such as autism and epilepsy, the Committee encourages CDC to
incorporate information about TSC in CDC's surveillance systems
for those conditions.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriations, 2013\1\................................. $391,495,000
Budget estimate, 2014\2\................................ 469,305,000
Committee recommendation................................ 391,495,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $55,721,000 in business service funding.
The Committee recommendation for Public Health Scientific
Services is $391,495,000. This amount includes $247,769,000 in
transfers available under section 241 of the PHS Act, the same
amount as was transferred in fiscal year 2013. The President's
budget proposed $324,889,000 in section 241 transfers.
In addition, the Committee recommends transferring
$58,100,000 to these activities from the PPH Fund. The
President's budget proposed transferring $70,000,000 from the
PPH Fund; $51,501,000 was transferred from the PPH Fund in
fiscal year 2013.
The total program level recommended in this bill for these
services is $449,595,000.
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Health Statistics............................................ 138,683 181,475 138,683
Guide to Community Preventive Services....................... 7,378 10,000 7,400
Public Health Research....................................... ................. 5,000 ..............
Surveillance, Epidemiology, and PH Informatics............... 245,459 275,799 251,945
Public Health Workforce and Career Development............... 51,476 67,031 51,567
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $55,721 in funds from the Working Capital Fund realignment.
Integrated Public Health Surveillance.--The Committee
believes that significant opportunities exist to create
scientific, administrative, and fiscal efficiencies in the
reporting of public health surveillance data as a result of the
widespread adoption of electronic health records. For that
reason, the Committee directs CDC to develop a comprehensive
plan for public health surveillance that includes the
advantages, costs, and barriers to integrated surveillance
approaches, along with specific recommendations for increasing
the efficiency of State and local health reports to CDC. The
Director shall work with State and local health officials to
submit the report not later than 180 days after the date of
enactment of this act. The report should include full
consideration of information technology platforms that would
allow data brokering, validation, access, analysis, and
visualization tools to be shared within the public health
community and that would establish an integrated approach for
sharing of State and local data across CDC surveillance
programs. The Committee notes that some States and local
jurisdictions have invested significant resources in developing
surveillance systems in advance of this effort. CDC's plan
should build off those investments and identify ways that
jurisdictions can plan future modifications to those systems
Vital Statistics.--The Committee recommendation includes
sufficient funding to collect 12 months of vital statistics
data within the calendar year. In addition, the Committee notes
that standard certificates of births and deaths were finalized
10 years ago, yet 10 States have not fully adopted the 2003
modifications. The Committee urges CDC to survey States about
their reasons for and against adoption, prior to engaging in
any process to update the certificates again. The Committee
remains committed to expansions in the quality and timeliness
of vital statistics data, which can help prevent identity theft
and the fraudulent use of Federal and State benefits.
ENVIRONMENTAL HEALTH
Appropriations, 2013\1\................................. $104,819,000
Budget estimate, 2014\2\................................ 126,126,000
Committee recommendation................................ 113,827,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $18,235,000 in business service funding.
The Committee recommendation for the National Center for
Environmental Health is $113,827,000.
In addition, the Committee recommends transferring
$39,200,000 to the Center from the PPH Fund. The President's
budget proposed transferring $29,000,000 from the PPH Fund;
$20,740,000 was transferred from the PPH Fund in fiscal year
2013.
The total program level recommended in the bill for this
Center is $153,027,000.
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Environmental Health Laboratory.............................. 42,310 50,607 46,510
Core Operations.......................................... 34,534 50,607 34,534
Newborn Screening Quality Assurance...................... 6,813 .............. 6,813
Newborn Screening for SCID............................... 963 .............. 963
Chronic Disease Biomarkers............................... ................. .............. 4,200
Environmental Health Research................................ 12,337 42,096 12,337
Safe Water................................................... 7,097 .............. 7,097
ALS Registry................................................. 5,859 .............. 6,859
Built Environment & Health Initiative........................ 2,624 3,132 2,624
Climate Change............................................... 7,346 8,165 7,346
Environmental and Health Outcome Tracking Network............ 20,740 29,000 35,000
Asthma....................................................... 25,254 28,435 25,254
Healthy Homes/Childhood Lead Poisoning....................... 1,992 4,988 10,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $18,235 in funds from the Working Capital Fund realignment.
Chronic Disease Biomarkers.--Biomarkers are a uniquely
powerful tool to identify high-risk individuals, diagnose
disease conditions promptly and accurately, and effectively
track prevention and treatment efforts. However, biomarkers can
only be effective if the measurement tool can be standardized
and the quality of the testing assured. For example, the
Committee is aware of methods to screen for cholesterol that
examine not just the type of lipid particles but the size.
Researchers have demonstrated that this information can be used
to better determine the risk for heart disease; however, there
exists no standard to help clinicians interpret the data. As a
result, patients who receive advanced cholesterol tests can
receive dramatically disparate results. CDC's Environmental
Health Laboratory is one of the premier institutions for the
development of standards and the quality assurance of measuring
for biomarkers. The Committee recommendation includes funding
to begin the development of reference methods and materials for
several cardiovascular disease biomarkers, including small low-
density lipoprotein, apolipoprotein D, high-sensitivity C-
reactive protein, and troponin. In addition, CDC is encouraged
to begin development of a reference method and reference
materials for measurement of estrogen. The Committee recognizes
both the need for reference methods for these biomarkers and
the potential return on investment in the form of cost savings
for Federal healthcare programs including Medicare and
Medicaid.
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 recommendation is sufficient to continue to support
the 23 States and one city that were funded through this
program in fiscal year 2012. This investment allows State,
local, and tribal governments to evaluate potential linkages
between disease and environmental exposures in their areas. The
Committee encourages CDC to explore the feasibility of creating
interoperability between the tracking network and major
electronic health record systems to facilitate a more robust
collection of de-identified data from which to compare health
outcomes with environmental exposures.
INJURY PREVENTION AND CONTROL
Appropriations, 2013\1\................................. $137,456,000
Budget estimate, 2014\2\................................ 181,585,000
Committee recommendation................................ 162,456,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $8,611,000 in business service funding.
The Committee recommendation for the National Center for
Injury Prevention and Control is $162,456,000.
In addition, the Committee recommends transferring
$3,000,000 to the Center from the PPH Fund. The President's
budget included a proposed transfer of $5,000,000 under section
241 of the PHS Act.
The total program level recommended in this bill for the
Center is $165,456,000.
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 non-occupational injury and applied research in
acute care and rehabilitation of the injured.
The Committee recommendation includes funding for the
following activities:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Domestic Violence and Sexual Violence........................ 30,989 32,611 30,989
Youth Violence Prevention.................................... 14,942 15,890 14,942
Domestic Violence Community Projects......................... 5,402 5,738 5,402
Rape Prevention.............................................. 39,320 41,729 39,320
Gun Violence Prevention Research............................. ................. 10,000 10,000
National Violent Death Reporting System...................... 3,465 23,570 18,465
Injury Control Research Centers.............................. 9,957 10,220 9,957
Traumatic Brain Injury....................................... 6,016 .............. 6,016
Elderly Falls................................................ 1,955 .............. 4,955
All Other Unintentional Injury............................... 22,942 33,794 22,942
All Other Intentional Injury................................. 2,468 3,033 2,468
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $8,611 in funds from the Working Capital Fund realignment.
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.
National Violent Death Reporting System [NVDRS].--The
Committee recommendation includes $18,465,000 to allow CDC to
expand the NVDRS beyond the current 18 States. NVDRS is a
surveillance system that pools information from State and local
medical examiners, coroners, law enforcement, crime labs, and
vital statistics into a single incident record which presents a
more complete picture of the circumstances surrounding a
violent death. An enhanced NVDRS will provide States,
communities, and researchers the ability to identify the
preventable characteristics of violent deaths, including both
homicides and suicides, at a more localized level. The
Committee encourages CDC to plan how best to disseminate the
new data on the magnitude, trends, and characteristics of
violent deaths to prevention researchers, practitioners, and
policymakers. The Committee intends this expansion to aid in
the development, implementation, and evaluation of violence
prevention strategies at the national, State, and local levels.
Sports-Related Injuries.--The Committee is concerned about
the number and severity of injuries related to sports
activities at every age and experience level, from professional
sports to sports programs for children. While physical activity
is an important part of a healthy lifestyle and should be
promoted as a national public health goal, the number of
injuries, particularly those related to head injury and
concussion, is a matter of grave concern. The Committee
believes that new developments in sports safety equipment can
reduce the number of injuries to participants in sports
activities. In addition, safer technologies that have already
been implemented in one sport can be applied to safety
equipment in other sports, yielding widespread improvements in
safety and injury reduction. For example, the Committee is
aware of new designs for football helmets aimed at reducing or
eliminating the injuries that contribute to concussions and
traumatic brain injuries. The Committee encourages CDC to test
and improve these new helmet designs in cooperation with
academic centers, sports sanctioning organizations, and
equipment manufacturers.
TBI.--The Committee encourages CDC to consider supporting
multidisciplinary approaches to early identification and
treatment of TBI cases.
OCCUPATIONAL SAFETY AND HEALTH
Appropriations, 2013\1\................................. $292,275,000
Budget estimate, 2014\2\................................ 271,911,000
Committee recommendation................................ 292,275,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $32,693,000 in business service funding.
The Committee recommendation for National Institute for
Occupational Safety and Health [NIOSH] programs is
$292,275,000; this amount includes $110,724,000 in transfers
available under section 241 of the PHS Act.
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 basic and applied scientific research 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 request\2\ Committee
appropriation\1\ recommendation
----------------------------------------------------------------------------------------------------------------
National Occupational Research Agenda...................... 111,365 98,926 111,365
Education and Research Centers............................. 24,226 ............... 24,226
Healthier Workforce Centers................................ 5,007 5,433 5,007
Mining Research............................................ 52,273 62,374 52,273
Other Occupational Safety and Health Research.............. 99,404 105,178 99,404
Miners Choice (non-add)................................ (645) ............... (645)
National Mesothelioma Registry and Tissue Bank (non- (1,018) ............... (1,018)
add)..................................................
NanoTechnology (non-add)............................... (9,310) (11,150) (9,310)
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $32,693 in funds from the Working Capital Fund realignment
Facilities.--The Committee is proud of the decade of
investments made to implement the CDC Master Facilities Plan,
which recently concluded with the opening of Building 107. One
of the strategic goals of that plan was to move CDC from leased
facilities into federally owned property to reduce facility-
related costs to the agency. In furtherance of that goal, the
Committee directs NIOSH to maximize the use of existing
federally owned research facilities and property to conduct its
work. In particular, the Committee is concerned that NIOSH has
expanded its leasing activities while there remains unused
space it owns.
Mining Research.--The Committee appreciates the mine
research data submitted in the ``Significant Items'' section of
the fiscal year 2014 congressional budget justification and
requests that it be updated and included in the NIOSH section
of future justifications.
Mining Research Regional Approaches.--The Committee
strongly supports mine research done to prevent injury and
improve conditions in metal/non-metal mines located
predominantly in the western half of the country, including
mines in the newly revitalized Silver Valley of Idaho, the gold
mining areas of Nevada, the platinum area in Montana, the trona
mines in Wyoming, and the mines of various types in Alaska. In
particular, the Committee strongly supports the Catastrophic
Failure Detection and Prevention, Mining Injury and Disease
Prevention, and Mining and Surveillance and Statistical
programs. The Committee urges NIOSH to coordinate research
goals with mine operators and unions in the various regions of
the country.
National Occupational Research Agenda [NORA].--The
Committee includes no less than the fiscal year 2012 level for
the Agriculture, Forestry and Fishing Program within NORA.
Other Occupational Safety and Health Research.--The
Committee appreciates the occupational safety and health
research data submitted in the ``Significant Items'' section of
the fiscal year 2014 congressional budget justification and
requests that it be updated and included in the NIOSH section
of future justifications.
Skin Cancer.--The Committee directs NIOSH to conduct
research on the incidence of skin cancers among occupational
workers who spend a majority of their work hours in vehicles or
equipment operated outdoors. Such vehicles or equipment include
trucks, transit vehicles, tractors and related farm equipment,
and construction equipment. The Committee encourages NIOSH to
identify technologies to mitigate incidences of skin cancers
among this group of occupational workers by reducing worker
exposure to UVA and UVB radiation.
ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT
Appropriations, 2013\1\................................. $55,358,000
Budget estimate, 2014................................... 55,358,000
Committee recommendation................................ 55,358,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
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, 2013\1\................................. $346,964,000
Budget estimate, 2014\2\................................ 393,024,000
Committee recommendation................................ 391,964,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $29,014,000 in business service funding.
The Committee recommends $391,964,000 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Global AIDS Program......................................... 116,883 131,942 116,883
Polio Eradication........................................... 111,094 131,053 146,094
Other Global Immunization................................... 48,917 51,950 48,917
Global Disease Detection and Emergency Response............. 41,530 45,580 41,530
Parasitic Diseases and Malaria.............................. 19,334 22,231 19,334
Global Public Health Capacity Development................... 9,206 10,268 19,206
National Public Health Institutes (non-add)............. ................. .............. (10,000)
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $29,014 in funds from the Working Capital Fund realignment
National Public Health Institutes [NPHIs].--In many
countries around the world, public health functions are spread
across varying divisions of the ministry 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 diseases and setting common health research goals.
NPHIs are science-based organizations that administer 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.
The Committee includes a new initiative to support the
creation of NPHIs in developing countries. The Committee
provides $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 participating country must show a high
level of commitment to reorganize its ministry of health in
this manner.
Polio Eradication.--The Committee continues to support
strongly the worldwide partnership to eradicate endemic polio,
which now exists in only three countries in the world. The
Committee includes an increase of $35,000,000, or 32 percent
over the fiscal year 2013 level, in recognition of the
difficulty involved in the final phase of eradication,
including the need for enhanced security measures for
vaccination workers. Including this investment, this
subcommittee has provided over $1,700,000,000 since the
worldwide eradication effort began to ramp up in 1991, with
additional Federal resources provided through the State and
Foreign Operations subcommittee.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriations, 2013\1\................................. $1,297,248,000
Budget estimate, 2014\2\................................ 1,334,316,000
Committee recommendation................................ 1,292,498,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $52,338,000 in business service funding.
The Committee recommendation for the Office of Public
Health Preparedness and Response [PHPR] is $1,292,498,000.
The mission of PHPR is to build and strengthen national
preparedness for public health emergencies including natural,
biological, chemical, radiological, and nuclear incidents. PHPR
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
State and Local Preparedness and Response Capability......... 656,289 658,026 659,719
Public Health Emergency Preparedness Cooperative 640,570 658,026 644,000
Agreement...............................................
Academic Centers for Public Health Preparedness.......... 7,966 .............. 7,966
All Other State and Local Capacity....................... 7,753 .............. 7,753
CDC Preparedness and Response Capability..................... 138,031 166,012 137,177
Biosense................................................. 20,692 .............. 20,692
Real-time Lab Reporting.................................. 8,061 .............. 8,061
Core Preparedness and Response........................... 109,278 .............. 108,424
Strategic National Stockpile................................. 502,928 510,278 495,602
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes $52,338 in funds from the Working Capital Fund realignment.
Public Health Emergency Preparedness Cooperative
Agreement.--A critical component of protecting and securing our
Nation's public health is having State, local, and territorial
agencies prepared to prevent, detect, respond to, and rapidly
recover from a variety of threats. The Committee notes that the
level recommended is sufficient to return to a minimum State
grant level of $5,000,000 once the WCF transfer is completely
made.
Coordination.--The Committee encourages CDC to continue
efforts to align its preparedness grant programs with programs
of the Departments of Homeland Security and Transportation that
have complementary goals. As those efforts progress, the
Committee encourages CDC to seek greater efficiencies in
applications, reporting, and data collection for State and
local grantees.
Strategic National Stockpile.--When the WCF transfer is
accounted for, the Committee recommendation is the same level
as the President's request for the stockpile.
CDC-WIDE ACTIVITIES
Appropriations, 2013\1\................................. $616,854,000
Budget estimate, 2014\2\................................ 131,402,000
Committee recommendation................................ 616,563,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Assumes a realignment of $398,618,000 in business service funding.
The Committee provides $616,563,000 for public health
leadership and support activities at CDC.
In addition, the Committee includes $41,000,000 in
transfers from the PPH Fund. The President's budget proposed
transferring $41,200,000 from the PPH Fund; $22,585,000 was
transferred from the PPH Fund in fiscal year 2013.
The Committee recommendation includes funding for the
following activities in the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity Fiscal year 2013 2014 Committee
appropriation\1\ request\2\ recommendation
----------------------------------------------------------------------------------------------------------------
Preventive Health and Health Services Block Grant............ 79,409 .............. 79,409
Business Services Support / Working Capital Fund............. 394,004 .............. 394,004
Building and Facilities Improvement.......................... 24,903 14,591 24,805
Public Health Leadership and Support......................... 118,538 116,812 118,345
National Public Health Improvement Initiative................ 21,663 40,200 40,000
National Prevention Strategy................................. 922 1,000 1,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
\2\Includes a reduction of $398,618 for the Working Capital Fund realignment.
The Committee is once again pleased with the progress CDC
made in improving its congressional budget justification in
fiscal year 2014, and continues to urge CDC to give a clear
accounting of how funds are being spent in this annual budget
document. In particular, the Committee appreciates the detailed
information on grant awards, staffing levels, and facility
needs. In addition, the Committee finds helpful the updated
statistics on the public health need that the funding is
requested to address. The Committee encourages CDC to include
in each future budget justification a chart on the funding
level and structure of CDC's laboratories. The Committee
expects progress on transparency to continue as CDC seeks
additional funding flexibility.
Buildings and Facilities.--The Committee includes
sufficient funding for CDC to complete the repairs and
improvements identified as necessary in the fiscal year 2014
budget justification. The Committee directs CDC to continue to
provide updated information in this format in all future
justification documents. The Committee notes that the building
and facilities funding is provided in a flexible manner with
respect to time limitations, individual project budgets, and
the variety of activities allowable in a given fiscal year,
such as acquisition, construction, and repair. When choosing
among current and prior year available funding for a specific
project, the Committee encourages CDC to obligate the most
restricted funding first, so as to allow maximum flexibility
within the carryover funding available for the acquisition and
equipping of a replacement site for the Lake Lynn laboratory.
While this flexibility may result in a different source year of
available funding for mine research lab replacement, the
Committee expects that the total funding level reserved for
this replacement effort be strictly maintained.
Preventive Health and Health Services [PHHS] Block Grant.--
The PHHS Block Grant allows each State to address its most
critical public health needs. The Committee notes that, in
approximately one-third of all States, the PHHS Block Grant is
either a significant source or the only source of funding to
support emergency medical services and trauma systems.
Transfer Authority.--The Committee declines to provide the
additional transfer authority that was requested in the budget
for the Director of CDC. The Committee notes that section 206
of this act provides authority for transfer and reprogramming
of CDC's funds within certain parameters and once certain
notifications are made. In fact, CDC funds were transferred in
two separate actions under similar authority in fiscal year
2013. The Director of CDC should use the authority provided in
section 206 of this act to implement any transfer of funds he
deems necessary.
Working Capital Fund [WCF].--The Committee is pleased with
the progress CDC has made to set up the new WCF. 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.
The Committee includes funding for the WCF in the CDC-wide
appropriation along with transfer authority to implement the
WCF in the first quarter of fiscal year 2014. The Committee
included statutory language in both the fiscal year 2012 and
2013 appropriation laws to allow CDC to implement the WCF
through a transfer early in the first quarter of fiscal year
2014. The Committee continues to direct CDC to implement the
WCF in this fashion, and rejects the proposal in the
President's budget to implement the WCF by adjusting each
individual program, project, and activity level herein. The
Committee notes that identical transfer authority was provided
in Public Law 113-6 to give CDC the ability to plan in advance
for this first quarter transfer. If CDC is operating under a
continuing resolution in October, the Committee directs CDC to
transfer the apportioned amount of the fiscal year 2014 working
capital fund appropriation to each program of CDC according to
the formula agreed upon for the WCF.
National Institutes of Health
The mission of NIH is to seek fundamental knowledge about
the nature and behavior of living systems and then to apply
that knowledge to enhance human health, lengthen life, and
reduce illness and disability. No other entity in the world has
performed that mission so successfully. Yet there are signs
that other countries are beginning to close the gap.
While China and India are investing heavily in biomedical
research, NIH funding has dropped significantly, in real terms,
since the end of the 5-year doubling in fiscal year 2003. An
investigator's chance of winning an NIH grant has fallen from
approximately 3 in 10 a decade ago to roughly 1 in 6 today. At
a time when the promise for medical advances has never been
greater, the Nation cannot afford to lose any more ground in
the life sciences.
The Committee provides $30,954,976,000 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 $31,101,976,000, which the administration has
described as approximately $471,000,000 higher than the fiscal
year 2012 level. However, this proposed increase is smaller
than it appears. As explained in the introduction to the HHS
title in this report, the administration also proposes to
increase the program evaluation tap on PHS agencies, including
NIH, from 2.5 percent to 3 percent. That would effectively cut
NIH funding by approximately $147,000,000, all of which would
be redirected to other operating divisions within HHS. The
Committee rejects the proposed increase in the tap. The
Committee's recommended total for NIH is effectively equal to
the budget request.
NATIONAL CANCER INSTITUTE
Appropriations, 2013\1\................................. $5,062,039,000
Budget estimate, 2014................................... 5,125,951,000
Committee recommendation................................ 5,091,885,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $5,091,885,000
for NCI. Of this amount, $8,000,000 is available for repairs
and improvements to the NCI facility in Frederick, Maryland.
Cancer Centers.--The Committee urges NCI to put a higher
priority on linking its designated cancer centers with
community health providers in order to better reach underserved
and rural populations with state-of-the-art treatment and care.
Strengthening these networks could help reduce disparities in
cancer survival rates among racial, ethnic minority, and rural/
non-rural groups.
Gastric Cancer.--The Committee continues to be concerned
about gastric cancer, particularly among young people, and is
pleased that gastric cancer has been selected for study under
The Cancer Genome Atlas [TCGA]. Given that research on gastric
cancer is less advanced than that of many other cancers, the
Committee urges NCI to put a priority on helping investigators
in this field make the best possible use of genomic data from
the TCGA.
Gastrointestinal Stromal Tumor [GIST].--Despite significant
treatment advances over the past decade, metastatic GIST
remains largely incurable. The Committee encourages NCI to
intensify its research on GIST and explore with NCATS whether
any drugs that have been approved for other uses could be
repurposed to treat this disease.
Information Technology.--Certain health behaviors,
including diet, exercise, and smoking, play a key role in
cancer risk. As new technologies that may address behavioral
risk factors are developed, the Committee urges NCI to expand
research opportunities into how information technology and
telecommunications can be leveraged to reduce these risks.
Liver Cancer.--The Committee continues to urge NCI to put a
higher priority on liver cancer research. In particular, the
Committee urges the Institute to develop sustaining models of
liver cancer for therapeutic drug development as well as to
continue work in the area of biomarkers and drug discovery.
Lung Cancer.--The Committee urges NCI to collaborate
closely with international lung cancer experts to continue to
explore ways to translate the findings from the National Lung
Cancer Screening Trial into public health recommendations that
will reduce the mortality and morbidity of this deadly form of
cancer.
Melanoma.--The Committee continues to put a high priority
on melanoma research. The Committee notes that increased
translational work into wild-type BRAF melanomas, which
represent 50 percent of tumors, is critical to spearhead drug
development. The recent discoveries of unique mutations in
uveal melanoma also warrant additional research. The Committee
continues to urge research into the mechanisms and early
detection of drug resistance in BRAF mutant melanoma; further
mapping of melanoma genetics and epigenetics; and clinical
research into immune therapy checkpoint inhibitors, including
biomarker research for response and lack of response,
mechanistic analyses in patient-derived samples, and the
testing of combination therapies that incorporate these
inhibitors. The Committee continues to urge NCI to support
research directed at the biology of tumor initiation and
metastasis, risk reduction, and the relative utility of novel
early detection strategies. The Committee requests an update in
the fiscal year 2015 congressional budget justification on
NCI's melanoma research portfolio.
Metastasis.--Although 90 percent of cancer deaths are
associated with metastasis, this phenomenon is not widely
studied due to its complexity and corresponding requirement for
the involvement of scientists representing multiple
disciplines. The Committee encourages NCI to develop a
consortium of institutions with expertise in cancer metastasis
and metastasis genetics to leverage the unique strengths of
each institution and facilitate progress toward controlling the
most deadly attribute of cancer cells.
Metastasis to Bone.--The Committee urges additional
research on how to repair bone defects caused by cancer cells.
Basic research is needed to understand the impact of matrix
properties on cell behavior. Translational research is also
needed to understand the impact of metastasis on the
biomechanical properties of bone and the mechanisms by which
bone marrow- and tumor-derived cells can influence metastatic
growth, survival, and therapeutic resistance.
Minority Population Cancer Rates.--The Committee remains
concerned by the disproportionately high cancer rates in
minority populations. The Committee requests an update from NCI
and NIMHD on efforts to address this disparity, including the
possibility of establishing centers of excellence focused on
research, treatment, prevention, and communication and outreach
to minority communities for early intervention.
Neuroblastoma.--The Committee commends NCI for its
leadership in convening a consensus panel to revise the
international neuroblastoma response criteria. The Committee
encourages NCI to expand its research portfolio on this
devastating pediatric cancer with a focus on new treatment
options for relapse patients.
Obesity.--Excess body weight is linked to increased risk of
primary diagnosis of colon, endometrium, kidney, esophageal,
and postmenopausal breast cancers. Obesity is also linked to
poor prognosis once cancer develops, especially in breast
cancer and likely for prostate and colon cancer, the three most
prevalent cancer types. Numerous underserved and minority
groups have higher than average rates of obesity and as a
result they suffer from higher obesity-related morbidity and
mortality from cancer compared to other groups. Despite this
statistic, these groups are typically underrepresented in
obesity-related cancer prevention trials. In particular, nearly
20 percent of adults in the United States reside in a rural
area, representing one of the largest medically underserved
populations in the Nation and among the most understudied
groups of cancer patients and survivors. The Committee urges
NCI to focus research efforts on the effects of obesity on
cancer outcomes in these underserved groups.
Ovarian Cancer.--The Committee urges NCI to integrate
expertise in cancer biology, drug discovery and development,
bioinformatics, and pharmacogenomics to advance treatment
options for patients with ovarian cancer. The Institute is also
encouraged to collaborate with NCATS on drug repurposing
efforts.
Pancreatic Cancer.--The Committee strongly supports the
goals of the Recalcitrant Cancer Research Act of 2012, a law
that provides NCI with the tools to develop a scientific
framework for addressing the deadliest forms of cancer,
including pancreatic cancer. While maintaining the integrity of
the peer review system, the scientific framework will enable
NCI to capitalize on the full range of its expertise, and that
of extramural scientists, to assess scientific progress against
the Nation's most lethal cancers, starting with pancreatic and
lung cancer, and to develop a research agenda to reduce
morbidity and mortality. The Committee urges the Institute to
ensure that the final framework for pancreatic cancer fully
addresses all aspects of the statute. The Committee also notes
that the new law reinforces NCI's authority to award
``exception funding'' when relevant to a scientific framework.
Pediatric Cancer.--The Committee encourages NCI to put a
higher priority on pediatric cancer, as cancer remains the
leading cause of disease-related death in children. More
effective and less toxic treatments are needed, including
materials-based strategies for localized drug delivery.
Robotic Biorepositories.--To determine the genetic
differences in the development, progression, and response to
treatment of individuals with cancer, biospecimens must be
collected and evaluated. As more are collected, NCI should
consider the application of new technologies such as automated
robotics to ensure an adequate supply of biospecimens and to
promote better standardization of the collection process. The
introduction of automated processes in biospecimen collection
may also help to ensure an adequate supply of high-quality
human biospecimens from multiethnic communities for research to
understand and overcome cancer health disparities. NCI has
established networks for biospecimen collection that can be
used to assess the application of robotic technology and
determine if robotics can improve the functions of the
biorepository network. The Committee encourages NCI to consider
a pilot robotic biorepository project to determine if this
technology can enhance the goals of NIH programs.
Slow-Growing Children's Brain Tumors.--The Committee urges
NCI to address the shortage of tissue samples for slow-growing
children's brain tumors by incentivizing researchers to
centralize and share such samples, and to support the
development of preclinical mouse models and other nonmammalian
models for pediatric brain tumors. The Committee requests an
update on these issues in the fiscal year 2015 congressional
budget justification.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2013\1\................................. $3,072,863,000
Budget estimate, 2014................................... 3,098,508,000
Committee recommendation................................ 3,077,916,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $3,077,916,000 for
NHLBI.
Cardiovascular Disease.--The costs of heart disease,
stroke, and other forms of cardiovascular disease, in terms of
lives lost and resources spent, remain the highest of any
disease in the Nation. The Committee continues to believe that
research against these devastating diseases should be a top NIH
priority. The Committee recommends that NHLBI allocate
resources for cardiovascular disease research according to the
priority areas included in the Division of Cardiovascular
Diseases Strategic Plan.
Cell-Based Regenerative Treatments.--The Committee commends
the Institute for its effort to harness the potential of cell-
based regenerative treatments to address lung diseases and
encourages additional work in this area.
Centers for Advanced Diagnostics and Experimental
Therapeutics [CADET].--The Committee applauds the Institute's
efforts to accelerate the translation of basic research
findings into clinical advances in respiratory diseases through
the CADET program.
Chronic Obstructive Pulmonary Disease [COPD].--The
Committee applauds NHLBI for leading a cross-agency effort to
respond to COPD, including collaborating with CDC in releasing
the first-ever, State-by-State prevalence data on this disease.
The Committee encourages the Institute to move forward with
this important initiative.
Congenital Heart Defects.--The Committee commends NHLBI for
its increasing efforts to develop translational research
activities related to congenital heart disease through programs
such as Bench to Bassinet and participation in the Congenital
Heart Public Health Consortium. The Committee urges NHLBI to
continue its work with other Federal agencies, as well as
professional and patient organizations, to expand collaborative
research initiatives and other related activities targeted to
the diverse life-long needs of individuals living with
congenital heart disease.
Jackson Heart Study.--The Committee continues to recognize
the efforts of the Jackson Heart Study to work with individuals
and family members across generations in this longitudinal
study of cardiovascular disease among African Americans. The
Committee acknowledges the continued need for comprehensive
research to address health disparities and the important
implications for such research to all persons threatened by
cardiovascular disease.
Lymphangioleiomyomatosis [LAM].--The Committee continues to
support both intramural and extramural means of expanding
research on LAM and urges NHLBI to use all available mechanisms
as appropriate to stimulate a broad range of clinical and basic
research on this often fatal lung disease. The Committee
commends NIH for supporting the MILES trial, which has shown
that sirolimus suppresses disease activity in patients with
moderate LAM. Additional controlled trials are needed to
determine if the disease can be arrested in early stages. The
Committee also applauds NHLBI for working with the LAM patient
community to organize patient populations in a manner that
facilitates clinical research.
Mind-Body Interventions.--The Committee understands that
mind-body interventions such as meditation have the potential
to contribute to the prevention of cardiovascular disease. The
Committee urges NHLBI to support multicenter, phase III
randomized controlled trials, and pilot studies to prepare for
such trials, of mind-body interventions that have shown promise
in phase II trials to reduce cardiovascular risk factors,
surrogate endpoints, and clinical events such as mortality,
nonfatal myocardial infarction, and stroke.
Pediatric Cardiomyopathy.--The Committee urges NHLBI to
work with private and nonprofit stakeholders to develop and
disseminate to the public a research agenda and 3-year
strategic plan with specific activities to address gaps in
research related to the causes, screening, diagnosis, and
treatment of pediatric cardiomyopathy. Emphasis should be given
on children who are at the highest risk for cardiomyopathy-
related mortality.
Pulmonary Fibrosis.--The Committee applauds NHLBI for
convening a workshop to develop a strategic plan for pulmonary
fibrosis and supports efforts to enhance research on this
disease.
Scleroderma.--The Committee recognizes that pulmonary
fibrosis is a complication of scleroderma and the most common
cause of death in a diagnosed patient. Therefore, the Committee
encourages NHLBI to expand scleroderma research related to
pulmonary complications and facilitate collaboration and data
sharing among scleroderma investigators.
Sleep Disorders.--The Committee continues to support the
implementation of the National Sleep Disorders Research Plan,
including the emphasis on cross-Institute collaborations.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2013\1\................................. $409,889,000
Budget estimate, 2014................................... 411,515,000
Committee recommendation................................ 409,947,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $409,947,000 for
NIDCR.
Temporomandibular Disorders [TMD].--The Committee
appreciates the advances that have been made as a result of
NIDCR funding of research on TMD pain and urges the Institute
to continue to lead this effort. Major findings that have
emerged confirm that TMD is one of several chronic pain
conditions co-occurring in some patients at odds greater than
chance. The Committee strongly urges NIDCR to collaborate with
other ICs to address these co-morbid conditions. The Committee
commends the Institute for working with NIAMS and NIBIB to
organize the Temporomandibular Joint Working Group, which is
charged with assessing the state of the science on the
temporomandibular joint and identifying research gaps and
future scientific opportunities.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2013\1\................................. $1,793,450,000
Budget estimate, 2014................................... 1,811,786,000
Committee recommendation................................ 1,799,745,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,799,745,000 in
this bill for NIDDK.
Diabetes.--The Committee recognizes that diabetes is the
leading cause of both kidney failure and adult-onset blindness.
The Committee therefore urges NIDDK to fund basic research to
better understand the causes of diabetic kidney and eye
disease, as well as clinical studies to test potential
therapies to prevent and treat these ailments.
Gestational Diabetes.--The Committee recognizes that women
with gestational diabetes and their babies face long-term
health consequences as a result of the disease, including an
increased risk of developing type 2 diabetes. Therefore, the
Committee urges NIDDK to explore additional opportunities for
research on gestational diabetes, a disease affecting up to 18
percent of all pregnant women.
Functional Gastrointestinal Disorders [FGIDs].--The
Committee continues to urge NIDDK to engage in multi-Institute
collaborations to improve understanding of FGIDs.
Inflammatory Bowel Disease.--The Committee commends NIDDK
for its continued support of the Human Microbiome Project and
urges the Institute to put a high priority on using the results
to advance the understanding of inflammatory bowel disease and
its impact on pediatric patients. The Committee requests an
update on this program in the fiscal year 2015 congressional
budget justification.
Interstitial Cystitis.--The Committee commends NIDDK for
its leadership in interstitial cystitis research and notes that
researchers are making progress to dispel myths about this
condition and identify potential therapeutic strategies.
Recognizing that patients turn to a variety of treatments, from
pharmaceutical to changes in diet and lifestyle, the Committee
encourages NIDDK to continue its focus on interstitial cystitis
research and to partner with NCCAM to study the impact of
complementary therapies on this condition.
Obesity.--The Committee supports the NIH strategic plan for
obesity research, which emphasizes a transdisciplinary approach
to addressing the growing obesity problem in the United States.
However, the Committee believes that additional efforts are
needed to increase the involvement of high-risk communities in
obesity studies and preventative research, particularly in
rural areas, among low-income and racial minorities. The
Committee urges NIH to prioritize its efforts on those areas of
the country with the highest obesity rates by utilizing the
existing resources of NIH-funded Nutrition Obesity Research
Centers and academic schools of public health located in high-
risk areas.
Pancreatitis.--The Committee encourages NIDDK to create a
long-term scientific framework for pancreatitis including
evaluating current efforts and making recommendations on ways
to accelerate progress and improve outcomes. The Committee
requests an update on this effort in the fiscal year 2015
congressional budget justification.
Pediatric Kidney Disease.--The Committee encourages NIDDK
to assign a higher priority to research that explores pediatric
renal disease. Because of the unique challenges of recruiting
children into clinical trials, the Committee urges NIDDK to
support research endeavors that include funding for
infrastructure and the enhancement of collaborative and
comparative multicenter, pediatric, prospective clinical/
translational trials that improve patient outcomes.
Pelvic Pain.--The Committee is pleased that the
Multidisciplinary Approach to the Study of Chronic Pelvic Pain
[MAPP] Research Network has moved to its second phase. The
Committee encourages NIDDK to continue these activities,
including finding new treatment approaches, identifying risk
factors, and helping to predict which patients may respond to
various interventions for interstitial cystitis and other
comorbid pelvic pain conditions.
Prostatitis.--The Committee urges NIDDK to continue the
MAPP initiative's support of research on the cause, cure, and
prevention of prostatitis.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2013\1\................................. $1,623,113,000
Budget estimate, 2014................................... 1,642,619,000
Committee recommendation................................ 1,631,703,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,631,703,000 for
NINDS.
Cerebral Cavernous Malformation [CCM].--The Committee urges
NINDS to put a higher priority on CCM by coordinating existing
research and surveillance activities as well as expanding
clinical and research centers with the potential to manage a
multisite clinical drug trial.
Duchenne Biomarkers.--The Committee recognizes the
importance of biomarkers and related surrogate endpoints for
application in clinical trials of potential therapies for
Duchenne muscular dystrophy. Therefore, the Committee urges
NINDS, in collaboration with the FDA, to develop a plan of
action to support the development and qualification of Duchenne
biomarkers and to support the regulatory science relevant to
advancing new technologies to treat this disease.
Epilepsy.--The Committee commends NINDS for its leadership
in sponsoring the April 2013 conference ``Curing the Epilepsies
2013: Pathways Forward'' and for evaluating and guiding
progress toward finding cures for the epilepsies through the
community's epilepsy research benchmarks. The Committee
applauds the enhanced focus of the NINDS Anticonvulsant
Screening Program on developing new compounds to better address
the needs of the patients for whom current therapies are not
effective and to focus on prevention and disease modification.
The Committee encourages the continuation of the targeted
Epilepsy Centers Without Walls grants to support
multidisciplinary, collaborative research in targeted areas
that can advance progress in the prevention, diagnosis, and
treatment of epilepsy and related comorbidities, including
mortality from epilepsy. The Committee also remains supportive
of Exceptional Unconventional Research Enabling Knowledge
Acceleration [EUREKA] grants and research in epileptogenesis,
comorbidities, translational research on epilepsies, treatment
resistant epilepsy, and sudden unexplained death in epilepsy.
Further, the Committee encourages the continuation of the
Interagency Collaborative to Advance Research in Epilepsy
[ICARE], led by NINDS, to coordinate the research efforts of
Federal agencies and voluntary organizations and to identify
areas for collaboration.
Headache.--The Committee commends NIH for efforts to
increase its focus on headache disorders over the past several
years, especially in encouraging more junior investigators to
enter the field. However, NIH's investment in this research is
still not commensurate with the enormous disease burden of
headache disorders. The Committee encourages intensified
efforts to understand the causes, prevention, treatment, and
eventual cure of headache disorders, including migraine,
cluster headache, and chronic daily headache. In particular,
the Committee urges NINDS to follow through on the
recommendations from the May 2010 NIH Headache Research
Planning Workshop by issuing requests for applications and
program announcements for fundamental and translational
research on headache disorders and providing career training
and transition awards specifically devoted to the investigation
of headache disorders.
Inflammatory Nervous System Disorders.--The Committee urges
NINDS to pursue expanded research focused on inflammatory
disorders impacting the peripheral nervous system such as
Guillain-Barre syndrome, chronic inflammatory demyelinating
polyneuropathy, and related conditions.
Muscular Dystrophy Coordinating Committee [MDCC].--The
Committee understands that the MDCC's next meeting is planned
for August 2013--more than 2 years since the last meeting--and
that the Action Plan for Muscular Dystrophy has not been
updated in 5 years. The MDCC's charter stipulates that meetings
of the full committee should be held not less than once each
fiscal year; the Committee strongly urges MDCC to resume a more
regular schedule. In addition, the Committee urges the MDCC to
review and revise the action plan so that it is relevant to the
full range of Duchenne patients, including adults and different
racial and ethnic populations affected by muscular dystrophy,
and informed by Duchenne patient, caregiver, clinician, and
research stakeholders.
Network for Excellence in Neuroscience Clinical Trials.--
The Committee is pleased that NINDS plans to expand its support
of the Network for Excellence in Neuroscience Clinical Trials
[NeuroNEXT] program. The Committee urges NINDS to increase the
efficiency of clinical trials conducted through NeuroNEXT,
facilitate patient recruitment and retention, and increase the
quality of the neuroscience trials.
Stroke.--The Committee continues to commend the effective
leadership role of NINDS in stroke research planning and
prioritization and congratulates the Institute for its efforts
that have culminated in the identification of nine top areas in
stroke prevention, treatment, and recovery research. The
Committee urges NINDS to stimulate investment in each of these
areas.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Appropriations, 2013\1\................................. $4,481,730,000
Budget estimate, 2014................................... 4,578,813,000
Committee recommendation................................ 4,548,383,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $4,548,383,000 for
NIAID.
Antibiotic-Resistant Infections.--The Committee remains
concerned about the need to develop and approve new
antibiotics. The Committee urges NIAID to facilitate, through
its new antibiotic-resistant bacterial infections clinical
research infrastructure, studies that lead to new endpoints for
serious and life-threatening infections caused by multidrug-
resistant pathogens, and in particular hospital-acquired and
ventilator-associated bacterial pneumonias. NIAID also should
support research leading to a better understanding of the
natural history of pneumonia and other antibiotic-resistant
infections.
Autoimmune Diseases.--The Committee urges NIAID and the
Autoimmune Disease Coordinating Committee to establish programs
to investigate common biological pathways of autoimmune
diseases and potential therapies that can broadly prevent and
treat them. The Committee requests an update on NIAID's current
activities and plans for additional research in the fiscal year
2015 congressional budget justification.
Food Allergy.--The Committee is aware of the promising
research on oral immunotherapy being funded by the Consortium
of Food Allergy Research [CoFAR]. The Committee strongly urges
NIAID to increase both the budget for and the number of
institutions funded by CoFAR when the program is renewed. In
addition, NIH should initiate other mechanisms of support for
research and career development of investigators focused on
food allergy research. The Committee also encourages NIAID to
continue its public-private partnerships in support of
complementary clinical immunological, immunomodulator,
mechanistic, and genetic studies with private donors and
foundations as components of ongoing food allergy clinical
trials.
Influenza Antivirals.--The Committee encourages NIAID to
invest in research on new antiviral drugs that are easy to use
and effective against emerging drug-resistant influenza
variants, as well as influenza diagnostics. NIAID should give
special consideration to treatment for the pediatric and
obstetric populations.
Microbicides.--The Committee encourages NIAID to continue
coordination with USAID, the State Department, and others to
advance the development of antiretroviral-based microbicides.
Tuberculosis [TB].--The Committee continues to urge NIAID
to expand its research into the development of new TB
diagnostic tests, drugs, and vaccines to prevent, detect, and
treat TB. In particular, the Committee encourages more research
on developing shorter treatments for multidrug-resistant TB.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2013\1\................................. $2,425,175,000
Budget estimate, 2014................................... 2,401,011,000
Committee recommendation................................ 2,435,570,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $2,435,570,000 for
NIGMS.
Critical Care.--The Committee recognizes that the burden
associated with the provision of care for critically ill
patients is expected to increase significantly as the
population ages. The Committee encourages NIGMS, through the
new Office of Emergency Care Research, to heed the
recommendations of the Critical Care Societies Collaborative in
developing future research directions on critical care.
Institutional Development Awards [IDeA].--The Committee
continues to recognize the importance of the IDeA program and
its focus on improving the necessary biomedical research
infrastructure and capacity of research institutions within
IDeA States. The Committee believes the IDeA program has made a
significant contribution to biomedical research and efforts to
create a skilled workforce in IDeA States. Therefore, the
Committee rejects the President's proposal to cut IDeA funding
to $225,438,000 and instead recommends $275,957,000, the same
as the fiscal year 2012 level, for this purpose. However, the
Committee is concerned that the eligibility criteria for IDeA
established when the program was created 20 years ago are no
longer relevant and have led to inequities. No States have been
added to or dropped from the list of States that are eligible
for this funding since 1997. The same 23 States have been
eligible for IDeA for the past 16 years and the same 27 States
have been ineligible. In addition, the authorizing statute says
a State's eligibility for the program is to be determined by
whether its research institutions have a low aggregate success
rate, relative to other States, of obtaining NIH funds. But
today, several IDeA States have higher success rates than those
of non-IDeA States. The Committee is aware that the National
Academy of Sciences [NAS] is conducting a study of the
Experimental Program to Stimulate Competitive Research [EPSCoR]
and related programs, such as IDeA, across the Federal
Government. The Committee directs NIH to provide a report to
the House and Senate Committees on Appropriations, as well as
the relevant authorizing committees, that responds to the NAS
analysis of IDeA and addresses whether changes to its
eligibility criteria are warranted. The report, which should be
delivered no later than 120 days after the release of the NAS
study, should include a discussion of whether all States that
are eligible for EPSCoR should be eligible for IDeA.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
Appropriations, 2013\1\................................. $1,318,755,000
Budget estimate, 2014................................... 1,339,360,000
Committee recommendation................................ 1,330,459,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,330,459,000 for
NICHD.
Chromosome Abnormalities.--The Committee commends NIH's
efforts to categorize genes, which are useful for the diagnosis
of chromosome abnormalities. The path to treatment requires a
greater understanding of gene function as it relates to
abnormal gene copy number. The Committee again asks NICHD to
hold a state of the science meeting focused on strategies for
devising treatments for nonrecurring as well as recurring gene
copy number changes. The Committee further urges new funding to
support other investigators of chromosome abnormalities,
particularly those involving chromosome 18.
Demographic Research.--The Committee is pleased that
NICHD's recent reorganization and Scientific Vision initiative
reflect the integral role that demographic, or population,
research plays in the Institute's mission. As such, the
Committee urges NICHD to include the Population Dynamics branch
in all appropriate research mechanisms and programs. Further,
the Committee encourages NICHD to sustain its support of large-
scale, longitudinal surveys, particularly the National
Longitudinal Survey of Adolescent Health and the Panel Study of
Income Dynamics Child Supplement Survey.
Preterm Birth.--The Committee notes that the Institute's
new Scientific Vision highlights pregnancy and pregnancy
outcomes as a priority for NICHD research. The Committee
encourages NICHD to continue to emphasize its support of
extramural preterm birth prevention research, the Maternal-
Fetal Medicine Units Network, the Neonatal Research Network,
and the intramural research program related to prematurity. The
Committee also encourages NICHD to support transdisiplinary
science as recommended in the Scientific Vision and to fund
transdisiplinary research grants to study and identify the
complex causes of prematurity.
Psychotropic Medications and Children.--The Committee
understands that little is known about the short- and long-term
effects of psychotropic medications on children's physical and
mental development. The Committee encourages NICHD to undertake
a concerted effort to determine the safety and efficacy of
these medications in children, and to explore research into the
effectiveness of evidence-based psychosocial therapies used
instead of, or in combination with, psychotropic medications.
Vulvodynia.--The Committee is pleased with the progress
that NICHD has made to implement the major recommendations from
the NIH Research Plan on Vulvodynia, particularly in convening
the May 2013 workshop to develop research diagnostic criteria.
The Committee urges NICHD to continue its work with the patient
advocacy, medical, and scientific communities to develop these
criteria, as well as common data elements to be collected
across clinical studies to allow for the comparison of study
populations and findings. The Committee also encourages the
Institute to expand the cadre of basic and clinical
investigators conducting vulvodynia research by helping
interested researchers obtain greater expertise in pain
research methodology and pelvic/urogenital neurobiology;
encouraging NIH-funded investigators from various fields to
expand their research to include vulvodynia; and reissuing a
general funding opportunity with a special review panel that
addresses foundational priority areas delineated in the
vulvodynia research plan.
NATIONAL EYE INSTITUTE
Appropriations, 2013\1\................................. $701,307,000
Budget estimate, 2014................................... 699,216,000
Committee recommendation................................ 701,407,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $701,407,000 for NEI.
Diabetic Retinopathy.--The Committee understands that
diabetic eye disease is the leading cause of blindness in
working age adults and urges NEI to continue its support of the
Diabetic Retinopathy Clinical Research Network.
Marfan Syndrome.--The Committee understands the negative
health effects that Marfan syndrome can have on the human eye
and vision. The Committee encourages NEI to initiate research
activities in this area.
Usher Syndrome.--The Committee urges NEI to put a higher
priority on Usher syndrome, the leading cause of deaf-
blindness.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
Appropriations, 2013\1\................................. $684,200,000
Budget estimate, 2014................................... 691,348,000
Committee recommendation................................ 686,753,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $686,753,000 for
NIEHS.
Childhood Lead Poisoning.--The Committee understands that
lead poisoning remains a serious health risk for children, with
life-long developmental consequences, and encourages NIEHS to
prioritize research in this area.
Environmental Exposures and Reproductive Health.--
Environmental exposures can have significant ramifications for
reproductive health, such as infertility, sterility, and birth
defects, in addition to causing other serious health conditions
including osteoporosis, heart attack, and stroke. The Committee
believes it is critical to examine these ramifications for both
men and women. NIEHS is urged to place a greater priority on,
and invest more funding in, environmental, sex-based,
reproductive health research.
National Toxicology Program [NTP].--The Committee urges NTP
to be highly precise when describing the results of its studies
on particular extracts of an herbal species to avoid any
possible confusion about the relevance of such studies to other
extracts of the species. The Committee also encourages NTP to
reinstitute its practice of making available on its Web site a
transcript and/or recording of its public meetings.
NATIONAL INSTITUTE ON AGING
Appropriations, 2013\1\................................. $1,101,234,000
Budget estimate, 2014................................... 1,193,370,000
Committee recommendation................................ 1,185,439,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,185,439,000 for
NIA.
Alzheimer's Disease.--The President's budget calls for an
increase of $80,000,000 over the fiscal year 2012 level for
Alzheimer's disease research at NIA. In keeping with
longstanding practice, the Committee does not recommend a
specific amount of NIH funding for this purpose, or for any
other individual disease. Doing so would establish a dangerous
precedent that could politicize the NIH peer review system.
Nevertheless, recognizing that Alzheimer's disease poses a
unique and serious threat to the Nation's long-term health and
economic stability, the Committee expects that a significant
portion of the recommended increase for NIA should be directed
to research on Alzheimer's. The exact amount should be
determined by the scientific opportunity of additional research
on this disease and the quality of grant applications that are
submitted for Alzheimer's relative to those submitted for other
diseases. The Committee encourages NIA to continue addressing
the research goals set forth in the National Plan to Address
Alzheimer's Disease, as well as the recommendations from the
Alzheimer's Disease Research Summit 2012. In addition, the
Committee continues to urge NIH to take advantage of existing
well-characterized, longitudinal, population-based cohort
studies to provide new insights into risk factors and
protective factors related to cognitive decline and dementia.
The Committee also continues to encourage additional research
in minority populations that are at particularly high risk for
cognitive decline and dementia.
Demographic, Economic, and Behavioral Research.--The
Committee recognizes NIA for investing in large-scale
longitudinal surveys, including the National Health and Aging
Trends Study and the Health and Retirement Study. Further, the
Committee applauds NIA for contributing to the recent National
Academies report ``Shorter Lives, Poorer Health,'' which found
that Americans live shorter lives and are in poorer health than
people in other high-income countries and that behaviors and
social circumstances are major contributing factors.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2013\1\................................. $534,715,000
Budget estimate, 2014................................... 540,993,000
Committee recommendation................................ 537,398,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $537,398,000 for
NIAMS.
Heritable Connective Tissue Disorders.--The Committee
commends NIAMS for ongoing research efforts into heritable
connective tissue disorders like Marfan syndrome.
Osteogenesis Imperfecta [OI].--The Committee continues to
be concerned that the impact of OI on adults is not well
understood and that very few primary care physicians or
specialists possess training or experience in treating adults
with OI. The Committee continues to encourage NIAMS to support
natural history studies of OI and subsequent clinical research
activities that will facilitate the development of clinical
practice guidelines for adults with OI. The Committee also
urges NIAMS to partner with the relevant professional
societies, the OI advocacy community, and other stakeholders to
develop opportunities for primary care physicians and
specialists to receive education and training on providing care
to adults with OI.
Scleroderma.--The Committee notes recent advances in
scleroderma research, particularly in systemic scleroderma, and
encourages NIAMS to provide sustained investments in this area.
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.
However, researchers investigating other joints too often
ignore TMD because they consider temporomandibular joints to be
a subject for dental researchers only. The Committee notes that
the Temporomandibular Joint Working Group has improved
collaborations among ICs that should have a role in TMD
research but believes that NIAMS, as well as NIBIB, should
participate more fully, so that NIDCR is not expected to carry
the workload alone.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2013\1\................................. $415,440,000
Budget estimate, 2014................................... 422,936,000
Committee recommendation................................ 420,125,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $420,125,000 for
NIDCD.
Central Auditory Plasticity.--The Committee continues to
support research in animals and humans on changes in the
functional organization of neural circuits along all of the
pathways in the brain that process sound, following both
temporary and permanent developmental and adult hearing loss.
Eustachian Tubes.--The Committee urges NIDCD to conduct
additional studies on potential treatments for dysfunctional
eustachian tubes.
Genetic Causes of Communication Disorders.--The Committee
recommends additional efforts by NIDCD to identify and
understand the structure, function, and regulation of genes
whose mutations are responsible for congenital and age-related
deficits. Research to develop high-throughput platforms for
testing of individuals is also encouraged.
Hearing Aids and Cochlear Implants.--The Committee strongly
urges NIDCD to support research grants that could lead to less
expensive hearing aids, so such aids could become accessible
and affordable to more people. The Committee also supports
device research to improve users' understanding of speech
through background noise. In addition, the Committee supports
research that would enable users of cochlear implants to
experience high-quality speech and music perception, as well as
studies that would improve bilateral implants, short electrode
implants, and hybrid cochlear implant/hearing aids.
Inner Ear Hair Cell Regeneration.--The Committee is aware
of advances being made in the identification of cells in the
inner ear that can be induced or reprogrammed to replace cells
lost in deafness. Additional research to understand the
processes of possible regeneration or transdifferentiation of
inner ear hair cells to restore natural hearing is strongly
encouraged. The Committee recommends funding to develop this
therapeutic approach and move it into clinical applications.
Noise-Induced Hearing Loss.--Hearing loss resulting from
noise damage represents a major form of acquired deafness. The
Committee therefore recommends studies to better understand the
pathogenesis of noise-induced hearing loss and encourages NIDCD
to continue to promote public awareness of the importance of
protecting hearing from noise, through public service
announcements or other means.
Otitis Media.--The Committee encourages NIDCD to accelerate
its research into susceptibility to and pathogenesis of otitis
media and its consequences, and into new treatments for chronic
and recurrent cases. In particular, the Committee urges studies
related to genetic risk factors, bacterial biofilms, and the
impact of vaccination on disease prevention.
Presbycusis.--The Committee urges NIDCD to continue to
delineate the multiple physiological and neurological processes
resulting in presbycusis, or age-related hearing loss.
Tinnitus.--The Committee urges NIDCD to continue basic
research on the specific neural dysfunction responsible for
tinnitus as well as clinical trials to translate basic science
into therapies.
Vestibular Research.--The danger of injury from falls is a
health hazard, especially in the elderly. Therefore, the
Committee urges NIDCD to conduct further basic vestibular-
system studies to understand the cellular mechanisms involved
in the coding of head movements necessary to assure an
individual's ability to maintain balance.
NATIONAL INSTITUTE OF NURSING RESEARCH
Appropriations, 2013\1\................................. $144,479,000
Budget estimate, 2014................................... 146,244,000
Committee recommendation................................ 145,272,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $145,272,000 for
NINR.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
Appropriations, 2013\1\................................. $458,600,000
Budget estimate, 2014................................... 463,848,000
Committee recommendation................................ 460,765,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $460,765,000 for
NIAAA.
Functional Integration Initiative.--The Committee applauds
the Trans-NIH Substance Use, Abuse, and Addiction Functional
Integration initiative to help NIAAA, NIDA, NCI, and other ICs
work more closely together on substance use, abuse, and
addiction research.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2013\1\................................. $1,051,261,000
Budget estimate, 2014................................... 1,071,612,000
Committee recommendation................................ 1,064,490,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,064,490,000 for
NIDA.
Drug Abuse and HIV/AIDS.--The Committee understands that
drug abuse and addiction continue to fuel the spread of HIV/
AIDS and that drug abuse prevention and treatment interventions
can be very effective in reducing HIV risk. Research should
continue to examine every aspect of this relationship. The
Committee is also concerned about drug abuse and HIV/AIDS in
criminal justice populations. Research efforts to empirically
test and expand the ``seek, test, treat, and retain'' paradigm
are encouraged.
Marijuana.--NIDA is encouraged to continue to fund research
on preventing and treating marijuana abuse and addiction, as
well as the possible health and policy implications of
proposals to implement ``medical marijuana'' or marijuana
legalization programs.
Pain Medications.--The Committee remains concerned about
the continued crisis of prescription drug abuse. NIDA is
strongly urged to continue its support of research on pain,
including the development of pain medications with reduced
abuse liability. In addition, NIDA should continue to fund
research to better prevent and treat prescription drug abuse.
NIDAMed.--The Committee is pleased with NIDAMed, the
Institute's physicians outreach initiative. The Committee urges
NIDA to continue its focus on providing physicians and other
medical professionals with the tools and skills they need to
incorporate drug abuse screening and treatment into their
clinical practices.
Tobacco Addiction.--The Committee applauds the recent
progress of NIDA-supported researchers toward identifying
genetic factors that contribute to nicotine dependence and
affect the efficacy of smoking cessation treatments. NIDA is
urged to continue developing evidence-based treatments,
medications, and prevention strategies to combat nicotine
addiction.
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2013\1\................................. $1,477,304,000
Budget estimate, 2014................................... 1,465,782,000
Committee recommendation................................ 1,456,041,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,456,041,000 for
NIMH. The decrease from fiscal year 2013 reflects a shift of
AIDS research funding to NIAID, not a cut to core NIMH
activities.
Autism.--The Committee continues to urge NIMH to focus on
genetic as well as possible environmental causes of autism.
Autism and Telehealth.--The Committee is aware of the
increasing use of telehealth resources in the diagnosis and
treatment of autism spectrum disorders [ASD]. The NIMH has
funded a small number of grants to examine whether such
technologies can specifically be used to improve ASD diagnosis
and treatment in underserved areas of rural States. Given the
significant expansion in recent years of telehealth networks in
rural States and the potential promise of such networks to
significantly lower costs while expanding care, the Committee
urges NIMH to expand its support of this research.
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 collaborate with other Institutes, including
NIDDK and NHLBI, on a focused research program into the causes
and interventions needed to address this crisis. The Committee
requests an update on this topic in the fiscal year 2015 budget
justification.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2013\1\................................. $511,847,000
Budget estimate, 2014................................... 517,319,000
Committee recommendation................................ 513,881,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $513,881,000 for
NHGRI.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
Appropriations, 2013\1\................................. $337,681,000
Budget estimate, 2014................................... 338,892,000
Committee recommendation................................ 337,728,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $337,728,000 for
NIBIB.
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE
Appropriations, 2013\1\................................. $127,800,000
Budget estimate, 2014................................... 129,041,000
Committee recommendation................................ 128,183,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $128,183,000 for
NCCAM.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES
Appropriations, 2013\1\................................. $275,887,000
Budget estimate, 2014................................... 283,299,000
Committee recommendation................................ 281,416,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $281,416,000 for
NIMHD.
Diabetes in Minorities.--The Committee continues to urge
NIMHD to support research and other activities with respect to
pre-diabetes and diabetes, particularly type 2 diabetes, in
minority populations.
Mental Health Disparities.--The lack of access to mental
health services in rural areas presents unique challenges in
providing services to an especially vulnerable population.
Greater poverty rates in rural areas, cultural attitudes toward
mental illness, and limited transportation options all
contribute to isolating individuals with mental health needs
from access to care. In addition, individuals with mental
health problems are at greater risk of poverty so the situation
becomes part of a cycle of poverty and mental illness. The use
of telemedicine in cooperation with community mental health
programs in rural areas presents a new and effective way of
providing for diagnosis and treatment of mental health
problems. The Committee encourages NIMHD to fund research
efforts to find innovative ways to address mental health
disparities in underserved populations, such as telepsychiatry
programs, especially in designated Psychiatric Manpower
Shortage Areas.
Research Centers in Minority Institutions [RCMI].--The
Committee continues to recognize the critical role played by
minority institutions, especially at the graduate level, in
addressing the health research and training needs of minority
populations. In particular, the RCMI program fosters the
development of new generations of minority scientists for the
Nation and provides support for crucial gaps in the biomedical
workforce pipeline. The RCMI program has the capability to
promote solutions to the significant gap in R01 grant funding
among black and other minority researchers when compared to
nonminority researchers. The Committee requests that NIH
describe in the fiscal year 2015 congressional budget
justification the extent to which the RCMI program is
addressing R01 funding disparities.
JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH
SCIENCES
Appropriations, 2013\1\................................. $69,483,000
Budget estimate, 2014................................... 72,864,000
Committee recommendation................................ 72,380,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $72,380,000 for the
Fogarty International Center.
The Center plays an essential role in global health
research and training that can both assist developing countries
advance their own research and health solutions and help the
United States form partnerships to fight malaria, neglected
tropical diseases, and other infectious diseases that
disproportionately impact the global poor. The Committee urges
FIC to continue this important work.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES
Appropriations, 2013\1\................................. $574,216,000
Budget estimate, 2014................................... 665,688,000
Committee recommendation................................ 661,264,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $661,264,000 for
NCATS. The Committee includes bill language allowing up to
$50,000,000 of this amount, the same as the budget request, to
be used for the Cures Acceleration Network [CAN]. The fiscal
year 2013 funding level for CAN is $9,961,000.
Clinical and Translational Science Awards [CTSAs].--The
Committee strongly endorses IOM's recommendations in its June
2013 report, ``The CTSA Program at NIH: Opportunities for
Advancing Clinical and Translational Research.'' In particular,
the Committee agrees that NCATS should provide leadership to
help the CTSAs function more as a network than as a collection
of discrete centers; only then will the full potential of the
program be realized. In addition, the Committee agrees with the
IOM that the CTSA program should address the full spectrum of
clinical and translational research. This should include
research on changing behaviors that impact the prevention and
outcome of diseases and conditions such as obesity and type 2
diabetes.
Cures Acceleration Network.--The Committee encourages NCATS
to look at existing successful public-private co-investment
models and partnerships, particularly In-Q-Tel and SEMATECH, in
establishing CAN's strategic focus, operating procedures, and
processes.
Drug Rescue and Repurposing.--NCATS' drug rescue and
repurposing initiatives have shown success since the Center's
establishment 2 years ago. Because rescue and repurposing
builds upon previous research and development efforts, new
candidate therapies could be ready for clinical trials quickly,
advancing the timeframe for FDA approval and their integration
into healthcare. The Committee notes with particular interest
the success of The Learning Collaborative, which has had
significant success employing drug repurposing strategies to
rapidly advance new blood cancer therapies. The Committee
encourages NCATS to pursue similar efforts for other rare
diseases and unmet medical needs.
Guillain-Barre Syndrome [GBS].--The Committee notes that
the causes of GBS and related inflammatory disorders which
impact the nervous system remain unknown. The Committee
encourages ORDR to initiate research activities in this area to
improve our scientific understanding of these conditions.
Hereditary Angioedema [HAE].--The Committee continues to
recognize that few treatment options are available for HAE and
that they are not effective for all patients. The Committee
continues to encourage the Center to convene a state of the
science conference on this rare disease.
Multifocal Motor Neuropathy [MMN].--The Committee
understands that ORDR will soon issue a new funding opportunity
announcement for the Rare Disease Clinical Research Network.
Given the importance of appropriate and early diagnosis of
patients with MMN, the Committee encourages ORDR to give
appropriate consideration to approving funding for a consortium
for MMN that includes a registry for patients diagnosed with
the disease.
Pulmonary Arterial Hypertension [PAH].--The Committee
recognizes that pulmonary arterial hypertension is a rare and
often fatal condition. The Committee encourages ORDR to expand
research in this area by collaborating on research projects
with the Pulmonary Hypertension Clinical Research Network, and
the Committee encourages NCATS to consider pursuing indications
for current drugs that have shown the potential to improve
health outcomes for PAH patients.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2013\1\................................. $345,163,000
Budget estimate, 2014................................... 390,452,000
Committee recommendation................................ 387,912,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $387,912,000 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, 2015.
Communication of Research Findings.--The Committee is
pleased that NLM has expanded the readership of NIH MedlinePlus
magazine and the bilingual NIH MedlinePlus Salud magazine,
which provide consumers and health professionals easy-to-read
health information based on the latest NIH-supported research.
The Committee urges NLM to continue exploring new avenues of
online distribution that extends the publications' reach to the
public.
OFFICE OF THE DIRECTOR
Appropriations, 2013\1\................................. $1,525,125,000
Budget estimate, 2014................................... 1,473,398,000
Committee recommendation................................ 1,463,606,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $1,463,606,000 for
the Office of the Director [OD]. Within this total,
$568,151,000 is provided for the Common Fund.
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 for
this purpose but does not specify an amount in bill language.
The Committee does not include bill language requested by
the administration that would provide additional transfer
authority to the Director beyond that which is already provided
to the Secretary.
The President's budget recommends eliminating the Science
Education and Partnership Awards [SEPA] program within OD and
consolidating it within the Education Department as part of a
governmentwide reorganization of STEM education activities. The
proposed consolidation would also affect the Office of Science
Education within OD and several other smaller STEM programs
throughout NIH. The Committee is not convinced that the quality
of these programs would be maintained if they were moved to
other Federal agencies. Therefore, the Committee directs NIH to
continue funding these programs in fiscal year 2014. The
Committee includes sufficient funding within OD to support SEPA
and the Office of Science Education.
Alzheimer's Disease.--The Committee commends NIH for the
recent use of its transfer authority and other means to direct
additional funding to research on Alzheimer's disease within
very tight budgets, with the goal of finding an effective
prevention or treatment by 2025.
Amyloidosis.--The Committee encourages NIH to continue its
research efforts into amyloidosis, a group of rare diseases
characterized by abnormally folded protein deposits in tissues.
The Committee requests an update in the fiscal year 2015
congressional budget justification on the steps taken to
understand the causes of amyloidosis and efforts to improve the
diagnosis and treatment.
Angiogenesis.--The Committee commends the research NIH is
conducting on angiogenesis, specifically examining the need to
address the lack of predictive markers for angiogenic therapies
and the prospects for dietary modifications with anti-
angiogenic properties to improve cancer prevention. The
Committee urges NIH to further examine angiogenic predictive
markers across NCI, NHLBI, NEI, NIDDK, and NICHHD and to also
consider focusing on angiogenic dietary modifications to reduce
cancer risks.
Basic Research.--The Committee urges the Director to
maintain the NIH's current focus on the funding of basic
biomedical research. The purpose of basic research is to
discover the nature and mechanics of disease and identify
potential therapeutic avenues likely to lead to the prevention
and treatment of human disease. Without this early scientific
investigation, future development of treatments and cures would
be impossible.
Biomedical Research Workforce Diversity.--The Committee
supports the Director's efforts to increase racial and ethnic
minority researchers in the biomedical research workforce
through the Building Infrastructure Leading to Diversity
[BUILD] and the National Research Mentoring Network programs.
The Committee encourages NIH to promote partnerships with
historically black colleges, universities, medical schools, and
other graduate research institutions that have demonstrated a
past commitment to this goal and proven achievement in
recruiting, training, and mentoring racial and ethnic minority
researchers. The Committee requests an update in the fiscal
year 2015 congressional budget justification on this effort.
BRAIN Initiative.--The Committee strongly commends NIH for
leading the Brain Research through Application of Innovative
Neurotechnologies [BRAIN] Initiative, a multi-agency effort
that also involves the National Science Foundation and the
Defense Advanced Research Projects Agency as well as several
private sector partners. Numerous researchers are already
working to accelerate the development and application of new
technologies that will help explain how the brain records,
processes, uses, stores, and retrieves information. The BRAIN
Initiative will help catalyze and integrate these efforts. The
Committee understands that this work may take decades before it
results in cures or treatments, but could eventually help
unlock the secrets behind diseases such as Alzheimer's and
epilepsy. The President's budget requests $40,000,000 for this
initiative in fiscal year 2014, to be pooled from several ICs
and the OD. The Committee supports that amount as an initial
investment but awaits more detailed budget projections for
future years.
Career Development Awards for Clinical Researchers.--The
Committee recommends continued support for ``K'' awards to
ensure the next generation of clinical researchers is properly
trained.
Chemical Risk Assessments.--The Committee supports NIH's
leadership role in the creation of a new paradigm for chemical
risk assessment based on the incorporation of advanced
molecular biological and computational methods in lieu of
animal toxicity tests. NIH has indicated that development of
this science is critical to several of its priorities, from
personalized medicine to tackling specific diseases such as
cancer and diabetes and including critical initiatives such as
BRAIN. The Committee encourages NIH to continue to expand both
its intramural and extramural support for the use of human
biology-based experimental and computational approaches in
health research to further define human biology, disease
pathways, and toxicity and to 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 human biology-based and
Tox21-related methods and prediction tools to assure readiness
and utility for regulatory purposes, including pilot studies of
pathway-based risk assessments. The Committee requests an
update on current activities, a plan for future activities, and
the fiscal year 2014 funding level for this area of research in
the fiscal year 2015 congressional budget justification.
Chimpanzees.--The Committee strongly commends NIH for its
recent decision to substantially reduce the use of chimpanzees
in NIH-funded biomedical research and designate for retirement
most of the chimpanzees it currently owns or supports. However,
technical changes in NIH's legal authority are needed to retire
additional chimpanzees to the Federal Sanctuary System.
Therefore, the Committee includes a new general provision that
will allow NIH to achieve this goal. Specifically, the
Chimpanzee Health Improvement, Maintenance and Protection
[CHIMP] Act limits the amount of financial resources NIH may
put toward retiring chimpanzees and caring for them in the
Federal Sanctuary System. The CHIMP Act does not limit the
amount of funding NIH may provide for chimpanzees who are not
in the Federal Sanctuary System. The general provision modifies
the CHIMP Act so that NIH funds that would otherwise be used to
care only for non-Federal Sanctuary System chimpanzees can also
be used for sanctuary chimpanzees.
Chronic Fatigue Syndrome [CFS].--The Committee commends the
Office of Disease Prevention for agreeing to review the case
definition for CFS, also known as ME/CFS, as part of an
evidence-based methodology workshop. NIH is urged to include
experienced professionals in the ME/CFS research and clinical
fields as well as patients and their advocates in this process.
Further, the Committee encourages NIH to issue a special
funding opportunity to spur research into ME/CFS using the
clinical specimens collected under an NIAID-funded study. This
resource could help speed diagnostics and better understanding
of the pathophysiology of this severely disabling condition.
Congenital Diaphragmatic Hernia [CDH].--The Committee
encourages NIH to put a higher priority on CDH research. In
particular, the Committee urges NHLBI to investigate the
pulmonary effects of this birth defect and requests NICHD to
support additional research on whether the timing of surgical
repair to the diaphragm can increase an infant's chances of
survival. Along with ORDR, these two Institutes are also
encouraged to promote greater research interest in CDH by
supporting a scientific meeting on this condition.
Cystic Fibrosis [CF].--The Committee encourages new
personalized approaches to CF therapeutics, including new means
to identify and characterize the efficacy of multidrug therapy
that addresses the mutant protein which is the underlying cause
of cystic fibrosis in the majority of those with the disease.
The Committee supports research into nonsense mutations of CF,
which impact about 10 percent of the CF population. In
addition, the Committee urges further research into live
imaging modalities that are able to characterize mucus and
monitor mucociliary clearance, defense mechanisms at the heart
of CF and many other respiratory diseases.
Down Syndrome.--The Committee applauds NIH for the
establishment of the Down Syndrome Patient Registry. The
Committee urges continued investment and development of the
registry to fully realize its potential as a tool to stimulate
meaningful clinical trials and research. The Committee
recognizes that investing in Down syndrome-focused research has
the potential to benefit many other diseases and conditions
such as Alzheimer's disease. Therefore, the Committee urges NIH
to seek public-private partnerships aimed at developing
preventive therapies for the dementia associated with both Down
syndrome and Alzheimer's disease. The Committee remains
troubled by the stagnant number of investigator-driven research
awards given in the area of Down syndrome and supports efforts
to increase the Federal investment. The Committee requests a
status update in the fiscal year 2015 congressional budget
justification. The Committee urges the NIH to continue to
utilize the Down Syndrome Consortium as it updates and
implements the NIH Down Syndrome Research Plan.
Drug Allergy.--The Committee commends NIAID for leading a
recent workshop to develop a research agenda on the diagnosis
and management of patients with drug hypersensitivity. The
Committee urges NCATS, NCI, NHLBI, NIAMS, and other relevant
Institutes to collaborate with NIAID to support research in
this area, as there is a critical need for better tools to
predict patient drug allergies and for improved drug
desensitization protocols. The Committee encourages NIH to
consider a multi-Institute, multidisciplinary collaborative
effort in this area that might include support for centers of
excellence as well as the development of a patient registry.
Eosinophil-Associated Disorders.--The Committee is pleased
that NIAID recently convened the Task Force on Research Needs
of Eosinophil-Associated Diseases [TREAD], which produced a
research agenda to improve the diagnosis and treatment of these
debilitating and often painful diseases. The Committee urges
NIDDK, NHLBI, NICHD, NIAMS, and NIMH to join NIAID's efforts to
foster research in this area.
Fragile X-Associated Disorders [FXD].--The Committee
commends NICHD for leading the effort to map the molecular,
physiological, biological, and genetic connections between
Fragile X (and the Fragile X protein) and autism. The Committee
urges all ICs with Fragile X and autism portfolios to explore
these connections with the goals of better understanding both
conditions and shortening the time it will take to bring
effective treatments for both conditions to market. The
Committee also commends NICHD and its NIH partners for leading
the effort to update the NIH Research Plan on Fragile X
Syndrome and Associated Disorders, and urges NIH to fully
implement the updated recommendations.
Health Disparities in Children and Adolescents.--The
Committee urges NIH to put a high priority on improving the
health status of children and adolescents, especially those
living in poverty.
Hepatitis B.--While hepatitis B is preventable as a result
of a safe and effective vaccine, this disease is not currently
curable for those who are already infected. An estimated
800,000 to 1.4 million Americans are infected with hepatitis B
and most do not know it. The Committee urges NIH to move
aggressively to research a cure. In particular, the Committee
urges more work in antiviral drug development and continued
support and use of appropriate animal models to study the
disease.
Human Microbiome Project.--The Committee commends NIH for
establishing the Common Fund Human Microbiome Project, which
has great potential to advance scientific understanding of many
important areas of human health, including the immune system,
and urges NIH to continue to work to understand the basis of
healthy microbiome-induced immunoregulation and how it is
altered in disease.
Human Tissue Supply.--The Committee continues to urge NIH
to support its nationwide human tissue and organ procurement
program.
Interstitial Cystitis.--The Committee commends ORWH for its
continued collaborations with NIDDK to support research on
interstitial cystitis, which disproportionately affects women.
Lupus.--The Committee urges the Director to promote
collaboration among NIAMS, NIAID, NHLBI, NIDDK, NIEHS, NINDS,
NICHD, and NIMHD on efforts to expand and intensify genetic,
clinical, and basic research on lupus. Given the complexity and
impact of lupus, the Committee urges a particular focus on
understanding the underlying mechanisms of the disease, gene-
gene and gene-environmental interactions, its relationship to
kidney disease, biomarkers, pediatric research, and factors
related to the health disparities and comorbidities associated
with lupus.
Lymphatic Research and Lymphatic Disease.--The Committee
commends the trans-NIH Coordinating Committee for Lymphatic
Research [CCLR] and, in particular, NHLBI, NIAID, and NIDDK for
their efforts to advance research on the lymphatic system and
medical care for lymphatic diseases. The Committee urges
greater participation from other Institutes in the CCLR,
particularly NIAMS, NHGRI, and NIBIB. The Committee encourages
the reconvening of a trans-NIH Working Group to evaluate the
implementation of the recommendations it made in 2007.
Continued efforts within the ICs to create support for
extramural interdisciplinary research training relevant to the
lymphatic system in health and disease and within the Center
for Scientific Review to incorporate reviewer expertise in
lymphatic biology/disease in the pertinent study sections are
also requested.
Mitochondrial Disease.--The Committee commends NIH for
supporting a 2-day workshop on ``Translational Research in
Primary Mitochondrial Diseases,'' which led to the development
of a white paper that identifies barriers to progress and makes
recommendations for addressing those barriers. NIH has also
created a working group on mitochondrial disease research with
broad participation from various Institutes and Centers. The
Committee urges NIH to expand its mitochondrial research
portfolio and fully implement the recommendations contained in
the white paper.
Mucopolysaccharidosis [MPS].--The Committee continues to
urge NIH to put a high priority on better understanding and
treating MPS and related diseases. The Committee commends NIH
for allocating funds to discover, develop, define, and make
available for research animal models of human genetic disease.
The Committee also commends NIDDK for funding gene therapy
efforts. Continued funding of these grants is critical to
understanding these diseases and evaluating the efficacy and
safety of combination therapies. The Committee encourages
NINDS, NIDDK, and ORDR to continue supporting the Lysosomal
Disease Network.
National Primate Research Centers [NPRCs].--The Committee
continues to support NPRCs, which are essential to ensuring the
availability of nonhuman primate models and the expertise
needed to help researchers pursue new drugs, treatments, and
vaccines.
Natural Product Collections.--The Committee continues to
urge NIH to increase access to comprehensive and professionally
organized natural product libraries.
Neurofibromatosis [NF].--The Committee commends NIH for its
continued support of NF research and again requests an update
in the fiscal year 2015 congressional budget justification of
relevant activities at NCI, NHLBI, NINDS, NICHD, NIMH, NIAMS,
NIDCD, and NEI.
OppNet.--The Committee commends NIH for its commitment to
the Basic Behavioral and Social Science Opportunity Network
[OppNet] initiative launched in 2009. Basic behavioral science
research helps improve human health by contributing to our
understanding of the complex factors that influence
individuals. As fiscal year 2014 is the fifth year of this
initiative, the Committee requests an update in the fiscal year
2015 congressional budget justification on the contributions
made by the initiative along with recommendations on how best
to continue the program and the OppNet mission.
Overlapping Chronic Pain Conditions.--The Committee
continues to strongly support an expanded trans-NIH research
effort to better understand and identify effective treatments
for overlapping chronic pain conditions that disproportionately
impact women, including chronic fatigue syndrome,
endometriosis, fibromyalgia, interstitial cystitis, irritable
bowel syndrome, chronic headache, temporomandibular disorders,
and vulvodynia. The Committee urges NIH to promptly implement
the recommendations from the August 2012 NIH scientific
workshop on this topic. These include: developing a case
definition and research diagnostic criteria for chronic
overlapping pain conditions; leveraging existing patient
cohorts, resources, and data repositories to achieve cost
savings; conducting prospective population-based
epidemiological studies to determine the natural history of and
risk factors for onset and progression of disease; developing
common data elements, standardized outcome measures, and
methods to classify phenotypic subgroups; studying central
sensitization as a theme for discovery of common mechanisms of
disease, diagnostics, and treatment; and developing
multidisciplinary training programs for scientists and
clinicians. As no one Institute has the responsibility for
addressing all overlapping chronic pain conditions, the
Committee strongly urges multiple Institutes to combine their
efforts through centers of excellence or other appropriate
means of carrying out these recommendations.
Polycystic Kidney Disease [PKD].--The Committee continues
to urge NIH to put a high priority on PKD research.
Pregnancy Health Status.--The Committee commends NIH for
its work on the relationship between a woman's health status
during pregnancy and her health post-pregnancy. The Committee
urges NIH to prioritize the joint NICHD-NHLBI funding
opportunity ``Pregnancy as a Window to Future Cardiovascular
Disease,'' as potential life-threatening conditions such as
heart disease can be prevented based on clues during a woman's
pregnancy. The Committee also urges NICHD to ensure that short-
term studies on lifestyle interventions and treatment for
preeclampsia, as well as interventional studies that go beyond
weight management to include gestational and type 2 diabetes,
cardiovascular disease, and other chronic diseases, can be
translated into longer-term trials that will ultimately lead to
changes in obstetrical practice which result in a healthier
population.
Psoriasis.--The Committee commends NIH for addressing the
significant public health burden resulting from psoriasis and
psoriatic arthritis, the Nation's most common autoimmune
disease. In order to address the connection between these
diseases and other serious, life-threatening comorbid
conditions such as cardiovascular disease, diabetes, stroke,
and cancer, the Committee urges NIH to further promote
integrated, interdisciplinary research on the inflammatory
nature of these diseases.
Rehabilitation Research.--The Committee recognizes the
importance of rehabilitation research and commends the agency
for its work to evaluate the performance of the National Center
for Medical Rehabilitation Research. The Committee further
recommends that NIH continue to implement the recommendations
included in the final December 2012 report titled, ``Blue
Ribbon Panel on Medical Rehabilitation Research at the NIH.''
Sleep Disorders.--The Committee urges NIH to initiate new
training programs in sleep and circadian sciences in all
relevant Institutes and Centers, consistent with the NIH Sleep
Disorders Research Plan.
Spinal Muscular Atrophy [SMA] Carrier Screening.--The
Committee continues to support the development of a pan-ethnic
carrier screening program for SMA. The Committee remains
concerned that contradicting SMA carrier screening
recommendations from professional societies persist and that
this inconsistency creates confusion among health professionals
and the public. The Committee encourages NHGRI, NICHD, and
NINDS to collaborate with stakeholders from government,
academia, professional societies, advocacy groups, and industry
to resolve the discrepancy and develop unified and consistent
recommendations, guidelines, and educational materials on SMA
carrier screening for providers and patients.
Traumatic Brain Injury [TBI].--The Committee understands
that current brain imaging technology is inadequate to
accurately characterize the various degrees of TBI. The
Committee urges support for the development of new brain
imaging technologies to address this challenge.
Tuberous Sclerosis Complex [TSC].--The Committee continues
to encourage NIH to coordinate a multi-Institute approach to
finding a cure for TSC. NINDS and NCATS should play leading
roles, given the promising translational potential of new
therapeutics for treating the neurological conditions of TSC,
including autism and epilepsy. Other Institutes involved in
this collaborative effort should include NCI, NIAMS, NHLBI,
NIDDK, NINDS, NICHD, and NIBIB, as well as ORDR.
Veterinary Medicine Loan Repayment Programs.--The Committee
recognizes the important role that doctors of veterinary
medicine [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. Like other medical professionals, a large
debt load upon graduation influences their choice to pursue
careers in biomedical research. The Committee was gratified
that eligibility for the loan repayment programs was expanded
to include DVMs and would like NIH to report to the Committee
if this change increased DVM participation in these programs.
Given the vital part DMVs play in clinical research, NIH is
encouraged to continue to make this eligibility change more
widely known to potential applicants, ICs, and reviewers.
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 2013 level and the budget request.
BUILDINGS AND FACILITIES
Appropriations, 2013\1\................................. $125,093,000
Budget estimate, 2014................................... 126,111,000
Committee recommendation................................ 125,308,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $125,308,000 for NIH
buildings and facilities. This funding will remain available
for obligation for 5 years. The budget request proposes making
the funding available until expended.
Substance Abuse and Mental Health Services Administration
The Committee recommends $3,529,944,000 for SAMHSA. The
recommendation includes $132,667,000 in transfers available
under section 241 of the PHS Act. In addition, the Committee
recommends transferring $92,000,000 to SAMHSA from the PPH
Fund. The total program level assumed in this bill for SAMHSA
is $3,621,944,000.
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 recommendation includes $119,000,000 in new
funding throughout SAMHSA to increase access to mental health
services. This includes a total of $95,000,000 for the
administration's Now is the Time initiative. The Committee
provides $15,000,000 for Mental Health First Aid programs that
teach individuals to identify and respond to the signs of
mental illness; $40,000,000 for Project AWARE State grants,
which will focus on making schools safer and connecting young
people with mental health services; and $40,000,000 to address
shortages in the behavioral health workforce, including a
$5,000,000 increase for the Minority Fellowship program. In
addition, the Committee includes a new 5 percent setaside
within the Community Mental Health Services Block Grant [MHBG]
that will allocate $24,187,000 to evidence-based programs
addressing the needs of individuals with the early signs of
serious mental illness.
The Committee is disappointed that the administration has
continued to use the Substance Abuse Prevention and Treatment
[SAPT] Block Grant and the MHBG as sources for program
evaluation transfers pursuant to section 241 of the PHS Act.
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 2014, as was done prior to fiscal year
2012.
The Committee does not include new bill language requested
by the administration that would require States to set aside at
least 3 percent of both the SAPT Block Grant and MHBG to assist
providers in improving their enrollment, billing, and business
practices. The Committee recognizes the challenges faced by
some mental health and substance abuse providers in
implementing the ACA but notes that States are at varying
stages of progress in expanding insurance coverage and
increasing access to behavioral health services, and therefore
may not find this requirement necessary. The Committee also
notes that enrollment and provider business practice activities
are allowable block grant activities under current law. Rather
than impose a new ``one size fits all'' requirement, the
Committee believes that rules governing both block grants
should be as flexible as possible in order to allow States the
ability to address their own unique needs related to mental
health, substance abuse prevention, treatment, and recovery
services.
The Committee is concerned that the combined block grant
application for fiscal years 2014-2015 does not make clear
that, in the absence of congressional action, using funds to
improve provider enrollment and billing practices is an
allowable use of funds but is not a requirement. The Committee
directs SAMHSA to clarify with State mental health and
substance abuse authorities which block grant activities are
required and which are optional.
CENTER FOR MENTAL HEALTH SERVICES
Appropriations, 2013\1\................................. $952,260,000
Budget estimate, 2014................................... 1,011,380,000
Committee recommendation................................ 1,059,282,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,059,282,000 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 $27,000,000 to CMHS from the
PPH Fund. The total program level assumed in this bill for CMHS
is $1,086,282,000. 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 $357,191,000 for PRNS within CMHS.
In addition, the Committee recommends that $27,000,000 be
transferred to PRNS from the PPH Fund. The total program level
assumed in this bill for PRNS at CMHS is $384,191,000. 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Seclusion and Restraint................................ $2,439 $1,149 $1,150
Youth Violence Prevention.............................. 23,110 23,156 23,156
Project AWARE State Grants............................. ................. 40,000 40,000
Mental Health First Aid................................ ................. 15,000 15,000
Prevention and Public Health Fund (non-add)........ ................. ............... (15,000)
Healthy Transitions.................................... ................. 25,000 ...............
National Child Traumatic Stress Initiative............. 45,622 45,714 46,000
Children and Family Programs........................... 6,461 6,474 6,474
Consumer and Family Network Grants..................... 6,212 4,966 4,966
MH System Transformation and Health Reform............. 10,582 10,603 10,582
Project LAUNCH......................................... 34,571 34,640 34,640
Primary and Behavioral Healthcare Integration.......... 30,687 26,004 65,000
Prevention and Public Health Fund (non-add)........ ................. (26,004) ...............
National Strategy for Suicide Prevention............... ................. 2,000 2,000
Prevention and Public Health Fund (non-add)........ ................. ............... (2,000)
Suicide Lifeline....................................... 5,501 5,512 7,212
Prevention and Public Health Fund (non-add)........ ................. ............... (1,700)
GLS Youth Suicide Prevention (State Grants)............ 29,622 29,682 35,500
Prevention and Public Health (non-add)............. ................. ............... (5,800)
GLS Youth Suicide Prevention (Campus Grants)........... 4,956 4,966 6,500
Prevention and Public Health Fund (non-add)........ ................. ............... (1,500)
AI/AN Suicide Prevention Initiative.................... 2,933 2,938 2,938
Homelessness Prevention Programs....................... 30,710 30,772 30,772
Tribal Behavioral Grants............................... ................. ............... 5,000
Minority AIDS.......................................... 9,247 22,770 9,247
Criminal and Juvenile Justice Programs................. 6,658 4,280 4,280
Grants for Adult Trauma Screening and Brief ................. 2,896 2,896
Intervention..........................................
SCIENCE AND SERVICE:
GLS Suicide Prevention Resource Center................. 4,938 4,948 6,000
Prevention and Public Health Fund (non-add)........ ................. ............... (1,000)
Practice Improvement and Training...................... 7,847 7,863 7,847
Primary and Behavioral Healthcare Integration T.A...... 1,992 1,996 1,996
Prevention and Public Health Fund (non-add)........ ................. (1,996) ...............
Consumer and Consumer Support T.A. Centers............. 1,920 1,923 1,923
Minority Fellowship Program............................ 5,079 ............... 8,079
Disaster Response...................................... 1,050 2,950 1,958
Homelessness........................................... 2,297 2,302 2,302
HIV/AIDS Education..................................... 771 773 773
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
Primary and Behavioral Healthcare Integration.--The
Committee provides funding for this program through budget
authority rather than through transfers from the PPH Fund as
requested by the administration. The Committee continues to
direct SAMHSA to ensure that new Integration grants awarded for
fiscal year 2014 are funded under the authorities in section
520K of the PHS Act.
Psychotropic Medications and Children.--The Committee has
become increasingly concerned about the safe, appropriate, and
effective use of psychotropic medications and children,
particularly children in foster care settings. According to a
December 2012 GAO report, an alarming 18 percent of foster
children are prescribed psychotropic medications, compared with
4.8 percent of privately insured children. The Committee
strongly encourages SAMHSA to establish meaningful partnerships
with Medicaid, the foster care program, medical specialty
societies, and treatment centers to develop new strategies for
treating this vulnerable population. The Committee would like
an update in next year's congressional justification on the
steps SAMHSA has taken to promote the most effective and
appropriate treatment approaches, including the use of
evidence-based psychosocial therapies instead of, or in
combination with, psychotropic medications.
Suicide Prevention in Indian Populations.--In order to
address the high incidence of substance abuse and suicide in
American Indian/Alaska Native [AI/AN] populations, the
Committee recommends $5,000,000 for competitively awarded
grants targeting tribal entities with the highest rates of
suicide per capita over the past 10 years. The Committee
expects funds to be used for effective and promising strategies
that address the problems of substance abuse and suicide and
promote mental health among AI/AN young people.
COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT
The Committee recommends $483,744,000 for the MHBG. 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 does not include bill language requested by
the administration requiring States to set aside 5 percent of
MHBG funds for effective mental health prevention and treatment
programs. The Committee is concerned that this language is too
broad to target early treatment services to those who need it
most: individuals with serious mental illness. Instead, the
Committee bill requires States to set aside 5 percent of their
MHBG funds for evidence-based programs that address the needs
of individuals with early serious mental illness, including
psychotic disorders.
The Committee notes that the majority of individuals with
severe mental illness experience their first symptoms during
adolescence or early adulthood. Despite the existence of
effective treatments, there are often long delays--years, and
sometimes decades--between the first onset of symptoms and when
people receive help. The consequences of delayed treatment can
include loss of family and social supports, disruption of
employment, substance abuse, increased hospitalizations, and
reduced prospects for long-term recovery.
One promising model that seeks to address serious mental
illness at an early stage is called First Episode Psychosis
[FEP], currently being used in Canada, the United Kingdom, and
Australia. This early treatment model may help reduce symptoms,
reduce relapse rates, and prevent deterioration of cognitive
function in individuals suffering from psychotic illness. The 5
percent setaside will provide $24,817,000 to programs such as
FEP. The Committee provides an increase to the block grant over
the fiscal year 2013 level to help States meet this new
requirement without losing funding for existing services. The
Committee directs SAMHSA to collaborate with NIMH in developing
guidelines to States regarding effective programs funded by
this setaside.
CHILDREN'S MENTAL HEALTH SERVICES
The Committee recommends $117,315,000 for the Children's
Mental Health Services program. 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.
PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS
The Committee recommends $64,794,000 for PATH, which
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
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.
CENTER FOR SUBSTANCE ABUSE TREATMENT
Appropriations, 2013\1\................................. $2,196,938,000
Budget estimate, 2014................................... 2,124,650,000
Committee recommendation................................ 2,128,307,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $2,128,307,000 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
$50,000,000 to CSAT from the PPH Fund. The total program level
assumed in this bill for CSAT in fiscal year 2014 is
$2,178,307,000.
PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE
The Committee recommends $308,451,000 for PRNS within CSAT.
The recommendation includes $2,000,000 in transfers available
under section 241 of the PHS Act. In addition, the Committee
recommends transferring $50,000,000 to PRNS from the PPH Fund.
The total program level assumed in this bill for PRNS in fiscal
year 2014 is $358,451,000.
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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Opioid Treatment Programs/Regulatory Activities........ 8,868 8,746 8,746
Screening, Brief Intervention and Referral to Treatment 28,135 30,000 52,000
Section 241 transfer (non-add)..................... (2,000) ............... (2,000)
Prevention and Public Health Fund (non-add)........ ................. (30,000) ...............
TCE--General........................................... 27,924 13,256 13,256
Pregnant and Postpartum Women.......................... 15,938 15,970 15,970
Strengthening Treatment Access and Retention........... 1,668 1,000 1,668
Recovery Community Services Program.................... 2,440 2,562 2,440
Access to Recovery..................................... 98,071 65,000 50,000
Prevention and Public Health Fund (non-add)........ ................. ............... (50,000)
Children and Families.................................. 30,559 29,678 29,678
Treatment Systems for Homeless......................... 41,488 41,571 41,488
Minority AIDS.......................................... 65,732 52,359 65,732
Criminal Justice Activities............................ 67,372 65,135 64,446
SCIENCE AND SERVICE:
Addiction Technology Transfer Centers.................. 9,046 8,081 9,046
Minority Fellowship Program............................ 545 ............... 2,545
Special Initiatives/Outreach........................... 2,262 1,436 1,436
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
Addiction Technology Transfer Centers [ATTCs].--The
Committee continues to direct SAMHSA to ensure ATTCs continue
to maintain a primary focus on addiction treatment and recovery
services in order to strengthen the addiction workforce.
Addiction Workforce.--The Committee notes that several
studies conducted over the past decade suggest that lack of
information about the addiction field and the perception that
addiction counselors are not viewed as a valued profession
appear to be recruitment barriers for the addiction workforce.
This is particularly concerning given that the demand for
substance abuse services is anticipated to increase in the
coming years as a result of the ACA and the Mental Health
Parity and Addictions Equity Act. The Committee strongly urges
SAMHSA to work with community colleges, universities, and State
substance abuse agencies to develop ways to encourage
individuals to enter the addiction prevention, treatment, and
recovery workforce.
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. 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 extensive evidence of working
directly and extensively with the corresponding State substance
abuse agency in the planning, implementation, and evaluation of
the grant.
Infectious Disease Testing.--The Committee remains
concerned by the high incidence of viral hepatitis and HIV
among the populations that SAMHSA serves. The Committee
encourages SAMHSA to continue to support hepatitis and HIV
testing within its activities and to utilize rapid tests to
encourage patient receipt of results. In addition, SAMHSA is
encouraged to continue surveillance of these activities in
order to monitor the progress of infectious diseases screening.
Minority AIDS Initiative.--The Committee rejects the
administration request to move funds to CMHS from the Minority
AIDS Initiative administered by CSAT. The Committee urges
SAMHSA to focus its efforts on building capacity and outreach
to individuals at risk for or with a primary substance use
disorder and to improve efforts to identify such individuals to
prevent the spread of HIV.
Screening, Brief Intervention, and Referral to Treatment
[SBIRT].--The Committee provides funding for SBIRT through
budget authority rather than through transfers from the PPH
Fund as requested by the administration. 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.
Workforce Development.--The Committee is concerned that
only 50 to 55 percent of addiction counselors hold a master's
degree. While 75 percent hold at least a bachelor's degree, the
remainder have only a high school diploma or equivalent. The
Committee urges SAMHSA to work with HRSA to ensure that
programs aimed at mental health and substance use disorder
professionals are available to addiction professionals seeking
to move from a bachelor's level to a master's level.
SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT
The Committee recommends $1,819,856,000 for the SAPT block
grant. 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 States according to a formula.
Overdose Fatality Prevention.--The Committee is deeply
concerned about the increasing number of unintentional overdose
deaths attributable to prescription and nonprescription
opioids. The Committee urges SAMHSA to take steps to encourage
and support the use of SAPT Block Grant funds for opioid safety
education and training, with a focus on initiatives that
improve access of naloxone to public health and law enforcement
professionals.
CENTER FOR SUBSTANCE ABUSE PREVENTION
Appropriations, 2013\1\................................. $185,637,000
Budget estimate, 2014................................... 175,560,000
Committee recommendation................................ 175,631,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $175,631,000 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 $175,631,000 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Strategic Prevention Framework/Partnership for Success... 109,587 109,754 109,754
Mandatory Drug Testing................................... 5,186 4,906 4,906
Minority AIDS............................................ 41,224 41,307 41,307
Sober Truth on Preventing Underage Drinking (STOP Act)... 6,973 7,000 7,000
SCIENCE AND SERVICE:
Fetal Alcohol Spectrum Disorder.......................... 9,783 1,000 1,000
Center for the Application of Prevention Technologies.... 8,043 7,511 7,511
Science and Service Program Coordination................. 4,770 4,082 4,082
Minority Fellowship Program.............................. 71 .............. 71
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
The Committee recommendation provides $109,754,000 for the
Strategic Prevention Framework State Incentive Grant [SPFSIG]
and Partnerships for Success programs. The Committee intends
that these two programs continue to focus exclusively on:
addressing State- and community-level indicators of alcohol,
tobacco, and drug use; targeting and implementing appropriate
universal prevention strategies; building infrastructure and
capacity; and preventing substance use and abuse. The Committee
does not concur with SAMHSA's proposal to allow grantees to use
funds to address trauma, as this would serve to redirect the
program's purpose. In addition, the Committee intends that the
specific drug and alcohol issues chosen by a grantee should be
dictated by its own unique needs as reflected by an analysis of
community-level epidemiological data. Grantees should emphasize
prevention of underage alcohol use or prescription drug abuse
only if the data support this need.
Given that youth drug use is on the rise and perceptions of
harm are waning, the Committee directs that all of the money
appropriated explicitly for substance abuse prevention purposes
both in CSAP's PRNS lines as well as the funding from the 20
percent prevention set-aside in the SAPT Block Grant be used
only for bona fide substance abuse prevention programs and
strategies and not for any other purposes.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriations, 2013\1\................................. $136,109,000
Budget estimate, 2014................................... 201,119,000
Committee recommendation................................ 166,724,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $166,724,000 for Health
Surveillance and Program Support activities. The recommendation
includes $30,428,000 in transfers available under section 241
of the PHS Act. In addition, the Committee recommends
transferring $15,000,000 to this account from the PPH Fund. The
total program level assumed in this bill for health
surveillance and support is $181,724,000.
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 does not include bill language requested by
the administration that would provide additional transfer
authority to the Administrator beyond that which is already
provided to the Secretary.
Within the total provided for Health Surveillance and
Program Support, the Committee recommendation includes funding
for the following activities:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
Health Surveillance........................................ $44,153 $47,428 $47,428
Section 241 transfer (non-add)......................... (27,428) (45,428) (30,428)
Prevention and Public Health Fund (non-add)............ (14,733) ............... (15,000)
Program Management......................................... 76,740 72,729 72,729
Military Families.......................................... 3,486 ............... ...............
Public Awareness and Support............................... 13,518 13,571 13,571
Section 241 transfer (non-add)......................... ................. (13,571) ...............
Performance and Quality Info Systems....................... 12,945 12,996 12,996
Section 241 transfer (non-add)......................... ................. (12,996) ...............
Minority Fellowship Program................................ ................. 9,395 ...............
Peer Professional Workforce Development.................... ................. 10,000 ...............
Mental and Behavioral Education and Training Program....... ................. 35,000 35,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6.
Mental and Behavioral Health Education and Training.--The
Committee recommendation includes $35,000,000 for the joint
effort with HRSA to increase the clinical service capacity of
the behavioral health workforce through the Mental and
Behavioral Health Education and Training Grant program.
Eligible entities for this program shall include accredited
programs that train master's level social workers,
psychologists, and marriage and family therapists; psychology
doctoral interns; and paraprofessionals.
Minority Fellowships.--The Committee recommendation
includes $10,695,000 for the Minority Fellowship program, a
$5,000,000 increase above the fiscal year 2013 level. The
Committee provides funding for this program within the three
Centers as it has done in previous years, rather than in the
Health Surveillance and Program Support account as requested by
the administration. The Committee intends that the increase
provided in CSAT for Minority Fellowship be used to increase
the number of addiction counselors receiving Master's level
training.
National Survey on Drug Use and Health [NSDUH].--The
Committee is concerned about the exclusion of American Samoa,
Guam, the Northern Mariana Islands, Puerto Rico and the U.S.
Virgin Islands from NSDUH. The exclusion is especially
troubling with respect to Puerto Rico and the U.S. Virgin
Islands, which are designated as a high intensity drug
trafficking area, because NSDUH is a leading evidence-based
resource used to measure the effectiveness of Federal drug
control policies and programs. The Committee encourages SAMHSA
to consider fully incorporating each territory into the
redesign of NSDUH.
Agency for Healthcare Research and Quality
Appropriations, 2013\1\................................. $369,053,000
Budget estimate, 2014................................... 333,697,000
Committee recommendation................................ 364,008,000
\1\Excludes transfers and reprogrammings allowed under Public Law 113-6.
The Committee provides $364,008,000 for AHRQ through
transfers available under section 241 of the PHS Act. In
addition, the Committee recommends transferring $7,000,000 to
AHRQ from the PPH Fund. The total program level assumed in this
bill for AHRQ is $371,008,000.
AHRQ was established in 1990 to enhance the quality,
appropriateness, and effectiveness of health services, as well
as access to such services. AHRQ conducts, supports, and
disseminates scientific and policy-relevant research on topics
such as promoting high-quality care, eliminating healthcare
disparities, using information technology, and evaluating the
effectiveness of clinical services.
The Committee strongly supports AHRQ's unique mission
within the Department to fund health services research that
improves patient safety and promotes the delivery of high-
quality healthcare. Whereas NIH conducts biomedical research to
prevent, diagnose, and treat diseases, and CDC focuses on
population health and community-based interventions, only AHRQ
supports research that identifies the most effective clinical
and system-level interventions, prevents medical errors, and
promotes the wide-scale adoption of proven safety and quality
practices throughout the healthcare system. The Committee
recognizes the Comprehensive Unit-based Safety Program [CUSP]
as an example of successful AHRQ-funded research aimed at
preventing healthcare-associated infections [HAIs]. Within 3
months of being implemented in Michigan hospitals, this program
reduced the rate of central line-related blood stream
infections by two-thirds in more than 100 intensive care units,
and within 18 months saved more than 1,500 lives and nearly
$200,000,000. The Committee supports AHRQ's efforts in fiscal
year 2014 to expand the implementation of CUSP to include other
healthcare settings and other HAIs.
HEALTH COSTS, QUALITY, AND OUTCOMES
The Committee provides $231,384,000 for research on health
costs, quality, and outcomes [HCQO]. In addition, the Committee
recommends that $7,000,000 be transferred to HCQO from the PPH
Fund. The total program level assumed in this bill for HCQO is
$238,384,000. 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
Research on Health Costs, Quality, and Outcomes:
Patient-Centered Health Research........................ $16,600 .............. ...............
Prevention/Care Management.............................. 22,369 $20,704 $22,904
Prevention and Public Health Fund (non-add)......... (6,465) .............. (7,000)
Value................................................... 3,730 3,252 3,252
Health Information Technology........................... 25,572 25,572 29,572
Patient Safety.......................................... 65,585 62,614 71,584
Research Innovations.................................... 108,377 88,931 111,072
----------------------------------------------------------------------------------------------------------------
\1\Excludes transfers and reprogrammings allowed under Public Law 113-6.
Within the Prevention portfolio, the Committee recommends
that $7,000,000 from the PPH Fund be transferred to support the
U.S. Preventive Services Trust Fund, which works to improve
healthcare by making evidence-based recommendations about
clinical preventive services such as screenings, counseling
services, or preventive medications.
Coordination of Health Services Research.--The Committee is
concerned that the various Federal agencies conducting health
services research do not sufficiently coordinate their efforts
to optimize Federal investments in patient safety, especially
regarding HAIs. As the lead agency for health services
research, the Committee requests that AHRQ examine health
services research efforts in patient safety (including HAIs)
supported by Federal agencies since fiscal year 2010. In
particular, AHRQ should identify research gaps, areas that
could be consolidated, and emerging research priorities, and
propose strategies for better coordination among Federal
agencies. The Committee requests that AHRQ report on its
findings no later than 1 year after the enactment of this act.
Health IT Safety.--The Committee is aware that the 2011 IOM
report, ``Health IT and Patient Safety: Building Safer Systems
for Better Care,'' found large gaps in our knowledge of how
health IT impacts overall patient safety. Despite the clear
potential for health IT to improve overall healthcare quality,
patients can be harmed if IT systems fail, are poorly designed,
or provide bad information. The Committee recommendation
includes $4,000,000 for AHRQ to research safe health IT
practices specifically related to the design, implementation,
usability, and safe use of these systems. The Committee hopes
that this investment will generate new evidence on safe health
IT practices that would ultimately be used by ONC, FDA, CMS,
and others to inform certification and other policy
interventions.
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 $5,000,000 for research grants authorized by section
933 of the PHS Act. This funding will support grants for
multidisciplinary teams, consisting of patients and their
families, clinicians, technology experts, and engineers, to
develop and test best practices in healthcare delivery. This is
a new activity that was not funded in fiscal year 2013 or
requested by the administration.
Investigator-Initiated Research.--The Committee believes
that investigator-initiated research forms the backbone of
AHRQ's ability to improve healthcare with creative,
groundbreaking approaches to ongoing and emerging healthcare
issues. Within the Research Innovations portfolio, the
Committee provides $45,882,000 for investigator-initiated
research. The fiscal year 2013 level for this research is
$43,364,000 and the administration request is $29,259,000.
Training Grants.--The Committee continues to be concerned
by the reduction in training grants for health services
researchers. The Committee requests an update from AHRQ in next
year's budget justification outlining the recent status of
``K'' and ``T'' awards and other training activities.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee provides $63,811,000 for Medical Expenditure
Panel Surveys [MEPS], which 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 $68,813,000 for program support.
This activity funds the overall management of AHRQ, including
salaries, benefits, and overhead costs such as rent.
Centers for Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriations, 2013
$178,575,680,000
Budget estimate, 2014
177,872,985,000
Committee recommendation
177,872,985,000
The Committee recommends $177,872,985,000 in mandatory
funding for Grants to States for Medicaid.
The fiscal year 2014 recommendation excludes
$106,335,631,000 in fiscal year 2013 advance appropriations for
fiscal year 2014. As requested by the administration,
$103,472,323,000 is provided for the first quarter of fiscal
year 2015.
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, 2013\1\
$234,265,790,000
Budget estimate, 2014
255,185,000,000
Committee recommendation
255,697,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $255,697,000,000 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 $194,565,000,000 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 $58,596,000,000 for the
general fund share of benefits paid under Public Law 108-173,
the Medicare Prescription Drug, Improvement and Modernization
Act of 2003. 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 $373,000,000 to
be transferred to the Supplementary Insurance Trust Fund as the
general fund share of part D administrative expenses. The
Committee recommendation includes $640,000,000 in
reimbursements to the HCFAC fund.
REDUCED COST SHARING FOR INDIVIDUALS ENROLLING IN QUALIFIED HEALTH
PLANS
Appropriations, 2013....................................................
Budget estimate, 2014................................... $3,977,893,000
Committee recommendation................................................
The Committee recommendation does not include a mandatory
appropriation, requested by the administration, for reduced
cost sharing assistance for individuals enrolling in qualified
health plans purchased through the Health Insurance
Marketplace, as provided for in sections 1402 and 1412 of the
ACA.
This program helps eligible low- and moderate-income
individuals and families afford the out-of-pocket costs
associated with healthcare services.
PROGRAM MANAGEMENT
Appropriations, 2013\1\................................. $3,864,571,000
Budget estimate, 2014................................... 5,217,357,000
Committee recommendation................................ 5,217,357,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $5,217,357,000 for CMS program
management, which includes funding for research, program
operations, survey and certification programs, and Federal
administration.
Research, Demonstrations, and Evaluations
The Committee has consolidated the research office into
program operations, as requested by the President.
Program Operations
The Committee recommends $4,011,200,000 for the Program
Operations account, which 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 2013 level to support
expanding workloads due to the enrollment of the baby boom
generation in the Medicare program and to support the work
required of CMS to implement the ACA.
Fiscal year 2014 begins on the very same day the ACA will
open enrollment for new health coverage in the Health Insurance
Marketplace, which will for the first time offer Americans a
single place where they can compare the costs and benefits of
different health insurance plans and choose the one that fits
their needs. Funding in this bill will be used to oversee the
operations in the first year of the Marketplace, ensuring that
Americans get access to affordable health coverage and
understand their rights as they begin to use that coverage. In
addition, CMS will ensure compliance with the Patient's Bill of
Rights and other insurance market rules, help States enforce
the Medical Loss Ratio regulations, and implement additional
quality measures to improve healthcare services for all
Americans.
The Committee recommendation also includes funding to
continue and expand data initiatives that, for the first time,
give consumers information about healthcare costs and
utilization. For example, in 2013, CMS released data on what
hospitals charge for common procedures across the country and
data on how much Medicare spends on a State-by-State and
county-by-county basis. Businesses and consumers can use this
detailed pricing data to make important choices about needed
healthcare and health coverage. The Committee believes that
this transparency will reduce and rationalize healthcare costs
in the future.
Antimicrobial Stewardship.--The Committee continues to be
concerned by the growing problem of antimicrobial resistance.
The Committee encourages CMS to collaborate with participating
healthcare institutions to develop and implement antimicrobial
stewardship programs in all healthcare facilities, including
hospitals, long-term care facilities, long-term acute care
facilities, ambulatory surgical centers, and dialysis centers.
Community Living.--The Committee encourages CMS and ACL to
continue their joint expansion and support of home- and
community-based services for individuals with disabilities
through the Money Follows the Person program, the Community
First Choice Option, and other programs. In support of this
effort, the Committee encourages CMS and ACL to provide
regulatory guidance and technical assistance to States and
other interested parties regarding the various Federal tools
that have been created to help them expand access to home- and
community-based long-term services and supports. In addition,
the Committee encourages CMS and ACL to create an interagency
task force on implementing the Olmstead decision.
Critical Access Hospitals.--The Committee requests a list
of critical access hospitals that would be re-designated under
the administration's proposal to remove critical access
hospital status from facilities located less than 10 miles from
another hospital. CMS is encouraged to work with the Office of
Rural Health Policy at HRSA to ensure that rural patients
maintain access to necessary health services.
Dental Services.--The Committee commends CMS on its plan to
clarify dental payment policy through a State Medicaid Director
letter in 2013. CMS is directed to notify the Committee when
the letter is issued.
Frontier Health.--The Committee notes that the Frontier
Extended Stay Clinic Demonstration program reached its
statutorily mandated completion in April 2013. The Committee
directs CMS to submit a report on the outcomes of this
demonstration no later than 90 days after enactment of this
act. In addition, the Committee includes $150,000 for the
planned implementation of the Frontier Community Health
Integration Demonstration program, slated to begin in fiscal
year 2014.
Hepatitis C Screening.--The Committee is aware that the
U.S. Preventive Services Task Force recently recommended that
all Americans born between 1945 and 1965 receive one-time
screening for hepatitis C. Given that this population is
currently aging into Medicare, the Committee urges CMS to
include this one-time screening in the Welcome to Medicare
physical exam.
Immunization Payment.--The Committee strongly supports
efforts to vaccinate Americans for preventable conditions. The
Committee is concerned that a new coding rule for preventive
services when administered in conjunction with immunization may
undermine such efforts by discouraging the provision of
immunizations at well baby and well child visits. The Committee
urges CMS to reconsider this change. The Committee directs CMS
to submit a report no later than 180 days after the
implementation of the new coding rule on the impact of the
change in policy on immunization rates.
Influenza Vaccine for Healthcare Workers.--The Committee
supports the new requirement for acute care hospitals
participating in the CMS Inpatient Prospective Payment System
Hospital Inpatient Quality Reporting Program to submit summary
data on influenza vaccination of healthcare personnel via CDC's
National Healthcare Safety Network. The Committee encourages
CMS to expand required reporting to all hospitals, skilled
nursing facilities, and nursing facilities.
Infusion Pumps.--The Committee encourages CMS to conduct
further research and analysis that will determine whether small
volume infusion pumps could be used to improve patient care and
reduce healthcare costs.
Integrative Medicine.--The Committee is aware of controlled
clinical trials that have shown promising results for mind-body
approaches to preventing and treating hypertension, other
cardiovascular risk factors, and cardiovascular disease.
Additional research is warranted to determine if integrative
medicine interventions offer a unique opportunity to improve
the quality of care while reducing healthcare costs from the
Nation's leading causes of death. The Committee encourages CMS
to test integrative health interventions to determine health
outcomes and the potential for healthcare savings. In
particular, the Committee is supportive of research into mind-
body interventions for cardiovascular disease that have been
previously shown in peer-reviewed publications of clinical
trials to reduce cardiovascular risk factors, mortality,
myocardial infarction, and stroke.
Outpatient Drug Dispensing.--The Committee is strongly
committed to eliminating waste in Medicare part D and believes
that more should be done to reduce wasteful spending on
outpatient prescription drugs in long-term care facilities. The
Committee directs the Administrator of CMS to develop
additional proposals designed to encourage short-cycle
dispensing of outpatient prescription drugs in long-term care
facilities and investigate the effects of dispensing fee
changes on cost savings in the short-cycle dispensing program.
These proposals should be submitted to the Committee no later
than 180 days after enactment of this act.
Provider Nondiscrimination.--Section 2706 of the ACA
prohibits certain types of health plans and issuers from
discriminating against any healthcare provider who is acting
within the scope of that provider's license or certification
under applicable State law, when determining networks of care
eligible for reimbursement. The goal of this provision is to
ensure that patients have the right to access covered health
services from the full range of providers licensed and
certified in their State. The Committee is therefore concerned
that the FAQ document issued by HHS, DOL, and the Department of
Treasury on April 29, 2013, advises insurers that this
nondiscrimination provision allows them to exclude from
participation whole categories of providers operating under a
State license or certification. In addition, the FAQ advises
insurers that section 2706 allows discrimination in
reimbursement rates based on broad ``market considerations''
rather than the more limited exception cited in the law for
performance and quality measures. Section 2706 was intended to
prohibit exactly these types of discrimination. The Committee
believes that insurers should be made aware of their obligation
under section 2706 before their health plans begin operating in
2014. The Committee directs HHS to work with DOL and the
Department of Treasury to correct the FAQ to reflect the law
and congressional intent within 30 days of enactment of this
act.
Research.--The Committee strongly supports the research
activities that CMS undertakes to improve the efficiency of
payment, delivery, access, and quality of Medicare, Medicaid,
and ACA programs. In particular, the Committee supports the
proposed increase for the Chronic Conditions Data Warehouse,
which makes data on chronic disease rates and health
utilization trends within the beneficiary population available
to researchers. In addition, the Committee recommendation
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.
Treatment of Hard-to-Heal Wounds.--The Committee
recommendation includes $500,000 for CMS to initiate a pilot
study on the health outcomes of new medical technologies for
treating hard-to-heal wounds. This pilot study should focus on
medical technologies that are not currently eligible for
reimbursement in CMS programs.
State Survey and Certification
The Committee recommends $412,353,000 for State Survey and
Certification activities, which 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.
Infection Control Surveillance in Ambulatory Surgery
Centers.--The Committee recommendation includes full funding of
the President's requested increase for surveying ambulatory
surgical centers [ASCs], particularly in the area of infection
control surveillance. In response to a July 2012 GAO report,
CMS committed to collecting data using the agency's ASC
Infection Control Surveyor Worksheet. The Committee supports
this effort and encourages CMS to continue collecting and
analyzing the findings from this surveillance tool to inform
the agency's education and surveillance efforts moving forward.
In addition, the Committee encourages CMS to make the aggregate
data publicly available to build a better understanding of
current and future injection practices in ASCs.
High-Risk Insurance Pools
The Committee includes $22,004,000 for High-Risk Insurance
Pools. This amount is intended to reimburse States for
operational losses incurred by such pools during the first 6
months of fiscal year 2013, which allows a 3-month period for
beneficiaries to make the transition to the health insurance
marketplace.
Federal Administration
The Committee recommends $771,800,000 for Federal
Administration, which funds the majority of CMS' staff and
operating expenses for routine activities such as planning,
implementing, evaluating, and ensuring accountability in the
programs administered by CMS.
HEALTH CARE FRAUD AND ABUSE CONTROL
Appropriations, 2013\1\................................. $309,170,000
Budget estimate, 2014................................... 311,000,000
Committee recommendation\2\............................. 640,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Includes funding available under program integrity cap adjustment
provided by Public Law 112-25.
The Committee recommends $640,000,000, 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 $329,000,000 through a budget
cap adjustment authorized by section 251(b) of the Balanced
Budget and Emergency Deficit Control Act of 1985.
Funding in this bill, in addition to the $1,320,554,000 in
mandatory monies for these activities, will provide a total of
$1,960,554,000 for HCFAC activities in fiscal year 2014.
Secure Medicare Card Pilot Project.--The Committee commends
CMS on the completion of a Medicare smart card pilot project
for providers. When analysis of the data is complete, CMS is
directed to submit a report of the findings of this project to
the Committees on Appropriations. The report should include
recommendations on further study of smart card use in the
beneficiary context. Smart card technology may hold promise for
reducing identity theft and increasing the accuracy of Medicare
billing.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2013\1\................................. $2,903,752,000
Budget estimate, 2014................................... 2,965,245,000
Committee recommendation................................ 2,965,245,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $2,965,245,000 in
fiscal year 2014 mandatory funds for Child Support Enforcement
and Family Support programs. In addition, the Committee
recommends $1,250,000,000 in advance funding for the first
quarter of fiscal year 2015.
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 noncustodial 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, 2013\1\................................. $3,464,729,000
Budget estimate, 2014................................... 3,020,000,000
Committee recommendation................................ 3,614,729,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $3,614,729,000 for LIHEAP, which
provides home heating and cooling assistance to low-income
households, generally in the form of payments to energy vendors
on behalf of the recipient. Within the total, the Committee
recommendation includes up to $2,988,000 for program integrity
and oversight efforts, the same as the fiscal year 2013 level.
The Committee recommendation provides the full amount for
LIHEAP under the State formula grant and does not include
funding for the contingency fund. The Committee recommendation
also does not include funding for new energy burden reduction
grants requested by the administration.
REFUGEE AND ENTRANT ASSISTANCE
Appropriations, 2013\1\................................. $1,013,968,000
Budget estimate, 2014................................... 1,123,432,000
Committee recommendation................................ 1,121,432,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,121,432,000 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
(collectively 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 $391,477,000 for
Transitional and Medical Services [TAMS]. This program 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.
Within the total, the Committee recommendation includes not
less than $65,000,000 for the Voluntary Agencies Matching Grant
program, which provides grants to resettlement agencies to
support comprehensive services for arriving refugees with the
goal of refugees becoming self-sufficient within their first 4
months in the United States.
Victims of Trafficking
The Committee recommendation includes $15,775,000 for
Victims of Trafficking programs. Within this amount, the
Committee recommendation includes $12,775,000 for programs
serving foreign national victims and $3,000,000 for a new
program to improve services available to U.S. citizens and
legal permanent residents who are victims of trafficking.
U.S. citizens and permanent residents who are victims of
trafficking, or at risk of becoming victims, are likely to
receive services from a number of existing programs that serve
vulnerable populations, including runaway and homeless youth
shelters, domestic violence programs, and organizations working
within the criminal justice system. However, these programs may
not have the capacity to provide for the unique needs of this
particularly vulnerable population. This new funding will
increase the capacity of existing programs and the availability
of services to all victims of trafficking.
Social Services
The Committee recommendation includes $153,407,000 for
Social Services programs for refugees. 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.
The Committee continues to strongly encourage ORR to
explore the use of existing discretionary funds for case
management services and emergency housing assistance for
particularly vulnerable refugee populations.
Preventive Health
The Committee recommendation includes $4,730,000 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 for the
Targeted Assistance program. This program provides additional
funds to States with an influx of refugee arrivals and a high
concentration of refugees facing difficulties achieving self-
sufficiency.
Unaccompanied Alien Children
The Committee recommendation includes $494,597,000 for the
UAC program. 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.
There has been a significant increase in the number of
unaccompanied alien children arriving in the United States in
recent years, from approximately 7,100 in fiscal year 2011 to
an estimated 23,500 in fiscal year 2013. Many of the children
placed into HHS's care are fleeing dangerous situations in
their home country and are victims of severe forms of abuse,
neglect, or trafficking. The Committee expects HHS to continue
to provide it periodic updates on this situation. In addition,
the Committee continues to be concerned about the impact of
this dramatic increase in the number of children on the
availability of support services, including access to pro bono
legal representation, child advocates, social workers,
physicians, and psychologists. Accordingly, within the total
for the UAC program, the Committee recommendation includes
$13,000,000, an approximately $3,327,000 increase over the
fiscal year 2013 level, for the pro bono legal services
initiative. This funding supports legal representation for both
released and detained children. Given that the vast majority of
children are released to a family member or sponsor pending
resolution of their immigration status, the Committee directs
ACF to allocate a significant portion of this increase to
improve the availability of legal representation for released
children. In addition, the Committee recommendation includes
$1,000,000 for the child advocate program. This program helps
protect the interests and rights of the most vulnerable
children while awaiting adjudication of their immigration
status.
Victims of Torture
The Committee recommendation includes $13,045,000 for the
Victims of Torture program. 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, 2013\1\................................. $2,323,656,000
Budget estimate, 2014................................... 2,478,313,000
Committee recommendation................................ 2,500,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $2,500,000,000 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 child care programs.
The Committee recommendation provides $110,000,000 of the
increase over the fiscal year 2013 level for formula grants to
States, tribes, and territories to improve the quality of child
care programs. In May 2013 the administration announced new
rules to strengthen State child care standards and requirements
to improve the health, safety, and school readiness of children
in child care. These funds will support these and other efforts
to improve the quality of child care programs across all States
and settings. Funds should be used to help States raise the bar
on quality, including through training, education, and other
professional development for staff (including coaching,
mentoring, and other on-site training and technical
assistance); technical assistance to help providers become
licensed and comply with licensing and regulatory requirements;
scholarships for further education; compensation improvement
(including rewards or bonuses) linked to increased credential
or degree completion; and improving health and safety
standards. States should work with their State Early Childhood
Advisory Councils in coordinating these activities. States
applying for these funds should provide assurances that funds
will be prioritized first in areas with significant
concentrations of poverty and unemployment and 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 directs the remaining $66,344,000 increase
over the fiscal year 2013 level to the base 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 frozen
reimbursement rates for providers. As a result, fewer families
are receiving assistance and many that do are struggling to
find quality affordable child care options. This increase will
help improve low-income families' access to quality affordable
child care.
The Committee recommendation also maintains several
existing set-asides at their fiscal year 2013 level. This
includes $996,000 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. Funds set
aside for quality improvement activities within the block grant
are in addition to the $110,000,000 in new formula funds
described above and the 4 percent quality improvement set-aside
established in the authorizing legislation.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2013\1\................................. $1,700,000,000
Budget estimate, 2014................................... 1,700,000,000
Committee recommendation................................ 1,700,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,700,000,000 in mandatory funds
for the SSBG, 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, 2013\1\................................. $9,927,328,000
Budget estimate, 2014................................... 11,088,944,000
Committee recommendation................................ 11,417,876,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $11,417,876,000 in budget
authority for Children and Families Services programs,
including $5,762,000 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 $9,621,070,000 for
Head Start. Head Start provides grants directly to local public
and private organizations to provide comprehensive early
childhood education services to low-income children and their
families, from before birth to age 5.
The Committee recommendation includes bill language that
restores funding for current grantees to their fiscal year 2012
funding level and then further allows for a 1.9 percent cost of
living adjustment. This will help current grantees retain and
recruit highly qualified staff and keep pace with rising costs
to maintain high-quality services.
Within the total for Head Start, the Committee
recommendation also includes $1,430,376,000 to expand Early
Head Start services through new and existing Early Head Start
providers and through new Early Head Start-Child Care
Partnerships, as requested by the administration. Early Head
Start, which provides services to children and their families
from before birth to age 3, currently serves less than 5
percent of eligible children, yet research increasingly
supports the importance and benefits of high-quality early
childhood education beginning at the earliest ages, including
for families before birth. This increase in funding will nearly
double enrollment in Early Head Start.
Through Early Head Start-Child Care Partnerships, Early
Head Start providers will partner with local center and family-
based child care providers, leveraging current investments
through the Child Care and Development Fund, to increase the
quality of existing child care programs. Early Head Start
providers will enter into contractual relationships with local
child care programs to provide training, technical assistance,
and funding to raise the bar on the quality of those programs
to meet Early Head Start program performance standards. The
Committee includes bill language specifying that partnering
child care providers have 18 months to meet such standards
before being subject to the requirements of the Designation
Renewal System [DRS]. HHS should establish standards to ensure
that the responsibilities and expectations of the Early Head
Start provider and partnering child care providers,
respectively, are clearly defined. The Committee recommendation
also includes bill language specifying that funding for Early
Head Start-Child Care Partnerships may be used to provide
services for children through age 3.
In awarding Early Head Start expansion funds, the Committee
urges HHS to prioritize organizations that seek to develop a
unified birth-to-school-entry continuum through alignment with
maternal and infant health home visiting programs, State funded
pre-K programs, and other federally, State, or locally funded
early childhood care and education programs. Moreover, HHS
should prioritize organizations that seek to work with child
care providers across settings, including center and home-based
programs. The Committee also urges HHS to encourage a wide-
range of organizations to apply, including States, and new and
existing Early Head Start providers. Early Head Start expansion
funds, including funding for Early Head Start-Child Care
Partnerships, should be allocated to States proportionally
based on the number of young children from families whose
income is below the poverty line. Further, the Secretary shall
reserve no less than 3 percent for Indian Head Start programs
and no less than 4.5 percent for migrant and seasonal Head
Start programs, to expand services for children and their
families from before birth through age 3 in those programs.
Within the total for Head Start, the Committee
recommendation also includes up to $25,000,000, as requested by
the administration, for transition-related costs associated
with the Head Start DRS. Under the DRS, each year certain Head
Start programs are required to recompete for continued funding.
These funds support start-up and other transition-related costs
to ensure that new grantees are fully operational when an
incumbent grant ends. This minimizes any disruption in services
for children and families. In addition, the Committee continues
to encourage HHS to consider the unique challenges faced by
Head Start providers in remote and frontier areas when
reviewing grantees as part of the DRS.
Consolidated Runaway and Homeless Youth Program
The Committee recommendation includes $99,355,000 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.
The Committee recommendation for runaway and homeless youth
programs does not include funding for the ``Prevalence, Needs
and Characteristics of Homeless Youth'' study, as requested by
the administration. Instead, the Committee directs new funding
provided over the fiscal year 2013 level to the core runaway
and homeless youth programs. The Committee includes $54,636,000
for the Basic Centers program and $44,719,000 for the
Transitional Living program. The fiscal year 2013 level for the
Basic Centers program is $53,429,000 and the budget request is
$53,536,000. The fiscal year 2013 level for the Transitional
Living program is $43,731,000 and the budget request is
43,819,000.
Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth
The Committee recommendation includes $17,865,000 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 Grants
The Committee recommendation includes $26,379,000 for the
Child Abuse Prevention and Treatment State Grant program. This
program provides formula grants to States to improve their
child protective service systems.
Child Abuse Discretionary Activities
The Committee recommendation includes $25,693,000 for Child
Abuse Discretionary Activities. 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.
Community-Based Child Abuse Prevention
The Committee recommendation includes $41,444,000 for the
Community-Based Child Abuse Prevention program. 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 $11,530,000 for the
Abandoned Infants Assistance program. 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 $280,088,000 for
Child Welfare Services. This formula grant program helps State
and tribal public welfare agencies improve their child welfare
services with the goal of keeping families together. These
funds help 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 $26,039,000 for child
welfare research, training, and demonstration projects. 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 continues to encourage ACF to work with ACL
and other HHS agencies to evaluate intergenerational approaches
for improving outcomes for at-risk youth and families. The
Committee strongly encourages HHS to use existing discretionary
resources for such initiatives.
Adoption Opportunities
The Committee recommends $44,100,000 for the Adoption
Opportunities program. This 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.
Within the total, the Committee recommendation includes
$7,500,000 for discretionary grants to test intensive and
exhaustive child-focused adoptive parent recruitment strategies
for children in foster care. Such intensive recruitment
strategies have been shown to move foster youth into permanent
families at a much higher rate than traditional recruitment
approaches. These programs should focus on children that are
hardest to place because of age, disability, or sibling group
membership. In addition, the Committee encourages HHS to
provide guidance to State child welfare agencies on the use of
title IV-E Foster Care and Adoption Assistance training funds
for the implementation of intensive child-focused recruitment
strategies and other evidence-based models that have been shown
to increase the rate of placement of children in foster care,
particularly older children, into adoptive families.
The Committee remains concerned about the availability of
post-adoption services for children and their adoptive families
and strongly encourages ACF to increase funding within this
program explicitly available for such activities. The Committee
also directs ACF to submit a report by July 31, 2014, on how
ACF has used, and plans to use, Adoption Opportunities funding
to strengthen post-adoption services.
Adoption Incentives
The Committee recommends $39,268,000 for the Adoption
Incentives program. This program provides formula-based
incentive payments to States to encourage them to increase the
number of adoptions of children from the foster care system,
with an emphasis on children who are the hardest to place.
Social Services and Income Maintenance Research
The Committee recommends $14,762,000 for Social Services
and Income Maintenance Research, including $5,762,000 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 families
and contribute to the healthy development of children and
youth.
Within the total, as requested by the administration, the
Committee recommendation includes $3,000,000 for a rigorous
evaluation to examine which features of early care and
education programs most influence child and family outcomes,
and how those features interact with other child, family, and
community-level characteristics to affect such outcomes.
Within the total, the Committee recommendation also
includes $6,000,000 for the National Survey of Child and
Adolescent Well-Being, as requested by the administration.
The Committee recommendation does not include funding
requested by the administration for a new initiative addressing
financial deterrents to marriage.
Developmental Disabilities and Voting Access for Individuals with
Disabilities
In order to better align disability and aging policies and
programs, in 2012 HHS moved the Administration on Developmental
Disabilities from ACF to the newly established ACL. The
Committee supports this administrative change and accordingly
funds these programs within ACL in fiscal year 2014.
Native American Programs
The Committee recommends $48,486,000 for Native American
programs. 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 strongly encourages ACF to give priority to grantees
with rigorous immersion programs.
Community Services Block Grant
The Committee recommendation includes $676,003,000 for the
Community Services Block Grant [CSBG]. The CSBG is a formula
grant to States and Indian tribes to provide a wide range of
services 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 rejects the administration's proposed cut to
the CSBG and continues to strongly support the program, which
provides critical and flexible funding for local organizations
that serve as a central source of assistance for low-income
populations at the local level.
Community Economic Development
The Committee recommendation includes $29,883,000 for the
Community Economic Development [CED] program. This program
provides grants to community development corporations to
support employment and business development opportunities for
low-income individuals. Within the total for the CED program,
the Committee recommendation includes up to $10,000,000 for the
Healthy Foods Financing Initiative [HFFI].
The administration proposed eliminating the CED program and
moving CED funding for HFFI to the Department of the Treasury,
which also provides funding for HFFI through the Community
Development Financial Institutions [CDFI] program. The
Committee rejects this elimination and continues to allow
funding for HFFI within the CED program. The Committee strongly
encourages continued collaboration between HHS and Treasury but
notes that HFFI projects funded under CED are distinct from
those funded under CDFI.
Within the HFFI program, the Committee encourages ACF to
promote the establishment of food hubs in local communities.
Food hubs address challenges in both the distribution and
retail of healthy foods by connecting local producers to the
market. Specifically, food hubs aggregate locally grown
products from a group of producers and distribute and market
them to consumers, whether households, retailers, or
wholesalers.
Rural Community Facilities
The Committee recommendation includes $5,971,000 for the
Rural Community Facilities program. This 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 $20,000,000 for the
Assets for Independence [AFI] program. 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.
National Domestic Violence Hotline
The Committee recommendation includes $4,500,000 for the
National Domestic Violence Hotline. 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 $135,000,000 for
Family Violence Prevention and Services programs. 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 improve the availability
of services for victims of domestic violence. According to a
2012 survey, on any given day domestic violence programs must
turn down over 15 percent of requests for services, the vast
majority of which are for emergency shelter and housing,
because of a lack of resources.
Chafee Education and Training Vouchers
The Committee recommendation includes $45,084,000 for the
Chafee Education and Training Voucher program. This program
supports vouchers to foster care youth to help pay for expenses
related to postsecondary education and vocational training.
Disaster Human Services Case Management
The Committee recommends $1,988,000 for Disaster Human
Services Case Management. 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
monitoring through the recovery process.
Program Administration
The Committee recommendation includes $203,368,000 for the
Federal costs of administering ACF programs. This amount
includes up to $1,368,000 for the Center for Faith-Based and
Neighborhood Partnerships. The Committee recommendation for ACF
program administration does not include costs for administering
developmental disabilities programs and the Voting Access for
Individuals with Disabilities program, which have moved to ACL.
The Committee urges ACF to ensure that the interests of
Hispanic children and families, as well as other underserved
populations, are considered throughout their grant programs and
processes, including in grant announcements, review panels, and
evaluation activities. The Committee directs ACF to provide a
report no later than March 31, 2014, on its current and planned
efforts to meet this priority.
PROMOTING SAFE AND STABLE FAMILIES
Appropriations, 2013\1\................................. $407,938,000
Budget estimate, 2014................................... 408,065,000
Committee recommendation................................ 408,065,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $408,065,000 for the Promoting
Safe and Stable Families program. 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, 2013\1\................................. $4,817,220,000
Budget estimate, 2014................................... 4,806,000,000
Committee recommendation................................ 4,806,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $4,806,000,000 in mandatory funds
for Payments for Foster Care and Permanency. In addition, the
Committee recommends $2,200,000,000 in advance mandatory
funding for the first quarter of fiscal year 2015. 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.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriations, 2013\1\................................. $1,467,974,000
Budget estimate, 2014................................... 1,714,755,000
Committee recommendation................................ 1,716,664,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $1,716,664,000
for ACL, which includes $52,115,000 in Medicare trust funds. In
addition, the Committee recommends that $31,700,000 be
transferred to ACL from the PPH Fund. The total program level
assumed in this bill for ACL is $1,748,364,000. Both the budget
request and Committee recommendation reflect a consolidated
account structure for ACL, which was established by HHS in
April 2012 by combining the organizational components of AoA,
the HHS Office on Disability, and the Administration on
Developmental Disabilities. The fiscal year 2013 total for ACL
does not reflect this reorganization, and therefore is not
directly comparable to fiscal year 2014.
ACL was created with the goal of increasing access to
community supports for older Americans and people with
disabilities. It 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 the Home- and Community-Based Supportive Services program.
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, and in-home assistance
such as personal care and homemaker assistance.
Preventive Health Services
The Committee recommends $20,944,000 for Preventive Health
Services. This program funds activities such as medication
management and enhanced fitness and wellness programs. These
programs help seniors stay healthy and avoid chronic disease,
thus reducing the need for costly medical interventions. The
Committee maintains bill language that requires States to use
these funds to support evidence-based models that enhance the
wellness of seniors.
Protection of Vulnerable Older Americans
The Committee recommends $21,797,000 for grants to States
for 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.
The Committee urges the Long-term Care Ombudsman program to
include ombudsman training on the possible dangers of chemical
and physical restraints, including portable adult bedrails, and
how to safely minimize their use.
National Family Caregiver Support Program
The Committee recommends $153,621,000 for the National
Family Caregiver Support program. 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 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 $216,830,000 for home-
delivered meals. These programs address the nutritional needs
of older individuals, thus helping them to stay healthy and
reduce their risk of disability. 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]. NSIP augments
funding for congregate and home-delivered meals provided to
older adults. States and tribes may choose to receive all or
part of their funding in the form of commodities from the
Department of Agriculture.
Aging Grants to Indian Tribes and Native Hawaiian Organizations
The Committee recommends $27,601,000 for grants to Native
Americans. This program provides grants to eligible tribal
organizations for the delivery of nutrition and supportive
services to Native Americans.
Aging Network Support Activities
The Committee recommends $7,873,000 for Aging Network
Support activities. 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.
Improving Transportation for Older Americans.--The
Committee is aware of the growing need for transportation
services for older Americans and urges ACL to support efforts
to encourage private-public partnerships to carry out section
416 of the OAA.
Alzheimer's Disease Demonstration Grants to States
The Committee recommendation includes $4,002,000 for
Alzheimer's Disease Demonstration Grants to States. This
program funds competitive grants to States to test and
implement new models of care for individuals with Alzheimer's
disease.
Alzheimer's Disease Initiative
The Committee recommends $14,700,000 in mandatory funding
be transferred from the PPH Fund to ACL for the Alzheimer's
Disease Initiative. Of the total, $10,500,000 is provided to
expand the availability of home- and community-based dementia
services and supports. The remaining $4,200,000 is provided for
a public awareness outreach campaign regarding Alzheimer's
disease.
Lifespan Respite Care
The Committee recommends $2,490,000 for the Lifespan
Respite Care program. 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.
Chronic Disease Self-Management Program
The Committee recommends $10,000,000 in mandatory funding
be transferred from the PPH Fund to ACL for the Chronic Disease
Self-Management Program [CDSMP]. 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. 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. Preventing falls will help
seniors stay independent and in their homes and avoid costly
hospitalizations and hip fractures, which frequently lead to
nursing home placement. The Committee intends that these funds
should be used in coordination with CDC 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 new program, as
authorized in the Elder Justice Act, will provide competitive
grants to States to test and evaluate innovative approaches to
preventing and responding to elder abuse. The Committee
encourages ACL to test innovative practices in local
communities that develop partnerships across disciplines for
the prevention, investigation, and prosecution of abuse,
including financial abuse against the elderly.
Senior Medicare Patrol
The Committee recommends $9,402,000 for the Senior Medicare
Patrol program. These funds support a network of retired senior
volunteers who educate older adults on preventing and
identifying healthcare fraud and abuse.
Elder Rights Support Activities
The Committee recommends $4,088,000 for Elder Rights
Support activities. 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 $6,444,000 for ADRCs.
These centers provide information, one-on-one counseling, and
access for individuals to learn about their long-term services
and support options with the goal of allowing seniors and
individuals with disabilities to maintain their independence.
The Committee urges ACL to improve coordination among ADRCs,
area agencies on aging, and centers for independent living to
ensure that there is ``no wrong door'' to access services.
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.
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. About two-thirds of the
54 State SHIPs are already administered by State units on
aging. SHIP activities are aligned with ACL's mission to
develop a comprehensive system of home- and community-based
services to help seniors maintain their health and
independence.
National Clearinghouse on Long-Term Care Information
The Committee recommendation includes $3,000,000 for the
National Clearinghouse on Long-Term Care Information. The
Clearinghouse supports activities that raise awareness of
public and private options available for long-term care needs.
Community Service Employment for Older Americans
The budget request proposes moving the CSEOA program to
ACL. The Committee rejects that change and continues to provide
funding for this program in the Department of Labor.
Paralysis Resource Center
The Committee recommendation includes $6,700,000 for the
Paralysis Resource Center [PRC], which provides comprehensive
information and referral services to people living with
paralysis and their families. The Committee concurs with the
administration request to transfer funding and administrative
responsibility for the PRC from CDC to ACL. The Committee
believes the PRC will benefit from ACL's goals of maximizing
the independence and well-being of people with disabilities, as
well as its ties to disability networks.
Developmental Disabilities State Councils
The Committee recommendation includes $74,774,000 for State
councils on developmental disabilities. These councils work to
develop, improve, and expand the system of services and
supports for people with developmental disabilities at the
State and local level. Councils engage in activities such as
training, educating the public, building capacity, and
advocating for change in State policies with the goal of
furthering 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 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 to improve
voting access for individuals with disabilities. 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 $9,317,000 for
projects of national significance to assist persons with
developmental disabilities. 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.
Human Services Transportation.--The Committee
recommendation includes $1,000,000 for a competitive grant or
contract for the purpose of providing generally available
technical assistance to local government and nonprofit
transportation providers. This assistance should focus on the
most cost-effective ways to provide transportation assistance
to all persons of any age with disabilities. The activities
should be limited to onsite technical assistance, establishment
of a technical assistance Web site, a toll free hotline and
preparation of technical material. 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.
University Centers for Excellence in Developmental Disabilities
The Committee recommendation includes $38,792,000 for
University Centers for Excellence in Developmental Disabilities
[UCEDDs]. The UCEDD program supports a network of 67
university-based centers that conduct research, provide
interdisciplinary education, 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 $30,035,000 for program
administration at ACL. These funds support salaries and related
expenses for program management and oversight activities. The
Committee recommendation includes the administrative costs
associated with the Administration on Developmental
Disabilities and the Office on Disability, which are now part
of ACL. The fiscal year 2013 level does not reflect the
administrative costs of these other components and therefore is
not directly comparable to fiscal year 2014.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriations, 2013\1\................................. $542,585,000
Budget estimate, 2014................................... 421,276,000
Committee recommendation................................ 517,381,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $517,381,000 for General
Departmental Management [GDM]. The recommendation includes
$70,173,000 in transfers available under section 241 of the PHS
Act.
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 $250,000 for
continued support of the Advisory Council on Alzheimer's
Research, Care, and Services.
Adolescent Health.--The Committee supports the efforts of
the Office of Adolescent Health [OAH] to improve health and
reduce risky behaviors among adolescents. The recommendation
includes not less than $1,500,000 for OAH to coordinate
activities within the Department with respect to adolescent
health, including program design and support, trend monitoring
and analysis, research projects, the training of healthcare
professionals, and demonstration projects to improve adolescent
health.
Alzheimer's Disease.--The Committee strongly supports the
National Plan to Address Alzheimer's Disease and its goal of
preventing and effectively treating Alzheimer's disease by
2025. The Committee encourages the Department to include
specific annual milestones as well as measures to assess
progress within each annual report authorized by the National
Alzheimer's Project Act. To ensure all appropriate Federal
departments and agencies are informing the plan, the Department
should consider adding representatives from NCATS and the
Office of Science and Technology Policy to the Advisory Council
on Alzheimer's Research, Care and Services. The Committee also
encourages the Department to ensure the perspectives of
patients with Alzheimer's disease are represented by
establishing a patient representative position to the council.
Asthma.--The Committee is concerned that in the 6 years
since the release of NIH's Expert Panel Guidelines for the
Diagnosis and Management of Asthma, very few children being
treated in a primary care setting are receiving in vitro
testing or skin testing to manage their asthma more effectively
with an increased focus on achieving and maintaining good
asthma control over time. The Committee directs the Secretary
to report to the Committee within 60 days of enactment of this
act on the barriers to primary care adoption of standardized
and reproducible allergy tests for children and adults with
asthma and related conditions. The report should recommend
actions to remove such barriers to testing, which is a critical
component of the guidelines.
Chronic Fatigue Syndrome [CFS].--The Committee endorses the
Department's continued support of the CFS Advisory Committee
and urges accelerated progress to enact its recommendations to
strengthen research, education, training, care, and services to
better address the needs of one million Americans living with
CFS.
Federal E-Health Working Group.--The Committee encourages
the Secretary to convene a national working group on e-health
and telemedicine to improve communication, coordination and
collaboration among relevant Federal agencies regarding e-
health needs, standards, Federal goals, and Federal efforts.
Such a working group should seek to reduce duplication and e-
health incompatibility, as well as improve health quality,
effectiveness, and outcomes.
Hiring Individuals With Disabilities.--The Committee is
very supportive of Executive Order 13548 and the Department's
goal to raise the representation of individuals with
disabilities in its workforce from 9 percent in fiscal year
2011 to 11 percent by fiscal year 2015. However, the Committee
understands that the Department is not on pace to meet this
target. The Committee encourages the Department to accelerate
its efforts toward achieving the goals of this important
executive order.
Immunotherapy and Asthma.--The Committee notes that an AHRQ
review published earlier this year concluded that allergy
immunotherapy is an effective treatment for allergic rhinitis,
reduces asthma symptoms, lowers the use of asthma medications,
and improves patient quality of life. Studies have also shown
that allergy immunotherapy is highly cost-effective and
severely underutilized. The Committee encourages the Secretary
to develop a multi-agency initiative involving the NIH, AHRQ,
CMS, and CDC to support research that will identify patient,
healthcare provider, and systems barriers to initiation and
adherence to allergy immunotherapy and develop interventions to
address these problems.
National Advisory Committee on Children and Disasters.--The
Committee is concerned about the Nation's preparedness to meet
the needs of children and pregnant women during disasters. The
Committee notes that the Pandemic and All-Hazards Preparedness
Reauthorization Act of 2013 requires the Secretary to establish
a National Advisory Committee on Children and Disasters which
would bring together Federal and non-Federal experts to provide
advice and recommendations on medical and public health
preparedness before, during, and after a disaster or public
health emergency. The Committee requests a report from the
Secretary on the status of the National Advisory Committee
within 90 days of enactment of this act.
Overdose Prevention.--The Committee notes that 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 is concerned that many healthcare
professionals, treatment providers and at-risk populations are
unaware of overdose prevention and reversal strategies. The
Committee urges the Secretary, in collaboration with other
agencies such as SAMHSA and CDC, to raise awareness of the
symptoms and risk factors of overdose, how to deploy naloxone,
rescue breathing and emergency services for someone
experiencing an overdose, and how to help individuals make the
linkage to treatment and recovery services.
Prescriber Education.--The administration's ``Prescription
Drug Abuse Plan'' called on the Department to work with the
Department of Justice and the Office of National Drug Control
Policy on ways to educate practitioners on safe and proper
prescribing of opioid painkillers as a prequalification for
those individuals obtaining a Drug Enforcement Administration
license to prescribe and dispense controlled substances. The
Committee requests an update on these efforts in next year's
congressional justification.
Urban-Based Network.--The Committee continues to support
the efforts of the Secretary and other agencies within the
Department, such as HRSA, AHRQ, CDC, CMS, NIMHD, and the Office
of Minority Health, to support a network of urban-based
institutions focused on 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 $113,245,000 for the
Teenage Pregnancy Prevention program. The recommendation
includes $8,455,000 in transfers available under section 241 of
the PHS Act. The Committee provides $104,790,000 in funding for
this activity through budget authority, rather than through
transfers from the PPH Fund as requested by the administration.
This program supports competitive grants to public and private
entities to replicate evidence-based teen pregnancy prevention
approaches.
Office of Minority Health
The Committee recommends $42,560,000 for OMH. This Office
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 recommendation includes $2,000,000 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. The Committee
continues to strongly support this program, which is intended
to engage healthcare providers, educators, and schools of
health professions in working together to improve lupus
diagnosis and treatment through education.
Chronic Kidney Disease [CKD].--The Committee continues to
encourage OMH to prioritize early detection and treatment of
CKD in minority communities to improve health outcomes and
eliminate these severe health disparities.
Offices of Minority Health.--The Committee continues to
support 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 notes that the Offices of Minority Health in the
Office of the Secretary, AHRQ, CDC, CMS, FDA, HRSA, and SAMHSA
are charged with leading the strategy.
Abstinence Education
The Committee recommendation does not include funding for
abstinence education. Instead of funding a separate program for
this purpose, the Committee supports the Teen Pregnancy
Prevention program, which funds evidence-based strategies to
reduce teen pregnancy, including those that emphasize
abstinence.
Office of Women's Health
The Committee recommends $26,808,000 for OWH. This office
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, in
order to address the disparities in women's health.
The Committee recommendation includes $2,300,000 to
continue the violence against women's health initiative. This
initiative provides a public health response to abuse by
training healthcare providers in interventions that identify,
assess, and refer victims of domestic and sexual violence.
HIV/AIDS in Minority Communities
The Committee recommends $53,891,000 to address high-
priority HIV prevention and treatment needs of minority
communities heavily impacted by HIV/AIDS. 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. 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, 2013\1\................................. $71,867,000
Budget estimate, 2014................................... 82,381,000
Committee recommendation................................ 82,381,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee provides $82,381,000 for OMHA. This Office is
responsible for hearing Medicare appeals at the administrative
law judge level, which is the third level of Medicare claims
appeals. OMHA 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 for OMHA to hire
more administrative law judge teams and increase its capacity
to process its rising caseload.
The Committee is concerned by both the growing backlog of
cases at OMHA and the high rate of claims overturned by the
Office. Over half of the cases sent to OMHA are overturned; of
the remaining cases, 37 percent are overturned through the
departmental appeal process. The Department is urged to work
with providers at the early stages of the audit process so that
only a small number of cases are ultimately appealed and the
loss of provider time, energy, and resources due to incorrect
audit results are limited.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
Appropriations, 2013\1\................................. $61,193,000
Budget estimate, 2014................................... 76,883,000
Committee recommendation................................ 71,597,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee makes available $71,597,000 to ONC, which
includes $51,307,000 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.
The Committee includes new bill language providing ONC with
the authority to collect and spend user fees authorized in a
new general provision. These user fees will support its
electronic health record certification and standards
development activities. These activities previously were
supported with funding appropriated in the American Recovery
and Reinvestment Act. This appropriation will expire at the end
of fiscal year 2013.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2013\1\................................. $49,983,000
Budget estimate, 2014................................... 68,879,000
Committee recommendation................................ 59,879,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $59,879,000
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 $200,279,000
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.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2013\1\................................. $40,857,000
Budget estimate, 2014................................... 42,205,000
Committee recommendation................................ 42,205,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $42,205,000 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.
The recommendation will allow OCR to strengthen its capacity to
enforce Federal standards for health information privacy and
security called for in the Health Insurance Portability and
Accountability Act.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriations, 2013.................................... $527,151,000
Budget estimate, 2014................................... 550,372,000
Committee recommendation................................ 550,372,000
The Committee provides an estimated $550,372,000 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, 2013\1\\2\.............................. $1,799,207,000
Budget estimate, 2014................................... 1,289,530,000
Committee recommendation................................ 1,304,400,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Includes emergency funding of $800,000,000 in the Disaster Relief
Appropriations Act, 2013 (division A of Public Law 113-2).
The Committee recommends $1,304,400,000 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.
Office of the Assistant Secretary for Preparedness and Response
The Committee recommendation includes $1,065,817,000 for
activities administered by ASPR. This Office 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.
Public Health Emergency Research.--The Committee recognizes
that important infectious diseases research often must be
conducted during a public health emergency and that the lack of
clear Federal guidelines in this area presents barriers to
researchers. The Committee encourages ASPR to consult with the
Office for Human Research Protections and other HHS offices and
agencies about establishing a public health emergency research
review board. ASPR also should work to coordinate and
strengthen research capacities between CDC, NIH, FDA, DOD, the
VA, and the academic medical community.
Virtual Training.--The Committee continues to note the need
for realistic virtual reality simulation training technologies
at the local community level that will help prepare medical
responders and hospitals for public health emergencies. The
Committee encourages ASPR to develop core competencies and
standardized curricula for virtual training using state-of-the-
art, simulation medical response technology.
Hospital Preparedness Program
The Committee's recommendation includes $254,555,000 for
the Hospital Preparedness Program. This program provides grants
to States to build healthcare coalitions that enhance regional
and local hospital preparedness and improve overall surge
capacity in public health emergencies.
Emergency System for Advance Registration of Volunteer
Health Professionals [ESAR VHP]
The Committee recommendation includes $505,000 for the ESAR
VHP program, which has established a national network of health
professionals who provide assistance during an emergency.
Funding will provide technical support to States to continue
the program's mission.
Biomedical Advanced Research and Development
The Committee recommendation includes $415,000,000 for
advanced research and development. The Committee provides
funding for BARDA through budget authority rather than through
transfers from the Project BioShield Special Reserve Fund [SRF]
advance appropriation, as it has done in previous years.
BioShield SRF balances will expire at the end of fiscal year
2013.
Anthrax Vaccine.--While the Committee remains concerned
about the Nation's preparedness against biological threats, it
recognizes that BARDA has made strides in developing and
acquiring products to combat anthrax, including a next-
generation recombinant anthrax vaccine. The Committee
encourages the continuation of these targeted efforts toward a
clinically advanced and affordable vaccine.
Antimicrobial Development.--The Committee is aware that CDC
recently reported a four-fold increase in multidrug-resistant
bacteria over the last 10 years. Unfortunately, existing
treatment options are limited and few new drugs are likely to
become available to address these bacterial threats in the near
term. The Committee strongly encourages BARDA to prioritize its
Broad Spectrum Antimicrobial program.
Strategic Investor
The Committee recommendation includes $15,000,000 to create
the Strategic Investor program. This program will provide
financial support and business expertise to emerging biodefense
companies that develop medical countermeasures for the Federal
stockpile.
Medical Countermeasure Dispensing
The Committee recommendation includes $5,000,000 for the
Medical Countermeasure Dispensing program. 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.
Project BioShield Special Reserve Fund
The Committee recommendation includes $250,000,000 for the
Project BioShield SRF. The Committee strongly supports the
mission of Project BioShield and intends to continue providing
support for the procurement of medical countermeasures [MCMs]
in future fiscal years. The Committee includes a new general
provision requested by the administration allowing BARDA to
enter into incrementally funded, multiyear contracts for up to
10 years rather than the standard limit of 5 years. The new
provision also modifies existing multiyear contracting
authority by allowing BARDA to repurpose unused termination
costs to pay contract invoices in subsequent years. These
modifications will allow BARDA to use multiyear authority to
engage in long-term contracts with companies that develop
medical countermeasures.
The Committee directs BARDA to utilize this new multiyear
contracting authority, providing for termination as appropriate
in the event that funds are not made available in future fiscal
years, to meet the known current and future national need for
particular MCMs. The Committee believes that the multiyear
contracts will provide a clear indicator to industry of the
Federal Government's future support for medical countermeasure
development, while at the same time promoting economy in the
administration, performance, and operation of BARDA. The
Committee requests that BARDA provide a 5-year spend plan for
fiscal years 2014-2018, which shall be made public, detailing
the funding amounts required to support advanced development
contracts for these products.
Other Activities
The Committee recommendation includes the following amounts
for the following activities within ASPR:
--Operations.--$33,213,000;
--Preparedness and Emergency Operations.--$24,789,000;
--National Disaster Medical System.--$52,502,000; and
--Policy and Planning.--$15,253,000.
Office of the Assistant Secretary for Administration
The Committee recommends $41,125,000 for information
technology cybersecurity in the Office of the Assistant
Secretary for Administration. 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 $8,979,000 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.
Office of the Secretary
The Committee recommendation includes $188,479,000 for
activities within the Office of the Secretary.
Pandemic Influenza Preparedness
The Committee recommendation includes $140,009,000 for
Pandemic Influenza Preparedness. Of the total, $32,009,000 is
provided in annual funding and $108,000,000 in no-year funding.
Since fiscal year 2012 the Department's pandemic flu activities
have been funded from existing balances from prior supplemental
appropriations. However, HHS anticipates spending all of these
balances by the end of fiscal year 2013. The Committee
recommendation will support the goals defined in the HHS
Pandemic Influenza Plan, which includes maintaining the
Department's egg supply program, developing new methods for
extending the life of vaccines in the Strategic National
Stockpile, maintaining a fill-finish manufacturing network, and
supporting the advancement of vaccine capability in other
countries.
Lease Replacement
The Committee recommendation includes $41,000,000 for space
consolidation for several HHS agencies, as well as fit-out
costs for lease replacement.
Office of Security and Strategic Information
The Committee includes $7,470,000 for the Office of
Security and Strategic Information to maintain the security of
the Department's personnel, systems, and critical
infrastructure.
PREVENTION AND PUBLIC HEALTH FUND
The PPH Fund was created in the ACA and provides
$13,500,000,000 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. Recognizing the Committee's
responsibility to determine funding levels for community-based
prevention and public health programs, the ACA specifically
gives the Committee authority to transfer funds into Federal
programs that support the goal of making America healthier.
In fiscal year 2014, the level appropriated for the fund is
$1,000,000,000, the same as the fiscal year 2013 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
----------------------------------------------------------------------------------------------------------------
HRSA.................................... Health Workforce.......... Alzheimer's Disease $5,300,000
Education and Outreach.
HRSA.................................... Health Workforce.......... Public Health Training 25,000,000
Centers.
CDC..................................... Immunization and Immunization program...... 150,000,000
Respiratory Diseases.
CDC..................................... HIV/AIDS, Viral Hepatitis, Viral Hepatitis screening 10,000,000
STD, and TB Prevention. and prevention.
CDC..................................... Emerging and Zoonotic Epidemiology and 40,000,000
Infectious Diseases. Laboratory Improvement
program.
CDC..................................... Emerging and Zoonotic Healthcare-Associated 12,000,000
Infectious Diseases. Infections.
CDC..................................... Chronic Disease Breastfeeding Promotion 15,000,000
Prevention, Health and Support program.
Promotion, and Genomics.
CDC..................................... Chronic Disease Community Transformation 280,000,000
Prevention, Health Grants.
Promotion, and Genomics.
CDC..................................... Chronic Disease Diabetes Prevention 10,000,000
Prevention, Health Program.
Promotion, and Genomics.
CDC..................................... Chronic Disease High-Obesity Regions...... 5,000,000
Prevention, Health
Promotion, and Genomics.
CDC..................................... Chronic Disease Let's Move (National Early 4,000,000
Prevention, Health Care and Education
Promotion, and Genomics. Collaboratives).
CDC..................................... Chronic Disease Million Hearts............ 5,000,000
Prevention, Health
Promotion, and Genomics.
CDC..................................... Chronic Disease National School Food 1,700,000
Prevention, Health Marketing Assessment.
Promotion, and Genomics.
CDC..................................... Chronic Disease Nutrition, Physical 10,000,000
Prevention, Health Activity, Obesity Grants.
Promotion, and Genomics.
CDC..................................... Chronic Disease Office of Smoking and 95,000,000
Prevention, Health Health.
Promotion, and Genomics.
CDC..................................... Chronic Disease Prevention Research 10,000,000
Prevention, Health Centers.
Promotion, and Genomics.
CDC..................................... Chronic Disease Racial and Ethnic 40,000,000
Prevention, Health Approaches to Community
Promotion, and Genomics. Health.
CDC..................................... Chronic Disease Workplace Wellness grants. 10,000,000
Prevention, Health
Promotion, and Genomics.
CDC..................................... Public Health Scientific Guide to Community 7,400,000
Services. Preventive Services.
CDC..................................... Public Health Scientific National Center for Health 35,000,000
Services. Statistics.
CDC..................................... Environmental Health...... Chronic Disease Biomarkers 4,200,000
CDC..................................... Environmental Health...... Environmental and Health 35,000,000
Outcome Tracking Network.
CDC..................................... Injury Prevention and Falls Prevention 3,000,000
Control. activities.
CDC..................................... CDC-Wide Activities....... National Prevention, 1,000,000
Health Promotion and
Public Health Council.
CDC..................................... CDC-Wide Activities....... Public Health 40,000,000
Infrastructure grants.
CDC..................................... CDC-Wide Activities....... Public Health Workforce... 15,700,000
SAMHSA.................................. Mental Health............. Mental Health First Aid... 15,000,000
SAMHSA.................................. Mental Health............. Suicide Prevention........ 12,000,000
SAMHSA.................................. Substance Abuse Treatment. Access to Recovery........ 50,000,000
SAMHSA.................................. Health Surveillance and Surveillance activities... 15,000,000
Program Sup- port.
AHRQ.................................... Health Costs, Quality, and U.S. Preventive Services 7,000,000
Outcomes. Task Force.
ACL..................................... Aging and Disability Alzheimer's Disease Self- 14,700,000
Services Programs. Management.
ACL..................................... Aging and Disability Chronic Disease Self- 10,000,000
Services Programs. Management.
ACL..................................... Aging and Disability Falls Prevention.......... 7,000,000
Services Programs.
----------------------------------------------------------------------------------------------------------------
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.
Section 215. The Committee recommendation continues a
provision permitting NIH to use up to $3,500,000 per project
for improvements and repairs of facilities.
Section 216. The Committee recommendation includes a
provision that transfers funds from NIH to HRSA and AHRQ, to be
used for National Research Service Awards.
Section 217. The Committee recommendation includes a new
provision allowing continued funding of the Sanctuary System
for Surplus Chimpanzees.
Section 218. The bill continues a provision prohibiting the
use of funds for lobbying activities related to gun control.
Section 219. The Committee recommendation modifies a
provision requiring a publicly available Web site that details
expenditures from the PPH Fund.
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 authorizing user fee collections to the Office of the
National Coordinator for Health Information Technology to
support certification and standards activities.
Section 222. The Committee recommendation includes a new
provision that provides BARDA with authority to enter into a
multiyear contract for up to 10 years and to repurpose unused
termination costs to pay contract invoices.
Section 223. The Committee recommendation includes a new
provision requiring fiscal year 2015 budget justifications to
include certain FTE information with respect to ACA.
Section 224. The bill includes a new general provision
allowing National Health Service Corps contracts to be canceled
up to 60 days after award.
Section 225. The Committee recommendation includes a new
general provision that ensures that NIH has the contracting
flexibility it needs to efficiently manage the federally Funded
Research and Development Center it sponsors while also ensuring
that all financial obligations incurred in fiscal year 2014 are
fully funded with fiscal year 2014 appropriations.
Section 226. The bill includes a new provision expressing
the sense of the Senate on income verification for ACA exchange
plans.
Section 227. The bill includes a new provision related to
ACA exchange funding transparency.
TITLE III
DEPARTMENT OF EDUCATION
Education for the Disadvantaged
Appropriations, 2013\1\................................. $15,710,221,000
Budget estimate, 2014................................... 15,655,002,000
Committee recommendation................................ 15,875,231,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of
$15,875,231,000 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 2014-2015 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. Title I Grants are
distributed through four formulas: basic, concentration,
targeted, and education finance incentive grant.
The Committee recommends $14,612,425,000 for the Title I
Grants to LEAs program. Of the funds available for Title I
Grants to LEAs, up to $4,000,000 shall be available on October
1, 2013, and may be transferred to the Census Bureau for
poverty updates; $3,767,248,000 will become available on July
1, 2014; and $10,841,177,000 will become available on October
1, 2014. The funds that become available on July 1, 2014, and
October 1, 2014, will remain available for obligation through
September 30, 2015.
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.
School Improvement Grants
The Committee recommendation includes $567,485,000 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, States may 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 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 bill also provides new flexibility to LEAs that are
eligible to receive services under the Rural Education
Achievement Program to modify not more than one element
required under a school improvement model. The bill also
includes new language allowing SEAs, with the approval of the
Secretary, the ability to establish an alternative State-
determined school improvement strategy that may be used by LEAs
under the SIG program. The purpose of this alternative strategy
is to allow SEAs to develop their own flexible models that can
be implemented by LEAs that receive SIG funds.
The Committee expects that any approach taken with SIG
funds should address schoolwide factors, whole school culture,
the individual needs of the students, and the use of data to
inform instruction and provide continuous improvement; ensure
that the needs of the students are met through the organization
of the school, curriculum and instruction, and social and
emotional support services; and improve teacher and leader
effectiveness, including through training and support for
teachers and school leaders in school improvement efforts and
in the needs of students.
The Committee bill also includes new language that extends
the availability of SIG funds in order to provide LEAs and
schools with the time needed to implement effective,
sustainable turnaround efforts. The Committee believes that
this flexibility should be used to provide schools with the
opportunity to receive performance-based grant extensions.
Striving Readers Comprehensive Literacy Program
The Committee recommends $164,378,000 to continue the
Striving Readers Comprehensive Literacy program.
The Committee bill includes language that continues the
competitive portion of the program as it was established in the
fiscal year 2010 appropriations act. Striving Readers is a
birth-through-12th grade comprehensive initiative focused on
data and assessment, systemic interventions, professional
development, and explicit literacy instruction. To strengthen
State grantees' ability to improve students' literacy skills,
the Committee directs the Secretary to provide it with a report
within 60 days of enactment of this act on the Department's
policies and procedures for providing timely, evidence-based,
and effective technical assistance and support, particularly
with regard to State grantees' evaluation activities. In
addition, the program offers an important opportunity to test,
learn, and share effective policies and practices to strengthen
student literacy. Therefore, the Committee directs the
Secretary to utilize the 5 percent set-aside for national
activities to implement a national evaluation of the Striving
Readers program.
Migrant Education Program
The Committee recommends $392,450,000 for the title I
Migrant Education program.
This funding supports grants to SEAs for programs to meet
the special educational needs of the children of migrant
agricultural workers and fishermen. Funding 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 $50,130,000 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 reentry of youth
offenders who are age 20 or younger and have received a
secondary school diploma or its recognized equivalent.
Evaluation
The Committee recommends $3,028,000 for evaluation of title
I programs.
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,
except for titles I and III of the ESEA, for evaluation of ESEA
programs funded in this act. The Department is required to
provide the Senate Committees on Appropriations and HELP an
operating plan describing the proposed uses of this new
evaluation authority as well as the source appropriation for
such activities. In addition, not later than 45 days prior to
the submission of the required operating plan, the Department
shall brief the Senate Committees on Appropriations and HELP on
the programs and activities being considered for inclusion in
the plan. Further, the Committee expects the Department to
include in future congressional budget justifications a
discussion of its planned use of this new authority.
High School Graduation Initiative
The Committee recommends $48,809,000 for the High School
Graduation Initiative under title I, part H of the ESEA.
The High School Graduation Initiative provides competitive
grants to LEAs or SEAs to implement effective high school
graduation and reentry 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 for Special Programs
for Migrant Students, which consist of HEP and CAMP.
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, attain admission
to a postsecondary 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.
School Readiness
Appropriations, 2013....................................................
Budget estimate, 2014................................... $750,000,000
Committee recommendation................................ 750,000,000
The Committee recommends $750,000,000 to create a new
Preschool Development Grants program.
This program will award competitive grants to States to
support their efforts to expand or create high-quality
preschool systems for 4-year-olds from low- and moderate-income
families, including children with disabilities. Preschool
Development Grants will complement the administration's
Preschool for All proposal, which will provide matching
mandatory funds to States for improving access to such high-
quality preschool systems. The Department will award two types
of grants, one to low-capacity States with small or no State-
funded preschool programs and another to high-capacity States
that have a larger State-funded preschool program. These grants
will help States address fundamental needs including workforce
development, quality improvement efforts, and the scale-up of
proven preschool models. The bill allows States to subgrant
funds to LEAs and to LEAs in partnership with other early
learning providers. The Committee directs the Department to
require any use of child assessments to conform to the
recommendations and cautions of reports by the National
Research Council on assessments of children.
This new program, combined with investments in programs
administered by HHS, will help improve the quality of early
learning and development programs for ages birth through 5 and
help close the achievement gap for children from low-income
families.
Impact Aid
Appropriations, 2013\1\................................. $1,288,603,000
Budget estimate, 2014................................... 1,224,239,000
Committee recommendation................................ 1,290,945,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,290,945,000 for the Impact Aid
program.
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 for the Basic Support Payments program. 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.
The Committee bill also includes new language that would
continue heavily impacted payments through 2014 for LEAs that
received such payments in 2009.
Payments for Children With Disabilities.--The Committee
bill includes $48,316,000 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
$4,835,000 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 for
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. Fiscal year 2012 and 2013 funds were
available for distribution only under the competitive portion
of the program.
Payments for Federal Property.--The Committee recommends
$66,813,000 for Payments for Federal Property. These payments
compensate LEAs in part for revenue lost due to the removal of
Federal property from local tax rolls.
The Committee bill includes new language allowing a
district to carry its section 8002 eligibility to a new school
district that was formed as a result of district consolidation.
School Improvement Programs
Appropriations, 2013\1\................................. $4,535,506,000
Budget estimate, 2014................................... 2,028,313,000
Committee recommendation................................ 4,621,862,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommendation includes $4,621,862,000 for
the School Improvement Programs 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, as authorized under the ESEA.
State Grants for Improving Teacher Quality
The Committee recommends $2,461,634,000 for State Grants
for Improving Teacher Quality.
The appropriation for this program primarily supports
activities associated with the 2014-2015 academic year. Of the
funds provided, $780,193,000 will become available on July 1,
2014, and $1,681,441,000 will become available on October 1,
2014. These funds will remain available for obligation through
September 30, 2015.
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 for the Supporting
Effective Educator Development program, which provides
competitive awards to national not-for-profit organizations for
recruiting, training, or providing professional enhancement
activities for teachers and school leaders, particularly for
high-need schools most likely to face shortages in these areas.
These funds may be used to support such activities in civic
learning. The Committee recommends that up to 5.5 percent of
funds available for State Grants for Improving Teacher Quality
shall be used for this purpose; in fiscal year 2013, 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 $149,417,000 for the Mathematics
and Science Partnerships program.
At the recommended funding level, the ESEA requires the
Department to award grants by formula to States for competitive
awards to eligible partnerships, which must include an
engineering, math, or science department of an institution of
higher education 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.
Supplemental Education Grants
The Committee recommendation includes $17,583,000 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
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 $1,200,000,000
for the 21st Century Community Learning Centers [21st CCLC]
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 after-school programs, recreational activities, drug and
violence prevention, and family literacy programs for students
and related services to their families. Centers must target
their services 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.
The Committee is aware of a growing interest in extending
the school day and/or school year as a means of providing
additional educational opportunities to students. Therefore,
the Committee includes new bill language that will give LEAs
the option of using 21st CCLC subgrants for extended learning
time programs. LEAs will continue to be able to use the funding
for high-quality, afterschool, before school, and summer
learning programs if they choose.
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 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 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, particularly in data-sharing arrangements;
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 also believes SEAs should ensure that local
communities receiving 21st CCLC program funds identify
strategies for students to engage in programs and services
during the afternoon and early evening hours while most parents
or guardians are at work.
The Committee is aware that many States already have the
option of using 21st CCLC funding for extended learning time
through the ESEA-No Child Left Behind waiver process. The
Committee directs the Secretary to provide it with a report on
the impact of the flexibility provided to SEAs under waiver
option 11 on the 21st CCLC program. 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 $408,436,000 for the State
Assessments and Enhanced Assessment Instruments program.
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 not less than $398,436,000 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 up to $10,000,000.
Javits Gifted and Talented Education
The Committee recommends $15,000,000 for the Javits Gifted
and Talented Students Education program. Funds will be used for
awards to State and local educational agencies, institutions of
higher education, and other public and private agencies for
research, demonstration, and training activities designed to
enhance the capability of elementary and secondary schools to
meet the special educational needs of gifted and talented
students, including those from disadvantaged and
underrepresented populations.
Within these funds, the Committee also directs the
Department to support a National Research Center on the Gifted
and Talented.
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 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 $6,947,000.
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.
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 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 concerned that the fiscal year 2012
competition for this program did not sufficiently recognize the
statutory provisions related to applications from Alaska Native
regional nonprofit organizations or from consortia that include
at least one Alaska Native regional nonprofit organization. The
Committee notes that two competitive preference points were
awarded for applications from such organizations, and nine
points were awarded for non-statutory priorities established by
the Department. The Committee finds this unacceptable and
directs the Department to more appropriately adhere to sections
7304(c) and 7305(b) of the ESEA in all future funding decisions
and grant competitions and ensure that all grantees have
meaningful plans for consultation with Alaska Native leaders.
The Committee also directs the Department to prepare and
submit a report, within 180 days of the enactment of this act,
on how the Department will work to improve consultation with
and promote the maximum participation of Alaska Native
organizations, Alaska Native regional nonprofit organizations,
and consortia that include at least one Alaska Native regional
nonprofit organization in the program. The report should also
outline steps the Department will take to ensure that all
current grantees have meaningful plans for consultation with
Alaska Native organizations.
Rural Education
The Committee recommends $179,193,000 for rural education
programs.
The Committee expects that rural education funding will be
equally divided between the Small, Rural School Achievement
Program, which provides funds to LEAs that serve a small number
of students, and the Rural and Low-Income School Program, which
provides funds to LEAs that serve concentrations of poor
students, regardless of the number of students served.
The Committee notes that almost one-third of the Nation's
schools are in rural areas. The GAO and others have noted the
unique challenges faced by these schools, including recruiting
and retaining highly qualified teachers; offering access to
advanced coursework, such as Advanced Placement courses;
meeting transportation costs that diminish resources available
for academic and enrichment programs; and writing successful
applications for grant competitions given their more limited
administrative capacity. The Committee is very concerned that
the Department has generally failed to recognize these
challenges over the past 4 years, particularly in some of its
grant competitions. The Investing in Innovation program offers
a welcome departure from this pattern, as the Department
altered its competition to provide an absolute priority for
rural applicants, instead of the competitive preference
priority it established in the initial competition. The
Committee directs the Department to immediately take action to
improve its record in the area of rural education. The
Committee requests a report not later than 30 days after
enactment of this act describing the actions the Department has
taken and will take to ensure that the needs of students in
rural schools are effectively met by the programs it
administers. The report should specifically address how the
Department organizes or will organize itself to ensure rural
expertise is available to program staff throughout the
Department, and strategies the Department is taking or will
take to ensure that students in rural LEAs are able to benefit
from competitive grant opportunities and other resources
available through Department's discretionary appropriations.
Comprehensive Centers
The Committee recommends $51,113,000 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 15 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 7 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 2015 congressional budget justification.
Indian Education
Appropriations, 2013\1\................................. $130,318,000
Budget estimate, 2014................................... 130,779,000
Committee recommendation................................ 130,318,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $130,318,000 for Indian education
programs.
Grants to Local Educational Agencies
For grants to LEAs, the Committee recommends $105,710,000.
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 $18,948,000 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 $5,660,000 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, 2013\1\................................. $1,524,482,000
Budget estimate, 2014................................... 5,699,092,000
Committee recommendation................................ 1,331,598,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,331,598,000 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 recommendation includes $250,000,000 to
create a new Race to the Top for College Affordability and
Completion [RTT-CAC] initiative to incentivize State-level
postsecondary education reform. State investments in
postsecondary education have declined over the past several
years, shifting the cost burden to students and families
through higher tuition and fees. At the same time, total
student loan debt has crossed the $1,000,000,000,000 mark and
average student loan debt has topped nearly $27,000.
Given that public colleges and universities educate about
three-quarters of all students, States are in a critical
position to reform policies that will improve student outcomes
and lead to lower costs. The RTT-CAC initiative will reward and
incentivize States that undertake reforms, including:
modernizing funding policies that incentivize completion and
maintaining fiscal support for education; supporting innovative
methods of student learning; empowering consumer choice through
increased transparency; and, improving the transition from
secondary into postsecondary education and between institutions
of higher education. The majority of funding will flow through
States to institutions of higher education and support
innovative practices that increase productivity and reduce
costs. The Committee directs the Secretary to prioritize
applications that will specifically address college
affordability and completion issues facing low-income,
minority, and nontraditional students and students with
disabilities.
Investing in Innovation
The Committee recommends $170,000,000 for the Investing in
Innovation program.
Investing in Innovation, which was established in ARRA,
provides funding 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 absolute priority given to rural
applicants in previous competitions and believes that this
priority should continue to be used in the fiscal year 2014
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 bill also includes new language providing that funds
for this program are available until expended. This authority
will ensure that funds can be used to effectively implement and
evaluate program models being tested under this program.
Effective Teachers and Leaders
The Committee recommends no funding to create the Effective
Teachers and Leaders State Grant program.
The Committee has provided $2,461,634,000 for State Grants
for Improving Teacher Quality within the School Improvement
Programs account. These funds may be used for purposes that are
similar to those under this proposed program.
Effective Teaching and Learning: Literacy
The Committee recommends no funds for the proposed
Effective Teaching and Learning: Literacy program. 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 for a Well-Rounded Education
The Committee recommends no funds for the proposed
Effective Teaching and Learning for a Well-Rounded Education
program. 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. 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.
Science, Technology, Engineering, and Mathematics [STEM] Innovation
The Committee does not recommend creating a new STEM
Innovation program, a collection of STEM activities requested
by the administration. Instead, the bill provides funding for
some of the same proposed activities through existing programs,
including $55,000,000 within FIE for STEM Innovation Networks.
The proposed STEM Innovation initiative is comprised of
STEM Innovation Networks, STEM Teacher Pathways, the STEM
Master Teacher Corps, and the Effective Teaching and Learning:
STEM program. These programs are intended to develop, validate,
and scale up effective practices in pre-K-12 STEM instruction;
increase student engagement in STEM subjects; and recruit,
prepare, and further develop highly effective STEM educators.
High School Redesign
The Committee recommends no funds for the proposed High
School Redesign program because of budget constraints.
This program would promote the whole school redesign of the
high school experience in order to provide students with
challenging and relevant academic and career-related learning
experiences that prepare them for postsecondary education and
careers.
Expanding Educational Options
The Committee recommends no funding to create the Expanding
Educational Options program. The program would generally
support competitive grants to SEAs, LEAs, charter school
authorizers, charter management organizations, and other
nonprofit organizations to start or expand high-performing
charter schools and other autonomous public schools.
The Committee provides resources under current law programs
that may be used for purposes that are similar to those
proposed under this new program.
Transition to Teaching
The Committee recommends no funds for the Transition to
Teaching program.
This program has provided 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.
School Leadership
The Committee recommends $64,049,000 for the School
Leadership program.
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 district and school leaders and managers
play in creating an environment that fosters effective teaching
and high academic achievement for students. The Committee bill
includes new language allowing grant funds to be awarded
directly to not-for-profit organizations and to be used to
train district leaders and managers, in addition to school
leaders. The Committee bill also includes new language that
allows the Secretary to further define eligibility as a high-
need LEA.
Charter Schools
The Committee recommends a total of $254,326,000 for the
support of charter schools.
The Committee allocates the recommended funding as follows:
$175,326,000 for Charter School Grants, up to $11,000,000 for
State Facilities incentives, not less than $12,000,000 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.
Charter Schools Grants support the planning, development,
and initial implementation of charter schools. SEAs that have
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. In addition, this year's bill requires that
not less than $45,000,000 of funds available for charter school
grants shall 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.
The Committee bill also includes new language that allows
charter school funds to be used for preschool programs in
charter schools.
Magnet Schools Assistance
The Committee recommends $99,611,000 for the Magnet Schools
Assistance program.
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 $137,644,000
for FIE.
Within programs of national significance, the Committee
includes $29,000,000 to continue an initiative of 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
awarded to 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 bill also includes $55,000,000 for grants to support
STEM Innovation Networks. These funds will be used to make
competitive awards to LEAs or groups of LEAs, in partnership
with institutions of higher education, not-for-profit
organizations, museums, and businesses, to transform STEM
teaching and learning, particularly for high-need students and
underrepresented populations, as well as support a virtual
learning network for STEM educators. The goal of the networks
is to increase the number of students interested in and
prepared for postsecondary education and STEM careers. The
Committee is particularly interested in approaches that will
engage students in the early grades.
The Committee urges the Department to put a priority on
reaching underrepresented populations, such as girls and
minorities, and using nontraditional STEM teaching activities,
including robotics competitions, as a means of further engaging
and inspiring students to pursue further study or careers in
STEM education.
The Committee recommendation also includes $17,000,000 for
the Improving Mathematics Achievement and Transition to College
from High School [IMATCH] program. 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 in the last 2 years of high school and first 2
years of college.
The Committee is particularly interested in available funds
being used to encourage, engage, inspire, and motivate students
to enter and succeed in the STEM fields.
The Committee is aware of specialized teacher preparation
programs at university-based schools of education that prepare
teachers to work in urban school districts and support hands-on
science and math curriculum in middle schools. These programs
provide tuition assistance and specialized coursework to
teacher candidates and partner with local school districts to
support co-teaching by master teachers, mentorships, and field
placements. The Committee supports high-quality programs that
focus on meeting the needs of children in urban school systems.
Within programs of national significance, the Committee
also recommends $2,024,000, combined with funds available
through the Department's new Disability Innovation Fund and the
Department of Labor, to support interagency strategies to
strengthen reengagement activities and outcomes of Federal
programs serving disconnected youth including through
performance partnership pilots, $5,344,000 to continue awards
for full-service community schools, $1,176,000 for data quality
and evaluation initiatives, and $100,000 for peer review. It
also includes $1,000,000 to continue the education facilities
clearinghouse, 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
$27,000,000 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 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 to support a partnership with the
National Endowment for the Arts.
Teacher Incentive Fund
The Committee recommendation includes $298,834,000 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.
The Committee is concerned that TIF's focus has been
diverted away from its intended purpose, as first authorized by
the Department of Education Appropriations Act, 2006, which is
specifically to develop and implement performance-based teacher
and principal compensation systems in high-need schools.
However, the Department's final priorities, requirements,
definitions, and selection criteria for TIF competitions in
fiscal year 2012 greatly expanded what Congress intended in
creating this program. Therefore, the Committee directs the
Secretary to restore the original focus of TIF by limiting
awards to eligible entities in support of innovative approaches
at the State and local level to design, implement, and improve
performance-based compensation systems for teachers and
principals in high-need schools.
Effective Teachers and Leaders Innovation Fund
The Committee recommends no funding to create the Effective
Teachers and Leaders Innovation Fund proposed in the budget
request.
The Committee provides $298,834,000 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.
Ready-To-Learn Television
The Committee recommendation includes $27,139,000 for the
Ready-to-Learn Television program.
This 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 $29,995,000 for AP programs.
Funds have supported 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, 2013\1\................................. $255,241,000
Budget estimate, 2014................................... 580,000,000
Committee recommendation................................ 330,481,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends a total of $330,481,000 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 $56,754,000 for the Promise
Neighborhoods program.
Funds are available for obligation through December 31,
2014. By providing an extra quarter to obligate these funds,
the Committee gives 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.
Competitive grants are awarded to not-for-profit,
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.
Successful, Safe, and Healthy Students
The Committee recommends no funds for this proposed
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 $143,000,000 for the
national activities portion of the Safe and Drug-Free Schools
and Communities program. This funding, part of the Committee's
violence prevention initiative, will help schools address the
consequences of their students witnessing or being the victim
of violence and other root causes of unhealthy school climates.
From the amount available for national activities, the
Committee recommends $71,500,000 to help schools create
positive learning environments, including $50,000,000 for a new
School Climate Transformation Grants program, which will train
school staff to implement evidence-based strategies, such as
positive behavioral interventions and supports, to improve
school climate. The Committee recommendation also provides
$25,000,000 for grants to SEAs to help LEAs develop, implement,
and improve their emergency management plans; $25,000,000 for
Project Prevent, which will award grants to LEAs to help
schools in troubled communities break the cycle of violence; up
to $8,000,000, to remain available until expended, for Project
SERV, which offers education-related services following violent
or traumatic events; $10,000,000 for other national activities;
and $3,500,000 for continuation costs related to technical
assistance contracts awarded in prior years.
Elementary and Secondary School Counseling
The Committee recommends $52,191,000 to establish or expand
counseling programs in elementary and secondary schools. 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 $78,536,000 to help
LEAs and community-based organizations initiate, expand, and
improve physical education programs for students in grades K-
12. 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, 2013\1\................................. $730,680,000
Budget estimate, 2014................................... 732,144,000
Committee recommendation................................ 730,680,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $730,680,000
for the English Language Acquisition program.
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, 2013\1\................................. $12,615,427,000
Budget estimate, 2014................................... 12,657,307,000
Committee recommendation................................ 12,803,387,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of
$12,803,387,000 for special education programs.
Grants to States
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 2014-2015 academic year. Of the
funds available for this program, $2,439,563,000 will become
available on July 1, 2014, and $9,283,383,000 will become
available on October 1, 2014. These funds will remain available
for obligation through September 30, 2015.
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 continues language clarifying provisions of
the IDEA. The first provision clarifies that penalties for
violating the State maintenance of effort [MOE] 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 the current 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 most recent
fiscal year for which the LEA met the MOE compliance standard.
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 for Preschool Grants.
This 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 for the Grants for
Infants and Families program under part C of the IDEA. 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 $43,829,000 for the State
Personnel Development program. Ninety percent of funds must 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. The bill
includes language proposed in the budget request that allows
funds under the program to be used for program evaluation.
Technical Assistance and Dissemination
The Committee recommends $46,688,000 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.
Personnel Preparation
The Committee recommends $88,122,000 for the Personnel
Preparation program.
Funds support competitive awards to help address State-
identified needs for personnel who are qualified to work with
children with disabilities, including special education
teachers and related services personnel. The 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 $28,917,000 for Parent Information
Centers.
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 $29,529,000 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
As proposed in the budget, the Committee does not continue
funding for PROMISE in OSEP. Instead, the bill continues
support for this program by means of 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.
Special Olympics
The Committee recommendation includes $8,000,000 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.
Consistent with the President's budget request, the
Committee bill clarifies that funds made available under the
Special Olympics Sport and Empowerment Act of 2004 may be used
to support expenses associated with the Special Olympics
National and World Games hosted in the United States. This
language was not included in last year's bill, but has been
included in bills from prior years.
The Committee notes that the Special Olympics National
Games are held only once every 4 years in the United States and
that the next National Games are to be held in 2014. Through
the spirit of sport, the National Games showcase and celebrate
the abilities of athletes with intellectual disabilities and
promote inclusion and acceptance of all people, most especially
those with intellectual disabilities. The Committee expresses
its support for the National Games and recognizes the
significant contribution that the Special Olympics organization
has made to children and adults with intellectual disabilities
across America. The Committee intends that up to $2,000,000
available under this act be used to support the Games.
Rehabilitation Services and Disability Research
Appropriations, 2013\1\................................. $3,619,762,000
Budget estimate, 2014................................... 3,655,577,000
Committee recommendation................................ 3,698,174,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
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Vocational Rehabilitation State Grants
The Committee recommends $3,302,053,000 for VR State
Grants. The Committee recommends the full amount authorized by
the Rehabilitation Act of 1973 for this mandatory funding
stream.
Basic State Grants 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 2014 for VR State Grants be set aside for Grants
for American Indians.
The Committee bill includes language, as requested by the
administration, allowing unmatched funds in excess of any funds
requested during the reallotment process to support a new
Disability Innovation Fund [DIF] that will support activities
aimed at improving outcomes for individuals with disabilities
as defined in section 7(20)(B) of the Rehabilitation Act,
including activities under the PROMISE program. Such funds used
for these activities will remain available for obligation
through September 30, 2015.
PROMISE was created in fiscal year 2012 with the goal of
improving outcomes, such as employment and completion of
postsecondary education, of children who receive SSI, as well
as their families. Competitive grants will be awarded in the
fall of 2013 to a small number of States for a period of 5
years. States will use funds to improve outcomes, enhance
coordination, and increase the use of existing services for
which children receiving SSI and their families are already
eligible.
After covering the costs of PROMISE, the administration
requests and the Committee recommends new authority through the
DIF to provide $5,000,000 to support a new cross-agency
initiative aimed at improving the educational and employment
outcomes for disconnected youth with disabilities and providing
targeted technical assistance to support performance
partnership pilots. The Committee expects the initiative to
serve youth with disabilities between the ages of 14 and 24 who
are homeless, in foster care, involved in the justice system,
or are neither employed nor enrolled in an educational
institution.
As requested by the administration, the Committee bill also
includes new bill language that allows the DIF to support Pay
for Success pilots, which will provide performance-based awards
to States or local governments and not-for-profit organizations
providing or arranging services that improve education,
employment, and other key outcomes for youth with disabilities.
The Committee expects to be notified prior to the issuance of
any notice related to Pay for Success activity.
The DIF will also support a joint SSA-ED demonstration
targeted at individuals who are likely to be eligible for
services under the VR State Grant program and at risk of
becoming future SSI or SSDI beneficiaries. The Committee
intends for SSA and ED to incentivize State efforts and use
various State and Federal programs and funding streams, which
could include the VR State Grant program, to provide early
intervention services aimed at preserving the well-being and
work ability of the nonbeneficiaries most at risk of becoming
severely impaired. The Committee strongly supports
demonstrations that are focused on college to career pathways.
The amount of unused VR State Grant funding will not be
determined until the end of fiscal year 2014. If an excess
amount of funds are available after supporting PROMISE and the
disconnected youth and SSA-ED initiatives, the Committee
expects the DIF to support the development of effective,
evidence-based strategies to improve the long-term outcomes for
people with disabilities. The Committee should be notified in
advance of announcements related to any additional activities.
Client Assistance State Grants
The Committee recommends $12,215,000 in discretionary funds
for Client Assistance State Grants.
This 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 $35,444,000 for training
rehabilitation personnel. The budget request provides
$30,188,000 and proposes to eliminate funding for the In-
Service Training program. The Committee maintains funding for
this program.
Funding for training is intended 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 not-for-profit 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 $6,514,000 for demonstration and
training programs.
This program awards grants to States and not-for-profit
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 designed to promote promising
and evidence-based practices to improve postsecondary and
employment outcomes for youth with disabilities. The technical
assistance will include practices developed and implemented by
RSA's Transition Model Demonstration projects that ended in
September 2012.
The Committee recommendation also includes $750,000 to
support a new competition for parent information and training
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 $1,259,000 for the Migrant and
Seasonal Farmworkers program. The budget request proposes to
eliminate this program and to pay continuation costs for fiscal
year 2014 out of funding for the VR State Grant 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 $17,995,000 for the Protection and
Advocacy of Individual Rights program.
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 $29,010,000 for the Supported
Employment State Grant program. The budget request does not
include funding for this program.
Supported Employment State Grants provide assistance to the
most severely disabled individuals by providing ongoing support
needed to obtain competitive employment.
Independent Living State Grants
The Committee recommends $23,312,000 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 $79,794,000 for Centers for
Independent Living.
These funds support consumer-controlled, cross-disability,
nonresidential, community-based centers that are designed and
operated within local communities by individuals with
disabilities. These centers provide an array of independent
living services.
Independent Living Services for Older Individuals Who Are Blind
The Committee provides $33,951,000 for the Independent
Living Services for Older Individuals Who Are Blind program.
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 $9,127,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults.
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 11
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 $110,000,000 for NIDRR. This
funding level includes $1,200,000, as requested by the
administration, to support research activities that focus on
improving employment outcomes for people with disabilities.
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.
Assistive Technology
The Committee recommends $37,500,000 for the Assistive
Technology program.
This 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.
Special Institutions for Persons With Disabilities
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriations, 2013\1\................................. $24,456,000
Budget estimate, 2014................................... 24,505,000
Committee recommendation................................ 24,456,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $24,456,000 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.
The Committee notes that APH has established a digital data
action plan that explores new technologies, and is supportive
of APH's efforts to improve Braille translation and tactile
graphics through digital data software.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2013\1\................................. $65,291,000
Budget estimate, 2014................................... 65,422,000
Committee recommendation................................ 66,422,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $66,422,000 for NTID.
The Committee recommendation for NTID consolidates funds
into the operations line for NTID and does not include funding
for construction. The Committee will consider funding for
construction in the future as needs may warrant.
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, 2013\1\................................. $125,265,000
Budget estimate, 2014................................... 117,541,000
Committee recommendation................................ 118,541,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $118,541,000 for Gallaudet
University.
Gallaudet University is a private, not-for-profit
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
university's Kendall Demonstration Elementary School develops
and provides instruction for children from infancy through age
15.
The Committee recommendation increases operations funding
over the fiscal year 2013 level by $1,235,000 but does not
include funding for construction. Congress appropriated a total
of $15,934,000 in fiscal years 2012 and 2013 to support
construction. This funding, combined with approximately
$13,000,000 available from prior fiscal years, is covering the
costs of constructing a new 200-bed dormitory to house all
residential students at the Model Secondary School for the
Deaf.
Career, Technical, and Adult Education
Appropriations, 2013\1\................................. $1,733,680,000
Budget estimate, 2014................................... 1,750,154,000
Committee recommendation................................ 1,743,949,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
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Career and Technical Education
The Committee recommends $1,135,844,000 for the Career and
Technical Education [CTE] account.
State Grants.--The Committee recommends $1,123,030,000 for
CTE State grants.
Funds provided under the State grant program assist States,
localities, and outlying areas to 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 what these groups receive under other provisions of the
Perkins Act.
Of the funds available for this program, $332,030,000 will
become available July 1, 2014, and $791,000,000 will become
available on October 1, 2014. These funds will remain available
for obligation until September 30, 2015.
National Programs.--The Committee recommends $12,814,000
for national research programs and other national activities,
including $5,000,000 for a new dual enrollment initiative that
supports CTE career pathways and targets local workforce needs.
The Committee adds new bill language allowing adult education
providers as eligible partners and adult education students as
eligible participants as well as requiring grantees to use
funding to supplement and not supplant other Federal, State, or
local public funds used for adult education and literacy
activities.
Dual enrollment programs enable high school students and
adults without a high school equivalency credential to pursue
postsecondary education and earn course credit that can be
applied to a college degree or credential. Research shows dual
enrollment programs are associated with gains in college
enrollment and credit accumulation and higher grades. The
Department will make competitive awards that help establish or
expand dual enrollment programs through partnerships among
institutions of higher education, LEAs that operate high-need
public schools or adult education providers, and State and
local agencies responsible for secondary and adult education
and workforce training. This funding will provide students with
support services, including tutoring, assistance completing
financial aid applications and selecting courses, mentoring,
career counseling, and assistance transferring from 2-year to
4-year institutions of higher education. Funds will also
support activities designed for students with limited
proficiency in English or from groups traditionally
underrepresented in postsecondary education, individuals with
disabilities, students who are homeless or in foster care, or
disconnected youth.
The Committee recommendation includes additional funding
for this dual enrollment initiative in the Government
Performance and Results Act [GPRA] Data/HEA Program Evaluation
program.
Adult Education
The Committee recommends $608,105,000 for Adult Education
programs.
Adult Education State Grants.--For adult basic and literacy
education State grants, the Committee recommends $593,803,000.
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,
$74,559,000 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.
National Leadership Activities.--The Committee recommends
$14,302,000 for national leadership activities, including
$3,000,000 to support new awards for prisoner reentry education
models that build on the success of the Promoting Reentry
Success through Continuity of Education Opportunities [PRSCEO]
competition. PRSCEO was funded in fiscal year 2013 with funds
transferred from the Department of Justice under an interagency
agreement.
The Committee recommendation will support projects that
develop evidence of reentry education's effectiveness and align
with the model described in ``A Reentry Education Model:
Supporting Education and Career Advancement for Low-Skill
Individuals in Corrections,'' published by the Department in
August 2012.
Student Financial Assistance
Appropriations, 2013\1\................................. $24,486,210,000
Budget estimate, 2014................................... 24,685,281,000
Committee recommendation................................ 24,536,210,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of
$24,536,210,000 for programs under the Student Financial
Assistance account.
Student Complaint System.--The Committee commends the
Department for working with the Department of Veterans Affairs
[VA], DOD, and the Federal Trade Commission to develop a
uniform student complaint system for students receiving Federal
education benefits from the VA, DOD, and the Department
pursuant to Executive Order 13607. The Committee is aware that
the Department intends to publicize information on its
StudentAid.gov Web site on how to submit complaints regarding
institutional issues by the end of fiscal year 2013. While this
is a positive step, the complaint system would address Federal
education benefits alone, and only students who receive such
benefits would be likely to view the Web site. The complaint
system would not address other types of deceptive and
misleading conduct by institutions. The Committee directs the
Department to broaden the scope of the complaint system and
make it more accessible to all students attending institutions
of higher education, regardless of their receipt of Federal
education benefits. The Committee on HELP's recent
investigation into the practices of proprietary institutions of
higher education demonstrated that students in all sectors of
postsecondary education lack a clear understanding of how or
where to lodge complaints regarding deceptive and misleading
conduct and other problematic practices, including but not
limited to problems with accessibility of course materials and
the physical plant on college campuses. This kind of a
complaint system would be particularly valuable as online
postsecondary education programs expand, as students in such
programs may have no State-specific resource for consumer
protection. The Committee directs the Department to post
information on its main Web site about its uniform complaint
system no later than 6 months after enactment of this act.
Foster Youth.--The Committee is very concerned that many
foster youth who are eligible for postsecondary education and
training financial aid programs outside of support offered
through the Department, including HHS's John H. Chafee Foster
Care Independence Program and the Education and Training
Vouchers Program for Youths Aging Out of Foster Care, are
unaware that this assistance is available to them. The
Committee urges the Department to inform foster youth, to the
extent practicable, of their potential eligibility for
additional Federal financial assistance, and post information
about these programs on its Web site. The Committee directs the
Secretary to submit a report no later than 120 days after
enactment of this act detailing its outreach efforts to foster
youth who may be eligible for additional Federal financial aid
programs and ways in which modifications to the Free
Application for Federal Student Aid could assist in these
efforts.
Federal Pell Grant Program
The Committee recommends $22,778,352,000 in discretionary
funding for the Pell grant program. This amount will support an
increase in the maximum Pell grant award from $5,645 in
academic year 2013-2014 to a projected level of $5,785 in
academic year 2014-2015.
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 9.3 million students are expected to receive a
Pell grant during the 2014-2015 academic year. Of the 9.4
million students who relied on Pell grants during the 2011-2012
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 [CPI] 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 2014 meets that
requirement, so it will trigger enough mandatory funding to add
an estimated $925 ($140 more than in fiscal year 2013) to the
discretionary portion of the award, for a projected total
maximum award of $5,785. The Department will rely on CPI data
available at the end of the 2013 calendar year to determine the
exact increase for academic year 2014-2015.
Taking into account mandatory funding provided in the
fiscal year 2012 Consolidated Appropriations Act, plus
$9,797,000,000 in cumulative surplus budget authority from
previous fiscal years, the fiscal year 2014 funding level will
provide an estimated $4,889,000,000 more than is needed to
support the discretionary base award of $4,860 and trigger the
mandatory increase in the maximum award. In fiscal year 2015,
however, the program will face a funding gap of $793,000,000
under current projections.
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 access and successfully
complete a postsecondary education.
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 a new general provision
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 intended for education
to do so. This reform will target Federal resources at
educating students, as opposed to online advertisements and
aggressive recruiting strategies, and help ensure that both
taxpayers and students receive a good return on their
investment.
On a related matter, the Committee is aware that some
students are wasting their Federal financial aid and going into
debt to earn occupation-related degrees that they cannot use.
While postsecondary education institutions as a whole must be
accredited in order to participate in the Department's
financial aid programs, there are no accreditation or licensure
requirements for specific programs. Some students are paying to
attend a program only to learn that they cannot take the
licensing exam required for entry into the workforce because
the program is not accredited or licensed.
To address this problem, the Committee bill includes a new
provision requiring postsecondary education programs that
prepare students for gainful employment in occupations
requiring licensing or other credentials to meet State
licensure requirements and programmatic accreditation in order
to be eligible for HEA funding. This provision will ensure that
students who receive Federal financial aid to enroll in
industry-specific programs will be eligible to attain
credentials they can actually use to enter their chosen
profession.
Federal Supplemental Educational Opportunity Grant Program
The Committee recommends $733,130,000 for the SEOG program.
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. Priority is given to Pell grant
recipients with exceptional need.
The budget request recommends reforming the SEOG allocation
formula to target and incentivize SEOG funding toward
institutions that enroll and graduate comparatively high
numbers of Pell-eligible students and offer low net tuition and
fees. The Committee supports the proposals in principle but
believes they deserve more deliberation in Congress.
Federal Work-Study Program
The Committee bill provides $1,024,728,000 for the FWS
program. The budget request proposes to direct new funds to
institutions opting to participate in an enhanced work-study
partnership with prospective employers. The Committee
recommendation does not include this proposal.
The budget request also recommends reforming the FWS
allocation formula to target and incentivize funding toward
institutions that enroll and graduate comparatively high
numbers of Pell-eligible students and offer low net tuition and
fees. The budget request does not include bill language on this
proposal. The Committee supports the administration's goals,
but believes the proposal deserves more deliberation in
Congress.
This program provided grants to approximately 3,400
institutions and helped an estimated 700,000 undergraduate,
graduate, and professional students meet the costs of
postsecondary education through part-time employment in
academic year 2010-2011. Institutions must provide at least 25
percent of student earnings.
The Committee recommendation expects the Department to
provide $8,390,000 from the FWS program appropriation for the
Work Colleges program authorized under section 448 of the HEA.
This is an increase of $2,403,337 over the fiscal year 2013
level. The recommended level is the amount the seven work
colleges are capable of matching dollar for dollar.
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 Loan
program. 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, 2013\1\................................. $1,041,301,000
Budget estimate, 2014................................... 1,050,091,000
Committee recommendation................................ 1,044,301,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $1,044,301,000 for the Student Aid
Administration account. These funds are available until
September 30, 2015, and support the Department's student aid
management expenses.
The Committee recommendation includes $727,434,000 for
administrative costs and $316,867,000 for loan servicing
activities. The Committee recommendation will ensure the
operational integrity of Federal student aid systems and
provide high-quality service to student and parent borrowers.
The budget request includes a new general provision
transferring the Health Education Assistance Loan program from
HHS to the Department. The Committee recommendation includes
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, 2013\1\................................. $1,865,915,000
Budget estimate, 2014................................... 2,146,273,000
Committee recommendation................................ 1,912,615,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $1,912,615,000
for higher education programs.
Aid for Institutional Development
The Committee recommends $530,014,000 for Aid for
Institutional Development.
Strengthening Institutions.--The Committee bill recommends
$80,462,000 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 $100,231,000 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 $8,992,000 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 $227,524,000 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 $58,840,000 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 $9,244,000 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 $3,113,000 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; expand student services; and
construct classrooms, libraries, laboratories, and other
instructional facilities.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions [ANNHSIs].--The Committee recommends $12,833,000
for the Strengthening ANNHSIs 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; improve administrative
management; renovate educational facilities; enhance student
services; purchase library and other educational materials;
and, provide 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 $3,113,000 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; improve
administrative management; renovate educational facilities;
enhance student services; and purchase library and other
educational materials.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $25,662,000 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 $80,938,000 for International
Education and Foreign Language Studies programs.
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 $73,487,000
for domestic program activities related to international
education and foreign language studies under title VI of the
HEA. This is an increase of $7,034,000 over the fiscal year
2013 level. The majority of funding will support new awards in
the national resource centers, foreign language and area
studies fellowships, international business education centers,
and language resource centers. Funding will also support
continuation awards in the American overseas research centers
as well as new and continuation awards in the Undergraduate
International Studies and Foreign Language Program. 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 Committee recommendation includes $2,000,000 to support
new awards authorized by section 604(b) of the HEA. 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, particularly for
underserved student populations and to nontraditional
destinations, especially in developing countries. The Committee
expects that competitive grants will be awarded under the
authority of section 604(b) individually or through
partnerships to institutions of higher education and public and
private not-for-profit agencies and organizations, and be
consistent with the recommendations of the Commission on the
Abraham Lincoln Study Abroad Fellowship program that Congress
created in Public Law 108-199.
The Committee urges the Department to support efforts among
higher education stakeholders in issuing a comprehensive report
on meeting the goals of the Lincoln Commission on Study Abroad,
including hosting a conference on study abroad. The conference
should address the importance of study abroad in meeting the
Department's international education goals of global
competencies, educational diplomacy, and program integration
and coordination. The conference should solicit ideas from the
higher education community on how to significantly increase the
number of American students studying abroad.
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. 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 $5,852,000 for FIPSE.
Training for Realtime Writers.--Within the total for FIPSE,
the Committee recommendation includes $1,126,000 for the
Training for Realtime Writers program authorized by section 872
of the HEA. This program 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, and trained captioners help
remove barriers to full-quality captioning of realtime
television programming such as news, weather, and emergency
messaging.
Center for Best Practices To Support Single Parent
Students.--The Committee recommendation includes $500,000 to
support a Center for Best Practices to Support Single Parent
Students, as authorized by section 741(c) of the HEA, to
promote replication of programs that have proven effective at
providing postsecondary degree completion opportunities to low-
income single parents. The Center will study and develop best
practices, and assist other institutions in implementing
innovative programs that support this target population.
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 should 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.
Centers for the Study of Distance Education and
Technological Advancements.--The Committee recommendation
includes $2,750,000 to carry out section 741(a)(3) of the HEA
to establish no less than two Centers for the Study of Distance
Education and Technological Advancements at institutions of
higher education. At least one of the centers should have a
minority enrollment of no less than 15 percent and no two
centers shall be located in the same State.
The Committee recognizes the increasing role that online
education plays in postsecondary education. Over 6 million
college students take at least one online course in a given
year, representing almost 1 in 3 students nationally. Data are
needed to understand the outcomes of online learning as well as
the factors that impact such outcomes. The new centers should
collaborate with and provide evaluation of learning outcomes
for students attending institutions of higher education across
the country and partner with other institutions of higher
education and organizations interested in online education.
Model Comprehensive Transition and Postsecondary Programs for Students
With Intellectual Disabilities
The Committee recommendation includes $10,935,000 for
competitive grants to postsecondary institutions to establish
model programs to help students with intellectual disabilities
transition to and complete college, as authorized by section
769 of the HEA. 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.
Minority Science and Engineering Improvement
The Committee recommends $9,447,000 for the Minority
Science and Engineering Improvement program. Funds are used to
provide discretionary grants to institutions with minority
enrollments greater than 50 percent to purchase equipment,
develop curricula, and support advanced faculty training.
Grants are intended to improve science and engineering
education programs and increase the number of minority students
in the fields of science, mathematics, and engineering.
Tribally Controlled Postsecondary Career and Technical Institutions
The Committee recommends $8,114,000 for tribally controlled
postsecondary vocational institutions. 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 $849,932,000 for Federal TRIO
programs, which 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 last Upward Bound grant competition may have
disadvantaged applicants in rural areas. Many of the rural
programs that were not renewed in the last round are located in
areas of extreme poverty that would appear to be prime targets
for Upward Bound grants. The Committee directs the Department
to provide an analysis within 60 days of enactment of this act
of how selection criteria and outcomes changed in the past
Upward Bound grant cycle, to determine whether applicants from
rural areas were put at a disadvantage compared to other
applicants.
Gaining Early Awareness and Readiness for Undergraduate Programs
The Committee recommends $307,244,000 for GEAR UP, which
provides grants to 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.
The Committee adds new bill language, as requested by the
administration, allowing the Department to increase the
evaluation set-aside from 0.75 percent to 1.5 percent to work
with the GEAR UP community and grantees to standardize data
collection, including through the use of third-party data
systems. The increase in the evaluation set-aside will build
evidence about effective college access and completion
strategies and inform the HEA reauthorization process in 2014.
The Committee directs the Department to submit a report to the
Senate Committees on Appropriations and HELP that provides an
update on how GEAR UP evaluation set-aside funds are being used
and recommendations on how to improve student outcomes; the
Committee expects the report no later than 6 months after
enactment of this act.
Graduate Assistance in Areas of National Need and Javits Fellowships
The Committee recommends $30,848,000 to support the GAANN
and Javits Fellowships programs.
In fiscal year 2012, Congress consolidated the GAANN and
Javits Fellowships programs, as proposed by the administration.
The Committee recommendation continues bill language allowing
funds awarded under GAANN to be used to fund continuation costs
for the Javits Fellowships program.
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.
Teacher Quality Partnership Program
The Committee recommends $42,747,000 for the Teacher
Quality Partnership program. The budget request consolidates
activities supported by this program into a proposed new
Effective Teachers and Leaders State Grants 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 $15,938,000
for CCAMPIS. This program 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 campus-based child care programs primarily serving
the needs of low-income students enrolled at the institutions.
GPRA Data/Higher Education Act Program Evaluation
The Committee recommends $20,606,000 to collect data
associated with the GPRA and to evaluate programs authorized by
the HEA. The Committee recommendation includes $15,000,000 to
support a new dual enrollment demonstration program for low-
income students and evaluate its impact on the success of
participants. The Committee is concerned that the cost of
tuition, fees, and supplies for low-income students and
families could be a deterrent to the students' participation in
dual enrollment programs that do not cover such costs for low-
income students. The recommended funding level will support
tuition, fees, and supplies for low-income students enrolled in
dual enrollment programs who would qualify for Pell grants but
are not eligible because they do not have a high school
diploma. Funding for this demonstration is also provided in
CTE's National Programs. The Department will give priority to
dual enrollment programs that demonstrate a cost-effective
approach to providing dual enrollment opportunities to low-
income students.
Studies on dual enrollment programs have found that student
participation is positively related to college enrollment and
persistence and higher college GPAs. Dual enrollment programs
can also shorten the time to degree or credential completion
and reduce the cost of college for students and families.
The Committee recommendation also includes $2,000,000 to
support an evaluation of the dual enrollment projects to test
whether providing student aid to low-income students increases
access to dual enrollment programs, and whether the programs
improve degree and credential attainment.
The Committee also provides $3,606,000 to support program
improvement activities and evaluation, including evaluating the
impact of loan counseling on borrower behavior; examining the
effectiveness of allowing institutions of higher education
additional funding to support Pell grant students if the
students meet certain outcome measures of success; and
evaluating the impacts of consumer information on making
college selection decisions.
Howard University
Appropriations, 2013\1\................................. $233,596,000
Budget estimate, 2014................................... 234,064,000
Committee recommendation................................ 234,064,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $234,064,000
for Howard University. Located in the District of Columbia,
Howard 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 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, 2013\1\................................. $458,000
Budget estimate, 2014................................... 459,000
Committee recommendation................................ 459,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
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. 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, 2013.................................... $20,462,000
Budget estimate, 2014................................... 20,502,000
Committee recommendation................................ 20,502,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
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 2014. 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, 2013\1\................................. $592,477,000
Budget estimate, 2014................................... 671,073,000
Committee recommendation................................ 652,937,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $652,937,000 for IES. This account
supports education research, development, dissemination, and
evaluation; data collection and analysis activities; and the
assessment of student progress.
Under the Education Sciences Reform Act of 2002, Congress
established IES to provide objective and valid research-driven
knowledge that was free of political influence or bias so as to
better inform effective education practices at the State and
local levels. The act required IES, in carrying out its
mission, ``to compile statistics, develop products, and conduct
research, evaluations, and wide dissemination activities in
areas of demonstrated national need . . . and ensure that such
activities conform to high standards of quality, integrity, and
accuracy and are objective, secular, neutral, and
nonideological and are free of partisan political influence.''
The Committee commends IES for its efforts to improve the
rigor, relevance, and utilization of education research that
leads to enhanced education policy and classroom practices. The
Committee urges IES to consider how it can organize its
investment opportunities to bring more focus to solving
specific and enduring problems of practice in our Nation's
classrooms. The Committee requests that IES include in the
fiscal year 2015 congressional budget justification the
specific changes it will make to bring more focus and coherence
to its investments and how those changes are expected to solve
specific problems of practice. To the extent that it believes
that it is achieving this goal, the Committee requests that IES
identify and describe the problems of practice that have been
solved through its investments.
The Committee directs the Director to submit an operating
plan within 90 days of enactment of this act detailing how IES
plans to allocate funding available to the Institute for
research, evaluation, and other activities authorized under
law.
RESEARCH, DEVELOPMENT, AND DISSEMINATION
The Committee recommends $195,000,000 for education
research, development, and national dissemination activities.
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.
STATISTICS
The Committee recommends $112,000,000 for data gathering
and statistical analysis activities at NCES. Increased funds
over the fiscal year 2013 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.
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 $57,311,000 to continue support
for the Regional Educational Laboratories program. 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 timely, relevant, and responsive to the
needs of the field.
RESEARCH AND INNOVATION IN SPECIAL EDUCATION
The Committee recommends $69,905,000 for research and
innovation in special education conducted by the National
Center for Special Education Research [NCSER]. This amount
should enable NCSER to fund roughly $20,000,000 in new awards
in fiscal year 2014.
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.
The Committee commends NCSER for the rigor and relevancy of
its research. NCSER-supported research has informed early
identification, the development and testing of interventions to
improve school outcomes, and the validation of assessments to
help identify and monitor the progress of the Nation's 6
million children with disabilities. An investment in research
continues to fill a critical need to better understand the most
effective ways of educating and improving school outcomes for
those with or at risk for disabilities.
SPECIAL EDUCATION STUDIES AND EVALUATIONS
The Committee recommends $11,415,000 for special education
studies and evaluations.
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 $75,000,000 for the
Statewide Data Systems program.
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 $21,000,000 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 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.
Within the funds appropriated, the Committee recommends
$7,690,000 for NAGB, which is responsible for formulating
policy for NAEP.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2013\1\................................. $445,366,000
Budget estimate, 2014................................... 463,450,000
Committee recommendation................................ 447,366,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $447,366,000 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 $2,000,000 for
building modernization activities for the Department.
The Committee is very supportive of Executive Order 13548
and the Department's goal to raise the representation of
individuals with disabilities in its workforce from 6.25
percent in fiscal year 2010 to 9 percent in fiscal year 2015.
However, fiscal year 2012 results demonstrate a lack of
progress, with representation falling below the fiscal year
2011 level. The Committee encourages the Department to
accelerate its efforts toward achieving the goals of this
important executive order.
The Committee is concerned about the number of children, in
particular children with disabilities and children of racial
and ethnic minorities, that are subject to the abusive and
potentially deadly application of restraint and seclusion
techniques in our Nation's schools. Every child has the right
to be safe at school.
The Committee commends the Department for releasing its
``Restraint and Seclusion: Resource Document.'' The Committee
directs the Department to issue guidance that, at minimum, is
consistent with the 15 principles identified in the Resource
Document that help ensure that restraint or seclusion in
schools should not occur except when there is a threat of
imminent danger of serious physical harm to the student or
others. If these practices are used, they must be carried out
in a manner that protects the safety of all children and adults
at a school. Finally, the Committee requests that the
Department co-convene with SAMHSA a stakeholder summit on
reducing and preventing the use of restraint and seclusion in
schools.
The Committee is concerned with deficiencies in geography
education research and geography education at the elementary
and secondary education levels. 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 further directs GAO to report on the
challenges elementary and secondary schools face in providing
geographic education with limited resources.
The Committee is disappointed that the administration
failed to meet its scheduled March 2013 release date for the
notice of proposed rulemaking related to the phasing out of
alternate assessments based on modified academic achievement
standards. The Committee supports this phase-out and believes
the administration should move forward expeditiously in this
rulemaking.
The Committee appreciates and strongly supports Executive
Order 13592 related to improving educational outcomes for
American Indian and Alaska Native students. The Committee
believes that the establishment of the Interagency Working
Group on American Indian and Alaska Native Education, co-
chaired by the Secretaries of Education and the Interior, and
Memorandum of Agreement between the two Departments are
important steps forward in this effort. The Committee requests
that the Department include in the fiscal year 2015 and future
congressional budget justifications the goals, benchmarks, and
key activities accomplished and planned for improving
educational outcomes for American Indian and Alaska Native
students.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2013\1\................................. $102,418,000
Budget estimate, 2014................................... 107,500,000
Committee recommendation................................ 102,418,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $102,418,000 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.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2013\1\................................. $59,700,000
Budget estimate, 2014................................... 62,347,000
Committee recommendation................................ 59,700,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $59,700,000 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.
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 related to
eligibility under the Impact Aid program.
Section 311. The bill includes a new provision concerning
licensing, certification, and accreditation requirements for
certain postsecondary education programs.
Section 312. The bill includes a new provision that
modifies the Free Application for Federal Student Aid and
requires the Department to inform foster youth of their
eligibility for certain financial aid programs.
TITLE IV
RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $5,364,000
Budget estimate, 2014................................... 5,396,000
Committee recommendation................................ 5,396,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $5,396,000 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
CNCS, a corporation owned by the Federal Government, was
established to enhance opportunities for national and community
service. CNCS administers programs authorized under the
Domestic Volunteer Service Act, the National and Community
Service Trust Act, and the SERVE America Act. Grants are
awarded to States, public and private nonprofit organizations,
and other entities to create service opportunities for
students, out-of-school youth, adults, and seniors.
The Committee recommendation for CNCS provides a total
program level of $1,061,156,000, a level sufficient to maintain
the number of AmeriCorps members at over 82,000.
OPERATING EXPENSES
Appropriations, 2013\1\................................. $748,752,000
Budget estimate, 2014................................... 760,264,000
Committee recommendation................................ 756,641,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $756,641,000 for the operating
expenses of CNCS.
VOLUNTEERS IN SERVICE TO AMERICA [VISTA]
The Committee recommends $94,820,000 for VISTA. This
program 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 $207,491,000 for the National
Senior Volunteer Corps programs, 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 each of
the Senior Corps programs at no less than fiscal year 2013
levels.
AMERICORPS STATE AND NATIONAL GRANTS
The Committee recommends $345,800,000 for AmeriCorps State
and National Grants, which 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.
National Civilian Community Corps [NCCC]
The Committee recommendation includes $30,000,000 for NCCC.
The recommended reduction reflects the completion of one-time
relocation activities related to the loss of the Perry Point
campus in Maryland.
NCCC is a full-time, team-based residential program for men
and women ages 18 to 24. Members are assigned to one of five
campuses for a 10-month service commitment.
INNOVATION, DEMONSTRATION, AND ASSISTANCE ACTIVITIES
The Committee recommendation includes $58,224,000 for
innovation, demonstration, and assistance activities.
Within the funds provided, the Committee recommendation
includes $46,724,000 for the Social Innovation Fund authorized
under section 1807 of the SERVE America Act. The fiscal year
2013 level is $44,726,000. The budget request is $48,815,000.
The increase provided is intended to fund Pay for Success pilot
programs. The Committee has included statutory language needed
for this program, identical to language included in the fiscal
year 2013 President's budget and Senate bill.
In addition, $5,000,000 is included for the Volunteer
Generation Fund authorized under section 198P of the SERVE
America Act, compared to $3,976,000 enacted in fiscal year 2013
and $10,000,000 in the budget request. The Committee
recommendation also provides $1,000,000 for MLK Service Day,
which was eliminated by the administration in fiscal year 2013
and not requested in the fiscal year 2014 budget request.
The Committee recommendation includes $1,000,000 for a new
national initiative on volunteerism. Volunteerism is a type of
community service that is distinct from most of the programs of
CNCS because of its unpaid and intermittent nature. For
example, many AmeriCorps members build capacity at
organizations by recruiting and coordinating volunteers for a
series of individual projects. The AmeriCorps member devotes a
year of sustained service, while the volunteers come
episodically to engage on a particular task. The Committee
intends for this new effort to build a shared knowledge base
among CNCS and long standing organizations with deep expertise
in volunteer engagement. National volunteer organizations
include youth sports leagues, youth service organizations,
charitable food preparation and delivery organizations,
churches, and other entities that have large, ever-rotating
volunteer pools. The Committee believes that CNCS should
convene these organizations and develop shared resources on
recruitment, training, and retention efforts. The Committee
expects this initiative to be primarily intramural, and expects
that it will not be implemented exclusively or primarily
through intermediary organizations. CNCS should build direct
partnerships to ensure that the knowledge gained in this effort
immediately informs the work of all of CNCS' staff and
programs.
EVALUATION
The Committee recommendation includes $5,000,000 for CNCS
evaluation activities. 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 2013.
The Committee strongly supports efforts of CNCS to evaluate
the impact of service on both the lives of those served and the
lives of those serving. In particular, the Committee is pleased
to see research progressing on the impact of a service
experience on an individual's employment options. Congress
provided for a dramatic expansion of AmeriCorps and VISTA in
the American Recovery and Reinvestment Act in response to a
body of research that shows that individuals who graduate
college during a recession have reduced employment options and
earnings that persist throughout their lifetimes. The Committee
encourages CNCS to consider evaluating whether participating in
federally funded service programs mitigated the negative
effects of graduating during the recent recession, in whole or
in part.
STATE COMMISSION GRANTS
The Committee recommendation includes $15,306,000 for State
Commission Grants.
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 continues to believe that this consolidation will
create efficiencies at both the Federal and State levels of
government by combining two State grants with overlapping
purposes. In implementing this consolidation, the Committee
expects CNCS to develop measures to ensure that States
adequately train new applicants and newly awarded grantees in
accountability procedures.
The Committee deletes a provision added 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.
PAYMENT TO THE NATIONAL SERVICE TRUST
Appropriations, 2013\1\................................. $211,373,000
Budget estimate, 2014................................... 207,293,000
Committee recommendation................................ 209,840,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $209,840,000
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 more
than 82,000 servicemembers. The Committee is aware of
significant demand for the Education Award-only Program [EAP]
and has provided funding above the budget request to address
this need. In addition, the Committee notes that community
service can be an important strategy in achieving many national
and community goals. For that reason, the Committee strongly
supports the work CNCS is doing to partner with other Federal
agencies. The Committee believes that EAP awards are a good
tool to further those partnerships.
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $82,677,000
Budget estimate, 2014................................... 87,109,000
Committee recommendation................................ 88,209,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $88,209,000
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 recommendation rejects the proposed cut to
the maintenance and improvement of information technology [IT]
systems. The Committee feels strongly that antiquated
technology at CNCS creates unacceptable challenges for
oversight, imposes unnecessary burdens in grantee reporting,
and reduces the efficiency of the programs as a whole. CNCS is
directed to place a high priority on the goals and objectives
of the CNCS IT Strategic Plan, with a particular emphasis on
streamlining the grantee reporting process.
The Committee reiterates its strong support for efforts to
redesign the outreach activities meant to recruit and support
national servicemembers with disabilities. The program should
build on successful models of integration of persons with
disabilities. The Committee directs CNCS to report in the
annual congressional budget justification the amount for
disability training and support activities proposed for the
pending fiscal year, the amount estimated for the current
fiscal year, and the amount obligated in the 3 prior fiscal
years.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2013\1\................................. $3,984,000
Budget estimate, 2014................................... 6,466,000
Committee recommendation................................ 6,466,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends an appropriation of $6,466,000 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 new criminal investigators, criminal analysts, auditors,
and audit managers. The Committee intends that the OIG fully
reclaim the responsibilities CNCS temporarily assumed on behalf
of the OIG in fiscal year 2012.
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 adds a provision relating to section 189D of
the National and Community Service Act of 1990, which requires
that all applicants for federally funded national service
positions pass through both a criminal history fingerprint
check and a check of the National Sex Offender Public Registry.
Applicants who are considered for positions working with
vulnerable populations are required to undergo an FBI check or
go through a waiver process if that check is not made available
to them. The Committee is aware that States are the sole entity
with the authority to query the FBI database and that some
States are not conducting this background check. This is
leading to an unanticipated flood of individual waiver
petitions. The Committee rejects the proposal in the
President's budget to make the FBI check optional for all
except members applying to work with children. Instead, the
Committee includes a statutory provision (section 405) allowing
the required background checks to be processed by States under
the terms and conditions set out for ``volunteers'' in the
National Child Protection Act [NCPA]. The Committee notes that
the definition of a national servicemember who works with
vulnerable populations included in section 189D falls within
the definition of those eligible for background checks under
the NCPA; therefore, the Committee views this provision as a
clarification of existing authorities. The provision also
designates State Commissions as eligible recipients of the
background check information, in addition to the organizations
which are currently authorized in the NCPA. In some instances
involving small and local organizations, the Committee believes
that a State Commission can better secure this criminal history
information.
Corporation for Public Broadcasting
Appropriations, 2015.................................... $445,000,000
Budget estimate, 2016................................... 445,000,000
Committee recommendation, 2016.......................... 445,000,000
The Committee recommends $445,000,000 for CPB as an advance
appropriation for fiscal year 2016. 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, 2013\1\................................. $46,071,000
Budget estimate, 2014................................... 47,620,000
Committee recommendation................................ 47,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $47,000,000 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. 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, 2013\1\................................. $17,569,000
Budget estimate, 2014................................... 16,423,000
Committee recommendation................................ 17,000,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $17,000,000 for FMSHRC, which
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.
FMSHRC received a significant increase in funding in fiscal
year 2012, continued in fiscal year 2013, to help address the
growing backlog of contested mine safety cases appealed to the
commission. This funding also covered the one-time costs of
developing an electronic case processing system and moving
FMSHRC to new office space. Funds for those costs are no longer
required in fiscal year 2014. The Committee recommendation will
allow FMSHRC to increase staffing to continue to reduce the
number of pending cases and the average time for processing
cases.
The Committee directs FMSHRC, in conjunction with the
Department of Labor, to provide a joint report to the
Committees on Appropriations of the House of Representatives
and Senate for reducing the number of pending cases and average
case processing time to appropriate levels by the end of fiscal
year 2015. The report should fully explain how such levels were
determined. It also should establish goals and metrics for
determining when the levels will be achieved and how they will
be maintained in the future.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION
Appropriations, 2013\1\................................. $231,490,000
Budget estimate, 2014................................... 225,813,000
Committee recommendation................................ 231,490,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $231,490,000 for IMLS. This agency
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.
Within the total for IMLS, the Committee recommendation
includes the amounts below:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2013 Fiscal year Committee
Budget activity appropriation\1\ 2014 request recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
Grants to States......................................... 156,052 150,000 157,266
Native American Library Services......................... 3,861 3,869 3,869
National Leadership: Libraries........................... 11,922 13,200 13,200
Laura Bush 21st Century Librarian........................ 12,499 10,000 10,000
--------------------------------------------------
Subtotal, LSTA......................................... 184,335 177,069 184,335
--------------------------------------------------
Museum Services Act:.........................................
Museums for America...................................... 17,994 22,707 21,119
21st Century Museum Professionals........................ 1,965 .............. ..............
Conservations Project Support............................ 2,608 .............. ..............
Native American/Hawaiian Museum Services................. 924 926 926
National Leadership: Museums............................. 5,899 7,880 7,880
--------------------------------------------------
Subtotal, MSA.......................................... 29,390 31,513 29,925
--------------------------------------------------
African American History and Culture Act................. 1,407 1,410 1,410
Administration........................................... 14,476 14,000 14,000
Policy, Research, Program Evaluation, and Statistics..... 1,882 1,820 1,820
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013 sequester of funds under Public Law 112-25 and excludes transfers and
reprogrammings allowed under Public Law 113-6, and any other re-alignment of funds.
Note: Totals may not add due to rounding.
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
Appropriations, 2013.................................... $5,777,000
Budget estimate, 2014................................... 9,500,000
Committee recommendation................................ 9,000,000
The Committee recommends $9,000,000 for MACPAC. This
commission 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, 2013\1\................................. $11,754,000
Budget estimate, 2014................................... 12,087,000
Committee recommendation................................ 11,954,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $11,954,000 for MedPAC, which
provides independent policy and technical advice on issues
affecting the Medicare program.
National Council on Disability
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $3,251,000
Budget estimate, 2014................................... 3,345,000
Committee recommendation................................ 3,345,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $3,345,000 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.
The Committee directs NCD to study the accessibility of
taxicabs in the United States and internationally, and to make
recommendations about how to increase the number and
availability of accessible taxicabs in the United States. The
Committee also directs NCD, in conjunction with the Access
Board, to work with the World Bank to develop a safeguard on
disability in order to increase the inclusion and opportunities
for individuals with disabilities in countries that receive
funds from the World Bank.
National Health Care Workforce Commission
SALARIES AND EXPENSES
Appropriations, 2013....................................
Budget estimate, 2014................................... $3,000,000
Committee recommendation................................ 3,000,000
The Committee recommendation includes $3,000,000 for the
National Health Care Workforce Commission. This 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, 2013\1\................................. $277,749,000
Budget estimate, 2014................................... 284,991,000
Committee recommendation................................ 284,991,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $284,991,000 for the NLRB, which
administers and enforces the National Labor Relations Act and
protects employee and employer rights provided under that act.
The General Services Administration [GSA] has mandated that
the NLRB move into a smaller, more flexible office space,
consistent with the administration initiative to reduce the
Federal Government's footprint. GSA estimates this will cost
approximately $10,000,000 but is expected to reduce rent costs
by approximately 30 percent, or $4,600,000, annually once
completed. The Committee recommendation provides sufficient
funds to execute the move.
National Mediation Board
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $13,384,000
Budget estimate, 2014................................... 13,347,000
Committee recommendation................................ 13,384,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $13,384,000 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 remains concerned about oversight and
reporting requirements included in the FAA Modernization and
Reform Act of 2012 and accordingly includes a modest increase
over the budget request.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriations, 2013\1\................................. $11,644,000
Budget estimate, 2014................................... 12,634,000
Committee recommendation................................ 12,300,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $12,300,000 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, 2013\1\................................. $50,813,000
Budget estimate, 2014................................... 39,000,000
Committee recommendation................................ 39,000,000
The Committee recommends $39,000,000 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, 2013\1\................................. $150,000
Budget estimate, 2014................................... 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, 2013\1\................................. $110,927,000
Budget estimate, 2014................................... 111,793,000
Committee recommendation................................ 110,927,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $110,927,000 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 includes new bill language giving RRB the
authority to hire new attorneys in the excepted service. A
recently identified contradiction between statutes has
effectively left RRB unable to hire any new attorneys.
LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2013\1\................................. $8,138,000
Budget estimate, 2014................................... 8,877,000
Committee recommendation................................ 8,638,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $8,638,000 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, 2013.................................... $20,404,000
Budget estimate, 2014................................... 16,400,000
Committee recommendation................................ 16,400,000
The Committee recommends $16,400,000 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, 2013.................................... $38,769,285,000
Budget estimate, 2014................................... 40,737,000,000
Committee recommendation................................ 40,568,741,000
The Committee recommends $40,568,741,000 in fiscal year
2014 mandatory funds for the SSI program. In addition, the
Committee recommends $19,700,000,000 in advance funding for the
first quarter of fiscal year 2015. 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 2014
program level of $55,579,000,000 for Federal benefit payments.
This will support an average monthly benefit of approximately
$556 for 8.2 million recipients.
Beneficiary Services
The Committee recommendation includes $3,000,000 in new
mandatory budget authority for beneficiary services. Carryover
of prior year unobligated balances will be sufficient to fund a
total estimated fiscal year 2014 program level of $48,000,000.
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 $54,000,000 in
mandatory funds for research and demonstration projects
conducted under sections 1110, 1115, and 1144 of the Social
Security Act. 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 $2,500,000, the same amount as the budget
request, for the PROMISE program. This demonstration program is
an interagency effort between SSA and the Departments of
Education, Labor, and HHS to test interventions that improve
health, education, postsecondary, employment, and family
outcomes for older children receiving SSI, and reduce their
dependency on the program. In fiscal year 2013 the Department
of Education will award competitive, multi-year grants to a
small number of States that propose innovative strategies to
improve such outcomes by enhancing coordination between
existing programs and services for children ages 14-16
receiving SSI. These funds at SSA will support evaluation
activities, including providing technical assistance to State
grantees.
The Committee believes that promoting public understanding
of Social Security programs is a critical task for SSA.
Therefore, within the total for research and demonstration, the
Committee recommendation includes $5,000,000 to test the impact
of providing community outreach on Social Security programs and
benefits, particularly to students, individuals just entering
the workforce, and new parents.
Administrative Expenses
The Committee recommendation includes $4,232,741,000 for
SSI program administrative expenses. 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, 2013\1\\2\.............................. $11,431,895,000
Budget estimate, 2014................................... 11,069,846,000
Committee recommendation\2\............................. 11,965,473,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
\2\Includes funding available under program integrity cap adjustment
provided by Public Law 112-25.
The Committee recommends $11,965,473,000 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. These funds support core administrative activities
including processing retirement and disability claims,
conducting hearings to review disability determination appeals,
issuing Social Security numbers and cards, processing
individuals' annual earnings information, and ensuring the
integrity of Social Security programs through continuing
disability reviews [CDR] and SSI redeterminations of non-
medical eligibility.
The Committee remains concerned about the impact of
persistently high workloads, coupled with recent budget
constraints, on SSA's ability to provide quality services.
After years of inadequate funding in the mid-2000s basic
services began to suffer. By 2008 it took an average of 532
days to process a disability hearing, and a substantial number
of cases were pending for over 900 and even 1,000 days.
Significant funding increases in fiscal years 2009 and 2010
allowed SSA to work down this backlog while keeping pace with
increases in disability claims, and reduce the average
disability hearing processing time to 362 days in fiscal year
2012. The Committee is deeply concerned that budget constraints
are reversing these positive trends and impacting basic
services to the American public, while an aging population will
continue to put increased demands on the agency. Therefore, the
Committee recommendation includes a $533,578,000 increase over
the fiscal year 2013 level to keep pace with rising costs and
consistently record-high workloads, and to increase program
integrity efforts.
Veterans Affairs [VA] Benefits.--The Committee commends the
work SSA has done in recent years to improve coordination and
data sharing with the VA to help improve the VA's disability
claims process. The Committee directs SSA to continue to
provide it with periodic updates on steps taken to continue to
improve the process.
Work Incentives Planning and Assistance [WIPA] and
Protection and Advocacy for Beneficiaries of Social Security
[PABSS].--The Committee recommendation includes $7,000,000 for
WIPA and $23,000,000 for PABSS. These programs provide valuable
services to help Social Security disability beneficiaries
return to work.
Representative Payee Oversight.--SSA assigns representative
payees when beneficiaries are unable to financially manage
their own benefit payments. The GAO and SSA's OIG have
consistently identified management challenges and intensive
administrative requirements with SSA's oversight of
representative payees. The Committee strongly encourages SSA to
continue to pursue efforts to improve representative payee
oversight, including continuing to partner with outside
organizations to identify, investigate, and prevent fraud and
abuse.
Social Security Annual Statements.--The Committee directs
SSA to resume mailing annual Social Security account statements
to all eligible individuals over age 25, consistent with
section 1143(c)(2) of the Social Security Act. These annual
statements provide valuable information to workers on their
benefits under Social Security programs, including allowing
workers to check their earning history and notify SSA of any
errors in a timely fashion. Earnings discrepancies identified
years later can be complicated and time-consuming to resolve.
Due to budget constraints, SSA began limiting the mailing of
annual Social Security account statements in 2011 and currently
only mails it to workers near retirement over age 60 and once
to younger workers when they turn age 25.
Field Office Closings.--The Committee remains concerned
that in recent years SSA has lacked a long-term strategic plan
or comprehensive, transparent policies regarding field office
closings. The Committee directs SSA to submit a report to the
Committees on Appropriations of the Senate and House of
Representatives by March 31, 2014, on its policies and
procedures for closing and consolidating field offices. In
addition, the Committee directs SSA to provide a readily
available public notice of proposed field office closures to
ensure that impacted communities are aware of proposed changes,
and allow an opportunity for public input.
Use of Predictive Analytics.--In recent years SSA has begun
to utilize predictive analytics and other data analysis tools
in a number of areas, including in its disability claims
process, for example through its Quick Disability Determination
and Compassionate Allowance initiatives, and program integrity
activities. The Committee encourages SSA to continue to explore
the expanded use of predictive analytic tools in these areas,
as well as others, including in return-to-work initiatives and
representative payee oversight.
Social Security Advisory Board.--The Committee
recommendation includes not less than $2,300,000 for the Social
Security Advisory Board. This 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.
Program Integrity
Within the total for LAE, the Committee recommendation
includes $1,197,000,000 for program integrity activities. This
includes $273,000,000 in base funding and $924,000,000 in cap
adjustment funding allowed under the Budget Control Act of
2011. These funds support program integrity activities such as
CDRs and SSI redeterminations which save $9 and $5,
respectively, for each $1 spent by reducing waste, fraud,
abuse, and improper payments in Social Security, Medicare, and
Medicaid programs. The Committee recommendation for Social
Security program integrity activities is expected to save
approximately $9,600,000,000 over 10 years to those programs.
The budget request proposes funding the base amount out of
discretionary budget authority in fiscal year 2014 but funding
an additional $1,227,000,000 out of new mandatory budget
authority, for a total of $1,500,000,000. Beginning in fiscal
year 2015, the administration proposes funding the entire
amount for program integrity with mandatory funding. The
Committee recommends funding all program integrity expenses
with discretionary budget authority, including utilizing the
full cap adjustment allowed under the Budget Control Act.
User Fees
Within the total for LAE, the Committee recommendation
includes up to $174,000,000 for administrative activities
funded from user fees. This includes $173,000,000 in fees
collected from States that request SSA to administer State SSI
supplementary payments and up to $1,000,000 from fees collected
from non-attorney claimant representatives.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2013\1\................................. $102,078,000
Budget estimate, 2014................................... 105,733,000
Committee recommendation................................ 104,670,000
\1\Does not reflect the March 1, 2013, sequester of funds under Public
Law 112-25 and excludes transfers and reprogrammings allowed under
Public Law 113-6.
The Committee recommends $104,670,000 for SSA's OIG. This
includes $74,972,000 funded from the OASI and DI trust funds
for those programs' share of OIG's expenses and $29,698,000
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 continues 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 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 522. The bill adds a new provision establishing
Performance Partnership Pilots related to discretionary funds
available in this act.
Section 523. The bill continues a provision requiring
departments, agencies, boards, and commissions funded in this
act to submit annual reports regarding conferences.
The Committee directs that expenses associated with the
fulfillment of official monitoring, technical assistance, and
emergency response duties should not be subject to the
reporting requirements of this provision. Examples of
nonconference related travel include outbreak response, audits,
inspections, and investigations.
Section 524. The Committee includes a new provision to
promote public access to research supported by Federal funding.
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; Institute of Education Sciences;
parts C and D of the Individuals with Disabilities Education
Act; Special Olympics Sport and Empowerment Act of 2004;
Workforce Investment Act; Women in Apprenticeship and Non-
Traditional Occupations Act; Homeless Veterans Reintegration
Program; Nurse Education Loan Repayment; Education and Training
Related to Geriatrics; Mental and Behavioral Health Training;
Children's Hospital Graduate Medical Education; Title XVII of
the PHS Act; Ryan White CARE Act; Family Violence Prevention
and Services Act; 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
grants for Primary and Behavioral Healthcare Integration; Low
Income Home Energy Assistance Program; Refugee and Entrant
Assistance programs (except for Victims of Trafficking); Child
Care and Development Block Grant; Head Start; Runaway and
Homeless Youth programs; Adoption Incentives; Developmental
Disabilities programs; Voting Access for Individuals with
Disabilities; Native American Programs; Community Services
Block Grant Act programs; National Institutes of Health; Assets
for Independence; Alzheimer's Disease Demonstration Grants;
Office of Disease Prevention and Health Promotion;
Rehabilitation Services and Disability Research; Assistive
Technology Act; Carl D. Perkins Career and Technical Education
Improvement Act; Corporation for Public Broadcasting; National
Council on Disability; Older Americans Act; Second Chance Act;
Work Incentive Planning and Assistance; and Protection and
Advocacy for Beneficiaries of Social Security.
COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE STANDING RULES OF THE
SENATE
Pursuant to paragraph 7(c) of rule XXVI, on July 11, 2013,
the Committee ordered favorably reported, en bloc, an original
bill (S. 1284) making appropriations for the Departments of
Labor, Health and Human Services, and Education, and related
agencies for the year ending September 30, 2014, and for other
purposes, and an original bill (S. 1283) making appropriations
for the Legislative Branch for the fiscal year ending September
30, 2014, and for other purposes provided, that each bill be
subject to amendment and that each bill be consistent with the
subcommittee funding guidance, by a recorded vote of 16-14, a
quorum being present. The vote was as follows:
Yeas Nays
Chairwoman Mikulski Mr. Shelby
Mr. Leahy Mr. Cochran
Mr. Harkin Mr. McConnell
Mrs. Murray Mr. Alexander
Mrs. Feinstein Ms. Collins
Mr. Durbin Ms. Murkowski
Mr. Johnson Mr. Graham
Ms. Landrieu Mr. Kirk
Mr. Reed Mr. Coats
Mr. Pryor Mr. Blunt
Mr. Tester Mr. Moran
Mr. Udall Mr. Hoeven
Mrs. Shaheen Mr. Johanns
Mr. Merkley Mr. Boozman
Mr. Begich
Mr. Coons
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 5--GOVERNMENT ORGANIZATION AND EMPLOYEES
CHAPTER 53--PAY RATES AND SYSTEMS
SUBCHAPTER II--EXECUTIVE SCHEDULE PAY RATES
Sec. 5315. Positions at level IV
Level IV of the Executive Schedule applies to the following
positions, for which the annual rate of basic pay shall be the
rate determined with respect to such level under chapter 11 of
title 2, as adjusted by section 5318 of this title:
* * * * * * *
Assistant Secretaries of Agriculture (3).
Assistant Secretaries of Commerce (11).
Assistant Secretaries of Defense (16).
Assistant Secretaries of the Air Force (4).
Assistant Secretaries of the Army (5).
Assistant Secretaries of the Navy (4).
Assistant Secretaries of Health and Human Services
(6).
Assistant Secretaries of the Interior (6).
Assistant Attorneys General (11).
Assistant Secretaries of Labor (10), one of whom
shall be the Assistant Secretary of Labor for Veterans'
Employment and Training.
Administrator, Wage and Hour Division, Department of
Labor.
Assistant Secretaries of State (24) and 4 other State
Department officials to be appointed by the President,
by and with the advice and consent of the Senate.
Assistant Secretaries of the Treasury (10).
* * * * * * *
Sec. 5316. Positions at level V
Level V of the Executive Schedule applies to the following
positions, for which the annual rate of basic pay shall be the
rate determined with respect to such level under chapter 11 of
title 2, as adjusted by section 5318 of this title:
* * * * * * *
Manpower Administrator, Department of Labor.
Members, Renegotiation Board.
Members, Subversive Activities Control Board.
Assistant Administrator of General Services.
Director, United States Travel Service, Department of
Commerce.
[Administrator, Wage and Hour and Public Contracts
Division, Department of Labor.]
Assistant Director (Program Planning, Analysis and
Research), Office of Economic Opportunity.
Deputy Director, National Security Agency.
Director, Bureau of Land Management, Department of
the Interior.
Director, National Park Service, Department of the
Interior.
National Export Expansion Coordinator, Department of
Commerce.
------
TITLE 8--ALIENS AND NATIONALITY
CHAPTER 12--IMMIGRATION AND NATIONALITY
SUBCHAPTER II--IMMIGRATION
Part II--Admission Qualifications for Aliens; Travel Control of
Citizens and Aliens
Sec. 1184. Admission of nonimmigrants
(a) Regulations
* * * * * * *
(c) Petition of importing employer
(1) The question of importing any alien as a nonimmigrant
under subparagraph (H), (L), (O), or (P)(i) of section
1101(a)(15) of this title (excluding nonimmigrants under
section 1101(a)(15)(H)(i)(b1) of this title) in any specific
case or specific cases shall be determined by the Attorney
General, after consultation with appropriate agencies of the
Government, upon petition of the importing employer. Such
petition, shall be made and approved before the visa is
granted. The petition shall be in such form and contain such
information as the Attorney General shall prescribe. The
approval of such a petition shall not, of itself, be construed
as establishing that the alien is a nonimmigrant. For purposes
of this subsection with respect to nonimmigrants described in
section 1101(a)(15)(H)(ii)(a) of this title, the term
``appropriate agencies of Government'' means the Department of
Labor and includes the Department of Agriculture. The
provisions of section 1188 of this title shall apply to the
question of importing any alien as a nonimmigrant under section
1101(a)(15)(H)(ii)(a) of this title. In this subsection, the
term ``consultation'' includes, with respect to nonimmigrants
described in section 101(a)(15)(H)(ii)(B), the authority of the
Secretary of Labor to issue labor market determinations,
including temporary labor certifications, and to establish
regulations and policies for such issuance, including
determining the appropriate prevailing wage rates for
occupations in which such nonimmigrants will be employed.
(14)(A) * * *
* * * * * * *
(B) The Secretary of Homeland Security may delegate to the
Secretary of Labor, with the agreement of the Secretary of
Labor, any of the authority given to the Secretary of Homeland
Security under [subparagraph (A)(i)] subparagraph (A).
------
TITLE 20--EDUCATION
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
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--
(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 A--APPROVAL AND IMPLEMENTATION OF ORIGINAL COMPACT
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]
2014, 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
guidance\1\ bill guidance bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee guidance
to its subcommittees of amounts for 2014: Subcommittee on
Labor, HHS, Education, and Related Agencies:
Mandatory.............................................. NA 614,974 NA \2\592,629
Discretionary.......................................... 164,330 165,583 NA \2\162,281
Security........................................... ............ ........... NA NA
Nonsecurity........................................ 164,330 165,583 NA NA
Projections of outlays associated with the recommendation:
2014................................................... ............ ........... ........... \3\666,735
2015................................................... ............ ........... ........... 68,828
2016................................................... ............ ........... ........... 17,534
2017................................................... ............ ........... ........... 3,113
2018 and future years.................................. ............ ........... ........... 648
Financial assistance to State and local governments for NA 342,199 NA 315,483
2014......................................................
----------------------------------------------------------------------------------------------------------------
\1\There is no section 302(a) allocation to the Committee on Appropriations for fiscal year 2014.
\2\Includes outlays from prior-year budget authority.
\3\Excludes outlays from prior-year budget authority.
NA: Not applicable.
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2014
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2013 Budget estimate Committee -----------------------------------
appropriation recommendation 2013
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I -- DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
Grants to States:
Adult Training, current year.............................. 57,269 79,644 79,644 +22,375 ................
Advance from prior year............................... (712,000) (712,000) (712,000) ................ ................
Fiscal year 2015...................................... 712,000 712,000 712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 769,269 791,644 791,644 +22,375 ................
Youth Training............................................ 822,704 846,632 846,632 +23,928 ................
Dislocated Worker Assistance, current year................ 146,135 185,490 185,490 +39,355 ................
Advance from prior year............................... (860,000) (860,000) (860,000) ................ ................
Fiscal year 2015...................................... 860,000 860,000 860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 1,006,135 1,045,490 1,045,490 +39,355 ................
=========================================================================================
Subtotal, Grants to States.......................... 2,598,108 2,683,766 2,683,766 +85,658 ................
Current Year.................................... (1,026,108) (1,111,766) (1,111,766) (+85,658) ................
Fiscal year 2015................................ (1,572,000) (1,572,000) (1,572,000) ................ ................
Federally Administered Programs:
Dislocated Worker Assistance National Reserve:
Current year.......................................... 24,066 20,859 20,859 -3,207 ................
Disaster Relief PL 113-2 (Emergency).................. 25,000 ................ ................ -25,000 ................
Advance from prior year............................... (199,952) (200,000) (200,000) (+48) ................
Fiscal year 2015...................................... 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 249,066 220,859 220,859 -28,207 ................
-----------------------------------------------------------------------------------------
Subtotal, Dislocated Worker Assistance.............. 1,255,201 1,266,349 1,266,349 +11,148 ................
Native Americans.......................................... 47,467 47,562 47,467 ................ -95
Migrant and Seasonal Farmworker programs.................. 84,123 84,291 84,123 ................ -168
Women in Apprenticeship................................... 994 ................ 994 ................ +994
YouthBuild activities..................................... 79,530 79,689 84,530 +5,000 +4,841
Workforce Innovation Fund................................. 49,806 150,000 49,806 ................ -100,194
=========================================================================================
Subtotal, Federally Administered Programs [FAP]......... 510,986 582,401 487,779 -23,207 -94,622
Current Year........................................ (285,986) (382,401) (287,779) (+1,793) (-94,622)
Emergency Appropriations............................ 25,000 ................ ................ -25,000 ................
Fiscal year 2015.................................... (200,000) (200,000) (200,000) ................ ................
National Activities:
Pilots, Demonstrations, and Research.................. 6,590 25,000 6,590 ................ -18,410
Reintegration of Ex-Offenders......................... 80,078 90,238 80,078 ................ -10,160
Evaluation............................................ 9,544 ................ ................ -9,544 ................
Workforce Data Quality Initiative..................... 6,450 6,000 6,000 -450 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 102,662 121,238 92,668 -9,994 -28,570
=========================================================================================
Total, Training and Employment Services [TES]....... 3,211,756 3,387,405 3,264,213 +52,457 -123,192
Current Year.................................... (1,414,756) (1,615,405) (1,492,213) (+77,457) (-123,192)
Emergency appropriations........................ 25,000 ................ ................ -25,000 ................
Fiscal year 2015................................ (1,772,000) (1,772,000) (1,772,000) ................ ................
OFFICE OF JOB CORPS
Administration................................................ 29,019 30,147 30,147 +1,128 ................
Operations.................................................... 1,565,940 1,586,776 1,586,776 +20,836 ................
Construction, Rehabilitation and Acquisition.................. 104,582 75,000 90,000 -14,582 +15,000
-----------------------------------------------------------------------------------------
Total, Office of Job Corps.............................. 1,699,541 1,691,923 1,706,923 +7,382 +15,000
Current Year........................................ (1,699,541) (1,691,923) (1,706,923) (+7,382) (+15,000)
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\........... 447,355 380,000 447,355 ................ +67,355
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES.................. 797,000 656,000 656,000 -141,000 ................
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT
SERVICE OPERATIONS
Unemployment Compensation [UI]:
State Operations.......................................... 3,158,717 2,881,575 2,931,575 -227,142 +50,000
Demonstration grants...................................... ................ 25,000 25,000 +25,000 ................
National Activities....................................... 11,243 11,297 11,243 ................ -54
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation..................... 3,169,960 2,917,872 2,967,818 -202,142 +49,946
Employment Service [ES]:
Allotments to States:
Federal Funds......................................... 22,550 22,595 22,550 ................ -45
Trust Funds........................................... 676,890 708,247 708,247 +31,357 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 699,440 730,842 730,797 +31,357 -45
ES National Activities.................................... 20,871 20,912 20,871 ................ -41
-----------------------------------------------------------------------------------------
Subtotal, Employment Service............................ 720,311 751,754 751,668 +31,357 -86
Federal Funds....................................... (22,550) (22,595) (22,550) ................ (-45)
Trust Funds......................................... (697,761) (729,159) (729,118) (+31,357) (-41)
Foreign Labor Certification:
Federal Administration.................................... 50,222 50,501 50,222 ................ -279
Grants to States.......................................... 15,040 15,099 15,040 ................ -59
-----------------------------------------------------------------------------------------
Subtotal, Foreign Labor Certification................... 65,262 65,600 65,262 ................ -338
One-Stop Career Centers/Labor Market Information.............. 63,346 90,473 63,346 ................ -27,127
=========================================================================================
Total, State UI and ES.................................. 4,018,879 3,825,699 3,848,094 -170,785 +22,395
Federal Funds....................................... (85,896) (113,068) (85,896) ................ (-27,172)
Trust Funds......................................... (3,932,983) (3,712,631) (3,762,198) (-170,785) (+49,567)
STATE PAID LEAVE FUND......................................... ................ 5,000 5,000 +5,000 ................
ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\................... ................ 600,000 600,000 +600,000 ................
PROGRAM ADMINISTRATION
Adult Employment and Training................................. 46,583 ................ ................ -46,583 ................
Trust Funds............................................... 8,503 ................ ................ -8,503 ................
Youth Employment and Training................................. 12,235 ................ ................ -12,235 ................
Training and Employment....................................... ................ 60,325 60,325 +60,325 ................
Trust Funds............................................... ................ 8,639 8,639 +8,639 ................
Employment Security........................................... 3,469 3,522 3,522 +53 ................
Trust Funds............................................... 39,264 39,856 39,856 +592 ................
Apprenticeship Services....................................... 27,620 28,015 30,000 +2,380 +1,985
Executive Direction........................................... 7,034 7,147 7,147 +113 ................
Trust Funds............................................... 2,079 2,113 2,113 +34 ................
-----------------------------------------------------------------------------------------
Total, Program Administration........................... 146,787 149,617 151,602 +4,815 +1,985
Federal Funds....................................... (96,941) (99,009) (100,994) (+4,053) (+1,985)
Trust Funds......................................... (49,846) (50,608) (50,608) (+762) ................
=========================================================================================
Total, Employment and Training Admin. [ETA]............. 10,321,318 10,695,644 10,679,187 +357,869 -16,457
Federal Funds....................................... 6,338,489 6,932,405 6,866,381 +527,892 -66,024
Current Year.................................... (4,541,489) (5,160,405) (5,094,381) (+552,892) (-66,024)
Emergency appropriations........................ 25,000 ................ ................ -25,000 ................
Fiscal year 2015................................ (1,772,000) (1,772,000) (1,772,000) ................ ................
Trust Funds......................................... 3,982,829 3,763,239 3,812,806 -170,023 +49,567
=========================================================================================
EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]
SALARIES AND EXPENSES
Enforcement and Participant Assistance........................ 142,400 146,032 143,400 +1,000 -2,632
Policy and Compliance Assistance.............................. 33,695 26,329 26,329 -7,366 ................
Executive Leadership, Program Oversight and Admin............. 6,692 6,743 6,743 +51 ................
-----------------------------------------------------------------------------------------
Total, EBSA............................................. 182,787 179,104 176,472 -6,315 -2,632
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Pension Insurance Activities.................................. (87,532) (80,000) (80,000) (-7,532) ................
Pension Plan Termination...................................... (238,128) (268,230) (268,230) (+30,102) ................
Operational Support........................................... (151,241) (157,211) (157,211) (+5,970) ................
-----------------------------------------------------------------------------------------
Total, PBGC (program level)............................. (476,901) (505,441) (505,441) (+28,540) ................
Enforcement of Wage & Hour Standards.......................... 226,607 243,254 243,254 +16,647 ................
Office of Labor-Management Standards.......................... 41,206 46,891 41,206 ................ -5,685
Federal Contractor EEO Standards Enforcement.................. 104,976 108,467 106,000 +1,024 -2,467
FEDERAL PROGRAMS FOR WORKERS' COMPENSATION
Salaries and Expenses......................................... 115,488 118,458 115,488 ................ -2,970
Trust Funds............................................... 2,116 2,142 2,116 ................ -26
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses............................ 117,604 120,600 117,604 ................ -2,996
Federal Funds....................................... (115,488) (118,458) (115,488) ................ (-2,970)
Trust Funds......................................... (2,116) (2,142) (2,116) ................ (-26)
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.............................................. 177,000 128,000 128,000 -49,000 ................
Administration................................................ 5,227 5,235 5,235 +8 ................
-----------------------------------------------------------------------------------------
Subtotal, Fiscal year 2014 program level................ 182,227 133,235 133,235 -48,992 ................
Less funds advanced in prior year................... -41,000 -35,000 -35,000 +6,000 ................
-----------------------------------------------------------------------------------------
Total, Current Year, Fiscal Year 2014................... 141,227 98,235 98,235 -42,992 ................
New advances, 1st quarter fiscal year 2015.............. 40,000 24,000 24,000 -16,000 ................
-----------------------------------------------------------------------------------------
Total, Special Benefits for Disabled Coal Miners........ 181,227 122,235 122,235 -58,992 ................
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
Part B Administrative Expenses................................ 52,147 55,176 55,176 +3,029 ................
BLACK LUNG DISABILITY TRUST FUND
Benefit Payments and Interest on Advances..................... 242,200 257,478 257,478 +15,278 ................
Workers' Compensation Programs, Salaries and Expenses......... 32,906 33,033 33,033 +127 ................
Departmental Management, Salaries and Expenses................ 25,217 25,365 25,365 +148 ................
Departmental Management, Inspector General.................... 327 327 327 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability......................... 300,650 316,203 316,203 +15,553 ................
Treasury Department Administrative Costs...................... 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................. 301,006 316,559 316,559 +15,553 ................
=========================================================================================
Total, Federal Programs for Workers' Compensation....... 1,001,984 1,010,570 1,007,574 +5,590 -2,996
Federal Funds....................................... 999,868 1,008,428 1,005,458 +5,590 -2,970
Current year.................................... (959,868) (984,428) (981,458) (+21,590) (-2,970)
Fiscal year 2015................................ (40,000) (24,000) (24,000) (-16,000) ................
Trust Funds......................................... 2,116 2,142 2,116 ................ -26
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA)
SALARIES AND EXPENSES
Safety and Health Standards................................... 19,922 22,071 21,000 +1,078 -1,071
Federal Enforcement........................................... 207,337 207,785 207,785 +448 ................
Whistleblower enforcement..................................... 15,841 21,883 21,883 +6,042 ................
State Programs................................................ 103,987 104,196 103,987 ................ -209
Technical Support............................................. 25,768 24,767 24,767 -1,001 ................
Compliance Assistance:
Federal Assistance........................................ 76,203 75,294 75,294 -909 ................
State Consultation Grants................................. 57,775 57,890 57,775 ................ -115
Training Grants........................................... 10,687 10,709 10,709 +22 ................
-----------------------------------------------------------------------------------------
Subtotal, Compliance Assistance......................... 144,665 143,893 143,778 -887 -115
Safety and Health Statistics.................................. 34,670 34,349 32,922 -1,748 -1,427
Executive Direction and Administration........................ 11,468 11,575 10,890 -578 -685
=========================================================================================
Total, OSHA............................................. 563,658 570,519 567,012 +3,354 -3,507
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Coal Enforcement.............................................. 163,572 168,871 168,871 +5,299 ................
Metal/Non-Metal Enforcement................................... 88,486 92,870 92,870 +4,384 ................
Standards Development......................................... 4,456 5,619 5,619 +1,163 ................
Assessments................................................... 7,088 8,358 8,358 +1,270 ................
Educational Policy and Development............................ 38,249 29,230 29,230 -9,019 ................
Technical Support............................................. 33,546 34,113 34,113 +567 ................
Program Evaluation and Information Resources [PEIR]........... 18,120 20,268 20,268 +2,148 ................
Program Administration........................................ 19,030 21,392 21,392 +2,362 ................
=========================================================================================
Total, Mine Safety and Health Administration............ 372,547 380,721 380,721 +8,174 ................
=========================================================================================
Total, Worker Protection Agencies....................... 1,609,385 1,649,556 1,632,269 +22,884 -17,287
Federal Funds....................................... (1,607,269) (1,647,414) (1,630,153) (+22,884) (-17,261)
Trust Funds......................................... (2,116) (2,142) (2,116) ................ (-26)
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
Employment and Unemployment Statistics........................ 209,854 209,481 210,854 +1,000 +1,373
Labor Market Information...................................... 67,041 67,176 67,041 ................ -135
Prices and Cost of Living..................................... 204,612 209,699 205,612 +1,000 -4,087
Compensation and Working Conditions........................... 80,105 82,128 80,105 ................ -2,023
Productivity and Technology................................... 12,031 10,313 12,031 ................ +1,718
Executive Direction and Staff Services........................ 34,209 34,997 34,209 ................ -788
=========================================================================================
Total, Bureau of Labor Statistics....................... 607,852 613,794 609,852 +2,000 -3,942
Federal Funds....................................... 540,811 546,618 542,811 +2,000 -3,807
Trust Funds......................................... 67,041 67,176 67,041 ................ -135
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES......................................... 38,802 42,432 42,432 +3,630 ................
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
Executive Direction........................................... 33,154 31,812 31,812 -1,342 ................
Departmental Program Evaluation............................... 8,467 9,000 8,467 ................ -533
Legal Services................................................ 128,619 127,684 127,684 -935 ................
Trust Funds............................................... 325 326 326 +1 ................
International Labor Affairs................................... 92,125 95,425 95,425 +3,300 ................
Administration and Management................................. 30,221 30,435 30,221 ................ -214
Adjudication.................................................. 29,113 30,352 29,113 ................ -1,239
Women's Bureau................................................ 11,536 9,214 11,536 ................ +2,322
Civil Rights Activities....................................... 6,772 8,268 6,772 ................ -1,496
Chief Financial Officer....................................... 5,329 5,440 5,329 ................ -111
-----------------------------------------------------------------------------------------
Total, Salaries and expenses............................ 345,661 347,956 346,685 +1,024 -1,271
Federal Funds....................................... (345,336) (347,630) (346,359) (+1,023) (-1,271)
Trust Funds......................................... (325) (326) (326) (+1) ................
VETERANS EMPLOYMENT AND TRAINING
State Administration, Grants.................................. 169,852 203,081 203,081 +33,229 ................
Transition Assistance Program................................. 14,242 14,000 14,000 -242 ................
Federal Administration........................................ 38,245 41,838 41,838 +3,593 ................
National Veterans Training Institute.......................... 3,459 3,414 3,414 -45 ................
Homeless Veterans Program..................................... 38,109 38,185 38,185 +76 ................
Veterans Workforce Investment Programs........................ ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Total, Veterans Employment and Training................. 263,907 300,518 300,518 +36,611 ................
Federal Funds....................................... 38,109 38,185 38,185 +76 ................
Trust Funds......................................... 225,798 262,333 262,333 +36,535 ................
INFRASTRUCTURE TECHNOLOGY MODERNIZATION
Departmental support systems.................................. 11,806 4,898 4,898 -6,908 ................
Infrastructure technology modernization....................... 7,969 15,689 14,877 +6,908 -812
-----------------------------------------------------------------------------------------
Total, IT Modernization................................. 19,775 20,587 19,775 ................ -812
OFFICE OF INSPECTOR GENERAL
Program Activities............................................ 77,634 79,805 77,634 ................ -2,171
Trust Funds............................................... 5,886 5,909 5,886 ................ -23
-----------------------------------------------------------------------------------------
Total, Office of Inspector General...................... 83,520 85,714 83,520 ................ -2,194
=========================================================================================
Total, Departmental Management.......................... 712,863 754,775 750,498 +37,635 -4,277
Federal Funds....................................... 480,854 486,207 481,953 +1,099 -4,254
Current Year.................................... (480,854) (486,207) (481,953) (+1,099) (-4,254)
Trust Funds......................................... 232,009 268,568 268,545 +36,536 -23
=========================================================================================
Total, Title I, Department of Labor............... 14,174,600 14,646,171 14,604,208 +429,608 -41,963
Federal Funds................................. 9,890,605 10,545,046 10,453,700 +563,095 -91,346
Current Year.............................. (8,053,605) (8,749,046) (8,657,700) (+604,095) (-91,346)
Emergency appropriations.................. 25,000 ................ ................ -25,000 ................
Fiscal year 2015.......................... (1,812,000) (1,796,000) (1,796,000) (-16,000) ................
Trust Funds................................... 4,283,995 4,101,125 4,150,508 -133,487 +49,383
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]
HEALTH RESOURCES AND SERVICES
Primary Health Care
Community Health Centers...................................... 1,574,606 1,566,892 1,574,606 ................ +7,714
Free Clinics Medical Malpractice.............................. 40 40 40 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Primary Health Care........................... 1,574,646 1,566,932 1,574,646 ................ +7,714
Bureau of Health Professions [BHP]
Health Workforce
Health Professions, Training for Diversity:
Centers of Excellence..................................... 22,863 22,909 22,863 ................ -46
Health Careers Opportunity Program........................ 14,942 ................ 14,942 ................ +14,942
Faculty Loan Repayment.................................... 1,253 1,243 1,253 ................ +10
Scholarships for Disadvantaged Students................... 47,357 47,452 47,357 ................ -95
-----------------------------------------------------------------------------------------
Subtotal, Training for Diversity........................ 86,415 71,604 86,415 ................ +14,811
Training in Primary Care Medicine............................. 38,884 50,962 50,962 +12,078 ................
Pediatric Loan Repayment...................................... ................ 5,000 5,000 +5,000 ................
Oral Health Training.......................................... 32,654 32,392 32,654 ................ +262
Interdisciplinary Community-Based Linkages:
Area Health Education Centers............................. 30,025 ................ 30,025 ................ +30,025
Geriatric Programs........................................ 30,877 30,629 30,629 -248 ................
Alzheimer's--Prevention and Public Health Fund\3\......... (1,847) (5,300) (5,300) (+3,453) ................
Mental and Behavorial Health.............................. 2,916 2,892 3,916 +1,000 +1,024
-----------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Community Linkages.......... 63,818 33,521 64,570 +752 +31,049
Evaluation Tap Funding.............................. ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\................ 1,847 5,300 5,300 +3,453 ................
-----------------------------------------------------------------------------------------
Total, Interdisciplinary Community Linkages....... 65,665 38,821 69,870 +4,205 +31,049
Workforce Information and Analysis............................ 2,804 5,000 5,000 +2,196 ................
Public Health and Preventive Medicine programs................ 8,177 3,226 10,177 +2,000 +6,951
Prevention and Public Health Fund\3\...................... ................ (4,776) (25,000) (+25,000) (+20,224)
-----------------------------------------------------------------------------------------
Subtotal, Public Health and Preventive Medicine......... 8,177 8,002 35,177 +27,000 +27,175
Nursing Programs:
Advanced Education Nursing................................ 63,797 83,469 83,469 +19,672 ................
Nurse Education, Practice, and Retention.................. 39,499 39,638 39,638 +139 ................
Nursing Workforce Diversity............................... 15,947 15,819 15,819 -128 ................
Loan Repayment and Scholarship Program.................... 82,968 83,135 83,135 +167 ................
Comprehensive Geriatric Education......................... 4,521 4,485 4,485 -36 ................
Nursing Faculty Loan Program.............................. 24,751 24,553 24,553 -198 ................
-----------------------------------------------------------------------------------------
Subtotal, Nursing programs.............................. 231,483 251,099 251,099 +19,616 ................
Children's Hospitals Graduate Medical Education............... 267,313 88,000 267,313 ................ +179,313
National Practitioner Data Bank............................... 28,016 28,016 28,016 ................ ................
User Fees................................................. -28,016 -28,016 -28,016 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Bureau of Health Professions.................. 731,548 540,804 773,190 +41,642 +232,386
Prevention and Public Health Fund................... (1,847) (10,076) (30,300) (+28,453) (+20,224)
-----------------------------------------------------------------------------------------
Total, Health Professions Program Level................. 733,395 550,880 803,490 +70,095 +252,610
Maternal and Child Health
Maternal and Child Health Block Grant......................... 643,807 638,646 643,807 ................ +5,161
Sickle Cell Anemia Demonstration Program...................... 4,703 4,665 4,670 -33 +5
Traumatic Brain Injury........................................ 9,840 9,760 9,760 -80 ................
Autism and Other Developmental Disorders...................... 47,523 47,142 47,142 -381 ................
Heritable Disorders........................................... 9,913 ................ 9,913 ................ +9,913
Heritable Disorders-Prevention and Public Health Fund......... ................ (9,834) ................ ................ (-9,834)
Healthy Start................................................. 104,369 103,532 103,532 -837 ................
Universal Newborn Hearing..................................... 18,811 ................ 18,660 -151 +18,660
Universal Newborn Hearing--Prevention and Public Health Fund.. ................ (18,660) ................ ................ (-18,660)
Emergency Medical Services for Children....................... 21,286 21,116 21,116 -170 ................
-----------------------------------------------------------------------------------------
Subtotal, Maternal and Child Health..................... 860,252 824,861 858,600 -1,652 +33,739
Prevention and Public Health Fund................... ................ (28,494) ................ ................ (-28,494)
-----------------------------------------------------------------------------------------
Total, Maternal and Child Health Program Level.......... 860,252 853,355 858,600 -1,652 +5,245
Ryan White HIV/AIDS Program
Ryan White AIDS Programs:
Emergency Assistance...................................... 669,915 666,071 669,915 ................ +3,844
Comprehensive Care Programs............................... 1,317,999 1,370,827 1,369,327 +51,328 -1,500
AIDS Drug Assistance Program [ADAP] (NA).............. (896,502) (943,299) (943,299) (+46,797) ................
Early Intervention Program................................ 204,765 225,086 204,765 ................ -20,321
Children, Youth, Women, and Families...................... 77,013 77,167 77,013 ................ -154
AIDS Dental Services...................................... 13,458 13,485 13,458 ................ -27
Education and Training Centers............................ 34,473 34,542 34,473 ................ -69
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDS programs...................... 2,317,623 2,387,178 2,368,951 +51,328 -18,227
Evaluation Tap Funding (NA)......................... (25,000) (25,000) (25,000) ................ ................
-----------------------------------------------------------------------------------------
Total, Ryan White AIDs Program Level.................... (2,342,623) (2,412,178) (2,393,951) (+51,328) (-18,227)
Health Care Systems
Organ Transplantation......................................... 24,799 26,015 26,015 +1,216 ................
National Cord Blood Inventory................................. 11,864 11,887 11,864 ................ -23
Bone Marrow Program........................................... 23,283 23,330 23,283 ................ -47
Office of Pharmacy Affairs.................................... 4,463 4,472 4,463 ................ -9
340B Drug Pricing User Fees................................... ................ 6,000 6,000 +6,000 ................
User Fees................................................. ................ -6,000 -6,000 -6,000 ................
Poison Control................................................ 18,793 ................ 19,793 +1,000 +19,793
Poison control-Prevention and Public Health Fund\3\........... ................ (18,830) ................ ................ (-18,830)
Hansen's Disease Services..................................... 16,013 16,045 16,013 ................ -32
Buildings and Facilities...................................... 128 127 128 ................ +1
Payment to Hawaii, treatment of Hansen's...................... 1,956 1,960 1,956 ................ -4
-----------------------------------------------------------------------------------------
Subtotal, Health Care Systems........................... 101,299 83,836 103,515 +2,216 +19,679
Prevention and Public Health Fund................... ................ (18,830) ................ ................ (-18,830)
-----------------------------------------------------------------------------------------
Total, Health Care Systems Program Level................ 101,299 102,666 103,515 +2,216 +849
Rural Health
Rural Outreach Grants......................................... 55,442 55,553 55,442 ................ -111
Rural Health Research/Policy Development...................... 9,847 9,866 9,847 ................ -19
Rural Hospital Flexibility Grants............................. 40,958 26,200 40,958 ................ +14,758
Rural and Community Access to Emergency Devices............... 2,490 ................ 5,000 +2,510 +5,000
State Offices of Rural Health................................. 10,016 10,036 10,016 ................ -20
Black Lung Clinics............................................ 7,125 7,140 7,125 ................ -15
Radiation Exposure Screening and Education Program............ 1,931 1,935 1,931 ................ -4
Telehealth.................................................... 11,479 11,502 11,479 ................ -23
-----------------------------------------------------------------------------------------
Subtotal, Rural Health.................................. 139,288 122,232 141,798 +2,510 +19,566
Family Planning............................................... 296,244 327,402 327,402 +31,158 ................
Program Management............................................ 161,186 161,794 161,794 +608 ................
-----------------------------------------------------------------------------------------
Total, Health resources & services appropriation........ (6,182,086) (6,015,039) (6,309,896) (+127,810) (+294,857)
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT
HEAL Liquidating Account...................................... (1,000) (1,000) (1,000) ................ ................
HEAL Program Management....................................... 2,830 2,807 2,807 -23 ................
-----------------------------------------------------------------------------------------
Total, HEAL............................................. 2,830 2,807 2,807 -23 ................
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Post-Fiscal Year 1988 Claims.................................. 235,000 235,000 235,000 ................ ................
HRSA Administration........................................... 6,464 6,477 6,464 ................ -13
-----------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund........... 241,464 241,477 241,464 ................ -13
=========================================================================================
Total, Health Resources & Services Administration....... 6,426,380 6,259,323 6,554,167 +127,787 +294,844
Evaluation tap funding.............................. (25,000) (25,000) (25,000) ................ ................
Prevention and Public Health Fund\3\................ (1,847) (57,400) (30,300) (+28,453) (-27,100)
-----------------------------------------------------------------------------------------
Total, HRSA program level............................... (6,453,227) (6,341,723) (6,609,467) (+156,240) (+267,744)
CENTERS FOR DISEASE CONTROL AND PREVENTION
DISEASE CONTROL, RESEARCH, AND TRAINING
Immunization and Respiratory Diseases......................... 575,095 668,696 575,095 ................ -93,601
Evaluation Tap Funding.................................... (12,864) (12,864) (12,864) ................ ................
Pandemic Flu balances (Public Law 111-32)................. (11,829) ................ ................ (-11,829) ................
Prevention and Public Health Fund\3\...................... (90,883) (72,460) (150,000) (+59,117) (+77,540)
-----------------------------------------------------------------------------------------
Subtotal................................................ (690,671) (754,020) (737,959) (+47,288) (-16,061)
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention............. 1,097,823 1,173,942 1,097,823 ................ -76,119
Evaluation Tap Funding.................................... ................ (3,000) ................ ................ (-3,000)
Prevention and Public Health Fund\3\...................... ................ ................ (10,000) (+10,000) (+10,000)
-----------------------------------------------------------------------------------------
Subtotal, HIV/AIDS, Viral Hepathitis, STD & TB.......... 1,097,823 1,176,942 1,107,823 +10,000 -69,119
Emerging and Zoonotic Infectious Diseases..................... 252,043 380,664 283,237 +31,194 -97,427
Prevention and Public Health Fund\3\...................... (44,174) (51,750) (52,000) (+7,826) (+250)
-----------------------------------------------------------------------------------------
Subtotal, Emerging and Zoonotic Infectious.............. 296,217 432,414 335,237 +39,020 -97,177
Chronic Disease Prevention and Health Promotion............... 755,079 620,189 774,831 +19,752 +154,642
Evaluation Tap Funding.................................... ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\...................... (233,033) (415,904) (485,700) (+252,667) (+69,796)
-----------------------------------------------------------------------------------------
Subtotal, Chronic Disiease Prevention................... (988,112) (1,036,093) (1,260,531) (+272,419) (+224,438)
Birth Defects and Developmental Disabilities.................. 137,051 67,148 123,483 -13,568 +56,335
Prevention and Public Health Fund\3\...................... ................ (74,796) ................ ................ (-74,796)
-----------------------------------------------------------------------------------------
Subtotal, Birth Defects................................. (137,051) (141,944) (123,483) (-13,568) (-18,461)
Public Health Scientific Services............................. 143,726 144,416 143,726 ................ -690
Evaluation Tap Funding.................................... (247,769) (324,889) (247,769) ................ (-77,120)
Prevention and Public Health Fund\3\...................... (51,501) (70,000) (58,100) (+6,599) (-11,900)
-----------------------------------------------------------------------------------------
Subtotal................................................ (442,996) (539,305) (449,595) (+6,599) (-89,710)
Environmental Health.......................................... 104,819 126,126 113,827 +9,008 -12,299
Prevention and Public Health Fund\3\...................... (20,740) (29,000) (39,200) (+18,460) (+10,200)
-----------------------------------------------------------------------------------------
Subtotal................................................ (125,559) (155,126) (153,027) (+27,468) (-2,099)
Injury Prevention and Control................................. 137,456 176,585 162,456 +25,000 -14,129
Prevention and Public Health Fund\3\...................... ................ ................ (3,000) (+3,000) (+3,000)
Evaluation Tap Funding.................................... ................ (5,000) ................ ................ (-5,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ (137,456) (181,585) (165,456) (+28,000) (-16,129)
National Institute for Occupational Safety & Health\3\........ 181,551 ................ 181,551 ................ +181,551
Evaluation Tap Funding.................................... (110,724) (271,911) (110,724) ................ (-161,187)
-----------------------------------------------------------------------------------------
Subtotal................................................ (292,275) (271,911) (292,275) ................ (+20,364)
Energy Employees Occupational Illness Compensation Program.... 55,358 55,358 55,358 ................ ................
Global Health................................................. 346,964 393,024 391,964 +45,000 -1,060
Public Health Preparedness and Response....................... 1,297,248 1,334,316 1,292,498 -4,750 -41,818
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,297,248 1,334,316 1,292,498 -4,750 -41,818
CDC-Wide Activities........................................... 616,854 131,402 616,563 -291 +485,161
Prevention and Public Health Fund\3\...................... (22,585) (41,200) (41,000) (+18,415) (-200)
-----------------------------------------------------------------------------------------
Subtotal, CDC-Wide Activities........................... (639,439) (172,602) (657,563) (+18,124) (+484,961)
Total, Centers for Disease Control...................... 5,701,067 5,271,866 5,812,412 +111,345 +540,546
Discretionary....................................... 5,645,709 5,216,508 5,757,054 +111,345 +540,546
Evaluation Tap Funding (NA)......................... (371,357) (617,664) (371,357) ................ (-246,307)
Pandemic Flu balances (Public Law 111-32)........... (11,829) ................ ................ (-11,829) ................
-----------------------------------------------------------------------------------------
Prevention and Public Health Fund\3\................ (462,916) (755,110) (839,000) (+376,084) (+83,890)
=========================================================================================
Total, Centers for Disease Control Program Level........ (6,547,169) (6,644,640) (7,022,769) (+475,600) (+378,129)
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute..................................... 5,062,039 5,125,951 5,091,885 +29,846 -34,066
National Heart, Lung, and Blood Institute..................... 3,072,863 3,098,508 3,077,916 +5,053 -20,592
National Institute of Dental & Craniofacial Research.......... 409,889 411,515 409,947 +58 -1,568
National Institute of Diabetes and Digestive and Kidney 1,793,450 1,811,786 1,799,745 +6,295 -12,041
Diseases [NIDDK].............................................
National Institute of Neurological Disorders & Stroke......... 1,623,113 1,642,619 1,631,703 +8,590 -10,916
National Institute of Allergy and Infectious Diseases......... 4,481,730 4,578,813 4,548,383 +66,653 -30,430
Global HIV/AIDS Fund Transfer............................. ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal, NIAID program level........................... 4,481,730 4,578,813 4,548,383 +66,653 -30,430
National Institute of General Medical Sciences................ 2,425,175 2,401,011 2,435,570 +10,395 +34,559
National Institute of Child Health & Human Development........ 1,318,755 1,339,360 1,330,459 +11,704 -8,901
National Eye Institute........................................ 701,307 699,216 701,407 +100 +2,191
National Institute of Environmental Health Sciences........... 684,200 691,348 686,753 +2,553 -4,595
National Institute on Aging................................... 1,101,234 1,193,370 1,185,439 +84,205 -7,931
National Institute of Arthritis and Musculoskeletal and Skin 534,715 540,993 537,398 +2,683 -3,595
Diseases.....................................................
National Institute on Deafness and Other Communication 415,440 422,936 420,125 +4,685 -2,811
Disorders....................................................
National Institute of Nursing Research........................ 144,479 146,244 145,272 +793 -972
National Institute on Alcohol Abuse and Alcoholism............ 458,600 463,848 460,765 +2,165 -3,083
National Institute on Drug Abuse.............................. 1,051,261 1,071,612 1,064,490 +13,229 -7,122
National Institute of Mental Health........................... 1,477,304 1,465,782 1,456,041 -21,263 -9,741
National Human Genome Research Institute...................... 511,847 517,319 513,881 +2,034 -3,438
National Institute of Biomedical Imaging and Bioengineering... 337,681 338,892 337,728 +47 -1,164
National Center for Complementary and Alternative Medicine.... 127,800 129,041 128,183 +383 -858
National Institute on Minority Health and Health Disparities.. 275,887 283,299 281,416 +5,529 -1,883
John E. Fogarty International Center.......................... 69,483 72,864 72,380 +2,897 -484
National Center for Advancing Translation Sciences............ 574,216 665,688 661,264 +87,048 -4,424
National Library of Medicine (NLM)............................ 336,963 382,252 379,712 +42,749 -2,540
Evaluation Tap Funding.................................... (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 345,163 390,452 387,912 +42,749 -2,540
Office of the Director........................................ 1,525,125 1,473,398 1,463,606 -61,519 -9,792
Common fund............................................... (544,870) (572,948) (568,151) (+23,281) (-4,797)
Buildings and Facilities...................................... 125,093 126,111 125,308 +215 -803
=========================================================================================
Total, National Institutes of Health (NIH).............. 30,639,649 31,093,776 30,946,776 +307,127 -147,000
Evaluation Tap Funding.............................. (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Total, NIH Program Level................................ (30,647,849) (31,101,976) (30,954,976) (+307,127) (-147,000)
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
[SAMHSA]
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
Mental Health:
Programs of Regional and National Significance............ 275,205 333,277 357,191 +81,986 +23,914
Prevention and Public Health Fund\3\...................... ................ (28,000) (27,000) (+27,000) (-1,000)
-----------------------------------------------------------------------------------------
Subtotal, PRNS.......................................... (275,205) (361,277) (384,191) (+108,986) (+22,914)
Mental Health block grant................................. 437,840 438,717 462,705 +24,865 +23,988
Evaluation Tap Funding................................ (21,039) (21,039) (21,039) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, MHBG Program level........................ (458,879) (459,756) (483,744) (+24,865) (+23,988)
Children's Mental Health.................................. 117,345 117,315 117,315 -30 ................
Grants to States for the Homeless (PATH).................. 64,665 64,794 64,794 +129 ................
Protection and Advocacy................................... 36,166 36,238 36,238 +72 ................
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................. 931,221 990,341 1,038,243 +107,022 +47,902
-----------------------------------------------------------------------------------------
Subtotal, Mental health program level................... (952,260) (1,039,380) (1,086,282) (+134,022) (+46,902)
Substance Abuse Treatment:
Programs of Regional and National Significance............ 398,048 304,794 306,451 -91,597 +1,657
Prevention and Public Health Fund\3\...................... ................ (30,000) (50,000) (+50,000) (+20,000)
Evaluation Tap Funding................................ (2,000) ................ (2,000) ................ (+2,000)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (400,048) (334,794) (358,451) (-41,597) (+23,657)
Substance Abuse block grant............................... 1,717,690 1,748,132 1,740,656 +22,966 -7,476
Evaluation Tap Funding................................ (79,200) (71,724) (79,200) ................ (+7,476)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (1,796,890) (1,819,856) (1,819,856) (+22,966) ................
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment................. 2,115,738 2,052,926 2,047,107 -68,631 -5,819
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (2,196,938) (2,154,650) (2,178,307) (-18,631) (+23,657)
Substance Abuse Prevention:
Programs of Regional and National Significance............ 185,637 175,560 175,631 -10,006 +71
-----------------------------------------------------------------------------------------
Subtotal, Program Level................................. (185,637) (175,560) (175,631) (-10,006) (+71)
Health Surveillance and Program Support:
Health Surveillance, Crosscutting Issues and Support...... 108,681 129,124 136,296 +27,615 +7,172
Prevention and Public Health Fund..................... (14,733) ................ (15,000) (+267) (+15,000)
Evaluation Tap Funding (NA)........................... (27,428) (71,995) (30,428) (+3,000) (-41,567)
Data Requests and Publications............................ ................ 1,500 1,500 +1,500 ................
User fees................................................. ................ -1,500 -1,500 -1,500 ................
-----------------------------------------------------------------------------------------
Total, Health Surveillance Program Level................ 150,842 201,119 181,724 +30,882 -19,395
=========================================================================================
Total, SAMHSA........................................... 3,341,277 3,347,951 3,397,277 +56,000 +49,326
Evaluation Tap Funding.............................. (129,667) (164,758) (132,667) (+3,000) (-32,091)
Prevention and Public Health Fund\3\................ (14,733) (58,000) (92,000) (+77,267) (+34,000)
-----------------------------------------------------------------------------------------
Total, SAMHSA Program Level............................. (3,485,677) (3,570,709) (3,621,944) (+136,267) (+51,235)
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]
HEALTHCARE RESEARCH AND QUALITY
Research on Health Costs, Quality, and Outcomes:
Evaluation Tap funding.................................... (235,768) (201,073) (231,384) (-4,384) (+30,311)
Prevention and Public Health Fund\3\...................... (6,465) ................ (7,000) (+535) (+7,000)
-----------------------------------------------------------------------------------------
Subtotal, Health Costs, Quality, and Outcomes........... (242,233) (201,073) (238,384) (-3,849) (+37,311)
Medical Expenditures Panel Surveys:
Evaluation Tap Funding (NA)............................... (60,700) (63,811) (63,811) (+3,111) ................
-----------------------------------------------------------------------------------------
Subtotal, Medical Expenditures Panel Surveys............ (60,700) (63,811) (63,811) (+3,111) ................
Program Support:
Evaluation Tap Funding (NA)............................... (72,585) (68,813) (68,813) (-3,772) ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (72,585) (68,813) (68,813) (-3,772) ................
Evaluation Tap Funding (NA)......................... (369,053) (333,697) (364,008) (-5,045) (+30,311)
AHRQ, Prevention and Public Health Fund\3\.......... (6,465) ................ (7,000) (+535) (+7,000)
-----------------------------------------------------------------------------------------
Total, AHRQ Program Level............................... (375,518) (333,697) (371,008) (-4,510) (+37,311)
=========================================================================================
Total, Public Health Service (PHS) appropriation........ 46,108,373 45,972,916 46,710,632 +602,259 +737,716
Total, Public Health Service Program Level.............. (47,510,440) (47,993,745) (48,581,164) (+1,070,724) (+587,419)
CENTERS FOR MEDICARE AND MEDICAID SERVICES
GRANTS TO STATES FOR MEDICAID
Medicaid Current Law Benefits................................. 249,401,000 263,462,118 263,462,118 +14,061,118 ................
State and Local Administration................................ 16,181,506 16,453,115 16,453,115 +271,609 ................
Vaccines for Children......................................... 3,607,256 4,293,383 4,293,383 +686,127 ................
-----------------------------------------------------------------------------------------
Subtotal, Medicaid Program Level........................ 269,189,762 284,208,616 284,208,616 +15,018,854 ................
Less funds advanced in prior year................... -90,614,082 -106,335,631 -106,335,631 -15,721,549 ................
-----------------------------------------------------------------------------------------
Total, Grants to States for Medicaid.................... 178,575,680 177,872,985 177,872,985 -702,695 ................
New advance, 1st quarter............................ 106,335,631 103,472,323 103,472,323 -2,863,308 ................
PAYMENTS TO HEALTH CARE TRUST FUNDS
Supplemental Medical Insurance................................ 181,351,000 194,565,000 194,565,000 +13,214,000 ................
Federal Uninsured Payment..................................... 228,000 204,000 204,000 -24,000 ................
Program Management............................................ 750,000 1,319,000 1,319,000 +569,000 ................
General Revenue for Part D Benefit............................ 51,245,000 58,596,000 58,596,000 +7,351,000 ................
General Revenue for Part D Administration..................... 382,000 373,000 373,000 -9,000 ................
HCFAC Reimbursement........................................... 309,790 128,000 640,000 +330,210 +512,000
-----------------------------------------------------------------------------------------
Total, Payments to Trust Funds, Program Level........... 234,265,790 255,185,000 255,697,000 +21,431,210 +512,000
Reduced Cost Sharing for Individuals in Qualified Plan........ ................ 3,977,893 ................ ................ -3,977,893
New Advance Fiscal Year 2015.............................. ................ 1,420,000 ................ ................ -1,420,000
PROGRAM MANAGEMENT
Research, Demonstration, Evaluation........................... 21,118 ................ ................ -21,118 ................
Program operations............................................ 2,653,582 4,011,200 4,011,200 +1,357,618 ................
Program Operations--PPHF\3\ (NA).............................. (453,803) ................ ................ (-453,803) ................
State Survey and Certification................................ 374,453 412,353 412,353 +37,900 ................
High Risk Insurance Pools..................................... 44,000 22,004 22,004 -21,996 ................
Federal Administration........................................ 771,418 771,800 771,800 +382 ................
=========================================================================================
Total, Program management, Limitation on new BA......... 3,864,571 5,217,357 5,217,357 +1,352,786 ................
Total, Program management, Program level................ 4,318,374 5,217,357 5,217,357 +898,983 ................
HEALTH CARE FRAUD AND ABUSE CONTROL
CMS Activities................................................ 249,942 251,420 429,846 +179,904 +178,426
HHS Office of Inspector General............................... 29,614 29,790 107,541 +77,927 +77,751
Department of Justice......................................... 29,614 29,790 102,613 +72,999 +72,823
-----------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control.............. 309,170 311,000 640,000 +330,830 +329,000
=========================================================================================
Total, Centers for Medicare and Medicaid Services....... 523,350,842 547,456,558 542,899,665 +19,548,823 -4,556,893
Federal funds....................................... 519,177,101 541,928,201 537,042,308 +17,865,207 -4,885,893
Current year.................................... (412,841,470) (437,035,878) (433,569,985) (+20,728,515) (-3,465,893)
New advance, Fiscal year 2015................... (106,335,631) (104,892,323) (103,472,323) (-2,863,308) (-1,420,000)
Trust Funds......................................... 4,173,741 5,528,357 5,857,357 +1,683,616 +329,000
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............................ 3,429,973 3,480,340 3,480,340 +50,367 ................
Federal Incentive Payments................................ 529,779 540,905 540,905 +11,126 ................
Access and Visitation..................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement..................... 3,969,752 4,031,245 4,031,245 +61,493 ................
=========================================================================================
Total, Family Support Payments Program Level............ 4,003,752 4,065,245 4,065,245 +61,493 ................
Less funds advanced in previous years............... -1,100,000 -1,100,000 -1,100,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Family Support Payments, current year............ 2,903,752 2,965,245 2,965,245 +61,493 ................
New advance, 1st quarter, Fiscal year 2015.......... 1,100,000 1,250,000 1,250,000 +150,000 ................
LOW-INCOME HOME ENERGY ASSISTANCE [LIHEAP]
Formula Grants................................................ 3,464,729 2,820,000 3,614,729 +150,000 +794,729
Contingency Fund.............................................. ................ 150,000 ................ ................ -150,000
Energy Reduction Burden Grants................................ ................ 50,000 ................ ................ -50,000
-----------------------------------------------------------------------------------------
Total, LIHEAP, Program Level............................ 3,464,729 3,020,000 3,614,729 +150,000 +594,729
REFUGEE AND ENTRANT ASSISTANCE
Transitional and Medical Services............................. 411,673 391,477 391,477 -20,196 ................
Victims of Trafficking........................................ 9,755 19,775 15,775 +6,020 -4,000
Social Services............................................... 153,100 153,407 153,407 +307 ................
Preventive Health............................................. 4,814 4,730 4,730 -84 ................
Targeted Assistance........................................... 48,304 48,401 48,401 +97 ................
Unaccompanied Minors.......................................... 375,088 494,597 494,597 +119,509 ................
Victims of Torture............................................ 11,234 11,045 13,045 +1,811 +2,000
-----------------------------------------------------------------------------------------
Total, Refugee and Entrant Assistance................... 1,013,968 1,123,432 1,121,432 +107,464 -2,000
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
GRANT
Child Care and Development Block Grant........................ 2,323,656 2,478,313 2,500,000 +176,344 +21,687
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................................ 7,986,040 9,621,070 9,621,070 +1,635,030 ................
Consolidated Runaway, Homeless Youth Program.............. 97,160 100,355 99,355 +2,195 -1,000
Prevention Grants to Reduce Abuse of Runaway Youth........ 17,865 17,901 17,865 ................ -36
Child Abuse State Grants.................................. 26,379 26,432 26,379 ................ -53
Child Abuse Discretionary Activities...................... 25,693 25,744 25,693 ................ -51
Community Based Child Abuse Prevention.................... 41,444 41,527 41,444 ................ -83
Abandoned Infants Assistance.............................. 11,530 11,553 11,530 ................ -23
Child Welfare Services.................................... 280,088 280,650 280,088 ................ -562
Child Welfare Training/Innovative Approaches to Foster 26,039 26,092 26,039 ................ -53
Care.....................................................
Adoption Opportunities.................................... 39,100 39,179 44,100 +5,000 +4,921
Adoption Incentive........................................ 39,268 39,346 39,268 ................ -78
Social Services and Income Maintenance Research............... ................ 44,000 9,000 +9,000 -35,000
Evaluation Tap Funding.................................... (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Program Level................................. (5,762) (49,762) (14,762) (+9,000) (-35,000)
Developmental Disabilities Programs:
State Councils............................................ 74,625 ................ ................ -74,625 ................
Protection and Advocacy................................... 40,783 ................ ................ -40,783 ................
Voting Access for Individuals with Disabilities........... 5,225 ................ ................ -5,225 ................
Developmental Disabilities Projects of National 8,301 ................ ................ -8,301 ................
Significance.............................................
University Centers for Excellence in Developmental 38,714 ................ ................ -38,714 ................
Disabilities.............................................
-----------------------------------------------------------------------------------------
Subtotal, Developmental Disabilities Programs........... 167,648 ................ ................ -167,648 ................
Native American Programs...................................... 48,486 48,583 48,486 ................ -97
Community Services:
Community Services Block Grant Act programs:
Grants to States for Community Services............... 676,003 350,000 676,003 ................ +326,003
Economic Development.................................. 29,883 ................ 29,883 ................ +29,883
Rural Community Facilities............................ 4,971 ................ 5,971 +1,000 +5,971
-----------------------------------------------------------------------------------------
Subtotal............................................ 710,857 350,000 711,857 +1,000 +361,857
Individual Development Account Initiative............. 19,830 19,469 20,000 +170 +531
-----------------------------------------------------------------------------------------
Subtotal, Community Services........................ 730,687 369,469 731,857 +1,170 +362,388
Domestic Violence Hotline..................................... 3,191 4,500 4,500 +1,309 ................
Family Violence/Battered Women's Shelters..................... 129,288 135,000 135,000 +5,712 ................
Independent Living Training Vouchers.......................... 45,084 45,174 45,084 ................ -90
Faith-Based Center............................................ 1,368 1,370 1,368 ................ -2
Disaster Human Services Case Management....................... 1,988 1,992 1,988 ................ -4
Program Direction............................................. 203,220 203,245 202,000 -1,220 -1,245
=========================================================================================
Total, Children and Families Services Programs.......... 9,921,566 11,083,182 11,412,114 +1,490,548 +328,932
Current Year........................................ (9,921,566) (11,083,182) (11,412,114) (+1,490,548) (+328,932)
Evaluation Tap Funding.............................. (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Total, Program Level.................................... (9,927,328) (11,088,944) (11,417,876) (+1,490,548) (+328,932)
PROMOTING SAFE AND STABLE FAMILIES............................ 345,000 345,000 345,000 ................ ................
Discretionary Funds....................................... 62,938 63,065 63,065 +127 ................
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Foster Care................................................... 4,285,540 4,279,000 4,279,000 -6,540 ................
Adoption Assistance........................................... 2,368,680 2,463,000 2,463,000 +94,320 ................
Kinship Guardianship.......................................... 123,000 124,000 124,000 +1,000 ................
Independent Living............................................ 140,000 140,000 140,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States................................. 6,917,220 7,006,000 7,006,000 +88,780 ................
Less Advances from Prior Year......................... -2,100,000 -2,200,000 -2,200,000 -100,000 ................
-----------------------------------------------------------------------------------------
Total, payments, current year..................... 4,817,220 4,806,000 4,806,000 -11,220 ................
New Advance, 1st quarter.......................... 2,200,000 2,200,000 2,200,000 ................ ................
=========================================================================================
Total, Administration for Children & Families......... 29,852,829 31,034,237 31,977,585 +2,124,756 +943,348
Current year...................................... (26,552,829) (27,584,237) (28,527,585) (+1,974,756) (+943,348)
Fiscal year 2015.................................. (3,300,000) (3,450,000) (3,450,000) (+150,000) ................
Evaluation Tap Funding............................ (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Total, ACF Program Level.............................. 29,858,591 31,039,999 31,983,347 +2,124,756 +943,348
ADMINISTRATION FOR COMMUNITY LIVING
AGING AND DISABILITY SERVICES PROGRAMS
Grants to States:
Home and Community-based Supportive Services.............. 366,182 366,916 366,916 +734 ................
Preventive Health......................................... 20,902 20,944 20,944 +42 ................
Protection of Vulnerable Older Americans--Title VII....... 21,754 21,797 21,797 +43 ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 408,838 409,657 409,657 +819 ................
Family Caregivers......................................... 153,314 153,621 153,621 +307 ................
Native American Caregivers Support........................ 6,351 6,364 6,364 +13 ................
-----------------------------------------------------------------------------------------
Subtotal, Caregivers.................................... 159,665 159,985 159,985 +320 ................
Nutrition:
Congregate Meals...................................... 438,191 439,070 439,070 +879 ................
Home Delivered Meals.................................. 216,397 216,830 216,830 +433 ................
Nutrition Services Incentive Program.................. 160,069 160,389 160,389 +320 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 814,657 816,289 816,289 +1,632 ................
-----------------------------------------------------------------------------------------
Subtotal, Grants to States.......................... 1,383,160 1,385,931 1,385,931 +2,771 ................
Grants for Native Americans................................... 27,546 27,601 27,601 +55 ................
Aging Network Support Activities.............................. 7,857 7,873 7,873 +16 ................
Alzheimer's Disease Demonstrations............................ 4,002 9,537 4,002 ................ -5,535
Alzheimer's Disease Initiative PPHF (NA)...................... (150) (14,700) (14,700) (+14,550) ................
Lifespan Respite Care......................................... 2,485 2,490 2,490 +5 ................
Chronic Disease Self-Management Program....................... ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\...................... (7,086) (10,000) (10,000) (+2,914) ................
Elder Falls................................................... ................ ................ ................ ................ ................
Prevention and Public Health Fund\3\...................... ................ ................ (7,000) (+7,000) (+7,000)
Adult Protective Services Demonstration....................... ................ 8,000 8,000 +8,000 ................
Elder Justice--PPHF (NA)...................................... (2,000) ................ ................ (-2,000) ................
Senior Medicare Patrol Program................................ 9,383 9,402 9,402 +19 ................
Elder Rights Support Activities............................... 4,080 4,088 4,088 +8 ................
Aging and Disability Resources................................ 6,444 ................ 6,444 ................ +6,444
State Health Insurance Program................................ ................ 52,115 52,115 +52,115 ................
National Clearinghouse for Long-Term Care Information......... ................ 3,000 3,000 +3,000 ................
Paralysis Resource Center..................................... ................ 6,700 6,700 +6,700 ................
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 9,317 +9,317 +1,000
Significance.............................................
University Centers of Excellence.......................... ................ 38,792 38,792 +38,792 ................
-----------------------------------------------------------------------------------------
Subtotal................................................ ................ 167,983 168,983 +168,983 +1,000
Program Administration........................................ 23,017 30,035 30,035 +7,018 ................
-----------------------------------------------------------------------------------------
Total, Administration for Community Living.............. 1,467,974 1,714,755 1,716,664 +248,690 +1,909
Federal funds....................................... 1,467,974 1,662,640 1,664,549 +196,575 +1,909
Trust Funds......................................... ................ (52,115) (52,115) (+52,115) ................
Prevention and Public Health Fund................... (9,236) (24,700) (31,700) (+22,464) (+7,000)
-----------------------------------------------------------------------------------------
Total, ACL Program Level................................ 1,477,210 1,739,455 1,748,364 +271,154 +8,909
OFFICE OF THE SECRETARY
GENERAL DEPARTMENTAL MANAGEMENT
General Departmental Management:
Federal Funds............................................. 219,159 234,067 219,159 ................ -14,908
-----------------------------------------------------------------------------------------
Subtotal................................................ 219,159 234,067 219,159 ................ -14,908
Teen Pregnancy Prevention Community Grants.................... 104,383 ................ 104,790 +407 +104,790
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.............................. (112,838) (109,022) (113,245) (+407) (+4,223)
Minority Health............................................... 55,670 40,560 42,560 -13,110 +2,000
Abstinence Education.......................................... 4,981 ................ ................ -4,981 ................
Office of Women's Health...................................... 33,615 26,808 26,808 -6,807 ................
Minority HIV/AIDS............................................. 53,574 ................ 53,891 +317 +53,891
Evaluation Tap Funding.................................... ................ (53,891) ................ ................ (-53,891)
Embryo Adoption Awareness Campaign............................ 1,992 ................ ................ -1,992 ................
Planning and Evaluation, Evaluation Tap Funding............... (60,756) (61,718) (61,718) (+962) ................
-----------------------------------------------------------------------------------------
Total, General Departmental Management.................. 542,585 421,276 517,381 -25,204 +96,105
Federal Funds....................................... (473,374) (301,435) (447,208) (-26,166) (+145,773)
Evaluation Tap Funding (NA)......................... (69,211) (119,841) (70,173) (+962) (-49,668)
Prevention and Public Health Fund\3\................ ................ (104,790) ................ ................ (-104,790)
-----------------------------------------------------------------------------------------
Total, General Departmental Management Program.......... 542,585 526,066 517,381 -25,204 -8,685
OFFICE OF MEDICARE HEARINGS AND APPEALS....................... 71,867 82,381 82,381 +10,514 ................
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 16,382 20,576 20,290 +3,908 -286
TECHNOLOGY...................................................
Evaluation Tap Funding.................................... (44,811) (56,307) (51,307) (+6,496) (-5,000)
Certification and Standards............................... ................ 1,000 1,000 +1,000 ................
User fees............................................. ................ -1,000 -1,000 -1,000 ................
-----------------------------------------------------------------------------------------
Total, Program Level................................ (61,193) (76,883) (71,597) (+10,404) (-5,286)
OFFICE OF INSPECTOR GENERAL
Inspector General Federal Funds............................... 49,983 68,879 59,879 +9,896 -9,000
HIPAA/HCFAC funding (NA).................................. (196,299) (200,279) (200,279) (+3,980) ................
-----------------------------------------------------------------------------------------
Total, Inspector General Program Level.................. (246,282) (269,158) (260,158) (+13,876) (-9,000)
OFFICE FOR CIVIL RIGHTS:
Federal Funds............................................. 40,857 42,205 42,205 +1,348 ................
-----------------------------------------------------------------------------------------
Total, Office for Civil Rights.......................... 40,857 42,205 42,205 +1,348 ................
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Retirement Payments........................................... 395,452 415,331 415,331 +19,879 ................
Survivors Benefits............................................ 31,043 28,239 28,239 -2,804 ................
Dependents' Medical Care...................................... 100,656 106,802 106,802 +6,146 ................
-----------------------------------------------------------------------------------------
Total, Medical Benefits for Commissioned Officers....... 527,151 550,372 550,372 +23,221 ................
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
Assistant Secretary for Preparedness and Response
Operations.................................................... 32,925 33,213 33,213 +288 ................
Preparedness and Emergency Operations......................... 29,532 24,789 24,789 -4,743 ................
National Disaster Medical System.............................. 52,645 52,502 52,502 -143 ................
Hospital Preparedness Cooperative Agreement Grants............ 374,007 254,555 254,555 -119,452 ................
Emergency Systems for Advanced Registration of Volunteer 4,981 505 505 -4,476 ................
Health Professionals (ESAR-VHP)..............................
Biomedical Advanced Research and Development Authority [BARDA] 415,000 395,130 415,000 ................ +19,870
Medical Countermeasure Strategic Investment Corp.............. ................ 20,000 15,000 +15,000 -5,000
Medical Countermeasure Dispensing............................. ................ 5,000 5,000 +5,000 ................
Policy and Planning........................................... 15,647 15,253 15,253 -394 ................
Project BioShield............................................. ................ 250,000 250,000 +250,000 ................
-----------------------------------------------------------------------------------------
Subtotal, AS for Preparedness and Response.............. 924,737 1,050,947 1,065,817 +141,080 +14,870
Assistant Secretary for Administration
Cybersecurity................................................. 39,845 41,125 41,125 +1,280 ................
Assistant Secretary for Health
Medical Reserve Corps......................................... 11,224 8,979 8,979 -2,245 ................
Office of the Secretary
Pandemic Influenza Preparedness:
Available until expended.................................. ................ 108,000 108,000 +108,000 ................
Annual.................................................... ................ 32,009 32,009 +32,009 ................
-----------------------------------------------------------------------------------------
Pandemic Influenza Program Level...................... ................ 140,009 140,009 +140,009 ................
Office of Security and Strategic Information.................. 6,435 7,470 7,470 +1,035 ................
HHS Lease Replacements........................................ 16,966 41,000 41,000 +24,034 ................
Disaster Relief Public Law 113-2 (emergency appropriation).... 800,000 ................ ................ -800,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Office of the Secretary....................... 823,401 188,479 188,479 -634,922 ................
-----------------------------------------------------------------------------------------
Subtotal, Non-pandemic flu/BARDA/BioShield/Parklawn..... 1,799,207 1,289,530 1,304,400 -494,807 +14,870
=========================================================================================
Total, PHSSEF........................................... 1,799,207 1,289,530 1,304,400 -494,807 +14,870
=========================================================================================
Total, Office of the Secretary.......................... 2,978,821 2,355,378 2,506,735 -472,086 +151,357
Federal Funds....................................... 2,106,954 2,272,997 2,424,354 +317,400 +151,357
Federal Funds (emergency)........................... 800,000 ................ ................ -800,000 ................
Trust Funds......................................... 71,867 82,381 82,381 +10,514 ................
Evaluation Tap Funding (NA)......................... (114,022) (176,148) (121,480) (+7,458) (-54,668)
-----------------------------------------------------------------------------------------
Total, Office of the Secretary Program Level...... 2,292,843 2,636,316 2,628,215 +335,372 -8,101
=========================================================================================
Total, Title II, Dept of Health & Human Services.. 603,758,839 628,533,844 625,811,281 +22,052,442 -2,722,563
Federal Funds..................................... 599,513,231 622,870,991 619,819,428 +20,306,197 -3,051,563
Current year.................................. (489,077,600) (514,528,668) (512,897,105) (+23,819,505) (-1,631,563)
Current Year (emergency)...................... (800,000) ................ ................ (-800,000) ................
Fiscal year 2015.............................. (109,635,631) (108,342,323) (106,922,323) (-2,713,308) (-1,420,000)
Trust Funds....................................... 4,245,608 5,662,853 5,991,853 +1,746,245 +329,000
Pandemic Flu balances (Public Law 111-32)......... (11,829) ................ ................ (-11,829) ................
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Grants to Local Educational Agencies [LEAs] Basic Grants:
Advance from prior year................................... (2,962,510) (3,313,597) (3,313,597) (+351,087) ................
Forward funded............................................ 3,599,514 2,834,559 3,767,248 +167,734 +932,689
Current funded............................................ ................ ................ 4,000 +4,000 +4,000
-----------------------------------------------------------------------------------------
Subtotal, Basic grants current year approp.............. 3,599,514 2,834,559 3,771,248 +171,734 +936,689
Subtotal, Basic grants total funds available............ (6,562,024) (6,148,156) (7,084,845) (+522,821) (+936,689)
Basic Grants Fiscal Year 2015 Advance..................... 2,962,510 3,743,345 2,790,776 -171,734 -952,569
-----------------------------------------------------------------------------------------
Subtotal, Basic grants, program level................... 6,562,024 6,577,904 6,562,024 ................ -15,880
Concentration Grants:
Advance from prior year............................... (1,362,301) (1,293,919) (1,293,919) (-68,382) ................
Fiscal Year 2015 Advance.............................. 1,362,301 1,362,301 1,362,301 ................ ................
Targeted Grants:
Forward funded........................................ 23,367 ................ ................ -23,367 ................
Advance from prior year............................... (3,258,183) (3,116,831) (3,116,831) (-141,352) ................
Fiscal Year 2015 Advance.............................. 3,258,183 3,288,126 3,344,050 +85,867 +55,924
-----------------------------------------------------------------------------------------
Subtotal (excluding emergencies).................... 3,281,550 3,288,126 3,344,050 +62,500 +55,924
Education Finance Incentive Grants:
Forward Funded........................................ 23,367 ................ ................ -23,367 ................
Advance from prior year............................... (3,258,183) (3,116,831) (3,116,831) (-141,352) ................
Fiscal Year 2015 Advance.............................. 3,258,183 3,288,126 3,344,050 +85,867 +55,924
-----------------------------------------------------------------------------------------
Subtotal............................................ 3,281,550 3,288,126 3,344,050 +62,500 +55,924
=========================================================================================
Subtotal, Grants to LEAs, program level............. 14,487,425 14,516,457 14,612,425 +125,000 +95,968
=========================================================================================
Subtotal, Grants to LEAs, program level............. 14,487,425 14,516,457 14,612,425 +125,000 +95,968
School Improvement Grants..................................... 532,485 658,552 567,485 +35,000 -91,067
Striving Readers.............................................. 159,378 ................ 164,378 +5,000 +164,378
State Agency Programs:
Migrant................................................... 392,450 393,236 392,450 ................ -786
Neglected and Delinquent/High Risk Youth.................. 50,130 50,231 50,130 ................ -101
-----------------------------------------------------------------------------------------
Subtotal, State Agency programs......................... 442,580 443,467 442,580 ................ -887
Evaluation.................................................... 3,188 ................ 3,028 -160 +3,028
High School Graduation Initiative............................. 48,712 ................ 48,809 +97 +48,809
Migrant Education:
High School Equivalency Program........................... 36,453 36,526 36,526 +73 ................
=========================================================================================
Total, Education for the disadvantaged.................. 15,710,221 15,655,002 15,875,231 +165,010 +220,229
Current Year........................................ (4,869,044) (3,973,104) (5,034,054) (+165,010) (+1,060,950)
Fiscal year 2015.................................... (10,841,177) (11,681,898) (10,841,177) ................ (-840,721)
Subtotal, Forward Funded................................ (4,780,691) (3,936,578) (4,941,691) (+161,000) (+1,005,113)
PRESCHOOL DEVELOPMENT GRANTS.................................. ................ 750,000 750,000 +750,000 ................
IMPACT AID
Basic Support Payments........................................ 1,151,233 1,153,540 1,153,540 +2,307 ................
Payments for Children with Disabilities....................... 48,316 48,413 48,316 ................ -97
Facilities Maintenance (Sec. 8008)............................ 4,835 4,845 4,835 ................ -10
Construction (Sec. 8007)...................................... 17,406 17,441 17,441 +35 ................
Payments for Federal Property (Sec. 8002)..................... 66,813 ................ 66,813 ................ +66,813
-----------------------------------------------------------------------------------------
Total, Impact aid....................................... 1,288,603 1,224,239 1,290,945 +2,342 +66,706
SCHOOL IMPROVEMENT PROGRAMS
State Grants for Improving Teacher Quality.................... 780,193 ................ 780,193 ................ +780,193
Advance from prior year................................... (1,681,441) (1,681,441) (1,681,441) ................ ................
Fiscal year 2015.......................................... 1,681,441 ................ 1,681,441 ................ +1,681,441
-----------------------------------------------------------------------------------------
Subtotal, State Grants for Improving Teacher Quality, 2,461,634 ................ 2,461,634 ................ +2,461,634
program level..........................................
Mathematics and Science Partnerships.......................... 149,417 ................ 149,417 ................ +149,417
Supplemental Education Grants................................. 17,583 17,619 17,583 ................ -36
21st Century Community Learning Centers....................... 1,149,370 1,251,673 1,200,000 +50,630 -51,673
State Assessments/Enhanced Assessment Instruments............. 388,436 389,214 408,436 +20,000 +19,222
Javits Gifted and Talented Education.......................... ................ ................ 15,000 +15,000 +15,000
Consolidated Runaway and Homeless Youth programs.............. 65,042 65,173 65,173 +131 ................
Training and Advisory Services (Civil Rights)................. 6,947 6,962 6,947 ................ -15
Education for Native Hawaiians................................ 34,113 34,181 34,181 +68 ................
Alaska Native Education Equity................................ 33,119 33,185 33,185 +66 ................
Rural Education............................................... 178,834 179,193 179,193 +359 ................
Comprehensive Centers......................................... 51,011 51,113 51,113 +102 ................
=========================================================================================
Total, School improvement programs...................... 4,535,506 2,028,313 4,621,862 +86,356 +2,593,549
Current Year........................................ (2,854,065) (2,028,313) (2,940,421) (+86,356) (+912,108)
Fiscal year 2015.................................... (1,681,441) ................ (1,681,441) ................ (+1,681,441)
Subtotal, Forward Funded................................ (2,711,292) (1,885,253) (2,782,412) (+71,120) (+897,159)
INDIAN EDUCATION
Grants to Local Educational Agencies.......................... 105,710 105,921 105,710 ................ -211
Federal Programs:
Special Programs for Indian Children...................... 18,948 18,986 18,948 ................ -38
National Activities....................................... 5,660 5,872 5,660 ................ -212
-----------------------------------------------------------------------------------------
Subtotal, Federal Programs.............................. 24,608 24,858 24,608 ................ -250
=========================================================================================
Total, Indian Education................................. 130,318 130,779 130,318 ................ -461
INNOVATION AND IMPROVEMENT
Race to the Top............................................... 547,863 1,000,000 250,000 -297,863 -750,000
Investing in Innovation Fund.................................. 149,118 215,000 170,000 +20,882 -45,000
Effective Teachers and Leaders State Grants................... ................ 2,466,567 ................ ................ -2,466,567
Effective Teaching and Learning Literacy...................... ................ 186,892 ................ ................ -186,892
Effective Teaching and Learning for a Well Rounded Education.. ................ 75,000 ................ ................ -75,000
College Pathways and Accelerated ZLearning.................... ................ 102,200 ................ ................ -102,200
STEM Innovation............................................... ................ 414,716 ................ ................ -414,716
High School Redesign.......................................... ................ 300,000 ................ ................ -300,000
Expanding Educational Options................................. ................ 294,836 ................ ................ -294,836
Transition to Teaching........................................ 26,002 ................ ................ -26,002 ................
School Leadership............................................. 29,049 97,994 64,049 +35,000 -33,945
Charter Schools Grants........................................ 254,326 ................ 254,326 ................ +254,326
Magnet Schools Assistance..................................... 96,512 99,611 99,611 +3,099 ................
Fund for the Improvement of Education (FIE)................... 65,644 46,276 137,644 +72,000 +91,368
Teacher Incentive Fund........................................ 298,834 ................ 298,834 ................ +298,834
Teacher and Leader Innovation Fund............................ ................ 400,000 ................ ................ -400,000
Ready-to-Learn television..................................... 27,139 ................ 27,139 ................ +27,139
Advanced Placement............................................ 29,995 ................ 29,995 ................ +29,995
=========================================================================================
Total, Innovation and Improvement....................... 1,524,482 5,699,092 1,331,598 -192,884 -4,367,494
Current Year........................................ (1,524,482) (5,699,092) (1,331,598) (-192,884) (-4,367,494)
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Successful, Safe and Healthy Students......................... ................ 280,000 ................ ................ -280,000
Promise Neighborhoods......................................... 59,767 300,000 56,754 -3,013 -243,246
National Activities........................................... 64,747 ................ 143,000 +78,253 +143,000
Elementary and Secondary School Counseling.................... 52,191 ................ 52,191 ................ +52,191
Carol M. White Physical Education Program..................... 78,536 ................ 78,536 ................ +78,536
=========================================================================================
Total, Safe Schools and Citizenship Education........... 255,241 580,000 330,481 +75,240 -249,519
ENGLISH LANGUAGE ACQUISITION
Current funded................................................ 47,494 47,589 47,494 ................ -95
Forward funded................................................ 683,186 684,555 683,186 ................ -1,369
=========================================================================================
Total, English Language Acquisition..................... 730,680 732,144 730,680 ................ -1,464
SPECIAL EDUCATION
State Grants:
Grants to States Part B current year...................... 2,271,317 1,453,752 2,439,563 +168,246 +985,811
Part B advance from prior year........................ (9,283,383) (9,283,383) (9,283,383) ................ ................
Grants to States Part B (Fiscal Year 2015)................ 9,283,383 10,124,103 9,283,383 ................ -840,720
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 11,554,700 11,577,855 11,722,946 +168,246 +145,091
Preschool Grants.......................................... 371,900 372,646 372,646 +746 ................
Grants for Infants and Families........................... 441,824 462,710 462,710 +20,886 ................
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 12,368,424 12,413,211 12,558,302 +189,878 +145,091
IDEA National Activities (current funded):
State Personnel Development............................... 43,829 45,011 43,829 ................ -1,182
Technical Assistance and Dissemination.................... 46,688 46,781 46,688 ................ -93
Personnel Preparation..................................... 88,122 85,799 88,122 ................ +2,323
Parent Information Centers................................ 28,859 28,917 28,917 +58 ................
Technology and Media Services............................. 29,529 29,588 29,529 ................ -59
-----------------------------------------------------------------------------------------
Subtotal, IDEA special programs......................... 237,027 236,096 237,085 +58 +989
Special Olympics Education Programs........................... 7,984 8,000 8,000 +16 ................
PROMISE....................................................... 1,992 ................ ................ -1,992 ................
=========================================================================================
Total, Special education................................ 12,615,427 12,657,307 12,803,387 +187,960 +146,080
Current Year........................................ (3,332,044) (2,533,204) (3,520,004) (+187,960) (+986,800)
Fiscal year 2015.................................... (9,283,383) (10,124,103) (9,283,383) ................ (-840,720)
Subtotal, Forward Funded................................ (3,085,041) (2,289,108) (3,274,919) (+189,878) (+985,811)
REHABILITATION SERVICES AND DISABILITY RESEARCH
Vocational Rehabilitation State Grants........................ 3,230,972 3,302,053 3,302,053 +71,081 ................
Discretionary modification (NA)........................... ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal, VR State grants program level................. 3,230,972 3,302,053 3,302,053 +71,081 ................
Client Assistance State grants................................ 12,215 12,240 12,215 ................ -25
Training...................................................... 35,444 30,188 35,444 ................ +5,256
Demonstration and Training programs........................... 5,314 5,750 6,514 +1,200 +764
Migrant and Seasonal Farmworkers.............................. 1,259 ................ 1,259 ................ +1,259
Protection and Advocacy of Individual Rights [PAIR]........... 17,995 18,031 17,995 ................ -36
Supported Employment State grants............................. 29,010 ................ 29,010 ................ +29,010
Independent Living:
State Grants.............................................. 23,312 23,359 23,312 ................ -47
Centers................................................... 79,794 79,953 79,794 ................ -159
Services for Older Blind Individuals...................... 33,951 34,018 33,951 ................ -67
-----------------------------------------------------------------------------------------
Subtotal................................................ 137,057 137,330 137,057 ................ -273
Helen Keller National Center for Deaf/Blind Youth and Adults.. 9,127 9,145 9,127 ................ -18
National Inst. Disability and Rehab. Research [NIDRR]......... 108,599 110,000 110,000 +1,401 ................
Assistive Technology.......................................... 32,770 30,840 37,500 +4,730 +6,660
-----------------------------------------------------------------------------------------
Subtotal, Discretionary programs........................ 388,790 353,524 396,121 +7,331 +42,597
=========================================================================================
Total, Rehabilitation services.......................... 3,619,762 3,655,577 3,698,174 +78,412 +42,597
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
AMERICAN PRINTING HOUSE FOR THE BLIND......................... 24,456 24,505 24,456 ................ -49
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF [NTID]:
Operations................................................ 65,291 63,422 66,422 +1,131 +3,000
Construction.............................................. ................ 2,000 ................ ................ -2,000
-----------------------------------------------------------------------------------------
Total, NTID............................................. 65,291 65,422 66,422 +1,131 +1,000
GALLAUDET UNIVERSITY:
Operations................................................ 117,306 117,541 118,541 +1,235 +1,000
Construction.............................................. 7,959 ................ ................ -7,959 ................
-----------------------------------------------------------------------------------------
Total, Gallaudet University............................. 125,265 117,541 118,541 -6,724 +1,000
=========================================================================================
Total, Special Institutions for Persons with 215,012 207,468 209,419 -5,593 +1,951
Disabilities...........................................
CAREER, TECHNICAL AND ADULT EDUCATION
Career Education:
Basic State Grants/Secondary & Technical Education State 329,784 332,030 332,030 +2,246 ................
Grants, current funded...................................
Advance from prior year............................... (791,000) (791,000) (791,000) ................ ................
Fiscal year 2015...................................... 791,000 791,000 791,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Basic State Grants, program level......... 1,120,784 1,123,030 1,123,030 +2,246 ................
National Programs......................................... 7,814 17,829 12,814 +5,000 -5,015
-----------------------------------------------------------------------------------------
Subtotal, Career Education.............................. 1,128,598 1,140,859 1,135,844 +7,246 -5,015
Adult Education:
State Grants/Adult Basic and Literacy Education:
State Grants, current funded.......................... 593,803 594,993 593,803 ................ -1,190
National Leadership Activities................................ 11,279 14,302 14,302 +3,023 ................
=========================================================================================
Subtotal, Adult education............................... 605,082 609,295 608,105 +3,023 -1,190
=========================================================================================
Total, Career and adult education....................... 1,733,680 1,750,154 1,743,949 +10,269 -6,205
Current Year........................................ (942,680) (959,154) (952,949) (+10,269) (-6,205)
Fiscal year 2015.................................... (791,000) (791,000) (791,000) ................ ................
Subtotal, Forward Funded................................ (942,680) (959,154) (952,949) (+10,269) (-6,205)
STUDENT FINANCIAL ASSISTANCE
Pell Grants--maximum grant (NA)............................... (4,860) (4,860) (4,860) ................ ................
Pell Grants................................................... 22,778,352 22,824,000 22,778,352 ................ -45,648
Federal Supplemental Educational Opportunity Grants........... 733,130 734,599 733,130 ................ -1,469
Federal Work Study............................................ 974,728 1,126,682 1,024,728 +50,000 -101,954
=========================================================================================
Total, Student Financial Assistance [SFA]............... 24,486,210 24,685,281 24,536,210 +50,000 -149,071
STUDENT AID ADMINISTRATION
Salaries and Expenses......................................... 698,371 733,224 727,434 +29,063 -5,790
Servicing Activities.......................................... 342,930 316,867 316,867 -26,063 ................
=========================================================================================
Total, Student Aid Administration....................... 1,041,301 1,050,091 1,044,301 +3,000 -5,790
HIGHER EDUCATION
Aid for Institutional Development:
Strengthening Institutions................................ 80,462 80,623 80,462 ................ -161
Hispanic Serving Institutions............................. 100,231 100,432 100,231 ................ -201
Promoting Post-Baccalaureate Opportunities for Hispanic 8,992 9,011 8,992 ................ -19
Americans................................................
Strengthening Historically Black Colleges (HBCUs)......... 227,524 227,980 227,524 ................ -456
Strengthening Historically Black Graduate Institutions.... 58,840 58,958 58,840 ................ -118
Strengthening Predominantly Black Institutions............ 9,244 9,262 9,244 ................ -18
Asian American Pacific Islander........................... 3,113 3,119 3,113 ................ -6
Strengthening Alaska Native and Native Hawaiian-Serving 12,833 12,859 12,833 ................ -26
Institutions.............................................
Strengthening Native American-Serving Nontribal 3,113 3,119 3,113 ................ -6
Institutions.............................................
Strengthening Tribal Colleges............................. 25,662 25,713 25,662 ................ -51
-----------------------------------------------------------------------------------------
Subtotal, Aid for Institutional development............. 530,014 531,076 530,014 ................ -1,062
International Education and Foreign Language:
Domestic Programs......................................... 66,453 73,487 73,487 +7,034 ................
Overseas Programs......................................... 7,436 7,451 7,451 +15 ................
-----------------------------------------------------------------------------------------
Subtotal, International Education & Foreign Lang........ 73,889 80,938 80,938 +7,049 ................
Fund for the Improvement of Postsec. Ed. [FIPSE].............. 3,486 260,000 5,852 +2,366 -254,148
Postsecondary Program for Students with Intellectual 10,935 ................ 10,935 ................ +10,935
Disabilities.................................................
Minority Science and Engineering Improvement.................. 9,447 9,466 9,447 ................ -19
Tribally Controlled Postsec Voc/Tech Institutions............. 8,114 8,131 8,114 ................ -17
Federal TRIO Programs......................................... 838,252 839,932 849,932 +11,680 +10,000
GEAR UP....................................................... 301,639 302,244 307,244 +5,605 +5,000
Graduate Assistance in Areas of National Need................. 30,848 30,909 30,848 ................ -61
Teacher Quality Partnerships.................................. 42,747 ................ 42,747 ................ +42,747
Child Care Access Means Parents in School..................... 15,938 15,970 15,938 ................ -32
GPRA Data/HEA Program Evaluation.............................. 606 67,607 20,606 +20,000 -47,001
=========================================================================================
Total, Higher Education................................. 1,865,915 2,146,273 1,912,615 +46,700 -233,658
HOWARD UNIVERSITY
Academic Program.............................................. 204,820 205,230 205,230 +410 ................
Howard University Hospital.................................... 28,776 28,834 28,834 +58 ................
-----------------------------------------------------------------------------------------
Total, Howard University................................ 233,596 234,064 234,064 +468 ................
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS [CHAFL]......... 458 459 459 +1 ................
HBCU CAPITAL FINANCING PROGRAM
HBCU Federal Administration................................... 352 352 352 ................ ................
HBCU Loan Subsidies........................................... 20,110 20,150 20,150 +40 ................
-----------------------------------------------------------------------------------------
Total, HBCU Capital Financing Program................... 20,462 20,502 20,502 +40 ................
INSTITUTE OF EDUCATION SCIENCES [IES]
Research, Development and Dissemination....................... 189,407 202,273 195,000 +5,593 -7,273
Statistics.................................................... 108,531 122,748 112,000 +3,469 -10,748
Regional Educational Laboratories............................. 57,311 57,426 57,311 ................ -115
Research in Special Education................................. 49,806 59,905 69,905 +20,099 +10,000
Special Education Studies and Evaluations..................... 11,393 11,415 11,415 +22 ................
Statewide Data Systems........................................ 38,001 85,000 75,000 +36,999 -10,000
Assessment:
National Assessment....................................... 129,356 124,616 124,616 -4,740 ................
National Assessment Governing Board....................... 8,672 7,690 7,690 -982 ................
-----------------------------------------------------------------------------------------
Subtotal, Assessment.................................... 138,028 132,306 132,306 -5,722 ................
=========================================================================================
Total, IES.............................................. 592,477 671,073 652,937 +60,460 -18,136
DEPARTMENTAL MANAGEMENT
PROGRAM ADMINISTRATION:
Salaries and Expenses..................................... 445,366 461,450 445,366 ................ -16,084
Building Modernization.................................... ................ 2,000 2,000 +2,000 ................
-----------------------------------------------------------------------------------------
Total, Program administration........................... 445,366 463,450 447,366 +2,000 -16,084
OFFICE FOR CIVIL RIGHTS....................................... 102,418 107,500 102,418 ................ -5,082
OFFICE OF THE INSPECTOR GENERAL............................... 59,700 62,347 59,700 ................ -2,647
-----------------------------------------------------------------------------------------
Total, Departmental management.......................... 607,484 633,297 609,484 +2,000 -23,813
=========================================================================================
Total, Title III, Department of Education............... 71,206,835 74,511,115 72,526,616 +1,319,781 -1,984,499
Current Year........................................ (48,609,834) (51,914,114) (49,929,615) (+1,319,781) (-1,984,499)
Fiscal year 2015.................................... (22,597,001) (22,597,001) (22,597,001) ................ ................
TITLE IV--RELATED AGENCIES
COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY 5,364 5,396 5,396 +32 ................
DISABLED.....................................................
CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
OPERATING EXPENSES
Domestic Volunteer Service Programs:
Volunteers in Service to America [VISTA].................. 94,631 94,820 94,820 +189 ................
National Senior Volunteer Corps:
Foster Grandparents Program........................... 110,344 110,565 110,565 +221 ................
Senior Companion Program.............................. 46,628 46,722 46,722 +94 ................
Retired Senior Volunteer Program...................... 50,104 50,204 50,204 +100 ................
-----------------------------------------------------------------------------------------
Subtotal, Senior Volunteers......................... 207,076 207,491 207,491 +415 ................
=========================================================================================
Subtotal, Domestic Volunteer Service Programs....... 301,707 302,311 302,311 +604 ................
National and Community Service Programs:
AmeriCorps State and National Grants...................... 343,659 345,800 345,800 +2,141 ................
Training and Technical assistance......................... 1,992 600 ................ -1,992 -600
Innovation, Assistance, and Other Activities.............. 53,174 61,830 58,224 +5,050 -3,606
Evaluation................................................ 2,988 5,000 5,000 +2,012 ................
National Civilian Community Corps......................... 31,818 29,882 30,000 -1,818 +118
State Commission Grants................................... 13,414 14,841 15,306 +1,892 +465
-----------------------------------------------------------------------------------------
Subtotal, National & Community Service Programs......... 447,045 457,953 454,330 +7,285 -3,623
-----------------------------------------------------------------------------------------
Total, Operating expenses............................... 748,752 760,264 756,641 +7,889 -3,623
Payment to the National Service Trust......................... 211,373 207,293 209,840 -1,533 +2,547
Salaries and Expenses......................................... 82,677 87,109 88,209 +5,532 +1,100
Office of Inspector General................................... 3,984 6,466 6,466 +2,482 ................
=========================================================================================
Total, Corp. for National and Community Service......... 1,046,786 1,061,132 1,061,156 +14,370 +24
CORPORATION FOR PUBLIC BROADCASTING:
Fiscal year 2016 (current) with Fiscal year 2015 445,000 445,000 445,000 ................ ................
comparable...............................................
Fiscal year 2015 advance with Fiscal year 2014 comparable (445,000) (445,000) (445,000) ................ ................
(NA).....................................................
Fiscal year 2014 advance with Fiscal year 2013 comparable (444,110) (445,000) (445,000) (+890) ................
(NA).....................................................
-----------------------------------------------------------------------------------------
Subtotal, Fiscal year 2014 appropriation................ ................ ................ ................ ................ ................
FEDERAL MEDIATION AND CONCILIATION SERVICE.................... 46,071 47,620 47,000 +929 -620
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION.............. 17,569 16,423 17,000 -569 +577
INSTITUTE OF MUSEUM AND LIBRARY SERVICES...................... 231,490 225,813 231,490 ................ +5,677
MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION............... 5,777 9,500 9,000 +3,223 -500
MEDICARE PAYMENT ADVISORY COMMISSION.......................... 11,754 12,087 11,954 +200 -133
NATIONAL COUNCIL ON DISABILITY................................ 3,251 3,345 3,345 +94 ................
NATIONAL HEALTH CARE WORKFORCE COMMISSION..................... ................ 3,000 3,000 +3,000 ................
NATIONAL LABOR RELATIONS BOARD................................ 277,749 284,991 284,991 +7,242 ................
NATIONAL MEDIATION BOARD...................................... 13,384 13,347 13,384 ................ +37
OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION.............. 11,644 12,634 12,300 +656 -334
RAILROAD RETIREMENT BOARD
Dual Benefits Payments Account................................ 50,813 39,000 39,000 -11,813 ................
Less Income Tax Receipts on Dual Benefits..................... -4,000 -3,000 -3,000 +1,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Dual Benefits................................. 46,813 36,000 36,000 -10,813 ................
Federal Payment to the RR Retirement Account.................. 150 150 150 ................ ................
Limitation on Administration.................................. 110,927 111,739 110,927 ................ -812
Inspector General......................................... 8,138 8,877 8,638 +500 -239
SOCIAL SECURITY ADMINISTRATION
Payments to Social Security Trust Funds....................... 20,404 16,400 16,400 -4,004 ................
SUPPLEMENTAL SECURITY INCOME
Federal Benefit Payments...................................... 53,300,000 55,579,000 55,579,000 +2,279,000 ................
Mandatory Program Integrity................................... ................ 587,000 ................ ................ -587,000
Beneficiary Services.......................................... 47,000 3,000 3,000 -44,000 ................
Research and Demonstration.................................... 16,980 54,000 54,000 +37,020 ................
Administration................................................ 3,605,305 3,814,000 4,232,741 +627,436 +418,741
-----------------------------------------------------------------------------------------
Subtotal, SSI program level............................. 56,969,285 60,037,000 59,868,741 +2,899,456 -168,259
Less funds advanced in prior year................... -18,200,000 -19,300,000 -19,300,000 -1,100,000 ................
-----------------------------------------------------------------------------------------
Subtotal, regular SSI current year...................... 38,769,285 40,737,000 40,568,741 +1,799,456 -168,259
New advance, 1st quarter, Fiscal year 2015.......... 19,300,000 19,700,000 19,700,000 +400,000 ................
-----------------------------------------------------------------------------------------
Total, SSI program...................................... 58,069,285 60,437,000 60,268,741 +2,199,456 -168,259
LIMITATION ON ADMINISTRATIVE EXPENSES
OASDI Trust Funds............................................. 5,309,388 5,091,671 5,063,298 -246,090 -28,373
HI/SMI Trust Funds............................................ 2,085,614 1,960,838 1,960,838 -124,776 ................
Social Security Advisory Board................................ 2,142 2,300 2,300 +158 ................
SSI........................................................... 3,117,329 3,568,037 3,568,037 +450,708 ................
-----------------------------------------------------------------------------------------
Subtotal, regular LAE................................... 10,514,473 10,622,846 10,594,473 +80,000 -28,373
User Fees:
SSI User Fee activities................................... 160,374 173,000 173,000 +12,626 ................
SSPA User Fee Activities.................................. 996 1,000 1,000 +4 ................
-----------------------------------------------------------------------------------------
Subtotal, User fees..................................... 161,370 174,000 174,000 +12,630 ................
-----------------------------------------------------------------------------------------
Subtotal, Limitation on administrative expenses......... 10,675,843 10,796,846 10,768,473 +92,630 -28,373
Program Integrity Funding:
OASDI Trust Funds......................................... 268,076 27,037 532,296 +264,220 +505,259
SSI....................................................... 487,976 245,963 664,704 +176,728 +418,741
-----------------------------------------------------------------------------------------
Subtotal, Program integrity funding..................... 756,052 273,000 1,197,000 +440,948 +924,000
=========================================================================================
Total, Limitation on Administrative Expenses............ 11,431,895 11,069,846 11,965,473 +533,578 +895,627
OFFICE OF THE INSPECTOR GENERAL
Federal Funds................................................. 28,829 30,000 29,698 +869 -302
Trust Funds................................................... 73,249 75,733 74,972 +1,723 -761
-----------------------------------------------------------------------------------------
Total, Office of the Inspector General.................. 102,078 105,733 104,670 +2,592 -1,063
Adjustment: Trust fund transfers from general revenues........ -3,605,305 -3,814,000 -4,232,741 -627,436 -418,741
=========================================================================================
Total, Social Security Administration................... 66,018,357 67,814,979 68,122,543 +2,104,186 +307,564
Federal funds....................................... 58,279,888 60,657,400 60,488,839 +2,208,951 -168,561
Current year.................................... (38,979,888) (40,957,400) (40,788,839) (+1,808,951) (-168,561)
New advances, 1st quarter....................... (19,300,000) (19,700,000) (19,700,000) (+400,000) ................
Trust funds......................................... 7,738,469 7,157,579 7,633,704 -104,765 +476,125
=========================================================================================
Total, Title IV, Related Agencies....................... 68,300,224 70,112,033 70,423,274 +2,123,050 +311,241
Federal Funds....................................... 60,430,936 62,821,751 62,658,051 +2,227,115 -163,700
Current Year.................................... (40,685,936) (42,676,751) (42,513,051) (+1,827,115) (-163,700)
Fiscal Year 2015 Advance........................ (19,300,000) (19,700,000) (19,700,000) (+400,000) ................
Fiscal Year 2016 Advance........................ (445,000) (445,000) (445,000) ................ ................
Trust Funds......................................... 7,869,288 7,290,282 7,765,223 -104,065 +474,941
=========================================================================================
Grand Total............................................. 757,440,498 787,803,163 783,365,379 +25,924,881 -4,437,784
--------------------------------------------------------------------------------------------------------------------------------------------------------
\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.