[House Report 114-195]
[From the U.S. Government Publishing Office]


114th Congress   }                                     {        Report
                        HOUSE OF REPRESENTATIVES
 1st Session     }                                     {       114-195

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATIONS BILL, 2016

                                _______
                                

 July 10, 2015.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

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

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 3020]

    The Committee on Appropriations submits the following 
report in explanation of the accompanying bill making 
appropriations for the Departments of Labor, Health and Human 
Services (except the Food and Drug Administration, the Agency 
for Toxic Substances and Disease Registry and the Indian Health 
Service), Education, Committee for Purchase from People Who Are 
Blind or Severely Disabled, Corporation for National and 
Community Service, Corporation for Public Broadcasting, Federal 
Mediation and Conciliation Service, Federal Mine Safety and 
Health Review Commission, Institute of Museum and Library 
Services, Medicare Payment Advisory Commission, National 
Council on Disability, National Labor Relations Board, National 
Mediation Board, Occupational Safety and Health Review 
Commission, Railroad Retirement Board, and the Social Security 
Administration for the fiscal year ending September 30, 2016, 
and for other purposes.

                        INDEX TO BILL AND REPORT

_______________________________________________________________________


                                                            Page number

                                                            Bill Report
Summary of Estimates and Appropriation.....................
                                                                      3
General Summary of the Bill................................
                                                                      3
Title I--Department of Labor:
        Employment and Training Administration.............     2
                                                                      6
        Employee Benefits Security Administration..........    15
                                                                     14
        Pension Benefit Guaranty Corporation...............    15
                                                                     14
        Wage and Hour Division.............................    16
                                                                     15
        Office of Labor-Management Standards...............    16
                                                                     15
        Office of Federal Contract Compliance Programs.....    16
                                                                     16
        Office of Workers' Compensation Programs...........    17
                                                                     16
        Occupational Safety and Health Administration......    21
                                                                     18
        Mine Safety and Health Administration..............    24
                                                                     21
        Bureau of Labor Statistics.........................    25
                                                                     23
        Office of Disability Employment Policy.............    26
                                                                     23
        Departmental Management............................    26
                                                                     23
        General Provisions.................................    30
                                                                     26
Title II--Department of Health and Human Services..........    39
                                                                     27
        Health Resources and Services Administration.......    39
                                                                     27
        Centers for Disease Control and Prevention.........    43
                                                                     36
        National Institutes of Health......................    49
                                                                     56
        Substance Abuse and Mental Health Services 
            Administration.................................    56
                                                                     82
        Centers for Medicare and Medicaid Services.........    59
                                                                     87
        Administration for Children and Families...........    64
                                                                     93
        Administration for Community Living................    72
                                                                     99
        Office of Secretary................................    75
                                                                    104
        General Provisions.................................    79
                                                                    115
Title III--Department of Education.........................    99
                                                                    117
        Education for the Disadvantaged....................    99
                                                                    117
        Impact Aid.........................................   100
                                                                    120
        School Improvement Programs........................   111
                                                                    121
        Indian Education...................................   103
                                                                    124
        Innovation and Improvement.........................   103
                                                                    125
        Safe Schools and Citizenship Education.............   105
                                                                    127
        English Language Acquisition.......................   106
                                                                    128
        Special Education..................................   106
                                                                    128
        Rehabilitation Services and Disability Research....   109
                                                                    130
        Special Institutions for Persons with Disabilities.   110
                                                                    132
        Career, Technical and Adult Education..............   110
                                                                    133
        Student Financial Assistance.......................   112
                                                                    134
        Student Aid Administration.........................   112
                                                                    135
        Higher Education...................................   112
                                                                    136
        Howard University..................................   113
                                                                    140
        College Housing and Academic Facilities Loans......   113
                                                                    141
        Historically Black College and University Capital 
            Financing......................................   114
                                                                    141
        Institute of Education Sciences....................   114
                                                                    141
        Departmental Management............................   115
                                                                    143
        General Provisions.................................   116
                                                                    145
Title IV--Related Agencies.................................   121
                                                                    146
        Committee for the Purchase from People Who Are 
            Blind or Severely Disabled.....................   121
                                                                    146
        Corporation for National and Community Service.....   122
                                                                    146
        Corporation for Public Broadcasting................   126
                                                                    148
        Federal Mediation and Conciliation Service.........   127
                                                                    148
        Federal Mine Safety and Health Review Commission...   128
                                                                    148
        Institute of Museum and Library Services...........   128
                                                                    148
        Medicare Payment Advisory Commission...............   129
                                                                    149
        Medicaid and CHIP Payment and Access Commission....   129
                                                                    149
        National Council on Disability.....................   129
                                                                    149
        National Labor Relations Board.....................   129
                                                                    149
        National Mediation Board...........................   132
                                                                    150
        Occupational Safety and Health Review Commission...   132
                                                                    150
        Railroad Retirement Board..........................   132
                                                                    150
        Social Security Administration.....................   134
                                                                    151
Title V--General Provisions................................   139
                                                                    154
        House of Representatives Report Requirements.......
                                                                    156

                Summary of Estimates and Appropriations

    The following table compares on a summary basis the 
appropriations, including trust funds for fiscal year 2016, the 
budget request for fiscal year 2016, and the Committee 
recommendation for fiscal year 2016 in the accompanying bill.

                                         2016 LABOR, HHS, EDUCATION BILL
                                 [Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                   Fiscal Year--                   2016 Committee compared to--
                                 -------------------------------------------------------------------------------
         Budget Activity                                               2016
                                   2015 Enacted    2016  Budget      Committee     2015 Enacted     2016 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.............     $11,945,326     $13,179,755     $11,881,960       ($63,366)    ($1,297,795)
Department of Health and Human        71,003,862      75,246,449      71,302,326         298,464     (3,944,123)
 Services.......................
Department of Education.........      67,135,576      70,747,119      64,224,007     (2,911,569)     (6,523,112)
Related Agencies................      14,177,289      15,045,000      13,754,043       (423,246)     (1,290,957)
----------------------------------------------------------------------------------------------------------------

                      General Summary of the Bill

    For fiscal year 2016, the Committee recommends a total of 
$154,536,000,000 in current year discretionary funding, 
including offsets and adjustments. The fiscal 2016 
recommendation is a decrease of $3,711,000,000 below the fiscal 
year 2015 level.
    The nation remains mired in a sluggish economy, which many 
economists believe has been exacerbated by runaway government 
spending. In addition, for the first time in our history, 
American debt has recently been downgraded, signifying the 
urgent need to return our fiscal house to order. This bill 
represents a clear step toward returning to fiscal 
responsibility, while ensuring that funding for critical and 
high-priority functions is maintained. The Committee bill 
promotes a pro-job growth fiscal environment by eliminating 
duplication and ineffective programs, making strategic funding 
priority choices and continuing to rein in out-of-control 
spending and regulatory burdens imposed by this Administration 
on small businesses.
    The president's health care law is one example of how this 
Administration is making things worse for struggling businesses 
and workers by driving up health costs and making it harder for 
small businesses to hire workers. The only way to change this 
is by repealing ObamaCare in its entirety. Families should be 
able to make their own choices in health care, visit the doctor 
of their choosing, and receive the health care they and their 
doctor feel is best. Those decisions shouldn't be made by 
Washington.
    The Committee bill recognizes this by including provisions 
ensuring that the Department of Health and Human Services (HHS) 
cannot use any funds to further implement, administer, or 
enforce the misguided health care bill.
    The Committee recommendation reflects the challenges 
inherent in achieving deficit reduction solely through 
reductions in discretionary spending. Significantly reducing 
our Federal budget deficit and the national debt will not occur 
until mandatory savings are achieved.
    Within the resources provided, the Committee has 
prioritized key public health, biomedical research, education 
and oversight responsibilities throughout the bill. The 
Committee recommendation also includes good government, pro-
life and pro-family provisions, limits the overreach of the 
federal government and reins in out-of-control regulatory 
bodies.

                      Reductions and Terminations

    In preparing this bill, the Committee scrutinized existing 
programs and activities to determine which ones could be 
eliminated in order to reduce unnecessary spending and 
duplicative programs. As a result, this bill terminates 26 
programs and activities which are narrowly targeted toward a 
small audience or do not represent a clear Federal role.
    The bill also consolidates duplicative efforts as it merges 
the Agency for Healthcare Research and Quality (AHRQ) into 
existing HHS agencies. The AHRQ mission and areas of research 
also exist in other HHS agencies. The Committee therefore 
includes bill language to consolidate these research activities 
into other agencies in a more efficient and effective way to 
meet the missions of both AHRQ and HHS. Specifically, the 
language provides the Secretary with transfer authority to use 
funds from across the HHS to fund the orderly termination of 
AHRQ. It also allows the National Institutes of Health, the 
Centers for Disease Control and Prevention, the Office of the 
National Coordinator for Health Information Technology, and 
Office of the Assistant Secretary for Health to incorporate the 
AHRQ activities each determines to support its mission, within 
its existing authority. In addition, the language transfers the 
Prevention Public Health Task Force to the Office of the 
Assistant Secretary for Health.

                           Setting Priorities

    As part of its review of existing programs and the budget 
request, the Committee carefully examined the programs funded 
in this bill, with an eye toward ensuring that scarce and 
precious taxpayer dollars are spent on essential ``must do'' 
priorities rather than on ``nice-to-do'' activities. As a 
result of that examination, high-priority programs have 
received greater emphasis in this bill, while programs that 
represent less pressing needs or are not basic federal 
responsibilities have been eliminated.

Protecting Public Health and Biomedical Research

    Funding for the National Institutes of Health (NIH) is 
funded at $100,000,000 above the budget request, to a total of 
$31,184,000,000 in the Committee bill, reflecting the 
Committee's ongoing emphasis on biomedical research that can 
lead to life-saving cures. Within the funds, the Committee 
supports research into Alzheimer's disease and the precision 
medicine initiative.
    Given their unique role in protecting public health, the 
Centers for Disease Control and Prevention (CDC) is also given 
priority for funding within the bill. CDC is funded at the 
budget request, reflecting a 1.6 percent increase with a focus 
on efforts to prevent heart disease, diabetes and stroke, as 
well as to combat opioid addiction and antibiotic resistance 
and ensure our country is prepared to defend ourselves from 
bioterrorism.

Helping States, Local Governments and Parents to Educate America's 
        Children

    The Committee recognizes that breaking the cycle of poverty 
and dependence must begin early in life, and that early 
childhood education is of critical importance in changing the 
trajectory of a child's life. The Committee has therefore 
prioritized the Head Start program, by providing a $192,000,000 
increase targeted toward early Head Start initiatives.
    The Committee recommendation also invests in education 
programs that represent core federal responsibilities. First 
and foremost among these are special education programs funded 
under the Individuals with Disabilities Education Act (IDEA). 
When the IDEA law was passed in the 1970s, the federal 
government promised to pay up to 40 percent of the additional 
costs of educating children with special needs. Despite 
tremendous gains in the late 1990s, we are still only funding 
these programs at less than half that goal. The Committee bill 
increases special education grants to states by over 
$500,000,000. This increase is paid for by eliminating narrowly 
targeted Administration priorities that benefit only a few 
schools or impose one-size-fits-all regulations that are 
unworkable and unauthorized, such as the Investing in 
Innovation Fund and School Improvement Grants.
    The Committee has also included increases for priority 
programs such as charter schools, Impact Aid, TRIO, GEAR UP and 
special institutions. While only constituting a small 
percentage of total education dollars available to school 
districts, these programs help fill gaps and meet the extra 
needs of certain categories of children and students. The 
Committee has also included increases needed to ensure 
continued administration of student aid and loan programs.
    Four years ago, this Congress met the daunting challenge of 
preserving the maximum Pell grant award in the face of 
explosive growth in the cost of the program by incorporating 
several common-sense reforms that produced savings of an 
estimated $11,000,000,000 over the next ten years. These 
reforms have enabled the Committee to increase the maximum Pell 
grant award to a total of $5,775 (when coupled with mandatory 
funding) while placing this program on sounder financial 
footing in the future.

Protecting the Most Vulnerable Americans

    In addition to educating our children and protecting the 
public health, the Committee placed an emphasis on programs 
that help to protect the most vulnerable populations. As such, 
the bill includes funding for the Low Income Home Energy 
Assistance Program (LIHEAP) formula grants to States. The bill 
also maintains the Community Services Block Grant program, 
which provides funding to states to provide basic services such 
as emergency food and housing assistance, at the fiscal year 
2015 enacted level. The Committee has also prioritized funding 
for Battered Women's Shelters, poison control centers, and 
``Meals on Wheels'' nutrition programs.
    Finally, the bill ensures our Nation's trust 
responsibilities within Indian country are honored by providing 
increased support for programs serving Native populations, 
including tribal colleges, nutrition programs, programs for 
both the elderly and youth, and Indian education programs.

                               Oversight

    In furtherance of its oversight responsibility, the 
Committee has again requested that major agencies funded in the 
bill provide information on the status of balances of 
appropriations, including amounts that are unobligated and 
uncommitted, committed to contracts, grants or other planned 
obligations, and obligated but unexpended. The Committee 
experienced delays in receiving this information in the past 
and found that the agency reports did not provide a 
comprehensive picture of the status of balances.
    Of particular concern, the Committee found that the 
agencies could not report on the age of balances by year of 
appropriation. As a result, it is not possible to tell whether 
the balances derive from uncommitted or unobligated balances in 
the immediately prior fiscal year or from appropriations acts 
enacted two, three or more years earlier.
    The source year of carryover is important. If balances have 
languished on the books for multiple fiscal years it is a 
symptom, at best, of administrative inefficiency. Of more 
concern, it may suggest that the Committee was asked to provide 
appropriations in excess of the amount required to accomplish 
program purposes. Given the obvious importance of the source 
year of balances to budget administration, the Committee is 
puzzled that agencies have not configured internal accounting 
systems to capture and routinely report this information.
    To ensure that all major Departments and agencies report 
the status fund balances in the future, the Committee has 
continued bill language that will compel the Departments of the 
Education, Health and Human Services and Labor prospectively to 
adopt source year accounting for the status of funds for both 
commitments and obligations. The bill language requires that 
each begin reporting quarterly on the status of balances, 
including the source year of balances. It is the Committee's 
intention that the agency reports show the status of balances 
at the appropriation account level, as well as at budget 
activity or other lower levels where such levels are reflected 
in the Committee's report accompanying an appropriations act.

                      TITLE I--DEPARTMENT OF LABOR


                 Employment and Training Administration


                    TRAINING AND EMPLOYMENT SERVICES

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $3,003,314,000 for Training and 
Employment Services (TES), which provides funding for federal 
government job training and employment service programs, 
authorized primarily by the Workforce Innovation and 
Opportunity Act of 2014 (WIOA). This recommendation is 
$136,392,000 less than the fiscal year 2015 enacted level (the 
amount provided by Public Law 113-235), and $399,117,000 less 
than the fiscal year 2016 budget request.
    Program Year Funding and Advance Appropriations.--Section 
189(g) of the WIOA sets forth a program year funding schedule 
for programs and activities funded under the authority of the 
WIOA. A program year, as defined by WIOA, provides that 
appropriated funds shall not become available for obligation 
until July 1 of the fiscal year in which they are appropriated, 
and shall remain available until June 30 of the following 
fiscal year (in the case of youth-related programs, funding 
becomes available on April 1).
    The Committee is concerned that the reliance on a funding 
mechanism that provides more than half of the annual TES 
appropriations as advance appropriations obscures the true 
annual cost of these federal job training programs and creates 
additional costs and unnecessary burdens on accounting, 
tracking, guidance, and coordination activities at the federal 
as well as State and local levels.
    The Committee directs the Secretary of Labor to review the 
current funding mechanism, including the provision of advance 
appropriations, and to make recommendations in the Department's 
fiscal year 2017 budget justifications for adjustments that 
would result in cost savings and efficiency gains throughout 
the Training and Employment Services workforce delivery system.
    Governor's Reserve Fund.--Section 128(a)(1) of the WIOA 
authorizes the governor of a State to reserve not more than 15 
percent of the funds allocated to that State in a given fiscal 
year for Statewide workforce investment activities. The 
Committee appropriates funding under these authorities to meet 
urgent workforce training needs. Despite reductions in the cap 
for Statewide activities enacted each year since fiscal year 
2012, many States continue to carryover high unobligated 
balances.
    The Committee supports the restoration of the cap on the 
Governor's Reserve to the authorized limit of 15 percent. 
Funding appropriated for State workforce investment activities 
under WIOA is the same as fiscal year 2015 enacted levels and 
language is included for fiscal year 2016 that increases the 
cap on the Governor's Reserve from 10 to 11 percent.
    The Committee is appreciative of the establishment of 
uniform performance measures under WIOA and looks forward to 
allocating funding to the workforce development system in 
future fiscal years on the basis of comparative performance 
results.
    Apprenticeship.--The Committee supports the Department's 
promotion and oversight of the National Registered 
Apprenticeship system in cooperation with State Apprenticeship 
Agencies. Funding is not included in fiscal year 2016 for the 
Department's proposed Apprenticeship Grants program; however, 
the Committee has included additional funds requested in the 
Program Administration account to continue and expand upon 
existing programs and to provide technical assistance and 
oversight to States in order to expand the capacity and 
effectiveness of Registered Apprenticeships throughout the 
country. The Committee is encouraged by research on the 
effectiveness of apprenticeship as a workforce training 
strategy and urges the Department to use its evaluation 
authority to determine the impact and effectiveness of 
Registered Apprenticeship programs.
    Licensing.--The Committee supports the Department's efforts 
to address ways in which harmonizing licensing requirements 
across States can reduce barriers to labor market entry and 
mobility including for dislocated workers, transitioning 
servicemembers, and veterans. Funding is not included in fiscal 
year 2016 for the Department's proposed licensing grants 
program; however, the Committee urges the Department to pursue 
activities within its existing authority including providing 
technical assistance and disseminating guidance and information 
on best practices to States interested in increasing economic 
opportunity through reciprocity agreements or other approaches 
to reducing licensing barriers.
    Evaluation.--The Committee supports rigorous evaluation of 
the Department's programs, particularly the workforce training 
programs authorized by WIOA. The Committee provides direct 
appropriations for program evaluations and continues a general 
provision, as requested, to transfer funds from specific 
accounts for purposes of evaluation and increases the cap on 
the amount the Secretary may transfer from 0.5 to 0.75 percent.
    Evaluations should be targeted in ways that will allow 
Department administrators to use the results to improve program 
delivery.
    Administrators in the Employment and Training 
Administration (ETA) must work cooperatively with State 
officials to ensure that program evaluators obtain appropriate 
and timely data.
    The Committee urges the Department to use its evaluation 
authority to identify and eliminate areas of duplication and to 
follow through on evaluation findings with budget proposals to 
allocate funding to the programs, projects and activities that 
demonstrate the best results and to improve upon or eliminate 
those that do not.
    Duplication, overlap, and structural inefficiencies 
throughout the workforce development system continue to be a 
serious concern for the Committee. Going back to 2007, the 
Committee noted (House Report 110-231) that there is ``evidence 
that the core services of the adult, dislocated and youth 
programs at local one-stop career centers sometimes overlap 
with the statewide labor exchange services provided with funds 
in the state unemployment insurance and employment services 
operations account. This diminishes the overall effectiveness 
of the two programs by creating unnecessary duplication.''
    The Committee is aware that the Department has been working 
with other agencies, specifically the Department of Health and 
Human Services, to evaluate the delivery strategies of certain 
programs to identify overlap and duplication. The Committee 
directs the Department to continue and expand these efforts and 
to continue efforts to implement the recommendations of the 
January, 2011 GAO report ``Multiple Employment and Training 
Programs'' (GAO-11-92).
    Infrastructure and Administrative Costs.--The Committee is 
concerned that the flexibility related to administrative 
expenses allows local workforce investment boards, one-stop 
career centers and other workforce training authorities to 
classify many administrative activities as ``program'' costs in 
order to circumvent the 15 percent cap on administrative 
expenses authorized under WIOA.
    In its response to a 2005 GAO report (GAO-05-650), then 
Assistant Secretary for ETA wrote that of the $4,000,000,000 
expended on Workforce Investment Act and Wagner-Peyser 
Employment Service programs, ``$1,500,000,000 is spent on 
`infrastructure' as reported by the States.''
    Testimony received by the Committee since that time 
indicates the system, as currently structured, continues to 
expend the majority of its resources on State and local staff 
to counsel and help customers with job searches, resume 
writing, intake interviews, and similar activities at the one-
stop career centers. While these core and intensive services 
are a value-added function to its customers, the workforce 
development system must be capable of delivering more given the 
amount of taxpayer investment. A transformational change in how 
services are delivered is needed to prevent the system from 
continuing to evolve into a personnel-heavy bureaucracy that 
lacks the flexibility and expertise to respond to rapidly 
changing economic conditions and workforce training needs.
    The Committee disagrees that innovative solutions equate to 
creating new programs at additional taxpayer expense. Rather 
than advancing a more training-focused program, the Department 
appears to have rested its reform efforts on the creation of 
new and costly programs, such as the Workforce Innovation Fund, 
Job-Driven Training Fund and Sector Partnerships. These 
duplicative and unauthorized programs undermine the steps 
Congress took in WIOA to consolidate and streamline Federal 
workforce development efforts.
    The Committee believes that a more fundamental solution is 
needed: A commitment to eliminating duplication and to reducing 
excessive and costly administrative overhead in order to free 
up the resources to train more workers.
    Adult Employment and Training Activities.--For Adult 
Employment and Training Activities, the Committee recommends 
$776,736,000, which is the same as the fiscal year 2015 enacted 
level and $38,820,000 less than the fiscal year 2016 budget 
request.
    Youth Employment and Training Activities.--For Youth 
Employment and Training Activities, the Committee recommends 
$831,842,000, which is the same as the fiscal year 2015 enacted 
level and $41,574,000 less than the fiscal year 2016 budget 
request.
    Dislocated Worker Employment and Training Activities.--For 
Dislocated Worker (DW) Employment and Training Activities, the 
Committee recommends $1,089,530,000 which is $146,859,000 less 
than the fiscal year 2015 enacted level and $172,189,000 less 
than the fiscal year 2016 budget request.
    Of the total provided for DW Employment and Training 
Activities, $1,015,530,000 is designated for State grants that 
provide core and intensive services, training, and supportive 
services for dislocated workers. In addition, States use these 
funds for rapid response assistance to help workers affected by 
mass layoffs and plant closures.
    The remaining $74,000,000 is available for the DW National 
Reserve. The National Reserve supports national emergency 
grants to respond to mass layoffs, plant and/or military base 
closings, and natural disasters. The funds provided are not to 
be used for other purposes. The Committee recommends that these 
activities be coordinated with local areas as needs arise.
    The Committee supports efforts by the Department to address 
the training and employment service needs of workers dislocated 
or laid off as a result of declining production in the coal 
mining industry.
    Native Americans.--For the Indian and Native Americans 
Program, the Committee recommends $50,000,000, which is 
$3,918,000 more than the fiscal year 2015 enacted level and the 
same as the fiscal year 2016 budget request.
    Migrant and Seasonal Farmworkers.--For the National 
Farmworkers Jobs Program (NFJP), the Committee recommends 
$81,896,000, which is the same as the fiscal year 2015 enacted 
level and the fiscal year 2016 budget request.
    The Committee continues language directing that not less 
than 70 percent of program funds be spent on employment and 
training services, together with language that prohibits the 
Department from restricting the provision of ``related 
assistance'' services by grantees. These provisions ensure that 
the program primarily addresses the employment and training 
needs of the target population while allowing grantees to 
provide related services, such as child care and 
transportation, which are often critical to the stabilization 
and availability of the farm labor workforce.
    The Committee directs that, of the amounts made available, 
$5,517,000 is targeted for migrant and seasonal farmworker 
housing grants. The Committee further directs that not less 
than 70 percent of this amount be used for permanent housing 
grants.
    YouthBuild.--For YouthBuild, the Committee recommends 
$82,000,000, which is the $2,311,000 more than the fiscal year 
2015 enacted level and $2,534,000 less than the fiscal year 
2016 budget request.
    YouthBuild is a competitively awarded workforce development 
program that supports disadvantaged young people at risk of 
long-term unemployment, and effectively connects them with 
basic, secondary, and post-secondary education, employment 
training and job placement, and personal counseling. 
Participants split time between the classroom and the 
construction site--earning high school diplomas while providing 
a valuable community service by constructing or rehabilitating 
affordable housing in their communities.
    Reintegration of ex-offenders.--The Committee recommends 
$82,078,000 for ex-offender retraining and reintegration 
activities, which is the same as the fiscal year 2015 enacted 
level and $13,000,000 less than the fiscal year 2016 budget 
request.
    Peer-to-Peer Mentoring.--The Committee recognizes the role 
of peer-to-peer mentoring and counseling in efforts to address 
employment barriers faced by incarcerated and formerly 
incarcerated individuals. The Committee urges ETA to 
incorporate this type of mentoring and counseling in its grant 
programs.
    Technical Assistance.--The Committee recommends $3,232,000 
for technical assistance activities for the workforce 
development system which is the same as the fiscal year 2016 
budget request.
    Technical Assistance funding will be provided to the 
workforce development system in program year 2016 to continue 
WIOA implementation efforts funded through the Dislocated 
Worker National Reserve in program year 2015.
    Workforce Data Quality Initiative.--The Committee 
recommends $6,000,000 for the Workforce Data Quality 
Initiative, which is $2,000,000 more than the fiscal year 2015 
enacted level and $31,000,000 less than the fiscal year 2016 
budget request.

                               JOB CORPS

    The Committee recommends $1,688,155,000 for Job Corps, 
which is the same as the fiscal year 2015 enacted level and 
$27,789,000 less than the fiscal year 2016 budget request.
    Job Corps is a residential education and vocational 
training program that helps young people ages 16 through 24 
improve the quality of their lives through vocational and 
academic training.
    The Committee directs the Department to submit a 
comprehensive plan to the House and Senate Committees on 
Appropriations at least 60 days prior to initiating the closure 
of any existing Job Corps centers. The plan should identify the 
centers that will be closed, provide the financial and 
management rationale for closing each center, and include a 
detailed analysis the costs and anticipated savings that will 
result from closure.
    Operations.--For Job Corps Operations, the Committee 
recommends $1,580,825,000, which shall be available from July 
1, 2016, through June 30, 2017. This recommendation is the same 
as the fiscal year 2015 enacted level and $17,000,000 less than 
the fiscal year 2016 budget request.
    The Committee remains concerned about financial oversight 
of the Job Corps program. Semi-annual reports were requested in 
the Explanatory Statement accompanying the fiscal year 2015 
Appropriations Act on the Department's implementation of the 
recommendations in the Office of Inspector General (OIG) report 
No. 22-13-015-03-370 (May 31, 2013) and the OIG report No. 26-
14-001-03-370 (April 29, 2014). The Committee directs the 
Department to continue to submit the reports until all OIG 
recommendations are resolved.
    The Committee directs the Department to conduct a review of 
financial management policies and procedures and to implement 
policy changes the Secretary deems appropriate to improve 
financial management of the Job Corps program and to protect 
public funds from waste and misuse. In addition, the Committee 
directs the Department to propose any recommendations for 
structural changes to the Department's financial management and 
oversight of the Job Corps program in the fiscal year 2017 
budget.
    The Committee remains concerned regarding the safety of 
students on Job Corps campuses throughout the country. In light 
of recent incidents in several locations, the Committee directs 
the Department to review and make any necessary changes to 
safety policies and requirements.
    Construction, Rehabilitation and Acquisition.--The 
Committee recommends $75,000,000 for construction, 
rehabilitation and acquisition activities of Job Corps centers, 
which shall be available for obligation from July 1, 2016 
through June 30, 2019. This recommendation is the same as the 
fiscal year 2015 enacted level and the fiscal year 2016 budget 
request.
    Administration.--The Committee recommends $32,330,000 for 
the administrative expenses of Job Corps. This recommendation 
is the same as the fiscal year 2015 enacted level and 
$10,789,000 less than the fiscal year 2016 budget request.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

    The Committee recommends $434,371,000 for the Community 
Service Employment for Older Americans (CSEOA) program, which 
shall be available for obligation from July 1, 2016 through 
June 30, 2017. This recommendation is the same as the fiscal 
year 2015 enacted level and the fiscal year 2016 budget 
request.
    The CSEOA program provides grants to public and private 
nonprofit organizations that subsidize part-time work in 
community service activities for unemployed persons aged 55 and 
older whose family's annual income does not exceed 125 percent 
of the poverty level.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

    The Committee recommends $3,580,123,000 for State 
Unemployment Insurance and Employment Service Operations. The 
total includes $3,498,557,000 from the Employment Security 
Administration Account in the Unemployment Trust Fund and 
$81,566,000 from the General Fund of the Treasury. These funds 
are used to support the administration of federal and State 
unemployment compensation laws and to provide assistance to 
State agencies that operate the public Employment Service.
    Unemployment Insurance Operations.--For Unemployment 
Insurance (UI) Operations, the Committee recommends 
$2,760,097,000. This recommendation is $30,588,000 less than 
the fiscal year 2015 funding level and $137,900,000 less than 
the fiscal year 2016 budget request. The total includes 
$2,745,550,000 for State Operations and $14,547,000 for 
National Activities. Funding provided for State Operations 
shall be available through December 31, 2016. Funds used for 
automation acquisitions shall be available for obligation by 
the States through September 30, 2018. Funds used for 
automation acquisitions by consortia of States shall be 
available for obligation by the States through September 30, 
2021.
    The recommendation for State UI Operations includes 
$150,000,000 to conduct in-person reemployment and eligibility 
assessments (REA). This recommendation will support the 
continuation and expansion of the REA program. These 
assessments are intended to reduce improper payments and 
expedite reemployment by assisting beneficiaries in their job 
search.
    The Committee remains supportive of the REA program as a 
means to reduce waste, fraud, abuse and improper payments. This 
initiative should be viewed not just as a savings mechanism, 
but also as a way to reform the manner in which the States can 
implement stronger controls over the UI program. The OIG noted 
in its March 31, 2011 review of funding provided in the 
Recovery Act, ``DOL's spending guidance did not direct states 
to address long-term weaknesses and problems . . . thereby 
missing an opportunity to create long-standing program 
improvements.'' In a report issued on January 31, 2012, the OIG 
further found that ETA had failed to establish goals to 
identify improper payments related to federally-funded 
emergency benefits, and that ``ETA and its regions could not 
objectively measure how well States were doing in identifying 
improper payments related'' to these benefits. Within the 
additional funds provided for REAs, the Committee expects that 
ETA will advance comprehensive technology-based overpayment 
prevention, detection, and collection infrastructure in support 
of efforts to reduce waste, fraud, abuse and improper payments.
    As in previous years, the bill provides for contingency 
funding for increased workloads that States may face in the 
administration of UI. During fiscal year 2016, for every 
100,000 increase in the total average weekly insured 
unemployment above 2,957,000, an additional $28,600,000 shall 
be made available from the Unemployment Trust Fund.
    Employment Service Operations.--The Committee recommends 
$664,184,000, for the Employment Service (ES) grants to states. 
This recommendation is the same as the fiscal year 2015 enacted 
level and $400,000,000 less than the fiscal year 2016 budget 
request. The total includes $642,771,000 from the Employment 
Security Administration Account in the Unemployment Trust Fund 
and $21,413,000 from the General Fund of the Treasury. Funding 
for ES grants shall be available for obligation from July 1, 
2016, through June 30, 2017.
    ES grants are authorized by the Wagner-Peyser Act and 
financed through employer taxes. These grants help jobseekers 
and employers by matching individuals seeking employment to job 
vacancies.
    The Committee recommends $19,818,000 for ES National 
Activities. The recommendation is the same as the fiscal year 
2015 enacted level and the fiscal year 2016 budget request.
    Foreign Labor Certification.--The Committee recommends 
$75,871,000 for Foreign Labor Certification (FLC) program. This 
recommendation is $13,561,000 more than the fiscal year 2015 
enacted level and the same as the fiscal year 2016 budget 
request. The recommendation includes $61,589,000 for federal 
administration activities and $14,282,000 for grants to States.
    The FLC program administers foreign visas including the H-
2A and the H-2B temporary worker programs. These programs are 
essential to employers in industries that have cyclical peaks 
or that are seasonal in nature, including agriculture, tourism, 
and hospitality. Nonimmigrant worker programs have provided 
critical support to these types of industries for many decades. 
Despite broad support and a clear need for these programs, the 
Department has engaged in rulemaking and policy changes that 
have resulted in far reaching and negative impacts on the 
industries and people these programs are intended to serve. 
Therefore, the Committee directs the Department to ensure 
continuity and viability of these programs in accordance with 
all applicable laws.
    H-2A.--The H-2A program is a critical source of labor for 
the agricultural industry. The program ensures a legal labor 
force to fill temporary jobs when an insufficient number of 
American workers are available; however, requirements for cost 
reimbursement, hiring practices, reporting, and wage rates have 
caused the H-2A program to become excessively burdensome and 
complex. The Committee believes this leads to perverse and 
counterproductive incentives for illegal immigration. The 
Committee urges the Department to review H2-A regulations and 
propose changes to streamline the process for employers and 
reduce incentives for farmers to hire immigrant workers 
illegally.
    H-2B.--The H-2B program is a critical source of labor for 
industries including fishing, tourism, hospitality, recreation 
and seasonal activities. The program ensures a legal labor 
force to fill temporary jobs when an insufficient number of 
American workers are available, however, requirements set forth 
in a series of proposed regulations makes the program 
excessively burdensome and complex on employers seeking to 
legally obtain temporary employees. The Committee directs the 
Department to administer and regulate the H-2B program in a 
manner that is consistent with the law, easier for employers 
legally seeking temporary workers at a reasonable prevailing 
wages, and reduces incentives for employers to hire immigrant 
workers illegally.
    One-Stop Career Centers/Labor Market Information.--The 
Committee recommends $60,153,000 for One-Stop Career Center and 
Labor Market Information (LMI). This recommendation is the same 
as the fiscal year 2015 enacted level and $20,000,000 less than 
the fiscal year 2016 budget request.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

    The Committee recommends such sums as necessary for 
Advances to the Unemployment Trust Fund and Other Funds. The 
appropriation is available to provide advances to several 
accounts for purposes authorized under various federal and 
State unemployment insurance laws and the Black Lung Disability 
Trust Fund when the balances in such accounts are insufficient.

                         Program Administration

    The Committee recommends $158,368,000 for Program 
Administration. This recommendation is $3,809,000 more than the 
fiscal year 2015 enacted level and $18,196,000 less than the 
Department's fiscal year 2016 budget request. The 
recommendation includes $107,636,000 in funds from the General 
Fund of the Treasury and $50,732,000 from the Employment 
Security Administration Account in the Unemployment Trust Fund.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

    The Committee recommends $180,699,000 for the Employee 
Benefits Security Administration (EBSA). This recommendation is 
$301,000 less than the fiscal year 2015 enacted level and 
$26,756,000 less than the fiscal year 2016 budget request.
    The EBSA assures the security of retirement, health and 
other workplace-related benefits of working Americans.

                  Pension Benefit Guaranty Corporation

    The Committee includes an obligation limitation for 
administrative expenses of $431,799,000 for the Pension Benefit 
Guaranty Corporation (PBGC). The limitation is $16,405,000 more 
than the fiscal year 2015 enacted level and the same as the 
fiscal year 2016 budget request. The recommendation includes 
bill language that defines PBGC's discretionary authority to 
incur additional unforeseen and emergency administrative 
expenses related to its multiemployer plan insurance program.
    The PBGC was established by Congress to insure the defined-
benefit pension plans of working Americans.
    The Committee expects PBGC to submit reports required by 
the Employee Retirement Income Security Act of 1974 and the 
Pension Protection Act of 2006 in a timely manner.

                         Wage and Hour Division


                         SALARIES AND EXPENSES

    The Committee recommends $215,500,000 for the Wage and Hour 
Division (WHD). This recommendation is $12,000,000 less than 
the fiscal year 2015 enacted level and $61,600,000 less than 
the fiscal year 2016 budget request.
    The WHD enforces federal minimum wage, overtime pay, 
recordkeeping, and child labor requirements of the Fair Labor 
Standards Act. WHD also has enforcement and other 
administrative responsibilities related to the Migrant and 
Seasonal Agricultural Worker Protection Act, the Employee 
Polygraph Protection Act, the Family and Medical Leave Act, the 
Davis Bacon Act and the Service Contract Act.
    The Committee directs the Wage and Hour Division to submit 
a report to the House and Senate Committee on Appropriations 
within 120 days of enactment of this Act on the steps taken to 
correct deficiencies, address recommendations, and improve the 
process for wage determinations for public works projects cited 
in OIG report No. 04-04-003-04-420, (Mar. 30, 2004) and in GAO 
testimony GAO-11-486T (April 14, 2011).

                  Office of Labor-Management Standards


                         SALARIES AND EXPENSES

    The Committee recommends $42,000,000 for the Office of 
Labor-Management Standards (OLMS). This recommendation is 
$2,871,000 more than the fiscal year 2015 enacted level and 
$4,981,000 less than the fiscal year 2016 budget request.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act, which establishes safeguards for union 
democracy and union financial integrity, and requires public 
disclosure reporting by unions, union officers, employees of 
unions, labor relations consultants, employers, and surety 
companies.
    The Committee is troubled that the Department continues to 
withhold appropriated and obligated transit grant funding to 
the State of California due to the State's bipartisan 2012 
pension reform law, the Public Employee Pension Reform Act 
(PEPRA). The Department contends that PEPRA violates transit 
worker's bargaining rights under the Urban Mass Transportation 
Act of 1964 [P.L. 88-365, USC Title 49, Chapter 53]. The United 
States Eastern District Court ruled that the Department has 
acted in violation of the Administrative Procedure Act [P.L. 
79-404, 60 Stat. 237] and its application of the Urban Mass 
Transportation Act of 1964 to justify withholding grants is 
``arbitrary'' and ``capricious.'' The Department's actions have 
forced layoffs; deferrals of preventive maintenance; delays in 
planned service expansions and capital improvements; and 
service cuts statewide, threatening the livelihood of the 
workers the Department claims to protect. The Committee directs 
the Department to act in accordance with the applicable court 
ruling in effect during the time leading up to the end of the 
fiscal year such that grants may be certified according to the 
prevailing court order, prior to the funds lapsing, in order to 
minimize further disruption to California's mass transit 
providers.

             Office of Federal Contract Compliance Programs


                         SALARIES AND EXPENSES

    The Committee recommends $100,500,000 for the Office of 
Federal Contract Compliance Programs (OFCCP). This 
recommendation is $5,976,000 less than the fiscal year 2015 
enacted level and $13,187,000 less than the fiscal year 2016 
budget request.
    The OFCCP ensures equal employment opportunity in the 
federal contracting community through enforcement, regulatory 
work, outreach and education to workers and their advocates.
    The Committee is concerned about the potential 
ramifications of the proposed Requirement to Report Summary 
Data on Employee Compensation (Compensation Data Collection) 
regulation (79 FR 46561, published in the Federal Register on 
August 8, 2014). Eliminating gender and race-based compensation 
discrimination is an important goal. The Committee understands 
that OFCCP is seeking input from stakeholders on issues 
relating to scope, content and format of the rule. The 
Committee urges OFCCP to carefully consider this input and 
public comments on the proposed rule. The Committee believes it 
is vital to ensure that new data collection requirements have 
limited costs of compliance for employers, do not unnecessarily 
burden contractors that are not being investigated or accused 
of wrongdoing, and fastidiously protects private and 
individually identifiable data.
    The Committee is concerned that OFCCP has lost its focus on 
identifying and addressing real discrimination in employment 
and has become hyper-focused on fulfilling quotas instead of 
equal opportunity by relying on statistics alone in evaluating 
contractors. The Committee believes OFCCP should take steps to 
use common sense in the use of government resources to focus on 
finding actual discriminatory treatment instead of presumed 
discrimination based solely on what OFCCP assumes through 
statistics. Further, the Committee believes that OFCCP should 
end its reliance on threatening sanctions, including debarment 
and the costs associated with an extremely drawn-out 
administrative litigation process, to induce contractors to 
waive their legal rights and to enter into conciliation 
agreements that are not justified by the evidence.

                Office of Workers' Compensation Programs


                         SALARIES AND EXPENSES

    The Committee recommends $114,842,000 for the Office of 
Workers' Compensation Programs (OWCP). This recommendation is 
$1,842,000 more than the fiscal year 2015 enacted level and 
$4,732,000 less than the fiscal year 2016 budget request. The 
recommendation includes $112,665,000 in General Funds from the 
Treasury the authority to expend $2,177,000 from the Special 
Fund established by the Longshore and Harbor Workers' 
Compensation Act.
    The OWCP administers the Federal Employees' Compensation 
Act, the Longshore and Harbor Workers' Compensation Act, the 
Energy Employees Occupational Illness Compensation Program Act, 
and the Black Lung Benefits Act. These programs provide 
eligible injured and disabled workers and their survivors with 
compensation, medical benefits, and services including 
rehabilitation, supervision of medical care, and technical and 
advisory counseling.

                            SPECIAL BENEFITS

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $210,000,000 for Special Benefits. 
This recommendation is the same as the fiscal year 2015 enacted 
level and the fiscal year 2016 budget request.
    These funds provide mandatory benefits under the Federal 
Employees' Compensation Act.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

    The Committee recommends $69,302,000 for Special Benefits 
for Disabled Coal Miners. This amount is in addition to the 
$21,000,000 appropriated in fiscal year 2015 as an advance for 
the first quarter of fiscal year 2016. The total program level 
recommendation of $90,302,000 is $10,960,000 less than the 
fiscal year 2015 enacted level and the same as the fiscal year 
2016 budget request.
    These funds provide mandatory benefits to coal miners 
disabled by black lung disease, to their survivors and eligible 
dependents, and for necessary administrative costs.
    The Committee recommendation also provides $19,000,000 as 
an advance appropriation for the first quarter of fiscal year 
2017. These funds ensure uninterrupted payments to 
beneficiaries.

    ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 
                           COMPENSATION FUND

    The Committee recommends $58,552,000 for the Energy 
Employees Occupational Illness Compensation Program. This 
recommendation is $2,146,000 more than the fiscal year 2015 
enacted level and the same as the fiscal year 2016 budget 
request.
    These funds provide mandatory benefits to eligible 
employees or survivors of employees of the Department of Energy 
(DOE); its contractors and subcontractors; companies that 
provided beryllium to DOE; atomic weapons employees 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; and uranium workers covered under the 
Radiation Exposure Compensation Act.
    The Committee is concerned about the backlog of claims 
under the Energy Employees Occupational Illness Compensation 
program and urges the Department to review policies and take 
any necessary steps to streamline the processing of claims for 
qualified beneficiaries.

                    BLACK LUNG DISABILITY TRUST FUND

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends such sums as necessary for payment 
of benefits and interest on advances for the Black Lung 
Disability Trust Fund. The Committee recommends $341,466,000 
for the Black Lung Disability Trust Fund. This recommendation 
is $15,511,000 more than the fiscal year 2015 enacted level and 
the same as the fiscal year 2016 budget request.
    The Black Lung Disability Trust Fund pays black lung 
compensation, medical and survivor benefits, and administrative 
expenses when no mine operator can be assigned liability for 
such benefits, or when mine employment ceased prior to 1970.
    The Black Lung Disability Trust Fund is financed by an 
excise tax on coal, reimbursements from responsible mine 
operators, and short-term advances from the Treasury. The 
Emergency Economic Stabilization Act of 2008 authorized a 
restructuring of the Black Lung Disability Trust Fund debt and 
required that annual operating surpluses be used to pay down 
the debt until all remaining obligations are retired.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

    The Committee recommends $535,000,000 for the Occupational 
Safety and Health Administration (OSHA). This recommendation is 
$17,787,000 less than the fiscal year 2015 enacted level and 
$57,071,000 less than the fiscal year 2016 request.
    OSHA enforces the Occupational Safety and Health Act of 
1970.
    The Committee strongly supports the underlying mission of 
OSHA to promote a safe and healthy work place and protect 
workers from injury, illness, and death. The Committee 
disagrees with the manner in which this policy is being 
implemented. The fiscal year 2016 budget request states that 
OSHA supports the Department's strategic goals and objectives 
through ``enforcement, standards, whistleblower protection, and 
compliance assistance and outreach programs.'' Yet virtually 
all of the requested funding increase for OSHA is proposed for 
additional enforcement. Compliance assistance remains less than 
25 percent of OSHA's overall budget.
    The Committee believes that overreliance on punitive 
enforcement at the expense of effective compliance assistance 
is a flawed approach. This approach is costly and overly 
burdensome on employers and is contrary to the intention of 
Executive Order 13563 to create a regulatory system that 
protects ``public health, welfare, safety, and our environment 
while promoting economic growth, innovation, competitiveness, 
and job creation.''
    The Committee recognizes that enforcement is a necessary 
component of an effective strategy to improve workplace safety 
but the Department's overreliance on enforcement has created an 
unnecessarily hostile environment between the federal 
government and private enterprises. The Department's Spring 
2015 regulatory agenda affirms OSHA's aggressive, enforcement-
focused agenda. Inspections and fines are costly, especially 
for the small businesses that are the primary drivers of job 
creation.
    The Committee believes that OSHA should partner with 
businesses to create safer workplaces. Compliance assistance is 
an important tool that is underutilized by OSHA. The Committee 
supports programs like the Voluntary Protection Programs that 
create safer workplaces by increasing compliance and avoiding 
costly inspections and fines.
    The Committee directs OSHA to reorient its approach and 
refocus its efforts and resources on helping companies to 
comply with workforce safety laws thereby freeing up funds 
being used for inspections and fines to create new jobs. The 
Committee recommendation for fiscal year 2016 reflects this 
reorientation.
    The Committee is aware that the statute clearly establishes 
that OSHA must receive an employee complaint to write 
citations. The Committee is concerned that OSHA is proceeding 
to unilaterally change this requirement to expand its own 
citation authority beyond the legally required complaint 
requirement.
    Safety and Health Standards.--The Committee recommends 
$20,000,000 for Safety and Health Standards.
    Federal Enforcement.--The Committee recommends $193,000,000 
for Federal Enforcement.
    Whistleblower Programs.--The Committee recommends 
$20,000,000 for Whistleblower Programs.
    State Programs.--The Committee recommends $103,000,000 for 
State Programs.
    Technical Support.--The Committee recommends $24,000,000 
for Technical Support.
    Compliance Assistance.--The Committee provides $129,000,000 
for federal and State compliance assistance programs.
    The Committee directs OSHA to submit a report to the House 
and Senate Committees on Appropriations within 120 days of 
enactment assessing the participation, detailed costs and 
effectiveness of the VPP.
    Federal Assistance.--The Committee recommends $71,000,000 
for Federal Assistance.
    State Consultation Grants.--The Committee recommends 
$58,000,000 for State Consultation Grants.
    Training Grants.--The Committee continues to support 
efforts to train and educate workers on occupational safety and 
health hazards within the programs and services currently 
offered by OSHA's Directorate of Training and Education (DTE), 
which includes the OSHA Training Institute and Education 
Centers, the revised Outreach Training Program, and the 
Resource Center Loan Program. The Susan Harwood Training Grant 
Program, the Committee believes, is comparatively inefficient 
and ineffective in achieving its intended purpose, at least in 
part due to a lack of effective oversight of grantee 
performance. The Committee recommendation provides no funding 
for the Susan Harwood Training Grant Program.
    The Committee is concerned that OSHA has shifted its focus 
in recent years toward ``capacity building'' grants versus 
``targeted'' training grants and has effectively done little 
more than supplant the infrastructure needs of the grantees. 
Not less than 120 days after enactment of this Act, OSHA shall 
provide a report to the House and Senate Committees on 
Appropriations that includes a list of Susan Harwood awardees 
for fiscal years 2013, 2014, and 2015, the selection criteria 
used to approve the initial award, and field evaluations for 
each of these awardees (to the extent the grantee was pre-
approved for a multi-year grant). OSHA shall also make this 
information available on its website.
    The Committee also directs that financial evaluations of 
grantees and the status of appropriated funds under this 
program be included in all OSHA evaluations of grantee 
performance. Should a recipient of Susan Harwood training grant 
funds be unable to fulfill the terms of its grant award or meet 
minimum performance standards, OSHA shall terminate the 
contract, recapture all remaining funds, and notify the House 
and Senate Committees on Appropriations within 15 days 
including the name of the grantee, reasons for termination, and 
amounts to be returned to the Treasury.
    Injury and Illness Incidence Rates.--BLS data on injury and 
illness incidence and fatality rates show a steady decline 
since 2003. While these rates are currently among the lowest on 
record, the most recent data indicates that rates have not 
significantly declined since 2009. The Committee questions 
whether the Department's intensified enforcement efforts since 
that time are achieving the expected results. Furthermore, the 
Committee notes the trend since 2003 has largely occurred in 
the absence of new regulations. The Committee sees no evidence 
to support the need for sweeping new regulations of the kind 
currently being promulgated by OSHA, especially given the 
significant impact they have on small businesses.
    The Committee questions the necessity of the proposed 
Injury and Illness Prevention Program (I2P2) regulation. The 
idea of an injury and illness program has existed in some 
variation for more than 30 years, and the Department has had 
voluntary safety and health guidelines in place since 1989, 
which have enabled companies to establish policies and 
procedures specific to their own workplaces. Still unclear is 
how this proposed regulation incorporates the recommendations 
from the 1998 panel that was convened to consider the Safety 
and Health Program Standard, the predecessor to the I2P2 
proposal. This panel cited several criticisms of a federally-
mandated safety and health programs and recommended to OSHA 
that it consider various concepts other than just a blanket, 
one-size fits-all regulation. The Committee is concerned that 
this regulation, as currently proposed, would impose additional 
and costly burdens on employers and subject currently effective 
safety programs to a new regulatory regime that may result in 
more fines and penalties but not necessarily safer workplaces.
    National/Regional/Local Emphasis Programs.--The Committee 
is concerned that OSHA's National Emphasis Program targets 
employers with exemplary safety records for no other reason 
than sharing a geographical area or industrial sector with an 
employer that has had an accident or otherwise come under OSHA 
scrutiny. The Committee recognizes that OSHA has to target its 
enforcement efforts and focusing on the regions and sectors 
that have experienced problems is one way to do that. The 
Committee urges OSHA to consider means such as the improved use 
of statistical analysis and other strategies to ensure that 
employers with excellent safety records are not subject to 
lengthy and costly inspections and enforcement processes 
without warrant. The Explanatory Statement accompanying the 
fiscal year 2015 Appropriations Act directed OSHA to notify the 
House and Senate Committees on Appropriations 10 days prior to 
the announcement of any new National, Regional or Local 
Emphasis Program including the circumstances and data used to 
determine the need for the launch of the new program. The 
Committee directs OSHA to continue to provide such notices in 
fiscal year 2016.
    Crystalline Silica.--The Committee understands that OSHA 
remains in the process of promulgating regulations to reduce 
the permissible exposure limit to crystalline silica. The 
Committee understands that silicosis and other silica-related 
illnesses are serious and can be deadly. The Committee is 
concerned, however, that OSHA has grossly underestimated the 
costs of implementing the proposed new standard. The Committee 
urges OSHA to delay enforcement of any new standard until it 
can demonstrate the effectiveness of equipment designed to 
accurately measure workers' exposure to silica and until it can 
demonstrate that methods for reducing workers' exposure to 
silica across all applicable industries can be feasibly 
implemented in a cost effective manner. The Explanatory 
Statement accompanying the fiscal year 2015 Appropriations Act 
urged OSHA to consider all currently available technology as it 
develops any new standard for workers exposure to silica dust. 
The Committee believes that personal protective equipment such 
as airstream helmets and respirators should be part of an all-
of-the-above approach to limiting workers' exposure to 
respirable silica. Employers and workers should have the 
flexibility to choose from all available technologies that are 
proven to be effective at reducing workers' exposure to silica 
rather than the environmental control approach put forward in 
the proposed rule. Lowering workers' exposure to respirable 
silica is the goal. The Committee urges OSHA to allow the 
maximum flexibility possible with all currently available 
technology to meet any new standard for workers' exposure to 
silica dust.
    Solid Ammonium Nitrate.--The Committee understands that 
OSHA is reviewing its standards related to the storage of 
ammonium nitrate and urges OSHA to propose any necessary 
changes under existing regulations on Explosives and Blasting 
Agents (29 C.F.R. 1910.109) and not to add ammonium nitrate to 
the list of chemicals covered under OSHA's Process Safety 
Management Standards of Highly Hazardous Chemicals (29 C.F.R. 
1910.119). The Committee believes that changes to improve the 
safety of storing ammonium nitrate should be made based on 
scientific review of current standards rather than through a 
one-size-fits-all approach under OSHA's Process Safety 
Management Standards.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

    The Committee recommends $371,000,000 for the Mine Safety 
and Health Administration (MSHA). This recommendation is 
$4,887,000 less than the fiscal year 2015 enacted level and 
$23,932,000 less than the fiscal year 2016 budget request.
    MSHA enforces the Federal Mine Safety and Health Act in 
underground and surface coal mines and metal/non-metal mines.
    The Committee continues bill language designating up to 
$2,000,000 for mine rescue recovery activities, and provides 
for the retention of fees up to $2,499,000 for the testing and 
certification of equipment.
    The Committee includes at least $8,441,000 for State 
assistance training grants under the Educational Policy and 
Development program.
    The Committee understands that enforcement is an important 
part of protecting the health and safety of miners. The 
Committee is concerned, however, about overreliance on an 
enforcement-focused strategy that disproportionally impacts 
small businesses. The Committee believes that the Department 
should do everything possible to assist companies with training 
and technical support to comply with health and safety 
standards instead of just inspecting and fining companies 
indiscriminately for violations large and small. Compliance 
assistance programs are a vital resource for helping smaller 
employers comply with regulations and improve their health and 
safety programs. The Committee appreciates the reductions in 
mining injury and illness rates that have been achieved in 
recent decades and remains a strong proponent for vigilant mine 
safety oversight. The Committee believes that MSHA needs to 
offer a more formal voluntary protection program including the 
ability for mine operators to request compliance inspections 
that do not incur fines for violations. Such a program would 
increase participation in voluntary inspections, advance the 
goal of improving health and safety in the mining industry, and 
achieve greater compliance with standards without the threat of 
punitive enforcement.
    The Committee supports the significant advances MSHA has 
achieved in mine rescue and communications capabilities.
    The Committee appreciates that MSHA is undertaking an 
effort to redistribute enforcement activity and personnel to 
reflect the changing levels of coal mining production across 
MSHA regions and encourages MSHA to continue review and 
accelerate these efforts in order to most effectively align 
enforcement activity with current production levels.
    The Committee is aware that rock dust may be used in mining 
operations to suppress coal dust and that recent changes 
required by the MSHA increase the amount of rock dust required 
and the frequency of its application. The Committee notes that 
this use may create the potential for the new Continuous 
Personal Dust Monitors, required by MSHA, to mischaracterize 
rock dust as coal dust, thus subjecting operators to 
enforcement actions where no overexposures to coal dust exist. 
The Committee notes that an extension on enforcement of the 
regulation would provide time for MSHA to complete its current 
review of this problem and design protocols to prevent the 
potential for inaccurate compliance determinations.
    The Committee is concerned that MSHA may be expending 
unnecessary resources by inspecting coal mines that are not in 
operation more frequently than necessary to reasonably ensure 
worker safety. The Committee directs MSHA to review its 
policies and procedures for inspecting coal mines not in 
operation and ensure that such guidelines are consistent with 
statutory requirements and established safety standards.
    The coal mining industry has experienced a period of 
significant decline in recent years and a substantial number of 
mines have ceased operations or closed as a result. The 
Committee understands that MSHA has ongoing personnel and 
training needs but urges MSHA to consider how recruitment 
efforts impact communities that have been the hardest hit by 
declining mining operations.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

    The Committee recommends $609,000,000 for the Bureau of 
Labor Statistics (BLS). This recommendation is $16,788,000 more 
than the fiscal year 2015 enacted level and $23,737,000 less 
than the fiscal year 2016 budget request. The recommendation 
includes $544,000,000 from the General Fund of the Treasury and 
$65,000,000 from the Employment Security Administration Account 
in the Unemployment Trust Fund.
    BLS is an independent national statistical agency that 
collects, processes, analyzes, and disseminates essential 
economic data to the Congress, federal agencies, State and 
local governments, businesses, and the general public. Its 
principal surveys include the Consumer Price Index and the 
monthly unemployment series.
    Employment and Unemployment Statistics.--The Committee 
recommends $208,000,000 for Employment and Unemployment 
Statistics.
    Labor Market Information.--The Committee recommends 
$65,000,000 for Labor Market Information.
    Prices and Cost of Living.--The Committee recommends 
$207,000,000 for Prices and Cost of Living.
    Compensation and Working Conditions.--The Committee 
recommends $83,500,000 for Compensations and Working 
Conditions.
    Productivity and Technology.--The Committee recommends 
$10,500,000 for Productivity and Technology.
    Executive Direction and Staff Services.--The Committee 
recommends $35,000,000 for Executive Direction and Staff 
Services.

                 Office of Disability Employment Policy


                         SALARIES AND EXPENSES

    The Committee recommends $38,203,000 for the Office of 
Disability Employment Policy (ODEP). This recommendation is 
$297,000 less than the fiscal year 2015 enacted level and the 
same as the fiscal year 2016 budget request.
    ODEP provides policy guidance and leadership to eliminate 
employment barriers to people with disabilities.

                        Departmental Management


                         SALARIES AND EXPENSES

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $284,537,000 for Departmental 
Management. This recommendation is $53,392,000 less than the 
fiscal year 2015 enacted level and $91,448,000 less than the 
fiscal year 2016 budget request. The recommendation includes 
$284,229,000 from the General Fund of the Treasury and $308,000 
from the Employment Security Administration Account in the 
Unemployment Trust Fund.
    The Departmental Management appropriation provides funds 
for the staff responsible for Departmental operations, 
management, and policy development. The appropriation also 
includes funding for several programs and activities that are 
not separate appropriations accounts.
    Program Direction and Support.--The Committee recommends 
$31,475,000 for Program Direction and Support.
    Departmental Program Evaluation.--The Committee recommends 
$8,161,000 for Departmental Program Evaluation.
    Legal Services.--The Committee recommends $128,336,000 for 
Legal Services.
    International Labor Affairs.--The Committee recommends 
$32,000,000 for International Labor Affairs (ILAB). This 
recommendation is intended to return ILAB to its original 
mission of research, advocacy, and technical assistance. No 
funding is provided for ILAB grants.
    The Committee is concerned by the findings of GAO in its 
May 2014 report, ``International Labor Grants: Labor Should 
Improve Management of Key Award Documentation'' and in its 
September 2014 report, ``International Labor Grants: DOL's Use 
of Financial and Performance Monitoring Tools Needs to be 
Strengthened.'' The Committee is not convinced that ILAB has 
the capacity to effectively manage a large and complex grant 
program. The Committee is also concerned that lack of demand 
results in funding for projects that are at higher risk of not 
achieving ILAB's program goals. The Committee directs ILAB to 
implement GAO's recommendations to provide guidance regarding 
document retention, demonstrate award requirements are met, 
ensure effective implementation of guidance, and provide 
guidance regarding the submission and review of financial and 
performance reports.
    The Committee directs ILAB to maintain funding for its core 
activities of international research and analysis, and to 
fulfill Congressional and legal mandates, including the Trade 
Acts of 2000 and 2002 and the William Wilberforce Trafficking 
Victims Protection Reauthorization Act of 2008. The Committee 
also expects ILAB to continue to carry out the administrative 
requirements of the labor provisions of free trade agreements.
    Administration and Management.--The Committee recommends 
$28,839,000 for Administration and Management.
    Adjudication.--The Committee recommends $32,000,000 for 
Adjudication.
    Women's Bureau.--The Committee recommends $11,709,000 for 
the Women's Bureau.
    Civil Rights Activities.--The Committee recommends 
$6,880,000 for Civil Rights Activities.
    Chief Financial Officer.--The Committee recommends 
$5,137,000 for the Chief Financial Officer.

                    VETERANS EMPLOYMENT AND TRAINING

    The Committee recommends $271,110,000 for Veterans 
Employment and Training (VETS) program. This recommendation is 
$1,129,000 more than the fiscal year 2015 enacted level and the 
same as the fiscal year 2016 budget request. The recommendation 
includes $38,109,000 from the General Fund of the Treasury and 
$233,001,000 from the Employment Security Administration 
Account in the Unemployment Trust Fund.
    The VETS program serves America's veterans and separating 
service members by preparing them for meaningful careers, 
providing employment resources and expertise, and protecting 
their employment rights.
    The Committee continues to be supportive of VETS program 
and wishes to reach and assist as many Veterans as possible. 
The Committee is also pleased by the efforts of private 
industry to offer its own resources for veterans employment 
services and encourages the Department to pursue opportunities 
to cooperation with private industry to help the country better 
serve its veterans.
    State Grants.--The Committee recommends $175,000,000 for 
State Grants.
    Transition Assistance Program.--The Committee recommends 
$14,100,000 for the Transition Assistance Program.
    Homeless Veterans' Reintegration Program.--The Committee 
recommends $38,109,000 for the Homeless Veterans' Reintegration 
Program.
    The Committee continues to support Administration efforts 
to direct grant awards to selective populations in the Veteran 
community, such as female Veterans, Veterans with families, and 
transition assistance to incarcerated Veterans.
    National Veterans' Employment and Training Service 
Institute.--The Committee recommends $3,414,000 for the 
National Veterans' Employment and Training Institute.

                  INFORMATION TECHNOLOGY MODERNIZATION

    The Committee recommends $29,778,000,000 for Information 
Technology (IT) Modernization. This recommendation is 
$14,384,000 more than the fiscal year 2015 enacted level and 
$89,824,000 less than the fiscal year 2016 budget request.
    While the Committee recognizes there are ongoing 
modernization needs with respect to the Department's 
information technology infrastructure, the Committee is 
concerned that the Department does not have sufficient capacity 
to effectively manage the large increase in IT modernization 
funds proposed in the fiscal year 2016 budget.
    The Committee directs the Department to establish a multi-
year IT modernization plan that staggers projects over time in 
a manner consistent with the Department's capacity to 
effectively oversee projects and within available 
appropriations. The Committee directs the Department to assign 
a qualified project manager that is a full-time employee of the 
Department to each modernization project to ensure that all IT 
modernization projects are executed effectively, according to 
Departmental requirements, on time, and within budget.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $84,660,000 for the OIG. This 
recommendation is $3,070,000 more than the fiscal year 2015 
enacted level and $3,325,000 less than the fiscal year 2016 
budget request. The recommendation includes $79,000,000 from 
the General Fund of the Treasury and $5,660,000 from the 
Employment Security Administration Account in the Unemployment 
Trust Fund.
    The Committee supports the OIG efforts to combat large-
scale, multi-state fictitious and fraudulent employer and 
identity theft schemes to defraud the UI program.
    The Committee supports OIG efforts to reduce improper 
payments in the UI program, an area identified by OMB, based at 
least in part on previous OIG audit work, as being particularly 
at risk for improper payments.
    The Committee supports the OIG's plan to initiate a long-
term, cyclical oversight program to independently review, on a 
prioritized basis, individual States' efforts to identify and 
recover UI overpayments.

                           General Provisions

    Sec. 101. The Committee modifies a provision to prohibit 
the use of Job Corps funds for the salary of an individual at a 
rate in excess of Executive Level III.

                          (TRANSFER OF FUNDS)

    Sec. 102. The Committee continues a provision providing the 
Secretary of Labor with the authority to transfer up to one 
percent of discretionary funds between appropriations, provided 
that no appropriation is increased by more than three percent 
by any such transfer.
    Sec. 103. The Committee continues a prohibition on use of 
funds to purchase goods that are in any part produced by 
indentured children.
    Sec. 104. The Committee continues a provision that grants 
made from funds available to the Department under the American 
Competitiveness and Workforce Improvement Act shall be used 
only for training activities in the occupations and industries 
for which employers use the visas that generate these funds, 
and that related activities be limited to those necessary to 
support such training.
    Sec. 105. The Committee modifies a provision to prohibit 
recipients of funds provided to the Employment and Training 
Administration from using such funds for the compensation of 
any individual at a rate in excess of Executive Level III.

                          (TRANSFER OF FUNDS)

    Sec. 106. The Committee continues a provision providing the 
Secretary of Labor with the authority to transfer funds made 
available to the Employment and Training Administration to 
Program Administration for technical assistance services.

                          (TRANSFER OF FUNDS)

    Sec. 107. The Committee modifies a provision that allows up 
to 0.75 percent of discretionary appropriations provided in 
this Act for specific Department of Labor 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.
    Sec. 108. The Committee modifies a provision relating to 
flexibility of H-2B nonimmigrant crossings.

                          (TRANSFER OF FUNDS)

    Sec. 109. The Committee continues a provision that allows 
up to 0.25 percent of discretionary appropriations provided in 
this Act for specific Department of Labor agencies to be used 
by the Office of the Chief Information Officer for authorized 
information technology purposes.
    Sec. 110. The Committee includes a new provision relating 
to section 147 of the WIOA authorizing competitive procurement 
of certain Job Corps Civilian Conservation Centers.
    Sec. 111. The Committee includes a new provision relating 
to the Department's Establishing a Minimum Wage for Contractors 
regulation.
    Sec. 112. The Committee includes a new provision relating 
to the Department's proposal to establish a new Office of Labor 
Compliance within the Departmental Management account.
    Sec. 113. The Committee includes a new provision relating 
to the Department's Definition of the Term ``Fiduciary''; 
Conflict of Interest Rule--Retirement Investment Advice 
regulation.
    Sec. 114. The Committee includes a new provision relating 
to the ``walkaround'' letter of interpretation issued by the 
OSHA on February 21, 2013.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES


              Health Resources and Services Administration

    The Committee recommends $6,048,754,000 for Health 
Resources and Services programs, which is $298,530,000 below 
the fiscal year 2015 enacted level and $413,423,000 below the 
budget request.
    The Health Resources and Services Administration (HRSA) 
supports programs that provide health services to 
disadvantaged, medically underserved, and special populations; 
decrease infant mortality rates; assist in the education of 
health professionals; and provide technical assistance 
regarding the utilization of health resources and facilities.

                          PRIMARY HEALTH CARE

Health Centers

    The Committee recommends $1,491,522,000 for the Health 
Centers program, which is the same as the fiscal year 2015 
enacted level and the budget request.
    The Committee includes bill language providing up to 
$99,893,000 for the Federal Tort Claims Act program, which is 
the same as the fiscal year 2015 enacted level and the budget 
request. The program provides medical malpractice liability 
protection to federally supported health centers.
    Perinatal transmission of Hepatitis B.--The Committee is 
pleased that progress is being made to develop and implement a 
strategic plan to reduce the rate of perinatal transmission of 
hepatitis B. The Committee has urged HRSA to expand efforts to 
eliminate perinatal transmission of Hepatitis B for the past 
three fiscal years and little progress has been made. The 
Committee expects HRSA to test intervention strategies followed 
by the adoption of best practices protocols in HRSA funded 
health care settings as soon as feasible in fiscal year 2016.

Free Clinics Medical Malpractice

    The Committee recommends $100,000 for extension of Federal 
Tort Claims Act (FTCA) coverage for volunteer free clinic 
health care professionals, which is the same as the fiscal year 
2015 funding level and the budget request. The program extends 
FTCA coverage to individuals involved in the operation of free 
clinics in order to expand access to health care services to 
low-income individuals in medically underserved areas. A free 
clinic must apply, consistent with the provisions applicable to 
community health centers, to have those individuals ``deemed'' 
an employee of the Public Health Service, and therefore 
eligible for coverage under the FTCA.

                            HEALTH WORKFORCE

Health Professions

    The Committee recommends $742,670,000 for Health 
Professions programs, which is $8,930,000 below the fiscal year 
2015 enacted level and $114,150,000 below the requested program 
level.
    The Bureau of Health Professions supports grants for the 
development of future workforce in fields challenged by a high 
need and insufficient supply of professionals. Given that 
colleges and universities serve the dual role of training 
students and carrying out a majority of federally funded 
biomedical research, the Committee believes that they serve as 
an ideal setting to expose future clinicians to the evidence 
base that underlies their intended profession.
    Within the total for Health Professions, the Committee 
recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Health Professions Training for Diversity
    Centers of Excellence............................        $21,711,000
    Health Careers Opportunity Program...............         14,189,000
    Faculty Loan Repayment...........................          1,190,000
    Scholarships for Disadvantaged Students..........         45,970,000
Health Care Workforce Assessment.....................          4,663,000
Primary Care Training and Enhancement................         38,924,000
Oral Health Training Programs........................         34,998,000
Interdisciplinary, Community-based Linkages
    Area Health Education Centers....................         30,250,000
    Geriatric Programs...............................         34,237,000
    Mental and Behavioral Health.....................          9,916,000
Public Health Workforce Development..................         10,000,000
Nursing Workforce Development
    Advanced Education Nursing.......................         63,581,000
    Nursing Workforce Diversity......................         15,343,000
    Loan Repayment and Scholarship Program...........         81,785,000
    Nurse Education, Practice, and Retention.........         39,913,000
    Nurse Faculty Loan Program.......................         26,500,000
    Comprehensive Geriatric Education................          4,500,000
------------------------------------------------------------------------

Health Professions Training for Diversity

    Health Careers Opportunity Program.--The Health Careers 
Opportunity Program (HCOP) seeks to increase the diversity of 
the health professions workforce by providing grants that 
improve the recruitment and enhance the academic preparation of 
students from economically and educationally disadvantaged 
backgrounds into the health professions. Greater diversity 
among health professionals is associated with improved access 
to care for underserved populations, greater patient choice and 
satisfaction, and better patient-clinician communication. In 
recent academic years, the program has supported more than 260 
grants and more than 13,600 trainees annually, half of whom are 
underrepresented minorities and more than three quarters come 
from financially or educationally disadvantaged backgrounds. 
The Committee believes that the program as currently structured 
holds the greatest promise to reach high school, baccalaureate, 
post-baccalaureate, and graduate students to attract them to 
the health professions to care for underserved populations, in 
both rural and urban areas, as originally intended by Congress.
    The Committee is concerned with the ability to track 
outcomes for HCOP funding that is invested early in the 
pipeline. The Committee encourages HRSA to focus the program on 
high school, collegiate, and post-baccalaureate programs that 
impact the health care professional pipeline. The Committee 
directs HRSA to work with institutions that have historically 
performed well in producing minority and underrepresented 
health professionals in order to devise a more accurate way to 
track HCOP students who ultimately become health professionals.

Primary Care Training and Enhancement

    Interprofessional Education.--The Committee is aware of a 
growing recognition that interprofessional clinical health 
programs represent the state of the art in health care. 
Further, the Committee believes inter-professional clinical 
care teams that include physicians, nurses and other 
disciplines (such as physician assistants, oral health 
practitioners, behavioral health professionals, allied health 
providers, other practitioners) can achieve better care, better 
population health and lower costs. Further, the Committee 
shares HRSA's viewpoint that health organizations and 
professionals should be trained for a contemporary practice 
environment focused on new and more efficient models of care 
that include interprofessional and team-based care. 
Accordingly, in carrying out the various workforce programs 
authorized by Title VII and VIII of the Public Health Service 
Act, and for which funding is provided in this bill, the 
Committee encourages the Bureau of Health Workforce to give 
preference to competitive applications that include an 
interprofessional education component in their programmatic 
activities.
    The Committee encourages the Administrator to research 
Physician Assistant (PA) educational innovation and 
effectiveness and track PA graduate practice patterns and 
health care outcomes when PAs are involved in team-based 
practice. It is vital that PA education and outcomes assessment 
be a part of efforts to address high priority health workforce 
needs.

Oral Health Training Programs

    The Committee recommends $34,998,000 for Training in Oral 
Health Care programs, which is $1,070,000 more than the fiscal 
year 2015 enacted level and the budget request. Within the 
funds provided, the Committee intends no less than $10,000,000 
for General Dentistry Programs and no less than $10,000,000 for 
Pediatric Dentistry programs. These programs serve to increase 
the number of medical graduates from minority and disadvantaged 
backgrounds and to encourage students and residents to choose 
primary care fields and practice in underserved urban and rural 
areas.
    The Committee urges HRSA to support innovative programs at 
new and established dental schools that will increase access to 
high quality dental services for underserved individuals, 
particularly where training clinics are located proximate to 
such underserved areas.

Area Health Education Centers (AHEC)

    The Committee encourages HRSA to support AHEC oral health 
projects that establish primary points of service and address 
the need to help patients find treatment outside of hospital 
emergency rooms. The Committee urges HRSA to work with State 
dental associations that have initiated programs to refer ER 
patients to dental networks.
    The Committee is pleased with the results of AHEC's efforts 
to improve access to healthcare in rural and underserved areas 
by increasing the number of primary healthcare professionals 
who practice in these areas. The Committee requests HRSA to 
provide an update on the AHEC program's impact to increase the 
primary healthcare workforce and the program's nationwide 
activities.

Mental and Behavioral Health

    The Committee recommendation includes $9,916,000 for the 
interprofessional Graduate Psychology Education Program to 
increase the number of health service psychologists (including 
doctoral-level clinical, counseling and school psychologists) 
trained to provide integrated services to high-need underserved 
populations in rural and urban communities. The Committee 
encourages HRSA to build on recent efforts to expand training 
to increase mental and behavioral health services for returning 
service members, veterans and their families, with a strong 
emphasis on veterans reintegrating into rural civilian 
communities. Recognizing the growing need for highly trained 
mental and behavioral health professionals to deliver evidence-
based services to the rapidly aging population, the Committee 
encourages HRSA to invest in geropsychology training programs 
and to help integrate health service psychology trainees at 
Federally Qualified Health Centers.

Children's Hospitals Graduate Medical Education Payment Program

    The Committee recommends $265,000,000 for the Children's 
Hospitals Graduate Medical Education Payment Program, which is 
the same as the fiscal year 2015 enacted level and $165,000,000 
more than the budget request.

National Practitioner Data Bank

    The Committee assumes $19,728,000 for the National 
Practitioner Data Bank for fiscal year 2016, which is $914,000 
more than the fiscal year 2015 enacted level and the same as 
the budget request. The Committee recommendation and the budget 
request assumes that the data bank will be self-supporting with 
collections of $19,728,000 in user fees. Bill language is 
continued to ensure that user fees are collected to cover the 
full costs of the data bank operations.

                       MATERNAL AND CHILD HEALTH

Maternal and Child Health Block Grant

    The Committee recommends $638,200,000 for the Maternal and 
Child Health (MCH) Block Grant, which is $1,200,000 more than 
the 2015 enacted level and the budget request. States use the 
MCH block grant to improve access to care for mothers, 
children, and their families; reduce infant mortality; provide 
pre- and post-natal care; support screening and health 
assessments for children; and provide systems of care for 
children with special health care needs.
    The Committee continues bill language identifying specific 
amounts for Special Projects of Regional and National 
Significance (SPRANS). The Committee intends that the following 
amounts be provided within SPRANS:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Set-aside for oral health............................         $5,000,000
Set-aside for epilepsy...............................          3,642,000
Set-aside for sickle cell disease....................          2,961,000
Set-aside for fetal alcohol syndrome demo............            477,000
------------------------------------------------------------------------

    Dental Health Projects.--The Committee recommends 
$5,000,000 to encourage HRSA to support early childhood oral 
health interventions and prevention programs encompassing the 
medical/dental interface, topical fluorides, school and 
community-based sealant programs, and systems working in 
collaboration with the Women, Infants, and Children (WIC) and 
Head Start programs.
    Fetal Alcohol Syndrome.--The Committee recommends that the 
fetal alcohol syndrome initiative within HRSA address high-risk 
Alaska Native and American Indian populations through a Native 
American-focused collaborative.

Maternal and Child Health Programs

    In addition to the Maternal and Child Health Block Grant, 
the Maternal and Child Health Bureau at HRSA supports several 
programs to improve the health of all mothers, children, and 
their families. These programs support activities that develop 
systemic mechanisms for the prevention and treatment of sickle 
cell disease; provide information and research on and promote 
screening of autism and other developmental disorders; provide 
newborn and child screening of heritable disorders; provide 
grants to reduce infant mortality and improve perinatal 
outcomes; fund States to conduct newborn hearing screening; and 
provide grants to improve existing emergency medical services.
    Within the total for Maternal and Child Health Programs, 
the Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Sickle Cell Anemia Demonstration Program.............         $4,455,000
Autism and other Developmental Disorders.............         47,099,000
Heritable Disorders..................................         13,883,000
Healthy Start........................................        102,000,000
Universal Newborn Hearing............................         17,818,000
Emergency Medical Services for Children..............         20,162,000
------------------------------------------------------------------------

Traumatic Brain Injury

    The Committee has transferred management of the Traumatic 
Brain Injury program to the Administration for Community Living 
(ACL) in recognition of the existence of complimentary programs 
within ACL that the TBI program can leverage the resources of 
and collaborate with.

Autism and other Developmental Disorders

    The Committee recognizes the importance of enhancing the 
capacity of existing autism and other developmental 
disabilities programs and expanding the number of sites and 
professionals trained to diagnose, treat, and provide 
interventions to individuals with autism spectrum disorders 
(ASD). Within the total for Autism and Other Developmental 
Disabilities, the Committee provides $30,043,000 for the 
Leadership Education in Neurodevelopmental and Related 
Disabilities (LEND) program to allow the existing programs to 
maintain their current capacity and expand the number of sites 
and professionals trained to diagnose, treat, and provide 
interventions to individuals with ASD and related developmental 
disabilities. The increased funding should be used to initiate 
LEND programs in States that do not currently have an 
established program, yet have a high incidence rate of ASD, to 
ensure children with ASD and related developmental disabilities 
across the country have access to the valuable resources that 
LEND programs provide.

Heritable Disorders

    The Committee recommends $13,883,000 for the Heritable 
Disorders program, which is the same as the fiscal year 2015 
enacted level and the budget request.
    Newborn Screening for SCID and Related Disorders.--The 
Committee provides level funding to assure that States are able 
to adopt newborn screening for Severe Combined Immune 
Deficiency (SCID) and related disorders. The grantee may also 
use funding to update and disseminate educational materials, 
enhance public awareness of Primary Immunodeficiencies, train 
healthcare and public health professionals, support specialized 
treatment centers accepting newly-diagnosed patients, support 
patient access to specialized treatment centers and expand the 
current newborn screening test to include complex mutations 
causing related life-threatening diseases.

Healthy Start

    The Committee recommends $102,000,000 for the Healthy Start 
program, which is the same as the fiscal year 2015 enacted 
level as well as the budget request. The program provides 
discretionary grants to communities with high rates of infant 
mortality to support primary and preventive health care 
services for mothers and their infants.
    Fetal Infant Mortality Review.--The Fetal Infant Mortality 
Review (FIMR) program is an important component of many Healthy 
Start Initiatives and providing evidence-based interventions 
are crucial to improving infant health in high risk 
communities. HRSA is encouraged to continue to support the FIMR 
program with Healthy Start funding while educating Healthy 
Start Programs on the successes of the FIMR.
    Transfer from Planned Home Birth to Hospital.--The 
Committee is aware that CDC data shows the rates for out of 
hospital births in the United States have been slowly but 
steadily increasing since 2004, and that because of this trend, 
collaboration within an integrated maternity care system is 
essential for optimal mother-baby outcomes. The Committee 
believes that all women and families planning a home or birth 
center birth have a right to respectful, safe, and seamless 
consultation, referral, transport and transfer of care when 
necessary. Therefore the Committee directs HRSA to develop a 
strategy for facilitating ongoing inter-professional dialogue 
and cooperation, and encouraging universal adoption of the Best 
Practice Guidelines for Transfer from Planned Home Birth to 
Hospital, in order to achieve optimal mother-baby outcomes in 
all settings and with all providers, and to report back to this 
Committee with an update on its progress.

Maternal, Infant, and Early Childhood Home Visiting Program

    The Committee encourages HRSA and the Administration for 
Children and Families to continue their collaboration and 
partnerships to improve health and development outcomes for 
at--risk pregnant women, parents, and young children through 
evidence-based home visiting programs.

                      RYAN WHITE HIV/AIDS PROGRAMS

    The Committee recommends $2,318,781,000 for Ryan White HIV/
AIDS Programs, which is the same as the fiscal year 2015 
enacted level and $4,000,000 below the budget request.
    The Ryan White HIV/AIDS programs fund activities to address 
the care and treatment of persons living with HIV/AIDS who are 
either uninsured or underinsured and need assistance to obtain 
treatment. The program provides grants to States and eligible 
metropolitan areas to improve the quality, availability, and 
coordination of health care and support services to include 
access to HIV-related medications; grants to service providers 
for early intervention outpatient services; grants to 
organizations to provide care to HIV infected women, infants, 
children, and youth; and grants to organizations to support the 
education and training of health care providers.
    Within the total for Ryan White HIV/AIDS Programs, the 
Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Emergency Assistance.................................       $655,876,000
Comprehensive Care Programs..........................      1,315,005,000
    AIDS Drug Assistance Program (ADAP)..............      (900,313,000)
Early Intervention Program...........................        201,079,000
Children, Youth, Women, and Families.................         75,008,000
AIDS Dental Services.................................         13,122,000
Education and Training Centers.......................         33,611,000
------------------------------------------------------------------------

                          HEALTH CARE SYSTEMS

    The Committee recommends $106,193,000 for Health Care 
Systems, which is $3,000,000 more than the fiscal year 2015 
enacted level and $4,000,000 below the budget request.
    The programs within Health Care Systems support national 
activities that enhance health care delivery in the United 
States. Activities include maintaining a national system to 
allocate and distribute donor organs to individuals awaiting 
transplant; building an inventory of cord blood units; 
maintaining a national system for the recruitment of bone 
marrow donors; operating the 340B drug discount system; and 
operating a national toll-free poison control hotline.
    Within the total for Health Care Systems, the Committee 
recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Organ Transplantation................................        $23,549,000
National Cord Blood Inventory........................         11,266,000
Cell Transplantation Program.........................         22,109,000
Office of Pharmacy Affairs...........................         10,238,000
Poison Control.......................................         21,846,000
National Hansen's Disease Program....................         15,206,000
National Hansen's Disease--Buildings/Facilities......            122,000
Hansen's Payment to Hawaii...........................          1,857,000
------------------------------------------------------------------------

    The Committee is aware of the current insufficient rate of 
organ donation to meet nationwide need. Further, the Committee 
is concerned that in some circumstances there is significant 
regional disparity in donation volume. The Committee urges the 
Secretary to allocate resources toward increasing the organ 
donor pool and coordinate efforts by the Organ Procurement and 
Transplantation Network and the Centers for Medicare and 
Medicaid Services in regions with disproportionately low 
numbers of organ donors. The Committee directs the Secretary to 
establish a coordinated initiative to increase the number of 
donated organs successfully procured and transplanted 
throughout the United States. The Committee requests a report 
not later than 90 days after enactment regarding the 
Department's effort to increased the number of organ donors in 
the United States.

Office of Pharmacy Affairs

    The Committee recommends $10,238,000 for the Office of 
Pharmacy Affairs, which is the same as the fiscal year 2015 
enacted level and is $14,500,000 below the budget request.
    The Committee urges OPA to complete the development of the 
secure website intended to verify 340B ceiling prices. The 
Committee directs OPA to provide a briefing within 30 days of 
enactment on the progress made to make the secure website 
available.

Poison Control Centers

    The Committee recommends $21,846,000 for Poison Control 
Centers, which is $3,000,000 more than the fiscal year 2015 
enacted level and the budget request. In 2012 more than 3.3 
million poisoning, toxic exposure, drug, food safety and public 
health emergency calls were managed by the nation's 55 
accredited poison centers an average of more than 9,000 calls 
per day. Multiple studies have demonstrated that accurate 
assessment and triage of poisoning, drug and toxic exposures by 
the nation's poison centers save critical healthcare dollars by 
reducing the severity of illness, preventing deaths and 
avoiding the expense of unnecessary trips to emergency 
departments and the length of hospital stays. HRSA reports that 
utilization of poison centers by hospitals and health care 
professionals continues to increase as the severity and 
complexity of poisonings and toxic exposures require the need 
for increased toxicological expertise in clinical settings. It 
is estimated that every dollar invested in the national poison 
center program saves $13.39 in medical costs and lost 
productivity, thus generating annual cost savings exceeding 
$1.8 billion.

                              RURAL HEALTH

    The Committee recommends $147,471,000 for Rural Health 
programs, which is the same as the fiscal year 2015 enacted 
level and $19,909,000 more than the budget request.
    Rural Health programs provide funding to improve access, 
quality, and coordination of care in rural communities; for 
research on rural health issues; for the purchase of automatic 
external defibrillators; for technical assistance and 
recruitment of health care providers; for screening activities 
for individuals affected by the mining, transport, and 
processing of uranium; for the outreach and treatment of coal 
miners and others with occupation-related respiratory and 
pulmonary impairments; and for the expansion of telehealth 
services.
    Within the total for Rural Health activities, the Committee 
recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2016 Committee
------------------------------------------------------------------------
Rural Outreach Programs..............................        $59,000,000
Rural Health Research................................          9,351,000
Rural Hospital Flexibility Grants....................         41,609,000
Rural/Community Access to Emergency Devices..........          4,500,000
State Offices of Rural Health........................          9,511,000
Black Lung Clinics...................................          6,766,000
Radiation Exposure Screening and Education...........          1,834,000
Telehealth...........................................         14,900,000
------------------------------------------------------------------------

                            FAMILY PLANNING

    The Committee does not recommend funding for the Family 
Planning program, which is $286,479,000 below the fiscal year 
2015 enacted level and $300,000,000 below the request.

                           PROGRAM MANAGEMENT

    The Committee recommends $154,000,000 for the cost of 
federal staff and related activities to coordinate, direct, and 
manage the programs of HRSA, which is the same as the fiscal 
year 2015 enacted level and $3,061,000 below the budget 
request.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

    The Committee estimates that $237,000,000 will be released 
from the Vaccine Injury Compensation Trust Fund, which is 
$2,000,000 more than the fiscal year 2015 enacted level and the 
same as the budget request.
    The National Vaccine Injury Compensation Program provides a 
system of compensation for individuals with vaccine-associated 
injuries or deaths. Funds for claims from vaccines administered 
on or after October 1, 1988 are generated by a per-dose excise 
tax on the sale of selected prescribed vaccines. Revenues 
raised by this tax are maintained in a Vaccine Injury 
Compensation Trust Fund.
    Trust funds made available will support the liability costs 
of vaccines administered after September 30, 1988. They will 
also support the $7,500,000 in costs incurred by HRSA in the 
operation of the program, which is the same as the fiscal year 
2015 enacted funding level and the budget request.

              Centers for Disease, Control and Prevention

    The Committee recommends a program level of $7,010,103,000 
for the Centers for Disease Control and Prevention (CDC), which 
is $139,685,000 more than the fiscal year 2015 program level 
and equal to the budget request. The level includes 
$6,095,803,000 in discretionary appropriated dollars in 
conjunction with $914,300,000 in transfers from the Prevention 
and Public Health (PPH) Fund.
    The CDC works with state, local and tribal health 
authorities and other non-governmental health-related 
organizations to understand, control, and reduce disease and 
other health problems.
    The Committee recommendation increases support to state, 
local, and tribal public health departments in disease areas 
like Diabetes, Heart Disease and Stroke prevention activity and 
furthers efforts to reduce prescription drug overdose. The 
recommendation expands funding to build state, local, and 
tribal preparedness and response capacity through increased 
support for the public health preparedness infrastructure. It 
also provides support to expand state laboratory capacity to 
combat antibiotic resistance and other infectious diseases and 
supports flexible funds for states to address local and tribal 
public health issues through the preventative health and health 
services block grant. Globally, the recommendation continues 
support for the global polio eradication program and global 
public health activities.
    The Committee expects that unless provided for differently 
in the bill or report, CDC will follow the policy, funding 
source, and levels described in its budget request.
    The Committee expects CDC to communicate more clearly in 
the fiscal year 2017 budget request on how all its lab capacity 
upgrades and AMD initiatives are linked to measurable 
improvements in public health and preparedness.
    The Committee understands that due to the timing of the 
release of the budget request, CDC did not include certain 
information requested in the fiscal year 2015 report. 
Specifically, the public health and preparedness goals and 
measures for each CDC report level program line, grant table 
data, and other similar items were omitted. The Committee 
expects this information to be transmitted as soon as possible.
    The Committee reinforces its expectation for CDC to work 
with state, local and tribal health officials to move forward 
with the plan for a single web-based data collection 
information technology platform for CDC programs to reduce the 
voluntary reporting burden on states and reduce CDC's total 
operational costs of its independent program data collection 
actions.
    The Committee remains interested in reducing duplication of 
effort and overlapping of responsibilities between NIH and CDC. 
The Committee encourages CDC and NIH to more actively 
coordinate on cross-cutting initiatives, ensuring that each 
agencies focuses on its respective core mission. Further the 
Committee requests an update in the fiscal year 2017 budget 
request on how each CDC report level program coordinates with 
the NIH Institutes and Centers (ICs) to share scientific gaps 
related to activities supported in NIH research portfolios.

                 IMMUNIZATION AND RESPIRATORY DISEASES

    The Committee recommends $758,066,000 for Immunization and 
Respiratory Diseases, which includes $607,781,000 in 
discretionary appropriations, and $150,285,000 in transfers 
from the PPH Fund. The level is $40,339,000 less than the 
fiscal year 2015 program level and $10,000,000 more than the 
budget request program level.
    Immunization grants are awarded to states and local 
agencies for planning, developing, and conducting childhood, 
adolescent, and adult immunization programs including 
enhancement of the vaccine delivery infrastructure. CDC 
directly maintains a stockpile of vaccines, supports 
consolidated purchase of vaccines for State and local health 
agencies, and conducts surveillance, investigations, and 
research into the safety and efficacy of new and presently used 
vaccines.
    Within the total for Immunization and Respiratory Diseases, 
the Committee recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Section 317 Immunization Program.....................       $585,508,000
    National Immunization Survey.....................         12,864,000
Influenza Planning & Response........................        172,558,000
------------------------------------------------------------------------

    Childhood Immunizations.--The Committee requests CDC to 
include an updated Section 317 Immunization Program report in 
the fiscal year 2017 budget request. The update should include 
the 2017 cost estimate, an estimate of State, local, and tribal 
operations funding, as well as a discussion of the evolving 
role of the 317 program as expanded coverage for vaccination 
becomes available from private and public sources over the next 
several years. The Committee includes a $25,000,000 increase 
specifically to support the essential infrastructure funding 
for the state, local, and tribal public health departments to 
deliver the Vaccines for Children program and respond to 
disease outbreaks. A strong public health immunization 
infrastructure is critical for ensuring high vaccination 
coverage levels, the prevention of vaccine-preventable 
diseases, and for responding to outbreaks.

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

    The Committee recommends $1,117,609,000 for HIV/AIDS, Viral 
Hepatitis, Sexually Transmitted Diseases (STD), and 
Tuberculosis (TB) prevention in discretionary appropriations, 
which is equal to the fiscal year 2015 level and $44,138,000 
less than the budget request.
    The Division of HIV/AIDS Prevention provides national 
leadership and support for HIV prevention research and the 
development, implementation, and evaluation of evidence-based 
HIV prevention programs serving persons affected by, or at risk 
for, HIV infection. Activities include surveillance, 
epidemiologic and laboratory studies, and prevention 
activities. CDC provides funds to state, local and tribal 
health departments and community-based organizations to develop 
and implement integrated community prevention plans.
    Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB 
Prevention, the Committee recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............       $786,712,000
    HIV Prevention by Health Departments.............        397,161,000
    HIV Surveillance.................................        119,861,000
    Activities to Improve Program Effectiveness......        103,208,000
    National, Regional, Local, Community, and Other          135,401,000
     Orgs............................................
    School Health-HIV................................         31,081,000
Viral Hepatitis......................................         31,331,000
Sexually Transmitted Diseases........................        157,310,000
Tuberculosis.........................................        142,256,000
------------------------------------------------------------------------

    Hepatitis C (HCV) Screening.--The Committee commends CDC 
for working to integrate recommended viral hepatitis screening 
in primary care provider services. The Committee urges CDC to 
continue outreach to underserved populations through screening 
activities in non-clinical and public health settings.
    HIV Prevention Activities.--The Committee understands most 
CDC HIV prevention funding is distributed to the primary 
implementers of prevention activities. The Committee requests 
CDC to evaluate its prevention program funding to determine if 
the current mix successfully reaches the most at-risk 
individuals to best ensure early detection with targeted 
interventions. Further, the review should examine methods, with 
available total HIV funding, to increase the reliance on state, 
local, and tribal public health departments and efforts to 
increase the use of burden of disease as a significant criteria 
factor in making funding allocation decisions and awards. The 
Committee requests an update on this review in the fiscal year 
2017 budget request.
    HIV Screening.--The Committee is aware of concerns related 
to CDC's draft HIV screening algorithms that would limit 
antibody testing. The Committee commends CDC for leading the 
early adoption of advancements in HIV prevention technology but 
cautions CDC to encourage access to a variety of FDA-approved 
screening options including antibody, antigen, oral fluid, and 
rapid testing technologies to facilitate screening in all 
settings. Further, the Committee continues to support HIV 
status awareness. CDC is encouraged to work with States that 
scored low on the goals to Increase HIV Testing and Reduce Late 
State Diagnosis in order to improve the rates of persons with 
HIV that know their status and are enabled to seek appropriate 
care and prevent transmission.
    Tuberculosis (TB) Elimination.--The Committee notes that in 
1987, HHS established an Advisory Committee for the Elimination 
of TB with a goal of TB elimination by the 2010. The Committee 
requests CDC to review its resource allocation in preparation 
for the fiscal year 2017 budget request to ensure it supports 
appropriate control that can eventually eliminate TB in the 
United States. Further, the Committee requests an update in the 
fiscal year 2017 budget request on how CDC's TB program directs 
resources to state, local, and tribal public health departments 
to provide for adequate diagnostic, treatment and prevention 
education tools. The update should outline the plan and how the 
resources in the request will accomplish the goal.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

    The Committee recommends $512,598,000 for Emerging and 
Zoonotic Infectious Diseases, which includes $460,598,000 in 
discretionary appropriations and $52,000,000 that is made 
available from amounts in the PPH Fund. The level is which is 
$107,608,000 more than the fiscal year 2015 program level and 
$186,669,000 less than the budget request program level.
    The Emerging and Zoonotic Infectious Disease programs 
support the prevention and control of infectious diseases 
through surveillance, outbreak investigation and response, 
research, and prevention.
    Within the total for Emerging and Zoonotic Infectious 
Diseases, the Committee recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Core Infectious Diseases.............................       $334,598,000
    Emerging Infectious Diseases.....................        136,248,000
        Lab Safety and Quality (non add).............          8,248,000
    Antibiotic Resistance Initiative.................        120,000,000
    Emerging and Zoonotic Core Activities............         29,840,000
    Vector-borne Diseases............................         26,410,000
    Lyme Disease.....................................         10,700,000
    Prion Disease....................................          6,000,000
    Chronic Fatigue Syndrome.........................          5,400,000
Food Safety..........................................         48,000,000
National HealthCare Safety Network...................         18,000,000
Quarantine...........................................         30,000,000
Advanced Molecular Detection (AMD)...................         30,000,000
Epi and Lab Capacity.................................         40,000,000
Healthcare-Associated Infections.....................         12,000,000
------------------------------------------------------------------------

    Antimicrobial Resistance.--The Committee expands its 
support for CDC to enhance the regional lab network to improve 
tracking of and response to outbreaks. The Committee expects a 
significant level of support for the state and regional lab 
capacity and intends for funds to support programs with 
measurable goals and objectives that will be reported annually 
in the budget request for this program. Further, CDC is 
expected to support states to use evidence based approaches to 
stop the spread of drug-resistant bacteria and preserve 
existing antibiotics.
    Guideline for Disinfection and Sterilization in Healthcare 
Facilities.--The Committee is concerned that according to the 
CDC 2014 National and State Healthcare-Associated Infections 
Progress Report, the U.S. did not meet the healthcare-
associated infection (HAI) prevention goals for 2013. The 
Committee requests that within 120 days, CDC shall update its 
2008 Guideline for Disinfection and Sterilization in Healthcare 
Facilities to incorporate more recent peer-reviewed literature 
regarding the role of the healthcare environment in the spread 
of antibiotic-resistant bacteria and the current best practices 
for containment that have been demonstrated in health facility 
environments. The Committee understands new technologies now 
exist that were not considered when the guidelines were last 
updated.
    Hand Hygiene.--The Committee encourages CDC to improve hand 
hygiene habits to help prevent the spread of germs and 
infectious disease. The Committee requests an update in the 
fiscal year 2017 budget request on how CDC has incorporated the 
use of hand sanitizers, including Alcohol Based Hand Rubs 
(ABHRs), into its hand hygiene programs when hand washing is 
not readably accessible.
    Laboratories.--CDC provides funding for State and Regional 
laboratories across numerous centers, programs, and initiatives 
to support, increase, enhance, or modernize laboratory 
capacity. To streamline the funding and reduce potential 
duplication, the Committee directs CDC to consolidate all its 
State and Regional laboratory funding sources into a single 
funding line in one CDC Center in the fiscal year 2017 budget 
request and include a CDC-wide consolidated plan with 
measurable goals and objectives on how CDC leverages State and 
Regional laboratory support and capacity across all CDC 
programs, initiatives, and activities.
    Laboratory Training.--The Committee includes support to 
enhance CDC's internal laboratory management and training to 
improve laboratory safety at CDC laboratories. The Committee 
requests an update in the fiscal year 2017 budget request on 
the progress made to create and routinely review standard 
operating procedures, laboratory safety, and laboratory worker 
training.
    Lyme Disease.--The Committee encourages CDC to consider 
expanding activities related to developing sensitive and more 
accurate diagnostic tools and tests for Lyme disease, including 
evaluating emerging diagnostic methods and improving the 
utilization of adequate diagnostic testing; expanding its 
epidemiological research to determine the frequency and nature 
of the long-term complications of Lyme disease; improving 
surveillance and reporting of Lyme disease to produce more 
accurate data on its incidence; and evaluating the development 
of a national reporting system.
    Valley Fever.--The Committee commends NIH and CDC on the 
continued joint efforts to combat coccidioidomycosis, also 
known as Valley Fever. Specifically, the Committee supports 
ongoing efforts by NIH and CDC to conduct a Randomized 
Controlled Trial (RCT) to identify an effective treatment for 
Valley Fever, encourage development of a vaccine, and help 
increase awareness of this disease among medical professionals 
and the public. The Committee looks forward to when patients 
can begin enrolling in the RCT later this year.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

    The Committee recommends $1,097,482,000 for Chronic Disease 
Prevention and Health Promotion, which includes $570,467,000 in 
discretionary appropriations and $527,015,000 that is made 
available from amounts in the PPH Fund. The level is 
$101,738,000 less than the fiscal year 2015 program level and 
$39,424,000 more than the budget request program level.
    The programs funded through this budget activity provide 
support for State and community programs, surveillance, 
prevention research, evaluation, and health promotion.
    Within the total provided, the Committee recommends the 
following amounts for Chronic Disease Prevention and Health 
Promotion activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Tobacco..............................................       $105,492,000
Nutrition, Physical Activity, and Obesity............         49,920,000
    High Obesity Rate Counties.......................         10,000,000
School Health........................................         15,400,000
Health Promotion.....................................         20,275,000
    Community Health Promotion.......................          6,350,000
    Glaucoma.........................................          3,300,000
    Visual Screening Education.......................            525,000
    Alzheimer's Disease..............................          3,500,000
    Inflammatory Bowel Disease.......................            750,000
    Interstitial Cystitis............................            750,000
    Excessive Alcohol Use............................          3,000,000
    Chronic Kidney Disease...........................          2,100,000
Prevention Research Centers..........................         24,000,000
Heart Disease and Stroke.............................        170,000,000
Diabetes.............................................        180,000,000
National Diabetes Prevention Program.................         20,000,000
Cancer Prevention and Control........................        348,895,000
    Breast and Cervical Cancer.......................        207,000,000
        WISEWOMAN....................................         21,120,000
    Breast Cancer Awareness for Young Women..........          4,960,000
    Cancer Registries................................         49,440,000
    Colorectal Cancer................................         39,515,000
    Comprehensive Cancer.............................         19,675,000
    Johanna's Law....................................          5,500,000
    Ovarian Cancer...................................          7,000,000
    Prostate Cancer..................................         13,205,000
    Skin Cancer......................................          2,125,000
    Cancer Survivorship Resource Center..............            475,000
Oral Health..........................................         20,000,000
Safe Motherhood/Infant Health........................         46,000,000
    Preterm Birth....................................          2,000,000
Other Chronic Diseases...............................         24,000,000
    Arthritis........................................         10,000,000
    Epilepsy.........................................          8,000,000
    National Lupus Patient Registry..................          6,000,000
Racial and Ethnic Approach to Community Health.......         50,000,000
Million Hearts.......................................          4,000,000
Workplace Wellness...................................          7,500,000
National Early Child Care Collaboratives.............          4,000,000
Hospitals Promoting Breastfeeding....................          8,000,000
------------------------------------------------------------------------

    Burden of Disease.--The Committee expects CDC to use the 
burden of disease (age-adjusted population) as a significant 
criteria for activities funded through the Chronic Disease 
programs and to ensure applicants identify the expected level 
of community burden reductions, tracked, and reported.
    Cardiomyopathy.--The Committee understands the risk of 
sudden cardiac arrest is highest among those with undiagnosed 
cardiomyopathy. The Committee continues support to increase 
awareness through appropriate public health mechanisms and 
encourages CDC to consider methods to increase support. The 
Committee requests an update in the fiscal year 2017 budget 
request on on-going and planned activities related to pediatric 
cardiomyopathy.
    Community Prevention Grants.--No funds are provided to 
support the Community Prevention Grants. The Committee 
recognizes the program supported chronic disease risk factors 
funded by other Chronic Disease program lines. To lessen 
community disruption during program wind down, the Committee 
encourages fiscal year 2016 continuation costs of current 
cities, counties, and tribal grantees shift to the specific 
Chronic Disease program lines, as long as CDC deems these one-
time funding activities within the existing program's goals and 
scope of activity.
    Division of Diabetes Translation (DDT).--The Committee 
recognizes the work of the DDT to address diabetes. The 
Committee supports efforts to work with public and private 
organizations to prevent and reduce the occurrence of diabetes 
in Americans. The Committee reinforces its desire for CDC to 
use burden of disease as a significant criteria in awarding 
funds. The Committee urges significant resources be put toward 
DDT's efforts to expand state, local, and tribal community 
diabetes control and prevention activities. The Committee 
believes these activities must include clear outcomes, ensure 
transparency and accountability that demonstrate how funding is 
expected to be used, were used, and tracked to ensure 
prevention funding reached state, local, and tribal communities 
with the greatest population adjusted burden.
    Division of Oral Health (DOH).--The Committee provides the 
DOH support for enhancements to the State oral health 
infrastructure grants, national surveillance activities and 
community prevention programs. The Committee is aware that 20 
States were approved but unfunded in the last State 
infrastructure grant cycle. The Committee expects DOH to 
support clinical and public health interventions that target 
pregnant women and young children at highest risk for dental 
caries. A recent study demonstrates such approaches can result 
in cost-savings to State Medicaid programs. We further 
encourage CDC to work across HHS to improve the coordination of 
oral health surveillance in a manner that reliably measures and 
reports health outcomes.
    Diabetes.--The Committee understands that Diabetes is now 
the seventh leading cause of death and overall, the risk for 
death among people with diabetes is about twice that of people 
of similar age but without diabetes. Research has shown 
targeted interventions for modest lifestyle changes in people 
at highest risk can prevent or delay the onset of type 2 
diabetes. For example, lifestyle interventions of losing weight 
and increasing physical activity reduced the development of 
type 2 diabetes by 58%, and by 71% among adults aged 60 years 
or older. Local communities are a catalyst for diabetes 
evidence-based health education, self-management prevention and 
awareness. The Committee provided a significant increase for 
Diabetes prevention and control activities. The Committee 
expects support to target communities with the highest burden 
of disease, as adjusted for population, and to use risk factor 
reduction measures. The Committee requests a report in the 
fiscal year 2017 budget request on how the amount of funds 
provided to state, local, and tribal communities with the 
highest burden.
    Heart Disease and Stroke.--The Committee understands heart 
disease and stroke are the first and fifth leading causes of 
death in the United States. Each year nearly 800,000 people die 
in the U.S. from cardiovascular diseases while 795,000 
experience a stroke. In addition to the human suffering, the 
cost on the health care system is excessive: some data 
indicates that in 2011 the total direct and indirect cost for 
cardiovascular disease and stroke in the United States was over 
$320 billion. However, heart disease and stoke are preventable 
in many cases due to risk factors such as high blood pressure 
and high LDL cholesterol. Local health departments serve as a 
catalyst for effective evidence-based approaches in their 
communities for heart disease and stroke prevention and 
awareness. The Committee provided a significant increase to 
support Heart Disease and Stroke prevention at state, local and 
tribal public health departments. The Committee expects support 
to target communities with the highest burden of disease, as 
adjusted for population, and use risk factor reductions 
measures. The Committee requests a report in the fiscal year 
2017 budget request on how the amount of funds provided to 
state, local, and tribal community with the highest burden.
    Tobacco Prevention.--The Committee notes CDC supports 
tobacco use and prevention activities throughout numerous 
programs like the Prevention Research Centers and Chronic 
Disease Prevention activities. The Committee provides funding 
in the tobacco line to primarily focus on underage smoking. 
Further, CDC is directed to consolidate and reduce duplication 
with other tobacco prevention programs and activities. The 
Committee does not provide support for CDC's tobacco research 
activity. The NIH has an existing tobacco research portfolio 
that in fiscal year 2015 is estimated at $322,000,000. The CDC 
shall coordinate with NIH to identify meritorious tobacco 
research opportunities for NIH to consider through its peer-
reviewed process and its existing portfolio funding level. The 
Committee requests an analysis in the fiscal year 2017 budget 
request identifying all the CDC programs that provide any 
funding for tobacco control or prevention activities with the 
name of the program and annual tobacco related funding level.
    Inflammatory Bowel Disease.--The Committee continues to 
support inflammatory bowel disease epidemiology activity and 
requests an update in the fiscal year 2017 budget request on 
these efforts. Further, the Committee encourages CDC to 
continue exploring the disease burden and communicate findings 
to patients and providers in an effort to improve and inform 
best public health practices.
    National Lupus Patient Registry (NLPR).--The Committee 
continues to support the NLRP efforts. The Committee expects 
CDC to coordinate with NIH to explore new or revised research 
methods to conduct cohort and burden of illness studies.
    National Early Childcare Collaboratives (NECC).--The 
Committee continues to support the collaboratives to assist 
early care and education providers.
    National Diabetes Prevention Program (NDPP).--The Committee 
understands the NDPP grantees, such as the YMCA, have leveraged 
NDPP support to expand the program to other communities. For 
example, the YMCA was awarded a nearly $12,000,000 grant over 
three years from the Center for Medicare and Medicaid to expand 
the program to 17 communities in an effort to reduce Medicare 
costs. The Committee significantly increased support for the 
NDPP and expects CDC to continue to encourage awardees to 
leverage these funds with more collaboration among federal 
agencies, community-based organizations, employers, insurers, 
health care professionals, academia, and other stakeholders. 
The Committee expects CDC to provide all increased funds 
through competitive process and that funds not be used to 
support internal CDC functions. The Committee appreciates that 
CDC has ensured the fidelity of the original Diabetes 
Prevention Program clinical trial through its NDPP by utilizing 
the evidence-based curricula and having program providers 
report on participant attendance and observed and measured 
weight loss. The Committee directs CDC to continue to ensure 
accurate results through observed weight measurement. 
Reliability of this data is critical to ensuring the confidence 
of various third-party payers. The Committee requests CDC to 
include long-term public health measures, how this program 
coordinates with other CDC and HHS programs, and the total 
amount of federal, public and private sector funds leveraged to 
support the NDDP annually in the fiscal year 2017 and future 
budget requests.
    Obesity.--The Committee expands support for the rural 
extension and outreach services program to support additional 
grants for rural counties with an obesity prevalence of over 40 
percent. The Committee expects CDC to support childhood obesity 
interventions that are supported by scientific evidence and 
work with state, local and tribal public health departments to 
support measurable outcomes through evidenced based obesity 
research, intervention, and prevention programs. The program 
should include a special focus on areas with the highest 
population adjusted burden of obesity and with co-morbidities 
like hypertension, cardiac disease and diabetes.
    Pulmonary Hypertension (PH).--The Committee understands 
some PH patients are not diagnosed until the late stages of the 
disease. The Committee encourages CDC to work with providers to 
increase early diagnosis and awareness of the disease and 
requests an update in the fiscal year 2017 budget request on 
steps taken to increase provider awareness of early 
intervention education.
    Scleroderma.--The Committee encourages CDC efforts to 
improve awareness and education of rare and potentially life-
threatening conditions, like scleroderma.
    Sleep Disorders.--The Committee is aware of CDC's recent 
public health awareness work on sleep disorders and requests an 
update on these activities. The Committee encourages CDC to 
review the value of a national public health awareness campaign 
on sleep.
    Special Interest Projects (SIPs).--The Explanatory 
Statement to accompany the fiscal year 2015 Appropriations Act 
directed CDC to ensure funds used to support SIPs be 
competitively awarded through an open process that is available 
to all qualified entities. The Committee remains concerned that 
SIP funds made available through the Prevention Research 
Centers are not being competed from all qualified entities. The 
Committee requests the Government Accountability Office (GAO) 
to review the CDC Prevention Research Center SIPs in its yearly 
report and identify duplication in work between Federal 
agencies to consider if CDC has taken steps to fully revise its 
process to ensure open competition. GAO should also examine 
whether any of these programs represent duplication with other 
CDC or federal agencies/programs engaged in the same activities 
or provide the same service to the same general beneficiaries. 
The Committee further asks GAO to determine if there is broad 
dissemination of applications for the CDC SIPs and whether full 
disclosure occurs annually on who has applied for the funds; 
what entities were awarded funds; and, descriptions of how the 
final funding decisions were determined.
    The Committee supports the CDC in continuing their 
important work on excessive drinking. However, the Committee 
notes the work on monitoring of youth exposure to alcohol 
advertising and the level of risk faced by youth from exposure 
to alcohol advertising as duplicative with work ongoing in 
other Federal agencies, specifically, the Federal Trade 
Commission (FTC) and the National Institutes of Health (NIH), 
which is currently funding an R01 on alcohol marketing and 
underage drinking. The FTC's March 2014 Report to Congress 
titled Self-Regulation in the Alcohol Industry was produced to 
address concerns about underage exposure to alcohol marketing.

              BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES

    The Committee recommends $133,510,000 for Birth Defects and 
Developmental Disabilities program level in discretionary 
appropriations, which is $1,729,000 more than the fiscal year 
2015 level and the budget request program level.
    This program collects, analyzes, and makes available data 
on the incidence and causes of birth defects and developmental 
disabilities.
    Within the total, the Committee recommends the following 
amounts for Birth Defects and Developmental Disabilities 
activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Child Health and Development.........................        $65,800,000
    Birth Defects....................................         19,900,000
        Fetal Death..................................            900,000
    Fetal Alcohol Syndrome...........................         11,000,000
    Folic Acid.......................................          3,150,000
    Infant Health....................................          8,650,000
    Autism...........................................         23,100,000
Health and Development for People with Disabilities..         52,910,000
    Disability & Health incl. Child Development......         20,250,000
    Tourette Syndrome................................          2,000,000
    Early Hearing Detection and Intervention.........         10,760,000
    Muscular Dystrophy...............................          6,000,000
    Attention Deficit Hyperactivity Disorder.........          1,900,000
    Fragile X........................................          2,000,000
    Spina Bifida.....................................          6,000,000
    Congenital Heart Failure.........................          4,000,000
Blood Disorders......................................         14,800,000
    Public Health Approach to Blood Disorders........          4,500,000
    Hemophilia Activities............................          3,500,000
    Hemophilia Treatment Centers.....................          4,800,000
    Thalassemia Blood Disorders......................          2,000,000
------------------------------------------------------------------------

    Duchenne Muscular Dystrophy (DMD).--The Committee notes the 
Muscular Dystrophy CARE Act was amended in the fall of 2014. 
The Committee requests an update in the fiscal year 2017 budget 
request that describes CDC's plans and timeframe to enhance its 
collection of surveillance data across all forms of muscular 
dystrophy and to develop updated care standards, including for 
adults with Duchenne and for other forms of muscular dystrophy.
    Duchenne Muscular Dystrophy (DMD) Newborn Screening.--The 
Committee understands a successful DMD newborn screening pilot 
exists. The Committee requests the Center to conduct a 
comprehensive review and provide an update in the fiscal year 
2017 budget request on how, if scientifically appropriate, CDC 
can encourage public/private organizations to expand or build 
on the existing model.
    Fetal Alcohol Syndrome (FAS).--The Committee includes 
increased resources to support an information clearinghouse, 
expansion of existing national community-based FAS networks, 
dissemination of evidence-based intervention strategies, and an 
Alaska Native/Native American-focused collaborative for FAS.
    Fragile X (FXD).--The Committee appreciates that CDC has 
recognized the public health impact of FXD and its efforts to 
identify and define this population. The Committee encourages 
CDC to coordinate with NIH and the FXD Clinical & Research 
Consortium. The Committee urges CDC to explore cross-divisional 
funding opportunities to accelerate data driven public health 
research to reduce the public health burden of both FXD and 
autism.
    Prenatal Screening.--The Committee notes that rapid 
scientific advances have brought cell free DNA non-invasive 
prenatal screening (NIPS) into prenatal care settings. As one 
of the fastest growing applications of genomic medicine, this 
test can generate confusion for patients and healthcare 
providers about the meaning of screening results. The Committee 
requests a report in the fiscal year 2017 budget request on how 
CDC and other HHS agencies ensure patients and providers 
understand the accuracy of and meaning of screening results and 
tested-for conditions; possible screening results and technical 
limits of screenings; appropriate follow-up and results 
communication. The report should also address CDC's role in the 
development of materials to support the informed consent and 
patient decision-making and how it is made available to 
providers and patients involved in the decision making. The 
Committee expects CDC to also describe how the federal 
government works with private organizations through public-
private partnerships on these issues.
    Specific Birth Defects.--The Committee appreciates that the 
Center's website provides information on a number of birth 
defects on the specific birth defects webpage. The Committee 
requests a report in the fiscal year 2017 budget request on the 
criteria to add new birth defects, as well as treatments, the 
target audience of the information, how often the information 
is updated, and how effectiveness of the information is 
measured and validated to ensure it is useful for parents and 
providers. Finally, the report should explain whether the 
Center is considering adding new conditions like persistent 
pulmonary hypertension of the newborn and autosomal recessive 
polycystic kidney disease to the list.
    Spina Bifida Program.--The Committee recognizes this 
complex birth defect affects a number of individuals. The 
Committee encourages CDC to coordinate with NIH on the 
identification of research gaps and data that is needed to 
improve prevention interventions.

                          ENVIRONMENTAL HEALTH

    The Committee recommends $160,580,000 for Environmental 
Health program level, which includes $145,580,000 in 
discretionary appropriations and $15,000,000 that is made 
available from amounts in the PPH Fund. The level is 
$18,824,000 less than the fiscal year 2015 level and 
$17,920,000 less than the budget request program level.
    The Environmental Health program focuses on preventing 
disability, disease, and death caused by environmental factors 
through laboratory and field research.
    Within the total, the Committee recommends the following 
amounts for Environmental Health activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Environmental Health Laboratory......................        $56,000,000
    Newborn Screening Quality Assurance Program......          8,300,000
    Newborn Screening/Severe Combined                          1,200,000
     Immunodeficiency (SCID) Diseases................
Environmental Health Activities......................         35,580,000
    Environmental Health Activities..................         17,580,000
    Safe Water.......................................          8,000,000
    Amyotrophic Lateral Sclerosis (ALS) Registry.....         10,000,000
Environmental and Health Outcome Tracking Network....         24,000,000
Asthma...............................................         30,000,000
Childhood Lead Poisoning.............................         15,000,000
------------------------------------------------------------------------

    Environmental Health Activities.--The Committee does not 
provide support for CDC's environmental health research. The 
NIH houses the National Institute of Environmental Health 
Sciences (NIEHS) whose mission is to discover how the 
environment affects people in order to promote healthier lives. 
The CDC shall coordinate with NIEHS to identify meritorious 
research opportunities for it to consider through its peer-
reviewed process and within its existing portfolio funding 
level. Further, no funds are provided to support the Building 
Resilience Against Climate Effects, Climate and Health, and 
Built Environment and Health Initiative program activities, 
which will allow CDC to focus on more direct public health 
activities.

                     INJURY PREVENTION AND CONTROL

    The Committee recommends $211,300,000 for Injury Prevention 
and Control program level in discretionary funds, which is 
$40,853,000 more than the fiscal year 2015 program level and 
$45,677,000 less than the budget request program level.
    The injury prevention and control program supports 
intramural research, injury control research centers, 
extramural research grants, and technical assistance to state, 
local, and tribal health departments to prevent premature death 
and disability and to reduce human suffering and medical costs 
caused by injury and violence.
    Within the total, the Committee recommends the following 
amounts for Injury Prevention and Control activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Intentional Injury...................................        $92,300,000
    Domestic Violence and Sexual Violence............         32,700,000
        Child Maltreatment...........................          7,250,000
    Youth Violence Prevention........................         15,100,000
    Domestic Violence Community Projects.............          5,500,000
    Rape Prevention..................................         39,000,000
National Violent Death Reporting System..............         11,300,000
Unintentional Injury.................................          8,750,000
    Traumatic Brain Injury...........................          6,750,000
    Elderly Falls....................................          2,000,000
Injury Prevention Activities.........................         28,950,000
Prescription Drug Overdose Prevention................         70,000,000
------------------------------------------------------------------------

    Asthma.--The Committee increased support for the National 
Asthma Control Program (NACP) and directs CDC to increase the 
number of states carrying out programmatic activities and use a 
population-adjusted burden of disease criteria as a significant 
factor for new competitive awards.
    Gun Research.--The Committee continues the general 
provision to prevent any funds provided from being spent on gun 
research, to include collecting data for potential future 
research, such as was proposed in the budget request for the 
National Violent Death Reporting System. The Committee notes 
the budget request for Gun Violence Prevention Research is not 
funded and would be contrary to the prohibition. The Committee 
reminds CDC that the long-standing general provision's intent 
is to protect rights granted by the Second Amendment. The 
restriction is to prevent activity that would undertake 
activities (to include data collection) for current or future 
research, including under the title ``gun violence 
prevention'', that could be used in any manner to result in a 
future policy, guidelines, or recommendations to limit access 
to guns, ammunition, or to create a list of gun owners.
    Injury Control Research Centers.--The Committee provides 
support of at least $11,000,000 within the Injury Prevention 
Activities line to support activities such core operations, 
evaluation of injury control interventions, and training 
activities within the injury control research centers.
    Prescription Drug Overdose Prevention Activity.--The 
Committee commends CDC for its leadership to expand the efforts 
on prescription drug overdose. The Committee directs the CDC 
Director to implement these activities based on population-
adjusted burden of disease criteria of the mortality data (age 
adjusted rate) as a significant criteria when distributing 
funds for the state Prescription Drug Overdose Prevention 
activities and to adhere to all terms and conditions identified 
in the fiscal year statement of mangers accompanying the 2015 
Appropriations Act and accompanying statement for this program.
    National Vital Statistics System (NVSS).--The Committee 
continues support for the NVSS which provides data on births, 
deaths, and fetal deaths that are essential for understanding 
our nation's health. The Committee does not provide any funds 
to support the collection of any gun or firearms data as 
proposed in the budget request.
    Sepsis.--The Committee encourages CDC to significantly and 
materially increase its public awareness, outreach, and 
education efforts on sepsis, including health provider outreach 
and other related activities to improve diagnosis and treatment 
of sepsis. These activities should include greater coordination 
with other federal agencies, including the NIH.

     NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH (NIOSH)

    The Committee recommends $341,100,000 for the National 
Institute for Occupational Safety and Health (NIOSH) program 
level with discretionary appropriations, which is $6,237,000 
more than the fiscal year 2015 program level and $57,682,000 
more than the budget request program level.
    NIOSH conducts applied research, develops criteria for 
occupational safety and health standards, and provides 
technical services to government, labor and industry, including 
training for the prevention of work-related diseases and 
injuries. This appropriation supports surveillance, health 
hazard evaluations, intramural and extramural research, 
instrument and methods development, dissemination, and training 
grants.
    Within the total for NIOSH, the Committee recommends the 
following amounts:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
National Occupational Research Agenda................       $147,000,000
    Agricultural, Forestry, and Fishing..............         27,000,000
Education and Research Centers.......................         28,500,000
Personal Protective Technology.......................         20,000,000
Healthier Workforce Centers..........................          5,000,000
Mining Research......................................         59,500,000
National Mesothelioma Registry and Tissue Bank.......          1,100,000
Other Occupational Safety and Health Research........         80,000,000
------------------------------------------------------------------------

       ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM

    The Committee recommends $55,358,000 for CDC to administer 
the mandatory Energy Employees Occupational Illness 
Compensation Program Act (EEOICPA), which is the same as the 
fiscal year 2015 funding level and the budget request.
    EEOICPA provides compensation to employees or survivors of 
employees of Department of Energy facilities and private 
contractors who have been diagnosed with a radiation-related 
cancer, beryllium-related disease, or chronic silicosis as a 
result of their work. NIOSH estimates occupational radiation 
exposure for cancer cases, considers and issues determinations 
for adding classes of workers to the Special Exposure Cohort, 
and provides administrative support to the Advisory Board on 
Radiation and Worker Health.

                             GLOBAL HEALTH

    The Committee recommends $426,925,000 for Global Health 
with discretionary appropriations, which is $10,408,000 more 
than the fiscal year 2015 level and $21,167,000 less than the 
budget request.
    Through its Global Health activities, CDC coordinates, 
cooperates, participates with, and provides consultation to 
other nations, U.S. agencies, and international organizations 
to prevent and contain diseases and environmental health 
problems and to develop and apply health promotion activities. 
In cooperation with ministries of health and other appropriate 
organizations, CDC tracks and assesses evolving global health 
issues and identifies and develops activities to apply CDC's 
technical expertise to be of maximum public health benefit.
    Within the total, the Committee recommends the following 
amounts for Global Health activities:

------------------------------------------------------------------------
                   Budget Activity                        FY Committee
------------------------------------------------------------------------
Global AIDS Program..................................       $128,425,000
Global Immunization Program..........................        219,000,000
    Polio Eradication................................        169,000,000
    Other Global/Measles.............................         50,000,000
Parasitic Diseases and Malaria.......................         24,500,000
Global Disease Detection and Emergency Response......         55,000,000
------------------------------------------------------------------------

    Chikungunya.--The Committee is aware of the arrival of 
chikungunya in the Caribbean and encourages CDC to continue its 
work to prepare and monitor any potential arrival of 
chikungunya in the United States. The Committee encourages the 
National Center for Emerging and Zoonotic Infectious Diseases 
to work with the Center for Global Health on this cross-cutting 
issue. The Committee requests an update in the fiscal year 2017 
budget request on CDC actions with respect to the chikungunya 
outbreak in Puerto Rico.
    Global Health Strategy.--The Committee requests an update 
on how CDC, FDA, and NIH jointly coordinate global health 
research activities with specific measurable metrics used to 
track the progress toward agreed upon global health goals.
    Global Public Health.--The Committee requests the Secretary 
to provide an operating plan for all international activities 
funded through other CDC accounts to the Appropriations 
Committees of the House of Representatives and the Senate. The 
Committee does not support the use of funds for chronic disease 
prevention or injury prevention activities abroad.
    Neglected Tropical Diseases (NTD).--The Committee notes the 
threat of NTD like Chagas and Dengue are a serious risk from 
mosquito-borne viral diseases. The Committee encourages CDC to 
continue to monitor and evaluate efforts for malaria and NTDs 
in collaboration with other divisions and agencies. The 
Committee urges CDC to work closely with NIH and BARDA to 
identify research opportunities that can lead to improved 
diagnostics, treatments and vaccines. The Committee expects CDC 
to conduct close coordination with all its vector borne 
activities to jointly support advances and development of the 
next generation of tools to address vector and parasite 
resistance, and to be vigilant in monitoring for new and 
resurging threats.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

    The Committee recommends $1,460,836,000 for Public Health 
Preparedness and Response in discretionary appropriations, 
which is $108,285,000 more than the fiscal year 2015 level and 
$79,018,000 more than the budget request.
    CDC distributes grants to state, local, and territorial 
public health agencies, Centers for Public Health Preparedness, 
and others to support infrastructure upgrades to respond to all 
potential hazards, including acts of terrorism, infectious 
disease outbreaks, or natural disasters. Funds are used for 
needs assessments, response planning, training, strengthening 
epidemiology and surveillance, and upgrading laboratory 
capacity and communications systems. Activities support the 
establishment of procedures and response systems, and build the 
infrastructure necessary to respond to a variety of disaster 
scenarios.
    Within the total, the Committee recommends the following 
amounts for Public Health Preparedness and Response activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
State and Local Preparedness and Response Capability.       $692,700,000
    Public Health Emergency Preparedness Cooperative         675,000,000
     Agreement.......................................
    Academic Centers for Public Health Preparedness..          8,200,000
    All Other State and Local Capacity...............          9,500,000
CDC Preparedness and Response........................        158,000,000
    BioSense.........................................         23,000,000
    All Other CDC Preparedness and Response..........        135,000,000
Strategic National Stockpile (SNS)...................        610,136,000
------------------------------------------------------------------------

    Public Health Emergency Preparedness (PHEP) Cooperative 
Agreement Program.--The Committee funding level will enable the 
CDC to restore PHEP capacity in state, local, tribal, and 
territorial health departments and ensure they have the tools 
to quickly detect, monitor, and respond to health threats. The 
Committee seeks to understand how state PHEP funding is 
supporting capacity building at the state and local levels. The 
CDC is expected to track PHEP capacity goals via the Public 
Health Emergency Preparedness Index capabilities tool and work 
with states to agree on cooperative agreement objectives for 
each state. The Committee requests an update in the fiscal year 
2017 budget request on how CDC is implementing improved public 
health preparedness capacity measures.
    SNS Replenishment of Medical Countermeasures.--The 
Committee understands certain antivirals in the Strategic 
National Stockpile will begin to expire soon. The Committee is 
concerned the 2016 budget request was insufficient to fully 
support the SNS to replenish all of the necessary medical 
countermeasures and to meet the government's established 
countermeasure requirements and contractual obligations with 
its private sector partners. The Committee directs the Director 
of CDC to conduct a comprehensive review of the current SNS to 
ensure an adequate supply of antivirals is stockpiled. The 
review should include: enumeration of the current stockpile; 
product expiration and/or extension of dating (including cost); 
cost of replenishment; contract requirements; manufacturing 
capability including capacity and lead production time and 
methods CDC will employ to distribute a pandemic stockpile. The 
CDC is directed to provide this report to the Committee no 
later than 120 days after the date of enactment of this act. 
Further, the Committee requests CDC to provide additional 
detail annually in its budget request beginning in fiscal year 
2017 that identifies the total projected costs of all expired 
or expiring SNS assets with the projected allocation of the 
current year resources and budget funding allocated to 
replacement of expiring assets. Further, the annual SNS budget 
section shall annotate the annual amount of current year and 
requested funds dedicated to the purchase of new assets, 
replacement of expiring assets, training, and cost of 
operations separately.

                        BUILDINGS AND FACILITIES

    The Committee recommends $10,000,000 for CDC buildings and 
facilities in discretionary appropriations, which is equal to 
the fiscal year 2015 level and the request level. In addition, 
the Committee understands CDC has more than $12,000,000 in 
unobligated funds in the Individual Learning Accounts not 
projected to be spent and directs these funds to be used to 
support the replacement of the underground and surface coal 
mine safety and health research capacity facility.
    The Committee believes it is critical for CDC to ensure 
appropriate stewardship of public resources, especially 
buildings and facilities that provide vital capability to the 
nation. The Committee understands the NIOSH Taft and Hamilton 
facilities are becoming obsolete. The Committee requests an 
update in the fiscal year 2017 budget request on CDC's plan to 
provide appropriate stewardship for these facilities.
    Underground Mine Safety.--The Committee appreciates that 
based on Congressional direction, the Administration is 
starting to take steps to ensure that the mine explosive 
research capacity that was present at the now-closed CDC Lake 
Lynn, PA facility continues to exist. The Lake Lynn Laboratory 
and Experimental Mine was a unique and critical resource for 
conducting large scale explosion tests and mine fire research, 
which are essential components of preventing accidents and 
disasters in the mining industry. Therefore, the Committee 
continues to direct CDC to move forward to ensure the 
capability that was present at that facility is maintained to 
support mine safety research. Specifically, CDC is directed to 
provide a plan and updated timeline on the steps to replace the 
Lake Lynn facility capabilities that will be suitable for 
conducting tests that simulate full scale mine fires and coal 
dust explosions. The Committee requests the plan include the 
construction schedule and an estimate of the cost for 
construction, equipment and machinery. The plan shall also 
identify how the experimental activities are expected to be 
conducted during the process. The Committee expects a report 
with 90 days of enactment. The Committee rejects any proposal 
to redirect existing resources intended for a new mine safety 
research center to other CDC facility projects and expects this 
funding to remain available for an alternative site for Lake 
Lynn.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

    The Committee recommends $496,597,000 for the Public Health 
Scientific Services program level with discretionary funds that 
includes funds for the National Center for Health Statistics 
(NCHS). The level is $15,536,000 more than the fiscal year 2015 
program level and $42,212,000 less than the budget request 
program level.
    NCHS is responsible for collecting, interpreting, and 
disseminating data on the health status of the U.S. population 
and the use of health services. Surveys include the National 
Health Interview Survey (NHIS), the National Health and 
Nutrition Examination Survey (NHANES), the National Health Care 
Survey, and the National Vital Statistics System (NVSS).
    Within the total, the Committee recommends the following 
amounts for Public Health Scientific Services activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16 Committee
------------------------------------------------------------------------
Health Statistics....................................       $160,397,000
Surveillance, Epidemiology, and Informatics..........        284,000,000
    Laboratory Training & Oversight..................         10,000,000
Public Health Workforce..............................         52,200,000
------------------------------------------------------------------------

    Enhance Laboratory Training & Oversight.--The Committee 
provides $10,000,000 to support enhanced laboratory training 
and oversight, to include the CDC strengthening the oversight 
and training of CDC's intramural laboratories. The Committee 
requests CDC to provide an update in the fiscal year 2017 
request on the number and percentage of its laboratory 
employees provided with annual safety training, standard 
operating procedures, and other recommendations from CDC's most 
recent incidents. Further, the update should identify all the 
lab incidents recommendations and the status of implementing 
each recommendation.
    Surveillance, Epidemiology, and PH Informatics.--The 
Committee reminds the Center that funds specifically requested 
through the PPH and not supported with PPH funds or directly 
specified in the report are not provided. For example, the 
Committee does not provide support for the Community Guide or 
the operations of the Community Prevention Services Task Force.
    Neurological Diseases Surveillance System.--The Committee 
requests an update in the fiscal year 2017 budget request 
describing CDC's role, infrastructure, and tracking systems 
relative to tracking of epidemiology of neurological diseases, 
including multiple sclerosis.

                        CROSS-CUTTING ACTIVITIES

    The Committee recommends $283,500,000 for Cross-Cutting 
Activities program activities, which includes $113,500,000 in 
discretionary funds and $170,000,000 in PPH funds. The level is 
$9,930,000 more than the fiscal year 2015 comparable program 
level and $169,930,000 more than the comparable budget request 
program level.
    This activity supports several cross-cutting areas within 
CDC. Included is CDC's leadership and management function, 
which funds the CDC Office of the Director.
    Within the total, the Committee recommends the following 
amounts for Cross-cutting activities:

------------------------------------------------------------------------
                   Budget Activity                      FY 16  Committee
------------------------------------------------------------------------
Preventive Health/Health Services Block Grant........       $170,000,000
Public Health Leadership and Support.................        113,500,000
------------------------------------------------------------------------

Preventive Health and Health Services Block Grant (PHHSBG)

    The Committee rejects the Administration's proposed 
elimination of the PHHSBG. The Committee restores it to a level 
of $170,000,000. For over 30 years, the PHHSBG has been a vital 
source of funding, allowing each State to address its most 
critical public health needs. States use these flexible dollars 
to offset funding gaps in programs that address the leading 
causes of death, disability, and to respond to unanticipated or 
emerging public health threats. The Committee expects CDC to 
provide these flexible funds to State public health agencies. 
Further, States should work with local and tribal public health 
agencies to use these resources to address the most critical 
public health needs through measurable evidence-based 
activities.

Public Health Leadership and Support

    This activity supports CDC's leadership and management 
function performed outside the Centers or outside support 
provided through the working capital fund.
    The Committee expects the fiscal year 2017 budget to 
include specific details of each budget activity supported with 
these funds, including functions, mission, full time employees, 
bonus, travel costs, and other typical object class data and 
information for each separate activity supported through the 
Public Health Leadership and Support funding line. The 
Committee also expects specific performance measures to 
evaluate the effectiveness of each office and function. 
Finally, for each office and function, the Committee expects 
the budget will describe clearly what the prior year funds 
supported, the current year projections and proposed budget 
year policy for each activity.
    Advocacy Restrictions.--The Committee requests an update in 
the fiscal year 2017 budget request describing CDC's current 
mechanisms and processes to prevent advocacy violations. 
Further, CDC should describe its on-going efforts to educate 
its staff and recipients to prevent violations.
    Burden of Disease Review.--The Committee appreciates CDC's 
efforts to provide information on-line about the health 
profiles for all 3,143 counties in the country. The Committee 
requests the CDC Director to review all CDC programs and public 
health activities; where population adjusted burden of disease 
is not already being used as a significant factor for CDC 
competitive awards, contracts, cooperative agreements, or other 
funding mechanism, to develop a timeline and procedures to 
ensure burden of disease is used as a significant criteria for 
awards, tracking measures, and evaluation public health 
activities.
    CDC Data Collection Duplication.--The Committee requests a 
report in the fiscal year 2017 budget request detailing its 
data collection responsibilities and examining potential 
duplication of effort with the National Health and Nutrition 
Examination Survey (NHANES) and American Heart Association.
    CDC Duplication of Research.--The Committee remains 
concerned that some of CDC's research efforts may duplicate 
research that more directly falls into the mission of other 
federal agencies. The Committee encourages CDC to conduct a 
CDC-wide review of all its Centers research portfolios in 
conjunction with NIH and other federal agencies research to 
reduce duplication and enhance CDC funding available for more 
pressing public health activities. The Committee requests an 
update in the fiscal year 2017 request on the timeline and 
process for this review.
    Cross-Border Disease Control.--The Committee requests CDC 
to provide a report in the fiscal year 2017 budget request on 
how CDC coordinates its various programs with State and local 
public health departments to measure, track, control, and 
manage cross-border infectious disease in high volume port 
cities.
    Director's Discretionary Funds.--The Committee encourages 
the CDC Director to only use a portion of the funds made 
available to the Director's Discretionary Fund (DDF) to support 
additional Middle East Respiratory Syndrome (MERS) surveillance 
or response and to support the Antibiotic Resistance 
initiative. The Committee requests, within 30 days after the 
end of each quarter, a quarterly report on DDF obligations and 
each activity supported. The report should include a 
description of the activity, how this supports a high priority 
need beyond that already provided, and the total CDC support 
for this activity, with the specific DDF funding level. 
Further, the quarterly reports shall be posted on-line via the 
CDC web-site within 30 days after being released to the 
Committee.
    Institute of Medicine (IOM) Review.--The Committee is 
concerned about the focus on the reduction of sodium as a 
growing body of evidence suggest low sodium consumption can 
lead to health problems in healthy individuals. The Committee 
includes bill language that requires the CDC Director to engage 
the IOM to develop a report on the safe sodium intake for 
healthy individuals from the funds provided. The review and 
report shall determine the blood pressure effect and 
Cardiovascular Disease (CVD) implications for healthy people 
consuming sodium at 3,000 mg or less per day. The Committee 
expects CDC to not undertake sodium reduction activities below 
3,000 mg per day until the science is formally considered 
surrounding healthy and safe sodium intake, especially for 
healthy individuals, and the impact of lower sodium on blood 
pressure (and an extrapolation to health), including direct 
research suggesting a negative impact of lower sodium on 
health. To ensure that the report is free from bias, the 
Committee recommends that panelists be chosen, where possible, 
from individuals that have not previously published on the 
issue. To the extent that a panelist has published, care must 
be taken to balance that viewpoint with a contrary viewpoint. 
Since the debate involves the modeling and extrapolation of 
data sets, the committee recommends panelists with an expertise 
in medical statistical analysis. The Committee expects the 
Director to charter the IOM review within 90 days of enactment.
    Transparency.--Sound science, peer review and transparency 
are essential to effective protection of public health. The 
Committee is concerned that data from scientific studies 
utilized in forming public policy may not be available for 
public review, even under Freedom of Information Act requests. 
The Committee believes that if public policy is based on a 
scientific study, that study should be available for public 
review. The Committee urges the CDC to immediately provide, on 
its website, the data and studies it uses to support public 
policy used by CDC or other federal agencies based on CDC 
studies.
    Tribal Epidemiology Centers (TECs).--The Committee 
appreciates work undertaken by CDC to engage with 
representatives from Indian Country. Important gains have been 
made to promote greater dialogue between Tribes and the Agency; 
however, CDC has done little to invest in a surveillance system 
to support respectful and reliable data collection methods. The 
TECs work in partnership with Tribes to improve the health and 
well-being of their Tribal community members by offering 
culturally-competent approaches that work toward eliminating 
health disparities that are faced by American Indian and Alaska 
Native populations. The Committee understands most CDC programs 
incorporate surveillance into their specific program funding 
lines with funds supporting state and local health departments. 
It is unclear to the Committee how these funds support 
surveillance and technical support of public health activity at 
the tribal or TECs levels. The Committee directs the CDC 
Director to conduct a review and develop an action plan, in 
consultation with Indian Country, within 180 days of enactment 
on actions CDC can undertake to address improved surveillance 
and measurable public health impacts in tribal communities. The 
report should include how much is currently spent to support 
Tribes and TECs directly from CDC or indirectly through other 
CDC mechanisms like state and public health departments, the 
public health measures currently in place, specific steps to 
improve tribal public health surveillance, capacity, and 
outcome, the expected annual funding, and how CDC will work 
with TECs to support culturally appropriate approaches.
    Updates.--The Committee requests general updates in the 
fiscal year 2017 budget request for each of the listed topics 
that describe the latest efforts ongoing and planned:
    Advanced Molecular Detection Initiative;
    Asthma;
    Atrial Fibrillation;
    Division of Adolescent and School Health (DASH) to evaluate 
and improve school HIV prevention activities and increase 
outreach strategies;
    Epilepsy;
    Hydrocephalus;
    Interstitial Cystitis;
    National Mesothelioma Patient Registry;
    Neonatal Abstinence Syndrome;
    Nutrients;
    Perinatal Collaboratives; and
    Vision Health Initiative.

                     National Institutes of Health

    The Committee recommends an appropriation of 
$31,184,000,000 for the National Institutes of Health (NIH), 
which is $1,100,000,000 above the fiscal year 2015 level, and 
$100,000,000 above the request. The level includes 
$30,174,000,000 in discretionary appropriations and 
$1,010,000,000 in PHS Act section 241 evaluation set-aside 
(TAP) transfers. The Committee did not include the 
Administration's requested bill language to increase the TAP, 
which would have allowed the Secretary to divert an estimated 
$850,000,000 away from NIH. Consistent with the fiscal year 
2015 appropriations, all the TAP funds received by NIH are 
allocated to the National Institute of General Medical Sciences 
(NIGMS). This continues to ensure the TAP transfers are a net 
benefit to NIH rather than a liability. The Committee provided 
level is $560,741,000 above the pre-sequester level of 
$30,623,259,000 that NIH received in fiscal year 2012.
    The core mission of NIH is to invest in basic biomedical 
research to uncover new knowledge that can lead to better 
health and disease cures for everyone. NIH has historically 
enjoyed a great deal of flexibility from Congress as the 
Committee has not directed spending for particular diseases or 
research out of respect for the scientific process.
    The Committee understands the value of the extramural 
research community that is composed of scientists, clinicians, 
and other research personnel affiliated with more than 2,600 
organizations, including universities, medical schools, 
hospitals, and other research facilities in all 50 states. The 
Committee encourages NIH to restore at least 90 percent of all 
NIH resources to the extramural community. Further, the 
Committee expects NIH to continue its focus on emerging 
investigators and first-time renewals of these young 
investigators in an effort to significantly reduce the average 
age of an NIH-supported new investigator. The Committee expects 
NIH to support a consistent NIH-wide inflationary policy across 
all Institutes and Centers (ICs).
    The Committee remains concerned that the number of Ruth L. 
Kirschstein National Research Service Awards declined in fiscal 
year 2014 and is only projected to increase by 15 in fiscal 
year 2015. The Committee notes the NIH budget policy is to 
increase the number of training grants to 15,735. The Committee 
expects to adhere to at least this budget policy level for 
training grants and to provide a stipend level that is at least 
consistent with any fiscal year 2016 federal employee pay 
raise.
    The Committee appreciates NIH's commitment to ensure NIH is 
not supporting research aligned to the ``Strengthen Health 
Care'' goal of the HHS Strategic Plan and to other research 
related to data or policy support of Health Reform as these 
activities do not directly relate to NIH's mission. The 
Committee directs NIH to continue this policy and commitment.
    The Committee appreciates NIH's recent movement to start an 
NIH-wide portfolio analysis and strategic planning process. The 
Committee encourages NIH to engage with outside strategic 
planning experts and the community on this effort to promote 
the advancement of biomedical science in a manner that builds 
public trust and accountability. Further, the Committee 
encourages NIH to use this tool in a manner that allows for 
more rigorous oversight prior to the awarding of funds to 
ensure that NIH grants are connected to the core mission and 
priorities of NIH.
    The bill continues to provide specific funding levels for 
the Clinical and Translational Science Awards program, the 
Institutional Development Awards program, Cures Acceleration 
Network, Common Fund, and the National Children's Study (NCS) 
in bill language.
    The increase provided to NIH is generally distributed 
proportionately among NIH Institutes and Centers (ICs). 
However, additional resources were added to specific ICs to 
support specific initiatives. The Committee has provided a 
$300,000,000 increase for Alzheimer's disease research 
initiative in the National Institute on Aging and a $85,000,000 
increase for the Brain Research through Application of 
Innovative Neurotechnologies (BRAIN) initiative spread across 
the 10 ICs that participate in BRAIN. The Committee also 
provides the requested level of $200,000,000 for the Precision 
Medicine Initiative (PMI) with $130,000,000 within the Common 
Fund to support the trans-NIH project and $70,000,000 with 
National Cancer Institute for specific PMI projects. Finally, 
the Committee also provides the requested $100,000,000 increase 
to support the antibiotic initiative in the National Institute 
of Allergy and Infectious Diseases (NIAID).
    The Common Fund is supported as a set-aside within the 
Office of the Director at $675,639,000, which includes the 
$12,600,000 to support pediatric research as described in the 
recently enacted Gabriella Miller Kids First Research Act.

                    NATIONAL CANCER INSTITUTE (NCI)

    Mission.--NCI conducts and supports basic and applied 
cancer research in early detection, diagnosis, prevention, 
treatment, and rehabilitation. NCI provides training support 
for research scientists, clinicians and educators, and 
maintains a national network of cancer centers, clinical 
cooperative groups, and community clinical oncology programs, 
along with cancer prevention and control initiatives and 
outreach programs to rapidly translate basic research findings 
into clinical practice. The Committee expects the Institute to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through various other HHS outreach programs. The 
Committee modifies the bill language, as requested by the 
Administration, to allow NCI to use up to $16,000,000 for 
repairs and improvements at the NCI Frederick Federally Funded 
Research and Development Center in Frederick, MD due to the 
increasing maintenance backlog of this site.
    Breast Cancer.--The Committee is aware of recent news 
coverage highlighting studies about mammography screening for 
breast cancer that questions the use and validity of screening 
for discovering cancers. Although the majority of scientific 
studies have corroborated the value of early detection of 
breast cancers through screening, other studies have concluded 
that screening sometimes results in false positives and over 
treatment. This has created a less clear picture of the 
benefits of screening and may lead women to avoid periodic 
mammography, an experience some women already view as 
uncomfortable. From 1990 to 2010, deaths from breast cancer 
decreased by 34%. This drop in breast cancer mortality has been 
attributed to both improvements in treatment and earlier 
detection of cancers. However, in 2013, 230,000 new cases of 
breast cancer were diagnosed in the United States and almost 
40,000 women died from breast cancer. Given the current 
controversies over screening and the need to validate new 
screening technologies versus existing technologies, it is 
clear that a new, comprehensive study of these issues is 
warranted. The Committee encourages NCI to support research to 
address these issues and to hopefully provide women and 
physicians with a clearer, more informed picture of how breast 
cancer imaging should be considered as part of the overall 
women's health care environment and urges the Secretary not to 
implement changes to the breast cancer screening 
recommendations until this research is completed.
    Cancer Disparities.--The Committee requests NCI and the 
National Institute on Minority Health and Health Disparities 
(NIMHD) to prepare a joint update for the fiscal year 2017 
budget request on efforts underway and planned to end this 
disparity, including activities to focus on research, 
prevention, and treatment of cancer in minority communities.
    Colorectal Cancer.--The Committee encourages support of 
meritorious scientific research on colorectal cancer to better 
understand the biology of young-onset colorectal cancer. 
Specifically, the Committee requests an update in the fiscal 
year 2017 budget request related to research activity on the 
biology of young-onset colorectal cancer in adults under the 
age of 50.
    Gastrointestinal Cancer.--The Committee continues to be 
concerned about gastric cancer, particularly among young adults 
and supports gastric cancer being studied in The Cancer Genome 
Atlas (TCGA). The Committee notes that research on gastric 
cancer is less advanced than that of many other cancers. The 
Committee therefore encourages NCI to consider requesting 
applications for gastric cancer research that leverages the use 
of genomic data from the TCGA.
    Heavy Ion Cancer Therapy and Research--The Committee 
understands NCI recently issued a planning grant for a Heavy 
Ion Therapy and Research. The Committee encourages NCI to 
coordinate with other federal agencies on the need and 
potential funding sources in determining the scientific 
justification to move forward or retrofit any existing 
facilities.
    Liver Cancer.--The Committee continues to be concerned with 
the lack of a focused liver cancer research program. The NCI is 
urged to support a Specialized Program of Research Excellence 
on liver cancer, as well as liver cancer program projects. The 
Committee encourages more focus on the development of 
biomarkers to serve as early detection markers of cancer to 
therefore offer the prospect of improved outcomes.
    Melanoma.--The Committee encourages NCI to develop a 5-year 
plan across NCI's divisions, and coordinate with other federal 
agencies and advocates to align melanoma research resources. 
The Committee understands the NCI MATCH Trial and Exceptional 
Responders Initiative may provide valuable insight to benefit 
melanoma subpopulations knowledge and encourages use of these 
mechanisms. The Committee requests an update in the fiscal year 
2017 budget request on these efforts.
    NCI Designated Cancer Centers.--The Committee requests an 
update in the fiscal year 2017 request on how NCI supports or 
plans to support Institutional Development Award programs in 
states to broaden the NCI designated cancer center 
representation within these states.
    NCI Precision Medicine Initiative (PMI).--The Committee 
provides the requested funds to support the five-year NCI PMI 
plan that will support activities such as the pediatric MATCH 
trial, clinical trials for five major cancer types based on 
genomic driven data, liquid biopsies, new models of cancer 
diagnostics, test targeted agents for clinical trials, and the 
related informatics infrastructure. The Committee understands 
the NCI PMI is a one-time increase of $70,000,000 for five 
years. The Committee requests NCI to provide a breakout in the 
fiscal year 2017 budget request and future years with the 
specific science and funding details with these and NCI funds 
already supporting the PMI activity. The details should include 
long-term goals, milestones, and annual progress. The Committee 
encourages NCI, as scientifically feasible, to support existing 
research networks, especially collaborative efforts among NCI-
supported cancer centers and institutions serving historically 
underserved populations as they have certain attributes of 
cancer genomic data sharing that may be particularly effective.
    Office of Cancer Survivorship.--The Committee requests a 
report in the fiscal year 2017 budget request on actions 
planned or on-going to focus resources and attention to the 
youngest of cancer survivors.
    Pancreatic Cancer.--The Committee encourages NCI to 
prioritize support for meritorious research for pancreatic 
cancer generally and specifically related to early detection of 
pancreatic cancer. The Committee encourages a focus on 
promising research to test members of high-risk pancreatic 
cancer families, including non-invasive screening methods. The 
Committee requests an update in the fiscal year 2017 budget 
request on these efforts.
    Pediatric Low Grade Astrocytoma Research (PLGA).--The 
Committee encourages continued research efforts toward the 
identification of new therapies for PLGA patients, to include 
clinical trials. The Committee urges NCI and NIH to seek 
public/private partnerships opportunities on PLGA research. The 
Committee requests an update in the fiscal year 2017 budget 
request on on-going and planned activities across NIH.

           NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

    Mission.--NHLBI provides leadership for a national research 
program in diseases of the heart, blood vessels, lungs, and 
blood, in blood resources, and in sleep disorders through 
support of basic, clinical, and population-based research. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.
    Chronic Obstructive Pulmonary Disease (COPD).--The 
Committee commends NHLBI for convening an interagency meeting 
on federal COPD planning. The Committee is eager to review the 
forthcoming peer-reviewed publications and urges NHLBI to move 
forward efforts to address the rising burden of COPD in the 
U.S. Further, the Committee is aware that Alpha 1 Antitrypsin 
Deficiency (Alpha 1) is a major genetic risk factor for 
developing COPD. The Committee encourages NHLBI to convene a 
group of expert stakeholders and other federal agencies to 
develop a treatment algorithm for Alpha 1 related disease and a 
coordinated federal and private approach to increase knowledge 
that can improve the diagnosing of this disease.
    Pulmonary Hypertension (PH).--The Committee applauds NHLBI 
for leading research efforts that have helped prolong life for 
individuals affected by PH and encourages continued research 
related to the underlying mechanisms of PH, particularly 
idiopathic pulmonary arterial hypertension as additional gains 
may benefit patient health and wellness.

     NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)

    Mission.--The mission of NIDCR is to improve the nation's 
oral, dental and craniofacial health through research and 
research training. NIDCR accomplishes its mission by performing 
and supporting basic and clinical research; conducting and 
funding research training and career development programs to 
ensure that there is an adequate number of talented, well-
prepared, and diverse investigators; and coordinating and 
assisting relevant research and research-related activities. 
The Committee expects the Institute to systematically 
coordinate through other HHS agencies to share new scientific 
information to ensure it reaches the community and providers 
through various other HHS outreach programs.

   NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES 
                                (NIDDK)

    Mission.--NIDDK supports research in three major disease 
categories: diabetes, endocrinology, and metabolic diseases; 
digestive diseases and nutrition; and kidney, urologic, and 
hematologic diseases. NIDDK supports a coordinated program of 
fundamental and clinical research and demonstration projects 
relating to the causes, prevention, diagnosis, and treatment of 
diseases within these categories. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.
    Focal Segmental Glomerulosclerosis (FSGS).--The Committee 
commends NIDDK for partnering with NCATS on the Nephrotic 
Syndrome (NS) Study Network with the goal of developing 
precision medicine for NS. The Committee encourages continued 
support for studies on the mechanisms of the FSGS/NS disease 
process.
    Gestational Diabetes.--The Committee recognizes the 
importance of research related to gestational diabetes and 
encourages NIDDK to continue to support highly meritorious 
research on gestational diabetes.
    Inflammatory Bowel Disease.--The Committee commends NIDDK 
for hosting a conference on inflammatory bowel disease in 
children which could lead to further research in this area. The 
Committee encourages NIDDK to continue efforts to identify the 
etiology of the disease in order to inform the development of 
cures for inflammatory bowel disease.

    NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS)

    Mission.--NINDS supports and conducts basic, translational, 
and clinical neurological research and research training to 
increase understanding of the brain and improve the prevention 
and treatment of neurological and neuromuscular disorders. The 
NINDS mission encompasses over 600 disorders, including stroke, 
head and spinal cord injury, epilepsy, multiple sclerosis, and 
neurodegenerative disorders such as Parkinson's disease. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.
    Brain Aneurysms.--The Committee notes that brain aneurysm 
research appears to be a lower priority. The Committee requests 
an update in the fiscal year 2017 budget request on on-going 
and planned research related to this issue.
    Brain Research through Advancing Innovative 
Neurotechnologies (BRAIN) Initiative.--The human brain remains 
one of the greatest mysteries in science and one of the 
greatest challenges in medicine. Neurological and psychiatric 
disorders, such as Alzheimer's disease, Parkinson's disease, 
autism, epilepsy, schizophrenia, depression, and traumatic 
brain injury, exact a tremendous toll on individuals, families, 
and society. The BRAIN initiative, created with a 10-year plan, 
was expected to require an annual budget of at least 
$400,000,000 by fiscal year 2019. The Committee accelerates the 
requested funding for BRAIN to $150,000,000 to ensure the 
initiative stays on track towards it program goals and 
objectives. The funds are allocated to NINDS, NICHD, NEI, NIA, 
NIDCD, NIAAA, NIDA, NIMH, NIBIB, and NCCIH on the same pro-rata 
bases as provided in the budget request.
    The Committee recognizes initiatives of this nature must 
maintain adequate funding to assure achievement of the goals 
and plan milestones. The Committee expects NIH to ensure the 
fiscal year 2017 request provides an appropriate level of 
funding to keep on this path. Further, the Committee encourages 
the distribution of a reasonable portion of BRAIN research 
resources through co-funded projects in the IDeA program.
    Dystonia Research.--The Committee commends NINDS for its 
leadership of dystonia research. The Committee encourages NINDS 
to continue to prioritize dystonia research that can advance 
the pace of clinical and translational research to find better 
treatments and a cure.
    Hydrocephalus Research.--The Committee encourages NIH, 
under the direction of the NINDS, to conduct a state of the 
science workshop to investigate the status of current federally 
and non-federal supported hydrocephalus specific research 
projects. The Committee requests the fiscal year 2017 budget 
request include a summary of the key recommendations and other 
findings from the workshop.

     NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)

    Mission.--NIAID supports and conducts basic, applied, and 
clinical research and research training programs in infectious, 
immunologic, and allergic diseases. NIAID-supported research 
includes research on HIV/AIDS, malaria, tuberculosis, sexually 
transmitted infections, neglected tropical diseases, emerging 
and re-emerging infectious diseases, asthma, allergic and 
autoimmune diseases, and transplantation. The goals of NIAID 
research are to increase the understanding of disease 
pathogenesis and the immune system, to improve disease 
diagnosis, to develop new and improved drugs to treat such 
diseases, and to develop new and improved vaccines and other 
approaches to prevent such diseases, many of which 
significantly affect public health. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.
    National Strategy for Combating Antibiotic Resistant 
Bacteria (CARB).--The Committee directs the Department to work 
with the Departments of Defense, Agriculture, Veterans Affairs 
and the Food and Drug Administration (FDA) to both track and 
store antibiotic resistance (AbR) genes and the mobile genetic 
elements from AbR bacteria. This information, along with 
metadata, including geographic information system coordinates 
describing where they were isolated, is essential to monitor 
emerging AbR bacteria, assess their threat to public health and 
develop mitigation strategies. The Committee further directs 
the Department to include in their fiscal year 2017 request the 
progress being in implementing the above language and the 
overall CARB national strategy initiative.
    Antibiotic Resistance (AbR).--The Committee provides the 
requested $100,000,000 increase to spur research and 
development related to scientific gaps to reduce AbR and 
develop new antibiotics. The Committee directs NIAID to work 
with BARDA to develop a joint plan toward addressing this 
growing and serious threat posed by AbR bacteria. NIAID is 
encouraged to consider research focused on novel approaches to 
combat AbR, which may include unique modalities such as 
antibodies and vaccines, new mechanisms, new rapid diagnostics, 
and a genomic database of reported human infections. The 
Committee encourages consideration of research on novel 
approaches to antimicrobial resistance like unique modalities, 
new mechanisms, or new antimicrobials. The Committee requests 
NIAID to provide a multi-year AbR research and funding plan, 
developed in conjunction with BARDA, which includes specific 
goals and annual milestones to support this initiative within 
180 days of enactment.
    Biodefense Spend Plan.--The Committee appreciates ASPR's 
completion of the 5-year spending plan for the medical 
countermeasure (MCM) enterprise, but notes concerns on the 
level of detail included in the spend plan for NIAID's 
biodefense activities. The spend plan offered little insight 
into the NIAID's spending priorities for the numerous MCM 
candidates in its portfolio. The Committee requests NIAID, 
working with ASPR, to provide more detail on NIAID's future 
goals for MCM research, including its efforts to transition 
these projects to advanced research at BARDA, and identify how 
NIAID coordinates with BARDA's on advanced development and 
procurement priorities. Further, the Committee requests a 
summary of this information be included in the fiscal year 2017 
budget request. The Committee encourages NIAID to focus on 
biodefense MCM candidates that have received a Material Threat 
Determination from the Department of Homeland Security.
    Valley Fever.--The Committee commends NIH and CDC on the 
continued joint efforts to combat coccidioidomycosis, also 
known as Valley Fever. Specifically, the Committee supports 
ongoing efforts by NIH and CDC to conduct a Randomized 
Controlled Trial (RCT) to identify an effective treatment for 
Valley Fever, encourage development of a vaccine, and help 
increase awareness of this disease among medical professionals 
and the public. The Committee looks forward to when patients 
can begin enrolling in the RCT later this year.

         NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)

    Mission.--NIGMS supports research and research training in 
the basic biomedical sciences. Institute grantees, working in 
such fields as cell biology, biophysics, genetics, 
developmental biology, pharmacology, physiology, biological 
chemistry, bioinformatics, and computational biology study 
normal biological processes to better understand what goes 
wrong when disease occurs. In this way, NIGMS supports the 
development of new knowledge, theories, and technologies that 
can then be applied to the disease-targeted studies supported 
by other NIH components. NIGMS-supported basic research 
advances also find applications in the biotechnology and 
pharmaceutical industries. The Institute's training programs 
help develop scientists needed in industry and academia and 
increase the diversity of the biomedical workforce. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through the 
various other HHS outreach programs.
    Institutional Development Award (IDeA).--The Committee 
provides a significant increase to the IDeA program in 
recognition of the success of this program. The Committee 
expects NIH to ensure the program is supported at a level of at 
least 1 percent of total NIH funding in future budget requests. 
Further, the Committee notes the NIH Centers of Biomedical 
Research Excellence (COBRE) is proven to successfully increase 
the number of new scientists at institutions in states eligible 
for IDeA. The NIH policy has limited the number of COBRE 
institutions in IDeA states. The Committee expects NIH and 
NIGMS Directors to jointly review this policy and develop a 
plan to expand the number of competitively awarded COBREs per 
institution that include shared funding from outside NIGMS 
resources. The Committee requests a summary of the outcome of 
the review and plan forward in the fiscal year 2017 budget 
request. The Committee expects the NIH Director to ensure all 
Clinical Translations Science Research awardees actively 
solicit interaction with IDeA designated states.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                          DEVELOPMENT (NICHD)

    Mission.--The NICHD conducts and supports basic, 
translational, and clinical research on the reproductive, 
developmental, and behavioral processes that determine and 
maintain--and rehabilitation that restores and improves--the 
health and well-being of children, adults, families and 
populations. The Committee expects the Institute to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through the various other HHS outreach programs.
    Capacity for Data Collection on Severe Maternal 
Morbidity.--The Committee understands there are no uniform 
definitions of severe maternal morbidity and that uniform 
definitions would help Federal, State and local agencies and 
research institutions establish standardized and interoperable 
processes for surveillance, data collection, and research. The 
Committee encourages NICHD to work with CDC to hold a multi-
stakeholder consensus workshop to identify uniform definitions 
for severe maternal morbidity.
    Preterm Birth.--The Committee applauds NICHD's work with 
leading global health organizations to develop a research 
agenda aimed at reducing preterm birth. Public and privately 
funded research that spans the range of discovery, development, 
and delivery science is needed in order to identify the causes 
of premature birth. The Committee urges NICHD to continue to 
invest in biomedical and clinical research related to the 
prevention of preterm birth and the care and treatment of 
preterm infants.

                      NATIONAL EYE INSTITUTE (NEI)

    Mission.--NEI conducts and supports basic and clinical 
research, research training, and other programs with respect to 
blinding eye diseases, visual disorders, and mechanisms of 
visual function, preservation of sight, and the special health 
problems and needs of individuals who are visually-impaired or 
blind. The Committee expects NEI to systematically coordinate 
closely with other HHS agencies to share new scientific 
information, specifically aimed at the prevention of blindness 
and increase awareness to the community and providers through 
various other HHS outreach programs.
    Accelerate Cures Related to Retina Disease.--The Committee 
directs NEI to create a challenge program to advance the speed 
of basic research to cure retina disease by creating a forum 
for the NEI Director to survey the field of basic retina 
research discoveries to provide rewards for research not 
otherwise funded through NEI or other NIH supported competitive 
awards. The Committee expects NEI to provide an update and 
timeline in the fiscal year 2017 budget request to describe how 
the program will be advertised, funding allocated, and criteria 
to evaluate submissions for possible challenge rewards to 
further incentive non-NIH supported researchers to accelerate 
basic research through this mechanism. The Committee further 
expects NEI to distribute the findings of this program widely 
to the NEI research community to further promote the leveraging 
of federal and non-federally supported retina research.

      NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)

    Mission.--The mission of NIEHS is to prevent and reduce the 
burden of human illness and disability by understanding how the 
environment influences the development and progression of human 
disease. In addition, NIEHS is responsible for the research of 
the National Toxicology Program whose mission is to coordinate 
toxicity testing across the Federal government and to evaluate 
substances of public health concern. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.

                   NATIONAL INSTITUTE ON AGING (NIA)

    Mission.--NIA supports and conducts biomedical, social and 
behavioral research with respect to the aging process and the 
diseases and other special problems and needs of older 
Americans. The Committee expects the Institute to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through various other HHS outreach programs.
    Alzheimer's Disease.--In 2012, the National Plan to Address 
Alzheimer's Disease was released to address the major 
challenges presented by Alzheimer's disease by 2025. Since 
then, although Alzheimer's research has received annual 
increases for federally funded Alzheimer's research, it is 
still funded less than the annual level needed to accomplish 
the goal of the national Alzheimer's plan. The Committee 
accelerates funding for Alzheimer's disease research to 
$886,000,000, an increase of $300,000,000 over fiscal year 2015 
as an important next step to ensure success of this critical 
initiative to develop preventative treatments and cures. The 
Committee recognizes that initiatives of this nature must be 
adequately funded to assure achievement of the goals and plan 
milestones. The Committee expects NIH will ensure the fiscal 
year 2017 request provides the appropriate level of funding to 
keep on this path. Further, the Committee encourages the 
distribution of a reasonable portion of Alzheimer's research 
support to meritorious IDeA program researchers.
    The Committee requests NIA to convene a working group of 
stakeholders, including patient advocacy organizations and 
nonprofit funders of Alzheimer's and dementia research, within 
180 days of enactment of this act to develop possible 
frameworks and strategies for a direct public-private 
partnership to fund meritorious research proposals on 
Alzheimer's Disease that are not supported directly by NIH. NIH 
shall provide a report annually in its fiscal year 2017 and out 
year budget requests identifying the total level of NIH peer-
reviewed research supported by qualified third-party 
Alzheimer's Disease researchers through such a partnership. 
Finally, the Committee notes continued support for Alzheimer's 
Disease Research Centers.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES 
                                (NIAMS)

    Mission.--NIAMS conducts and supports basic and clinical 
research and on the more than 100 forms of arthritis; 
osteoporosis and other bone diseases; muscle biology and muscle 
diseases; orthopedic disorders, such as back pain and sports 
injuries; and numerous skin diseases. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.
    Lupus Research Plan.--The Committee commends NIAMS for 
leading the effort to review the current state of the science, 
evaluate progress on the existing lupus research plan and 
develop a new action plan for lupus research. The Committee 
applauds the broad solicitation of input across NIH and the 
greater research and advocacy community, and encourages special 
attention for efforts in this research area.

   NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS 
                                (NIDCD)

    Mission.--NIDCD funds and conducts research in human 
communication. Included in its program areas are research and 
research training in the normal and disordered mechanisms of 
hearing, balance, smell, taste, voice, speech and language. The 
Institute addresses special biomedical and behavioral problems 
associated with people who have communication impairments or 
disorders. In addition, NIDCD is actively involved in health 
promotion and disease prevention, and supports efforts to 
create devices that substitute for lost and impaired sensory 
and communication functions. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through the various other 
HHS outreach programs.

             NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)

    Mission.--NINR supports and conducts scientific research 
and research training to reduce the burden of illness and 
disability; improve health-related quality of life; enhance 
end-of-life and palliative care; and establish better 
approaches to promote health and prevent disease. The Committee 
expects the Institute to systematically coordinate through 
other HHS agencies to share new scientific information to 
ensure it reaches the community and providers through various 
other HHS outreach programs.

       NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)

    Mission.--NIAAA supports research to generate new knowledge 
to answer crucial questions about why people drink; why some 
individuals are vulnerable to alcohol dependence or alcohol-
related diseases and others are not; the relationship between 
genetic and environmental factors involved in alcoholism; the 
mechanisms whereby alcohol produces its disabling effects, 
including organ damage; how to prevent alcohol abuse and 
associated damage, especially in the underage population; and 
how alcoholism treatment can be improved. NIAAA addresses these 
questions through a program of biomedical, behavioral, and 
epidemiologic research on alcoholism, alcohol abuse, and 
related problems. The Committee expects the Institute to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through the various other HHS outreach programs.
    Fetal Alcohol Syndrome (FAS) Research.--The Committee was 
pleased that NIAAA's budget request proposed increases in 
research on how alcohol interferes with human development and 
the various underlying aspects of alcohol-induced fetal damage. 
The Committee encourages NIH to consider the benefits and 
methods to support a clearinghouse and improved coordination 
with federal and private sector partners to best facilitate the 
translation of science into public health promotion strategies 
and interventions benefiting individuals living with FAS.

                NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

    Mission.--NIDA-supported science addresses questions about 
drug abuse and addiction, which range from its causes and 
consequences to its prevention and treatment. NIDA research 
explores how drugs of abuse affect the brain and behavior and 
develops effective prevention and treatment strategies. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.
    Adolescent Behavioral and Cognitive Development (ABCD).--
The Committee applauds the Collaborative Research on Addictions 
at NIH initiative and the launch of the ABCD study. Unique in 
its scope and duration, the study will recruit 10,000 youth 
before they begin using alcohol, marijuana, nicotine and other 
drugs, and follow them over 10 years into early adulthood to 
assess how substance use affects the trajectory of the 
developing brain. The Committee commends the study design which 
will use advanced brain imaging as well as psychological and 
behavioral research tools to evaluate brain structure and 
function and track substance use, academic achievement, IQ, 
cognitive skills, and mental health over time.
    Medications Development.--The Committee understands NIDA is 
considering new technologies for the development of next-
generation pharmaceuticals. For example, NIDA is exploring 
approaches to develop viable immunotherapeutic or biologic 
(e.g., bioengineered enzymes) approaches for treating 
addiction. The Committee looks forward to hearing more about 
work in this area in the fiscal year 2017 budget request.
    NIDAMED.--The Committee encourages its support for NIDAMED, 
an initiative designed to reach out to physicians, physicians 
in training, and other health care professionals to increase 
especially those treating our youth to better recognize the 
signs that lead to drug abuse and addiction.
    Opioid Drug Abuse.--The Committee remains concerned about 
prescription drug abuse, specifically the misuse of orally 
administered opioid drugs. According to some reports, more than 
35 million Americans have abused prescription opioids at some 
point in their lifetimes. The June 2011 Institute of Medicine 
report on relieving pain indicates that such abuse and misuse 
resulted in an annual estimated cost to the Nation of $72.5 
billion. The Committee expects NIDA to continue to support 
meritorious scientific activities related to research on 
medications to alleviate pain with reduced abuse liability and, 
as appropriate, to work with private partners on innovative 
research into such medications. In addition, NIDA should 
continue to fund research to better prevent and treat 
prescription drug abuse and to coordinate with CDC to help 
identify scientific research gaps. The Committee requests an 
update in the fiscal year 2017 budget request on the activities 
related to addressing the opioid drug abuse problem.

               NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)

    Mission.--NIMH is responsible for basic and clinical 
research to improve diagnosis, treatments, and overall quality 
of care for persons with mental illnesses. Disorders of high 
priority to NIMH include schizophrenia; depression and manic 
depressive illness; obsessive-compulsive disorder; anxiety 
disorders and other mental and behavioral disorders that occur 
across the lifespan, which include childhood mental disorders 
such as autism and attention-deficit/hyperactivity disorder; 
eating disorders; and other illnesses. NIMH supports and 
conducts fundamental research in neuroscience, genetics, and 
behavioral science. In addition to laboratory and controlled 
clinical studies, NIMH supports research on the mental health 
needs of special populations and health services research. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.
    Community Based Participatory Research (CBPR).--The 
Committee is aware that CBPR is an applied collaborative 
approach that enables community residents to more actively 
participate in the full spectrum of research. The Committee 
requests NIMHD to provide an update in the fiscal year 2017 
budget request on any CBPR activities its supports and the most 
appropriate role for CBPR within the NIMH portfolio.
    Early Detection and Prevention of Psychosis.--The Committee 
applauds NIMH's early detection and intervention efforts 
involving psychosis in young people and encourages NIMH to 
coordinate with other ICs to expand these efforts.

            NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)

    Mission.--NHGRI provides leadership for the development of 
resources and technology to accelerate genome research and its 
application to human health. NHGRI-supported activities include 
basic and translational research to understand the sequence and 
function of both human and non-human genomes, human genetic 
variation, and the genetic and environmental basis of disease. 
Also central to NHGRI research goals are training programs and 
a strong focus on the ethical, legal, and social implications 
of genomic science and medicine. The Committee expects the 
Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.

  NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)

    Mission.--The NIBIB mission is to improve human health by 
leading the development and accelerating the application of 
biomedical technologies. The Institute is committed to 
integrating the engineering and physical sciences with the life 
sciences to advance basic research and medical care. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.

  NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD)

    Mission.--NIMHD conducts and supports research, training, 
and other programs aimed at reducing the disproportionately 
high incidence and prevalence of disease, burden of illness and 
mortality experienced by certain American populations, 
including racial and ethnic minorities and other groups, such 
as the urban and rural poor, with disparate health status. The 
Committee expects the Institute to systematically coordinate 
through other HHS agencies to share new scientific information 
to ensure it reaches the community and providers through 
various other HHS outreach programs.
    Research Centers in Minority Institutions (RCMIs).--The 
Committee continues to support RCMIs and expects the RCMIs to 
receive no less than $55,319,000, which is the fiscal year 2015 
level plus the general increase provided to NIMHD.

    NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH)

    Mission.--NCCIH was established to stimulate, develop, and 
support rigorous and relevant research of high quality and 
open, objective inquiry into the safety and effectiveness of 
complementary and integrative health (CIH) practices and to 
train individuals to apply the tools of exacting science to CIH 
systems and modalities in order to provide health care 
professionals and the American public with reliable information 
about these practices. The Committee expects the Center to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through various other HHS outreach programs.

      NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)

    Mission.--NCATS was established to advance translational 
sciences, coordinating and developing resources that leverage 
basic research in support of translational science and 
developing partnerships and working cooperatively to foster 
synergy in ways that do not create duplication, redundancy, and 
competition with industry activities. NCATS also includes the 
Office of Rare Disease Research (ORD) that was established in 
recognition of the need to provide a focal point of attention 
and coordination at NIH for research on rare diseases. ORD 
works within the authorized mission of NCATS to provide an 
increase focus on rare disease research and orphan products 
development; develops a centralized database on rare diseases 
research; and stimulates rare diseases research by supporting 
scientific workshops and symposia to identify research 
opportunities. The Committee expects the NCATS to 
systematically coordinate through other HHS agencies to share 
new scientific information to ensure it reaches the community 
and providers through the various other HHS outreach programs.
    Bridging Interventional Development Gaps BrIDGs Program.--
The Committee understands the BrIDGs program has supported new 
drug interventions and encourages NCATS to look for 
opportunities to encourage additional success.
    Clinical and Translational Science Awards (CTSA).--The 
Committee is pleased that NCATS is implementing recommendations 
from the recent IOM report on the CTSA program. NCATS is 
encouraged to continue to work closely with the CTSA community 
and related stakeholders moving forward to continue to identify 
emerging opportunities and areas for programmatic improvement.
    Therapeutics for Rare and Neglected Diseases (TRND) 
Program.--The Committee encourages NCATS to focus on additional 
neglected diseases through the TRND program. The Committee 
expects NCATS' contributions to neglected disease research be 
included in the joint CDC, FDA and NIH global health strategy 
describing coordination and prioritization of global health 
research activities within the three agencies.

               JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)

    Mission.--FIC was established to improve the health of the 
people of the United States and other nations through 
international collaborations in the biomedical sciences. In 
support of this mission, the FIC pursues the following four 
goals: (1) mobilize international research efforts against 
global health threats; (2) advance science through 
international cooperation; (3) develop human resources to meet 
global research challenges; and (4) provide leadership in 
international science policy and research strategies. The 
Committee urges FIC to coordinate systematically and closely 
with other HHS agencies on any efforts to disseminate research 
results in a manner that uses the various existing HHS outreach 
programs.

                   NATIONAL LIBRARY OF MEDICINE (NLM)

    Mission.--The NLM collects and organizes information 
important to biomedicine; serves as a national information 
resource for medical education, research, and health service 
activities; enhances access to biomedical literature through 
electronic services; serves the public by providing electronic 
access to reliable health information for consumers; supports 
and directs the national network of libraries of medicine; 
provides grants for research in biomedical communications, 
medical library development, and training health information 
specialists; conducts and supports research in biomedical 
informatics and computational biology; and creates information 
resources for genomics, molecular biology, toxicology, medical 
images, environmental health, emergency preparedness and 
response, and health services research. The Committee expects 
the Institute to systematically coordinate through other HHS 
agencies to share new scientific information to ensure it 
reaches the community and providers through various other HHS 
outreach programs.

                      OFFICE OF THE DIRECTOR (OD)

    Mission.--The OD provides leadership to the NIH research 
enterprise and coordinates and directs initiatives that cross-
cut NIH. OD is responsible for the development and management 
of intramural and extramural research and research training 
policy, the review of program quality and effectiveness, the 
coordination of selected NIH-wide program activities, and the 
administration of centralized support activities essential to 
the operations of NIH. The Committee expects OD to establish a 
systematic process with the ICs and HHS agencies to coordinate 
the dissemination of research results in a manner that uses 
existing HHS outreach programs and prevents duplication from 
NIH organizations to allow better focus of NIH IC funds to 
support research efforts.
    The Committee expects the NIH Director to ensure all ICs 
continue to support the pathways to independence program, which 
provides new investigators with mentored grants that convert 
into independent research project grants. In addition, the 
Committee continues to support an increase in new innovator 
awards, director's pioneer awards, and the transformative R01 
program through the Common Fund.
    The Committee has provided bill language for specific funds 
authorized by the recently enacted Gabriella Miller Kids First 
Research Act within the Common Fund to support the second year 
of the 10-year Pediatric Research Initiative. Further, to 
ensure enhanced support for pediatric research, the Committee 
urges the NIH Director to use a portion of the $10,000,000 made 
available to the Director's Discretionary Fund (DDF) to support 
additional pediatric research, such the development of cutting 
edge bioinformatics programs for pediatric cancers; tools, 
methods, and other regulatory science to directly support the 
data that accelerate drug approval for pediatric patients; or 
projects that integrate cutting-edge technology like bio-
microelectromechanical systems (MEMS), biomaterials or portable 
advanced imaging technologies related to pediatric diseases. 
The Committee requests, within 30 days after the end of each 
quarter, a quarterly report on DDF obligations for each 
activity supported. The report should include a description of 
the program, the ICs that will provide the continuation costs 
and how this research serves a high priority. Further, the 
quarterly reports shall be posted on-line via the NIH web-site 
within 30 days after being released to the Committee.
    The Committee expects NIH to continue the longstanding 
policy for Common Fund projects to be short-term, high-impact 
awards, with no projects receiving funding for more than 10 
years. The Committee appreciates NIH's efforts to support only 
bio-medical research within the Common Fund.
    Capstone Awards.--The Committee expects NIH to pursue the 
establishment of new grants, called Capstone Awards. Capstone 
Awards could be made to promote partnership between a senior 
and junior investigator, to provide opportunities for acquiring 
skills needed for transitioning to a new role, or other reasons 
as determined by the NIH Director in consultation with the IC 
Directors, patient advocacy groups, and industry leaders. The 
NIH is expected to develop a duration and amount for each 
Capstone Award by the NIH Director in consultation with the IC 
Directors, researchers, patient advocacy groups, and industry 
leaders.
    Grant Review.--The Committee encourages NIH to establish 
policies for the Director of each IC to review and approve 
every grant awarded by his or her IC. The Committee requests an 
update in the fiscal year 2017 budget request on this endeavor.
    New Innovative Awards.--The Committee encourages NIH to 
continue to support new grant models similar to the Maximizing 
Investigators Research Award (MIRA) program at NIGMS that would 
provide a single award in support of all of the projects in an 
investigator's lab. The Committee encourages the NIH Director 
to facilitate similar programs in all ICs.
    Marijuana Research.--The Committee is concerned that as 
more states in the nation choose to enact laws that allow 
access to and use of marijuana for medical purposes the fact 
remains that there is no significant body of medical and 
scientific research validated by NIH or NIDA on the actual 
medical efficacy of marijuana. Consequently, despite anecdotal 
evidence to the contrary, it is entirely possible that 
Americans may be putting their health at risk when using 
marijuana for medicinal purposes. The Committee believes it is 
time to settle the matter of whether or not marijuana has 
medical benefits that can be validated and documented by 
scientific research. The Committee directs the NIH to report 
back to the Committee within 120 days after enactment with a 
plan by which the NIH could engage the appropriate institutes, 
including NIDA but not only NIDA, but other agencies the 
Director determines are appropriate (e.g., FDA) to construct 
long- and short-term studies on the potential benefits and 
detriments of the use of marijuana for medical purposes. The 
marijuana to be used in the studies shall be supplied by NIDA 
for control purposes.
    Quarterly Updates of NIH Operating Plans.--The Committee 
continues the understanding that the IC mechanism tables serve 
as the NIH operating plans for available resources and requests 
NIH continue to provide quarterly updates of these plans to the 
Appropriations Committee of the House.
    Review of Maternal Deprivation Studies.--The Committee is 
aware that prominent experts and animal advocacy organizations 
have raised concerns about the scientific and ethical 
justifications for maternal deprivation studies involving baby 
monkeys being conducted in both intramural and extramural NIH 
funded laboratories. The Committee is further aware that the 
NIH Office of Laboratory Animal Welfare opened an investigation 
in response to these allegations on September 9, 2014. The 
investigations consulted with research investigators, the USDA, 
nonhuman primate center scientists, veterinarians, animal care 
staff and other relevant experts. As a result of the 
investigation, several modifications were made to the protocol 
and several procedures removed. Accordingly, the Committee 
requests NIH to conduct a review of its ethical policies and 
processes with respect to nonhuman primate research subjects, 
in consultation with outside experts, to ensure it has 
appropriate justification for animal research protocols and to 
provide an update on these efforts in the fiscal year 2017 
budget request.
    Women's Health Research.--The Committee appreciates NIH's 
recent work to improve the gender balance in pre-clinical 
research and continues to encourage all future NIH-funded 
research to include both sexes unless there is a specific 
reason not to include them. The Committee requests an update on 
NIH's new policy to require that both sexes be represented in 
preclinical research. That report should include an analysis of 
the impact on applications for funding in fiscal year 2015, the 
projected impact in 2016, and NIH's plan to ensure the analysis 
of data by sex and other subgroup demographics as a part of 
grant progress reporting and the compliance of institute 
directors for funding studies on sex differences and conditions 
that predominantly impact women.

Division of Program Coordination, Planning, and Strategic Initiatives 
        (DPCPSI)

    The mission of DPCPSI is to coordinate and facilitate 
trans-NIH research initiatives and emerging areas of scientific 
opportunities and public health challenges. The Division houses 
these NIH offices: the Office of Research on Women's Health; 
the Office of AIDS Research; the Office of Dietary Supplements; 
the Office of Behavioral and Social Sciences Research; the 
Office of Disease Prevention; and the Office Research 
Infrastructure Programs. The Committee directs the Director of 
DPCPSI to develop a trans-NIH strategic approach to improve 
coordination and facilitation of trans-NIH research with 
measurable objectives. The Director should also take specific 
steps with the ICs to strengthen to reduce duplication and 
increase effectiveness and efficiency of research.
    Common Fund.--The Committee is concerned that resources in 
the Common Fund are being moved away from the Pioneer, New 
Innovator, and the Transformative R01 awards. These high risk 
high impact awards have shown great success and the Committee 
expects NIH to use more of these types of awards throughout 
NIH, not less.
    Gabriella Miller Kids First Research Act.--The Committee 
includes funding within the Common Fund to support the 
Gabriella Miller Kids First Research Act, named after Gabriella 
Miller, who died in 2013 as a result of pediatric cancer. The 
Committee directs the NIH Director to use at least $12,600,000 
of Common Fund resources in fiscal year 2016 to support 
pediatric research as authorized in the Gabriella Miller Kids 
First Research Act. The Committee encourages NIH to prioritize 
research relating to childhood cancer within the Kids First 
program and requests an update in the fiscal year 2017 budget 
request on the 10-year program, planned activities, and on-
going research.

Office of Research on Women's Health

    The Office of Research on Women's Health (ORWH) works in 
collaboration with the NIH ICs to promote and foster efforts to 
address gaps in knowledge related to women's health through the 
enhancement and expansion of funded research and/or the 
initiation of new investigative studies. ORWH is responsible 
for supporting the inclusion of women in clinical research 
funded by NIH, including the development of a computerized 
tracking system and the implementation of guidelines on such 
inclusion. ORWH is also involved in promoting programs to 
increase the number of women in biomedical science careers, and 
in the development of women's health and gender factors as a 
focus in biology.

Office of AIDS Research

    The Office of AIDS Research (OAR) is authorized to manage 
trans-NIH AIDS research. The Director of OAR and the Director 
of NIH jointly determine the total for AIDS research within the 
NIH appropriation based on scientific need and meritorious 
scientific opportunity relative to NIH's overall plan. The 
Committee expects NIH to continue to track NIH AIDS funding.
    The bill continues language permitting OAR to use up to 
$8,000,000 for construction or renovation of facilities, as 
authorized in title XXIII of the Public Health Service Act.

Office of Dietary Supplements

    The Office of Dietary Supplements (ODS) was established in 
recognition that dietary supplements can have an important 
impact on prevention and health maintenance. In collaboration 
with other NIH institutes and centers and other federal 
agencies, ODS works to strengthen knowledge about dietary 
supplements by supporting and coordinating scientific research 
in the field.

Office of Behavioral and Social Sciences Research

    The Office of Behavioral and Social Sciences Research 
(OBSSR) provides leadership and direction for the development 
of a trans-NIH plan to increase the scope of and support for 
behavioral and social sciences research and in defining an 
overall strategy for the integration of these disciplines 
across NIH institutes and centers; develops initiatives to 
stimulate research in the behavioral and social sciences arena 
and to integrate a bio-behavioral perspective across the 
research areas of NIH; and promotes studies to evaluate the 
contributions of behavioral, social and lifestyle determinants 
in the development, course, treatment, and prevention of 
illness and related public health problems.

Office of Science Education

    The Office of Science Education (OSE) plans, develops, and 
coordinates a comprehensive science education program to 
strengthen and enhance efforts of the NIH to attract young 
people to biomedical and behavioral science careers and to 
improve science literacy in both adults and children. The 
Office develops curriculum supplements and other educational 
materials; maintains a website as a central source of 
information about NIH science education resources; establishes 
national model programs in public science education, and 
promotes science education reform as outlined in the National 
Science Education Standards and related guidelines.

Office of Disease Prevention

    The Office of Disease Prevention (ODP) assesses, 
facilitates, and stimulates research into disease prevention 
and health promotion in collaboration with NIH and other public 
and private partners, and disseminates the results of this 
research to improve public health. ODP produces evidence-based 
consensus statements addressing controversial medical issues. 
The Committee expects ODP to disseminate consensus statements 
and disease prevention and health promotion information through 
appropriate HHS outreach programs.

Office of Research Infrastructure Programs

    The Office of Research Infrastructure Programs (ORIP) 
provides support for research and a variety of research 
infrastructure needs, including animal models and facilities; 
research models, biological materials, and human biospecimens; 
training and career development for veterinarians engaged in 
research; the acquisition of state-of-the-art instrumentation 
through the Shared and High-End Instrumentation Programs; 
research resources grants to expand, re-model, renovate, or 
alter existing research facilities or to construct new research 
facilities; and coordinates science education activities.

Multi-institute Research Issues

    Angelman Syndrome.--The Committee recognizes the promising 
scientific gains made in the pursuit of treatments for angelman 
syndrome. The Committee applauds the contributions of the 
angelman syndrome natural history study and the private 
partners working diligently to advance the growing body of 
angelman syndrome research towards practical treatments. 
Further research in this area holds great promise for both 
angelman syndrome and forms of autism also linked to 
misexpression of the UBE3A gene. The Committee encourages NIH 
to support angelman syndrome research and to consider 
meritorious research. The Committee encourages NIH to leverage 
Federal funds with public-private partnerships in the areas of 
angelman syndrome, autism, and UBE3A related disorders.
    Anhydramnios.--The Committee requests NIH conduct a state 
of the science on anhydramnios research and possible treatments 
and provide an update in the fiscal year 2017 budget request.
    Basic Biomedical Research.--The Committee urges the NIH 
Director to continue the traditional focus on 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. Basic biomedical research must remain a key 
component of both the intramural and extramural research 
portfolio at the NIH. The Committee also requests NIH take 
actions to ensure the percentage of funding in the extramural 
research program on basic research does not fall below 55 
percent of NIH resources.
    Children in NIH Research.--The inclusion of children in 
clinical research is essential to ensure that children benefit 
from important scientific advances. The Committee understands 
NIH has a formal policy mandating the inclusion of children in 
research relevant to child health, but it does not 
systematically track enrollment data to determine if children 
are actually being enrolled appropriately in clinical research. 
The Committee recognizes that without better data collection, 
the Committee is unable to fully exercise its oversight role 
and researchers are unable to determine whether children as a 
whole, or particular pediatric subpopulations, are 
underrepresented in federally funded biomedical research. The 
Committee directs NIH to collect data and report publicly on 
the actual numbers of children in the various pediatric age 
groups that are enrolled in its clinical studies.
    Coordination with CDC.--The Committee remains concerned 
regarding the duplication of efforts and overlapping of 
responsibilities and funding priorities between the NIH and 
CDC. The Committee encourages NIH and CDC to coordinate further 
on cross-cutting initiatives, ensuring that each funds programs 
within its respective core mission. The Committee requests an 
update in the fiscal year 2017 budget request how each NIH 
program coordinates with the CDC Centers.
    Clinical Trial Participation.--The Committee encourages NIH 
to further the discussion with organizations that participated 
in the July 2014 NIH Clinical Trial Improvement Workshop as it 
explores methods to improve participation, enrollment, 
retention, in NIH supported clinical trials, especially among 
underrepresented populations. The Committee requests an update 
on the steps NIH has taken and planned in the fiscal year 2017 
budget request.
    Conflict of Interest.--The Committee encourages NIH to 
review and clarify conflict of interest policies to ensure more 
effective and transparent industry/institutional research 
collaborations.
    Duchenne Muscular Dystrophy.--The Committee requests an 
update in the fiscal year 2017 budget request on NIH's plans to 
implement the recent changes to the Muscular Dystrophy CARE Act 
and summary of the outcome from the latest Muscular Dystrophy 
Coordinating Committee and timeframe for the next two meetings.
    Enhanced NIH Reporting on Research Spending by Disease and 
Affected Populations.--The Committee reiterates its direction 
identified in the fiscal year 2015 Explanatory Statement for 
NIH to make public, on an annual basis, enhanced RCDC spending 
data with the number of Americans affected by each category of 
disease according to CDC or other federally-sourced data. 
Further, the Committee requests NIH to include the number of 
Americans living with each disease, annual number of newly 
diagnosed Americans for each disease, and number of Americans 
who die from each disease annually. The Committee appreciates 
that NIH may not have all available category data during fiscal 
year 2016 but expects NIH to upload all available data 
immediately and to have the full data set on-line no later than 
May 1, 2016. The Committee requests an update on the process in 
the fiscal year 2017 budget request. In addition, the Committee 
encourages NIH to add pediatric cardiomyopathy to the RCDC and 
spending on the disease for at least the last five year and 
projected forward.
    Fragile X Research.--The Committee commends NICHD for 
leading the effort to map the molecular, physiological, 
biological, and genetic connections between fragile X (FX), the 
fragile X protein, and autism. The fragile X gene and its 
protein continue to present important insight into discovering 
the root cause of autism and disease modifying treatments for 
FX and autism. The Committee encourages NIH to explore ways to 
utilize FX and autism research in tandem to accelerate the pace 
of research toward identification of the commonality between 
the two conditions and the development of disease modifying 
treatments that will reduce health burdens.
    Hepatitis B.--The Committee encourages NIAID and NIDDK to 
continue their long-standing commitment to advancing the 
scientific knowledge on hepatitis B and chronic hepatitis B. 
The Committee urges aggressive discovery to find ways to 
prevent and develop new therapies for hepatitis B that have the 
potential to be a cure. The Committee requests the NIH Director 
to consider establishing a hepatitis B specific Integrated 
Review Group (IRG) to review the grant applications associated 
with hepatitis B. The Committee also encourages development of 
an HBV Cure initiative, analogous to the HIV Cure initiative, 
to coordinate and accelerate the development of a cure for 
those afflicted with HBV.
    New Initiatives.--The Committee is concerned that every 
year new NIH initiatives are announced and that, although new 
initiatives start at the planned level, over time these 
projects are not supported in the budget requests at levels 
that will result in achievement of initial expectations. The 
Committee requests NIH to provide a table in the fiscal year 
2017 and future budget requests with the current year plus 
five-year planned funding levels for each initiative started 
over the past five years or on-going and proposed in the 
current budget. The table should identify the planned budget 
level provided; a list of participating Institutes and Centers 
(ICs); the linkage to the NIH-wide strategic plan; and 
percentage of the funds focused on basic science, as a minimum 
for each initiative.
    Reproducibility of Scientific Methods.--The Committee notes 
that the gold standard of good science is the ability of a lab 
to reproduce a method and finding and is therefore continues to 
be concerned with reports that some published biomedical 
research cannot be easily reproduced. The Committee expects NIH 
to continue to stress the importance of experimental rigor and 
transparency of reporting of research findings in order to 
enhance the ability of others to replicate them. The Committee 
requests an update in the fiscal year 2017 budget request on 
how NIH is measuring the effectiveness of each step NIH has 
taken to develop and implement best practice guidelines to 
better facilitate the conduct of replicable research and 
research transparency in the reporting of methods and findings.
    Medication Assisted Treatment (MAT).--The Committee 
understands that NIDA supports 90 research projects totaling 
over $41 million related to MAT that include how to incorporate 
MAT into models of integrated healthcare. The Committee 
requests an update in the fiscal year 2017 request on research 
supported across NIH related to MAT, with specific review of 
MAT in primary care settings. In addition, the Committee 
expects NIH to conduct a review to identify the scientific gaps 
related to MAT research.
    Minority Researchers.--The Committee continues to support 
the development of health professionals and scientists, 
including minorities, committed to researching and eliminating 
health disparities.
    Mitochondrial Disease.--The Committee continues to support 
the study of mitochondrial function and primary mitochondrial 
disease. The Committee understands NIH supported a two-day 
workshop in March 2012 on primary mitochondrial diseases, which 
led to the development of a white paper and a working group on 
mitochondrial disease research with broad participation from 
various ICs. The Committee requests an update on the steps NIH 
has taken, on-going, and planned to further each of the white 
paper recommendations in the fiscal year 2017 budget request.
    National Children's Study Alternative.--The Committee was 
disappointed that NIH determined it was not feasible for NIH to 
implement the National Children's Study (NCS) as originally 
conceived. The NCS was intended to be a 25 year longitudinal 
birth cohort observational study with the overall goal of 
improving child health and well-being and identifying 
antecedents of healthy adulthood by examining the effects of a 
broad range of environmental, behavioral, and biological 
factors. The Institute of Medicine's (IOM) June 2014 report 
noted the NCS' goals and mission had the potential to add to 
the scientific knowledge of children's health and development. 
The Committee directs and provides funding for continuation of 
the NCS in an alternative form called the National Children's 
Study Alternative (NCS-A). The NIH is directed to work in 
consultation with pediatric groups to develop a series of 
alternative research activities that build on NCS data and the 
overarching goals of the NCS to address the developmental 
origins of health and disease through a series of studies 
(including longitudinal) that incorporate expertise in biology 
and epidemiology, integrate basic science, and leverage 
maternal/infant cohorts, either de novo or from extant 
networks. NIH is expected to focus on at least prematurity, 
obesity, autism, asthma, and pediatric rare diseases like 
cancer. The Committee expects NIH to obtain data, biological 
samples, and specimens that can ultimately improve child health 
and well-being. The Committee understands that such a program 
can be built by leveraging existing cohort studies by expanding 
or adding study components; supporting projects with smaller 
cohorts that can investigate unique, disease-specific 
questions; expanding studies to increase sample size; and using 
or expanding pediatric networks and extant programs to include 
a focus on pediatric health.
    The Committee directs NIH to draw on the lessons learned 
from the NCS as it develops a long-term plan for the NCS-A, and 
to establish an advisory panel with outside pediatric experts. 
Within 180 days of enactment, NIH is directed to submit and 
make public a NCS-A 10-year plan that includes milestones, 
goals, objectives, and projected funding estimates. The 
Committee urges NIH to review the plan at least every five 
years in a manner that obtains public input and that allows for 
flexibility to expand or adjust the focus areas based on the 
state of the science and the best impact on children's health. 
In addition, NIH shall ensure it establishes and maintains a 
tracking system to ensure these funds do not supplant but 
supplement other children's research on-going or planned by 
NIH. Finally, NIH shall report on the NCS-A in the annual 
budget request.
    Neurofibromatosis (NF).--The Committee continues to support 
NF research and treatment at multiple NIH ICs, including NCI, 
NINDS, NIDCD, NHLBI, NICHD and NEI. Children and adults with NF 
are at risk for the development of many forms of cancer. The 
Committee encourages NCI to continue its NF research portfolio 
in fundamental basic science, translational research and 
clinical trials focused on NF. The Committee appreciates NCI 
support to centers, clinical trials consortia, preclinical 
mouse models consortia and other NF-associated tumor sequencing 
efforts. The Committee encourages NIDCD activities in NF2 basic 
and clinical research. Further, the Committee notes NF1 can 
cause vision loss due to optic gliomas and encourages NEI to 
expand its investment in NF1 basic and clinical research.
    Pediatric Research Network.--The Committee notes the 
enactment of the National Pediatric Research Network Act that 
authorizes a collaborative and multi-institution pediatric 
research network to accelerate the pace of pediatric disease 
discovery. The Committee requests the NIH Director to provide 
an update in the fiscal year 2017 budget request on the 
specific steps on-going and planned towards the aims of the Act 
and describe how the network can participate in the alternative 
approach to support the goal of increasing biomedical knowledge 
on children's diseases to accelerate cures, treatment, and 
prevention activities as anticipated in the National Children's 
Study.
    Precision Medicine Initiative (PMI).--The Committee 
provides the requested funds to support the trans-NIH PMI 
within the Common Fund. The Committee expects to receive a 
comprehensive plan that outlines the way in which NIH plans to 
execute the PMI, initiative length and how data on human 
subjects will be protected. The NIH shall, as part of the 
planning for this project, examine similar activities being 
performed by industry, nonprofits, or academia to ensure 
federal funds are used to fill gaps and not duplicate effort. 
The PMI plan should consider and evaluate how public-private 
partnership opportunities can be leveraged. Further, the plan 
should include an examination of drug regulatory processes to 
ensure the FDA is positioned to support therapies that may 
result from private or public sector PMI research.
    The plan should also describe the practical application of 
genetic discoveries, including how to support the development 
of appropriate data analytic tools using genetic data and the 
consideration of pathways involved in chronic diseases. The 
Committee requests NIH to submit the plan within 90 days of 
enactment. Future funding requests for the PMI are expected to 
identify how much existing NIH personalized and precision 
medicine portfolio funds are being re-competed annually. The 
Committee notes that further proposed NIH initiatives and 
programs of this nature should be more fully developed prior to 
requesting funds and the funds should be specifically 
identified by IC.
    Prioritization of Funding.--The Committee expects NIH to 
prioritize federal funds for medical research on discovery over 
outreach and education. The Committee expects NIH to distribute 
funding based on the merit of researchers ideas and 
productivity, without applying discriminatory review 
requirements to extramural investigations, or creating barriers 
to funding for research institutes or team-based research. The 
Committee reiterates its desire for NIH to subject intramural 
resources to the same policies and review as extramural 
researchers. Further, NIH is expected to complete and actively 
use the NIH 5-year scientific strategic plan, directed in the 
fiscal year 2016 Appropriations Act, to prioritize funding. The 
Committee expects NIH to allocate resources through a 
meritoriously based competitive peer review process to best 
target resources to diseases with the significant opportunity 
to improve the current or future health of the American 
population.
    Protecting Human Subject Data.--The Committee reiterates 
its concerns related to the protection of privacy of 
individuals who are the subject of research. The fiscal year 
2015 Appropriations Act included statement language directing 
NIH to include requirements related to privacy protections in 
every grant that involves human research, such as the issuance 
of certificates of confidentiality. The Committee provides bill 
language to require investigators receiving NIH funding for new 
and competing research projects designed to generate and 
analyze large volumes of data derived from human research 
participants to obtain a certificate of confidentiality. 
Further, the Committee is aware that NIH recognizes that 
privacy protections will be critical for the success of the PMI 
and other similar genomic research. The Committee requests that 
no later than 90 days after enactment, NIH provide a report on 
specific steps NIH can and will take to further protect the 
privacy of human subjects and specific legislative actions that 
could further protect these individuals who may participate in 
future NIH supported research.
    Psychotropic Medications and Children.--The Committee 
encourages NICHD, NIMH, CDC and the FDA to undertake a 
concerted effort to identify the research gaps and work with 
these agencies to determine the safety and efficacy of these 
medications, and to explore research into the biological 
evidence-base of psychosocial interventions that can be used 
instead of, or in combination with, psychotropic medications.
    Translational Research.--The Committee understands NIH has 
undertaken an expansion of translational research and sciences 
over the past several years. The Committee requests an update 
on the specific results of these efforts, current activities, a 
plan for future activities, and the fiscal year 2013 through 
2016 annual NIH expenditures on translational sciences in the 
fiscal year 2017 budget request. Further, the updates should 
provide the definition for Translational Research and how it 
applies the definition as it makes awards to various 
institutions.
    Undiagnosed Disease Program (UDP).--The Committee continues 
support for the Undiagnosed Disease Network (UDN) within the 
UDP. The Committee requests an update in the fiscal year 2017 
budget request on steps NIH has taken to develop public/private 
partnership for the UDN and how it can support physicians who 
are handling cases of undiagnosed diseases with new knowledge, 
consistent with applicable privacy laws, including HIPAA 
privacy and security law, through an ability to search for 
similar cases and to network and collaborate with physicians 
handling similar cases in order to accelerate the diagnosis, 
treatment options, and improve patient outcomes across the 
country. Further, the update should describe the criteria NIH 
uses to allow various level of access to the database based on 
the circumstances of the users' requirements.
    Usher Syndrome.--The Committee continues to encourage 
support for research activities to prevent and correct the 
health related issues of Usher Syndrome. The Committee requests 
an update in the fiscal year 2017 budget request on the planned 
and on-going activities related to this syndrome. The update 
should address the funding level and manner in which the 
various ICs coordinate on common goals and objectives.
    Vitiligo.--The Committee is concerned that although 
vitiligo is not a terminal or debilitating disease, it 
nonetheless can have serious effects on the lives of those 
afflicted with this skin-discoloring condition. The Committee 
is further concerned that this may lead to other conditions 
that have not been thoroughly considered including the impact 
on behavior and mental health consequences. The Committee 
requests an update in the fiscal year 2017 budget request on 
the epidemiology of the disease including incidence, causal 
factors, any associations with racial populations and 
hereditary occurrence. The update should include planned and 
on-going medical research to move towards a cure.
    Young Investigators.--The Committee directs NIH to report 
on actions it has taken to lower the median age at which 
investigators receive their first R01 awards within 120 days of 
enactment. In addition, the NIH shall submit an accompanying 
plan outlining concrete steps to lower the median age at which 
individuals receive their first R01 award. The Committee urges 
NIH to convene a working group of stakeholders from academia, 
young researchers, industry leaders, and government officials 
to move forward on this goal.
    Updates.--In addition the specific interest items, the 
Committee requests general updates in the fiscal year 2017 
budget request for each of the listed disease, condition, or 
topic to describe the latest efforts ongoing and planned:
    Administrative Burden Workgroup;
    Aging Demographic Research;
    Alcohol Dependence;
    Amyloidosis;
    Atrial Fibrillation;
    Behavioral Science Research in NIMH;
    Cerebral Palsy;
    Chronic Pelvic Pain;
    Congenital Heart Disease;
    Diabetes;
    Environmental Exposures;
    Global Infections Disease Health Research;
    Kennedy's Disease;
    Kidney Disease;
    Interstitial Cystitis;
    Lymphangioleiomyomatosis;
    Microbicides to Prevent HIV/AIDS;
    Neglected Tropical Diseases;
    NCI Scientific Frameworks for pancreatic ductal 
adenocarcinoma;
    NCI Pancreatic Ductal Adenocarcinoma Progress Working 
Group;
    Nanovaccines;
    NIH Workforce Study;
    Preterm Birth;
    Preeclampsia;
    Pulmonary Atresia;
    Science, Technology, Education and Mathematics (to include 
specific actions related to Hispanic Serving Institutions, and 
other minority serving institutions);
    Sickle Cell Research;
    Sleep and Circadian Health;
    Scleroderma;
    Spina Bifida;
    Study Sections Pediatric Expertise;
    Stroke-Induced Respiratory Dysfunction; and
    Sturge-Weber Syndrome.

                        BUILDINGS AND FACILITIES

    Mission.--The Buildings and Facilities appropriation 
provides for the design, construction, improvement, and major 
repair of clinical, laboratory, and office buildings and 
supporting facilities essential to the mission of the National 
Institutes of Health. The funds in this appropriation support 
the buildings on the main NIH campus in Bethesda, Maryland; the 
Animal Center in Poolesville, Maryland; the National Institute 
of Environmental Health Sciences facility in Research Triangle 
Park, North Carolina; and other smaller facilities throughout 
the United States.
    The Committee notes NIH has a significant backlog of 
maintenance and repairs. The Committee encourages NIH and HHS 
to develop a coordinated plan to address the backlog with the 
Office of Management and Budget in the fiscal year 2017 
congressional budget request.

       Substance Abuse and Mental Health Services Administration

    The Committee recommends $3,642,710,000 for the Substance 
Abuse and Mental Health Services Administration (SAMHSA), which 
is $22,998,000 more than the fiscal year 2015 enacted program 
level and $21,577,000 below the requested program level.
    The Committee includes bill language directing the 
Administrator of SAMHSA and the Secretary to exempt the Mental 
Health Block Grant and the Substance Abuse Prevention and 
Treatment Block Grant as a source for the PHS evaluation set-
aside in fiscal year 2016.
    The Committee does not include the requested bill language 
allowing the Administrator to transfer three percent or less of 
funds between any of the SAMHSA accounts.

                             MENTAL HEALTH

    The Committee recommends $1,073,975,000 for Mental Health 
Services, which is $5,000,000 below the fiscal year 2015 
enacted program level and $1,308,000 more than the requested 
program level.
    Within the total provided for Mental Health Programs of 
Regional and National Significance, the Committee recommends 
the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Capacity:
    Seclusion and Restraint..........................         $1,147,000
    Youth Violence Prevention........................         23,099,000
    National Child Traumatic Stress Initiative.......         45,887,000
    Project Aware State Grants.......................         39,902,000
    Mental Health First Aid..........................         14,963,000
    Healthy Transitions..............................         19,951,000
    Children and Family Programs.....................          6,458,000
    Consumer and Family Network Grants...............          4,954,000
    MH System Transformation & Health Reform.........          3,779,000
    Project LAUNCH...................................         34,555,000
    Primary and Behavioral Health Integration........         43,000,000
    National Strategy for Suicide Prevention.........          2,000,000
    Suicide Lifeline.................................          7,198,000
Garrett Lee Smith--Youth Suicide Prevention
        State Grants.................................         47,427,000
        Campus Grants................................          6,488,000
    Homeless Prevention Programs.....................         28,696,000
    Minority AIDS....................................          8,224,000
    Alaskan-Indian/American Native Suicide Prevention          2,931,000
    Tribal Behavioral Health Intervention Grants.....         15,000,000
    Criminal and Juvenile Justice Programs...........          4,269,000
    Science to Service:..............................
    Garrett Lee Smith--Suicide Resource Center.......          6,681,000
    Consumer & Consumer Support TACenters............          1,918,000
    Primary & Behavioral Health Care Integ. TA.......          1,991,000
    Minority Fellowship Program......................          8,059,000
    Disaster Response................................          1,953,000
    Homelessness.....................................          2,296,000
    HIV/AIDS Education...............................            771,000
------------------------------------------------------------------------

    Childhood Trauma.-- The Committee appreciates SAMSHA's 
ongoing support of the National Child Traumatic Stress Network. 
A recent report, Childhood Adversity Narratives, makes clear 
that childhood trauma is an all-encompassing and costly 
national public health problem contributing directly to serious 
mental and medical conditions. The Committee encourages SAMSHA 
to more broadly disseminate information regarding evidence-
based interventions for the prevention and treatment of 
childhood trauma so more children can benefit from proven 
practices.
    Mental Health First Aid.--The Committee directs SAMHSA to 
make competitive funding opportunities for this program 
available to all qualified community mental health education 
programs. Consistent with a broad public safety approach, 
SAMHSA is directed to include as eligible grantees local law 
enforcement agencies, fire departments, emergency medical 
services units and hospital systems. SAMHSA is encouraged to 
allow training for veterans, armed services personnel and their 
family members within the Mental Health First Aid program.
    Tribal Behavioral Health Grants.--The Committee is 
recommending an overall total of $32,931,000 to support the 
expansion of suicide prevention, overall mental health and 
substance abuse prevention activities for Native American 
youth. The Committee expects SAMHSA to ensure that the 
activities conducted under the American Indian and Alaskan 
Native Suicide Prevention program are effectively coordinated 
with the Tribal Behavioral Health Grants (TBHG). These two 
grant programs must work as an integrated whole to accomplish 
the goal of reducing suicides and drug abuse amongst Native 
American youth. Prior to the announcement of the TBHG grant 
opportunities, SAMHSA is directed to brief the Committee 
regarding the criteria for grant awards. Following the award of 
the grants, SAMHSA is directed to provide a briefing within 120 
days to review the progress made and any unforeseen challenges 
that arise.

Mental Health Block Grant

    The Committee recommends a total of $482,571,000 for the 
Mental Health Block Grant, which is the same as the fiscal year 
2015 enacted program level and the budget request. The block 
grant provides funds to States to support mental illness 
prevention, treatment, and rehabilitation services. Funds are 
allocated according to a statutory formula among the States 
that have submitted approved annual plans.
    The Committee continues the five percent set-aside within 
the Mental Health Block Grant for evidence-based programs that 
address the needs of individuals with early serious mental 
illness, including psychotic disorders. The Committee expects 
SAMHSA to continue its collaboration with the National 
Institute of Mental Health to encourage States to use this 
block grant funding to support programs that demonstrate strong 
evidence of effectiveness.

Children's Mental Health

    The Committee recommends $117,026,000 for the Children's 
Mental Health Services program, which is the same as the fiscal 
year 2015 enacted level and the budget request. Funding for 
this program supports grants and technical assistance for 
community-based services for children and adolescents up with 
serious emotional, behavioral, or mental disorders. The program 
assists States and local jurisdictions in developing integrated 
systems of community care.

Projects for Assistance in Transition from Homelessness

    The Committee recommends $54,635,000 for the Projects for 
Assistance in Transition from Homelessness (PATH) program, 
which is $10,000,000 below the fiscal year 2015 enacted level 
and the budget request. The PATH program supports grants to 
States and territories to provide assistance to individuals 
suffering from severe mental illness and/or substance abuse 
disorders and who are homeless or at imminent risk of becoming 
homeless. Grants may be used for outreach, screening and 
diagnostic treatment services, rehabilitation services, 
community mental health services, alcohol or drug treatment 
services, training, case management services, supportive and 
supervisory services in residential settings, and a limited set 
of housing services.

Protection and Advocacy for Individuals with Mental Illness

    The Committee recommends $36,146,000 for the Protection and 
Advocacy program, which is the same as the fiscal year 2015 
enacted level and the budget request. This program serves to 
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. Funds are 
allocated to States according to a formula based on population 
and relative per capita incomes.

                       SUBSTANCE ABUSE TREATMENT

    The Committee recommends $2,196,856,000 for Substance Abuse 
Treatment programs, which is $12,998,000 more than the fiscal 
year 2015 enacted program level and $56,299,000 more than the 
requested program level.
    Within the total provided for Programs of Regional and 
National Significance, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Capacity:
    Opioid Treatment Programs/Reg Activities.........         $8,724,000
Screening, Brief Intervention, Referral, and                  46,889,000
 Treatment (SBIRT)...................................
Targeted Capacity Expansion--General.................         36,303,000
Pregnant and Postpartum Women........................         15,931,000
Strengthening Treatment Access and Retention.........          1,000,000
Recovery Community Services Program..................          2,434,000
Access to Recovery...................................         38,223,000
Children and Families................................         29,605,000
Treatment Systems for Homeless.......................         41,304,000
Minority AIDS........................................         65,570,000
Criminal Justice Activities..........................         78,000,000
Science to Service:
    Addiction Technology Transfer Grants.............          9,046,000
    Minority Fellowship Program......................          2,539,000
    Special Initiatives/Outreach.....................          1,432,000
------------------------------------------------------------------------

    Addiction Technology Transfer Centers (ATTCs).--The 
Committee once again rejects the Administration's request to 
reduce funding for the ATTCs. SAMHSA is directed to ensure that 
ATTCs maintain a primary focus on addiction treatment and 
recovery services.
    Targeted Capacity Expansion.--The Committee recommends 
$36,303,000 for Targeted Capacity Expansion activities, which 
is $13,100,000 more than the fiscal year 2015 enacted level and 
the same as the budget request. Together with the $12,000,000 
increase provided in the Consolidated and Further Continuing 
Appropriations Act of fiscal year 2015, this additional funding 
is provided to increase the number of States from 11 to 22 that 
are receiving funding to expand services that address 
prescription drug abuse and heroin use in high-risk 
communities. The Committee expects SAMHSA to provide a briefing 
within 45 days of enactment regarding how it intends to execute 
these activities and carry out the two mandates described 
below.
    The United States has seen a 500 percent increase in 
admissions to treatment for prescription drug abuse since 2000. 
Moreover, according to a recent study, 28 states saw an 
increase in admissions to treatment for heroin dependence 
during the past two years. The fiscal year 2015 Consolidated 
and Further Continuing Appropriations Act provided funding for 
Targeted Capacity Expansion specifically for prescription drug 
and heroin treatment. The Center for Substance Abuse Treatment 
is directed to include as an allowable use medication-assisted 
treatment and other clinically appropriate services to achieve 
and maintain abstinence from all opioids and heroin and 
prioritize treatment regimes that are less susceptible to 
diversion for illicit purposes.
    Since the passage of the Drug Addiction Treatment Act of 
2000, SAMHSA has led the nation in educating physicians, 
patients and treatment systems on the use of medication-
assisted treatment. To keep pace with advancements in science 
and research, SAMHSA is directed to update all of its public-
facing information and treatment locators such that all 
evidence-based innovations in counseling, recovery support, and 
abstinence-based relapse prevention medication-assisted 
treatments are fully incorporated.
    Criminal Justice Activities.--The Committee provides 
$78,000,000 for the Criminal Justice Activities program and 
expects that no less than $60,000,000 will be used exclusively 
for Drug Court activities.
    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. SAMHSA is 
directed to ensure that all drug treatment court grant 
recipients work directly with the corresponding State substance 
abuse agency in the planning, implementation, and evaluation of 
the grant. The Committee further directs SAHMHSA to expand 
training and technical assistance to drug treatment court grant 
recipients to ensure evidence-based practices are fully 
implemented.
    Oral Fluid Drug Testing.--The Committee supports the 
development of oral fluid as an alternative specimen for drug 
testing and commends SAMHSA for the progress made to issue oral 
fluid guidelines for the Federal Workplace Drug Testing 
Programs. The Committee urges SAMHSA to publish the guidelines 
expeditiously and to implement the guidelines in partnership 
with stakeholders.

Substance Abuse Prevention and Treatment Block Grant

    The Committee recommends $1,819,856,000 in discretionary 
budget authority, which is the same as the fiscal year 2015 
enacted program level and the requested program level. The 
Substance Abuse Prevention and Treatment (SAPT) Block Grant 
provides funds to States to support alcohol and drug abuse 
prevention, treatment, and rehabilitation services.

                       SUBSTANCE ABUSE PREVENTION

    The Committee recommends $190,219,000 for the Substance 
Abuse Prevention programs, which is $15,000,000 more than the 
fiscal year 2015 enacted level and $20,699,000 below the budget 
request.
    Within the total provided for Programs of Regional and 
National Significance, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Capacity:
    Strategic Prevention Framework...................       $109,484,000
    Minority AIDS....................................         41,205,000
    Mandatory Drug Testing...........................          4,894,000
    Sober Truth on Preventing (STOP) Underage                  7,000,000
     Drinking........................................
    Tribal Behavioral Health.........................         15,000,000
Science to Service:
    Fetal Alcohol Spectrum Disorder..................          1,000,000
    Center for the Application of Prevention                   7,493,000
     Technologies....................................
    Science & Service Program Coordination...........          4,072,000
    Minority Fellowship Program......................             71,000
------------------------------------------------------------------------

                    HEALTH SURVEILLANCE AND SUPPORT

    The Committee recommends $181,660,000 for Health 
Surveillance and Support, which is the same as the fiscal year 
2015 enacted program level and $53,485,000 below the requested 
program level.
    Within the total provided for Health Surveillance and 
Support, the Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Health Surveillance..................................        $47,258,000
Program Management...................................         72,002,000
Behavioral Health Workforce..........................         35,000,000
Public Awareness and Support.........................         13,482,000
Performance & Quality Info. Systems..................         12,918,000
Behavioral Health Workforce Data.....................          1,000,000
------------------------------------------------------------------------

    Mental and Behavioral Health Education and Training 
Program.--Within the amount available for Health Surveillance 
Support, the Committee recommends $35,000,000 for the joint 
SAMHSA HRSA 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, counselors, marriage and family therapists, 
psychology doctoral interns, as well as behavioral health 
paraprofessionals. The Committee directs SAMHSA to share 
information concerning pending grant opportunity announcements 
with State licensing organizations and all the relevant 
professional associations.

               Centers For Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

    The Committee recommends $243,545,410,000 for the Federal 
share of current law State Medicaid costs, which is 
$8,936,494,000 more than fiscal year 2015 enacted level and the 
same as the budget request. This amount does not include 
$113,272,140,000, which was advance funded for the first 
quarter of fiscal year 2016. In addition, the Committee 
recommends an advance appropriation of $115,582,502,000 for 
program costs in the first quarter of fiscal year 2016. The 
Committee continues indefinite budget authority bill language 
for unanticipated costs in fiscal year 2016.
    Federal Medicaid grants reimburse States for a portion of 
their expenditures in providing health care for individuals 
whose income and resources fall below specified levels. Subject 
to certain minimum requirements, states are provided certain 
limited authority within the law to set eligibility, coverage, 
and payment levels.

                PAYMENTS TO THE HEALTH CARE TRUST FUNDS

    The Committee recommends $283,171,800,000 for the Payments 
to the Health Care Trust Funds account, which supports Medicare 
Part B and prescription drug benefits in fiscal year 2016. This 
amount is $23,959,800,000 more than the fiscal year 2015 
enacted level and equal to the budget request. This entitlement 
account includes the general fund subsidy to the Federal 
Supplementary Medical Insurance Trust Fund for Medicare Part B 
benefits, and Medicare drug benefits and administration, as 
well as other reimbursements to the Federal Hospital Insurance 
Trust Fund for benefits and related administrative costs, which 
have not been financed by payroll taxes or premium 
contributions. The Committee continues bill language providing 
indefinite authority to pay the general revenue portion of the 
Medicare Part B premium match and providing resources for the 
Medicare Part D drug benefit program in the event that the 
annual appropriation is insufficient.

                           PROGRAM MANAGEMENT

    The Committee makes available $3,325,690,000 in trust funds 
for Federal Administration of the Medicare and Medicaid 
programs, which is $344,054,000 less than the fiscal year 2015 
enacted level and $919,496,000 less than the budget request. 
This activity supports the two largest Federal health care 
programs, Medicare and Medicaid, along with the Children's 
Health Insurance Program (CHIP) and the Medicare prescription 
drug program. The Committee does not support the consumer 
information and insurance oversight functions. The Committee 
provides resources in the program operations line to support 
the Medicare current beneficiary survey. The bill includes 
language to prohibit funding the research, demonstration, and 
evaluation line within Program Management account.

Program Operations

    The Committee recommends $2,195,823,000 for Program 
Operations to support activities used to administer the 
Medicare program, primarily to pay contractors to process 
providers' claims, to fund beneficiary outreach and education, 
to maintain information technology (IT) infrastructure needed 
to support various claims processing systems and to continue 
programmatic improvements.
    Access to Home Health Care.--The Committee is aware that 
the current requirement that home health plans be solely 
certified by a physician has resulted in problems with access 
to home health care. The Committee urges CMS to insure access 
to home health care by considering methods to waive the 
requirement that home health plans be solely certified by a 
physician.
    Alzheimer's.--The Committee is concerned the CMS guidelines 
limit access to Positron Emission Tomography (PET) scans for 
diagnosing Alzheimer's disease. The Committee strongly urges 
CMS to review its reimbursement guidance, based on current 
scientific information on the value of PET testing for 
diagnosis of Alzheimer's.
    Colorectal Cancer Screening.--The Committee understands 
that regardless of the fact that colorectal cancer screening by 
colonoscopy has an A grade from the U.S. Preventive Services 
Task Force, CMS has determined that it does not have authority 
to waive Medicare beneficiary coinsurance for a colorectal 
cancer screening colonoscopy when a polyp or other tissue is 
removed during the preventive screening. The Committee requests 
an update in the fiscal year 2017 budget request outlining the 
rationale for this determination, to include why CMS believes 
it does not the waiver authority. Further, the Committee 
requests the update describe CMS's rationale related to the 
coverage of virtual colonoscopy.
    Coding System.--The Committee is concerned that 
implementation of the ICD 10 coding system will place a 
hardship on physicians and in particular those in small 
practices. The Committee urges the Secretary to work with 
medical providers to establish a hardship exemption for those 
practices that would be harmed by the change.
    CMS Test Environment for Testing Industry Solutions.--The 
Committee requests an update in the fiscal year 2017 budget 
request on how it is using this initiative to test IT 
solutions.
    Durable Medical Equipment, Prosthetics, Orthotics and 
Suppliers (DMEPOS).--The Committee is aware of concerns related 
to the potential negative impact on rural beneficiary access 
and rural providers from the Home Respiratory Therapy Rule. The 
Committee requests CMS to provide its detailed analysis and 
assumptions related to this rule's impact on rural provides and 
rural beneficiary access within 180 days after enactment. 
Further, the Committee urges CMS to delay the rule and to work 
with the community to address its concerns before any further 
action.
    Disproportionate Share Hospital (DSH).--The Committee is 
concerned with the lack of an appeals process for hospitals on 
Medicare payment determinations to correct errors with DSH 
payments for uncompensated care. The Committee requests CMS to 
provide an update in the fiscal year 2017 budget request on the 
judicial and administrative review processes available for 
hospitals to address payment error related to DSH payments.
    The Committee also is concerned that the Secretary has not 
addressed the financial impacts of CMS's one-year policy change 
in 2014 regarding hospital mergers where the new owner accepts 
assignment of the provider agreement. The Committee requests a 
report within 90 days on how this issue is being resolved.
    Long-Term Care Hospitals (LTCHs).--The Committee is 
concerned about recent actions taken by CMS forcing 
approximately 30 grandfathered LTCHs to abide by costly and 
inefficient rules, thereby preventing these hospitals from 
achieving the CMS goal of integrating the delivery of care 
between hospitals. This is contrary to the intent of the 
Balanced Budget Act of 1997 that clearly grandfathered existing 
co-located LTCHs to be exempt from the hospital within hospital 
regulations of 1995. The Committee requests CMS to provide 
justification in the fiscal year 2017 budget request describing 
why these grandfathered hospitals are held to regulations 
inconsistent with the intent of the original legislation.
    Health Insurance Exchange Transparency.--The Committee 
continues to include bill language in section 223 that requires 
CMS to provide cost information for the following categories: 
Federal Payroll and Other Administrative Costs; Exchange 
related Information Technology [IT]; Non IT Program Costs, 
including Health Plan Benefit and Rate Review, Exchange 
Oversight, Payment and Financial Management, Eligibility and 
Enrollment; Consumer Information and Outreach, including the 
Call Center, Navigator Grants and Consumer Education and 
Outreach; Exchange Quality Review; Small Business Health 
Options Program [SHOP] and Employer Activities; and Other 
Exchange Activities. Cost Information should be provided for 
each fiscal year since the enactment of the Patient Protection 
and Affordable Care Act (Public Law 111-148). CMS is also 
required to include the estimated costs for fiscal year 2017.
    Medicaid 1115 Waivers.--The Committee is concerned that CMS 
has not acted in a timely manner to approve a number of state 
applications for Medicaid 1115 waivers. The Committee requests 
CMS to report on the status of all pending Medicaid section 
1115 waivers in the fiscal year 2017 budget request.
    Fraud, Waste, and Abuse.--The Committee requests a update 
in the fiscal year 2017 request on the CMS process, across all 
operations, to ensure CMS maintains a focus on preventing 
improper payments and paying claims right the first time. The 
Committee requests the update include the metric to measure 
prevention in lieu of the ``pay and chase'' typical measures 
reported by CMS.
    Medicare Star Quality Rating System's (Stars).--The 
Committee understands that the CMS is near finalizing the 
Advance Notice of Methodological Changes for Calendar Year (CY) 
2016 for Medicare Advantage (MA) Capitation Rates, Part C and 
Part D Payment Policies. The CMS 2016 Call Letter proposes to 
adjust the methodology for accounting for low-income 
individuals who represent a significant portion of plan 
membership. The Committee encourages CMS not to remove plans 
from markets until they identify a methodology that 
appropriately judges all plans. Further, concerns are noted 
that the new methodology may harm plans that have made 
significant investments in assisting those with high levels of 
chronic conditions. The Committee urges CMS to address these 
concerns in the final Call Letter.
    Medicare Secondary Payer (MSP) Claims.--The Committee notes 
concern that CMS erroneously refers disputed MSP claims to the 
Treasury Department to seek repayment of secondary payer funds 
from small and large businesses and insurers for health care 
payments subject to a secondary source of payment. In some 
cases the responsibility for or amount of payment is disputed. 
Rather than permit entities with disputed claims due process 
and an opportunity to resolve their differences with the 
Agency, CMS regularly refers the debts to the Treasury for 
collection as ``final claims.'' The Committee requests CMS to 
provide an update in the fiscal year 2017 budget request on the 
process CMS uses prior to submitting such claims and 
alternative steps that could be used to prevent erroneous 
referrals to the Treasury.
    Medicare Survey and Certification.--The Committee is 
concerned by the number of preventable medication errors in 
hospitals. The Committee encourages CMS to review its 
guidelines and standards to support the reduction of human 
error in the medication administration process.
    Mental Health Crisis Stabilization Code.--The Committee 
requests CMS to provide an update in the fiscal year 2017 
budget request on the CPT codes for Crisis Stabilization to 
support. Further the update should describe how the CPT codes 
can be used to support Psychiatric Emergency Department 
facilities, to include training.
    Ophthalmology Services.--The Committee requests an update 
in the fiscal year 2017 budget request on how CMS ensures 
Federally-designated medically underserved areas have access to 
sufficient ophthalmology services necessary to ensure that at 
risk individuals not suffer preventable vision loss and 
blindness.
    Psychotropic Drugs and Children.--The Committee is aware of 
the Department's efforts to reduce the inappropriate use of 
psychotropic medications with children and adolescents in 
foster care. In addition to the potential for serious long-term 
health and developmental problems for children, this alarming 
pattern has dramatically increased Medicaid costs. CMS is urged 
to examine research into reasons for this disparity, including 
whether current reimbursement policy incentivizes reliance on 
medication rather than evidence-based psychosocial therapies 
instead of, or in combination with, psychotropic medications.
    Recovery Audit Contractors (RACs).--The Committee is 
concerned that the unintended consequences of RAC audits 
conducted by the CMS contractors continue to reduce patient 
access to care and are jeopardizing the economic viability of 
upstanding small businesses and critical health care providers. 
The fiscal year 2015 Appropriations Act included language 
directing HHS to develop a strategy and take steps to improve 
consistency, transparency, and processing of the appeals. It is 
imperative that a reasonable balance be found that allows CMS 
to eliminate true fraud and abuse while not slowing payment to 
providers so significantly that they cannot function. The 
Committee includes bill language to redirect all offsetting 
collections derived from the RACs be used to educate health 
care providers on how to reduce errors and on the program 
integrity and compliance audits; for the Office of Medicare 
Hearings and Appeals (OMHA) to reduce its backlog; and to 
establish a process to provide feedback from the OMHA to CMS to 
reduce the claims overturn rate from claims elevated to the 
OMHA. The Committee notes concern over the use of contingency 
fee based payment for entities that contract with State 
Medicaid programs to conduct RAC audits; specifically, in cases 
where extrapolation audits are conducted. The audits should be 
done in a manner that is valid and statistically sound. The 
Committee requests CMS continue to monitor the return on 
investment for compensating auditors on a contingency fee 
basis, review contractor audit practices, and provide the 
Committee with its findings in the fiscal year 2017 budget 
request. The Committee looks forward to the forthcoming plan 
and expects the fiscal year 2017 budget request include an 
update to the plan's goals, timeline, and measurable annual 
milestones to address concerns with the RACs and significantly 
reduce the appeal wait times in a manner that does not propose 
to charge the providers for appealing. Finally, the Committee 
reiterates its request for CMS to publish in the fiscal year 
2017 budget request, and future years, a CMS actuarial report 
that estimates the dollar level of improper payments by year 
and the actual and estimated recovery of each year's improper 
payments, and the percentage of each year's recovered level 
compared to the estimate of improper payments.
    Risk Corridor.--The Committee continues the fiscal year 
2015 bill language to prevent the CMS Program Management 
appropriation account from being used to support risk corridors 
payments.
    Robotic Stereotactic Radiosurgery.--The Committee was 
encouraged by the CMS decision in the fiscal year 2015 Medicare 
Physician Fee Schedule Final Rule (79 Fed. Reg. 67548) to 
maintain G codes and contractor pricing for robotic 
stereotactic radiosurgery procedures performed in a 
freestanding setting. The Committee urges CMS to maintain the 
current coding and payment methodology for at least three years 
to provide stability while determining the most appropriate 
policy for this important treatment option.
    Treatment Resistance Depression (TRD).--The Committee 
encourages CMS to review available meritorious peer reviewed 
literature to determine if additional therapies exist for safe 
and effective treatment of TRD that could be considered for CMS 
coverage determinations.
    Two Midnights Rule.--The Committee is concerned with the 
potential negative impact to Medicare beneficiaries if CMS 
continues to move forward with its proposed ``Two Midnights'' 
rule that was introduced and implemented through the fiscal 
year 2014 Inpatient Prospective Payment System regulation. The 
Committee requests the Secretary to review the negative 
consequences of the Two Midnights rule and work with impacted 
stakeholders on alternative options.
    Prescription Drug Report.--The Committee directs the 
Secretary of Health and Human Services, in consultation with 
the Secretary of the Veterans Administration, to submit a 
report to the Committee on Appropriations of the House of 
Representatives not later than 120 days after the date of the 
enactment of the Bill to which this Committee Report pertains 
regarding price changes of prescription drugs since 2003. The 
report should include prescription drug prices (net of rebates) 
paid by Federal programs for the 10 most frequently prescribed 
drugs and the 10 highest-cost drugs under the following:
    (1) The Medicare program under part B of title XVIII of the 
Social Security Act.
    (2) The Medicare prescription drug program under part D of 
title XVIII of the Social Security Act.
    (3) The Medicaid program under title XIX of the Social 
Security Act.
    (4) The Veterans Administration.
    (5) In countries bordering the United States and, as 
available, other nations.
    In addition, the report should include total annual costs 
to the Medicare program under part B of title XVIII of the 
Social Security Act, the Medicare prescription drug program 
under part D of title XVIII of such Act, the Medicaid program 
under title XIX of such Act, and the Veterans Administration 
for all prescription drugs. And finally, the Secretary of 
Health and Human Services shall review how the Federal 
Government has achieved competitive cost reductions for drugs 
since 2001.

Federal Administration

    The Committee recommends $732,533,000 to support Federal 
Administrative activities related to the Medicare and Medicaid 
programs, which is equal to the fiscal year 2015 enacted level 
and $51,067,000 less than the budget request. The Federal 
Administration funding supports CMS staff, along with operating 
and administrative expenses for planning, developing, managing, 
and evaluating healthcare financing programs and policies.
    The Committee appreciates the information in the CMS budget 
request. However, the Committee expects CMS to provide the 
additional items and enhanced Congressional notice described in 
the statement accompanying the fiscal year 2015 Appropriations 
Act. The Committee reminds HHS and CMS to ensure that all 
tables include the prior year actual, current year request 
level, current year actual (based on the operating plan) and 
budget request year level.

              HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT

    The Committee recommendations includes $672,000,000, to be 
transferred from the Medicare trust funds, for Health Care 
Fraud and Abuse Control (HCFAC) activities. This includes a 
base amount of $311,000,000 and an additional $361,000,000 
through a budget cap adjustment authorized by section 251(b) of 
the Balanced Budget and Emergency Deficit Control Act of 1985. 
The HCFAC funds support activities conducted by CMS, the HHS 
Inspector General, and the Department of Justice. The level is 
equal to the fiscal year 2015 enacted level and $34,000,000 
less than the budget request. This funding is in addition to 
other mandatory funding through authorizing legislation. The 
funding will provide resources to continue efforts for Medicaid 
program integrity activities, for safeguarding the Medicare 
prescription drug benefit and the Medicare Advantage program, 
and for program integrity efforts carried out by the Department 
of Justice. The bill includes language to ensure the Secretary 
fully funds the senior Medicare patrol program administered 
through the Administration for Community Living from the level 
provided in this account.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

    The Committee recommends $3,256,743,000 for the Child 
Support Enforcement and Family Support programs, which is 
$818,220,000 more than the fiscal year 2015 enacted level and 
the same as the budget request. The Committee also recommends 
$1,300,000,000 in advance funding, as requested, for the first 
quarter of fiscal year 2017 to ensure timely payments for Child 
Support Enforcement programs. These programs support state-
administered programs of financial assistance and services for 
low-income families to promote their economic security and 
self-sufficiency.

                   LOW INCOME HOME ENERGY ASSISTANCE

    The Committee recommends $3,365,304,000 for the Low Income 
Home Energy Assistance Program (LIHEAP), which is $25,000,000 
below the fiscal year 2015 enacted level and the budget 
request. Within the amount provided, the Committee recommends 
$3,365,304,000 exclusively for the State formula grants.
    Within the amount available for formula grants, the 
Committee recommends up to $2,988,000 for program integrity 
initiatives. The funding will allow additional technical 
assistance both on the State and federal level for program 
training, and monitoring of program activities for compliance 
with internal controls, policies, and procedures.

                     REFUGEE AND ENTRANT ASSISTANCE

    The Committee recommends $1,429,884,000 for Refugee and 
Entrant Assistance programs, which is $130,000,000 below the 
fiscal year 2015 enacted level and $198,728,000 below the 
budget request.
    The Office of Refugee Resettlement (ORR) programs are 
designed to help refugees, asylees, Cuban and Haitian entrants, 
and trafficking victims become employed and self-sufficient. 
These programs also provide for care of unaccompanied immigrant 
children in federal custody and victims of torture.
    Within the total, the Committee recommends the following 
amounts for Refugee and Entrant Assistance programs:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Transitional and Medical Services....................       $383,266,000
Victims of Trafficking...............................         15,755,000
Social Services......................................        149,927,000
Preventive Health....................................          4,600,000
Targeted Assistance..................................         47,601,000
Unaccompanied Minors.................................        818,000,000
Victims of Torture...................................         10,735,000
------------------------------------------------------------------------

Refugees and Unaccompanied Minors

    Victims of Trafficking Services.--For all programs for 
victims of trafficking as authorized by section 107(b) of 
Public Law 106-386, as amended, the Committee directs the 
Department to provide an annual consolidated report to the 
House Appropriations Committee, the House Foreign Affairs 
Committee, and the House Energy and Commerce Committee on the 
percent of funds spent on food, housing, clothing, mental 
health screening and therapy, legal assistance, employability 
services, and health screening and medical services. For health 
screening and medical services, the Department is directed to 
include specific information regarding the types of services 
provided or referred and the names of the entities providing 
such medical services. For each of the entities providing 
medical services, the Department shall record the amount of 
money expended on each type of medical service provided. The 
Department is directed to make this information available 
annually and more frequently by request.
    Healthcare and Education Costs of Illegal Immigration.--The 
Committee is concerned with the significant healthcare and 
education costs to State and local communities resulting from 
illegal immigration. These costs are especially high in States 
along the southern border of the United States. The Committee 
directs the Department of Education and the Department of 
Health and Human Services to provide all available federal 
resources to assist State and local governments with these 
increased costs that are a direct result of federal law or 
policy. The Committee further directs the Departments to 
provide a report to the House Appropriations Subcommittee on 
Labor, Health and Human Services, and Education, the 
Subcommittee on Commerce, Justice, Science and the Subcommittee 
on Homeland Security within 90 days of enactment on the costs 
borne by State and local governments and the federal government 
for providing health and education services to individuals 
without legal immigration status, to include those who 
qualified under the President's November 20, 2014 executive 
immigration action. The report should cover the costs incurred 
over the course of fiscal years 2014 and 2015 and include 
projected costs for fiscal years 2016 through 2020. The report 
shall also include an accounting of the federal resources that 
have been and will be directed in each year to cover these 
added expenses.
    School Impact Grants.--The Committee continues to support 
the School Impact Grants to enable vulnerable children to 
integrate in their new schools and communities. These services 
are critical to help children overcome primary and secondary 
trauma and behavioral and emotional obstacles to learning so 
they can rebuild their lives. The Committee also recommends 
that the Office of Refugee Resettlement (ORR) make School 
Impact Grant funds available to serve all children in ORR's 
care to fully participate in educational opportunities and 
provide local schools with the support they need in fiscal year 
2016 and beyond.
    Preferred Communities Program.--The Committee is encouraged 
that ORR integrates long-term intensive case management 
services for vulnerable refugee populations and secondary 
migrants through the Preferred Communities Program. The 
Committee has provided sufficient funds for case management 
services for vulnerable refugees, and encourages ORR to include 
victims of torture, women-headed households, refugees who are 
disabled or have serious medical issues, and other vulnerable 
refugees. Extended case management services will help to ensure 
refugees achieve self-sufficiency and integrate into their new 
communities.

   PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

    The Committee recommends $2,435,000,000 for the 
discretionary portion of the Child Care and Development Block 
Grant (CCDBG), which is the same as the fiscal year 2015 
enacted level and $370,149,000 below the budget request.

                      SOCIAL SERVICES BLOCK GRANT

    The Committee recommends $1,700,000,000 for the Social 
Services Block Grant (SSBG), which is the same as the fiscal 
year 2015 enacted level and the budget request. Funds are 
distributed to States by formula grants and States have the 
flexibility to determine what services and activities are 
supported, provided they are targeted at a broad set of goals, 
including reducing or eliminating poverty, achieving or 
maintaining self-sufficiency, and preventing neglect and abuse.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

    The Children and Families Services programs fund activities 
serving children, youth, families, the developmentally 
disabled, Native Americans, victims of child abuse and neglect 
and domestic violence, and other vulnerable populations.
    The Committee recommendation below for ``Social Services/
Income Maintenance Research'' includes $750,000 for the 
Secretary to enter into an agreement with the National Academy 
of Sciences to provide an evidence-based, non-partisan analysis 
of the macroeconomic, health, and crime/social costs of child 
poverty, to study current efforts aimed at reducing poverty, 
and to propose recommendations with the goal of reducing the 
number of children living in poverty in the United States by 
half in 10 years.
    Within the total, the Committee recommends the following 
amounts for Children and Families Services Programs:

------------------------------------------------------------------------
                                                            FY 2016
                   Budget Activity                         Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families
    Head Start.......................................     $8,790,095,000
    Runaway/Homeless Youth...........................         97,000,000
    Abuse of Runaway Youth Prevention................         17,141,000
    State Child Abuse Prevention.....................         25,310,000
    Discretionary Child Abuse Prevention.............         28,744,000
    Community-based Child Abuse Prevention...........         39,764,000
    Abandoned Infants Assistance.....................         11,063,000
    Child Welfare Services...........................        268,735,000
    Child Welfare Training...........................         15,984,000
    Adoption Opportunities...........................         39,100,000
    Adoption Incentives..............................         37,943,000
    Social Services/Income Maintenance Research......          5,762,000
    Native American Programs.........................         50,000,000
Community Services
    Community Services Block Grant...................        674,000,000
    Economic Development.............................         29,883,000
    Rural Community Facilities.......................          6,500,000
    Individual Development Account Initiative........         18,950,000
Domestic Violence Hotline............................          4,500,000
Family Violence/Battered Women's Shelters............        145,000,000
Independent Living Training Vouchers.................         43,257,000
Faith-Based Center...................................          1,299,000
Disaster Human Services Case Management..............          1,864,000
Program Direction....................................        199,701,000
------------------------------------------------------------------------

Head Start

    The Committee recommends $8,790,095,000 for the Head Start 
program, which is $192,000,000 more than the fiscal year 2015 
enacted level and $1,327,611,000 below the budget request. 
Within the total for Head Start, the Committee recommendation 
supports a 0.5 percent cost-of-living adjustment and includes 
$25,000,000 for the Designation Renewal System. Additionally, 
the Committee recommends $650,000,000 for Early Head Start 
(EHS) grants within the total for fiscal year 2016, which is 
$150,000,000 more than the fiscal year 2015 enacted level and 
the same as the budget request.
    The Committee supports efforts to strengthen and expand 
Head Start and Early Head Start and is pleased to see the 
continuous focus on quality improvement through the increasing 
number of teachers with bachelor's degrees, a reformed 
monitoring system, and the implementation of recompetition to 
the Head Start program. The Committee strongly encourages the 
Administration to release revised Head Start Program 
Performance Standards that are currently several years 
deficient.
    The Committee is additionally pleased with how efficiently 
the Secretary has moved to bring Early Head Start-Child Care 
Partnership grants online, and continues to support this 
emerging program. Given the challenges expressed by providers 
in the field, and the collective desire to expand access to 
high-quality programs immediately, the Committee notes its 
concern that grants may be restricted to one model design of 
partnerships. This practice may limit the pool of competitive 
applicants by discouraging diverse locally-designed models, who 
aim to expand the availability of high quality infant and 
toddler care, from applying. It would also eliminate the 
opportunity for many providers, especially in rural 
communities, with few available partner options to compete for 
these funds. The grants, whether for expansion, conversion, or 
partnerships, should be awarded based on how effectively the 
model design fits the needs of the community in question, 
versus adherence to a partnership model that may be 
inappropriate to that locality.

Child Abuse Discretionary Activities

    Within the funding for Child Abuse Discretionary 
Activities, the Committee recommends continued funding for the 
Quality Improvement Center for Research-Based Infant-Toddler 
Court Teams program. These funds support efforts that bring 
together the court system, child welfare agencies, health 
professionals, and community leaders to improve current 
practices in the child welfare system and make better informed 
decisions on behalf of the child.

Native American Programs

    The Committee recommends $50,000,000 for Native American 
Programs, which is $3,480,000 more than the fiscal year 2015 
enacted level and the same as the request. Within the total, 
the Committee recommendation includes $12,000,000 for Native 
American language preservation activities, including the 
requested $3,000,000 for the Generation Indigenous initiative 
focused on improving Native American language instruction 
across the educational continuum and 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

    The Committee recommends $729,333,000 for the Community 
Services programs, which is the same as the fiscal year 2015 
enacted level and $36,383,000 more than the budget request.

Community Economic Development Grants

    The Committee recommends $29,883,000 for Community Economic 
Development (CED) grants. Community Development Corporations 
(CDCs) use CED grants to lend and invest in private businesses 
that create jobs for low income people. Program guidelines 
require that at least 75 percent of the jobs created from CED 
funded projects be filled by low-income individuals. The CED 
program is the only federal economic development program that 
requires such targeted job creation. Using CED funds, CDCs have 
created hundreds of jobs and improved economic opportunity in 
urban and rural communities across the country.

Family Violence Prevention and Battered Women's Shelters

    The Committee recommends $145,000,000 for the Family 
Violence Prevention and Battered Women's Shelters programs, 
which is $10,000,000 more than the fiscal year 2015 enacted 
level and is $5,000,000 below the budget request. In 2013, 
domestic violence programs funded by the Family Violence 
Prevention & Services Act provided shelter and nonresidential 
services to more than 1,300,000 victims. Yet, due to lack of 
capacity an additional 186,552 requests for shelter went unmet. 
This funding increase is intended to address the growing demand 
for emergency family, domestic and dating violence shelter and 
supportive services.

                   PROMOTING SAFE AND STABLE FAMILIES

    The Committee recommends $345,000,000 in mandatory funds 
for the Promoting Safe and Stable Families program, which is 
the same as the fiscal year 2015 enacted level and the budget 
request. The Committee also recommends $59,765,000 in 
discretionary funds for this program, which is the same as the 
fiscal year 2015 enacted level and is $30,000,000 below the 
budget request. This program enables each State to operate a 
coordinated program of family preservation services, community-
based family support services, time-limited reunification 
services, and adoption promotion and support services. States 
receive funds based on their share of children in all States 
receiving food stamp benefits.

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

    The Committee recommends $5,478,450,000 for payments to 
States for foster care and adoption assistance, which is 
$646,450,000 more than the fiscal year 2015 enacted level and 
$250,000,000 below the budget request. The Committee also 
recommends an advance appropriation of $2,300,000,000 for the 
first quarter of fiscal year 2017 to ensure timely completion 
of first quarter grant awards.
    Within the total, the Committee recommends $4,952,550,000 
for the Foster Care program, which is $663,550,000 below the 
fiscal year 2015 enacted level and the same as the budget 
request. This program provides funds to States for foster care 
maintenance payments for children living in foster care. These 
funds also reimburse States for administrative costs to manage 
the program and training for staff and parents.
    Within the total, the Committee recommends $2,562,900,000 
for Adoption Assistance, which is $58,900,000 more than the 
fiscal year 2015 enacted level and the same as the budget 
request. This program provides funds to States to subsidize 
families who adopt children with special needs, such as older 
children, a member of a minority or sibling group, or children 
with physical, mental, and emotional disabilities. In addition, 
the program provides training for adoptive parents and State 
administrative staff. This annually appropriated entitlement 
provides alternatives to long, inappropriate stays in foster 
care by developing permanent placements with families.
    Within the total, the Committee recommends $123,000,000 for 
the Kinship Guardianship Assistance program, which is 
$24,000,000 more than the fiscal year 2015 enacted level and 
the same as the budget request. This program provides subsidies 
to a relative taking legal guardianship of a child for whom 
being returned home or adoption are not appropriate permanency 
options.
    Finally, within the total, the Committee recommends 
$140,000,000 for the Independent Living program, which is the 
same as the fiscal year 2015 enacted level and the budget 
request. This program assists foster children age 16 or older 
make successful transitions to independence. Funds support a 
variety of services, including educational assistance, career 
exploration, vocational training, job placement, life skills 
training, home management, health services, substance abuse 
prevention, preventive health activities, and room and board. 
Each State receives funds based on the number of children on 
whose behalf the State receives Federal Foster Care Payments.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

    The Committee recommends an appropriation of $1,962,058,000 
for the Administration for Community Living (ACL) program 
level, which is $261,102,000 more than the fiscal year 2015 
enacted program level and $161,297,000 below the requested 
program level. The recommended funding level for ACL reflects 
the transfer of the Workforce Innovation and Opportunity Act 
programs from the Department of Education and the Traumatic 
Brain Injury program from HRSA. Moreover, the recommended 
funding level for the Senior Medicare Patrol Program is 
provided under the Health Care Fraud and Abuse Control Account.

Home and Community-Based Supportive Services

    The Committee recommends $347,724,000 for Home and 
Community-Based Supportive Services, which is the same as the 
fiscal year 2015 enacted level and $38,458,000 below the budget 
request. This program provides formula grants to States and 
territories to fund a wide range of social services that enable 
seniors to remain independent in their homes for as long as 
possible.

Preventive Health Services

    The Committee recommends $19,848,000 for Preventive Health 
Services, which is the same as the fiscal year 2015 enacted 
level and the budget request. This program funds activities 
that help seniors remain healthy and avoid chronic diseases.

Protection of Vulnerable Older Americans

    The Committee recommends $20,658,000, which is the same as 
the fiscal year 2015 enacted level and the budget request for 
grants to States for protection of vulnerable older Americans.

National Family Caregiver Support Program

    The Committee recommends $145,586,000 for the National 
Caregiver Support program, which is the same as the fiscal year 
2015 enacted level and $5,000,000 below the budget request. 
This program supports a multifaceted support system in each 
State for family caregivers.

Native American Caregiver Support Program

    The Committee recommends $7,531,000 for the Native American 
Caregiver Support program, which is $1,500,000 more than the 
fiscal year 2015 enacted level and $731,000 more than the 
budget request. This program provides grants to tribes for the 
support of American Indian, Alaskan Native, and Native Hawaiian 
families caring for older relatives with chronic illness or 
disabilities.

Congregate and Home-Delivered Nutrition Services

    The Committee recommends $440,691,000 for Congregate 
Nutrition Services, which is $2,500,000 more than the fiscal 
year 2015 enacted level and $17,400,000 below the budget 
request. The Committee further recommends $219,897,000 for 
Home-Delivered Meal Services, which is $3,500,000 more the 
fiscal year 2015 enacted level and $16,500,000 below the budget 
request.

Nutrition Services Incentives Program

    The Committee recommends $160,069,000 for the Nutrition 
Services Incentives Program, which is the same as the fiscal 
year 2015 enacted level and the budget request. This funding 
augments programs that provide congregate and home-delivered 
meals to older adults.

Native American Nutrition and Supportive Services

    The Committee recommends $31,158,000 for Native American 
Nutrition and Supportive Services, which is $5,000,000 more 
than the fiscal year 2015 enacted level and $2,058,000 more 
than the budget request. This program provides grants to tribes 
to promote the delivery of nutrition and home and community-
based supportive services to Native American, Alaskan Native, 
and Native Hawaiian elders.

Aging Network Support Activities

    The Committee recommends $9,961,000 for the Aging Network 
Support Activities, which is the same as the fiscal year 2015 
enacted level and the budget request. This program supports 
activities that expand public understanding of aging and the 
aging process. The total amount includes $2,500,000 to help 
provide supportive services for aging Holocaust survivors 
living in the United States.

Alzheimer's Disease Supportive Services Program

    The Committee recommends $18,500,000 for the Alzheimer's 
Disease Supportive Services Program, which is the same as the 
2015 enacted program level and the requested program level. 
This program provides competitive matching grants to a limited 
number of States to encourage program innovation and 
coordination of public and private services for people with 
Alzheimer's disease and their families.

Lifespan Respite Care

    The Committee recommends $2,360,000 for Lifespan Respite 
Care, which is the same as the fiscal year 2015 enacted level 
and $2,640,000 below the budget request. The program focuses on 
easing the burdens of caregiving by providing grants to 
eligible State organizations to improve the quality of, and 
access to, respite care for family caregivers.

Chronic Disease Self-Management Program

    The Committee recommends $8,000,000 for Chronic Disease 
Self-Management program, which is the same as the fiscal year 
2015 enacted level and the budget request. This program 
supports grants to States for low-cost, evidence-based 
prevention models that use state-of-the-art techniques to help 
those with chronic conditions address issues related to the 
management of their disease.

Elder Falls

    The Committee recommends $5,000,000 for the Elder Falls 
program, which is the same as the fiscal year 2015 enacted 
program level and the requested program level. Fall prevention 
grants support the promotion and dissemination of prevention 
tools to be delivered in community settings.

Elder Rights Support Activities

    The Committee recommends $7,874,000 for Elder Rights 
Support Activities Demonstrations, which is the same as the 
fiscal year 2015 enacted level and $21,000,000 below the budget 
request. This program supports efforts that provide 
information, training, and technical assistance to legal and 
aging services organizations towards the end of preventing and 
detecting elder abuse and neglect. The total amount includes 
$4,000,000 for Elder Justice to provide competitive grants to 
States to test and evaluate innovative approaches to preventing 
and responding to elder abuse.

Aging and Disability Resource Centers

    The Committee recommends $6,119,000 for Aging and 
Disability Resource Centers, which is the same as the fiscal 
year 2015 enacted level and $13,881,000 below the budget 
request. These centers provide information, counseling and 
access for individuals to learn about the services and support 
options available to seniors and the disabled so they may 
retain their independence.

State Health Insurance Program

    The Committee recommends $52,115,000 for State Health 
Insurance program, which is the same as the fiscal year 2015 
enacted level and the budget request. This program provides 
accurate and understandable health insurance information to 
Medicare beneficiaries and their families.

Paralysis Resource Center

    The Committee recommends $6,700,000 for the Paralysis 
Resource Center, which is the same as the fiscal year 2015 
enacted level and the budget request. The center provides 
comprehensive information and referral services to people 
living with paralysis and their families.

Limb Loss

    The Committee recommends $2,810,000 for the Limb Loss 
program, which is $10,000 more than the fiscal year 2015 
enacted level and the same as the budget request.

Traumatic Brain Injury

    The Committee includes bill language transferring the 
Traumatic Brain Injury (TBI) program from HRSA to ACL. Placing 
the TBI program within ACL will enhance the services available 
to those with traumatic brain injuries by better aligning such 
services with other TBI focused programs and all the resources 
available to the disabled under ACL. The Committee recommends 
$9,321,000 for the TBI program, which is the same as the fiscal 
year 2015 enacted level and the budget request.

Developmental Disabilities State Councils

    The Committee recommends $71,692,000 for State Councils on 
Developmental Disabilities, which is the same as the fiscal 
year 2015 enacted level and the budget request. The State 
Councils work to develop, improve and expand the system of 
services and supports for people with developmental 
disabilities.

Developmental Disabilities Protection and Advocacy

    The Committee recommends $38,734,000 for Developmental 
Disabilities Protection and Advocacy, which is the same as the 
2015 enacted level and the budget request. This formula grant 
program provides funding to States to establish and maintain 
protection and advocacy systems to protect the legal rights of 
persons with developmental disabilities.

Voting Access for Individuals With Disabilities

    The Committee recommends $4,963,000 for Voting Access for 
Individuals With Disabilities program, which is the same as the 
fiscal year 2015 enacted level and the budget request.

Developmental Disabilities Projects of National Significance

    The Committee recommends $8,857,000 for Developmental 
Disabilities Projects of National Significance, which is the 
same as the 2015 enacted level and $5,643,000 below the budget 
request. This program funds grants and contracts that develop 
new technologies and demonstrate innovative methods to support 
the independence, productivity, and integration of the disabled 
into the community.

University Centers for Excellence in Developmental Disabilities

    The Committee recommends $37,674,000 for University Centers 
for Excellence in Developmental Disabilities (UCEDDs), which is 
the same as the fiscal year 2015 enacted level and $945,000 
below the budget request.
    The Committee continues to support the UCEDD network of 67 
centers that offer interdisciplinary education, research and 
public services within a university system or public or non-
profit entity associated with a university. The funding 
provided will allow Centers to assist states to initiate 
collaborative research, education, training, and service 
efforts to assist youth with disabilities to successfully 
transition from school to postsecondary education, and/or 
integrated employment. The funding will also allow the Centers 
to continue to address critical and emerging national needs, 
such as addressing the needs of the rising numbers of 
individuals on the autism spectrum; demonstrating cost 
effective long term services and supports for adults with 
disabilities and those aging with disabilities; supporting 
returning veterans; and providing technical assistance to 
strengthen and support the national network of Centers and to 
disseminate research and best practices nationwide.

Independent Living

    The Committee recommends $101,183,000 for the Independent 
Living program, of which $22,878,000 is for the Independent 
Living State Grants program and $78,305,000 is for the Centers 
for Independent Living program. This funding level is the same 
as the fiscal year 2015 enacted level and $5,000,000 below the 
budget request. Independent Living programs maximize the 
leadership, empowerment, independence and productivity of 
individuals with disabilities.
    Muscular Dystrophy.--The Committee is aware that the ACL is 
now serving on the Muscular Dystrophy Coordinating Committee 
through the Muscular Dystrophy CARE Act Amendments enacted in 
September 2014. The Committee directs ACL to provide an update 
on all programs relevant to the Duchenne population, 
particularly those focused on supporting transitions of persons 
with Duchenne into adulthood. The Committee encourages ACL to 
develop plans for conducting comprehensive studies focused on 
evaluating the cost-effectiveness of independent living 
programs and supports for persons living with various forms of 
muscular dystrophy.

National Institute on Disability, Independent Living, and 
        Rehabilitation Research

    The Committee recommends $103,970,000 for the National 
Institute on Disability, Independent Living, and Rehabilitation 
Research, which is the same as the fiscal year 2015 enacted 
level and $4,030,000 below the request. The National Institute 
serves to generate knowledge and promote its effective use to 
enhance the abilities of people with disabilities to perform 
activities of their choice in the community and to expand 
society's capacity to provide full opportunities for its 
citizens with disabilities.

Assistive Technology

    The Committee recommends $33,000,000 for Assistive 
Technology, which is the same as the fiscal year 2015 enacted 
level and $2,000,000 more than the budget request. Of this 
amount, the Committee provides $2,000,000 for competitive 
grants to support existing and new alternative financing 
programs that provide for the purchase of assistive technology 
(AT) devices. This funding is intended to support the expansion 
of existing programs and the creation of new programs that 
allow greater access to affordable financing to help people 
with disabilities purchase the specialized technologies 
required to live independently, to succeed at school and work 
and to otherwise live active and productive lives. Programs 
that have previously received funding are eligible to compete 
but must report on how the prior funding has been used, 
including the number of loans extended and individuals served, 
funding leveraged, and asset development programs created. The 
Committee intends for applicants to incorporate credit building 
activities into their programs, including financial education 
and information about other possible funding sources. 
Successful applicants must emphasize consumer choice and 
control and build programs that will provide financing for the 
full array of AT devices and services and ensure that all 
people, regardless of type of disability or health condition, 
age, level of income, and residence have access to the program.

Program Administration

    The Committee recommends $40,063,000 for Program 
Administration, which is $2,354,000 more than the fiscal year 
2015 comparable funding level and the same as the budget 
request. The recommended funding level reflects the transfer of 
the Workforce Innovation and Opportunity Act (WIOA) programs 
from the Department of Education to ACL. The increased funding 
above the comparably adjusted figure will support the 
additional grant administrative staff required to support the 
WIOA programs as well as the relocation of ACL's headquarters 
to the Switzer Building.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

    The Committee recommends a program level total of 
$419,422,000 for General Departmental Management, which is 
$93,440,000 below the fiscal year 2015 enacted level and 
$139,172,000 below the budget request. Of the funds provided, 
$58,028,000 shall be derived from evaluation set-aside funds 
available under section 241 of the Public Health Service Act, 
which is $6,800,000 below the fiscal year 2015 set-aside and 
$8,050,000 below the budget request.
    This appropriation supports activities that are associated 
with the Secretary's roles as policy officer and general 
manager of the Department of Health and Human Services. The 
Office of the Secretary also implements administration and 
congressional directives, and provides assistance, direction 
and coordination to the headquarters, regions, and field 
organizations of the department. In addition, this funding 
supports the Office of the Surgeon General and several other 
health promotion and disease prevention activities that are 
centrally administered. The Committee recommendation does not 
include funding for the proposed HHS ``Idea Lab'' or the 
Digital Services Team.
    Administrative and overhead costs.--The Committee is 
extremely troubled by the amount of funds being spent on 
administrative costs throughout the Department, and the fact 
that the Department routinely skims program funds ``off the 
top'' of appropriated line items to support central grants 
management staff and other indirect costs. Although these costs 
are capped at approximately 10 percent for most grants and 
contracts, this practice greatly reduces the resources 
available to projects in the field. Difficult economic times 
and flat budgets have exacerbated this problem. The Committee 
notes that the annual budget justification does not routinely 
provide information on how much, if any, of a line item 
supports central office overhead versus being used directly in 
the field for grants and contracts.The Committee therefore 
directs the Department to include in the annual budget 
justification for fiscal year 2017, and each year thereafter, 
the amount and percentage of administrative and overhead costs 
spent by the Department for each program line item.
    Health Reform Oversight.--The Committee understands that 
the lack of effective tracking, monitoring, and feedback 
systems at HHS may be resulting in improper payments of health 
reform subsidies. The Treasury Inspector General for Tax 
Administration recently noted, in part, that because the IRS 
and the Department of Health and Human Services are responsible 
for the administration of the Premium Tax Credit (PTC), 
improper PTC payments can result from weaknesses in either 
agency's programs. As a result, the IRS cannot effectively 
assess the risk of PTC improper payments, estimate the improper 
payment rate and dollars, or establish corrective actions to 
address the causes of and reduce improper PTC payments. The 
Committee understands the Administration has yet to identify a 
definition of ``improper payments'' for PTC or other ACA 
payments. The Committee directs the Government Accountability 
Office (GAO) to conduct a comprehensive review of the process 
and coordination between HHS and Treasury functions and to make 
recommendations to ensure solid processes are in place at both 
front and back ends to prevent improper payments.At a minimum, 
the review should examine whether HHS is appropriately 
validating the information provided by individuals in any 
Exchange to match the information reported in the prior year 
IRS data. The review should also examine how monthly PTC 
subsidies paid to insurers are appropriately tracked, 
monitored, and audited in a manner that provides for timely 
adjustments due to over/underpayments due to changes in 
eligibility criteria and the share of the monthly premium owed 
by the policyholder.Finally, the review should evaluate how HHS 
and IRS are jointly using existing authorities to recoup 
overpayment and to prevent intentional fraud and unintentional 
errors. The Committee expects to receive this report within 120 
days of enactment.
    Dietary Guidelines for Americans.--The Secretary, in 
coordination with the Secretary of Agriculture, is responsible 
for issuing the Dietary Guidelines for Americans every five 
years. This has traditionally been a science-based process that 
provides diet and nutrition recommendations according to 
statutory authority. However, the advisory committee selected 
to provide recommendations for consideration as the final 2015 
guidelines has included suggestions beyond the historical scope 
of the panel, resulting in controversial, agenda-driven 
recommendations. To preserve the scientific integrity of the 
dietary guidelines, bill language is included to provide 
transparency to the process and ensure the final 
recommendations are based upon strong scientific evidence and 
within scope. The Committee notes that the advisory committee 
report is merely a set of recommendations and reminds both USDA 
and HHS that the final 2015 Dietary Guidelines for Americans 
are a product of their scientific assessment that must comply 
with the statute.
    Conscience Protections.--The Committee continues a general 
provision that has been carried since 2005 relating to the 
conscience protection rights of health care providers. In the 
Explanatory Statement accompanying the fiscal year 2015 
Appropriations Act, the Secretary was directed to respond 
expeditiously to complaints regarding violations of this 
provision. The Committee notes that no resolution has been made 
to date and reiterates its directive that such complaints be 
responded to immediately and that this general provision be 
enforced.
    Needle Exchange Programs.--The Committee maintains its 
support for federal, state and local efforts to address the 
abuse of prescription painkillers and other opioids. The 
Committee is alarmed by trends in urban and rural communities 
which indicate a transition to injection drug use, and supports 
state and local efforts to mitigate the spread of related 
infections, such as Hepatitis and HIV/AIDS, and associated 
healthcare costs. The Committee believes the determination 
about whether to implement needle exchange programs remains a 
quintessentially local function, and therefore maintains its 
prohibition on the use of federal funds for the purchase of 
syringes or sterile needles as a title V general provision. The 
provision is modified, however, to allow existing programs in 
hard-hit communities to access federal funds for other program 
elements, including substance use counseling and referral to 
treatment, that support communities in their drive to end the 
cycle of dependency. Eligible programs must demonstrate a need 
for federal support based on actual cases of Hepatitis or HIV/
AIDS or on conditions posing a significant risk for an 
outbreak.
    Healthcare Plan Coverage of Abortions.--The committee is 
aware that, while the Affordable Care Act did not prevent 
taxpayer funding for exchange plans that include elective 
abortion, it did contain a provision requiring that plans 
covering elective abortion collect from each enrollee in the 
plan a separate payment for elective abortion. The Committee is 
concerned that this payment is not being collected separately 
and Administration-proposed regulations would instead allow 
insurance issuers to collect a single payment. In addition the 
Committee is concerned that consumers are not made aware of the 
abortion payment when shopping for healthcare plans. The 
Committee requests a report within 180 days of enactment 
outlining what steps are being taken to ensure consumers are 
aware of the abortion payment prior to purchasing a plan and 
that the payment is collected separately.
    Premium Class Travel.--The Committee is aware of recent 
reports that HHS has experienced a significant increase in the 
use premium class travel, costing taxpayers over $31,000,000, 
with most of the first and business class tickets attributed to 
waivers granted for medical issues. The Committee directs the 
Secretary to evaluate HHS rules related to allowing premium 
class travel, specifically the appropriate use of medical 
waiver authority. The Committee also expects the fiscal year 
2017 and future budget requests to include, for each operating 
division and the Office of the Secretary, the total number of 
premium class travel waivers granted and the number and 
percentage of these related to medical waivers.

Office of the Assistant Secretary for Health

    Assisted Outpatient Treatment Grant Program.--The Committee 
includes $15,000,000 within the Office of the Assistant 
Secretary for Health to implement section 224 of the Protecting 
Access to Medicare Act of 2014 (Public Law 113-93), the 
Assisted Outpatient Treatment Grant Program for Individuals 
with Serious Mental Illness (AOT). The Committee is aware that 
nearly half of individuals with schizophrenia or bipolar 
disorder do not recognize they have a mental illness, making it 
exceedingly difficult for them to follow through on a treatment 
regimen. The AOT program will work with families and courts to 
allow these individuals to obtain treatment while continuing to 
live in their communities and homes. AOT has been proven to 
reduce the imprisonment, homelessness and emergency room visit 
rate among this population by 70 percent. The Committee expects 
a full report in the fiscal 2017 budget request on the 
implementation and uses of this $15,000,000.
    Viral Hepatitis.--The Committee recognizes the tremendous 
health and financial burden of viral hepatitis. CDC estimates 
that upwards of 5.3 million nationwide are living with 
hepatitis B or hepatitis C (HCV) and 65 75 percent are not 
aware of their infection. Furthermore it is estimated that the 
medical costs associated with HCV among the 1945 1965 birth 
cohort many of whom will age into the Medicare system at age 65 
will rise to $85 billion annually. With the introduction of new 
screening guidelines and technology, as well as new treatment 
options, HHS has an unprecedented opportunity to address this 
national health problem. The Committee encourages HHS to 
continue to implement the Action Plan on Viral Hepatitis and to 
ensure that all appropriate agencies are actively involved and 
coordinated. The Committee encourages the HHS Assistant 
Secretary for Health to work with partners to tackle the issue 
of disease status awareness by leveraging federal with non-
federal contributions and organizing partnerships with 
stakeholders.
    Privacy Protections.--The Committee notes that the 
regulations issued under the Health Insurance Portability and 
Accountability Act (HIPAA) regarding protection of individually 
identifiable health information are generally more protective 
of patient privacy than the comparable requirements of the 
Federal Policy for the Protection of Human Subjects, otherwise 
known as the Common Rule. The Committee further notes that the 
duplicative application of the Common Rule and HIPAA 
regulations is causing confusion and imposing undue burdens on 
the development of clinical data registries. The Committee 
encourages the Office of Human Research Protections (OHRP) in 
the Department of Health and Human Services and other Federal 
agencies and departments that administer the Common Rule to 
adopt an exception to the Common Rule for situations where 
individuals or entities are collecting identifiable patient 
information, but are not engaged in direct human subjects 
intervention or interaction (e.g., clinical studies) and are 
following all the applicable requirements of the HIPPA 
regulations with respect to protecting the privacy and security 
of such information.
    Definition of an ``Indian''.--The Committee recognizes the 
Federal government's trust responsibility for providing 
healthcare for American Indians and Alaska Natives. The 
Committee is aware that the definition of who is an ``Indian'' 
is inconsistent across various federal health programs, which 
has led to confusion, increased paperwork and even differing 
determinations of health benefits within Indian families 
themselves. The Committee therefore encourages the Department 
of Health and Human Services, the Indian Health Service, and 
the Department of the Treasury to work together to establish a 
consistent definition of an ``Indian'' for purposes of 
providing health benefits.
    Adult Vaccinations.--The Committee is concerned that each 
year, hundreds of thousands of American adults are hospitalized 
and tens of thousands die from diseases that could have been 
prevented by vaccination. It is estimated that the cost of the 
health burden to society from vaccine preventable diseases is 
approximately $10 billion annually. In particular, the 
Committee is concerned that many health care workers do not get 
regularly recommended vaccinations and that adult vaccination 
rates are particularly low for minority groups. Therefore the 
Committee encourages the Secretary of Health and Human Services 
to develop an adult vaccine strategy that includes assessments 
of barriers to adult immunizations, and strategies to overcome 
those barriers, including public outreach about the importance 
of adult immunization and strategies to increase influenza 
vaccination rates among health care workers.
    Breastfeeding.--The Committee is aware of the Surgeon 
General's Call to Action to Support Breast Feeding and 
encourages the Secretary to support and expand efforts to 
guarantee continuity of skilled support for breastfeeding 
between hospitals and health care settings in the community. 
The Committee strongly supports efforts to combat childhood 
obesity. Research shows that suboptimal breastfeeding rates are 
a significant contributor to our nation's epidemic of obesity, 
increasing risks of several acute and chronic diseases and 
conditions, including diabetes and cardiovascular disease.
    Embryo Adoption Awareness Campaign.--The Committee 
recommends $1,000,000 for the embryo adoption awareness 
campaign, the same as the fiscal year 2015 enacted level. The 
budget request did not include funding for this program. These 
funds will be used to educate Americans about the existence of 
frozen human embryos (resulting from in-vitro fertilization), 
which may be available for donation/adoption. The Committee 
includes bill language permitting these funds also to be used 
to provide medical and administrative services to individuals 
adopting embryos, deemed necessary for such adoptions, 
consistent with the Code of Federal Regulations.
    HIV/AIDS in Minority Communities.--The Committee 
recommendation includes $52,224,000 for specific program 
activities to address the high-priority HIV prevention and 
treatment needs of minority communities, the same as the fiscal 
year 2015 level and $1,676,000 below the budget request. These 
funds are provided to promote an effective, culturally 
competent and linguistically appropriate public health response 
to the HIV/AIDS epidemic.
    Teen Pregnancy Prevention and Sexual Risk Avoidance.--The 
Committee provides $20,000,000 in budget authority for Teen 
Pregnancy Prevention Community Grants. Included in the 
Committee recommendation is not less than $10,000,000 for 
sexual risk avoidance programs.
    In implementing the $20,000,000 provided for teen pregnancy 
prevention and sexual risk avoidance, the Committee encourages 
HHS to provide substantive and practical technical assistance 
to grantees that emphasizes sexual risk avoidance (SRA) in all 
educational messaging to teens. The Committee notes that such 
technical assistance should be provided during national and 
regional conferences, webinars and one-on-one conversations 
with funded projects. The Committee further encourages SRA-
credentialed experts to directly train grantees and HHS staff 
with oversight of these programs on methodologies and best 
practices in SRA for teens. The Committee also encourages HHS 
to consistently implement a public health model that stresses 
risk avoidance or a return to a lifestyle without risk.
    The Committee notes that adolescents from communities of 
color are disproportionately affected by teenage pregnancy, and 
that research also shows teenage dating violence and abuse are 
associated with higher levels of teenage pregnancy and 
unplanned pregnancy. Adolescent girls in physically abusive 
relationships are three times more likely to become pregnant 
than non-abused girls. The Committee encourages the Secretary, 
through the Office of Adolescent Health, to include teen dating 
violence prevention and healthy relationship strategies within 
existing adolescent health working groups and better integrate 
preventing violence and abuse as a strategy to prevent teen and 
unplanned pregnancy within communities of color. Additionally, 
the Committee encourages the Secretary to conduct a review of 
programs chosen by the Teen Pregnancy Prevention Program and 
issue a report to determine which programs address teen dating 
violence and healthy relationship strategies as a means to 
prevent teen pregnancy.

Office of Minority Health

    The Committee provides $56,670,000 for the Office of 
Minority Health (OMH), which is the same as the fiscal year 
2015 enacted level and the same as the budget request.
    The OMH works with U.S. Public Health Service agencies and 
other agencies of the Department to address the health status 
and quality of life for racial and ethnic minority populations 
in the United States. OMH develops and implements new policies; 
partners with States, tribes, and communities through 
cooperative agreements; supports research, demonstration, and 
evaluation projects; and disseminates information.
    Hepatitis B.--The Committee is aware that Hepatitis B and 
liver cancer, as caused by the Hepatitis B virus, are the 
single greatest health disparities affecting the Asian and 
Pacific Islander populations in the United States. Asian 
Americans, Native Hawaiians, and other Pacific Islanders 
comprise more than one-half of the 2 million estimated 
Hepatitis B carriers in the United States and consequently have 
the highest rate of liver cancer among all ethnic groups. The 
Committee urges the OMH to expand outreach and preventive 
Hepatitis B programs specific to Asian and Pacific Islanders 
and other groups disproportionately affected by Hepatitis B.
    Hepatitis C Treatment.--More than three million people in 
the United States are chronically infected with hepatitis C 
virus (HCV) and most do not know it. If untreated, or 
unsuccessfully treated, they are at risk for life-threatening, 
expensive complications such as liver cancer and liver failure. 
Standard of care for HCV is evolving rapidly with dozens of 
new, more effective, oral direct-acting antivirals available. 
With the opportunity to improve the health outcomes of millions 
of patients, evidence-based recommendations are needed to help 
expand the pool of qualified providers and guide medical 
practice in the United States. The Committee urges HHS to 
convene an ongoing, multidisciplinary treatment guidelines 
panel or other mechanism to issue periodically updated 
recommendations for the treatment of hepatitis C virus (HCV) 
infection.
    Lupus Health Education Program.--The Committee is aware 
that the 2011 HHS report to Congress highlighted the effect of 
disparities on lupus patients and reinforced the need for 
health education efforts. The Committee supports this 
nationwide effort and remains concerned about racial 
disparities and barriers to early diagnosis of lupus. This 
debilitating autoimmune disease affects over 1.5 million 
persons, 90 percent of whom are women, with disproportionate 
impact among African Americans, Hispanics, Asians and Native 
Americans. The Committee continues to support this national 
education effort to engage health care providers, educators and 
schools of health professions in working together to improve 
lupus diagnosis and treatment through education and has 
included funding to continue implementation of a national 
health education program on lupus for health care providers 
with a the goal of improving diagnosis for those with lupus and 
reducing health disparities.
    Health Disparities Research in Women.--Women of racial and 
ethnic minorities face higher rates of diseases including 
obesity, cancer, diabetes, heart disease, and HIV/AIDS, when 
compared with white women. There is also a disproportionately 
higher rate of pre-term birth among African American women that 
cannot be accounted for by known risk factors. The Committee 
understands that continued and expanded collection of data 
capturing racial and ethnic information is essential in 
understanding and reducing disparities and encourages the 
Office of Minority and Women's Health to conduct research into 
the causes of health disparities and develop and evaluate 
interventions to address these causes.
    Autism.--The Committee is concerned about recent studies 
showing that on average, a diagnosis of Autism Spectrum 
Disorder is delayed by almost two years for African American 
and Hispanic children as compared to their Caucasian 
counterparts. Furthermore, minority children are much more 
likely to be misdiagnosed with conduct-related or adjustment 
disorders. The Committee directs the Secretary of HHS in 
carrying out the programs of the Combating Autism 
Reauthorization Act to expand its efforts to address the 
disparities faced by African American and Hispanic children. 
The Committee asks that the Secretary include in the reports 
required by the Act the steps being taken to address the needs 
of minority populations.
    Diabetes.--The Committee is concerned by the incidence of 
diabetes that disproportionately affects minority populations, 
especially the elderly among these populations. Therefore, the 
Committee encourages OMH to undertake a coordinated approach 
across all HHS operating divisions to translate biomedical 
research, behavioral research and training programs to bring 
innovative approaches to diabetes prevention to minority 
communities. The Committee encourages OMH to develop an 
extramural grant program that specifically focuses on the broad 
spectrum of diabetes prevention and control, including 
approaches to predict, prevent, treat and cure diabetes. The 
Committee is particularly interested in studies to predict 
those at highest risk for Type 2 diabetes accurately, including 
those utilizing metabolomics and proteomics.
    Female Genital Mutilation Prevention and Education 
Initiative.--The Committee encourages OWH to support community-
based efforts to prevent female genital mutilation (FGM). The 
Committee recognizes that hundreds of thousands of women and 
girls in the U.S. may have been subjected to, or are at risk, 
of FGM. Prevention, education, and outreach programs to address 
FGM can complement a need for more diligent law enforcement 
efforts. The Committee recognizes that FGM is illegal in the 
U.S. and is classified as a human rights violation by the World 
Health Organization. The Committee encourages the OWH to work 
with other Federal agencies in developing a comprehensive 
prevention, education, and outreach plan to stop FGM in the 
U.S., focusing on communities in which FGM is likely to be more 
prevalent.
    Lupus.--The Committee commends OWH for launching a 
sustained awareness and education campaign on lupus. The 
Committee understands that lupus is a serious, complex, 
debilitating chronic autoimmune disease that can cause 
inflammation and tissue damage to virtually any organ system in 
the body and impacts an estimated 1.5 million Americans. The 
Committee further understands that public and health 
professional recognition and understanding of lupus is 
extremely low, contributing to misdiagnoses or late diagnoses 
that can result in disability or death.
    Sickle Cell.--The Committee encourages HRSA to initiate 
Sickle Cell Trait informational awareness to encourage at risk 
populations to learn about their SCT status and help persons 
living with SCT understand their status. Information can 
include the implications for reproductive decision-making, the 
possibility of negative health outcomes for persons living with 
SCT and ways to reduce those outcomes, and understanding 
possible hemoglobin A1C test errors for diagnosing or 
monitoring diabetes and prediabetes.
    Office of Women's Health.--The Committee includes 
$31,500,000 for the Office of Women's Health, the same as the 
budget request and $640,000 below fiscal year 2015 levels.
    Quick Health Data Online System.--The Committee directs the 
Secretary to continue the operation of the Quick Health Data 
Online system. The Committee also requests a report with a 
recommendation on the feasibility of moving the Quick Health 
Data Online system to another HHS agency.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

    The Committee provides $87,381,000 for the Office of 
Medicare Hearings and Appeals, which is the same as the fiscal 
year 2015 enacted level and $52,619,000 below the budget 
request. This Office supports hearings at the administrative 
law judge level, the third level of Medicare claims appeals.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

    The Committee provides $60,367,000 for the Office of the 
National Coordinator for Health Information Technology (ONC), 
which is the same as the fiscal year 2015 enacted level. The 
budget proposed to fund this entire office from the evaluation 
tap.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $75,000,000 for the Office of 
Inspector General (OIG), which is $4,000,000 more than the 
fiscal year 2015 enacted level and $8,000,000 less than the 
budget request. In addition, within the Health Care Fraud and 
Abuse Control (HCFAC) program discretionary appropriations for 
fiscal year 2015, the Committee provides the OIG with 
$67,200,000. Mandatory appropriations for this office also are 
contained in the HCFAC program and the Health Insurance 
Portability and Accountability Act of 1996. Total funds 
provided in this bill and other appropriations are estimated to 
be $142,200,000 in fiscal year 2016.
    The Department's programs touch the lives of virtually 
every American, so too does the oversight responsibility of the 
OIG. The OIG was created to protect the integrity of 
departmental programs as well as the health and welfare of 
beneficiaries served by those programs. Through a comprehensive 
program of audits, investigations, inspections and program 
evaluations, the OIG attempts to reduce the incidence of fraud, 
waste, abuse and mismanagement, and to promote economy, 
efficiency and effectiveness throughout the Department.
    The Committee expects the OIG to continue to increase its 
support for discretionary funded HHS activities within 
resources provided. The Committee understands the OIG is 
responsible for more than 300 programs that spend more than 
$900 billion. The diversity and complexity of these HHS 
programs--ranging from health care insurance and clinical 
research to epidemiology, public health services and 
education--have increased over the past decade, which increased 
the importance and challenge of providing oversight. The 
Committee encourages the OIG's to continue to improve its 
annual budget request and looks forward to a revised format 
with more details and performance measures related to 
discretionary oversight. Further, the Committee expects the OIG 
to continue its oversight of ACA and describe the activity in 
the fiscal year 2016 work plan.
    Within the total provided, the Committee provides 
sufficient funding for the OIG to monitor HHS compliance with 
the provision that prohibits the use of federal funding for 
lobbying campaigns. The Committee remains concerned that 
certain HHS operating divisions have skirted the prohibition on 
using taxpayer funding to lobby State and or local governments. 
As such, the Committee requests that the OIG monitor grantee 
activities to ensure that no taxpayer resources are used for 
lobbying.
    Top-25 Unimplemented Recommendations.--The Committee again 
requests that within 90 days of enactment the OIG provide a 
revised top-25 unimplemented recommendations report under the 
same terms and conditions as described in the Explanatory 
Statement accompanying the Consolidated Appropriations Act of 
2014.
    Health Reform Oversight.--The Committee appreciates the 
joint efforts of the OIG to work with the Treasury Inspector 
General for Tax Administration on reconciliation of the Advance 
Premium Tax Credit. The Committee encourages more and broader 
collaboration on other aspects of health reform and other HHS 
programs that may touch Treasury jurisdictions to reduce, 
fraud, overpayments, and enhance government operations.

                        OFFICE FOR CIVIL RIGHTS

    The Committee provides $38,798,000 for the Office for Civil 
Rights (OCR), which is the same as the fiscal year 2015 enacted 
level and $3,907,000 below the budget request.
    The OCR is responsible for enforcing civil rights statutes 
that prohibit discrimination in health and human services 
programs. OCR implements the civil rights laws through a 
compliance program designed to generate voluntary compliance 
among all HHS recipients.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

    The Committee provides for retirement pay and medical 
benefits of Public Health Service Commissioned Officers, for 
payments under the Retired Serviceman's Family Protection Plan, 
and for medical care of dependents and retired personnel. Total 
costs are estimated to be $586,188,000 for fiscal year 2016, 
which is $23,947,000 above the fiscal year 2015 enacted level 
and the same as the budget request.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

    The Committee provides $1,171,523,000 for the Public Health 
and Social Services Emergency Fund to support a comprehensive 
program to prepare for and respond to the health and medical 
consequences of all public health emergencies, including 
bioterrorism, and support the cybersecurity efforts of the 
Department of Health and Human Services (HHS). This amount is 
$3,546,000 less than the fiscal year 2015 base funding level 
and $738,458,000 less than the budget request.

Office of the Assistant Secretary for Preparedness and Response

    The Committee provides $1,044,928,000 for activities 
administered by the Office of the Assistant Secretary for 
Preparedness and Response (ASPR). This amount is $652,000 less 
than the fiscal year 2015 funding level and $498,157,000 less 
than the budget request. ASPR is responsible for coordinating 
national policies and plans for medical and public health 
preparedness and for administering a variety of public health 
preparedness programs, including the National Disaster Medical 
System, the Hospital Preparedness Cooperative Agreement Grants 
Program, Project BioShield, and the Office of Biomedical 
Advanced Research and Development Authority.

Biomedical Advanced Research and Development Authority

    The Committee provides $415,000,000 for the Office of 
Biomedical Advanced Research and Development Authority (BARDA), 
which is equal to the fiscal year 2015 enacted level and 
$106,732,000 less than the budget request. In addition, the 
Committee provides $255,000,000 for Project BioShield, which is 
equal to the fiscal year 2015 level and $391,425,000 less the 
budget request. The funds support acquisitions of medical 
countermeasures to address chemical, biological, radiological, 
and nuclear (CBRN) threats.
    The Committee remains committed to ensuring the nation is 
adequately prepared against CBRN attacks. Public-private 
partnership to develop MCMs is required to successfully prepare 
and defend the nation against these threats. The Committee 
supports the goal of a market development where there is little 
or no existing commercial market. The funds allow for sustained 
management and funding of critical priorities, facilitate 
flexible and rapid response to emerging threats, and prevent 
the loss of resources.
    The Committee maintains its commitment to protecting the 
U.S. population from pandemic influenza and other new and 
emerging threats and recognizes a public-private partnership is 
also required to develop MCMs for these threats. The Committee 
recommends $72,000,000 for the ASPR's pandemic influenza 
program. This funding can support research and development of 
next generation influenza MCMs, preparedness testing and 
evaluation, and stockpiling.
    The Committee remains concerned about potential gaps in 
preparedness created by conflicting stockpiling priorities of 
the BARDA and the CDC.
    While the Public Health and Emergency Medical 
Countermeasure Enterprise (PHEMCE) was established as the 
interagency coordinating body to ensure consensus priorities 
and smooth transitions, no specific process is in place to 
prevent gaps in preparedness related to disparate priorities 
that continue to arise related to countermeasure stockpiling. 
Therefore, the Committee directs BARDA and CDC to develop a 
process to coordinate the ongoing stockpiling of medical 
countermeasures in order to maintain adequate supplies of 
approved and purchased countermeasures. The coordination is 
important as products transition from the advanced research and 
development phase, where procurement is controlled by BARDA, to 
the approval phase, where procurement responsibility shifts to 
CDC. The Committee requests an update on this stockpiling 
coordination process between BARDA and CDC in the fiscal year 
2017 budget request. The Committee provided an increase to the 
CDC SNS program to better enable the hand off of MCM between 
BARDA and CDC and to better support SNS new acquisition and 
replenishment activity that is required to protect the American 
public. The Committee further expects CDC and BARDA leadership 
to coordinate on the spend plan for the CDC SNS funds as part 
of the improved process.
    The Committee commends the ASPR for delivering the first 
multiyear budget plan. The Committee requests that the 
multiyear budget plan be updated annually and include 
additional details, such as influenza MCM program budgets and 
life cycle management costs.
    Antibiotic Resistance (AbR).--The Committee recognizes the 
importance of combating AbR, while funding for BARDA remains 
focused on its statutory mission to develop CBRN 
countermeasures, BARDA is directed to work closely with CDC and 
NIAID on the government-wide antibiotic resistance activity. 
The Committee provided support in NIAID and CDC and directs 
these organizations to jointly work with BARDA on coordinated 
goals, measurable objectives, and funding plans to spur 
research and development on AbR, build AbR laboratory capacity 
in states, and best leverage the funds provided support for 
evidence based public health activities in states on the 
government-wide effort. The Committee requests an update in the 
fiscal year 2017 budget request on the joint BARDA, NIAID, and 
CDC goals and measurable objectives to ensure the best 
leveraging of the funds provided to CDC and NIAID on this 
effort.

                           General Provisions


              PREVENTION AND PUBLIC HEALTH TRANSFER TABLE

    The Committee continues a provision that directs the 
transfer of all available Prevention and Public Health (PPH) 
fund. In fiscal year 2016 the level appropriated for the fund 
is $932,000,000 after accounting for sequestration. The 
Committee includes bill language in section 218 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:

                                                [$ in thousands]
----------------------------------------------------------------------------------------------------------------
                 Agency                           Account                    Program           FY 2016 Committee
----------------------------------------------------------------------------------------------------------------
CDC                                      Immunization and           Section 317 Immunization            $150,285
                                          Respiratory Diseases.      Grants.
CDC                                      Emerging and Zoonotic      Epidemiology and                      40,000
                                          Infectious Diseases.       Laboratory Capacity
                                                                     Grants.
CDC                                      Emerging and Zoonotic      Healthcare Associated                 12,000
                                          Infectious Diseases.       Infections.
CDC                                      Chronic Disease            Breast Feeding Grants                  8,000
                                          Prevention and Health      (Hospitals Promoting
                                          Promotion.                 Breastfeeding).
CDC                                      Chronic Disease            Million Hearts Program...              4,000
                                          Prevention and Health
                                          Promotion.
CDC                                      Chronic Disease            Heart Disease & Stroke               170,000
                                          Prevention and Health      Prevention Program.
                                          Promotion.
CDC                                      Chronic Disease            Diabetes.................            180,000
                                          Prevention and Health
                                          Promotion.
CDC                                      Chronic Disease            National Diabetes                     10,000
                                          Prevention and Health      Prevention Program.
                                          Promotion.
CDC                                      Chronic Disease            Breast and Cervical                  104,000
                                          Prevention and Health      Cancer.
                                          Promotion.
CDC                                      Chronic Disease            Colorectal Cancer........             39,515
                                          Prevention and Health
                                          Promotion.
CDC                                      Chronic Disease            Workplace Wellness.......              7,500
                                          Prevention and Health
                                          Promotion.
CDC                                      Chronic Disease            Early Care Collaboratives              4,000
                                          Prevention and Health
                                          Promotion.
CDC                                      Environmental Health.....  Lead Poisoning Prevention             15,000
CDC                                      CDC-Wide Activities......  Prevention Health and                170,000
                                                                     Health Services Block
                                                                     Grants.
ACL                                      Aging and Disability       Alzheimer's Disease                   12,700
                                          Services Programs.         Prevention Education and
                                                                     Outreach.
ACL                                      Aging and Disability       Falls Prevention.........              5,000
                                          Services Programs.
----------------------------------------------------------------------------------------------------------------

    Sec. 201. The Committee continues a provision to limit the 
amount available for official reception and representation 
expenses.
    Sec. 202. The Committee continues a provision to limit the 
number of Public Health Service employees assigned to assist in 
child survival activities and to work in AIDS programs through 
and with funds provided by the Agency for International 
Development, the United Nations International Children's 
Emergency Fund, or the World Health Organization.
    Sec. 203. The Committee modifies a provision to limit the 
salary of an individual through an HHS grant or other 
extramural mechanism to not more than the rate of Executive 
Level III.
    Sec. 204. The Committee continues a provision to prohibit 
the Secretary from using evaluation set-aside funds until the 
Committees on Appropriations of the House of Representatives 
and the Senate receive a report detailing the planned use of 
such funds.
    Sec. 205. The Committee modifies a provision regarding the 
enacted level for the PHS evaluation set-aside, reducing it to 
the lesser of 2.4 percent or $1,068,000,000.

                          (TRANSFER OF FUNDS)

    Sec. 206. The Committee continues a provision permitting 
the Secretary of HHS to transfer up to one percent of any 
discretionary funds between appropriations, provided that no 
appropriation is increased by more than three percent by any 
such transfer to meet emergency needs. Advance notification 
must be provided to the Committees on Appropriations at the 
program, project, and activity level in advance of any 
transfer.

                          (TRANSFER OF FUNDS)

    Sec. 207. The Committee continues a provision to provide 
the Director of NIH, jointly with the Director of the Office of 
AIDS Research, the authority to transfer up to three percent of 
human immunodeficiency virus funds.

                          (TRANSFER OF FUNDS)

    Sec. 208. The Committee continues a provision to make NIH 
funds available for human immunodeficiency virus research 
available to the Office of AIDS Research.
    Sec. 209. The Committee continues a provision to prohibit 
the use of Title X funds unless the applicant for the award 
certifies to the Secretary that it encourages family 
participation in the decision of minors to seek family planning 
services and that it provides counseling to minors on how to 
resist attempts to coerce minors into engaging in sexual 
activities.
    Sec. 210. The Committee continues a provision stating that 
no provider of services under Title X shall be exempt from any 
state law requiring notification or the reporting of child 
abuse, child molestation, sexual abuse, rape, or incest.
    Sec. 211. The Committee continues a provision related to 
the Medicare Advantage program.
    Sec. 212. The Committee continues a provision to allow 
funding for HHS international HIV/AIDS and other infectious 
disease, chronic and environmental disease, and other health 
activities abroad to be spent under the State Department Basic 
Authorities Act of 1956.
    Sec. 213. The Committee continues a provision granting 
authority to the Office of the Director of the NIH to enter 
directly into transactions in order to implement the NIH Common 
Fund for medical research and permitting the Director to 
utilize peer review procedures, as appropriate, to obtain 
assessments of scientific and technical merit.
    Sec. 214. The Committee continues a provision clarifying 
that funds appropriated to NIH institutes and centers may be 
used for minor repairs or improvements to their buildings, up 
to $3,500,000 per project with a total limit for NIH of 
$45,000,000.

                          (TRANSFER OF FUNDS)

    Sec. 215. The Committee modifies a provision transferring 
one percent of the funding made available for National 
Institutes of Health National Research Service Awards to the 
Health Resources and Services Administration.
    Sec. 216. The Committee continues a provision prohibiting 
funds from being used to advocate or promote gun control.
    Sec. 217. The Committee continues a provision relating to 
publicly accessible information regarding uses of funds under 
section 4002 of Public Law 111-148.
    Sec. 218. The Committee continues language directing the 
spending of the Prevention and Public Health fund.
    Sec. 219. The Committee continues the Biomedical Advanced 
Research and Development Authority ten year contract authority.
    Sec. 220. The Committee continues language requiring HHS to 
include certain information concerning the number of full-time 
federal employees and contractors working on the ACA in the 
fiscal year 2017 budget request.
    Sec. 221. The Committee continues the 60 day flexibility 
for National Health Service Corps contract terminations.
    Sec. 222. The Committee continues a provision allowing NIH 
to retain payments for certain research organisms and 
substances.
    Sec. 223. The Committee continues specific report 
requirements for CMS's marketplaces activities in the fiscal 
year 2017 budget request.
    Sec. 224. The Committee continues a provision prohibiting 
CMS Program Account from being used to support risk corridor 
payments.

                              (RESCISSION)

    Sec. 225. The Committee includes a new provision rescinding 
the nonrecurring expenses fund.
    Sec. 226. The Committee includes a new provision 
transferring certain functions of the Agency for Healthcare 
Research and Quality and terminating the agency as a separate 
entity.
    Sec. 227. The Committee includes a new provision requiring 
HHS to submit an analysis of the impact of section 2713 of the 
PHS Act on discretionary programs.
    Sec. 228. The Committee includes a new provision 
prohibiting funds from being used for patient-centered outcomes 
research.
    Sec. 229. The Committee includes a new provision 
prohibiting funds from being used for Title X family planning 
activities.
    Sec. 230. The Committee includes a new provision to prevent 
funding of the Navigator program.

                              (RESCISSION)

    Sec. 231. The Committee includes a new provision rescinding 
expired funds under HRSA.
    Sec. 232. The Committee includes a new provision requiring 
the Secretaries of HHS and the Department of Agriculture to 
develop dietary guidelines based on scientific evidence and to 
provide for additional public comment.

                   TITLE III--DEPARTMENT OF EDUCATION


                    Education For The Disadvantaged

    The Committee recommends $14,869,641,000 for the Education 
for the Disadvantaged programs, which is $666,466,000 below the 
fiscal year 2015 enacted level and $1,722,905,000 below the 
budget request. Of the total amount available, $3,987,006,000 
is appropriated for fiscal year 2016 for obligation on or after 
July 1, 2016 and $10,841,177,000 is appropriated for fiscal 
year 2016 for obligation on or after October 1, 2016. This 
appropriation account includes compensatory education programs 
authorized under title I of the Elementary and Secondary 
Education Act of 1965 (ESEA) and section 418A of the Higher 
Education Act.

Grants to Local Educational Agencies

    For fiscal year 2016, the Committee recommends 
$14,409,802,000 for Title I grants to local educational 
agencies (school districts), which is the same as the fiscal 
year 2015 enacted level and $1,000,000,000 below the budget 
request. Title I grants support the ESEA's accountability 
system, which emphasizes State standards and aligned 
assessments, and measuring adequate yearly progress in reading 
and math for all students annually in grades three through 
eight, and once in high school.
    Of the amounts provided for Title I programs, 
$6,459,401,000 is available for Basic Grants to Local 
Educational Agencies (LEAs). This amount is the same as the 
fiscal year 2015 enacted level and the budget request.
    Within the amount for Title I Basic Grants, up to 
$3,984,000 is made available to the Secretary of Education on 
October 1, 2015, to obtain annually updated LEA-level poverty 
data from the Bureau of the Census.
    The Committee recommends $1,362,301,000 for Title I 
Concentration Grants, which is the same as the fiscal year 2015 
enacted level and the budget request. Concentration Grants 
target funds to school districts in which the number of low-
income children exceeds 6,500 or 15 percent of the total 
school-age population.
    The Committee recommends $3,294,050,000 for Title I 
Targeted Grants, which is the same as the fiscal year 2015 
enacted level and $500,000,000 below the budget request. 
Targeted Grants provide higher payments to school districts 
with high numbers or percentages of low-income students.
    The Committee recommends $3,294,050,000 for Title I 
Education Finance Incentive Grants (EFIGs), which is the same 
as the fiscal year 2015 enacted level and $500,000,000 below 
the budget request. EFIGs provide payments to States and school 
districts that incorporate ``equity'' and ``effort'' factors to 
improve the equity of State funding systems.
    The Department shall continue to use its existing formula 
in allocating funds to Bureau of Indian Education schools and 
to follow this practice in any relevant future emergency 
funding that provides it the same authority and discretion.

Evaluation

    The Committee does not include a specific appropriation for 
evaluation of the Title I program, which is $710,000 below the 
fiscal year 2015 enacted level. Instead of appropriating a 
specific dollar amount for this activity, the Committee bill 
includes language to allow the Department 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.

School Improvement Grants

    The Committee recommends no funding for School Improvement 
Grants (SIG), which is $505,756,000 below the fiscal year 2015 
enacted level and $555,756,000 below the budget request. This 
formula grant program provides assistance to States and school 
districts for Title I schools. The Committee is concerned that 
the Department has implemented this program in an overly 
prescriptive fashion that is not workable, especially in many 
rural areas. The Department has not demonstrated that these 
models have been effective in turning around low performing 
schools and has significant concerns about investing additional 
dollars into such a program in the absence of a reauthorized 
ESEA.

Striving Readers

    The Committee recommends no funding for Striving Readers, 
which is $160,000,000 below the fiscal year 2015 enacted level 
and the budget request.

State Agency Programs: Migrant

    The Committee recommends $374,751,000 for the State Agency 
Program for Migrant Education, which is the same as the fiscal 
year 2015 enacted level and the budget request. This program 
supports special educational and related services for children 
of migrant agricultural workers and fishermen, including: (1) 
supplementary academic education; (2) remedial or compensatory 
instruction; (3) English for limited English proficient 
students; (4) testing; (5) guidance counseling; and (6) other 
activities to promote coordination of services across States 
for migrant children whose education is interrupted by frequent 
moves.

State Agency Programs: Neglected and Delinquent

    For the State Agency Program for Neglected and Delinquent 
Children, the Committee recommends $47,614,000, which is the 
same as the fiscal year 2015 enacted level and the budget 
request. This formula grant program supports educational 
services for children and youth under age 21 in institutions 
for juvenile delinquents, adult correctional institutions, or 
institutions for the neglected. A portion of these funds may be 
used for projects that support the successful re-entry of youth 
offenders into postsecondary and vocational programs.

Special Programs for Migrant Students

    The Committee recommends $37,474,000 for the Special 
Programs for Migrant Students, which is the same as the fiscal 
year 2015 enacted level and $7,149,000 below the budget 
request. These programs support grants to colleges, 
universities, and nonprofit organizations to support 
educational programs designed for students who are engaged in 
migrant and other seasonal farm work. The High School 
Equivalency Program (HEP) recruits migrant students age 16 and 
over and provides academic and support services to help those 
students obtain a high school equivalency certificate and 
subsequently to gain employment or admission to a postsecondary 
institution or training program. The College Assistance Migrant 
Program (CAMP) provides tutoring and counseling services to 
first-year, undergraduate migrant students and assists those 
students in obtaining student financial aid for their remaining 
undergraduate years. The Committee recommendation assumes the 
allocation of funds between HEP and CAMP as proposed by the 
Administration.

School Readiness

    The Committee provides no funding for the Preschool 
Development Grants program, which is the same as the 2015 
enacted level and $750,000,000 below the budget request. While 
improving the availability and quality of early childhood 
education is a worthwhile goal, the activities proposed by the 
Administration would represent an enormous expansion of the 
federal role in education. Instead of creating new, multi-
billion dollar programs, the Committee encourages the 
Department and other related agencies to streamline federal 
support for early childhood education and care, simplify 
program administration in existing programs, and allow States 
to determine how best to coordinate services.
    The federal government already recognizes the importance of 
and provides a significant investment in programs that support 
and provide early childhood education and care every year. A 
2012 Government Accountability Office (GAO) report found 45 
such programs across multiple agencies costing taxpayers at 
least $13.3 billion in fiscal year 2010.
    Furthermore, as noted in the Department of Education's (the 
Department's) budget documents, 40 States and the District of 
Columbia have established at least one publicly-funded State 
preschool program. The president's plan would require States to 
disrupt these successful programs to meet prescriptive national 
benchmarks and standards.

                               Impact Aid

    The Committee recommends $1,298,603,000 for federal Impact 
Aid programs, which is $10,000,000 above the fiscal year 2015 
enacted level and the budget request. This account supports 
payments to school districts affected by federal activities, 
such as those that educate children whose families are 
connected with the military or who live on Indian land.
    The Committee recognizes that Congress has sought to ensure 
all qualified school districts are able to provide military 
dependent students with a quality education and essential 
student support services. Without proper guidance, school 
districts are at risk of losing funding, which can result in 
cuts to programs designed to address the emotional, 
psychological, and educational needs of military dependent 
students. The Committee urges the Department of Education to 
provide school districts with clear and timely guidance on how 
to measure a school district's tax rate compared to the State 
average tax rate.

Basic Support Payments

    The Committee recommends $1,161,233,000 for Basic Support 
Payments to LEAs, which is $10,000,000 above the fiscal year 
2015 enacted level and the budget request. Basic Support 
Payments compensate school districts for lost tax revenue and 
are made on behalf of federally-connected children, such as 
children of members of the uniformed services who live on 
federal property.

Payments for Children with Disabilities

    The Committee recommends $48,316,000 for Payments for 
Children with Disabilities, which is the same as the fiscal 
year 2015 enacted level and the budget request. These payments 
compensate school districts for the increased costs of serving 
federally-connected children with disabilities.

Facilities Maintenance

    The Committee recommends $4,835,000 for Facilities 
Maintenance, which is the same as the fiscal year 2015 enacted 
level and $66,813,000 below the budget request. These capital 
payments are authorized for maintenance of certain facilities 
owned by the Department.

Construction

    The Committee recommends $17,406,000 for the Construction 
program, which is the same as the fiscal year 2015 enacted 
level and the budget request. This program provides formula 
grants for building and renovating school facilities to LEAs 
that educate federally-connected students or have federally-
owned land.

Payments for Federal Property

    The Committee recommends $66,813,000 for Payments for 
Federal Property, which is the same as the fiscal year 2015 
enacted level and $66,813,000 above the budget request. Funds 
are awarded to school districts to compensate for lost tax 
revenue as the result of federal acquisition of real property 
since 1938.

                      School Improvement Programs

    The Committee recommends $3,500,720,000 for School 
Improvement Programs, which is $901,951,000 below the fiscal 
year 2015 enacted level and $1,192,451,000 below the budget 
request. The School Improvement account includes programs 
authorized under Titles II, IV, VI, and VII of the ESEA; the 
McKinney-Vento Homeless Assistance Act; Title IV A of the Civil 
Rights Act; section 203 of the Educational Technical Assistance 
Act of 2002; and section 105 of the Compact of Free Association 
Amendments Act of 2003.

State Grants for Improving Teacher Quality

    The Committee recommends $1,681,441,000 for State Grants 
for Improving Teacher Quality, which is $668,389,000 below the 
fiscal year 2015 enacted level and the budget request. Teacher 
Quality Grants provide States and districts with a flexible 
source of funding with which to strengthen the skills and 
knowledge of teachers, principals, and administrators to enable 
them to improve student achievement. States are authorized to 
retain 2.5 percent of funds for State activities, including 
reforming teacher certification, re-certification or licensure 
requirements; and expanding, establishing, or improving 
alternative routes to State certification.
    The Committee includes a 3.2 percent set-aside for 
Supporting Effective Educator Development (SEED), which 
supports competitive awards to national nonprofit organizations 
to support teacher or principal training or professional 
enhancement activities.
    The bill includes funding within the SEED set-aside for 
competitive grants to non-profit organizations with 
demonstrated effectiveness in the development and 
implementation of civic learning programs. Priority should be 
given to applicants that demonstrate innovation, scalability, 
and a focus on underserved populations, including rural schools 
and students.
    The bill does not include language included in the fiscal 
year 2015 omnibus setting aside up to 8 percent of SEED funds 
for research, dissemination, evaluation, and technical 
assistance.

Educational Technology State Grants

    The Committee recommends no funding for the newly proposed 
Educational Technology State Grants program, which is 
$200,000,000 below the budget request. This program was not 
funded in fiscal year 2015.

Mathematics and Science Partnerships

    The Committee recommends no funding for Mathematics and 
Science Partnerships, which is $152,717,000 below the fiscal 
year 2015 enacted level and $202,717,000 below the budget 
request. This program provides professional development for 
math and science teachers; these activities can be carried out 
under other authorities funded in this bill and through other 
federal agencies such as the National Science Foundation.

Supplemental Education Grants

    The Committee recommends $16,699,000 for Supplemental 
Education Grants to the Federated States of Micronesia and the 
Republic of the Marshall Islands, which is the same as the 
fiscal year 2015 enacted level and the budget request. The 
Compact of Free Association Amendments Act of 2003 (P.L. 108-
188) authorizes these entities to receive funding for general 
education assistance. The Committee recommendation includes a 
consolidated amount for Supplemental Education Grants because 
the underlying statute determines the allocation between 
Micronesia and the Marshall Islands.

21st Century Community Learning Centers

    The Committee recommends $1,151,673,000 for 21st Century 
Community Learning Centers (CCLC), which is the same as the 
fiscal year 2015 enacted level and the budget request. This 
program is a formula grant to States, which in turn distribute 
funds on a competitive basis to local school districts, 
community-based organizations, and other public entities and 
private organizations. Funds may be used for before and after 
school activities, recreational activities, and expanded 
library service hours.
    Expanded Learning Time.--The Committee is concerned about 
recent efforts by the Department to offer flexibility waivers 
for the 21st Century Community Learning Centers (21st CCLC) 
that would implement expanded learning time by adding time to 
the school day, school week, or school year, by diverting 21st 
CCLC funding away from quality afterschool, before school and 
summer learning programs. Current statute requires 21st CCLC 
funds be spent on quality afterschool, before-school or summer 
learning programming. The 21st CCLC initiative is the only 
federal funding source dedicated exclusively to before-school, 
afterschool and summer learning programs for students attending 
high-poverty, low-performing schools. Data demonstrates that 
quality afterschool programs have a positive impact on a number 
of measures of student academic achievement, positively 
affecting behavior and discipline and helping relieve parents' 
worries about their children's safety during the hours when 
school is out. The Committee notes that State and local 
governments currently have the flexibility to use other federal 
funding for expanded learning time that adds additional time to 
the school day, school week, or school year. Furthermore, the 
Committee strongly believes any changes to 21st CCLC funding 
require legislative action in the form of authorization by the 
appropriate congressional committees. Therefore, the Committee 
has included bill language prohibiting the Department from 
allowing 21st CCLC funds from being used for expanded learning 
time.

State Assessments

    The Committee recommends $300,000,000 for State 
Assessments, which is $78,000,000 below the fiscal year 2015 
enacted level and $103,000,000 below the budget request. This 
program provides States with funding to develop annual 
assessments and to carry out activities related to ensuring 
accountability for results in the State's schools and school 
districts.

Education for Homeless Children and Youth

    The Committee recommends $65,042,000 for the Education for 
Homeless Children and Youth program, which is the same as the 
fiscal year 2015 enacted level and $6,500,000 below the budget 
request. The Committee recognizes that without an education, 
these at-risk children and youth are unlikely to obtain the 
skills they need to become productive adults contributing to 
the economy and their communities. Grants are allocated to 
States in proportion to the total each State receives under the 
Title I program. For local grants, at least 50 percent must be 
used for direct services to homeless children and youth, 
including tutoring, remedial or other educational services.

Training and Advisory Services

    The Committee recommends $6,575,000 for Training and 
Advisory Services authorized by Title IV A of the Civil Rights 
Act, which is the same as the fiscal year 2015 enacted level 
and the budget request. Title IV A authorizes technical 
assistance and training services for LEAs to address problems 
associated with desegregation on the basis of race, sex, or 
national origin. The Department awards three-year grants to 
regional Equity Assistance Centers (EACs) located in each of 
the 10 Department of Education regions. The EACs provide 
services to school districts upon request. Typical activities 
include disseminating information on successful education 
practices and legal requirements related to nondiscrimination 
on the basis of race, sex, and national origin in educational 
programs.

Education for Native Hawaiians

    The Committee recommends $33,397,000 for the Education for 
Native Hawaiian program, which is $1,000,000 above the fiscal 
year 2015 level and the same as the budget request. Funds are 
used to provide competitive awards for supplemental education 
services to the Native Hawaiian population.

Alaska Native Education Equity

    The Committee recommends $32,453,000 for the Alaska Native 
Education Equity program, which is $1,000,000 above the fiscal 
year 2015 level and the same as the budget request. Funds are 
used to provide competitive awards for supplemental education 
services to the Alaska Native population.

Rural Education

    The Committee recommends $169,840,000 for Rural Education 
programs, which is the same as the fiscal year 2015 enacted 
level and the budget request. There are two programs to assist 
rural school districts with improving teaching and learning in 
their schools: the Small, Rural Schools Achievement program, 
which provides funds to rural districts that serve a small 
number of students; and the Rural and Low-Income Schools 
program that provides funds to rural districts that serve 
concentrations of poor students, regardless of the number of 
students served by the district. Funds appropriated for Rural 
Education shall be divided equally between these two programs.

Comprehensive Centers

    The Committee recommends $43,600,000 for Comprehensive 
Centers, which is $4,845,000 below the fiscal year 2015 enacted 
level and $11,845,000 below the budget request. First funded in 
fiscal year 2005, this grant program currently finances 21 
comprehensive centers, including 16 regional centers that are 
intended to provide technical assistance to State educational 
agencies within their geographic regions in helping to 
implement provisions of the No Child Left Behind Act. The 
remaining five centers are content centers that are designed to 
have in-depth knowledge of all aspects of school improvement. 
Each center specializes in one of five content areas: 
assessment and accountability; instruction; teacher quality; 
innovation and improvement; and high schools.
    The Committee bill includes language directing the 
Secretary to ensure that the Bureau of Indian Education has 
access to services provided under this section.

                            Indian Education

    The Committee recommends $143,939,000 for Indian Education, 
which is $20,000,000 above the fiscal year 2015 enacted level 
and $30,000,000 below the budget request. This account supports 
programs authorized by part A of title VII of the ESEA.

Grants to Local Educational Agencies

    The Committee recommends $100,381,000 for Grants to Local 
Educational Agencies, which is the same as the fiscal year 2015 
enacted level and the budget request. This program provides 
assistance through formula grants to school districts and 
schools supported or operated by the Bureau of Indian Affairs. 
The purpose of this program is to reform elementary and 
secondary school programs that serve Indian students, including 
preschool children. Grantees must develop a comprehensive plan 
and ensure that the programs they carry out will help Indian 
students reach the same challenging standards that apply to all 
students. This program supplements the regular school program 
to help Indian children sharpen their academic skills, bolster 
their self-confidence, and participate in enrichment activities 
that would otherwise be unavailable.

Special Programs for Indian Children

    The Committee recommends $37,993,000 for Special Programs 
for Indian Children, which $20,000,000 above the fiscal year 
2015 enacted level and $30,000,000 below the budget request. 
These programs make competitive awards to improve the quality 
of education for Indian students. The program also funds the 
American Indian Teacher Corps and the American Indian 
Administrator Corps to recruit and support American Indians as 
teachers and school administrators.
    Within the total, the Committee recommends $22,890,000 for 
the Native Youth Community Projects, $19,875,000 above the 
fiscal year 2015 enacted level and $30,000,000 below the budget 
request. This program makes competitive awards to support 
culturally-relevant coordinated strategies to improve college- 
and career-readiness of Native American youth.

National Activities

    The Committee recommends $5,565,000 for National 
Activities, which is the same as the fiscal year 2015 enacted 
level and the budget request. Funds under this authority 
support research, evaluation and data collection to provide 
information about the educational status of Indian students and 
the effectiveness of Indian education programs.
    State-Tribal Education Partnership Pilot.--The Committee 
recommends continued funding for the State-Tribal Education 
Partnership Pilot Program. In this pilot, tribes and States 
collaborate through agreements to implement ESEA programs in 
public schools located on reservations. Indian educators have 
long called for tribal-State-federal partnerships to involve 
Indian Tribes in educating their students and to improve 
American Indian/Alaska Native education outcomes. STEP pilots 
have, and will continue to, assist State and tribal governments 
to continue delivering the highest quality education for Indian 
students.

                       Innovation and Improvement

    The Committee recommends $275,000,000 for Innovation and 
Improvement programs, which is $827,111,000 below the fiscal 
year 2015 enacted level and $1,326,559,000 below the budget 
request. This appropriation account includes programs 
authorized under portions of Title V of the ESEA.

Investing in Innovation

    The Committee recommends no funding for the Investing in 
Innovation fund, which was established in the American Recovery 
and Reinvestment Act of 2009 and is not authorized. This amount 
is $120,000,000 below the fiscal year 2015 level and 
$300,000,000 below the budget request. In the absence of a new 
ESEA reauthorization setting forth Congressionally-approved 
parameters for a program such as Investing in Innovation, the 
Committee does not recommend funding for this program.

Teacher and Principal Pathways

    The Committee recommends no funding for the newly proposed 
Teacher and Principal Pathways program, $138,762,000 below the 
budget request.

Next Generation High Schools

    The Committee recommends no funding for the newly proposed 
Next Generation High Schools program, $125,000,000 below the 
budget request. This program was not funded in fiscal year 
2015.

Transition to Teaching

    The Committee recommends no funding for Transition to 
Teaching, which is $13,700,000 below the fiscal year 2015 
enacted level and the same as the budget request. The 
Administration proposed to consolidate this program into the 
Teacher and Principal Pathways program in its budget request.

School Leadership

    The Committee recommends no funding for School Leadership 
activities, which is $16,368,000 below the fiscal year 2015 
funding and the budget request. The Administration proposed to 
consolidate this program into the Teacher and Principal 
Pathways program in its budget request.

Charter Schools

    The Committee recommends $275,000,000 for support of 
Charter School Grants, which is $21,828,000 above the fiscal 
year 2015 enacted level and $100,000,000 below the budget 
request.
    The Charter Schools Grants program encourages education 
reform by supporting the planning, development, and initial 
implementation of charter schools. In exchange for a commitment 
to increase student achievement, charter schools are exempt 
from many statutory and regulatory requirements. The Charter 
Schools Grants program finances grants to State educational 
agencies (SEAs) or, if a State's SEA chooses not to 
participate, charter school developers to support the 
development and initial implementation of public charter 
schools. Facilities Incentive Grants and credit enhancement 
awards help charter schools obtain adequate school facilities. 
These programs work in tandem to support the development and 
operation of charter schools.

Magnet Schools Assistance

    The Committee recommends no funds for the Magnet Schools 
Assistance program, which is $91,647,000 below the fiscal year 
2015 enacted level and the budget request.

Fund for the Improvement of Education

    The Committee recommends no funds for the Fund for the 
Improvement of Education, which is $323,000,000 below the 
fiscal year 2015 enacted level and $166,926,000 below the 
budget request. In the past, this account has been used to 
allow the Administration to have a pot of flexible funding for 
new and often unauthorized initiatives. Given the fiscal 
constraints facing the Committee, funding is not provided for 
any of these purposes in this bill.

Teacher Incentive Fund

    The Committee recommends no funding for the Teacher 
Incentive Fund (TIF), which is $230,000,000 below the fiscal 
year 2015 enacted level and $350,000,000 below the budget 
request.

Ready to Learn Television

    The Committee recommends no funding for Ready to Learn 
Television, which is $25,741,000 below the fiscal year 2015 
enacted level and the budget request.

Advanced Placement Program

    The Committee recommends no funding for the Advanced 
Placement program, which is $28,483,000 below the fiscal year 
2015 enacted level and the budget request.

                 Safe Schools and Citizenship Education

    The Committee recommends $56,754,000 for Safe Schools and 
Citizenship Education programs, which is $166,561,000 below the 
fiscal year 2015 enacted level and $292,807,000 below the 
budget request. This appropriation account includes programs 
authorized under parts of Titles IV and V of the ESEA.

Promise Neighborhoods

    The Committee recommends $56,754,000 for Promise 
Neighborhoods, which is the same as the fiscal year 2015 level 
and $93,246,000 below the budget request. Promise Neighborhoods 
supports grants to nonprofit, community-based organizations for 
the development of comprehensive neighborhood programs designed 
to combat the effects of poverty and improve educational 
outcomes for children and youth, from birth through college.

Safe and Drug-Free Schools and Communities: National Activities

    The Committee recommends no funding for National 
Activities, which is $70,000,000 below the fiscal year 2015 
enacted level and $90,000,000 below the budget request.

Elementary and Secondary School Counseling

    The Committee recommends no funding for Elementary and 
Secondary School Counseling, which is $49,561,000 below the 
fiscal year 2015 enacted level and the budget request.

Carol M. White Physical Education Program

    The Committee recommends no funding for this program, which 
is $47,000,000 below the fiscal year 2015 enacted level and 
$60,000,000 below the budget request.

                      English Language Acquisition

    The Committee recommends $737,400,000 for the English 
Language Acquisition program, which is the same as the fiscal 
year 2015 enacted level and $36,000,000 below the budget 
request. Of this amount provided for the 2016-2017 academic 
year, funds are appropriated for obligation on or after July 1, 
2016 and available through September 30, 2017. The bill 
continues language to calculate all State awards based on a 
three-year average of data from the American Community Survey.
    This program provides formula grants to States to serve 
limited English proficient (LEP) students. Grants are based on 
each State's share of the national LEP and recent immigrant 
student population. Funds under this account also support 
professional development to increase the pool of teachers 
prepared to serve LEP students as well as evaluation 
activities.

                           Special Education

    The Committee recommends $13,024,510,000 for programs 
authorized under the Individuals with Disabilities Education 
Act (IDEA) for children with disabilities. This is $502,152,000 
above the fiscal year 2015 enacted level and $202,152,000 above 
the budget request. Of the total amount available, 
$3,367,611,000 is available for obligation on July 1, 2016, and 
$9,424,183,000 is available for obligation on October 1, 2016. 
These grants help States and localities pay for a free 
appropriate education for 6.6 million students with 
disabilities aged 3 through 21 years.

Grants to States

    The Committee recommends $12,000,000,000 for Part B Grants 
to States, which is $502,152,000 above the fiscal year 2015 
enacted level and $327,152,000 above the budget request. This 
program provides formula grants to assist States in meeting the 
costs of providing special education and related services to 
children with disabilities. States generally transfer most of 
the funds to LEAs; however, they can reserve some funds for 
program monitoring, technical assistance, and other related 
activities. In order to be eligible for funds, States must make 
free appropriate public education available to all children 
with disabilities.
    The Committee includes bill language excluding any amount 
by which a State's allocation is reduced for failure to meet 
the maintenance of effort threshold from being used to 
calculate the State's allocation under section 611(d) of the 
IDEA in subsequent years. The Committee also includes bill 
language directing the Secretary to distribute any reduction in 
a State's allocation under said section to all other States 
based on the formula established under section 611(d), 
excluding those States that are penalized.

Preschool Grants

    The Committee recommends $353,238,000 for Preschool Grants, 
which is the same as the fiscal year 2015 enacted level and 
$50,000,000 below the budget request. These funds provide 
additional assistance to States to help them make free, 
appropriate public education available to children with 
disabilities ages three through five.

Grants for Infants and Families

    The Committee recommends $438,556,000 for Grants for 
Infants and Families, which is the same as the fiscal year 2015 
enacted level and $65,000,000 below the budget request. These 
funds provide additional assistance to States to help them make 
free, appropriate public education available to children with 
disabilities from birth through age two.

IDEA National Activities

    The Committee recommends $232,716,000 for the IDEA National 
Activities program, which is the same as the fiscal year 2015 
enacted level and $10,000,000 below the budget request. The 
IDEA National Activities programs support State efforts to 
improve early intervention and education results for children 
with disabilities.
    State Personnel Development.--The Committee recommends 
$41,630,000 for State Personnel Development, which is the same 
as the fiscal year 2015 enacted level and the budget request. 
This program supports grants to States to assist with improving 
personnel preparation and professional development related to 
early intervention and educational and transition services that 
improve outcomes for students with disabilities.
    Technical Assistance and Dissemination.--The Committee 
recommends $51,928,000 for Technical Assistance and 
Dissemination, which is the same as the fiscal year 2015 
enacted level and $10,000,000 below the budget request. This 
program provides funding for technical assistance, 
demonstration projects, and information dissemination. These 
funds support efforts by State and local educational agencies, 
institutions of higher education, and other entities to build 
State and local capacity to make systemic changes and improve 
results for children with disabilities.
    Personnel Preparation.--The Committee recommends 
$83,700,000 for Personnel Preparation, which is the same as the 
fiscal year 2015 enacted level and the budget request. This 
program supports competitive awards to help address State-
identified needs for qualified personnel to work with children 
with disabilities, and to ensure that those personnel have the 
necessary skills and knowledge to serve children with special 
needs. Awards focus on addressing the need for leadership and 
personnel to serve low-incidence populations.
    Parent Information Centers.--The Committee recommends 
$27,411,000 for Parent Information Centers, which is the same 
as the fiscal year 2015 enacted level and the budget request. 
This program makes awards to parent organizations to support 
Parent Training and Information Centers, including community 
parent resource centers. These centers provide training and 
information to meet the needs of parents of children with 
disabilities living in the areas served by the centers, 
particularly underserved parents and parents of children who 
may be inappropriately identified. Technical assistance is also 
provided under this program for developing, assisting, and 
coordinating centers receiving assistance under this program.
    Technology and Media Services.--The Committee recommends 
$28,047,000 for Technology and Media Services, which is the 
same as the fiscal year 2015 enacted level and the budget 
request. This program makes competitive awards to support the 
development, demonstration, and use of technology and 
educational media activities of educational value to children 
with disabilities.

            Rehabilitation Services and Disability Research

    The Committee recommends $3,529,605,000 for Rehabilitation 
Services and Disability Research, which is $180,248,000 below 
the fiscal year 2015 enacted level and $2,504,000 below the 
budget request. The programs in this account are authorized by 
the Rehabilitation Act of 1973 and the Helen Keller National 
Center Act.
    Vocational Rehabilitation State Grants.--The Committee 
recommends $3,391,770,000 for Vocational Rehabilitation (VR) 
State Grants, which is $56,696,000 above the fiscal year 2015 
enacted level and the same as the budget request.
    This program supports basic vocational rehabilitation 
services through formula grants to the States. These grants 
support a wide range of services designed to help persons with 
physical and mental disabilities prepare for and engage in 
gainful employment to the extent of their capabilities. 
Emphasis is placed on providing vocational rehabilitation 
services to persons with the most significant disabilities. The 
Committee's recommendation provides the cost-of-living 
adjustment for Vocational Rehabilitation Grants to States, as 
authorized.
    The Committee does not include language allowing Vocational 
Rehabilitation State grant unmatched funds in excess of any 
funds requested during the reallotment process to be available 
for the Promoting Readiness of Minors in Supplemental Security 
Income program.

Client Assistance State Grants

    The Committee recommends $13,000,000 for Client Assistance 
State Grants, which is the same as the fiscal year 2015 enacted 
level and the budget request. Client Assistance State Grants 
support services for eligible individuals and applicants of the 
VR State Grants program, and other programs, projects, and 
services funded under the Rehabilitation Act. These formula 
grants are used to help persons with disabilities overcome 
problems with the service delivery system and improve their 
understanding of services available to them under the 
Rehabilitation Act.

Training

    The Committee recommends $30,188,000 for the Training 
program, which is the same as the fiscal year 2015 enacted 
level and the budget request. The program supports long-term 
and short-term training, in-service personnel training, and 
training of interpreters for deaf persons. Projects in a broad 
array of disciplines are funded to ensure that skilled 
personnel are available to serve the vocational needs of 
persons with disabilities. The Committee does not include the 
proposal in the budget request to shift funding from the In-
Service Training program from this account to the Vocational 
Rehabilitation State Grants account.

Demonstration and Training Programs

    The Committee recommends $5,796,000 for Demonstration and 
Training Programs, which is the same as the fiscal year 2015 
enacted level the budget request. These programs authorize 
discretionary awards on a competitive basis to public and 
private organizations to support demonstrations, direct 
services, and related activities for persons with disabilities.

Protection and Advocacy of Individual Rights

    The Committee recommends $17,650,000 for Protection and 
Advocacy of Individual Rights, which is the same as the fiscal 
year 2015 enacted level and the budget request. Grants are 
awarded to entities that have the authority to pursue legal, 
administrative, and other appropriate remedies to protect and 
advocate for the rights of persons with disabilities.

Supported Employment State Grants

    The Committee recommends $27,548,000 for Supported 
Employment State Grants, which is the same as the fiscal year 
2015 enacted level and $3,000,000 below the budget request. 
These formula grants assist States in developing collaborative 
programs with public agencies and nonprofit agencies for 
training and post-employment services leading to supported 
employment. In supported employment programs, persons with the 
most significant disabilities are given special supervision and 
assistance to enable them to work in an integrated setting.

Independent Living

    The Committee recommends $33,317,000 for Independent Living 
Programs, which is $101,183,000 below the fiscal year 2015 
enacted level and the same as the budget request. These 
programs provide services to individuals with disabilities to 
maximize their independence and productivity, and to help them 
integrate into the mainstream of American society.
    Independent Living State Grants.--The Committee recommends 
no funding within the Department for Independent Living State 
Grants. The Workforce Innovation and Opportunity Act of 2014 
(WIOA) transferred this program to the Department of Health and 
Human Services (HHS).
    Centers for Independent Living.--The Committee recommends 
no funding within the Department for Centers for Independent 
Living. The WIOA transferred this program to HHS.
    Independent Living Services for Older Individuals Who Are 
Blind.--The Committee recommends $33,317,000 for Independent 
Living Services for Older Individuals Who Are Blind, which the 
same as the fiscal year 2015 enacted level and the budget 
request. Funds are distributed to States according to a formula 
based on the population of individuals who are 55 or older, and 
provide support for services to persons 55 years old or over 
whose severe visual impairment makes gainful employment 
extremely difficult to obtain, but for whom independent living 
goals are feasible.

Helen Keller National Center

    The Committee recommends $10,336,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, which is 
$1,209,000 above the fiscal year 2015 enacted level and 
$496,000 above the budget request. These funds are used for the 
operation of a national center that provides intensive services 
for deaf-blind individuals and their families at Sands Point, 
New York, and a network of ten regional offices that provide 
referral, counseling, transition services, and technical 
assistance to service providers.

National Institute on Disability and Rehabilitation Research

    The Committee recommends no funding within the Department 
for the National Institute on Disability and Rehabilitation 
Research. The WIOA transferred this program to HHS.

Assistive Technology

    The Committee recommends no funding within the Department 
for Assistive Technology. The WIOA transferred this program to 
HHS.

           Special Institutions for Persons With Disabilities

    The Committee recommends $214,722,000 for Special 
Institutions for Persons with Disabilities, which is $2,500,000 
above the fiscal year 2015 enacted level and the budget 
request.

                 AMERICAN PRINTING HOUSE FOR THE BLIND

    The Committee recommends $25,431,000 for the American 
Printing House for the Blind, which is $500,000 above the 
fiscal year 2015 enacted level and the budget request. This 
funding subsidizes the production of educational materials for 
legally blind persons enrolled in pre-college programs. The 
Printing House, which is chartered by the Commonwealth of 
Kentucky, manufactures and maintains an inventory of 
educational materials in accessible formats that are 
distributed free of charge to schools and States based on the 
number of blind students in each State. The Printing House also 
conducts research and field activities to inform educators 
about the availability of materials and how to use them.
    The Committee recognizes that students who are blind or 
have a vision loss must have equal access to the same 
educational content and should receive that information at the 
same time as their sighted peers if they are to achieve 
academically. The transition from print to digital publishing 
poses significant challenges for producers of accessible 
educational materials--especially conveying information via 
tactile graphics and image descriptions. To address this 
concern, the Committee encourages the Department to support the 
Resources with Enhanced Accessibility for Learning (REAL) Plan 
implemented by the American Printing House for the Blind. REAL 
will provide new advances in software and hardware technology 
to ensure that students with vision loss receive high quality 
educational materials, in a timely manner, in the appropriate 
formats required to meet individual student learning needs.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

    The Committee recommends $68,016,000 for the National 
Technical Institute for the Deaf, which is $1,000,000 above the 
fiscal year 2015 enacted level and the budget request. The 
National Technical Institute for the Deaf was established by 
Congress in 1965 to provide a residential facility for 
postsecondary technical training and education for deaf persons 
with the purpose of promoting the employment of these 
individuals. The Institute also conducts applied research and 
provides training in various aspects of deafness. The Secretary 
of Education administers these activities through a contract 
with the Rochester Institute of Technology in Rochester, New 
York.

                          GALLAUDET UNIVERSITY

    The Committee recommends $121,275,000 for Gallaudet 
University, which is $1,000,000 above the fiscal year 2015 
enacted level and the budget request.
    Gallaudet is a private, non-profit educational institution 
federally-chartered in 1864 providing elementary, secondary, 
undergraduate, and continuing education for deaf persons. In 
addition, the University offers graduate programs in fields 
related to deafness for deaf and hearing students, conducts 
research on deafness, and provides public service programs for 
deaf persons.

                 Career, Technical, and Adult Education

    The Committee recommends $1,700,609,000 for Career, 
Technical, and Adult Education programs, which is $7,077,000 
below the fiscal year 2015 enacted level and $215,077,000 below 
the budget request. This account includes vocational education 
programs authorized by the Carl D. Perkins Career and Technical 
Education Act of 2006 and the Adult Education and Family 
Literacy Act (AEFLA).

Career and Technical Education: State Grants

    The Committee recommends $1,117,598,000 for Career and 
Technical Education: State Grants, which is the same as the 
fiscal year 2015 enacted level and $200,000,000 below the 
budget request. Funds are made available for obligation on 
October 1, 2016.
    State Grants support a variety of career and technical 
education programs developed in accordance with the State plan. 
The act focuses federal resources on institutions with high 
concentrations of low-income students. The populations assisted 
by State Grants range from secondary students in pre-vocational 
courses to adults who need retraining to adapt to changing 
technological and labor markets. Funding for State Grants will 
continue support for State-of-the art career and technical 
training to approximately 6 million students in secondary 
schools and more than 4 million students in community and 
technical colleges.
    The Committee includes no funding for the newly proposed 
American Technical Training Fund, $200,000,000 below the budget 
request. This program was not funded in fiscal year 2015.

National Programs

    The Committee recommends $3,816,000 for National programs, 
which is $3,605,000 below the fiscal year 2015 enacted level 
and $5,605,000 below the budget request. This authority 
supports the conduct and dissemination of research in career 
and technical education. It also includes support for the 
National Centers for Research and Dissemination in Career and 
Technical Education and other discretionary research.

Adult Basic and Literacy Education State Grants

    The Committee recommends $568,955,000 for Adult Basic and 
Literacy Education State Grants, which is the same as the 
fiscal year 2015 enacted level and the budget request. State 
formula grants, authorized under the AEFLA, support programs to 
enable all adults to acquire basic literacy skills, to enable 
those who so desire to complete secondary education, and to 
make available to adults the means to become more employable, 
productive, and responsible citizens.
    The bill also specifies that the set aside for English 
literacy and civics education State grants within the adult 
education program shall be $71,439,000 in fiscal year 2016, the 
same as the fiscal year 2015 enacted level.

Adult Education National Leadership Activities

    The Committee recommends $10,240,000 for National 
Leadership Activities, which is $3,472,000 below the fiscal 
year 2015 enacted level and $9,472,000 below the budget 
request. This program supports applied research, development, 
dissemination, evaluation, and program improvement efforts to 
strengthen the quality of adult education services.

                      Student Financial Assistance

    The Committee recommends $23,828,210,000 for Student 
Financial Assistance programs, which is $370,000,000 below the 
fiscal year 2015 enacted level and the budget request.

Pell Grants

    The Committee recommends $22,105,352,000 for the Pell Grant 
program, which is $370,000,000 below the fiscal year 2015 
enacted level and the budget request. These funds will support 
Pell grants to students for the 2016-17 academic year.
    The Congressional Budget Office estimates that the budget 
authority provided in this bill is sufficient to maintain the 
discretionary portion of the maximum Pell Grant award at 
$4,860. When combined with the mandatory add-on of $1,055, this 
will result in a $5,915 maximum Pell Grant in the 2016-17 
academic year.
    Pell Grants help to ensure access to higher educational 
opportunities for low- and middle-income students by providing 
need-based financial assistance. Grants are determined 
according to a statutory formula, which considers income, 
assets, household size, and the number of family members in 
college, among other factors. Pell Grants are the foundation of 
federal postsecondary student aid programs.
    In the past decade, Pell Grant spending has exploded. 
Expansions included in the College Cost Reduction and Access 
Act of 2007, the Higher Education Opportunity Act of 2008, the 
stimulus bill in 2009, and the Student Aid and Fiscal 
Responsibility Act of 2011 created an unsustainable situation 
that had recently put the program on a path toward bankruptcy. 
Numerous expansions, coupled with a dramatic rise in the number 
of eligible students due to the recession, caused the cost of 
discretionary Pell Grants to nearly double, from $16.1 billion 
in 2008 to over $31 billion in 2014. To address these 
challenges while maintaining the maximum Pell award, the 
Committee included responsible, common-sense reforms in the 
Consolidated Appropriations Act, 2012. As a result of these 
measures, the Pell Grant program has experienced a surplus in 
recent fiscal years. The Committee recommendation uses this 
surplus along with the funds appropriated in this bill to 
maintain the maximum Pell Grant award in the 2016-17 academic 
year. However, the Committee notes with concern that the Pell 
Grant program will again face a significant fiscal shortfall in 
future years without further reforms to make the program more 
efficient and targeted to the students and families that are 
most in need.

Federal Supplemental Educational Opportunity Grants

    The Committee recommends $733,130,000 for this program, 
which is the same as the fiscal year 2015 enacted level and the 
budget request. Supplemental Educational Opportunity Grants 
(SEOG) provide funds to postsecondary institutions for need-
based grants of up to $4,000 to undergraduate students, with 
priority given to students who are Pell-eligible. Approximately 
65 percent of dependent recipients have annual family incomes 
under $30,000 and nearly 80 percent of independent SEOG 
recipients have annual family incomes under $20,000. 
Institutions must contribute a 25 percent match toward their 
Supplemental Educational Opportunity Grant allocation.

Federal Work-Study

    The Committee recommends $989,728,000 for the Federal Work-
Study program, which is the same as the fiscal year 2015 
enacted level and the budget request. Federal Work-Study funds 
are provided through institutions to students who work part-
time. The funds assist with paying for the cost of education. 
Approximately 3,400 colleges and universities receive funding, 
according to a statutory formula, and may allocate it for job 
location and job development centers. Work-study jobs must pay 
at least the federal minimum wage and institutions must provide 
25 percent of student earnings.
    Within the total funding level for the Federal Work-Study 
program, the Committee recommends $8,390,000 for the Work 
Colleges program, which is the same as the fiscal year 2015 
enacted level. The Work Colleges program is authorized under 
section 448 of the Higher Education Act.

                       Student Aid Administration

    The Committee recommends $1,446,924,000 for Student Aid 
Administration (SAA), which is $50,000,000 above the fiscal 
year 2015 enacted level and $134,930,000 below the budget 
request. Programs administered under this account include Pell 
Grants, campus-based programs, Teacher Education Assistance for 
College and Higher Education (TEACH) grants, and federal 
student loan programs.
    Salaries and Expenses.--Within the total provided for 
Student Aid Administration, the Committee recommends 
$675,224,000 for salaries and expenses, which is the same as 
the 2015 enacted level and $51,419,000 below the budget 
request.
    Loan Servicing Activities.--Within the total provided for 
SAA, the Committee recommends $771,700,000 for Loan Servicing 
Activities, which is the same as the 2015 enacted level and 
$83,511,000 below the budget request.
    Private Collection Agencies.--The Committee recognizes the 
importance of the Department's contracts with private 
collection agencies (PCAs) to encouraging the timely repayment 
of federal student loans. The oversight and management of these 
contracts should be performed in a fair and consistent manner 
to ensure the rights of borrowers are paramount and to protect 
American taxpayers. However, the Committee is concerned about 
the current state of the contracting process with the PCAs and 
the Department. During the last contract period, the department 
relied on 22 PCAs to assist borrowers in rehabilitating their 
defaulted student loans and resuming timely payments. In 
anticipation of these contracts ending in April 2015, the 
Department awarded extensions to only 5 of the 22 companies, 
effectively reducing the pool of PCAs by almost 80 percent 
until the new contract period begins. The Committee is 
concerned that this sharp drop in the number PCAs could lead to 
poor administration and customer care for students and result 
in fewer rehabilitations and repayments of federal student 
loans. Within 60 days after the enactment of this Act, the 
Department is directed to submit a report to the House 
Appropriations Committee on how it plans to ensure proper 
oversight and management of the defaulted student loan 
portfolio and conduct effective monitoring of interactions 
between borrowers and the PCAs.

                            Higher Education

    The Committee recommends $1,909,042,000 for Higher 
Education programs, which is $15,797,000 below the fiscal year 
2015 enacted level and $163,003,000 below the budget request.

Strengthening Institutions

    The Committee recommends $82,071,000 for the Part A, 
Strengthening Institutions program, which is $1,609,000 above 
the fiscal year 2015 enacted level and the budget request. This 
program provides competitive grants for general operating 
subsidies to institutions with low average educational and 
general expenditures per student and significant percentages of 
low-income students. Funds may be used for faculty and academic 
program development, management, joint use of libraries and 
laboratories, acquisition of equipment, and student services.

Strengthening Hispanic-Serving Institutions

    The Committee recommends $102,236,000 for the Hispanic-
Serving Institutions program, which is $2,005,000 above the 
fiscal year 2015 enacted level and the budget request. The 
Hispanic-Serving Institutions program provides operating 
subsidies to schools that serve at least 25 percent Hispanic 
students. Funds may be used for faculty and academic program 
development, management, joint use of libraries and 
laboratories, acquisition of equipment, and student services.

Promoting Postbaccalaureate Opportunities for Hispanic Americans

    The Committee recommends $9,172,000 for the Promoting 
Postbaccalaureate Opportunities for Hispanic Americans program, 
which is $180,000 above the fiscal year 2015 enacted level and 
$1,393,000 below the budget request. This program provides 
expanded post baccalaureate educational opportunities for the 
academic attainment of Hispanic and low income students. In 
addition, it expands academic offerings and enhances program 
quality at institutions of higher education educating the 
majority of Hispanic college students.

Strengthening Historically Black Colleges and Universities

    The Committee recommends $232,074,000 for Strengthening 
Historically Black Colleges and Universities (HBCUs), which is 
$4,550,000 above the fiscal year 2015 enacted level and the 
budget request. This program provides operating subsidies to 
accredited, historically black colleges and universities that 
were established prior to 1964, with the principal mission of 
educating black Americans. Funds are distributed through a 
formula grant based on the enrollment of Pell Grant recipients, 
number of graduates, and the number of graduates entering 
graduate or professional schools in which blacks are 
underrepresented. The minimum grant is $500,000.

Strengthening Historically Black Graduate Institutions

    The Committee recommends $60,017,000 for the Strengthening 
Historically Black Graduate Institutions program, which is 
$1,177,000 above the fiscal year 2015 enacted level and the 
budget request. The program provides five-year grants to 18 
postsecondary institutions that are specified in section 
326(e)(1) of the Higher Education Act. Funds may be used to 
build endowments, provide scholarships and fellowships, and to 
assist students with the enrollment and completion of post 
baccalaureate and professional degrees.

Strengthening Predominantly Black Institutions

    The Committee recommends $9,429,000 for the Strengthening 
Predominantly Black Institutions (PBIs) program, which is 
$185,000 above the fiscal year 2015 enacted level and the 
budget request.

Strengthening Asian American and Native American Pacific-Islander-
        Serving Institutions

    The Committee recommends $3,175,000 for the Asian American 
Pacific Islander program, which is $62,000 above the fiscal 
year 2015 enacted level and the budget request. This program 
provides grants to undergraduate institutions that have an 
undergraduate student enrollment of at least ten percent Asian 
American or Native American Pacific Islander.

Strengthening Alaska Native and Native Hawaiian-Serving Institutions

    The Committee recommends $13,090,000 for the Strengthening 
Alaska Native and Native Hawaiian-Serving Institutions program, 
which is $257,000 above the fiscal year 2015 enacted level and 
the budget request, to provide competitive grants to improve 
capacity to serve Alaska Native and Native Hawaiian students.

Native American Serving Non-Tribal Institutions

    The Committee recommends $3,175,000 for the Native American 
Serving Non-Tribal Institutions program, which is $62,000 above 
the fiscal year 2015 enacted level and the budget request.

Strengthening Tribally Controlled Colleges and Universities

    The Committee recommends $30,000,000 for the Strengthening 
Tribally Controlled Colleges and Universities program, which is 
$4,338,000 above the fiscal year 2015 enacted level and the 
budget request.

International Education and Foreign Language Studies

    Domestic Programs.--The Committee recommends $65,103,000 
for the Domestic Programs of the International Education and 
Foreign Languages Studies program, which is the same as the 
fiscal year 2015 enacted level and $2,000,000 below the budget 
request. Authorized by title VI of the Higher Education Act, 
these programs include national resource centers, foreign 
language and area studies fellowships, undergraduate 
international studies and foreign language programs, 
international research and studies projects, business and 
international education projects, international business 
education centers, language resource centers, American overseas 
research centers, and technological innovation and cooperation 
for foreign information access.
    Overseas Programs.--The Committee recommends $7,061,000 for 
the Overseas Programs of the International Education, which is 
the same as the fiscal year 2015 enacted level and $2,000,000 
below the budget request. Funding for these programs support 
group projects, faculty research, special bilateral research, 
and doctoral dissertation research conducted abroad.

Fund for the Improvement of Postsecondary Education

    The Committee recommends no funding for the Fund for the 
Improvement of Postsecondary Education (FIPSE), which is 
$67,775,000 below the fiscal year 2015 enacted level and the 
same as the budget request. This program awards grants and 
contracts to a variety of postsecondary institutions and other 
organizations to improve the quality and delivery of 
postsecondary education. In the past, this account has been 
used primarily to allow the Administration to have a pot of 
flexible funding for new and often unauthorized initiatives. 
Given the fiscal constraints facing the Committee, funding is 
not provided for any of these purposes in this bill.

First in the World

    The Committee recommends no funding for the First in the 
World program. This program was funded within FIPSE in fiscal 
year 2015. The request included $200,000,000 for this program 
in a new budget line.

Postsecondary Programs for Students with Intellectual Disabilities

    The Committee recommends $11,800,000 for Postsecondary 
Programs for Students with Intellectual Disabilities, which is 
the same as the fiscal year 2015 level and the budget request. 
This program, first funded in fiscal year 2011, supports grants 
to create model transition programs for students with 
intellectual disabilities.

Minority Science and Engineering Improvement

    The Committee recommends $8,971,000 for the Minority 
Science and Engineering Improvement Program, which is the same 
as the fiscal year 2015 enacted level and the budget request. 
The Minority Science and Engineering Improvement Program awards 
grants to improve mathematics, science, and engineering 
programs at institutions serving primarily minority students 
and to increase the number of minority students who pursue 
advanced degrees and careers in those fields.

Tribally Controlled Postsecondary Career and Technical Institutions

    The Committee recommends $8,705,000 for this program, which 
is $1,000,000 above the fiscal year 2015 enacted level and the 
budget request. This program provides competitive grants to 
tribally controlled postsecondary career and technical 
institutions to provide career and technical education to 
Native American students.

Federal TRIO Programs

    The Committee recommends $900,000,000 for TRIO programs, 
which is $60,248,000 above the fiscal year 2015 enacted level 
and $40,248,000 above the budget request. The TRIO programs 
provide a variety of outreach and support services to encourage 
low-income, potential first-generation college students to 
enter and complete college. Discretionary grants of up to four 
or five years are awarded competitively to institutions of 
higher education and other agencies. At least two-thirds of the 
eligible participants in TRIO must be low-income, first-
generation college students. The bill does not include funding 
for the TRIO Demonstration Initiative proposed by the 
Department in the budget request.

GEAR UP

    The Committee recommends $322,754,000 for the GEAR UP 
program, which is $21,115,000 above the fiscal year 2015 
enacted level and the budget request. GEAR UP provides grants 
to States and partnerships of low-income middle and high 
schools, institutions of higher education and community 
organizations to target entire grades of students and give them 
the skills, encouragement, and scholarships to successfully 
pursue postsecondary education.
    The Committee bill continues language allowing the 
Department to maintain the Gaining Early Awareness and 
Readiness for Undergraduate Programs (GEAR UP) evaluation set-
aside at 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.

Graduate Assistance in Areas of National Need

    The Committee recommends $25,075,000 for the Graduate 
Assistance in Areas of National Need program, which is 
$4,218,000 below the fiscal year 2015 enacted level and the 
budget request. Funds are included to fully cover the cost of 
grants made in prior years. The program awards grants to 
institutions of higher education to provide fellowships to 
economically disadvantaged students who have demonstrated 
academic excellence and who are pursuing graduate education in 
designated areas of national need, such as the sciences, 
mathematics, engineering, and nursing.

Teacher Quality Partnerships Grants

    The Committee recommends no funding for Teacher Quality 
Partnerships, which is $40,592,000 below the fiscal year 2015 
enacted level and the same as the budget request. The 
Administration proposed to consolidate this program into the 
Teacher and Principal Pathways program in its budget request.

Child Care Access Means Parents in School

    The Committee recommends $15,134,000 for the Child Care 
Access Means Parents in School program, which is the same as 
the fiscal year 2015 enacted level and the budget request. This 
program helps to ensure that low-income student parents have 
access to postsecondary education and affordable and convenient 
child care. Colleges and universities may receive discretionary 
grants of up to four years to support or establish a campus-
based childcare program primarily serving the needs of low-
income students enrolled at the institution. Priority is given 
to childcare programs that leverage significant local or 
institutional resources and utilize a sliding fee scale.

GPRA Data/Higher Education Act Program Evaluation

    The Committee recommends no funding for program evaluation 
and development of data authorized under the Government 
Performance and Results Act for Higher Education programs 
administered by the Department. This amount is the same as the 
fiscal year 2015 enacted level and $30,000,000 below the budget 
request.

                           Howard University

    The Committee recommends $221,821,000 for Howard 
University, which is the same as the fiscal year 2015 enacted 
level and the budget request.
    Howard University is a ``Research I'' university located in 
the District of Columbia. Howard University provides 
undergraduate liberal arts, graduate and professional 
instruction to over 10,000 students from all 50 States.
    Within the amount provided, the Committee recommends 
$27,325,000 for the Howard University Hospital, which is the 
same as the fiscal year 2015 enacted level and the budget 
request. The hospital serves as a major acute and ambulatory 
care center for the District of Columbia, and functions as a 
major teaching facility.

         COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

    The Committee recommends $435,000 for the federal 
administration of the College Housing and Academic Facilities 
Loan program, the Higher Educational Facilities Loans program, 
and the College Housing Loans program, which is the same as the 
fiscal year 2015 enacted level and $15,000 below the budget 
request. Previously, these programs helped to ensure that 
postsecondary institutions were able to make necessary capital 
improvements to maintain and increase their ability to provide 
a high-quality education. Since 1994, no new loans have been 
made, and the Department's role has been to manage the 
outstanding loans.

  HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING PROGRAM 
                                ACCOUNT

    The Committee recommends $19,430,000 for the Historically 
Black College and University Capital Financing program, which 
is the same as the fiscal year 2015 enacted level and $6,000 
below the budget request. Funds are available through September 
30, 2016. The Historically Black Colleges and University 
Capital Financing program is authorized under part D of Title 
III of the Higher Education Act and makes capital available for 
repair and renovation of facilities at historically black 
colleges and universities. In exceptional circumstances, 
capital provided under the program can be used for construction 
or acquisition of facilities.
    Within the total provided for this program, the Committee 
recommendation includes $334,000 for the administrative 
expenses to carry out this program and $19,096,000 for loan 
subsidy costs that will be sufficient to guarantee up to 
$303,593,000 in new loans in fiscal year 2015. Funds will also 
be used to continue technical assistance services to help 
Historically Black Colleges and Universities improve their 
financial stability and access to capital markets.

                    INSTITUTE OF EDUCATION SCIENCES

    The Committee recommends $409,956,000 for the Institute of 
Education Sciences, which is $163,979,000 below the fiscal year 
2015 enacted level and $265,927,000 below the budget request. 
This account supports education research, statistics, 
dissemination, evaluation, and assessment activities.

Research, Development, and Dissemination

    The Committee recommends $93,144,000 for Research, 
Development, and Dissemination, which is $86,716,000 below the 
fiscal year 2015 enacted level and $109,129,000 below the 
budget request. Funds are included to fully cover the cost of 
grants made in prior years. The Institute of Education Sciences 
(IES) supports research, development, and national 
dissemination activities that are aimed at expanding 
fundamental knowledge of education and promoting the use of 
research and development findings in the design of efforts to 
improve education.

Statistics

    The Committee recommends $103,060,000 for the activities of 
the National Center for Education Statistics (NCES), which is 
the same as the fiscal year 2015 enacted level and $21,684,000 
below the budget request. Statistics activities are authorized 
under title I of the Education Sciences Reform Act of 2002. The 
Center collects, analyzes, and reports statistics on all levels 
of education in the United States. Activities are carried out 
directly and through grants and contracts and include 
projections of enrollments, teacher supply and demand, and 
educational expenditures. NCES also provides technical 
assistance to State and local educational agencies and 
postsecondary institutions.

Regional Educational Laboratories

    The Committee recommends no funding for Regional 
Educational Laboratories, which is $54,423,000 below the fiscal 
year 2015 enacted level and the budget request.

Research in Special Education

    The Committee recommends $35,978,000 for Research in 
Special Education, which is $18,022,000 below the fiscal year 
2015 enacted level and the budget request. This program 
supports competitive awards to produce and advance the use of 
knowledge to improve services and results for children with 
disabilities. The program focuses on producing new knowledge, 
integrating research and practice, and improving the use of 
knowledge.

Special Education Studies and Evaluations

    The Committee recommends $6,000,000 for Special Education 
Studies and Evaluations, which is $4,818,000 below the fiscal 
year 2015 enacted level and $7,000,000 below the budget 
request. This program awards competitive grants, contracts and 
cooperative agreements to assess the implementation of the IDEA 
and the effectiveness of State and local efforts to provide 
special education and early intervention programs and services 
to infants, toddlers, and children with disabilities.

Statewide Data Systems

    The Committee recommends $34,539,000 for Statewide Data 
Systems, which is the same as the fiscal year 2015 enacted 
level and $35,461,000 below the budget request. Competitive 
grants under this authority are made to State educational 
agencies to help them manage, analyze, disaggregate and use 
student data consistent with the ESEA.

Assessment

    The Committee recommends $137,235,000 for Assessment, which 
is the same as the fiscal year 2015 enacted level and 
$20,208,000 below the budget request. This amount includes 
$8,235,000 for the National Assessment Governing Board (NAGB), 
which is the same as the fiscal year 2015 enacted level and 
$408,000 above the budget request.
    The National Assessment of Educational Progress is the only 
nationally representative and continuing survey of educational 
ability and achievement of American students. The primary goal 
of the Assessment is to determine and report the status and 
trends of the knowledge and skills of students, subject by 
subject. Subject areas assessed in the past have included 
reading, writing, mathematics, science, and history, as well as 
citizenship, literature, art, and music. The National 
Assessment of Educational Progress is operated by contractors 
through competitive awards made by the National Center for 
Education Statistics. The NAGB formulates the policy guidelines 
for the program.

                        Departmental Management

    The Committee recommends $569,256,000 for Departmental 
Management, which is $465,000 above the fiscal year 2015 
enacted level and $94,780,000 below the budget request. These 
activities are authorized by the Department of Education 
Organization Act, P.L. 96-88, and include costs associated with 
the management and operation of the Department as well as 
separate costs associated with the Office for Civil Rights and 
the Office of the Inspector General.

Program Administration

    The Committee recommends $410,000,000 for Program 
Administration, which is $1,000,000 below the fiscal year 2015 
enacted level and $64,089,000 below the budget request. These 
funds support the staff and other costs of administering 
programs and activities at the Department. Items include 
personnel compensation and health, retirement, and other 
benefits as well as travel, rent, telephones, utilities, 
postage fees, data processing, printing, equipment, supplies, 
technology training, consultants, and other contractual 
services. The Committee bill does not include funding for 
building modernization.
    Vision and Educational Performance.--One out of four 
children in the United States have some form of low vision and 
at least two million schoolchildren start the school year not 
being able to see clearly. Thousands of schoolchildren from 
low-income families are unable to make the most of their 
education because they cannot see well. Most of these cases of 
poor vision are due to refractive error and are easily 
corrected.
    The Committee recommends that the Department consider 
funding programs that identify and provide prescription 
eyeglasses to children from low-income families whose 
educational performance and future vocational success may be 
hindered because of poor vision.
    Illegal Immigration.--The Committee is concerned with the 
significant healthcare and education costs to State and local 
communities resulting from illegal immigration. These costs are 
especially high in States along the southern border of the 
United States. The Committee directs the Department of 
Education and the Department of Health and Human Services to 
provide all available federal resources to assist State and 
local governments with these increased costs that are a direct 
result of federal law or policy. The Committee further directs 
the Departments to provide a report to the House Appropriations 
subcommittee on Labor, Health and Human Services, and 
Education, the subcommittee on Commerce, Justice, Science and 
the subcommittee on Homeland Security within 90 days of 
enactment on the costs borne by State and local governments and 
the federal government for providing health and education 
services to individuals without legal immigration status, to 
include those who qualified under the President's November 20, 
2014 executive immigration action. The report shall address the 
costs incurred over the course of fiscal years 2014 and 2015 
and include projected costs for fiscal years 2016 through 2020. 
The report shall also include an accounting of the federal 
resources that have been and will be directed in each year to 
cover these added expenses.
    Interagency Collaboration.--The Committee understands the 
importance of interagency collaboration in promoting student 
achievement and ensuring equal access to education. To achieve 
these goals, the Committee directs the Secretary to work 
jointly with the Director of the Institute of Museum and 
Library Services on initiatives, materials or technology to 
support educational and workforce development activities 
undertaken by libraries; resource and policy approaches to 
eliminate barriers to fully leveraging the role of libraries 
and museums in supporting the early learning, literacy, 
lifelong learning, digital literacy, workforce development, and 
education needs of the people of the United States; and 
initiatives, materials, or technology to support educational 
activities undertaken by museums.
    Expulsions from Early Education Programs.--The Committee is 
deeply concerned about expulsions and suspensions that occur in 
preschool settings and K-3 classrooms, particularly given the 
racial and gender disparities that exist. This is problematic 
given the research that indicates these practices can adversely 
affect development, health and education outcomes. The 
Committee strongly urges the Departments of Education and HHS 
to highlight evidence-based interventions and identify 
opportunities, including through relevant programs and the 
provision of technical assistance, that help prevent and 
severely limit expulsion and suspension practices in preschool 
settings and K-3 classrooms and ensure the safety and well-
being of all young children.

                        OFFICE FOR CIVIL RIGHTS

    The Committee recommends $100,000,000 for the Office for 
Civil Rights, which is the same as the fiscal year 2015 enacted 
level and $30,691,000 below the budget request. The Office for 
Civil Rights is responsible for enforcing laws that prohibit 
discrimination on the basis of race, color, national origin, 
sex, disability, and age in all programs and institutions that 
receive funds from the Department. These laws extend to 50 
State educational agencies, 14,000 LEAs, and nearly 6,500 
institutions of higher education, including proprietary 
schools. They also extend to 82 State rehabilitation agencies, 
libraries, museums, and other institutions receiving federal 
funds.

                    OFFICE OF THE INSPECTOR GENERAL

    The Committee recommends $59,256,000 for the Office of the 
Inspector General, which is $1,465,000 above the fiscal year 
2015 enacted level and the same as the budget request. This 
Office has authority to inquire into all program and 
administrative activities of the Department as well as into 
related activities of grant and contract recipients. It 
conducts audits and investigations to determine compliance with 
applicable laws and regulations, to check alleged fraud and 
abuse, efficiency of operations, and effectiveness of results.

                           General Provisions

    Sec. 301. The Committee continues a provision that 
prohibits funds in this act from being used for the 
transportation of students or teachers in order to overcome 
racial imbalances or to carry out a plan of racial 
desegregation.
    Sec. 302. The Committee continues a provision that 
prohibits funds in this act from being used to require the 
transportation of any student to a school other than the school 
which is nearest the student's home in order to comply with 
Title VI of the Civil Rights Act of 1964.
    Sec. 303. The Committee continues a provision that 
prohibits funds in this act from being used to prevent the 
implementation of programs of voluntary prayer and meditation 
in public schools.

                          (TRANSFER OF FUNDS)

    Sec. 304. The Committee continues a provision providing the 
Secretary of Education with the authority to transfer up to one 
percent of discretionary funds between appropriations, provided 
that no appropriation is increased by more than three percent 
by any such transfer. This transfer authority is available only 
to meet emergency needs, and may not be used to create any new 
program or fund a project or activity that is not otherwise 
funded in this act. All transfers are subject to notification 
to the Committees on Appropriations of the House of 
Representatives and the Senate.
    Sec. 305. The Committee continues a provision that allows 
the Outlying Areas to consolidate funds under title V of the 
ESEA.
    Sec. 306. The Committee continues a provision that permits 
Palau to continue participating in Department of Education and 
other programs pending formal ratification of a new compact 
agreement.
    Sec. 307. The Committee amends a provision allowing the 
Department to set aside up to 0.5 percent of ESEA funds for 
evaluation of ESEA programs to clarify that the Institute of 
Education Sciences is the primary entity to conduct research on 
and evaluations of these programs.
    Sec. 308. The Committee includes a provision allowing 
certain institutions to continue to use endowment income for 
student scholarships.
    Sec. 309. The Committee includes a provision that prohibits 
the Department from moving forward with a regulation that would 
define ``gainful employment'' through a series of complex 
calculations that could negatively impact schools and students.
    Sec. 310. The Committee includes a provision that prohibits 
the Department from creating, promulgating, or implementing new 
regulations that set a federal definition of a credit hour.
    Sec. 311. The Committee includes a provision prohibiting 
funds made available in this act from being used to implement, 
administer, or enforce regulations that dictate how States must 
authorize or license institutions of higher education within 
the State.
    Sec. 312. The Committee includes a provision prohibiting 
funds made available in this act from being used to develop or 
implement a college rating system.
    Sec. 313. The Committee includes a provision prohibiting 
funds made available in this act from being used to promulgate 
or enforce teacher preparation regulations.

                       TITLE IV--RELATED AGENCIES


 Committee for Purchase From People Who Are Blind or Severely Disabled


                         SALARIES AND EXPENSES

    The Committee recommends $5,362,000 for the Committee for 
Purchase From People Who Are Blind or Severely Disabled, which 
is equal to the fiscal year 2015 enacted level and $79,000 
below the budget request. The Committee is aware of a recent 
GAO study which found that the AbilityOne Commission cannot 
control how central nonprofit agencies, which administer much 
of the program, spend their funds, set and manage performance 
goals, or set and implement governance policies and other 
internal controls. The Committee believes greater oversight is 
necessary to ensure the program is operating in accordance with 
statutory requirements that blind or other severely disabled 
individuals provide at least 75 percent of hours or direct 
labor required for the production or provision of the products 
or services to Federal government agencies. To provide the 
AbilityOne Commission with greater oversight capacity, the 
Committee includes bill language requiring AbilityOne to enter 
into contracts with central nonprofit agencies prior to the 
remittance of fees. This will enable AbilityOne to increase 
auditing, oversight and reporting functions in accordance with 
standard federal procurement policies. The Committee urges the 
authorizing Committees of jurisdiction to consider additional 
means of program oversight, including the appointment of an 
independent Inspector General.

             Corporation For National and Community Service


                           OPERATING EXPENSES

    The Committee recommends $612,527,000 to the Corporation 
for National and Community Service (Corporation) to carry out 
activities authorized under the Domestic Volunteer Service Act 
of 1973 and the National and Community Service Act of 1990. 
This is $145,822,000 below the fiscal year 2015 enacted level 
and $242,681,000 below the budget request.

Volunteers in Service to America (VISTA)

    The Committee recommends $92,364,000 for VISTA, the same as 
the fiscal year 2015 enacted level and $4,521,000 below the 
budget request. 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 $202,117,000 for the National 
Senior Volunteer Corps programs, the same as the fiscal year 
2015 enacted level and the budget request. Senior Corps is a 
collection of programs that connect Americans older than the 
age of 55 with opportunities to contribute their job skills and 
expertise to community projects and organizations. The breakout 
of funding by program is as follows:

                               [$ in 000]
------------------------------------------------------------------------
                                                            FY 2016
           National Senior Volunteer Corps                 Committee
------------------------------------------------------------------------
Foster Grandparents Program..........................           $107,702
Senior Companion Program.............................             45,512
Retired Senior Volunteer Program.....................             48,903
                                                      ------------------
    Total............................................            202,117
------------------------------------------------------------------------

AmeriCorps State and National Grants

    The Committee recommends $318,046,000 for AmeriCorps State 
and National Grants, which is $17,384,000 below the fiscal year 
2015 enacted level and $107,059,000 below the budget request. 
This program provides funds to local and national organizations 
and agencies to address community needs in education, public 
safety, health, and the environment. Within the amount 
provided, the Committee expects the Corporation to maintain 
funding for competitive grants at the fiscal year 2015 level.

                 Payment to the National Service Trust

    The Committee recommends $50,000,000 for payments to the 
National Service Trust, $159,618,000 below the fiscal year 2015 
level and $187,077,000 below the budget request. The National 
Service Trust makes payments for 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 the Corporation.

                         SALARIES AND EXPENSES

    The Committee recommends $20,000,000 for Salaries and 
Expenses, $61,737,000 below the fiscal year 2015 level and 
$66,176,000 below the budget request.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $5,250,000 for the Office of 
Inspector General.

                       ADMINISTRATIVE PROVISIONS

    Sec. 401. The Committee continues bill language that 
combines separate matching requirements for AmeriCorps grants.
    Sec. 402. The Committee continues bill language related to 
National Service Trust minimum share requirements.
    Sec. 403. The Committee continues bill language related to 
donations.
    Sec. 404. The Committee continues bill language related to 
veterans.
    Sec. 405. The Committee continues bill language related to 
criminal history background checks.

                  Corporation for Public Broadcasting

    The Committee recommends $445,000,000 for the Corporation 
for Public Broadcasting in fiscal year 2018. According to the 
Public Broadcasting Act, one of the greatest priorities of 
public broadcasting is to address the needs of unserved and 
underserved audiences, particularly children and minorities. 
Programming that reflects the histories and perspectives of 
diverse racial and ethnic communities is a core value and 
responsibility of public broadcasting, therefore the Committee 
supports continued investment in the National Minority 
Consortia to help accomplish this goal.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

    The Committee recommends $48,748,000 for the Federal 
Mediation and Conciliation Service. This recommendation is 
$3,082,000 more than the fiscal year 2015 enacted level and the 
same as the fiscal year 2016 budget request.

            Federal Mine Safety and Health Review Commission


                         SALARIES AND EXPENSES

    The Committee recommends $17,085,000 for the Federal Mine 
Safety and Health Review Commission. This recommendation is 
$334,000 more than the fiscal year 2015 enacted level and the 
same as the fiscal year 2016 budget request.

               Institute for Museum and Library Services


    OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION

    The Committee recommends $227,860,000 for the Institute of 
Museum and Library Services (IMLS), which is the same as the 
fiscal year 2015 enacted level and $9,568,000 below the budget 
request. Within the total for IMLS, the Committee recommends 
the following amounts:

----------------------------------------------------------------------------------------------------------------
                                                                                   This Bill compared to--
                                                                           -------------------------------------
                    Budget activity                          This Bill                           FY 2016 Budget
                                                                                 FY 2015            Request
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act (LSTA):
    Grants to States...................................       $154,848,000                 $0           $348,000
    Native American Library Services...................          4,063,000            202,000                  0
    National Leadership: Libraries.....................         12,200,000                  0         -5,300,000
    Laura Bush 21st Century Librarian..................         10,000,000                  0           -500,000
Museum Services Act:
    Museums for America................................         20,983,000            783,000           -474,000
    21st Century Museum Professionals..................                  0                  0                  0
    Conservation Project Support.......................                  0                  0                  0
    Native American/Hawaiian Museum Services...........            972,000             48,000                  0
National Leadership:
    Museums............................................          7,600,000                  0         -3,568,000
African American History and Culture Act:
    Museum Grants for African American History and               1,407,000                  0            -74,000
     Culture...........................................
Museum and Library Services Act General Provisions:
    Research, Analysis and Data Collection.............          1,787,000            -33,000                  0
    Administration.....................................         14,000,000         -1,000,000                  0
----------------------------------------------------------------------------------------------------------------

Library Services and Technology

    The Grants to State Library Agencies program provides funds 
to State Library Administrative Agencies using a population-
based formula.

Program Administration

    The Committee recommends $14,000,000 for Program 
Administration, which is the $1,000,000 below the fiscal year 
2015 enacted level and the same as the budget request. These 
funds provide administrative and management support for all 
programs administered by IMLS. Funds are included for office 
relocation and renovation. Within the funds recommended, the 
Committee includes $1,787,000 for IMLS' activities in policy, 
research, and data collection, including functions formerly 
conducted by the National Commission on Libraries and 
Information Science.

                  Medicare Payment Advisory Commission


                         SALARIES AND EXPENSES

    The Committee recommends $11,925,000 for the Medicare 
Payment Advisory Commission (MedPAC), which is $176,000 more 
than the fiscal year 2015 enacted level and $175,000 less than 
the budget request.

             Medicaid & Chip Payment and Access Commission


                         SALARIES AND EXPENSES

    The Committee provides $7,765,000 for the Medicaid & CHIP 
Payment and Access Commission, which is $115,000 more than the 
fiscal year 2015 enacted level and $935,000 below the budget 
request.

                     National Council On Disability


                         SALARIES AND EXPENSES

    The Committee recommends $3,250,000 for the National 
Council on Disability, which is the same as the fiscal year 
2015 enacted level and $182,000 below the budget request.

                     National Labor Relations Board


                         SALARIES AND EXPENSES

    The Committee recommends $200,000,000 for the National 
Labor Relations Board (NLRB). This recommendation is 
$74,224,000 less than the fiscal year 2015 enacted level and 
$78,000,000 less than the fiscal year 2016 budget request.
    The NLRB Inspector General issued a report in April 2011 
(Case Processing Costs--Report No. OIG-AMR-64-11-02) citing 
numerous cost efficiencies, including the consolidation of 
regional offices to streamline operations. The Committee 
directs NLRB to continue its efforts to streamline operations 
and consolidate regional offices to achieve greater 
efficiencies and cost savings.

                       ADMINISTRATIVE PROVISIONS

    Sec. 406. The Committee continues a provision relating to 
electronic voting for purposes of collective bargaining.
    Sec. 407. The Committee includes a new provision relating 
to regulation of representation-case procedures.
    Sec. 408. The Committee includes a new provision relating 
to joint-employer standards.
    Sec. 409. The Committee includes a new provision relating 
to jurisdiction over Indian tribes.

                        National Mediation Board


                         SALARIES AND EXPENSES

    The Committee recommends $13,230,000 for the National 
Mediation Board (NMB). This recommendation is $3,000 more than 
the fiscal year 2015 enacted level and the same as the fiscal 
year 2016 budget request.

            Occupational Safety and Health Review Commission


                         SALARIES AND EXPENSES

    The Committee recommends $12,639,000 for the Occupational 
Safety and Health Review Commission (OSHRC). This 
recommendation is $1,000,000 more than the fiscal year 2015 
enacted level and $573,000 less than the fiscal year 2016 
budget request.

                       Railroad Retirement Board


                     DUAL BENEFITS PAYMENTS ACCOUNT

    The Committee recommends $29,000,000 for dual benefits, 
which is $5,000,000 less than the fiscal year 2015 enacted 
level and the same as the budget request. This appropriation is 
authorized by the Railroad Retirement Act of 1974 to fund 
vested dual benefits received by railroad retirees who, under 
prior law, would have become covered by both the railroad 
retirement system and the Social Security system because 
railroad retirement was not fully coordinated with social 
security from 1937 to 1974. The Committee includes a provision 
permitting a portion of these funds to be derived from income 
tax receipts on dual benefits as authorized by law. The 
Railroad Retirement Board estimates that approximately 
$2,000,000 may be derived in this manner.

          FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS

    The Committee recommends $150,000 for the interest earned 
on unnegotiated checks, which is the equal to the fiscal year 
2015 funding level and the budget request.

                      LIMITATION ON ADMINISTRATION

    The Committee recommends a consolidated limitation of 
$111,225,000 on the expenditure of Railroad Retirement and 
Railroad Unemployment Trust Funds for administrative expenses 
of the Railroad Retirement Board (RRB), which is the same as 
the fiscal year 2015 enacted level and $8,693,000 below the 
budget request.
    The Committee maintains its position that the financial 
statements and audit of the National Railroad Retirement 
Investment Trust should remain separate from the financial 
statements and audit of the RRB. The Committee notes that the 
Railroad Retirement and Survivors' Improvement Act of 2001 
mandates that the Trust function independently from the RRB. 
Further, the Act specifically requires a separate audit of the 
Trust by a nongovernmental auditor and requires that the 
results of this audit be included in the Trust's Annual 
Management Report to Congress. The Committee expects that the 
Trust shall be administered and audited solely in conformance 
with the Act of 2001.
    The Committee recommends the RRB maintain staffing levels 
at or below 860 FTEs and continue work toward increasing the 
effectiveness and efficiency of current staff members to 
decrease or eliminate any requirements for staff growth in 
future years.

             LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

    The Committee recommends authority to expend $8,437,000 
from the Railroad Retirement and Railroad Unemployment 
Insurance Trust Funds for the Office of Inspector General, 
which is equal to the fiscal year 2015 enacted level and 
$1,013,000 below the budget request. The Committee recommends 
the RRB OIG maintain staffing levels at or below 54 FTEs and 
continue work toward increasing the effectiveness and 
efficiency of current staff members to decrease or eliminate 
any requirements for staff growth in future years.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

    The Committee recommends $20,400,000 for mandatory payments 
necessary to compensate the Old Age and Survivors Insurance 
(OASI) Trust Fund and the Disability Insurance (DI) Trust Fund, 
which is $4,000,000 more than the fiscal year 2015 enacted 
level and the budget request. This appropriation provides 
reimbursement to the Social Security trust funds for non-trust 
fund activities.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

    The Committee recommends $46,232,978,000 for the 
Supplemental Security Income (SSI) program, which is 
$5,000,000,000 more than the fiscal year 2015 enacted level and 
$186,552,000 below the request level. The Committee recommends 
$14,500,000,000 in advance funding for the first quarter of 
fiscal year 2017, as requested.

Research and demonstration

    Within the appropriation for SSI, the Committee recommends 
$101,000,000 for the research and demonstration activities, 
which is $18,000,000 more than the fiscal year 2015 enacted 
level and the same as the request level.
    Disability Early Intervention Initiative.--The Disability 
Early Intervention Initiative will test innovativeand evidence-
based approaches to improveoutcomes for individuals with 
disabilitieswho are not yet receiving Social Security 
disability benefits, but who are likely to beeligible for 
benefits in the future. The intent of this initiative is to 
provide a multi-pronged approach to assisting such individuals 
to remain in the workforce.
    The Social Security Administration (SSA) has partnered with 
the National Institutes of Health to create a functional 
assessment tool that is reliable and objective and may inform 
the disability determination process.One of the major projects 
of this partnership is the Functional Assessment Battery 
(FAB).The Committee believes the FAB tool could serve to 
provide uniform, objective evidence to the disability 
determination.The Committee notes its concern that SSA is 
currently limiting the use of this tool for only survey 
research. The Committee directs SSA to test the use of the FAB 
as part of the demonstrations undertaken within the Disability 
Early Intervention Initiative.

Administration

    Within the appropriation for SSI, the Committee recommends 
$4,578,978,000, which is the same as fiscal year 2015 enacted 
level and $186,552,000 below the request level for payment to 
the Social Security trust funds for SSI's share of the base 
administrative expenses of SSA.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

    The Committee recommends $11,817,945,000 for the Limitation 
on Administrative Expenses (LAE) account activities to be 
funded from the Social Security and Medicare trust funds, which 
is $12,000,000 more than the 2015 enacted level and 
$695,055,000 below the budget request. The LAE funds support 
SSA operational costs to administer the Old Age and Survivors 
Insurance (OASI), Disability Insurance (DI), and Supplemental 
Security Income (SSI) programs, and to support the Centers for 
Medicare and Medicaid Services in administering their programs.
    Work Incentives Planning and Assistance [WIPA] and 
Protection and Advocacy for Beneficiaries of Social Security 
[PABSS].--The Committee recommendation for fiscal year 2016 
includes $23,000,000 for WIPA and $7,000,000 for PABSS.
    Fraud Risk Performance.--The Committee strongly encourages 
SSA to fully implement the recommendations found within the SSA 
Inspector General report on Fraud Risk Performance Audit. 
Specifically, the Committee urges SSA to take a risk-based 
approach to combating fraud, be more proactive in addressing 
and mitigating new fraud schemes, and improve the design 
operating effectiveness of anti-fraud measures. Additionally, 
the Committee directs SSA to provide a breakout within 60 days 
of enactment of the funding spent in fiscal year 2015 and the 
anticipated amount to be spent in fiscal year 2016 on anti-
fraud activities. This breakout should include activities that 
SSA is working on in concert with the SSA Office of Inspector 
General.
    Report on Medical Listings.--SSA employs medical listings 
to make disability determinations, many of which have not been 
updated for decades. The Committee directs SSA to provide a 
report within 60 days of enactment to the House Appropriations 
Subcommittee on Labor, Health and Human Services and Education 
and the House Ways and Means Subcommittee on Social Security 
regarding the number of years since the last update and when 
the agency expects to conduct all of the updates.
    Report on LAE Expenditures.--The Committee directs SSA to 
provide a report to the House Appropriations Subcommittee on 
Labor, Health and Human Services, and Education and the House 
Ways and Means Subcommittee on Social Security within 60 days 
of enactment detailing how much funding was expended on the 
following categories in fiscal year 2015:
         Personnel costs by General Schedule grade, 
        Administrative Law Judge personnel costs, Senior 
        Executive Service personnel costs, reemployed annuitant 
        personnel costs, and personnel costs by region
         Information technology costs broken out by 
        hardware/software technology and upgrade/maintenance 
        costs
         Physical infrastructure costs by region and 
        office function
         Overall costs for personnel, time and dollars 
        for the following:
                  OASI, DI and SSI
                  Other SSA missions, including return to work 
                efforts
                  Program integrity work broken out by OASI, DI 
                and SSI as well as types of spending (data 
                matching, predictive data work and data 
                analytics)
                  Disability Determination Services State costs 
                and federal staff costs
    Huntington's Disease.--The Committee urges the Social 
Security Administration to work with the National Institutes of 
Health to immediately revise the Huntington's disease (HD) SSDI 
guidelines, used to determine disability for individuals with 
the disease, to reflect the most up-to-date medical 
understandings of the physical, cognitive, and behavioral 
symptoms. The Committee understands that some believe the 
current guidelines do not fully recognize the emotional and 
psychological symptoms of Huntington's disease. Some research 
sources indicate that the emotional and psychological symptoms 
appear years before physical symptoms are exhibited. The 
Committee urges SSA to work with NIH to ensure the SSDI HD 
guidelines reflect the most current scientific data.
    Muscular Dystrophy.--The Committee is aware that SSA was 
added to the Muscular Dystrophy Coordinating Committee through 
the Muscular Dystrophy CARE Act Amendments enacted in September 
2014. The Committee requests that the agency provide relevant 
data within the fiscal year 2017 budget request on the rate at 
which persons with Duchenne and Becker Muscular Dystrophy 
utilize SSA programs, particularly those focused on promoting 
employment and community independence such as the Ticket to 
Work program.

Social Security Advisory Board

    The Committee recommends that not less than $2,300,000 of 
the LAE funding be available for the Social Security Advisory 
Board, which is the same as the fiscal year 2015 enacted level 
and $100,000 below the budget request.

User Fees

    In addition to the other amounts provided, the Committee 
recommends $137,000,000 for administrative activities funded 
from user fees. Of this amount, $136,000,000 is derived from 
fees collected from States that request SSA to administer State 
SSI supplementary payments.

Continuing Disability Reviews and Redeterminations

    The Committee recommends $1,396,000,000 for program 
integrity activities. In the wake of multiple large-scale 
disability fraud cases, the Committee believes that successful 
program integrity activities are vital to maintaining the 
public's support for benefit payments to recipients deserving 
of assistance.

                    OFFICE OF THE INSPECTOR GENERAL

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $108,795,000 for the Office of 
Inspector General, of which the bill provides authority to 
expend $78,795,000 from the OASI and DI trust funds.

                      TITLE V--GENERAL PROVISIONS


                          (TRANSFER OF FUNDS)

    Sec. 501. The Committee continues a provision allowing the 
Secretaries of Labor, Health and Human Services, and Education 
to transfer unexpended balances of prior appropriations to 
accounts corresponding to current appropriations to be used for 
the same purpose and for the same periods of time for which 
they were originally appropriated.
    Sec. 502. The Committee continues a provision prohibiting 
the obligation of funds beyond the current fiscal year unless 
expressly so provided.
    Sec. 503. The Committee continues a provision prohibiting 
funds from being used to support or defeat legislation.
    Sec. 504. The Committee continues a provision limiting the 
amount available for official reception and representation 
expenses for the Secretaries of Labor and Education, the 
Director of the Federal Mediation and Conciliation Service, and 
the Chairman of the National Mediation Board.
    Sec. 505. The Committee continues a provision requiring 
grantees receiving Federal funds to clearly state the 
percentage of the total cost of the program or project that 
will be financed with Federal money.
    Sec. 506. The Committee continues a provision prohibiting 
the use of funds for any abortion.
    Sec. 507. The Committee continues a provision providing 
exceptions to section 506 and a provision prohibiting funds 
from being made available to a Federal agency or program, or to 
a State or local government, if such agency, program or 
government discriminates against institutional or individual 
health care entities because they do not provide, pay for, 
provide coverage of, or refer for abortions.
    Sec. 508. The Committee continues a provision prohibiting 
use of funds for certain research involving human embryos.
    Sec. 509. The Committee continues a provision prohibiting 
use of funds for any activity that promotes the legalization of 
any drug or substance included in schedule I of the schedules 
of controlled substances.
    Sec. 510. The Committee continues a provision prohibiting 
use of funds to promulgate or adopt any final standard 
providing for a unique health identifier until legislation is 
enacted specifically approving the standard.
    Sec. 511. The Committee continues a provision related to 
annual reports to the Secretary of Labor.
    Sec. 512. The Committee continues a provision prohibiting 
transfer of funds made available in this Act except by 
authority provided in this Act or another appropriation Act.
    Sec. 513. The Committee continues a provision to limit 
funds in the bill for public libraries to those that comply 
with the requirements of the Children's Internet Protection 
Act.
    Sec. 514. The Committee continues a provision regarding 
procedures for reprogramming of funds.
    Sec. 515. The Committee continues a provision pertaining to 
appointments to scientific advisory committees.
    Sec. 516. The Committee continues a provision requiring 
each department and related agency funded through this Act to 
submit an operating plan within 45 days of enactment, detailing 
any funding allocations that are different than those specified 
in this Act, the accompanying detailed table, or budget 
request.
    Sec. 517. The Committee continues a provision requiring the 
Secretaries of Labor, Health and Human Services, and Education 
to submit a quarterly report to the Committees on 
Appropriations of the House of Representatives and the Senate 
containing certain information on noncompetitive contracts, 
grants, and cooperative agreements exceeding $500,000 in value.
    Sec. 518. The Committee continues a provision prohibiting 
use of funds to process claims for credit for quarters of 
coverage based on work performed under a Social Security number 
that was not the claimant's number, where the performance of 
such work under such number has formed the basis for a 
conviction of the claimant of a violation of section 208(a)(6) 
or (7) of the Social Security Act.
    Sec. 519. The Committee continues a provision prohibiting 
use of funds to implement a Social Security totalization 
agreement with Mexico.
    Sec. 520. The Committee modifies a provision related to 
needle exchange.

                              (RESCISSION)

    Sec. 521. The Committee rescinds $15,000,000 provided under 
section 3403 [Independent Payment Advisory Board] of Public Law 
111-148.
    Sec. 522. The Committee continues provision requesting 
quarterly reports on the status of balances of appropriations 
from the Departments of Labor, Health and Human Services and 
Education and the Social Security Administration.
    Sec. 523. The Committee continues a provision prohibiting 
the use of funds for the downloading or exchanging of 
pornography.
    Sec. 524. The Committee includes a new provision 
prohibiting use of funds to implement, administer, enforce or 
further the provisions of Public Law 111-148 and portions of 
Public Law 111-152 with certain exceptions.

                              (RESCISSION)

    Sec. 525. The Committee rescinds $18,000,000 provided under 
section 1322 [Consumer Operated and Oriented Plan] of Public 
Law 111-148.

                              (RESCISSION)

    Sec. 526. The Committee rescinds all remaining funds 
provided under section 1005 [Health Insurance Reform 
Implementation] of Public Law 111-152.

                              (RESCISSION)

    Sec. 527. The Committee rescinds $6,800,000,000 provided 
under section 3021(a) [Center for Medicare and Medicaid 
Innovation] of Public Law 111-148.

                              (RESCISSION)

    Sec. 528. The Committee rescinds $100,000,000 provided 
under section 6301(e) [Patient-Centered Outcomes Research Trust 
Fund] of Public Law 111-148.
    Sec. 529. The Committee continues a provision that 
prohibits funding from going to the Association of Community 
Organizations for Reform Now (ACORN), or any of its affiliates, 
subsidiaries, allied organizations, or successors.
    Sec. 530. The Committee includes a new provision relating 
to nondiscrimination with respect to health care entities that 
refuse to participate in abortions and providing conscience 
protections with regard to requirements for coverage of 
specific items and services.
    Sec. 531. The Committee includes a Spending Reduction 
Account.

            House of Representatives Reporting Requirements

    The following materials are submitted in accordance with 
various requirements of the Rules of the House of 
Representatives:

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(4) of rule XIII of the Rules of the 
House of Representatives, the following is a statement of 
general performance goals and objectives for which this measure 
authorizes funding: The Committee on Appropriations considers 
program performance, including a program's success in 
developing and attaining outcome-related goals and objectives, 
in developing funding recommendations.

                          RESCISSION OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following lists the rescissions 
of unexpended balances included in the accompanying bill:

                   RESCISSIONS RECOMMENDED IN THE BILL
------------------------------------------------------------------------
              Account                              Amount
------------------------------------------------------------------------
Department of Health and Human      ....................................
 Services
Nonrecurring Expenses Fund........  Unobligated Balances
Health Insurance Reform             Unobligated Balances
 Implementation Fund.
Health Resources and Services       $445,983
 Administration.
Consumer Operated and Oriented      18,000,000
 Plan.
Center for Medicare and Medicaid    6,800,000,000
 Innovation.
Independent Payment Advisory Board  15,000,000
Patient-Centered Outcomes Research  100,000,000
 Trust Fund.
------------------------------------------------------------------------

                           TRANSFER OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following lists the transfers of 
unexpended balances included in the accompanying bill:

                      TITLE I--DEPARTMENT OF LABOR

    Language is included under ``Job Corps'' permitting the 
transfer of funds for Job Corps Center construction, 
rehabilitation and acquisition to meet the operational needs of 
Job Corps Centers or to achieve administrative efficiencies.
    Language is included under ``Special Benefits'' which 
provides for the transfer of such sums as necessary from the 
``Postal Service'' account.
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Office of Workers' Compensation Program, 
Salaries and Expenses.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Departmental Management, Salaries and 
Expenses.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Departmental Management, Office of the 
Inspector General.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of the Treasury.''
    Language is included under ``Departmental Management, 
Salary and Expenses'' authorizing the transfer of funds 
available for program evaluation to any other account within 
the Department to carry out evaluation activities.
    A general provision is included that allows not to exceed 
one percent of any discretionary appropriations to be 
transferred between an appropriation of the Department of 
Labor, provided that no such appropriation is increased by more 
than three percent by such transfer.
    A general provision is included authorizes the transfer of 
funds to the ``Employment and Training Administration'' for 
technical assistance services to grantees to ``Program 
Administration.''
    A general provision is included that provides for the 
transfer of up to 0.75 percent of funds from each appropriation 
to carry out evaluations of any of the programs or activities 
from ``Training and Employment Services'', ``Job Corps'', 
``Community Service Employment for Older Americans,'' ``State 
Unemployment Insurance and Employment Service Operations'', 
``Employee Benefits Security Administration'', ``Office of 
Workers' Compensation Programs'', ``Wage and Hour Division'', 
``Office of Federal Contract Compliance Programs'', ``Office of 
Labor-Management Standards'', ``Occupational Safety and Health 
Administration'', ``Mine Safety and Health Administration'', 
Office of Disability Employment Policy, ``Bureau of 
International Affairs'' and ``Women's Bureau'' within the 
Departmental Management, Salaries and Expenses'' account, and 
``Veterans Employment and Training'' for use by the Office of 
the Chief Evaluation Officer.
    A general provision is included that provides for the 
transfer of up to 0.25 percent of funds from ``Employment and 
Training Administration Program Administration'', funding made 
available for Federal administration within ``Job Corps'', 
``Foreign Labor Certification Program Administration'', 
``Employee Benefits Security Administration'', ``Office of 
Workers' Compensation Programs'', ``Wage and Hour Division'', 
``Office of Federal Contract Compliance Programs'', ``Office of 
Labor Management Standards'', ``Occupational Safety and Health 
Administration'', ``Mine Safety and Health Administration'', 
``Veterans Employment and Training'', ``Bureau of Labor 
Statistics'', and ``Office of Disability Employment Policy'' to 
carry out information technology purchases and upgrades for any 
of the programs or activities funded in this Act.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Language is included under ``Centers for Disease Control 
and Prevention, Buildings and Facilities'' to allow the 
transfer of prior year unobligated Individual Learning Account 
funds to be transferred to this account to carry out the 
purpose of this account.
    Language is included under ``National Institutes of Health, 
Office of the Director'' for the transfer of excess National 
Children's Study funds to the NIH Institutes and Centers (IC) 
based a proportional formula to carry out biomedical research.
    Language is included under ``Administration for Community 
Living, Aging and Disability Services Programs'' for transfer 
to the Secretary of Agriculture to carryout section 311 of the 
Older Americans Act of 1965.
    A general provision is included that allows not to exceed 
one percent of any discretionary funds to be transferred 
between appropriation accounts of the ``Department of Health 
and Human Services'', provided that no appropriation account is 
increased by more than three percent by such transfer.
    A general provision is included that allows the transfer of 
up to three percent among the institutes and centers of the 
``National Institutes of Health'' from amounts identified as 
pertaining to the human immunodeficiency virus.
    A general provision is included that allows the transfer of 
funding determined to be related to the human immunodeficiency 
virus to the ``Office of AIDS Research''.
    A general provision is included that transfers one percent 
of the amount made available for ``National Research Service 
Awards'' at the ``National Institutes of Health'' to the 
``Health Resources and Services Administration''.
    A general provision is included to direct the transfer of 
the ``Prevention and Public Health Fund'' as specified in the 
explanatory statement accompanying this Act.
    A general provision in included to allow the Secretary to 
transfer authority for an orderly termination of the Agency for 
Healthcare Research and Quality agency if another HHS agency 
has the authority to perform such activity and the agency head 
determines it is appropriate within the scope of the provided 
bill language.

                   TITLE III--DEPARTMENT OF EDUCATION

    A general provision is included that allows not to exceed 
one percent of any discretionary funds to be transferred 
between appropriation accounts of the Department of Education, 
provided that no appropriation account is increased by more 
than three percent by such transfer.

                       TITLE IV--RELATED AGENCIES

    Language is included under Payment to the National Service 
Trust authorizing the transfer of funds from the ``Corporation 
for National and Community Service, Operating Expenses'' to 
support the activities of national service participants.
    Language is included under ``Social Security 
Administration'' authorizing the transfer of up to three 
percent of the Social Security Administration's ``Limitation on 
Administration Expenses'' account to be available for purposes 
of the Office of Inspector General.

                      TITLE V--GENERAL PROVISIONS

    A general provision is included that allows the Secretaries 
of Labor, Health and Human Services, and Education to transfer 
balances of prior appropriations to accounts corresponding to 
current appropriations.

   DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED SPENDING ITEMS

    Neither the bill nor the report contains any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI.

          Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                 CONSOLIDATED APPROPRIATIONS ACT, 2008


                          (Public Law 110-161)

   AN ACT Making appropriations for the Department of State, foreign 
 operations, and related programs for the fiscal year ending September 
                   30, 2008, and for other purposes.



           *       *       *       *       *       *       *
   DIVISION G--DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND 
EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2008

           *       *       *       *       *       *       *



                                TITLE II


DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROPRIATIONS ACT, 2008

           *       *       *       *       *       *       *



General Provisions

           *       *       *       *       *       *       *


  [Sec. 223. There is hereby established in the Treasury of the 
United States a fund to be known as the ``Nonrecurring expenses 
fund'' (the Fund): Provided, That unobligated balances of 
expired discretionary funds appropriated in this or any 
succeeding fiscal year from the General Fund of the Treasury to 
the Department of Health and Human Services by this or any 
other Act may be transferred (not later than the end of the 
fifth fiscal year after the last fiscal year for which such 
funds are available for the purposes for which appropriated) 
into the Fund: Provided further, That amounts deposited in the 
Fund shall be available until expended, and in addition to such 
other funds as may be available for such purposes, for capital 
acquisition necessary for the operation of the Department, 
including facilities infrastructure and information technology 
infrastructure, subject to approval by the Office of Management 
and Budget: Provided further, That amounts in the Fund may be 
obligated only after the Committees on Appropriations of the 
House of Representatives and the Senate are notified at least 
15 days in advance of the planned use of funds.]

           *       *       *       *       *       *       *

                              ----------                              


                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS

           *       *       *       *       *       *       *



Part B--Miscellaneous Provisions

           *       *       *       *       *       *       *



 abortion-related discrimination in governmental activities regarding 
  training [and licensing of physicians], licensing, and practice of 
               physicians and other health care entities

  Sec. 245. (a) In General.--The Federal Government, and any 
State or local government that receives Federal financial 
assistance, may not subject any health care entity to 
discrimination on the basis that--
          [(1) the entity refuses to undergo training in the 
        performance of induced abortions, to require or provide 
        such training, to perform such abortions, or to provide 
        referrals for such training or such abortions;]
          (1) the entity refuses--
                  (A) to undergo training in the performance of 
                induced abortions;
                  (B) to require or provide such training;
                  (C) to perform, participate in, provide 
                coverage of, or pay for induced abortions; or
                  (D) to provide referrals for such training or 
                such abortions;
          (2) the entity refuses to make arrangements for any 
        of the activities specified in paragraph (1); or
          (3) the entity attends (or attended) a post-graduate 
        physician training program, or any other program of 
        training in the health professions, that does not (or 
        did not) perform induced abortions or require, provide 
        or refer for training in the performance of induced 
        abortions, or make arrangements for the provision of 
        such training.
  (b) Accreditation of Postgraduate Physician Training 
Programs.--
          (1) In general.--In determining whether to grant a 
        legal status to a health care entity (including a 
        license or certificate), or to provide such entity with 
        financial assistance, services or other benefits, the 
        Federal Government, or any State or local government 
        that receives Federal financial assistance, shall deem 
        accredited any postgraduate physician training program 
        that would be accredited but for the accrediting 
        agency's reliance upon an accreditation [standards] 
        standard that requires an entity to perform an induced 
        abortion or require, provide, or refer for training in 
        the performance of induced abortions, or make 
        arrangements for such training, regardless of whether 
        such standard provides exceptions or exemptions. The 
        government involved shall formulate such regulations or 
        other mechanisms, or enter into such agreements with 
        accrediting agencies, as are necessary to comply with 
        this subsection.
          (2) Rules of construction.--
                  (A) In general.--With respect to subclauses 
                (I) and (II) of section 705(a)(2)(B)(i) 
                (relating to a program of insured loans for 
                training in the health professions), the 
                requirements in such subclauses regarding 
                accredited internship or residency programs are 
                subject to paragraph (1) of this subsection.
                  (B) Exceptions.--This section shall not--
                          (i) prevent any health care entity 
                        from voluntarily electing to be 
                        trained, to train, or to arrange for 
                        training in the performance of, to 
                        perform, or to make referrals for 
                        induced abortions; or
                          (ii) prevent an accrediting agency or 
                        a Federal, State or local government 
                        from establishing standards of medical 
                        competency applicable only to those 
                        individuals who have voluntarily 
                        elected to perform abortions.
  (c) Administration.--The Secretary shall designate the 
Director of the Office for Civil Rights of the Department of 
Health and Human Services--
          (1) to receive complaints alleging a violation of 
        this section, section 1566 of the Patient Protection 
        and Affordable Care Act, or any of subsections (b) 
        through (e) of section 401 of the Health Programs 
        Extension Act of 1973; and
          (2) to pursue the investigation of such complaints, 
        in coordination with the Attorney General.
  [(c)] (d) Definitions.--For purposes of this section:
          [(1) The term ``financial assistance'', with respect 
        to a government program, includes governmental payments 
        provided as reimbursement for carrying out health-
        related activities.
          [(2) The term ``health care entity'' includes an 
        individual physician, a postgraduate physician training 
        program, and a participant in a program of training in 
        the health professions.]
          (1) The term ``financial assistance'', with respect 
        to a government program, means governmental payments to 
        cover the cost of health care services or benefits, or 
        other Federal payments, grants, or loans to promote or 
        otherwise facilitate health-related activities.
          (2) The term ``health care entity'' includes an 
        individual physician or other health professional, a 
        postgraduate physician training program, a participant 
        in a program of training in the health professions, a 
        hospital, a provider-sponsored organization as defined 
        in section 1855(d) of the Social Security Act, a health 
        maintenance organization, an accountable care 
        organization, an issuer of health insurance coverage, 
        any other kind of health care facility, organization, 
        or plan, and an entity that provides or authorizes 
        referrals for health care services.
          (3) The term ``postgraduate physician training 
        program'' includes a residency training program.
          (4) The term ``State or local government that 
        receives Federal financial assistance'' includes any 
        agency or other governmental unit of a State or local 
        government if such government receives Federal 
        financial assistance.

SEC. 245A. CIVIL ACTION FOR CERTAIN VIOLATIONS.

  (a) In General.--A qualified party may, in a civil action, 
obtain appropriate relief with regard to a designated 
violation.
  (b) Definitions.--In this section--
          (1) the term ``qualified party'' means--
                  (A) the Attorney General; or
                  (B) any person or entity adversely affected 
                by the designated violation; and
          (2) the term ``designated violation'' means an actual 
        or threatened violation of section 245 of this Act, 
        section 1566 of the Patient Protection and Affordable 
        Care Act, or any of subsections (b) through (e) of 
        section 401 of the Health Programs Extension Act of 
        1973.
  (c) Administrative Remedies Not Required.--An action under 
this section may be commenced, and relief may be granted, 
without regard to whether the party commencing the action has 
sought or exhausted available administrative remedies.
  (d) Defendants in Actions Under This Section May Include 
Governmental Entities as Well as Others.--
          (1) In general.--An action under this section may be 
        maintained against, among others, a party that is a 
        Federal or State governmental entity. Relief in an 
        action under this section may include money damages 
        even if the defendant is such a governmental entity.
          (2) Definition.--For the purposes of this subsection, 
        the term ``State governmental entity'' means a State, a 
        local government within a State, or any agency or other 
        governmental unit or authority of a State or of such a 
        local government.
  (e) Nature of Relief.--The court shall grant--
          (1) all necessary equitable and legal relief, 
        including, where appropriate, declaratory relief and 
        compensatory damages, to prevent the occurrence, 
        continuance, or repetition of the designated violation 
        and to compensate for losses resulting from the 
        designated violation; and
          (2) to a prevailing plaintiff, reasonable attorneys' 
        fees and litigation expenses as part of the costs.

           *       *       *       *       *       *       *


TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *


Part B--Federal-State Cooperation

           *       *       *       *       *       *       *


             project grants for preventive health services

  Sec. 317. (a) The Secretary may make grants to States, and in 
consultation with State health authorities, to political 
subdivisions of States and to other public entities to assist 
them in meeting the costs of establishing and maintaining 
preventive health service programs.
  (b) No grant may be made under subsection (a) unless an 
application therefor has been submitted to, and approved by, 
the Secretary. Such an application shall be in such form and be 
submitted in such manner as the Secretary shall by regulation 
prescribe and shall provide--
          (1) a complete description of the type and extent of 
        the program for which the applicant is seeking a grant 
        under subsection (a);
          (2) with respect to each such program (A) the amount 
        of Federal, State, and other funds obligated by the 
        applicant in its latest annual accounting period for 
        the provision of such program, (B) a description of the 
        services provided by the applicant in such program in 
        such period, (C) the amount of Federal funds needed by 
        the applicant to continue providing such services in 
        such program, and (D) if the applicant proposes changes 
        in the provision of the services in such program, the 
        priorities of such proposed changes, reasons for such 
        changes, and the amount of Federal funds needed by the 
        applicant to make such changes;
          (3) assurances satisfactory to the Secretary that the 
        program which will be provided with funds under a grant 
        under subsection (a) will be provided in a manner 
        consistent with the State health plan in effect under 
        section 1524(c) and in those cases where the applicant 
        is a State, that such program will be provided, where 
        appropriate, in a manner consistent with any plans in 
        effect under an application approved under section 315;
          (4) assurances satisfactory to the Secretary that the 
        applicant will provide for such fiscal control and fund 
        accounting procedures as the Secretary by regulation 
        prescribes to assure the proper disbursement of and 
        accounting for funds received under grants under 
        subsection (a);
          (5) assurances satisfactory to the Secretary that the 
        applicant will provide for periodic evaluation of its 
        program or programs;
          (6) assurances satisfactory to the Secretary that the 
        applicant will make such reports (in such form and 
        containing such information as the Secretary may by 
        regulation prescribe) as the Secretary may reasonably 
        require and keep such records and afford such access 
        thereto as the Secretary may find necessary to assure 
        the correctness of, and to verify, such reports;
          (7) assurances satisfactory to the Secretary that the 
        applicant will comply with any other conditions imposed 
        by this section with respect to grants; and
          (8) such other information as the Secretary may by 
        regulation prescribe.
  (c)(1) The Secretary shall not approve an application 
submitted under subsection (b) for a grant for a program for 
which a grant was previously made under subsection (a) unless 
the Secretary determines--
          (A) the program for which the application was 
        submitted is operating effectively to achieve its 
        stated purpose,
          (B) the applicant complied with the assurances 
        provided the Secretary when applying for such previous 
        grant, and
          (C) the applicant will comply with the assurances 
        provided with the application.
  (2) The Secretary shall review annually the activities 
undertaken by each recipient of a grant under subsection (a) to 
determine if the program assisted by such grant is operating 
effectively to achieve its stated purposes and if the recipient 
is in compliance with the assurances provided the Secretary 
when applying for such grant.
  (d) The amount of a grant under subsection (a) shall be 
determined by the Secretary. Payments under such grants may be 
made in advance on the basis of estimates or by the way of 
reimbursement, with necessary adjustments on account of 
underpayments or overpayments, and in such installments and on 
such terms and conditions as the Secretary finds necessary to 
carry out the purposes of such grants.
  (e) The Secretary, at the request of a recipient of a grant 
under subsection (a), may reduce the amount of such grant by--
          (1) the fair market value of any supplies (including 
        vaccines and other preventive agents) or equipment 
        furnished the grant recipient, and
          (2) the amount of the pay, allowances, and travel 
        expenses of any officer or employee of the Government 
        when detailed to the grant recipient and the amount of 
        any other costs incurred in connection with the detail 
        of such officer or employee.
When the furnishing of such supplies or equipment or the detail 
of such an officer or employee is for the convenience of and at 
the request of such grant recipient and for the purpose of 
carrying out a program with respect to which the grant under 
subsection (a) is made. The amount by which any such grant is 
so reduced shall be available for payment by the Secretary of 
the costs incurred in furnishing the supplies or equipment, or 
in detailing the personnel, on which the reduction of such 
grant is based, and such amount shall be deemed as part of the 
grant and shall be deemed to have been paid to the grant 
recipient.
  (f)(1) Each recipient of a grant under subsection (a) shall 
keep such records as the Secretary shall by regulation 
prescribe, including records which fully disclose the amount 
and disposition by such recipient of the proceeds of such 
grant, the total cost of the undertaking in connection with 
which such grant was made, and the amount of that portion of 
the cost of the undertaking supplied by other sources, and such 
other records as will facilitate an effective audit.
  (2) The Secretary and the Comptroller General of the United 
States, or any of their duly authorized representatives, shall 
have access for the purpose of audit and examination to any 
books, documents, papers, and records of the recipient of 
grants under subsection (a) that are pertinent to such grants.
  (g)(1) Nothing in this section shall limit or otherwise 
restrict the use of funds which are granted to a State or to an 
agency or a political subdivision of a State under provisions 
of Federal law (other than this section) and which are 
available for the conduct of preventive health service programs 
from being used on connection with programs assisted through 
grants under subsection (a).
  (2) Nothing in this section shall be construed to require any 
State or any agency or political subdivision of a State to have 
a preventive health service program which would require any 
person, who objects to any treatment provided under such a 
program, to be treated or to have any child or ward treated 
under such program.
  (h) The Secretary shall include, as part of the report 
required by section 1705, a report on the extent of the 
problems presented by the diseases and conditions referred to 
in subsection (j) on the amount of funds obligated under grants 
under subsection (a) in the preceding fiscal year for each of 
the programs listed in subsection (j); and on the effectiveness 
of the activities assisted under grants under subsection (a) in 
controlling such diseases and conditions.
  (i) The Secretary may provide technical assistance to States, 
State health authorities, and other public entities in 
connection with the operation of their preventive health 
service programs.
  (j)(1) Except for grants for immunization programs the 
authorization of appropriations for which are established in 
paragraph (2), for grants under subsections (a) and (k)(1) for 
preventive health service programs to immunize without charge 
children, adolescents, and adults against vaccine-preventable 
diseases, there are authorized to be appropriated such sums as 
may be necessary. Not more than 10 percent ot the total amount 
appropriated under the preceding sentence for any fiscal year 
shall be available for grants under subsection (k)(1) for such 
fiscal year.
  (2) For grants under subsection (a) for preventive health 
service programs for the provision without charge of 
immunizations with vaccines approved for use, and recommended 
for routine use, there are authorized to be appropriated such 
sums as may be necessary.
  (k)(1) The Secretary may make grants to States, political 
subdivisions of States, and other public and nonprofit private 
entities for--
          (A) research into the prevention and control of 
        diseases that may be prevented through vaccination;
          (B) demonstration projects for the prevention and 
        control of such diseases;
          (C) public information and education programs for the 
        prevention and control of such diseases; and
          (D) education, training, and clinical skills 
        improvement activities in the prevention and control of 
        such diseases for health professionals (including 
        allied health personnel).
  (2) The Secretary may make grants to States, political 
subdivisions of States, and other public and nonprofit private 
entities for--
          (A) research into the prevention and control of 
        diseases and conditions;
          (B) demonstration projects for the prevention and 
        control of such diseases and conditions;
          (C) public information and education programs for the 
        prevention and control of such diseases and conditions; 
        and
          (D) education, training, and clinical skills 
        improvement activities in the prevention and control of 
        such diseases and conditions for health professionals 
        (including allied health personnel).
  (3) No grant may be made under this subsection unless an 
application therefor is submitted to the Secretary in such 
form, at such time, and containing such information as the 
Secretary may by regulation prescribe.
  (4) Subsections (d), (e), and (f) shall apply to grants under 
this subsection in the same manner as such subsections apply to 
grants under subsection (a).
  (l) Authority to Purchase Recommended Vaccines for Adults.--
          (1) In general.--The Secretary may negotiate and 
        enter into contracts with manufacturers of vaccines for 
        the purchase and delivery of vaccines for adults as 
        provided for under subsection (e).
          (2) State purchase.--A State may obtain additional 
        quantities of such adult vaccines (subject to amounts 
        specified to the Secretary by the State in advance of 
        negotiations) through the purchase of vaccines from 
        manufacturers at the applicable price negotiated by the 
        Secretary under this subsection.
  (m) Demonstration Program To Improve Immunization Coverage.--
          (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, shall establish a demonstration program to 
        award grants to States to improve the provision of 
        recommended immunizations for children, adolescents, 
        and adults through the use of evidence-based, 
        population-based interventions for high-risk 
        populations.
          (2) State plan.--To be eligible for a grant under 
        paragraph (1), a State shall submit to the Secretary an 
        application at such time, in such manner, and 
        containing such information as the Secretary may 
        require, including a State plan that describes the 
        interventions to be implemented under the grant and how 
        such interventions match with local needs and 
        capabilities, as determined through consultation with 
        local authorities.
          (3) Use of funds.--Funds received under a grant under 
        this subsection shall be used to implement 
        interventions that are recommended by the Task Force on 
        Community Preventive Services (as established by the 
        Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention) or other evidence-
        based interventions, including--
                  (A) providing immunization reminders or 
                recalls for target populations of clients, 
                patients, and consumers;
                  (B) educating targeted populations and health 
                care providers concerning immunizations in 
                combination with one or more other 
                interventions;
                  (C) reducing out-of-pocket costs for families 
                for vaccines and their administration;
                  (D) carrying out immunization-promoting 
                strategies for participants or clients of 
                public programs, including assessments of 
                immunization status, referrals to health care 
                providers, education, provision of on-site 
                immunizations, or incentives for immunization;
                  (E) providing for home visits that promote 
                immunization through education, assessments of 
                need, referrals, provision of immunizations, or 
                other services;
                  (F) providing reminders or recalls for 
                immunization providers;
                  (G) conducting assessments of, and providing 
                feedback to, immunization providers;
                  (H) any combination of one or more 
                interventions described in this paragraph; or
                  (I) immunization information systems to allow 
                all States to have electronic databases for 
                immunization records.
          (4) Consideration.--In awarding grants under this 
        subsection, the Secretary shall consider any reviews or 
        recommendations of the Task Force on Community 
        Preventive Services.
          (5) Evaluation.--Not later than 3 years after the 
        date on which a State receives a grant under this 
        subsection, the State shall submit to the Secretary an 
        evaluation of progress made toward improving 
        immunization coverage rates among high-risk populations 
        within the State.
          (6) Report to congress.--Not later than 4 years after 
        the date of enactment of the Affordable Health Choices 
        Act, the Secretary shall submit to Congress a report 
        concerning the effectiveness of the demonstration 
        program established under this subsection together with 
        recommendations on whether to continue and expand such 
        program.
          (7) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection, such sums as may be necessary for each of 
        fiscal years 2010 through 2014.
  [(a)] (n) Preventive Services Task Force.--
          (1) Establishment and purpose.--[The Director] The 
        Assistant Secretary for Health may periodically convene 
        a Preventive Services Task Force to be composed of 
        individuals with appropriate expertise. Such a task 
        force shall review the scientific evidence related to 
        the effectiveness, appropriateness, and cost-
        effectiveness of clinical preventive services for the 
        purpose of developing recommendations for the health 
        care community, and updating previous clinical 
        preventive recommendations.
          (2) Role of [agency] assistant secretary.--[The 
        Agency] The Assistant Secretary for Health shall 
        provide ongoing administrative, research, and technical 
        support for the operations of the Preventive Services 
        Task Force, including coordinating and supporting the 
        dissemination of the recommendations of the Task Force.
          (3) Operation.--In carrying out its responsibilities 
        under paragraph (1), the Task Force is not subject to 
        the provisions of Appendix 2 of title 5, United States 
        Code.

           *       *       *       *       *       *       *

                              ----------                              


               PATIENT PROTECTION AND AFFORDABLE CARE ACT

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

  (a) * * *
  (b) Table of Contents.--The table of contents of this Act is 
as follows:

     * * * * * * *

       TITLE I--QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS

     * * * * * * *

                  Subtitle G--Miscellaneous Provisions

     * * * * * * *
[Sec. 1563. Sense of the Senate promoting fiscal responsibility.]
1564. Conforming amendments.
1565. Sense of the Senate promoting fiscal responsibility.
1566. Respecting conscience rights in health coverage.

           *       *       *       *       *       *       *


TITLE I--QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS

           *       *       *       *       *       *       *


Subtitle G--Miscellaneous Provisions

           *       *       *       *       *       *       *


SEC. [1563] 1564. CONFORMING AMENDMENTS.

  (a) Applicability.--Section 2735 of the Public Health Service 
Act (42 U.S.C. 300gg-21), as so redesignated by section 
1001(4), is amended--
          (1) by striking subsection (a);
          (2) in subsection (b)--
                  (A) in paragraph (1), by striking ``1 through 
                3'' and inserting ``1 and 2''; and
                  (B) in paragraph (2)--
                          (i) in subparagraph (A), by striking 
                        ``subparagraph (D)'' and inserting 
                        ``subparagraph (D) or (E)'';
                          (ii) by striking ``1 through 3'' and 
                        inserting ``1 and 2''; and
                          (iii) by adding at the end the 
                        following:
                  ``(E) Election not applicable.--The election 
                described in subparagraph (A) shall not be 
                available with respect to the provisions of 
                subparts I and II.'';
          (3) in subsection (c), by striking ``1 through 3 
        shall not apply to any group'' and inserting ``1 and 2 
        shall not apply to any individual coverage or any 
        group''; and
          (4) in subsection (d)--
                  (A) in paragraph (1), by striking ``1 through 
                3 shall not apply to any group'' and inserting 
                ``1 and 2 shall not apply to any individual 
                coverage or any group'';
                  (B) in paragraph (2)--
                          (i) in the matter preceding 
                        subparagraph (A), by striking ``1 
                        through 3 shall not apply to any 
                        group'' and inserting ``1 and 2 shall 
                        not apply to any individual coverage or 
                        any group''; and
                          (ii) in subparagraph (C), by 
                        inserting ``or, with respect to 
                        individual coverage, under any health 
                        insurance coverage maintained by the 
                        same health insurance issuer''; and
                  (C) in paragraph (3), by striking ``any 
                group'' and inserting ``any individual coverage 
                or any group''.
  (b) Definitions.--Section 2791(d) of the Public Health 
Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the 
end the following:
          ``(20) Qualified health plan.--The term `qualified 
        health plan' has the meaning given such term in section 
        1301(a) of the Patient Protection and Affordable Care 
        Act.
          ``(21) Exchange.--The term `Exchange' means an 
        American Health Benefit Exchange established under 
        section 1311 of the Patient Protection and Affordable 
        Care Act.''.
  (c) Technical and Conforming Amendments.--Title XXVII of the 
Public Health Service Act (42 U.S.C. 300gg et seq.) is 
amended--
          (1) in section 2704 (42 U.S.C. 300gg), as so 
        redesignated by section 1201(2)--
                  (A) in subsection (c)--
                          (i) in paragraph (2), by striking 
                        ``group health plan'' each place that 
                        such term appears and inserting ``group 
                        or individual health plan''; and
                          (ii) in paragraph (3)--
                                  (I) by striking ``group 
                                health insurance'' each place 
                                that such term appears and 
                                inserting ``group or individual 
                                health insurance''; and
                                  (II) in subparagraph (D), by 
                                striking ``small or large'' and 
                                inserting ``individual or 
                                group'';
                  (B) in subsection (d), by striking ``group 
                health insurance'' each place that such term 
                appears and inserting ``group or individual 
                health insurance''; and
                  (C) in subsection (e)(1)(A), by striking 
                ``group health insurance'' and inserting 
                ``group or individual health insurance'';
          (2) by striking the second heading for subpart 2 of 
        part A (relating to other requirements);
          (3) in section 2725 (42 U.S.C. 300gg-4), as so 
        redesignated by section 1001(2)--
                  (A) in subsection (a), by striking ``health 
                insurance issuer offering group health 
                insurance coverage'' and inserting ``health 
                insurance issuer offering group or individual 
                health insurance coverage'';
                  (B) in subsection (b)--
                          (i) by striking ``health insurance 
                        issuer offering group health insurance 
                        coverage in connection with a group 
                        health plan'' in the matter preceding 
                        paragraph (1) and inserting ``health 
                        insurance issuer offering group or 
                        individual health insurance coverage''; 
                        and
                          (ii) in paragraph (1), by striking 
                        ``plan'' and inserting ``plan or 
                        coverage'';
                  (C) in subsection (c)--
                          (i) in paragraph (2), by striking 
                        ``group health insurance coverage 
                        offered by a health insurance issuer'' 
                        and inserting ``health insurance issuer 
                        offering group or individual health 
                        insurance coverage''; and
                          (ii) in paragraph (3), by striking 
                        ``issuer'' and inserting ``health 
                        insurance issuer''; and
                  (D) in subsection (e), by striking ``health 
                insurance issuer offering group health 
                insurance coverage'' and inserting ``health 
                insurance issuer offering group or individual 
                health insurance coverage'';
          (4) in section 2726 (42 U.S.C. 300gg-5), as so 
        redesignated by section 1001(2)--
                  (A) in subsection (a), by striking ``(or 
                health insurance coverage offered in connection 
                with such a plan)'' each place that such term 
                appears and inserting ``or a health insurance 
                issuer offering group or individual health 
                insurance coverage'';
                  (B) in subsection (b), by striking ``(or 
                health insurance coverage offered in connection 
                with such a plan)'' each place that such term 
                appears and inserting ``or a health insurance 
                issuer offering group or individual health 
                insurance coverage''; and
                  (C) in subsection (c)--
                          (i) in paragraph (1), by striking 
                        ``(and group health insurance coverage 
                        offered in connection with a group 
                        health plan)'' and inserting ``and a 
                        health insurance issuer offering group 
                        or individual health insurance 
                        coverage'';
                          (ii) in paragraph (2), by striking 
                        ``(or health insurance coverage offered 
                        in connection with such a plan)'' each 
                        place that such term appears and 
                        inserting ``or a health insurance 
                        issuer offering group or individual 
                        health insurance coverage'';
          (5) in section 2727 (42 U.S.C. 300gg-6), as so 
        redesignated by section 1001(2), by striking ``health 
        insurance issuers providing health insurance coverage 
        in connection with group health plans'' and inserting 
        ``and health insurance issuers offering group or 
        individual health insurance coverage'';
          (6) in section 2728 (42 U.S.C. 300gg-7), as so 
        redesignated by section 1001(2)--
                  (A) in subsection (a), by striking ``health 
                insurance coverage offered in connection with 
                such plan'' and inserting ``individual health 
                insurance coverage'';
                  (B) in subsection (b)--
                          (i) in paragraph (1), by striking 
                        ``or a health insurance issuer that 
                        provides health insurance coverage in 
                        connection with a group health plan'' 
                        and inserting ``or a health insurance 
                        issuer that offers group or individual 
                        health insurance coverage'';
                          (ii) in paragraph (2), by striking 
                        ``health insurance coverage offered in 
                        connection with the plan'' and 
                        inserting ``individual health insurance 
                        coverage''; and
                          (iii) in paragraph (3), by striking 
                        ``health insurance coverage offered by 
                        an issuer in connection with such 
                        plan'' and inserting ``individual 
                        health insurance coverage'';
                  (C) in subsection (c), by striking ``health 
                insurance issuer providing health insurance 
                coverage in connection with a group health 
                plan'' and inserting ``health insurance issuer 
                that offers group or individual health 
                insurance coverage''; and
                  (D) in subsection (e)(1), by striking 
                ``health insurance coverage offered in 
                connection with such a plan'' and inserting 
                ``individual health insurance coverage'';
          (7) by striking the heading for subpart 3;
          (8) in section 2731 (42 U.S.C. 300gg-11), as so 
        redesignated by section 1001(3)--
                  (A) by striking the section heading and all 
                that follows through subsection (b);
                  (B) in subsection (c)--
                          (i) in paragraph (1)--
                                  (I) in the matter preceding 
                                subparagraph (A), by striking 
                                ``small group'' and inserting 
                                ``group and individual''; and
                                  (II) in subparagraph (B)--
                                          (aa) in the matter 
                                        preceding clause (i), 
                                        by inserting ``and 
                                        individuals'' after 
                                        ``employers'';
                                          (bb) in clause (i), 
                                        by inserting ``or any 
                                        additional 
                                        individuals'' after 
                                        ``additional groups''; 
                                        and
                                          (cc) in clause (ii), 
                                        by striking ``without 
                                        regard to the claims 
                                        experience of those 
                                        employers and their 
                                        employees (and their 
                                        dependents) or any 
                                        health status-related 
                                        factor relating to 
                                        such'' and inserting 
                                        ``and individuals 
                                        without regard to the 
                                        claims experience of 
                                        those individuals, 
                                        employers and their 
                                        employees (and their 
                                        dependents) or any 
                                        health status-related 
                                        factor relating to such 
                                        individuals''; and
                          (ii) in paragraph (2), by striking 
                        ``small group'' and inserting ``group 
                        or individual'';
                  (C) in subsection (d)--
                          (i) by striking ``small group'' each 
                        place that such appears and inserting 
                        ``group or individual''; and
                          (ii) in paragraph (1)(B)--
                                  (I) by striking ``all 
                                employers'' and inserting ``all 
                                employers and individuals'';
                                  (II) by striking ``those 
                                employers'' and inserting 
                                ``those individuals, 
                                employers''; and
                                  (III) by striking ``such 
                                employees'' and inserting 
                                ``such individuals, 
                                employees'';
                  (D) by striking subsection (e);
                  (E) by striking subsection (f); and
                  (F) by transferring such section (as amended 
                by this paragraph) to appear at the end of 
                section 2702 (as added by section 1001(4));
          (9) in section 2732 (42 U.S.C. 300gg-12), as so 
        redesignated by section 1001(3)--
                  (A) by striking the section heading and all 
                that follows through subsection (a);
                  (B) in subsection (b)--
                          (i) in the matter preceding paragraph 
                        (1), by striking ``group health plan in 
                        the small or large group market'' and 
                        inserting ``health insurance coverage 
                        offered in the group or individual 
                        market'';
                          (ii) in paragraph (1), by inserting 
                        ``, or individual, as applicable,'' 
                        after ``plan sponsor'';
                          (iii) in paragraph (2), by inserting 
                        ``, or individual, as applicable,'' 
                        after ``plan sponsor''; and
                          (iv) by striking paragraph (3) and 
                        inserting the following:
          ``(3) Violation of participation or contribution 
        rates.--In the case of a group health plan, the plan 
        sponsor has failed to comply with a material plan 
        provision relating to employer contribution or group 
        participation rules, pursuant to applicable State 
        law.'';
                  (C) in subsection (c)--
                          (i) in paragraph (1)--
                                  (I) in the matter preceding 
                                subparagraph (A), by striking 
                                ``group health insurance 
                                coverage offered in the small 
                                or large group market'' and 
                                inserting ``group or individual 
                                health insurance coverage'';
                                  (II) in subparagraph (A), by 
                                inserting ``or individual, as 
                                applicable,'' after ``plan 
                                sponsor'';
                                  (III) in subparagraph (B)--
                                          (aa) by inserting 
                                        ``or individual, as 
                                        applicable,'' after 
                                        ``plan sponsor''; and
                                          (bb) by inserting 
                                        ``or individual health 
                                        insurance coverage''; 
                                        and
                                  (IV) in subparagraph (C), by 
                                inserting ``or individuals, as 
                                applicable,'' after ``those 
                                sponsors''; and
                          (ii) in paragraph (2)(A)--
                                  (I) in the matter preceding 
                                clause (i), by striking ``small 
                                group market or the large group 
                                market, or both markets,'' and 
                                inserting ``individual or group 
                                market, or all markets,''; and
                                  (II) in clause (i), by 
                                inserting ``or individual, as 
                                applicable,'' after ``plan 
                                sponsor''; and
                  (D) by transferring such section (as amended 
                by this paragraph) to appear at the end of 
                section 2703 (as added by section 1001(4));
          (10) in section 2733 (42 U.S.C. 300gg-13), as so 
        redesignated by section 1001(4)--
                  (A) in subsection (a)--
                          (i) in the matter preceding paragraph 
                        (1), by striking ``small employer'' and 
                        inserting ``small employer or an 
                        individual'';
                          (ii) in paragraph (1), by inserting 
                        ``, or individual, as applicable,'' 
                        after ``employer'' each place that such 
                        appears; and
                          (iii) in paragraph (2), by striking 
                        ``small employer'' and inserting 
                        ``employer, or individual, as 
                        applicable,'';
                  (B) in subsection (b)--
                          (i) in paragraph (1)--
                                  (I) in the matter preceding 
                                subparagraph (A), by striking 
                                ``small employer'' and 
                                inserting ``employer, or 
                                individual, as applicable,'';
                                  (II) in subparagraph (A), by 
                                adding ``and'' at the end;
                                  (III) by striking 
                                subparagraphs (B) and (C); and
                                  (IV) in subparagraph (D)--
                                          (aa) by inserting ``, 
                                        or individual, as 
                                        applicable,'' after 
                                        ``employer''; and
                                          (bb) by redesignating 
                                        such subparagraph as 
                                        subparagraph (B);
                          (ii) in paragraph (2)--
                                  (I) by striking ``small 
                                employers'' each place that 
                                such term appears and inserting 
                                ``employers, or individuals, as 
                                applicable,''; and
                                  (II) by striking ``small 
                                employer'' and inserting 
                                ``employer, or individual, as 
                                applicable,''; and
                  (C) by redesignating such section (as amended 
                by this paragraph) as section 2709 and 
                transferring such section to appear after 
                section 2708 (as added by section 1001(5));
          (11) by redesignating subpart 4 as subpart 2;
          (12) in section 2735 (42 U.S.C. 300gg-21), as so 
        redesignated by section 1001(4)--
                  (A) by striking subsection (a);
                  (B) by striking ``subparts 1 through 3'' each 
                place that such appears and inserting ``subpart 
                1'';
                  (C) by redesignating subsections (b) through 
                (e) as subsections (a) through (d), 
                respectively; and
                  (D) by redesignating such section (as amended 
                by this paragraph) as section 2722;
          (13) in section 2736 (42 U.S.C. 300gg-22), as so 
        redesignated by section 1001(4)--
                  (A) in subsection (a)--
                          (i) in paragraph (1), by striking 
                        ``small or large group markets'' and 
                        inserting ``individual or group 
                        market''; and
                          (ii) in paragraph (2), by inserting 
                        ``or individual health insurance 
                        coverage'' after ``group health 
                        plans'';
                  (B) in subsection (b)(1)(B), by inserting 
                ``individual health insurance coverage or'' 
                after ``respect to''; and
                  (C) by redesignating such section (as amended 
                by this paragraph) as section 2723;
          (14) in section 2737(a)(1) (42 U.S.C. 300gg-23), as 
        so redesignated by section 1001(4)--
                  (A) by inserting ``individual or'' before 
                ``group health insurance''; and
                  (B) by redesignating such section(as amended 
                by this paragraph) as section 2724;
          (15) in section 2762 (42 U.S.C. 300gg-62)--
                  (A) in the section heading by inserting ``and 
                application'' before the period; and
                  (B) by adding at the end the following:
  ``(c) Application of Part A Provisions.--
          ``(1) In general.--The provisions of part A shall 
        apply to health insurance issuers providing health 
        insurance coverage in the individual market in a State 
        as provided for in such part.
          ``(2) Clarification.--To the extent that any 
        provision of this part conflicts with a provision of 
        part A with respect to health insurance issuers 
        providing health insurance coverage in the individual 
        market in a State, the provisions of such part A shall 
        apply.''; and
          (16) in section 2791(e) (42 U.S.C. 300gg-91(e))--
                  (A) in paragraph (2), by striking ``51'' and 
                inserting ``101''; and
                  (B) in paragraph (4)--
                          (i) by striking ``at least 2'' each 
                        place that such appears and inserting 
                        ``at least 1''; and
                          (ii) by striking ``50'' and inserting 
                        ``100''.
  (d) [42 U.S.C. 18120] Application.--Notwithstanding any other 
provision of the Patient Protection and Affordable Care Act, 
nothing in such Act (or an amendment made by such Act) shall be 
construed to--
          (1) prohibit (or authorize the Secretary of Health 
        and Human Services to promulgate regulations that 
        prohibit) a group health plan or health insurance 
        issuer from carrying out utilization management 
        techniques that are commonly used as of the date of 
        enactment of this Act; or
          (2) restrict the application of the amendments made 
        by this subtitle.
  (e) Technical amendment to the Employee Retirement Income 
Security Act of 1974.--Subpart B of part 7 of subtitle A of 
title I of the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1181 et. seq.) is amended, by adding at the end the 
following:

``SEC. 715. ADDITIONAL MARKET REFORMS.

  ``(a) General Rule.--Except as provided in subsection (b)--
          ``(1) the provisions of part A of title XXVII of the 
        Public Health Service Act (as amended by the Patient 
        Protection and Affordable Care Act) shall apply to 
        group health plans, and health insurance issuers 
        providing health insurance coverage in connection with 
        group health plans, as if included in this subpart; and
          ``(2) to the extent that any provision of this part 
        conflicts with a provision of such part A with respect 
        to group health plans, or health insurance issuers 
        providing health insurance coverage in connection with 
        group health plans, the provisions of such part A shall 
        apply.
  ``(b) Exception.--Notwithstanding subsection (a), the 
provisions of sections 2716 and 2718 of title XXVII of the 
Public Health Service Act (as amended by the Patient Protection 
and Affordable Care Act) shall not apply with respect to self-
insured group health plans, and the provisions of this part 
shall continue to apply to such plans as if such sections of 
the Public Health Service Act (as so amended) had not been 
enacted.''.
  (f) Technical Amendment to the Internal Revenue Code of 
1986.--Subchapter B of chapter 100 of the Internal Revenue Code 
of 1986 is amended by adding at the end the following:

``SEC. 9815. ADDITIONAL MARKET REFORMS.

  ``(a) General Rule.--Except as provided in subsection (b)--
          ``(1) the provisions of part A of title XXVII of the 
        Public Health Service Act (as amended by the Patient 
        Protection and Affordable Care Act) shall apply to 
        group health plans, and health insurance issuers 
        providing health insurance coverage in connection with 
        group health plans, as if included in this subchapter; 
        and
          ``(2) to the extent that any provision of this 
        subchapter conflicts with a provision of such part A 
        with respect to group health plans, or health insurance 
        issuers providing health insurance coverage in 
        connection with group health plans, the provisions of 
        such part A shall apply.
  ``(b) Exception.--Notwithstanding subsection (a), the 
provisions of sections 2716 and 2718 of title XXVII of the 
Public Health Service Act (as amended by the Patient Protection 
and Affordable Care Act) shall not apply with respect to self-
insured group health plans, and the provisions of this 
subchapter shall continue to apply to such plans as if such 
sections of the Public Health Service Act (as so amended) had 
not been enacted.''.

           *       *       *       *       *       *       *


SEC. [1563] 1565. SENSE OF THE SENATE PROMOTING FISCAL RESPONSIBILITY.

  (a) Findings.--The Senate makes the following findings:
          (1) Based on Congressional Budget Office (CBO) 
        estimates, this Act will reduce the Federal deficit 
        between 2010 and 2019.
          (2) CBO projects this Act will continue to reduce 
        budget deficits after 2019.
          (3) Based on CBO estimates, this Act will extend the 
        solvency of the Medicare HI Trust Fund.
          (4) This Act will increase the surplus in the Social 
        Security Trust Fund, which should be reserved to 
        strengthen the finances of Social Security.
          (5) The initial net savings generated by the 
        Community Living Assistance Services and Supports 
        (CLASS) program are necessary to ensure the long-term 
        solvency of that program.
  (b) Sense of the Senate.--It is the sense of the Senate 
that--
          (1) the additional surplus in the Social Security 
        Trust Fund generated by this Act should be reserved for 
        Social Security and not spent in this Act for other 
        purposes; and
          (2) the net savings generated by the CLASS program 
        should be reserved for the CLASS program and not spent 
        in this Act for other purposes.

SEC. 1566. RESPECTING CONSCIENCE RIGHTS IN HEALTH CARE COVERAGE.

  (a) In General.--Notwithstanding any other provision of this 
title, no provision of this title (and no amendment made by any 
such provision) shall--
          (1) require an individual to purchase individual 
        health insurance coverage that includes coverage of an 
        abortion or other item or service to which such 
        individual has a moral or religious objection, or 
        prevent an issuer from offering or issuing, to such 
        individual, individual health insurance coverage that 
        excludes such item or service;
          (2) require a sponsor (or, in the case of health 
        insurance coverage offered to students through an 
        institution of higher education, the institution of 
        higher education offering such coverage) to sponsor, 
        purchase, or provide any health benefits coverage or 
        group health plan that includes coverage of an abortion 
        or other item or service to which such sponsor or 
        institution, respectively, has a moral or religious 
        objection, or prevent an issuer from offering or 
        issuing to such sponsor or institution, respectively, 
        health insurance coverage that excludes such item or 
        service;
          (3) require an issuer of health insurance coverage or 
        the sponsor of a group health plan to include, in any 
        such coverage or plan, coverage of an abortion or other 
        item or service to which such issuer or sponsor has a 
        moral or religious objection; or
          (4) authorize the imposition of a tax, penalty, fee, 
        fine, or other sanction, or the imposition of coverage 
        of the item or service to which there is a moral or 
        religious objection, in relation to health insurance 
        coverage or a group health plan that excludes an item 
        or service pursuant to this section.
  (b) Restriction on Contrary Governmental Action.--No 
provision in this title (or amendment made by such provision) 
or law, regulation, guideline or other governmental action that 
implements such provision or amendment, or derives its 
authority therefrom, shall be given legal effect to the extent 
that it violates this section.
  (c) No Effect on Other Laws.--Nothing in this section shall 
be construed to preempt, modify, or otherwise have any effect 
on--
          (1) the Civil Rights Act of 1964;
          (2) the Americans with Disabilities Act of 1990;
          (3) the Pregnancy Discrimination Act of 1978;
          (4) the Mental Health Parity Act of 1996; or
          (5) any other State or Federal law, other than a 
        provision in this title (or an amendment made by such 
        provision) or a law, regulation, guideline or other 
        governmental action that implements such provision or 
        amendment or derives its authority therefrom.
  (d) Aggregate Actuarial Value.--Nothing in this section shall 
be construed to prohibit the Secretary from issuing regulations 
or other guidance to ensure that health insurance coverage or 
group health plans excluding abortion or other items or 
services under this section shall have an aggregate actuarial 
value at least equivalent to that of health insurance coverage 
or group health plans at the same level of coverage that do not 
exclude such items or services.
  (e) Continued Application of Nondiscrimination Rules.--
Nothing in this section shall be construed to permit a health 
insurance issuer, group health plan, or other health care 
provider to act in a manner inconsistent with subparagraph (B) 
or (D) of section 1302(b)(4).

           *       *       *       *       *       *       *


               Changes in the Application of Existing Law

    Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of 
the House of Representatives, the following statements are 
submitted describing the effect of provisions in the 
accompanying bill that directly or indirectly change the 
application of existing law.

                      TITLE I--DEPARTMENT OF LABOR

    Language is included under ``Employment and Training 
Administration'' providing amounts available to the Governor 
for Statewide activities not to exceed 11 percent.
    Language is included under ``Employment and Training 
Administration'' providing amounts made available for 
dislocated workers may be used for State activities or across 
multiple local areas where workers remain dislocated.
    Language is included under ``Employment and Training 
Administration'' providing amounts available for technical 
assistance activities may be used to provide assistance to new 
entrants to the workforce and incumbent workers.
    Language is included under ``Employment and Training 
Administration'' providing that the Department of Labor may 
take no action to limit the number or proportion of eligible 
applicants.
    Language is included under ``Job Corps'' providing that 
amounts made available for construction and rehabilitation may 
include acquisition and maintenance of major items of 
equipment.
    Language is included under ``Job Corps'' providing 
authority to transfer up to 15 percent of construction and 
rehabilitation funds for operational needs with prior written 
notice to the Committee and that any such transfers are 
available for obligation through June 30, 2017.
    Language is included under ``Job Corps'' providing that no 
funds from any other appropriation may be used for meal 
services at Job Corps.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing for reemployment 
services and referrals to training for all claimants of 
unemployment insurance for ex-service members, for improper 
payment reviews, and for unemployment claimants most likely to 
exhaust their benefits.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing for additional 
administrative funds from the Unemployment Trust Fund if 
unemployment claims exceed certain levels.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing authority for 
States to use funds to assist other States to carry out 
authorized activities in cases of a major disaster declared by 
the President under the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may make payments from funds appropriated 
for States' grants on behalf of States to the entity operating 
the State Information Data Exchange System.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that 
appropriations for establishing a national one-stop career 
system may be obligated in contracts, grants or agreements with 
States or non-State entities.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that States 
awarded grants to support national activities of the federal-
State unemployment insurance system may award subgrants to 
other States.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that funds 
available for integrated Unemployment Insurance and Employment 
Service automation may be used by States notwithstanding Office 
of Management and Budget Circular A 87.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may reallot funds among States 
participating in a consortium.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' allowing the Secretary to 
collect fees, to remain available until September 30, 2017, for 
the costs associated with additional data collection, analyses, 
and reporting services related to the National Agricultural 
Workers Survey.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing for additional administrative funds if 
participants with plans terminated during the period exceed a 
certain level.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that obligations may exceed amounts 
provided for unforeseen and extraordinary pretermination 
expenses or unforeseen and extraordinary multiemployer program 
expenses if approved by the Office of Management and Budget.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that the Department of Labor may use 
authority to reimburse an employer who is not the employer at 
the time of injury for portions of the salary of a re-employed, 
disabled beneficiary.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that funds shall be transferred to the 
appropriation from entities identified under 5 U.S.C. 8147(c) 
as determined by the Department of Labor.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that of funds transferred from entities 
under 5 U.S.C 8147(c), specified amounts may be used by the 
Department of Labor for maintenance of data and communications 
systems, workload processing, roll disability management and 
medical review, and program integrity with remaining amounts 
paid into the Treasury.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that the Secretary may prescribe 
regulations requiring identification for the filing of benefit 
claims.
    Language is included under ``Administrative Expenses, 
Energy Employees Occupational Illness Compensation Fund'' 
providing that the Secretary may prescribe regulations for 
requiring identification for the filing of benefit claims.
    Language is included under ``Occupational Safety and Health 
Administration'' providing that up to a certain amount of fees 
collected from the training institute may be retained and used 
for related training and education.
    Language is included under ``Occupational Safety and Health 
Administration'' providing that fees collected from Nationally 
Recognized Testing Laboratories may be used to administer 
laboratory recognition programs that insure safety of equipment 
used in the workplace.
    Language is included under ``Occupational Safety and Health 
Administration'' that prohibits enforcement on farming 
operations of 10 or fewer employees or of an employer with 10 
or fewer employees that is below the national average in 
specific injury categories except under specific exclusions.
    Language is included under ``Mine Safety and Health 
Administration'' providing that a specific amount may be 
collected by the National Mine Health and Safety Academy and 
made available for mine safety and health education and 
training.
    Language is included under ``Mine Safety and Health 
Administration'' providing that a specific amount may be 
collected from the approval and certification of equipment and 
materials and made available for other such activities.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
accept lands, buildings, equipment, and other contributions 
from public and private sources for cooperative projects.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
promote health and safety education and training through 
cooperative agreements with States, industry and safety 
associations.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
recognize the Joseph A. Holmes Safety Association as the 
principal safety association and may provide funds or personnel 
as officers in local chapters or the national organization.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may use 
funds to provide for costs associated with mine rescue and 
survival operations.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that the Bureau of 
International Labor Affairs may operate international labor 
activities through grants, subgrants or other arrangements.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available for 
program evaluation may be used to administer grants for 
evaluation purposes under certain conditions.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available to the 
Women's Bureau may be used for grants to service and promote 
the interests of women in the workplace.
    Language is included under ``Veterans Employment and 
Training'' providing that up to three percent of States' grants 
may be used for federal expenditures for data systems and 
contract support.
    Language is included under ``Veterans Employment and 
Training'' providing that funds may be used for support 
specialists providing intensive services and services to 
wounded servicemembers.
    Language is included under ``Veterans Employment and 
Training'' providing that Department of Labor may reallocate up 
to three percent of funds provided among appropriated accounts.
    Language is included under ``Veterans Employment and 
Training'' providing that grants may be awarded through 
September 30, 2016.
    Language is included under ``Veterans Employment and 
Training'' providing that authorized services to veterans may 
also be provided to veterans recently released from 
incarceration.
    Language is included under ``General Provisions'' 
prohibiting the use of Job Corps funds to pay salaries and 
bonuses at a rate in excess of Executive Level III.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds appropriated for grants 
solicited after January 15, 2014, under section 414(c) of the 
American Competitiveness and Workforce Improvement Act of 1998, 
for purposes other than competitive grants for training 
individuals over the age of 16 who are not currently enrolled 
in school in the occupations and industries for which employers 
are using H-1B visas to hire foreign workers.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds appropriated for Employment 
and Training Administration programs to be used to pay salaries 
and bonuses at a rate in excess of Executive Level III except 
under specific exclusions.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may transfer funds from 
``Employment and Training Administration'' to ``Program 
Administration'' when it is determined that services will be 
more efficiently performed.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may transfer funds from specified 
accounts to the ``Office of the Chief Evaluation Officer'' for 
program evaluations.
    Language is included under ``General Provisions'' providing 
flexibility of crossing for H-2B nonimmigrant workers.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may transfer funds from specified 
accounts to ``Departmental Management'' for use by the Office 
of the Chief Information Officer.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may use the performance 
accountability system in effect prior to July 1, 2016 for 
purposes of implementing section 147 of the WIOA.
    Language is included under ``General Provisions'' 
prohibiting the Department of Labor from implementing the 
``Establishing a Minimum Wage for Contractors'' regulation in 
connection to seasonal recreation and equipment rental services 
on federal property.
    Language is included under ``General Provisions'' 
prohibiting the Department of Labor from establishing an Office 
of Labor Compliance.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds to implement the ``Definition 
of the Term `Fiduciary'; Conflict of Interest Rule--Retirement 
Investment Advice'' regulation.
    Language is included under ``General Provisions'' providing 
that a third party representative may accompany an OSHA 
inspector on a ``walkaround'' inspection subject to vote of 
approval by the employees of an affected worksite.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Language is included under ``Health Resources and Services 
Administration--Health Resources and Services'' providing that 
fees collected for the disclosure of information under the 
information reporting requirement program authorized by section 
1921 of the Social Security Act shall be sufficient to recover 
the full costs of the operation program and shall remain 
available until expended to carry out that Act.
    Language is included under ``Center for Disease Control and 
Prevention--Public Health Preparedness and Response'' 
permitting CDC to operate and maintain an aircraft.
    Language is included under ``Center for Disease Control and 
Prevention--Buildings and Facilities'' providing the use of 
funds to support acquisition, renovation, or replacement, of 
the National Institute Occupational Safety and Health's 
underground and surface coal mining research capacity.
    Language is included under ``Center for Disease Control and 
Prevention--Buildings and Facilities'' providing the use of all 
carryover funds to the Individual Learning Accounts to be 
available to support acquisition, renovation, or replacement, 
of the National Institute for Occupational Safety and Health's 
underground and surface coal mining research capacity.
    Language is included under ``National Institutes of 
Health--Office of the Director'' that provides NIH shall 
strengthen human subject privacy protections.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Program Management'' prohibiting the use of 
funds to support Research, Demonstration, and Evaluation 
activities.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Program Management'' providing specified 
funds for Program Operations and the Federal Administration 
Program.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Program Management'' prohibiting the use of 
funds to support the Center for Consumer Information and 
Insurance Oversight or activities developed, administered, or 
implemented by this Center.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Program Management'' specifying the total 
and use of offsetting collections.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Health Care Fraud and Abuse Control 
Account'' providing funds to support the full cost of the 
Senior Medicare Patrol program.
    Language is included under ``Substance Abuse and Mental 
Health Services Administration--Mental Health'' that allows 
SAMHSA to provide technical assistance to communities that do 
not receive grants but want to implement systems of care model 
programs.
    Language is included under ``Administration for Children 
and Families--Children and Families Service Programs'' 
providing that section 303(a)(2)(A)(i) of the Family Violence 
Prevention and Services Act shall not apply.
    Language is included transferring the Traumatic Brain 
Injury program and the unobligated balances from the Health 
Resources and Services Administration to the Administration for 
Community Living.
    Language is included prohibiting the use of the funds 
provided in the bill to pursue legal action on behalf of a 
protection and advocacy system described in section 103 of the 
Protection and Advocacy for Individuals with Mental Illness Act 
unless written consent is obtained from the named person or 
their legal guardian.
    Language is included under ``General Departmental 
Management'' for competitive grants that implement education in 
sexual risk avoidance using medically accurate information, 
evidence-based approaches and teach benefits of healthy 
relationships, goal setting and resisting sexual coercion and 
other youth risk behaviors.
    Section 201 limits the amount available for official 
reception and representation expenses.
    Section 202 limits the number of Public Health Service 
employees assigned to assist in child survival activities and 
to work in AIDS programs through and with funds provided by the 
Agency for International Development, the United Nations 
International Children's Emergency Fund, or the World Health 
Organization.
    Section 203 limits the salary of an individual through an 
HHS grant or other extramural mechanism to not more than the 
rate of Executive Level III.
    Section 204 prohibits the Secretary from using evaluation 
set-aside funds until the Committees on Appropriations of the 
House of Representatives and the Senate receive a report 
detailing the planned use of such funds.
    Section 205 reduces the PHS evaluation set-aside to the 
lesser of 2.4 percent or $1,068,000,000.
    Section 206 permits the Secretary of HHS to transfer up to 
one percent of any discretionary funds between appropriations, 
provided that no appropriation is increased by more than three 
percent by any such transfer to meet emergency needs. Advance 
notification must be provided to the Committees on 
Appropriations at the program, project, and activity level in 
advance of any transfer.
    Section 207 provides the Director of NIH, jointly with the 
Director of the Office of AIDS Research, the authority to 
transfer up to three percent of human immunodeficiency virus 
funds.
    Section 208 makes NIH funds available for human 
immunodeficiency virus research available to the Office of AIDS 
Research.
    Section 209 prohibits the use of Title X funds unless the 
applicant for the award certifies to the Secretary that it 
encourages family participation in the decision of minors to 
seek family planning services and that it provides counseling 
to minors on how to resist attempts to coerce minors into 
engaging in sexual activities.
    Section 210 states that no provider of services under Title 
X shall be exempt from any state law requiring notification or 
the reporting of child abuse, child molestation, sexual abuse, 
rape, or incest.
    Section 211 provides conscience protections to participants 
in the Medicare Advantage program who chose not to provide, pay 
for, provide coverage of, or provide referrals for abortions.
    Section 212 permits funding for HHS international HIV/AIDS 
and other infectious disease, chronic and environmental 
disease, and other health activities abroad to be spent under 
the State Department Basic Authorities Act of 1956.
    Section 213 grants authority to the Office of the Director 
of the NIH to enter directly into transactions in order to 
implement the NIH Common Fund for medical research and 
permitting the Director to utilize peer review procedures, as 
appropriate, to obtain assessments of scientific and technical 
merit.
    Section 214 clarifies that funds appropriated to NIH 
institutes and centers may be used for minor repairs or 
improvements to their buildings, up to $3,500,000 per project 
with a total limit for NIH of $45,000,000.
    Section 215 transfers one percent of the funding made 
available for National Institutes of Health National Research 
Service Awards to the Health Resources and Services 
Administration.
    Section 216 prohibits funds from being used to advocate or 
promote gun control.
    Section 217 requires HHS to provide details on its public 
web site related to how the Prevention and Public Health Funds 
are used.
    Section 218 directs the spending of the Prevention and 
Public Health fund.
    Section 219 continues the Biomedical Advanced Research and 
Development Authority ten year contract authority.
    Section 220 requires HHS to include certain information 
concerning the number of full-time federal employees and 
contractors working on the ACA in the fiscal year 2017 budget 
request.
    Section 221 continues the 60 day flexibility for National 
Health Service Corps contract terminations.
    Section 222 allows NIH to retain payments for certain 
research organisms and substances.
    Section 223 includes specific report requirements for CMS's 
marketplaces activities in the fiscal year 2017 budget request.
    Section 224 prohibits CMS Program Account from being used 
to support risk corridor payments.
    Section 225 rescinds the nonrecurring expenses fund.
    Section 226 transfers certain functions of the Agency for 
Healthcare Research and Quality and terminating the agency as a 
separate entity.
    Section 227 requires HHS to submit an analysis of the 
impact of section 2713 of the PHS Act on discretionary 
programs.
    Section 228 prohibits funds from being used for patient-
centered outcomes research.
    Section 229 prohibits funds from being used for Title X 
family planning activities.
    Section 230 prevents funding of the Navigator program.
    Section 231 rescinds expired funds under HRSA.
    Section 232 requires the Secretaries of HHS and the 
Department of Agriculture to develop dietary guidelines based 
on scientific evidence and to provide for additional public 
comment.

                   TITLE III--DEPARTMENT OF EDUCATION

    Language is included under ``School Improvement Programs'' 
directing the Secretary to ensure that the Bureau of Indian 
Education has access to services provided by the Comprehensive 
Centers program.
    Language is included under ``School Improvement Programs'' 
prohibiting funds from being used for expanded learning time in 
the 21st Century Community Learning Centers program.
    Language is included under ``General Provisions'' 
prohibiting the Department from moving forward with regulations 
that would define ``gainful employment'' or ``credit hour'' or 
dictate how States must authorize or license institutions of 
higher education.
    Language is included under ``General Provisions'' 
prohibiting funds made available in this act from being used to 
implement a college ratings system or teacher preparation 
regulations.

                       TITLE IV--RELATED AGENCIES

    Language is included under ``The Committee for Purchase 
from People Who are Blind or Severely Disabled'' requiring that 
certain authorized fees be paid directly to the AbilityOne 
Commission and specifying that those fees may be remitted to 
other organizations under contracts that include certain 
oversight provisions.
    Language is included under ``Federal Mediation and 
Conciliation Service--Salaries and Expenses'' providing that 
fees charged for special training and other services may be 
retained and used for authorized purposes and that fees for 
arbitration services may be used for training agency personnel 
only.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the use of 
electronic voting in representation elections.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the 
implementation or enforcement of the ``Representation-Case 
Procedures'' regulation.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the application 
of a new ``joint-employer'' standard.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the exertion of 
jurisdiction related to Indian tribes.

                      TITLE V--GENERAL PROVISIONS

    Section 501 permits the Secretaries of Labor, Health and 
Human Services, and Education to transfer unexpended balances 
of prior appropriations to accounts corresponding to current 
appropriations to be used for the same purpose and for the same 
periods of time for which they were originally appropriated.
    Section 502 prohibits the obligation of funds beyond the 
current fiscal year unless expressly so provided.
    Section 503 prohibits funds from being used to support or 
defeat legislation.
    Section 504 limits the amount available for official 
reception and representation expenses for the Secretaries of 
Labor and Education, the Director of the Federal Mediation and 
Conciliation Service, and the Chairman of the National 
Mediation Board.
    Section 505 requires grantees receiving Federal funds to 
clearly state the percentage of the total cost of the program 
or project that will be financed with Federal money.
    Section 506 prohibits the use of funds for any abortion.
    Section 507 provides exceptions to section 506 and a 
provision prohibiting funds from being made available to a 
Federal agency or program, or to a State or local government, 
if such agency, program or government discriminates against 
institutional or individual health care entities because they 
do not provide, pay for, provide coverage of, or refer for 
abortions.
    Section 508 prohibits use of funds for certain research 
involving human embryos.
    Section 509 prohibits use of funds for any activity that 
promotes the legalization of any drug or substance included in 
schedule I of the schedules of controlled substances.
    Section 510 prohibits use of funds to promulgate or adopt 
any final standard providing for a unique health identifier 
until legislation is enacted specifically approving the 
standard.
    Section 511 prohibits funds to be obligated or expended on 
a contract with an entity that has not submitted a report on 
qualified veteran employees as required under 38 U.S.C. 
4212(d).
    Section 512 prohibits any transfer of funds made available 
in this Act except by the authority provided in this Act or 
another appropriation Act.
    Section 513 limits funds in the bill for public libraries 
to those that comply with the requirements of the Children's 
Internet Protection Act.
    Section 514 dictates the procedures for the reprogramming 
of any funds provided in the bill.
    Section 515 continues a provision pertaining to 
appointments to federal scientific advisory committees to 
prevent the disclosure of information like political 
affiliation of candidates for appointment.
    Section 516 requires each department and related agency 
funded through this Act to submit an operating plan within 45 
days of enactment, detailing any funding allocations that are 
different than those specified in this Act, the accompanying 
detailed table, or budget request.
    Section 517 requires the Secretaries of Labor, Health and 
Human Services, and Education to submit a quarterly report to 
the Committees on Appropriations of the House of 
Representatives and the Senate containing certain information 
on noncompetitive contracts, grants, and cooperative agreements 
exceeding $500,000 in value.
    Section 518 prohibits use of funds to process claims for 
credit for quarters of coverage based on work performed under a 
Social Security number that was not the claimant's number, 
where the performance of such work under such number has formed 
the basis for a conviction of the claimant of a violation of 
section 208(a)(6) or (7) of the Social Security Act.
    Section 519 prohibits use of funds to implement a Social 
Security totalization agreement with Mexico.
    Section 520 prohibits federal funds for the purchase of 
syringes or sterile needles, but allows communities with rapid 
increases in cases of HIV and Hepatitis to access federal funds 
for other activities, including substance use counseling and 
treatment referrals.
    Section 521 rescinds $15,000,000 provided under section 
3403 [Independent Payment Advisory Board] of Public Law 111-
148.
    Section 522 requires quarterly reports on the status of 
balances of appropriations from the Departments of Labor, 
Health and Human Services and Education and the Social Security 
Administration.
    Section 523 prohibits the use of funds for the downloading 
or exchanging of pornography.
    Section 524 prohibits the use of funds to implement, 
administer, enforce or further the provisions of Public Law 
111-148 and portions of Public Law 111-152 with certain 
exceptions.
    Section 525 rescinds $18,000,000 provided under section 
1322 [Consumer Operated and Oriented Plan] of Public Law 111-
148.
    Section 526 rescinds all remaining funds provided under 
section 1005 [Health Insurance Reform Implementation] of Public 
Law 111-152.
    Section 527 rescinds $6,800,000,000 provided under section 
3021(a) [Center for Medicare and Medicaid Innovation] of Public 
Law 111-148.
    Section 528 rescinds $100,000,000 provided under section 
6301(e) [Patient-Centered Outcomes Research Trust Fund] of 
Public Law 111-148.
    Section 529 prohibits funding from going to the Association 
of Community Organizations for Reform Now (ACORN), or any of 
its affiliates, subsidiaries, allied organizations, or 
successors.
    Section 530 provides conscience protections with respect to 
health care entities that refuse to participate in abortions 
and with regard to requirements for healthcare coverage of 
specific items and services.

                  APPROPRIATIONS NOT AUTHORIZED BY LAW

    Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of 
the House of Representatives, the following table lists the 
appropriations in the accompanying bill which are not 
authorized by law for the period concerned (dollars in 
thousands):

----------------------------------------------------------------------------------------------------------------
                                                                              Appropriations
          Agency/Program              Last Year of    Authorization  Level   in Last Year of     Appropriations
                                     Authorization                            Authorization       in this Bill
----------------------------------------------------------------------------------------------------------------
        DEPARTMENT OF LABOR
                ETA
Reintegration of Ex-Offenders               FY 2010  $20,000,000..........        $15,000,000        $82,078,000
 (transition activities authorized
 by Second Chance Act, 2007).
Community Service Employment for            FY 2011  Such Sums............        450,000,000        434,371,000
 Older Americans.
Federal Unemployment Benefits and     Dec. 31, 2014  Such Sums............        710,600,000        664,200,000
 Allowances.
 VETERANS' EMPLOYMENT AND TRAINING
              SERVICE
Homeless Veterans Program.........          FY 2015  50,000,000...........         38,109,000         38,109,000
  DEPARTMENT OF HEALTH AND HUMAN
             SERVICES
               HRSA
Nursing Education Loan Repayment..          FY 2007  Such Sums............         31,055,000         81,785,000
Faculty Loan Repayment............          FY 2014  5,000,000............          1,187,000          1,190,000
Scholarships for Disadvantaged              FY 2014  Such Sums............         44,857,000         45,970,000
 Students.
Health Careers Opportunity Program          FY 2014  Such Sums............         14,153,000         14,189,000
National Center for Workforce               FY 2014  7,500,000............          4,651,000          4,663,000
 Analysis.
Primary Care Training and                   FY 2014  Such Sums............         36,831,000         38,924,000
 Enhancement.
Oral Health Training Programs.....          FY 2012  25,000,000...........         31,928,000         34,998,000
Area Health Education Centers.....          FY 2014  125,000,000..........         30,250,000         30,250,000
Education & Training--Geriatrics    ...............  .....................         33,237,000         34,237,000
    (Workforce Development).......          FY 2014  10,800,000...........
    (Career Incentive Awards).....          FY 2013  10,000,000...........
Mental & Behavioral Health                  FY 2013  35,000,000...........          7,896,000          9,916,000
 Education.
Nursing Workforce Development
    (Nurse Education, Practice,             FY 2014  Such Sums............         37,913,000         39,913,000
     Retention, and Quality
     Grants).
    (Nurse Faculty Loan Program)..          FY 2014  Such Sums............         24,500,000         26,500,000
    (Comprehensive Geriatric                FY 2014  Such Sums............          4,350,000          4,500,000
     Education).
Sickle Cell.......................          FY 2009  10,000,000...........          4,455,000          4,455,000
Healthy Start.....................          FY 2013  Formula..............        100,746,000        102,000,000
Emergency Relief--Part A..........          FY 2013  789,471,000..........        649,373,000        655,876,000
Comprehensive Care--Part B........          FY 2013  1,562,169,000........      1,314,446,000      1,315,005,000
Early Intervention--Part C........          FY 2013  285,766,000..........        205,544,000        201,079,000
Coordinated Services and Access to          FY 2013  87,273,000...........         75,088,000         75,088,000
 Research for Women, Infants,
 Children and Youth--Part D.
Special Projects of National                FY 2013  25,000,000...........         25,000,000         25,000,000
 Significance--Part F.
Education and Training Centers--            FY 2013  42,178,000...........         33,275,000         33,611,000
 Part F.
Dental Reimbursement--Part F......          FY 2013  15,802,000...........         12,991,000         13,122,000
Organ Transplantation.............          FY 1993  Such Sums............          2,767,000         23,549,000
Rural Health Outreach Grants......          FY 2012  45,000,000...........         55,553,000         59,000,000
Rural/Community Access to                   FY 2006  5,000,000............          1,485,000          4,500,000
 Emergency Devices.
Rural Hospital Flexibility Grants.          FY 2012  Such Sums............         41,040,000         41,609,000
State Offices of Rural Health.....          FY 2002  Such Sums............          4,000,000          9,511,000
Telehealth........................          FY 2006  Such Sums............          6,814,000         14,900,000
                CDC
Sexually Transmitted Diseases               FY 1998  Such Sums............        113,671,000        157,310,000
 Grants.
National Cancer Registries........          FY 2003  Such Sums............  .................         49,440,000
National Center for Health                  FY 2003  Such Sums............        125,899,000        160,397,000
 Statistics.
WISEWOMEN.........................          FY 2003  Such Sums............         12,419,000         21,120,000
Asthma Prevention.................          FY 2005  Such Sums............         32,422,000         30,000,000
Folic Acid........................          FY 2005  Such Sums............          2,188,000          3,150,000
Injury Prevention and Control.....          FY 2005  Such Sums............        138,237,000        211,300,000
Oral Health Promotion.............          FY 2005  Such Sums............         11,204,000         20,000,000
Safe Motherhood/Infant Health               FY 2005  Such Sums............         44,738,000         46,000,000
 Promotion.
Birth Defects, Developmental                FY 2007  Such Sums............        122,242,000        133,510,000
 Disability, Disability and Health.
Breast and Cervical Cancer........          FY 2012  275,000,000..........        204,779,000        207,000,000
Johanna's Law.....................          FY 2012  18,000,000...........          4,972,000          4,500,000
Epidemiology Laboratory Capacity            FY 2013  190,000,000..........         32,424,000         40,000,000
 Grants.
National TB Strategy Grants.......          FY 2013  243,101,000..........        132,997,000        142,256,000
National Diabetes Prevention                FY 2014  Such Sums............         10,000,000         20,000,000
 Program.
Section 317 Immunization..........          FY 2014  Such Sums............        610,847,000        585,508,000
Lead Poisoning Prevention.........          FY 2005  Such Sums............         36,474,000         15,000,000
Preventive Health Services Block            FY 1998  Such Sums............        194,092,000        170,000,000
 Grant.
                NIH
All 27 Institutes and Centers.....          FY 2009  Such Sums............     30,317,024,000     30,174,000,000
              SAMHSA
Grants for the Benefit of Homeless          FY 2003  50,000,000...........         16,700,000         28,696,000
 Individuals.
Residential Treatment Programs for          FY 2003  Such Sums............                  0         15,931,000
 Pregnant and Postpartum Women.
Priority Substance Abuse Treatment          FY 2003  300,000,000..........        322,994,000        377,000,000
 Needs of Regional and National
 Significance.
Substance Abuse Treatment Services          FY 2003  40,000,000...........         20,000,000         29,605,000
 for Children and Adolescents.
Priority Substance Abuse                    FY 2003  300,000,000..........        138,399,000        190,219,000
 Prevention Needs of Regional and
 National Significance.
Centers of Excellence on Services           FY 2003  5,000,000............          2,416,000          1,000,000
 for Individuals with FAS and
 Alcohol-related Birth Defects and
 Treatment.
Priority Mental Health Needs of             FY 2003  300,000,000..........         94,289,000        383,597,000
 Regional and National
 Significance.
Youth Interagency Research,                 FY 2007  5,000,000............          3,960,000          3,909,000
 Training, and Technical
 Assistance Centers.
Suicide Prevention for Children             FY 2007  35,000,000...........         22,779,000         53,915,000
 and Youth.
Grants for Jail Division Programs.          FY 2003  10,000,000...........          6,043,000          4,269,000
PATH Grants to States.............          FY 2003  75,000,000...........         46,855,000         54,635,000
Community Mental Health Services            FY 2003  100,000,000..........         96,694,000        117,026,000
 for Children with Serious
 Emotional Disturbances.
Children and Violence Program.....          FY 2003  100,000,000..........         83,035,000         23,099,000
Grants for Persons who Experienced          FY 2003  50,000,000...........         20,000,000         45,887,000
 Violence Related Stress.
Community Mental Health Services            FY 2003  450,000,000..........        433,000,000        482,571,000
 Block Grants.
Substance Abuse Prevention and              FY 2003  2,000,000,000........      1,785,000,000      1,819,856,000
 Treatment Block Grant.
Protection and Advocacy for                 FY 2003  19,500,000...........         32,500,000         36,146,000
 Individuals with Mental Illness
 Act.
               AHRQ
Research on Health Costs, Quality,          FY 2005  Such Sums............        260,695,000                  0
 and Outcomes.
                ACF
Low Income Home Energy Assistance           FY 2007  5,100,000,000........      2,161,170,000      3,365,304,000
 Program.
Children and Families Services
 Programs
    Adoption Awareness Programs...          FY 2005  Such Sums............         12,453,000         39,100,000
    Native American Programs......          FY 2002  Such Sums............         45,826,000         50,000,000
    Community Services Block Grant          FY 2003  Such Sums............        645,762,000        674,000,000
    Community Economic Development          FY 2003  Formula..............         27,082,000         29,883,000
     Program.
    Assets for Independence.......          FY 2003  25,000,000...........         24,827,000         18,950,000
Refugee and Entrant Assistance
    Transitional and Medical                FY 2002  Such Sums............        227,243,000        383,266,000
     Services.
    Social Services...............          FY 2002  Such Sums............        158,600,000        149,927,000
    Preventative Health...........          FY 2002  Such Sums............          4,835,000          4,600,000
    Targeted Assistance...........          FY 2002  Such Sums............         49,477,000         47,601,000
    Victims of Torture............          FY 2007  25,000,000...........          9,817,000         10,735,000
                ACL
Alzheimer's Diseases Demonstration          FY 2002  Such Sums............         11,483,000         18,500,000
Older Americans Act...............          FY 2011  Such Sums............      1,927,486,000      1,393,958,000
Lifespan Respite Care.............          FY 2011  94,810,000...........          2,495,000          2,360,000
Developmental Disabilities........          FY 2007  Such Sums............        155,115,000        161,920,000
Elder Justice/ Adult Protective             FY 2014  129,000,000..........                  0         46,608,000
 Services.
      DEPARTMENT OF EDUCATION
Education for the Disadvantaged--           FY 2008  25,000,000,000.......     13,898,875,000     14,409,802,000
 LEA formula grants.
Education for the Disadvantaged--           FY 2008  Such Sums............      1,557,267,000        422,365,000
 (except Grants to LEAs and
 Special Programs for Migrant
 Students).
Special Programs for Migrant                FY 2015  Such Sums............         37,474,000         37,474,000
 Students.
Impact Aid........................          FY 2008  Such Sums............      1,240,717,000      1,298,603,000
Indian Education..................          FY 2008  Such Sums............        119,564,000        143,939,000
Innovation and Improvement--                FY 2008  Such Sums............        985,518,000        275,000,000
 (except Investing in Innovation).
Safe Schools and Citizenship                FY 2008  Such Sums............        693,404,000         56,754,000
 Education (except Promise
 Neighborhoods).
English Language Acquisition......          FY 2008  Such Sums............        700,395,000        737,400,000
Adult Education...................          FY 2004  Such Sums............        590,233,000        579,195,000
Howard University--Endowment                FY 1985  Such Sums............          2,000,000          3,405,000
 Program.
Institute of Education Sciences...          FY 2009  Such Sums............        617,175,000        409,956,000
         RELATED AGENCIES
Institute of Museum and Library             FY 2009  Such Sums............        274,840,000        227,860,000
 Services.
National Council on Disability....          FY 2003  Such Sums............          3,144,000          3,186,000
----------------------------------------------------------------------------------------------------------------

                          PROGRAM DUPLICATION

    Pursuant to section 3(j)(2) of H. Res. 5 (113th Congress), 
no provision of this bill establishes or reauthorizes a program 
of the Federal Government known to be duplicative of another 
Federal program, a program that was included in any report from 
the Government Accountability Office to Congress pursuant to 
section 21 of Public Law 111-139, or a program related to a 
program identified in the most recent Catalog of Federal 
Domestic Assistance.

                          DIRECTED RULE MAKING

    The bill does not direct any rule making.

                 COMPARISON WITH THE BUDGET RESOLUTION

    Pursuant to clause 3(c)(2) of rule XIII of the Rules of the 
House of Representatives and Section 308(a)(1)(A) of the 
Congressional Budget Act of 1974, the following table compares 
the levels of new budget authority provided in the bill with 
the appropriate allocations under section 302(b) of the Budget 
Act:

                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                302(b) Allocation                         This Bill
                                     ---------------------------------------------------------------------------
                                       Budget Authority       Outlays        Budget Authority       Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary.......................           $154,536           $169,100           $154,536        \1\$167,196
Mandatory...........................            725,992            726,035            725,992        \1\$726,035
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.

                      FIVE YEAR OUTLAY PROJECTIONS

    Pursuant to section 308(a)(1)(B) of the Congressional 
Budget Act of 1974, the following table contains five-year 
projections prepared by the Congressional Budget Office of 
outlays associated with the budget authority provided in the 
accompanying bill:

                        [In millions of dollars]
------------------------------------------------------------------------
 
------------------------------------------------------------------------
Projection of outlays associated with the
 recommendation:
    2016.............................................        \1\$794,947
    2017.............................................             66,973
    2018.............................................             14,712
    2019.............................................              4,087
    2020 and future years............................            28,182.
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.

               ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

    Pursuant to section 308(a)(1)(C) of the Congressional 
Budget Act of 1974, the amounts of financial assistance to 
State and local governments is as follows:

                        [In millions of dollars]
------------------------------------------------------------------------
 
------------------------------------------------------------------------
New budget authority.................................           $416,526
Fiscal year 2016 outlays resulting therefrom.........         \1\395,861
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]


        MINORITY VIEWS OF REP. NITA LOWEY AND REP. ROSA DELAURO

    We are grateful that Chairman Rogers and Chairman Cole 
finally held the first full Committee markup of the Labor, 
Health and Human Services, Education, and Related Agencies bill 
since Republicans took control of the House. This bill includes 
some of the nation's most important investments in domestic 
programs and it deserves an open debate in Committee every 
year, not once every six years.
    The Committee has made a mistake, however, by approving a 
bill that cuts funding for labor, health, education, and 
community service programs by $3.7 billion compared to the FY 
2015 level and by $14.6 billion compared to the President's 
budget request.
    Budgeting is fundamentally about values. The fact that the 
Labor-HHS-Education subcommittee took the largest dollar cut of 
any appropriations bill this year is a telling indication of 
the Majority's priorities. These cuts, with which we strongly 
disagree, will harm children, seniors, women, workers, 
students, and families. We will continue to press this issue 
until critical funding levels are restored.
    The Majority's litany of cuts includes complete elimination 
of Preschool Development Grants, the Agency for Healthcare 
Research and Quality (AHRQ), and Title X family planning 
services for low-income women and families. The bill also 
eliminates 27 education programs and activities and nearly 
eliminates the Teen Pregnancy Prevention program.
    The bill is fundamentally flawed due to its grossly 
inadequate 302(b) allocation and the inclusion of ideological 
and unnecessary riders.
    We must take into account the historical context. In the 
last five years, the Labor-HHS-Education bill has been cut by 
approximately $20 billion in real terms. This decline led to 
more than a billion dollars in cuts to several critical 
investments, including Title I education grants for low-income 
children, special education State grants, job training 
programs, and the Centers for Disease Control and Prevention 
(CDC). During this period the National Institutes of Health 
lost more than $3.5 billion. While modest increases of $1.1 
billion for the NIH and $500 million for Special Education are 
provided, the Majority cuts another $5.3 billion from the 
remaining programs. Under the Majority's unacceptably low 
allocation, there is no way to sufficiently address funding 
gaps. Any attempt to fix this bill within its current 
allocation would simply rob Peter to pay Paul.
    The bill is also weighed down by ideological riders. It 
blocks funding for the Affordable Care Act (ACA), which would 
cause 19 million Americans to lose their health coverage. It 
also rescinds approximately $7 billion in mandatory funding 
provided through the ACA. To make matters worse, repealing the 
Affordable Care Act would cost American taxpayers more than 
$350 billion over 10 years, according to the nonpartisan 
Congressional Budget Office.
    In addition, the bill blocks the Department of Education, 
the Department of Labor, and the National Labor Relations Board 
from enforcing regulations to protect students, workers, and 
retirees.
    And the Majority continues to impose its rigid ideology by 
adding harmful riders to block funds for family planning 
services and, even worse, to allow employers to deny preventive 
health services to their workers if the employer has a 
religious or moral objection to those services. These 
provisions would roll back decades of progress, as once again 
the Majority is trying to take away a woman's right to make her 
own health care decisions in consultation with her doctor and 
family.
    During markup in the full committee, we offered a series of 
amendments to restore funding to critical programs like early 
childhood education, Title I grants, Pell Grants, job training, 
health research, Medicare program operations, medical 
countermeasures, family planning, teen pregnancy prevention, 
and community service programs. We are disappointed that the 
Majority rejected all of our proposals.
    But the funding to restore these necessary investments will 
not materialize unless, and until, we undo sequestration. 
Therefore alternative deficit reduction strategies--like those 
proposed in the President's budget to eliminate tax breaks and 
loopholes for special interests--must be part of an eventual 
budget agreement.
    The Majority has made it clear that it is willing to 
violate the budget caps for defense spending--having added $38 
billion in Overseas Contingency Operations funding without any 
spending offsets. We simply ask for a similar agreement for 
critical investments in non-defense discretionary spending, 
such as labor, health, education and community service 
programs.
    Both Chairman Rogers and Chairman Cole have said they look 
forward to revisiting these allocations when we reach a new 
budget agreement, and we certainly look forward to working with 
them at that point.
    And while the Labor-HHS-Education bill has a great many 
shortcomings due to its inadequate allocation, we do want to 
highlight some investments that we strongly support and that 
should be further increased:
     National Institutes of Health (NIH). The bill 
includes $31.2 billion for the NIH, an increase of $1.1 billion 
above the FY 2015 Omnibus. These additional funds will enable 
the NIH to move forward with the Precision Medicine Initiative, 
the BRAIN Initiative, the Combatting Antibiotic Resistant 
Bacteria (CARB) Initiative, Alzheimer's research, and to 
increase the number of research project grants for basic 
science research. Unfortunately, this is still $2.5 billion 
below 2010 funding levels after adjusting for inflation.
     Special Education State Grants. The bill includes 
$12 billion for IDEA Part B State Grants, an increase of $500 
million above the FY 2015 level. These additional funds will 
assist States in covering the excess costs of providing special 
education and services to children with disabilities. 
Unfortunately, this is still $500 million below 2010 funding 
levels after adjusting for inflation.
     TRIO and GEAR UP. The bill includes $900 million 
for TRIO, an increase of $60 million above the FY 2015 level, 
and a total of $323 million for GEAR UP, an increase of $21 
million above the FY 2015 level. Unfortunately, TRIO and GEAR 
UP are still $26 million and $28 million below 2010 funding 
levels when adjusting for inflation.
     Head Start. The bill includes $8.8 billion for 
Head Start, an increase of $192 million above the FY 2015 
level. However, this amount is $1.3 billion below the 
President's request.

Harmful Budget Cuts in the Majority's bill

    The Labor-HHS-Education bill is called the People's Bill 
for a reason. It is about providing people with opportunities. 
The programs we fund level the playing field for low-income 
children; help Americans learn new job skills in a tough 
economy and access higher education; and protect families from 
public health threats. That is why we are so disappointed that 
the Majority chose this bill to bear the brunt of its budget 
cuts.

                        DEPARTMENT OF EDUCATION

    The Department of Education alone takes $2.5 billion in net 
cuts--and that is after accounting for a $500 million increase 
for special education State grants. This is a larger cut than 
in the FY 2013 across-the-board sequester. The bill eliminates 
Preschool Development Grants, Mathematics and Science 
Partnerships, Carol M. White Physical Education Program, Magnet 
School Assistance Program, and 23 other programs and 
activities.

             Department of Education--Program Eliminations

     1 School Improvement Grants
     2 Striving Readers
     3 Title I Evaluation
     4 Preschool Development Grants
     5 Mathematics and Science Partnerships
     6 Investing in Innovation (I3)
     7 Teacher Incentive Fund
     8 Transition to Teaching
     9 School Leadership
    10 Magnet School Assistance Program
    11 Ready to Learn
    12 Advanced Placement
    13 Fund for the Improvement of Education (FIE): Non-
Cognitive Skills Initiative
    14 FIE: Arts in Education
    15 FIE: Full Service Community Schools
    16 FIE: Education Facilities Clearinghouse
    17 FIE: Innovative Approaches to Literacy
    18 FIE: Javits Gifted and Talented
    19 Safe and Drug-free Schools and Communities National 
Activities (including ``Now is the Time'')
    20 Elementary and Secondary School Counseling
    21 Carol M. White Physical Education Program
    22 Special Olympics
    23 Fund for the Improvement of Postsecondary Education 
(FIPSE): First in the World
    24 FIPSE: Centers of Excellence for Veteran Student Success
    25 FIPSE: National Center for Information and Technical 
Support for Postsecondary Students with Disabilities
    26 Teacher Quality Partnership
    27 Regional Educational Laboratories
    The elimination of Preschool Development Grants would de-
fund preschool programs that are creating or expanding high-
quality preschool programs for low- and moderate-income 
children in 18 States. This cut would be particularly painful 
for the 60,000 children who would lose access to preschool 
entirely. The United States is far behind many countries in 
providing access to preschool education, and ranks just 25th in 
the world in its enrollment of 4-year-olds. The need is there, 
but the resources are not. The elimination is particularly 
troubling given the growing mountain of evidence that high-
quality early childhood interventions work in reducing 
inequality and narrowing achievement gaps. As documented by 
Nobel laureate economist James Heckman, these interventions 
represent an excellent return on investment as children are 
less likely to get in trouble with the law, be held back a 
grade, and need special education services.
    We are also concerned that the bill eliminates several 
programs that foster a safe and secure learning environment in 
our country's most distressed communities, such as the Now is 
the Time initiative, which supports strategies to reduce gun 
violence and increase access to mental health services; 
Elementary and Secondary School Counseling, which supports the 
critical role school counselors play in helping to create a 
safe school environment; and the Carol M. White Physical 
Education program. With the prevalence of unhealthy body 
weights among children more than doubling over the past 30 
years, we should be investing more in physical education, not 
eliminating the program designed to combat this alarming trend.
    The bill even eliminates Striving Readers--the largest 
reading program for low-income children from birth through 
grade 12. Universal literacy is the mark of a civilized 
society.
    The Pell Grant program, which has allowed millions of low- 
and middle-income students to access college and the middle 
class, loses $370 million. This cut represents 15 percent of 
the total reduction to the Department of Education and is 
proposed without corresponding increases to other student aid 
programs.
    In the full committee markup, we offered amendments to 
restore funding for education programs that were eliminated and 
Pell Grants. We also offered an amendment to boost funding for 
early childhood programs, including Preschool Development 
Grants. We are disappointed that the Majority blocked all of 
these efforts.

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

    The Department of Health and Human Services does not fare 
much better. Aside from the NIH, it takes a cut of $1.3 billion 
below the FY 2015 level. Family Planning under Title X is 
zeroed out, and Teen Pregnancy Prevention is all but 
eliminated, facing a cut of 93 percent. These cuts will have a 
devastating impact on women's health and reproductive choice. 
The bill also fails to protect victims of human trafficking, 
despite the President's request for funds, and the 
acknowledgment on all sides that human trafficking--
particularly when it involves children--is a scourge on 
society.
    The Agency for Healthcare Research and Quality (AHRQ) is 
eliminated. Contrary to the Majority's talking points, AHRQ is 
not duplicative. While NIH carries out basic research and CDC 
tracks diseases, AHRQ focuses on the delivery of care in health 
care settings. AHRQ's work contributed to a 17 percent decline 
in healthcare-associated infections between 2010 and 2013, 
saving an estimated 50,000 lives and avoiding more than a 
million infections. Moreover, this bill shifts AHRQ's workload 
to other agencies without providing the necessary funding to 
carry out the additional responsibilities.
    CMS Program Management is cut by $650 million below the FY 
2015 level. Now that more than 10 million Americans are 
receiving their health coverage through the Health Insurance 
Marketplace, it is time to stop playing political games with 
these funds. A cut of this magnitude goes beyond funding for 
the Health Insurance Marketplace. It most likely would lead to 
serious disruptions to core Medicare operations, which would 
hurt our seniors and their health care providers.
    The bill fails to meet the President's request for the 
Biomedical Advanced Research and Development Authority (BARDA), 
BioShield, and pandemic influenza preparedness. These programs 
develop and procure drugs and vaccines to prevent or respond to 
serious public health threats, such as an outbreak of a deadly 
infectious disease or a terrorist attack.
    And while we appreciate the increase of $192 million for 
Head Start, along with Chairman Cole's support for early 
learning programs, funding for Head Start is still $1.3 billion 
below the President's request. The Office of Management and 
Budget has said that the House bill could result in 140,000 
fewer children in Head Start, or in more than 570,000 children 
in Head Start being denied the full-day, full-year services 
that provide the greatest benefit.
    Similarly, the bill fails to provide an increase for the 
Child Care and Development Block Grant (CCDBG), which means 
that States will not receive funds to implement the quality 
improvements and reforms that were recently enacted in 
bipartisan child care legislation--nor will we be able to reach 
the millions of eligible children and their families who do not 
receive any child care assistance due to insufficient funds for 
the CCDBG.
    Once again, we sought to improve the bill by offering 
amendments to restore funding for AHRQ, Title X Family 
Planning, Teen Pregnancy Prevention, and CMS Program 
Management. We also sought to boost funding for Head Start, 
CCDBG, and public health preparedness. But none of our 
colleagues across the aisle supported these efforts. All were 
rejected on party line votes.

                          DEPARTMENT OF LABOR

    The Department of Labor is cut by $205 million. The bill 
fails to make the necessary investments to deal with the fact 
that two-thirds of all jobs are set to require some 
postsecondary education and training by 2020. In addition, job 
training for dislocated workers is cut and worker protection 
agencies face substantial reductions.
    We are disappointed that the bill does not support the 
President's request of $100 million for an Apprenticeship 
Initiative. We know the apprenticeship model works, as it 
develops a highly skilled workforce that meets national and 
local needs and reduces turnover costs. And the bill slashes 
nearly $150 million from grants to respond to mass layoffs or 
natural disasters, which would mean less assistance for 
communities at the time when they need it the most.
    We are also disappointed that the bill provides no funding 
for the State Paid Leave Fund. At some point in our working 
lives, nearly all of us will need time off to deal with a 
serious illness or care for a newborn child or aging parent. 
Yet only 13 percent of American workers have access to paid 
family leave, which should be a fundamental right for all 
Americans.
    On top of cuts to job training, the bill further cuts 
funding for agencies charged with protecting the health, 
safety, and benefits of American workers. These cuts would 
leave workers more susceptible to wage theft, along with racial 
and gender discrimination in the workplace. It would also make 
it more difficult to identify the workplaces with the worst 
records of injuries on the job.
    And finally, all funds for grants through the International 
Labor Affairs Bureau, are eliminated, ending the Department's 
efforts to help children around the world escape from forced 
labor and the worst forms of child labor.
    In an effort to lessen the harm to American workers and 
their families, we offered amendments to restore funding to job 
training programs, worker protection agencies, and grants to 
eradicate child labor. We also offered amendments to provide 
funding for an apprenticeship initiative and a State Paid Leave 
Fund. Once again the Majority blocked those proposals.

                            RELATED AGENCIES

    Among related agencies, the Corporation for National and 
Community Service, which runs Vista, AmeriCorps and other 
national service organizations, is cut by more than one-third, 
with no funding for the Social Innovation Fund or the National 
Civilian Community Corps, and drastic cuts to the National 
Service Trust. In addition to reducing the number of AmeriCorps 
members, the bill de-funds critical disaster relief work. 
Moreover, the bill cuts the agency's administrative budget by 
75 percent, making it unable to effectively operate.
    The National Labor Relations Board is cut by more than 25 
percent, which would undermine the agency's ability to carry 
out its legal responsibilities under the National Labor 
Relations Act. While we recognize the Majority disagrees with 
some of the NLRB's recent decisions, we note that federal 
courts have upheld the NLRB's rulemaking authority.
    And lastly, the bill provides $695 million less than 
requested for the Social Security Administration's (SSA) 
operating expenses. This shortfall could lead to reduced field 
office hours, longer in-office wait times, and phone service 
delays for those who contact SSA for help.
    During markup in the full committee, we tried to restore 
funding for community service programs and the NLRB, and boost 
funding for SSA operating expenses to the President's request. 
But our proposals were rejected on party-line votes.

The Affordable Care Act

    Unfortunately, we also see yet another attempt to block 
funding for the Affordable Care Act, which would cause 19 
million Americans to lose their health coverage.
    Let us be clear: the Affordable Care Act is working. It is 
helping millions of families across the country. Americans can 
no longer be denied coverage for pre-existing conditions. 
Preventive screenings, maternity care, and pediatric care are 
now covered. Women's health has been put on an even footing. 
Millions of low-income children have healthcare through the 
Children's Health Insurance Program. Insurers can no longer 
subject families to lifetime caps on coverage.
    In addition, the Congressional Budget Office has determined 
that repealing the Affordable Care Act would cost American 
taxpayers more than $350 billion over the next decade--and the 
cost to taxpayers would only increase in subsequent decades.
    We offered an amendment in full committee markup to remove 
this harmful provision. We were disappointed, however, when the 
Majority voted to keep this poison pill.

Harmful Policy Riders

    The bill rescinds $6.8 billion from the Center for Medicare 
and Medicaid Innovation, which is testing new service delivery 
and payment models. These tests have already shown promising 
results, through the Pioneer Accountable Care Organization 
demonstration, that will lead to better care and reduced costs 
in the long run. In fact, the Congressional Budget Office 
estimates that rescinding these funds would actually increase 
the deficit by a net of $31 billion over the next decade. This 
rescission is the epitome of penny-wise, pound-foolish 
decision-making.
    During markup in the full committee, we tried to save 
taxpayers $31 billion by striking this rescission from the 
bill. The Majority, unfortunately, voted to keep it.
    The bill prohibits the Department of Labor from enforcing 
rules to ensure that financial advisers act in the best 
interests of their clients, and it blocks the Department from 
protecting taxpayer funds from federal contractors with records 
of serious, willful, repeated, and pervasive labor law 
violations. It continues the Majority's assault on workers by 
stopping the National Labor Relations Board from enforcing its 
own rulings facilitating union elections, the responsibilities 
of joint employers, and the certification of bargaining units.
    The bill also prohibits funds for research into patient-
centered outcomes, and it blocks some science-based 
recommendations from being included in the next edition of 
Dietary Guidelines for Americans. The bill also blocks a 
Department of Education rule related to career education 
programs.
    This type of legislation does not belong in appropriations 
bills, so we offered a variety of amendments to strike these 
extraneous provisions. The Majority, once again, chose to keep 
them.

Anti-Woman Ideology

    There is no way to say this other than bluntly: this bill 
is an affront to women and families. It eliminates funding for 
the Title X Family Planning program and tops that off by adding 
a policy rider to block any federal funds from being used for 
family planning purposes. This elimination of family planning 
services would have a devastating impact on women--especially 
women in rural communities and low-income women.
    To make matters worse, the funding for Teen Pregnancy 
Prevention services is cut by more than 90 percent. The Teen 
Pregnancy Prevention Program has achieved great success in 
reducing teenage pregnancy and abortion, as well as in 
addressing disparities in teen pregnancy and birth rates.
    In another shot at women, the bill allows employers to 
block their access to preventive health services if the 
employers have so-called ``religious or moral'' objections. 
Once again the Majority is trying to take away a woman's right 
to make her own health care decisions. This policy rider would 
give final say to employers, instead of women, on health 
services such as contraception, infertility treatment, prenatal 
testing, vaccination, testing for HIV/AIDS or sexually 
transmitted diseases, transfusions--or anything else to which 
someone might plausibly (or even implausibly) claim a religious 
or moral objection.
    These provisions are downright offensive. During markup in 
the full committee, we offered amendments to strike each of the 
provisions that would limit a woman's ability to make her own 
healthcare decisions. Quite frankly, we are appalled that our 
colleagues opposed our efforts.

Conclusion

    This bill is another example of the Majority's continued 
attempt to encode their extreme and divisive ideological 
preferences into law, no matter the cost. We ask our colleagues 
to stop pushing an ideological agenda that places the health of 
millions of women and their families at risk.
    Throughout this appropriations season we have heard about 
difficult choices. But we can make a choice, now, to work 
together on a deal to eliminate sequestration and to fund the 
government at levels that meet the nation's needs for medical 
research, public health, early childhood education, higher 
education, and job training, among others. That is a choice we 
can make. The reality is this bill, with its inadequate funding 
levels and ideological riders, is a consequence of Congress 
choosing inaction over a long-term solution for hard-working 
Americans.
    We remain hopeful that this bill can be improved once we 
receive a new allocation and the Majority drops its ideological 
and unnecessary riders. At that point, we look forward to 
working with Chairman Rogers and Chairman Cole to move forward.

                                   Nita M. Lowey.
                                   Rosa L. DeLauro

                                  [all]