[House Report 114-699]
[From the U.S. Government Publishing Office]
114th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 114-699
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2017
_______
July 22, 2016.--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
and
ADDITIONAL VIEWS
[To accompany H.R. 5926]
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, Medicaid and CHIP Payment and Access Commission,
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, 2017,
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
5
Employee Benefits Security Administration.......... 15
12
Pension Benefit Guaranty Corporation............... 16
12
Wage and Hour Division............................. 17
12
Office of Labor-Management Standards............... 17
13
Office of Federal Contract Compliance Programs..... 17
13
Office of Workers' Compensation Programs........... 18
14
Occupational Safety and Health Administration...... 22
16
Mine Safety and Health Administration.............. 25
18
Bureau of Labor Statistics......................... 27
19
Office of Disability Employment Policy............. 27
20
Departmental Management............................ 27
20
General Provisions................................. 31
22
Title II--Department of Health and Human Services:
Health Resources and Services Administration....... 40
23
Centers for Disease Control and Prevention......... 44
37
National Institutes of Health...................... 50
56
Substance Abuse and Mental Health Services
Administration................................. 58
81
Centers for Medicare and Medicaid Services......... 63
88
Administration for Children and Families........... 68
95
Administration on Aging............................
Office of Secretary................................ 80
107
Office of Inspector General........................ 82
112
Public Health and Social Services Emergency Fund... 83
114
General Provisions................................. 85
116
Title III--Department of Education:
Education for the Disadvantaged.................... 103
118
Impact Aid......................................... 104
121
School Improvement Programs........................ 105
122
Indian Education................................... 106
125
Innovation and Improvement......................... 106
126
Safe Schools and Citizenship Education............. 107
130
English Language Acquisition....................... 107
131
Special Education.................................. 107
131
Rehabilitation Services and Disability Research.... 110
134
Special Institutions for Persons with Disabilities. 111
135
Career, Technical and Adult Education.............. 111
136
Student Financial Assistance....................... 112
137
Student Aid Administration......................... 112
138
Higher Education................................... 113
139
Howard University.................................. 114
144
College Housing and Academic Facilities Loans...... 114
144
Historically Black College and University Capital
Financing...................................... 114
145
Institute of Education Sciences.................... 115
145
Departmental Management............................ 116
147
Office for Civil Rights............................ 116
148
Office of the Inspector General.................... 116
149
General Provisions................................. 116
149
Title IV--Related Agencies:
Committee for the Purchase from People Who Are
Blind or Severely Disabled..................... 123
150
Corporation for National and Community Service..... 125
152
Federal Mediation and Conciliation Service......... 130
154
Federal Mine Safety and Health Review Commission... 131
154
Institute of Museum and Library Services........... 132
155
Medicaid and CHIP Payment and Access Commission.... 132
156
Medicare Payment Advisory Commission............... 132
155
National Council on Disability..................... 132
156
National Labor Relations Board..................... 133
156
National Mediation Board........................... 136
157
Occupational Safety and Health Review Commission... 136
157
Railroad Retirement Board.......................... 137
157
Social Security Administration..................... 138
158
Title V--General Provisions:
House of Representatives Report Requirements....... 143
164
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2017, the
budget request for fiscal year 2017, and the Committee
recommendation for fiscal year 2017 in the accompanying bill.
2017 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2017 Committee compared to--
Budget Activity -------------------------------------------------------------------------------
2016 Enacted 2017 Budget 2017 Committee 2016 Enacted 2017 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $12,170,896 $12,797,741 $12,033,082 (137,814) (764,659)
Department of Health and Human 75,146,207 74,707,726 77,161,196 2,014,989 2,453,470
Services.......................
Department of Education......... 68,306,763 69,388,269 66,800,009 (1,506,754) (2,588,260)
Related Agencies................ 14,619,080 15,557,220 14,248,659 (370,421) (1,308,561)
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2017, the Committee recommends a total of
$163,081,000,000 in current year discretionary funding,
including offsets and adjustments. The fiscal year 2017
recommendation is a decrease of $569,000,000 below the fiscal
year 2016 level.
Within the funds provided, the Committee has focused
increases on priority areas and reduced funding for programs
that are no longer authorized, are of limited scope or
effectiveness, or do not have a clear Federal role.
First and foremost among these priority areas is to
continue the investment made last year in biomedical research
by increasing funding for the National Institutes of Health
(NIH) by $1,250,000,000. This builds on the $2,000,000,000
increase included in the fiscal year 2016 final bill and
reverses the Administration's proposed cut of $1,000,000,000 to
the NIH, for an increase of $2,225,000,000 above the budget
request. Within the total increase, the Committee provides an
increase of $100,000,000 to the Precision Medicine Initiative,
which holds forth the promise of designing personalized,
targeted cures. The Committee also includes an increase of
$350,000,000 to help find a cure for Alzheimer's disease and an
increase of $45,000,000 for the BRAIN initiative to help better
understand how the brain functions and learns.
Protecting the public health is a second priority area the
Committee has focused on in this bill. The Committee includes
an increase of $605,399,000 for the Centers for Disease Control
and Prevention (CDC), again building upon increases included in
the fiscal year 2016 bill and rejecting the Administration's
proposal to cut this agency. Funds are provided to continue the
antibiotic resistance initiative as well as to support other
public health prevention programs.
Within the total funding for CDC, the Committee includes
$390,000,000 for activities to prevent, prepare for and respond
to the Zika virus. Funds will be targeted toward impacted
States and localities for use in mosquito abatement and
control, education campaigns, increasing surveillance and
laboratory capabilities and ensuring that State and local
health departments have the tools they need to prevent the
spread of this virus while we await development of a vaccine.
In light of the recent crises with both Zika and Ebola, the
Committee has included $300,000,000 within the CDC to form a
new Infectious Diseases Rapid Response Reserve Fund. This
reserve, in which funds will be available until expended, will
provide an immediate source of funding, fully paid for with
annually appropriated dollars, that the Administration could
tap into to quickly respond to a future, imminent infectious
disease crisis that endangers American lives without waiting
for Congress to act on a supplemental funding bill. Funds would
be subject to all existing authorities and limitations.
The Committee has also placed a high priority on combatting
the opioid addiction problem by including $500,000,000 within
the Substance Abuse and Mental Health Services Administration
to create a network of grants to states, localities,
territories and Indian tribes to develop integrated opioid
abuse response initiatives focusing on prevention, education,
treatment, and recovery services.
In the area of education, the Committee has included an
increase of $500,000,000 to assist local school districts in
covering the cost of ensuring all children with disabilities
have access to a free, appropriate and public education. The
Committee has also provided an increase of $450,000,000 to the
Title I, Grants for Disadvantaged Students program to help
school districts close achievement gaps between groups of
students under the newly reauthorized Every Student Succeeds
Act (ESSA). A total of $1,000,000,000 is also provided for the
new Student Support and Academic Enrichment program created in
ESSA. These funds can be used flexibly by school districts
across the country to meet local challenges, whether those be
in the area of counseling, special curriculum services or other
school climate needs as local demands may dictate.
The Committee has also included robust increases for the
TRIO ($60,000,000) and GEAR UP ($22,000,000) programs to ensure
that students from disadvantaged backgrounds have access to a
college program. The bill also provides sufficient funding to
increase the maximum Pell grant award to $5,935 in the 2017-
2018 academic year.
The Head Start program is increased by $141,629,000 and the
Child Care and Development Block Grant is increased by
$40,000,000 to continue investments in early childhood
education. The Committee has also included $250,000,000 within
the Department of Health and Human Services for the Preschool
Development Grants program, also newly authorized in the ESSA.
Finally, the Committee recommendation includes increases to
the Bioshield ($90,000,000) and the Biomedical Research and
Advanced Development Authority (BARDA) ($8,300,000) programs to
ensure that the American people are prepared for and protected
against possible bioterrorism attacks.
These increases are offset by eliminating funding for
programs that were not reauthorized in ESSA or do not have a
clear or effective Federal role. The Committee also includes
provisions prohibiting the continued implementation of
``Obamacare'' and the resulting savings has been put toward
these higher priorities.
In addition, the Committee continues its focus on reducing
unnecessary expenditures and expects the Departments and
agencies funded by this Act to work with the Office of
Management and Budget (OMB) to reduce printing and reproduction
costs and directs agencies to provide information in the fiscal
year 2018 budget request on reductions made in fiscal year 2017
as a result of such efforts.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
The Committee recommends $3,177,115,000 for Training and
Employment Services (TES). TES 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
$158,310,000 less than the fiscal year 2016 enacted level (the
amount provided by Public Law 114-113), and $348,345,000 less
than the fiscal year 2017 budget request.
WIOA Implementation.--In a March 2016 report entitled
``Workforce Innovation and Opportunity Act: Information on
Planned Changes to State Performance Reporting and Related
Challenges'' (GAO-16-287), the Government Accountability Office
(GAO) cited limited guidance and lack of regulations
implementing WIOA as reasons for the slowed implementation of
the Workforce Innovation and Opportunity Act enacted in July
2014. The Committee directs the Department to finalize and
implement critical WIOA regulations as soon as possible.
Governor's Reserve Fund.--The Committee recommendation
maintains the Governors' Reserve at the level authorized by
WIOA. The Committee remains concerned that some States continue
to carry over high unobligated balances and directs the
Department of Labor to work with States to ensure that funds
are used for authorized purposes in a timely manner.
Apprenticeship.--No funding is included in fiscal year 2017
for the Apprenticeship Grants program. Prior to the
announcement of Apprenticeship Grant awards, the Employment and
Training Administration (ETA) is directed to submit a report to
the Committees on Appropriations of the House of
Representatives and the Senate, and to the authorizing
committees on jurisdiction, providing detail on the eligible
entities, selection criteria used, the amount of each award,
the score of each application awarded a grant, and the criteria
ETA will use to evaluate the performance of the grant. The
Committee urges ETA to use core WIOA performance metrics, as
appropriate, and directs ETA to make program performance
information publicly available within 90 days of the end of
each program year. ETA should continue to make program
performance results available each year until funds are fully
expended or a program authorization is enacted that otherwise
provides for tracking and reporting of program performance.
Licensing.--The Committee continues to support 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. $7,500,000
is provided for the Occupational Licensing Grant program, the
same as the fiscal year 2016 enacted level.
Evaluation.--The Committee supports rigorous, evidence-
based evaluation of the Department's programs, particularly the
workforce training programs authorized by WIOA. The Committee
provides $9,000,000 in direct appropriations for program
evaluations and continues a general provision authorizing the
transfer of up to 0.75 percent of appropriations from specific
program accounts for purposes of evaluation.
Evaluations should be targeted in ways that will allow
Department administrators to use the results to improve program
delivery. 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.
Infrastructure and Administrative Costs.--The Committee
remains 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 by WIOA.
The Committee directs the Department to review the
administrative structure of the workforce delivery system and
propose efforts in the fiscal year 2018 budget request that
will eliminate duplication, reduce excessive administrative
overhead, and allow more workers to be served with existing
resources.
Program Integrity.--The Committee is troubled that the
Unemployment Insurance (UI) program has one of the highest
improper payment rates of all government programs. In the March
28, 2016 Office of Inspector General (IG) report ``ETA Needs
Stronger Controls To Ensure Only Eligible Claimants Receive
Unemployment Compensation For Federal Employees,'' Report
Number 04-16-001-03-315, the IG found that ``ETA did not
establish adequate controls to assist states in making accurate
eligibility determinations for the UCFE program.'' The IG also
found that ``ETA did not reasonably ensure Federal agencies
provided timely and complete separation information to states
for making eligibility determinations.'' The Committee directs
ETA to work expeditiously with the IG to resolve these issues
and to implement the IG's recommendations to help reduce the
rate of improper payments in the UI program.
Information Technology (IT) Consortia.--The Committee is
concerned that serious challenges threaten the viability of the
UI IT modernization projects being carried out by State
consortia. The Committee directs the Department to continue to
provide annual reports to the Committees on Appropriations of
the House of Representatives and the Senate on the status of
projects, to review its policies and procedures for assessing
and funding projects by State consortia, and to make any
necessary recommendations to the Committee in the fiscal year
2018 budget request for language or direction that would be
helpful in ensuring the long-term viability of the projects and
that funds being used for IT modernization projects are
achieving intended results.
Adult Employment and Training Activities.--For Adult
Employment and Training Activities, the Committee recommends
$815,556,000, which is the same as the fiscal year 2016 enacted
level and $26,820,000 less than the fiscal year 2017 budget
request.
Youth Employment and Training Activities.--For Youth
Employment and Training Activities, the Committee recommends
$873,416,000, which is the same as the fiscal year 2016 enacted
level and $28,723,000 less than the fiscal year 2017 budget
request.
Dislocated Worker Employment and Training Activities.--For
Dislocated Worker (DW) Employment and Training Activities, the
Committee recommends $1,160,860,000 which is $80,859,000 less
than the fiscal year 2016 enacted level and $173,345,000 less
than the fiscal year 2017 budget request.
Of the total provided for DW Employment and Training
Activities, $1,040,860,000 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 $120,000,000 is available for the Dislocated
Workers National Reserve (DWNR). The Committee recommendation
eliminates advance appropriations for the DWNR by providing
$120,000,000 in current year funds and rescinding the advance
provided in fiscal year 2016. No advance is provided for fiscal
year 2018. The DWNR supports national emergency grants,
technical assistance and demonstration projects as authorized
by WIOA.
Funding for the DWNR is intended to return the program to
its authorized intent providing national emergency grants,
technical assistance and limited demonstration projects. In
fiscal years 2014 and 2015, the Department awarded $155,000,000
and $150,000,000, for Job-Driven Training grants and Sector
Partnerships grants, respectively. These unauthorized programs
have been requested in the Department's budget in prior fiscal
years and specifically not funded by Congress. The programs
undermine the efforts of Congress in WIOA to consolidate and
streamline Federal workforce development programs. Funding is
not provided for such programs in fiscal year 2017; however,
sufficient funding is provided for true demonstration projects
under the authority of WIOA. These demonstration projects are
intended to be proof of concept endeavors, rigorously
evaluated, and specifically targeted and limited in size.
The Committee appreciates the ongoing collaboration with
the Department and its efforts to address severe dislocations
of workers in the coal industry. The Committee urges ETA to
work with the communities and stakeholders to award funds
provided in fiscal year 2016 for job training and employment as
quickly as possible.
Native Americans.--For the Indian and Native Americans
Program, the Committee recommends $52,000,000, which is
$2,000,000 more than the fiscal year 2016 enacted level and the
same as the fiscal year 2017 budget request.
Migrant and Seasonal Farmworkers.--For the National
Farmworkers Jobs Program, the Committee recommends $81,896,000,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. The Committee urges the
Department to prioritize the enhancement of workers skills and
to address labor shortages in the agricultural sector.
YouthBuild.--For YouthBuild, the Committee recommends
$84,534,000, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 budget request.
Technical Assistance.--The Committee recommends $14,775,000
for technical assistance activities for the workforce
development system, which is $11,543,000 more than the fiscal
year 2016 enacted level and the fiscal year 2017 budget
request.
Technical Assistance funding is provided in addition to the
technical assistance authority under the DW National Reserve
account in order to support ongoing WIOA implementation needs.
Reintegration of Ex-Offenders.--The Committee recommends
$88,078,000 for ex-offender retraining and reintegration
activities, which is the same as the fiscal year 2016 enacted
level and $7,000,000 less than the fiscal year 2017 budget
request.
ETA is directed to submit a report to the Committees on
Appropriations of the House of Representatives and the Senate,
and the authorizing committees of jurisdiction, within 120 days
of enactment on whether the Reintegration of Ex-Offenders
program should require grantees to offer training and industry-
recognized credentials that meet the needs of local, high-
demand industries and establish formal partnerships and job-
placement services with industry employers and what effects
that policy change would have on the program.
Workforce Data Quality Initiative.--The Committee
recommends $6,000,000 for the Workforce Data Quality
Initiative, which is the same as the fiscal year 2016 enacted
level and $34,000,000 less than the fiscal year 2017 budget
request.
JOB CORPS
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $1,700,330,000 for Job Corps,
which is $11,175,000 more than the fiscal year 2016 enacted
level and $54,260,000 less than the fiscal year 2017 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 continues to be concerned following a number
of serious incidents about the safety and security of students
on Job Corps campuses throughout the country. The Committee
supports the Department's efforts to improve campus safety and
urges ETA to continue to review and implement policies that
will enhance safety throughout the Job Corps program.
The Committee directs the Department to continue to work
with ETA and the IG to improve safety and security on Job Corps
campuses and implement the recommendations of the IG report
``Job Corps Needs to Improve Enforcement and Oversight of
Student Disciplinary Policies to Better Protect Students and
Staff at Centers'' report No. 26-15-001-03-370 (February 27,
2015).
The Committee remains concerned about financial management
of the Job Corps program and directs the Department to continue
to work with ETA and the IG to improve financial and
administrative oversight of the Job Corps program.
The Committee directs the Department to submit a
comprehensive plan to the Committees on Appropriations of the
House of Representatives and the Senate 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.
The Committee encourages the Department to consider ways to
upgrade the telecommunications infrastructure of Job Corps
centers to provide students access to online learning and job
search tools.
Operations.--For Job Corps Operations, the Committee
recommends $1,583,000,000, which is $1,175,000 more than the
fiscal year 2016 enacted level and $25,535,000 less than the
fiscal year 2017 budget request.
Construction, Rehabilitation and Acquisition.--The
Committee recommends $85,000,000 for construction,
rehabilitation and acquisition activities of Job Corps centers,
which is $10,000,000 more than the fiscal year 2016 enacted
level and $20,000,000 less than the fiscal year 2017 budget
request. The Committee expects additional funds will be used to
improve Job Corps campus security.
Administration.--The Committee recommends $32,330,000 for
the administrative expenses of the Job Corps program, which is
the same as the fiscal year 2016 enacted level and $8,725,000
less than the fiscal year 2017 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
is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 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 income is below 125 percent of the poverty
level.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
The Committee recommends $849,000,000 for Federal
Unemployment Benefits and Allowances, which is $12,000,000 less
than the fiscal year 2016 enacted level and the same as the
fiscal year 2017 budget request.
The Trade Adjustment Assistance program (TAA) provides
assistance to workers adversely affected by international
trade. TAA provides training, income support, wage subsidies
for older workers, and job search and relocation allowances to
groups of workers who file a petition and are certified as
eligible to apply for such benefits due to job losses resulting
from increases in imports or foreign trade.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
The Committee recommends $3,489,169,000 for State
Unemployment Insurance and Employment Service Operations. The
total includes $3,400,103,000 from the Employment Security
Administration Account in the Unemployment Trust Fund and
$89,066,000 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.
The Committee is concerned that the Department's proposed
rule related to States' authority to implement drug testing in
the Unemployment Insurance (UI) program is more restrictive
than Congress intended in the Middle Class Tax Relief and Job
Creation Act of 2012. The Committee urges the Department to
make appropriate changes to any final regulation to allow
States to implement UI drug testing programs consistent with
the intent of the Act.
Unemployment Insurance Compensation.--For Unemployment
Insurance Compensation, the Committee recommends
$2,674,566,000, which is $85,531,000 less than the fiscal year
2016 enacted level and $118,600,000 less than the fiscal year
2017 budget request. The total includes $2,660,019,000 for
State Operations and $14,547,000 for National Activities.
The recommendation for State UI Operations includes
$120,000,000 to conduct in-person reemployment and eligibility
assessments (REA). The Committee remains supportive of the REA
program as a means to reduce waste, fraud, abuse and to reduce
the rate of improper payments in the UI system. The Committee
recommendation will support the continuation and expansion of
the REA program in fiscal year 2017.
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 2017, for every
100,000 increase in the total average weekly insured
unemployment above 2,453,000, 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,
which is $15,816,000 less than the fiscal year 2016 enacted
level and the fiscal year 2017 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.
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, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 budget request.
Foreign Labor Certification.--The Committee recommends
$62,948,000 for the Foreign Labor Certification (FLC) program,
which is $638,000 more than the fiscal year 2016 enacted level
and the same as the fiscal year 2017 budget request. The
recommendation includes $48,666,000 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.
The Committee is concerned about recent delays in the
processing of applications in the H-2A, H-2B, and PERM
programs. The Department is directed to use all appropriate
resources and authorities to prevent any backlogs of
applications in Foreign Labor Certification programs in fiscal
year 2017.
The Department is directed to implement Foreign Labor
Certification programs in accordance with the law and to ensure
that the laws and program policies in effect in fiscal year
2017 are enforced, including, if necessary, debarment of
persistent violators as authorized.
One-Stop Career Centers/Labor Market Information.--The
Committee recommends $67,653,000 for One-Stop Career Center and
Labor Market Information, which is the same as the fiscal year
2016 enacted level and $7,500,000 less than the fiscal year
2017 budget request. The amount includes $7,500,000 for the
Department's occupational licensing initiative to identify and
address areas where occupational licensing requirements create
an unnecessary barrier to labor market entry and mobility,
particularly for dislocated workers, transitioning
servicemembers, veterans, and military spouses.
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
funds are made available to accounts authorized under 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 $157,741,000 for Program
Administration, which is $3,182,000 more than the fiscal year
2016 enacted level and $23,085,000 less than the Department's
fiscal year 2017 budget request. The recommendation includes
$107,376,000 in funds from the General Fund of the Treasury and
$50,365,000 from the Employment Security Administration Account
in the Unemployment Trust Fund.
Employee Benefits Security Administration
SALARIES AND EXPENSES
The Committee recommends $174,000,000 for the Employee
Benefits Security Administration (EBSA). This recommendation is
$7,000,000 less than the fiscal year 2016 enacted level and
$31,761,000 less than the fiscal year 2017 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 $519,506,000 for the Pension Benefit
Guaranty Corporation (PBGC). The limitation is $87,707,000 more
than the fiscal year 2016 enacted level and the same as the
fiscal year 2017 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 recommendation includes a one-time provision,
requested in the fiscal year 2017 budget, of $98,500,000 for
expenses associated with relocation and consolidation of PBGC
headquarters over the next five years. The Committee expects
the fiscal year 2018 budget request for PBGC to return to its
base funding needs and that the consolidation of headquarters
space will result in lower operating costs for PBGC in the
future.
The Committee directs 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), which is $12,000,000 less than the fiscal year
2016 enacted level and $61,099,000 less than the fiscal year
2017 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 revised policy relating to joint-employment under the
Fair Labor Standards Act and Migrant and Seasonal Agricultural
Worker Protection Act issued by WHD on January 20, 2016 is an
example of the kind of policy change the Committee expects the
WHD to make under the formal regulatory process as required by
the Administrative Procedures Act (5 U.S.C. 551 et seq.). The
Committee directs WHD to propose changes to existing regulatory
policy through the rulemaking process rather than through
memoranda or other forms of ``administrative interpretation.''
Office Of Labor-Management Standards
SALARIES AND EXPENSES
The Committee recommends $41,129,000 for the Office of
Labor-Management Standards (OLMS), which is $536,000 more than
the fiscal year 2016 enacted level and $4,562,000 less than the
fiscal year 2017 budget request. The recommendation does not
include funding for the proposed Electronic Labor Organization
Reporting System (e.LORS) modernization project proposed in the
fiscal year 2017 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.
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 $4,976,000 less than the fiscal year 2016
enacted level and $13,669,000 less than the fiscal year 2017
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 remains concerned with OFCCP's implementation
of anti-discrimination policy by the overreliance upon
statistical evaluation methods to identify contractors that
will be subject to compliance evaluation reviews. Despite the
concerns expressed by both the Committees on Appropriations of
the House of Representatives and the Senate in 2015, OFCCP
continues to rely too heavily on the use of statistical methods
to target enforcement rather than seeking to fulfill its
critical mission of increasing compliance with Federal law
through a more comprehensive approach, such as identifying
persistent violators, and assisting Federal contractors with
compliance. Although OFCCP denies either the creation or
enforcement of quotas, the agency's requirements make clear
that any contractor that does not meet the statistical
definition of nondiscrimination can be subject to enforcement
evaluations, which the Committee believes is effectively
enforcement of a de facto quota.
The Committee is also concerned that once OFCCP targets
contractors through the methodology described above, OFCCP
compliance evaluations can take in excess of 150 days to
complete. The Committee reminds OFCCP that taxpayer funds are
being used to respond to the agency's compliance evaluations
and expects that OFCCP will consider the costs and burdens of
these evaluations and expedite reviews accordingly.
The Committee directs OFCCP to review its anti-
discrimination policies and procedures to ensure that
contractors are fairly selected for compliance evaluations with
no predetermined bias--statistical or otherwise. The Committee
also directs OFCCP to revise its compliance evaluation
procedures to reduce the costs and time required to complete
compliance evaluations.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
The Committee recommends $119,177,000 for the Office of
Workers' Compensation Programs (OWCP), which is $3,676,000 more
than the fiscal year 2016 enacted level and $6,982,000 less
than the fiscal year 2017 budget request. The recommendation
includes $117,000,000 in General Funds from the Treasury and
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 (FECA), 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.
The Committee is concerned about backlogs of claims in OWCP
programs. OWCP is urged to review case processing policies and
procedures and to consider ways in which processing times can
be brought more closely into alignment with agency goals.
The Committee is concerned about the rate of improper
payments in OWCP programs, particularly in the FECA program.
The IG found in its report, ``DOL Could Do More to Reduce
Improper Payments and Improve Reporting'' report No. 03-16-002-
13-001 (May 13, 2016), that the Department did not comply with
requirements for reducing improper payments and has not
implemented five prior-year recommendations. The Committee
directs the Department to work with the IG to implement these
recommendations and to continue to review and implement
policies to reduce improper payments across OWCP programs.
SPECIAL BENEFITS
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $220,000,000 for Special Benefits,
which is $10,000,000 more than the fiscal year 2016 enacted
level and the same as the fiscal year 2017 budget request.
These funds provide mandatory benefits under the Federal
Employees' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
The Committee recommends $61,319,000 for Special Benefits
for Disabled Coal Miners. This amount is in addition to the
$19,000,000 appropriated in fiscal year 2016 as an advance for
the first quarter of fiscal year 2017. The total program level
recommendation is $80,319,000, which is $9,983,000 less than
the fiscal year 2016 enacted level and the same as the fiscal
year 2017 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 $16,000,000 as
an advance appropriation for the first quarter of fiscal year
2018, which is the same as the fiscal year 2017 budget request.
These funds ensure uninterrupted payments to beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
The Committee recommends $59,846,000 for the Energy
Employees Occupational Illness Compensation Program, which is
$1,294,000 more than the fiscal year 2016 enacted level and the
same as the fiscal year 2017 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 remains concerned about the backlog of claims
under the Energy Employees Occupational Illness Compensation
program and directs the Department to take necessary steps to
bring claim processing times into alignment with agency goals.
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 $373,041,000
for the Black Lung Disability Trust Fund, which is $31,574,000
more than the fiscal year 2016 enacted level and $1,400,000
more than the fiscal year 2017 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.
The Committee is concerned that administrative funding for
the Black Lung Disability Trust Fund has been underestimated in
the Department's budget request for two of the past three
years. The Committee directs OWCP to review the budget
formulation process for the program to ensure that budget
estimates reflect the administrative funding needs for the
program in the future.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
The Committee recommends $534,442,000 for the Occupational
Safety and Health Administration (OSHA). This recommendation is
$18,345,000 less than the fiscal year 2016 enacted level and
$60,581,000 less than the fiscal year 2017 budget request. OSHA
enforces the Occupational Safety and Health Act of 1970.
The Committee strongly supports the mission of OSHA to
promote a safe and healthy work place and protect workers from
injury, illness, and death. The Committee continues to be
concerned regarding the manner in which the mission is
currently being implemented and urges OSHA to adopt an approach
that more effectively balances enforcement with education,
training, and compliance assistance. The Committee believes
that OSHA should be building partnerships in pursuit of the
mutual goal of safer workplaces. Instead, OSHA's overreliance
on enforcement and penalties has fostered a toxic environment
with the agency that undermines its goals and is at odds with
Federal policies that support economic growth and job creation.
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
$19,000,000 for Whistleblower Programs.
State Programs.--The Committee recommends $102,000,000 for
State Programs.
Technical Support.--The Committee recommends $24,469,000
for Technical Support.
Compliance Assistance.--The Committee recommends
$130,000,000 for Federal and State compliance assistance
programs. The Committee recommends $72,000,000 for Federal
Assistance. The Committee recommends $58,000,000 for State
Consultation Grants.
Training Grants.--No funding is provided for Training
Grants. The Committee remains concerned that OSHA training
grants are inefficient and ineffective.
The Committee directs that financial evaluations of
grantees and the status of appropriated funds under this
program be included in all OSHA evaluations of grantee
performance.
Voluntary Protection Program/Safety and Health Achievement
Recognition Program.--The Committee supports the Voluntary
Protection Program (VPP) and the Safety and Health Achievement
Recognition Program (SHARP) and urges OSHA to expand these
vital programs as part of a comprehensive strategy realignment
that focuses more on cooperative safety efforts and less on
punitive enforcement.
The Committee supports the changes OSHA made to the size
eligibility requirements of the SHARP program in 2015. These
changes allow larger worksites already participating in the
SHARP program to remain in the program or transition to the VPP
as appropriate.
The Committee directs OSHA to provide information in the
fiscal year 2018 budget request on the amount of funding used
in the past two fiscal years for the VPP and SHARP programs,
the amount of funding proposed for the programs in fiscal year
2018, and to include written justifications of the budget
request for these programs.
Whistleblower Provisions.--The Committee directs OSHA to
issue whistleblower citations consistent with and not to exceed
the authority provided in section 11(c) of the Occupational
Safety and Health Act.
Improve Tracking of Workplace Injuries and Illnesses.--The
Committee directs OSHA to ensure that no legally privileged or
personally identifiable information is made publically
available on the website, or other publication, that OSHA
intends to use to post injury and illness data pursuant to the
Improve Tracking of Workplace Injuries and Illnesses regulation
published in the Federal Register on May 12, 2016 (81 Fed. Reg.
29623 et seq.).
Outreach Training Program.--The Committee directs OSHA to
conduct a fair and open competition for any new or reissued
request for proposals for the Outreach Training Program.
Lock-out/Tag-out Update.--The Committee supports OSHA's
review of existing lock-out/tag-out standards in consideration
of recent technological advancements in computer-based controls
of hazardous energy and urges OSHA to propose appropriate
updates to the standards as soon as practicable.
Anhydrous Ammonia/Ammonium Nitrate.--The Committee
reiterates language in the House Report (114-195) and the
Explanatory Statement accompanying the fiscal year 2016
Consolidated Appropriations Act related to the storage and
handling of ammonium nitrate (AN) and anhydrous ammonia. OSHA
is urged to propose any necessary changes to the storage and
handling of AN under existing regulations for Explosives and
Blasting Agents (29 CFR 1910.109) rather than adding AN to the
list of chemicals regulated under OSHA's Process Safety
Management Standards of Highly Hazardous Chemicals. OSHA is
also expected to propose changes to the storage and handling of
anhydrous ammonia through the formal regulatory process rather
than by memoranda of ``administrative interpretation.'' The
Committee notes that the U.S. Chemical Safety Board (CSB), in a
January 2016 report, found ``no evidence to suggest that any
detonation of AN in the United States has occurred at a
facility compliant with OSHA's 1910.109(i) standard.'' The CSB
also stated that these requirements do not offer sufficient
safeguards for bulk storage of fertilizer grade ammonium
nitrate. In addition, CSB found that while anhydrous ammonia
storage tanks at the West Texas facility were damaged by the
2013 explosion, ``the vessels did not catastrophically fail.''
In addition, in May 2016, the Bureau of Alcohol, Tobacco,
Firearms and Explosives found that the West Texas explosion was
a criminal act rather than non-compliance with existing
standards for the storage and handling of AN or the result of
insufficient standards for the storage and handling of AN or
anhydrous ammonia. OSHA shall propose any necessary changes to
existing regulations for the storage and handling of AN and
anhydrous ammonia, based on scientific evidence, through the
formal regulatory process as required by the Administrative
Procedures Act (5 U.S.C. 551 et seq.). The revised enforcement
policy relating to the exemption of retail facilities from
coverage of the Process Safety Management of Highly Hazardous
Chemicals standard (29 CFR 191 0.119(a)(2)(i)) issued by the
OSHA on July 22, 2015, shall not be enforced nor deemed by the
Department of Labor to be in effect.
National/Regional/Local Emphasis Programs.--The Committee
remains concerned that OSHA's National, Regional, and Local
Emphasis Programs target employers 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 directs OSHA to review its policies and
consider changes that will better target its enforcement
activities on entities that persistently violate OSHA standards
and reduce the burden of enforcement on entities that are in
compliance OSHA standards. The Explanatory Statement
accompanying the fiscal year 2016 Consolidated Appropriations
Act directed OSHA to notify the Committee on Appropriations of
the House of Representatives and the Senate 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 2017.
Mine Safety and Health Administration
SALARIES AND EXPENSES
The Committee recommends $350,500,000 for the Mine Safety
and Health Administration (MSHA), which is $25,387,000 less
than the fiscal year 2016 enacted level and $46,872,000 less
than the fiscal year 2017 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 $10,537,000 for State assistance
training grants and provides the authority to use such funds
for the purchase and maintenance of equipment required by the
``Lowering Miners' Exposure to Respirable Coal Mine Dust,
Including Continuous Personal Dust Monitors'' regulation.
The Committee recognizes that enforcement is an important
part of protecting the health and safety of miners; however,
the Committee remains concerned about overreliance on
enforcement strategies that disproportionally impact small
businesses. The Committee believes that the Department should
do everything within its authority to assist mine operators to
comply with regulations without the threat of punitive
enforcement actions.
The Committee appreciates the significant 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 notes significant worker
dislocations and mine closures as a result of economic
conditions throughout the mining industry, and in coal mining
in particular. The Committee reiterates its support for the
ongoing effort to bring MSHA enforcement into proportion by
redistributing resources and activities to the areas where mine
production is currently occurring.
The Committee reiterates its support for advances MSHA has
achieved in mine rescue communications technology. Considering
changes in economic conditions throughout the mining industry
in recent years, the Committee urges MSHA to review its mine
rescue deployment capability and strategy including Federal,
State, and private resources that can be used to respond to
mine emergencies. MSHA should discuss any ongoing needs for
rescue operations and funding in the fiscal year 2018 budget
request.
The Committee understands that, as part of an effective
enforcement strategy, MSHA needs ways to help it identify
operators that consistently seek to evade applicable rules. The
Committee urges MSHA to review and make any changes necessary
to its Pattern of Violations policies to ensure that operators
that receive violations are not at risk of being drawn into the
Pattern of Violations system where no real pattern of evasion
exists.
The Committee directs MSHA not to exceed statutory and
regulatory requirements for inspecting coal mines not in
operation.
Bureau of Labor Statistics
SALARIES AND EXPENSES
The Committee recommends $609,000,000 for the Bureau of
Labor Statistics (BLS), which is the same as the fiscal year
2016 enacted level and $31,943,000 less than the fiscal year
2017 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 $198,864,000 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
$213,548,000 for Prices and Cost of Living.
Compensation and Working Conditions.--The Committee
recommends $85,793,000 for Compensation and Working Conditions.
Productivity and Technology.--The Committee recommends
$10,795,000 for Productivity and Technology.
Executive Direction and Staff Services.--The Committee
recommends $35,000,000 for Executive Direction and Staff
Services.
Report on the Effect of Free Trade Agreements.--The
Committee directs the Bureau of Labor Statistics to submit to
the Committees on Appropriations of the House of
Representatives and the Senate, not later than 120 days of the
date of enactment of this Act, a report detailing the impact to
domestic labor markets due to changing flows in goods and
services under each free trade agreement that entered into
force with respect to the United States after December 31,
2006. The report shall include an analysis of the relative
demand for and wages of college-educated workers and non-
college educated workers and the relative demand for and wages
of manufacturing workers and non-manufacturing workers.
Office of Disability Employment Policy
SALARIES AND EXPENSES
The Committee recommends $38,203,000 for the Office of
Disability Employment Policy (ODEP), which is the same as the
fiscal year 2016 enacted level and $341,000 less than the
fiscal year 2017 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 $281,187,000 for Departmental
Management, which is $53,186,000 less than the fiscal year 2016
enacted level and $106,738,000 less than the fiscal year 2017
budget request. The recommendation includes $280,879,000 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.
Within 30 days of enactment of fiscal year 2017
appropriations the Department is directed to send a letter to
the Committees on Appropriations of the House of
Representatives and the Senate listing each affected contract
entered into by the Federal government, including, but not
limited to contracts with the Bureau of Land Management,
National Park Service, and Forest Service, certifying the
application of the exemption to the final rule ``Establishing a
Minimum Wage for Contractors'' (79 Fed. Reg. 60634 et seq.) for
seasonal recreational employees on Federal lands that was
included in Sec. 110, division H of the Consolidated
Appropriations Act, 2016 (P.L. 114-113).
Program Direction and Support.--The Committee recommends
$31,258,000 for Program Direction and Support.
No funds are provided to establish an Office of Labor
Compliance or otherwise support implementation of the Fair Pay
Safe Workplaces Executive Order as requested in the fiscal year
2017 budget.
Departmental Program Evaluation.--The Committee recommends
$9,000,000 for Departmental Program Evaluation.
Legal Services.--The Committee recommends $120,000,000 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 remains concerned that ILAB does not have 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
continue to work with GAO to implement the recommendations 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 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 and to continue
to carry out the administrative requirements of the labor
provisions of free trade agreements.
Administration and Management.--The Committee recommends
$28,640,000 for Administration and Management.
Adjudication.--The Committee recommends $34,000,000 for
Adjudication.
Women's Bureau.--The Committee recommends $14,000,000 for
the Women's Bureau.
Civil Rights Activities.--The Committee recommends
$6,880,000 for Civil Rights Activities.
Chief Financial Officer.--The Committee recommends
$5,101,000 for the Chief Financial Officer.
VETERANS EMPLOYMENT AND TRAINING
The Committee recommends $285,520,000 for the Veterans
Employment and Training (VETS) program, which is $14,410,000
more than the fiscal year 2016 enacted level and the same as
the fiscal year 2017 budget request. The recommendation
includes $50,000,000 from the General Fund of the Treasury and
$235,520,000 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 support the VETS program and
encourages the Department to pursue opportunities to
cooperation with other Federal, State and private enterprises
to help the country better serve its veterans.
The Committee supports the Department's proposed expansion
of the Homeless Veteran Program and urges the Department to
leverage all appropriate resources to achieve the goal of
eliminating veterans' homelessness.
The Committee directs VETS to work with the IG to resolve
the issues and implement the recommendations in the March 29,
2016 report, ``Jobs for Veterans State Grants Program: VETS
Needs to Improve Financial Monitoring,'' Report Number 06-16-
001-02-001.
State Grants.--The Committee recommends $175,000,000 for
State Grants.
Transition Assistance Program.--The Committee recommends
$14,600,000 for the Transition Assistance Program.
Homeless Veterans' Reintegration Program.--The Committee
recommends $50,000,000 for the Homeless Veterans' Reintegration
Program.
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 $33,698,000,000 for Information
Technology (IT) Modernization which is $3,920,000 more than the
fiscal year 2016 enacted level and $29,464,000 less than the
fiscal year 2017 budget request.
While the Committee recognizes there are ongoing
modernization needs with respect to the Department's
information technology infrastructure, the Committee remains
concerned that the Department does not have the capacity to
effectively manage the large increase in IT modernization funds
proposed in the fiscal year 2017 budget request.
The Committee directs the Department to establish a multi-
year IT modernization plan 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 $91,500,000 for the Office of
Inspector General (OIG), which is $5,200,000 more than the
fiscal year 2016 enacted level and $3,041,000 less than the
fiscal year 2017 budget request. The recommendation includes
$85,840,000 from the General Fund of the Treasury and
$5,660,000 from the Employment Security Administration Account
in the Unemployment Trust Fund. The OIG conducts audits of
Department programs and operations in order to determine that
they are in compliance with the applicable laws and
regulations, that Department resources are being effectively
used, and that they are achieving their intended results.
The Committee supports OIG efforts to reduce improper
payments in the UI program and to continue to combat large-
scale, multi-State fictitious and fraudulent employer and
identity theft schemes to defraud the UI program.
General Provisions
Sec. 101. The Committee continues a provision to prohibit
the use of Job Corps funds for the salary of an individual at a
rate in excess of Executive Level II.
(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 modifies a provision related to
grants made from funds available to the Department under the
American Competitiveness and Workforce Improvement Act.
Sec. 105. The Committee continues 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 II.
(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 continues a provision allowing 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 continues a provision relating to
section 147 of the WIOA authorizing competitive procurement of
certain Job Corps Civilian Conservation Centers.
Sec. 109. The Committee modifies a provision relating to
the Department's Establishing a Minimum Wage for Contractors
regulation.
Sec. 110. 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. 111. The Committee includes a new provision relating
to the Department's Defining and Delimiting the Exemptions for
Executive, Administrative, Professional, Outside Sales and
Computer Employees regulation.
Sec. 112. The Committee modifies a provision relating to
flexibility of H-2B nonimmigrant crossings.
Sec. 113. The Committee continues a provision relating to
wage determinations in the H-2B program.
(RESCISSION)
Sec. 114. The Committee includes a new provision rescinding
advance appropriations in the Dislocated Workers' National
Reserve account.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
The Committee recommends $6,165,540,000 for Health
Resources and Services programs, which is $218,518,000 below
the fiscal year 2016 enacted level and $168,859,000 above the
fiscal year 2017 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.
The Committee does not include the requested bill language
allowing the Administrator to transfer three percent or less of
funds between any of the HRSA accounts.
PRIMARY HEALTH CARE
Health Centers
The Committee recommends $1,491,422,000 for the Health
Centers program, which is the same as the fiscal year 2016
enacted level and $150,000,000 above the fiscal year 2017
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 2016 enacted level and the fiscal
year 2017 budget request. The program provides medical
malpractice liability protection to Federally supported health
centers.
The Committee is supportive of ongoing efforts to expand
the capacity of community health centers to offer a
comprehensive, integrated range of services, through strategic
investment in behavioral health, substance abuse, oral health
and other services and capacity.
Diabetic Retinopathy.According to the National Eye
Institute, diabetic retinopathy is highly treatable and even
preventable for diabetic patients that receive early
interventions. As one of the major side effects of diabetic
patients, the rates of diabetic retinopathy diagnoses are
increasing at the same rate as the spike in diabetes diagnoses,
an unforeseen issue for urban healthcare institutions that
should not be neglected. The Committee encourages HRSA to
identify assistance to urban healthcare institutions that
currently serve underserved populations for diabetic
retinopathy and vision care.
Health Center Guaranteed Loan Program.--The Committee
recognizes the need for capital resources at community health
centers to meet increased demand and upgrade facilities. The
Committee supports administrative changes to the HRSA Loan
Guarantee Program designed to improve its efficiency and better
align the program with other successful Federal loan
guarantees, and to increase utilization of this tool to
leverage outside resources to meet health centers' capital
needs.
Perinatal Transmission of Hepatitis B.--The Committee is
pleased that progress is now being made to develop and
implement a strategic plan to reduce the rate of perinatal
transmission of Hepatitis B. The Committee notes however, that
HRSA has been urged to expand efforts to eliminate perinatal
transmission of Hepatitis B for the past three fiscal years and
little progress has been made. It is therefore expected that
HRSA engage a pilot to test intervention strategies followed by
the adoption of a best practices protocol in HRSA funded health
care settings as soon as possible in fiscal year 2016.
Tuberculosis.--The Committee notes that the National Action
Plan for Combating Drug Resistant Tuberculosis recommends the
creation of health-care liaisons between State and local health
departments and institutions, including health centers that
serve hard to reach groups who are at risk for tuberculosis
(TB). HRSA is directed to provide a report to the Committee on
the coordination between community health centers and State and
local TB control programs to help ensure appropriate
identification, treatment, and prevention of TB among
vulnerable populations.
Free Clinics Medical Malpractice
The Committee recommends $400,000 for extension of Federal
Tort Claims Act coverage for volunteer free clinic health care
professionals, which is $300,000 more than the fiscal year 2016
level and $600,000 less than the fiscal year 2017 budget
request. The program provides medical malpractice 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.
HEALTH WORKFORCE
Health Professions
The Committee recommends $823,706,000 for Health
Professions programs, which is $36,811,000 above the fiscal
year 2016 enacted level and $306,961,000 above the fiscal year
2017 budget request. The Bureau of Health Professions supports
grants for the development of the health workforce in fields
challenged by a high need and insufficient supply of health
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.
In response to the opioid epidemic, the Committee
encourages medical schools and teaching hospitals to enhance
existing curricular content on substance abuse and pain
management for future prescribers. The Committee supports
efforts by HRSA, through its Title VII health professions
programs, to provide educational and training grants to medical
schools and teaching hospitals to develop innovative
educational materials related to substance use disorders and
pain management.
Within the total for Health Professions, the Committee
recommends the following amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Health Professions Training for Diversity
Centers of Excellence............................ $21,711,000
Faculty Loan Repayment........................... 1,190,000
Scholarships for Disadvantaged Students.......... 45,970,000
Workforce Information and Analysis................... 4,663,000
Primary Care Training and Enhancement................ 38,924,000
Oral Health Training Programs........................ 35,873,000
Interdisciplinary, Community-based Linkages
Area Health Education Centers.................... 30,250,000
Geriatric Programs............................... 38,737,000
Mental and Behavioral Health..................... 9,916,000
Behavioral Health Workforce Education and 50,000,000
Training........................................
Public Health Workforce Development.................. 17,000,000
Nursing Workforce Development
Advanced Education Nursing....................... 64,581,000
Nursing Workforce Diversity...................... 15,343,000
Loan Repayment and Scholarship Program........... 83,135,000
Nurse Education, Practice, and Retention......... 39,913,000
Nurse Faculty Loan Program....................... 26,500,000
------------------------------------------------------------------------
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. The
Committee also believes that implementation of
interprofessional practice requires health students and
faculty, as well as staff at the clinic site, to be prepared to
work effectively side-by-side.
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, with special consideration for applicants who
address student and faculty learning as well as clinical site
readiness.
Oral Health Training Programs
The Committee recommends $35,873,000 for Training in Oral
Health Care programs, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. Within
the funds provided, the Committee includes not less than
$10,000,000 for General Dentistry Programs and not 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. HRSA is directed to provide
continuation funding for predoctoral and postdoctoral training
grants initially awarded in fiscal year 2015 and continuation
funding for section 748 Dental Faculty Loan Repayment grants
initially awarded in fiscal year 2016.
Area Health Education Centers
The Committee is pleased with the local and national work
of the Title VII Area Health Education Center (AHEC) Program,
and encourages HRSA to engage external stakeholders, including
current and former grantees of the program, in refining the
focus and core activities of the program.
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 is aware that some State dental
associations have already initiated programs to refer emergency
room patients to dental networks. HRSA is urged to work with
these programs.
Mental and Behavioral Health
The Committee recommendation includes $8,916,000 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. 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. 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.
Nursing Workforce Development
The Committee recognizes that the demand for a highly-
educated and diverse registered nursing workforce is
particularly critical in rural and underserved areas, and
acknowledges that the Institute of Medicine's report, Future of
Nursing: Leading Change, Advancing Health calls for a greater
number of baccalaureate-prepared registered nurses by 2020 and
promotes steps to foster greater diversity among the nursing
workforce to reflect an increasingly diverse patient
population. Therefore, the Committee encourages HRSA to support
the recruitment of individuals underrepresented in the field of
nursing through the Nursing Workforce Diversity program by
prioritizing the use of evidence-based strategies, including
holistic admissions in education programs.
Behavioral Health Workforce Education and Training
The Committee recommends $50,000,000 for the Behavioral
Health Workforce 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 HRSA to share information concerning pending
grant opportunity announcements with State licensing
organizations and all the relevant professional associations.
Social workers are a vital part of the behavioral health
workforce, and critical to closing the access gap to services.
The Committee is concerned that schools and programs of social
work were not eligible to apply for the fiscal year 2016
Behavioral Health Workforce Education and Training (BHWET) for
Paraprofessionals and Professionals program, and directs HRSA.
to include such schools and programs in fiscal year 2017
funding opportunities for the BHWET program.
Children's Hospitals Graduate Medical Education
The Committee recommends $300,000,000 for the Children's
Hospitals Graduate Medical Education Payment Program, which is
$5,000,000 above the fiscal year 2016 enacted level and
$300,000,000 more than the fiscal year 2017 budget request. The
Children's Hospitals Graduate Medical Education Payment Program
helps eligible hospitals maintain graduate medical education
programs, which support the training of residents to care for
the pediatric population and enhance the supply of primary care
and pediatric medical and surgical subspecialties.
National Practitioner Data Bank
The Committee assumes $18,814,000 for the National
Practitioner Data Bank for fiscal year 2017, which is the same
as the fiscal year 2016 enacted level and $2,223,000 less than
the fiscal year 2017 budget request. The Committee
recommendation and the fiscal year 2017 budget request assume
that the data bank will be self-supporting. The Committee
continues to include bill language to ensure that user fee
collections cover the full costs of the data bank operations.
National Health Service Corps
The Committee recognizes that the Secretary retains the
authority to include additional disciplines, such as optometry,
in the National Health Services Corps (NHSC), as eligible
recipients of scholarships and loan repayment through the
program. There are critical needs in rural communities with
underserved populations for optometry services, and recruitment
of providers to offer those services is key to expanding
capacity. The Committee therefore encourages the Secretary to
consider the inclusion of optometry as an eligible discipline.
The Committee notes that access to optometry services can
help prevent vision loss and encourages HRSA to explore funding
opportunities for Schools of Optometry, optometry students, and
optometrists within existing authorities and consider including
optometrists as an eligible discipline in the State Loan
Repayment Program.
The Committee recognizes that the NHSC is an essential tool
for recruitment and retention of health professionals at
community health centers, especially given recent expansions of
the Health Centers program. The Committee encourages HRSA to
increase the proportion of clinicians serving at health centers
to improve alignment between these two programs and to best
leverage investments in NHSC health professionals.
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 the same as the fiscal
year 2016 enacted level and the fiscal year 2017 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 2017
Budget Activity Committee
------------------------------------------------------------------------
Set-aside for Oral Health............................ $5,250,000
Set-aside for Epilepsy............................... 3,642,000
Set-aside for Sickle Cell Disease.................... 3,000,000
Set-aside for Fetal Alcohol Syndrome................. 477,000
------------------------------------------------------------------------
Set-aside for Oral Health.--The Committee has included
$250,000 for demonstration projects to increase the
implementation of integrating oral health and primary care
practice. The projects should model the core clinical oral
health competencies for non-dental providers that HRSA
published and initially tested in its 2014 report,
``Integration of Oral Health and Primary Care Practice.''
Fetal Alcohol Syndrome.--The Committee recommends continued
funding for the Fetal Alcohol Syndrome initiative that
addresses high-risk Alaska Native and American Indian
populations through a Native American-focused collaborative.
Hemophilia Treatment Centers.--The Committee recommends
level funding for Hemophilia Treatment Centers (HTCs).
Hemophilia is a rare, chronic bleeding disorder affecting
20,000 people in the United States. Individuals with hemophilia
require life-long infusions of expensive clotting factor
therapies that replace missing or deficient blood clotting
proteins, preventing debilitating and life-threatening internal
bleeding. HTCs improve the health of these patients by
providing diagnostic and educational services for these
inherited conditions; developing wide-ranging, culturally
sensitive and family-centered genetic services and an
understanding of how these genetic conditions affect people's
health.
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 2017
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........................................ 103,500,000
Universal Newborn Hearing............................ 17,818,000
Emergency Medical Services for Children.............. 20,162,000
------------------------------------------------------------------------
Vision Health.--The Committee is concerned that vision
disorders are among the leading cause of impaired health in
childhood as one in four school-aged children has a vision
problem significant enough to affect learning. The Committee
recognizes that early detection can help prevent vision loss
and blindness and understands many serious ocular conditions in
children are treatable if diagnosed at an early stage.
Therefore, to promote vision and eye health for the Nation's
children, the Committee encourages the development of public
health infrastructure to support a comprehensive, multi-tiered
continuum of vision care for young children.
Neonatal Abstinence Syndrome.--The Committee is alarmed by
the drastic rise in the incidence of Neonatal Abstinence
Syndrome (NAS), newborns suffering from withdrawal due to drug
exposure during pregnancy. The Committee requests an update in
the fiscal year 2018 budget request on HRSA efforts that
address NAS.
Autism and Other Developmental Disorders
The Committee recommends $47,099,000 for Autism and Other
Developmental Disorders, this funding level is the same as the
fiscal year 2016 enacted level and the fiscal year 2017 budget
request. These programs seek to improve the health and well-
being of children and adolescents with autism spectrum disorder
and other developmental disabilities and to advance best
practices for the early identification and treatment of autism
and related developmental disabilities. Within the total, the
Committee recommends $30,043,000 for the Leadership Education
in Neurodevelopmental and Related Disabilities (LEND) program.
This funding level will allow LEND programs to maintain their
capacity to train professionals to diagnose, treat, and provide
interventions to individuals with autism spectrum disorder and
expand the number of sites and professionals trained to
diagnose, treat, and provide interventions to individuals with
autism spectrum disorder authorized by the Combating Autism
Act. The increase will help these programs initiate or expand
their work in the area of interdisciplinary leadership training
to meet the needs of children with Autism Spectrum Disorders
and related developmental disabilities.
Heritable Disorders
The Committee recommends $13,883,000 for the Heritable
Disorders program, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. This
program provides grants to support State and local public
health agencies with the enhancement, improvement, or expansion
of their ability to provide screening, counseling or health
care services to newborns and children having or at risk for
heritable disorders. Since the original Newborn Screening Saves
Lives Act was signed into law, two additional screenings have
been added to the Recommended Uniform Screening Panel--critical
congenital heart disease and severe combined immunodeficiency.
Programs funded through the Heritable Disorders program and
programs established under the Newborn Screening Saves Lives
Act (P.L. 110-204) play a critical role in assisting States in
the adoption of additional screenings, enhancing provider and
consumer education and ensuring coordinated follow-up care. The
Committee encourages HRSA to increase assistance to States
implementing new conditions added to the Recommended Uniform
Screening Panel, including Severe Combined Immunodeficiency
(SCID), Glycogen Storage Disease Type II (Pompe disease),
Mucopolysaccharidosis Type I (MPS I) and X-linked
Adrenoleukodystrophy (X-ALD).
Newborn Screening for Severe Combined Immunodeficiency.--
The Committee provides level funding for Newborn Screening for
SCID to assure that States are able to continue supporting
wider implementation, education and awareness of Newborn
Screening for SCID.
Thalassemia.--The Committee supports the important work
HRSA has funded to establish expert recommendations for patient
care in three keys areas in thalassemia treatment and to aid
the development of regional partnership networks related to
thalassemia. Thalassemia is an inherited blood disorder that
causes the body to make an abnormal form of hemoglobin. The
Committee encourages HRSA to continue and expand work to
address more issues related to this patient population.
Healthy Start
The Committee recommends $103,500,000 for the Healthy Start
program, which is the same as the fiscal year 2016 enacted
level as well as the fiscal year 2017 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 and local health department initiatives that provide
evidence-based interventions 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 FIMR.
Transfer from Planned Home Birth to Hospital.--The
Committee continues to note the rising rates for out of
hospital births in the United States since 2004, and the
subsequent importance of collaboration within an integrated
maternity care system in order to achieve 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 work with its partners, including
those national organizations representing professionals who
attend home, birthing center and hospital births, to develop a
strategy for facilitating ongoing inter-professional dialogue
and cooperation and 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. HRSA is directed to provide a report to
the Committee with an update on its progress.
RYAN WHITE HIV/AIDS PROGRAM
Ryan White HIV/AIDS Program
The Committee recommends $2,322,781,000 for the Ryan White
HIV/AIDS Programs, which is the same as the fiscal year 2016
enacted level and $9,000,000 below the fiscal year 2017 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:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Emergency Assistance................................. $655,876,000
Comprehensive Care Programs.......................... 1,315,005,000
AIDS Drug Assistance Program..................... (900,313,000)
Early Intervention Program........................... 205,079,000
Children, Youth, Women, and Families................. 75,088,000
AIDS Dental Services................................. 13,122,000
Education and Training Centers....................... 33,611,000
------------------------------------------------------------------------
AIDS Drug Assistance Program.--The Committee recognizes the
importance of HIV health care and support services, and
supports granting Federal funds to States to address the growth
in the number of clients in need of supportive services--
including HIV service delivery, home and community-based care
services for individuals with HIV disease, continuation of
health insurance coverage for low-income persons with HIV
disease, and State AIDS Drug Assistance Programs (ADAP)--that
maintain persons in care. The Part B program provides 59 grants
to States and territories.
The Committee continues to be encouraged by the progress of
anti-retroviral therapy in reducing the mortality rates
associated with HIV infection and impacting the transmission of
HIV infections. The Committee supports continued funding for
AIDS medications in ADAP. These funds ensure that low-income
individuals maintain access to HIV/AIDS medications. Their
importance increases as more individuals are identified through
increased testing efforts by State and local health departments
and seek treatment earlier in the progression of their HIV
disease.
Ryan White Part D.--The Committee does not recommend
combining Parts C and D of the Ryan White HIV/AIDS program.
Populations served by Part D, namely pregnant women, infants,
children, and youth (WICY), require different treatment than
the standard adult patient served by the Part C program. These
unique WICY populations require care providers with special
expertise and intensive counseling oversight, making robust use
of case managers who are vital to the success of the Part D
programs. The Committee commends HRSA on the progress made to
reduce viral transmission from mother to infant in the United
States and believes the gains are attributable in large part to
the hands-on approach taken by the Ryan White Part D
recipients. HRSA should remain cognizant of the special needs
of this population, and recognize that treating them in the
same manner as adults will result in increased perinatal
transmissions and poorer outcomes among HIV infected children
and youth.
Dental Reimbursement Program.--The Ryan White Part F
program provides for the Dental Reimbursement Program (DRP),
which covers the unreimbursed costs of providing dental care to
persons living with HIV/AIDS. Programs qualifying for
reimbursement are dental schools, hospitals with postdoctoral
dental education programs, and colleges with dental hygiene
programs. The Committee is concerned that although the program
has provided oral health care to many people living with HIV/
AIDS, it has not kept pace with the number of individuals in
need. The Committee requests an update in the fiscal year 2018
budget request on the non-reimbursed costs covered by the DRP.
HEALTH CARE SYSTEMS
The Committee recommends $109,193,000 for Health Care
Systems, which is $6,000,000 above the fiscal year 2016 enacted
level and $10,000,000 below the fiscal year 2017 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:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Organ Transplantation................................ $23,549,000
National Cord Blood Inventory........................ 16,266,000
C.W. Bill Young Cell Transplantation Program......... 22,109,000
Office of Pharmacy Affairs........................... 10,238,000
Poison Control Centers............................... 19,846,000
National Hansen's Disease Program.................... 15,206,000
National Hansen's Disease--Buildings/Facilities...... 122,000
Hansen's Payment to Hawaii........................... 1,857,000
------------------------------------------------------------------------
Organ Donation.--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 HRSA to allocate resources toward increasing
the organ donor pool and coordinate efforts by the Organ
Procurement and Transplantation Network and the Centers for
Medicare & Medicaid Services in regions with disproportionately
low numbers of organ donors. The Committee directs HRSA to
establish a coordinated initiative to increase the number of
donated organs successfully procured and transplanted
throughout the United States. The Committee requests an update
in the fiscal year 2018 budget request on HRSA's efforts to
increase organ donors, specifically new efforts undertaken that
seek to address regional disparity. The Committee also requests
a report within 120 days of enactment detailing a comprehensive
strategy to encourage organ donation throughout the United
States, including ways to share best practices from high
donation areas to low donation areas.
National Cord Blood Inventory
The Committee recommends $16,266,000 for the National Cord
Blood Inventory, which is $5,000,000 more than the fiscal year
2016 enacted level and $5,000,000 more than the fiscal year
2017 budget request. The National Cord Blood Inventory program
builds a genetically and ethnically diverse inventory of high-
quality umbilical cord blood for transplantation.
Office of Pharmacy Affairs
The Committee recommends $10,238,000 for the Office of
Pharmacy Affairs (OPA), which is the same as the fiscal year
2016 enacted level and is $7,000,000 below the fiscal year 2017
budget request. The Committee again rejects the budget request
to establish a user fee. The Office of Pharmacy Affairs
oversees the 340B Drug Pricing Program, which requires drug
manufacturers to provide discounts on outpatient prescription
drugs to certain safety net health care providers.
The Committee recognizes that OPA published the first,
comprehensive program guidance for the 340B program, and
expected this guidance to provide clarity for all stakeholders.
The Committee is concerned about the large number of negative
comments on the guidance. The Committee is also aware that the
340B statute requires HRSA to make 340B ceiling prices
available to covered entities through a secure website, but
that OPA has failed to meet its own deadlines to complete work
on the secure website. The Committee urges OPA to complete the
development of a secure website. The Committee directs OPA to
include an update on the status of the secure website in the
fiscal year 2018 budget request.
Poison Control Centers
The Committee recommends $19,846,000 for Poison Control
Centers, which is $1,000,000 above the fiscal year 2016 enacted
level and the fiscal year 2017 budget request. There is an
acknowledged epidemic of prescription drug (opioid) abuse and
heroin addiction in our country. According to the CDC, in 2013,
the most recent year for which data are available,
unintentional poisoning was the leading cause of unintentional
injury deaths. Ninety-one percent of unintentional poisonings
were caused by prescription drugs, primarily opioid analgesics.
The Committee recognizes that Poison Control Centers (PCCs)
play a critical role in combatting opioid drug-related abuse
and misuse from helping to define and trace the problem within
a local and national context to responding to calls from
healthcare providers seeking treatment advice for substance
abuse patients. PCCs also provide vital public and health care
provider education. The Committee recognizes the critical role
of this proven national public health program and the value of
its highly effective public-private/local-State-Federal
partnership in helping the country address this opioid
epidemic, as well as contributing significantly to
Congressional goals of achieving the most efficient delivery of
healthcare services to all citizens.
RURAL HEALTH
The Committee recommends $169,571,000 for Rural Health
programs, which is $20,000,000 more than the fiscal year 2016
enacted level and $25,409,000 more than the fiscal year 2017
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 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 2017 Committee
------------------------------------------------------------------------
Rural Outreach Programs.............................. $65,500,000
Rural Health Research................................ 9,351,000
Rural Hospital Flexibility Grants.................... 45,609,000
State Offices of Rural Health........................ 10,511,000
Black Lung Clinics................................... 7,766,000
Radiation Exposure Screening and Education........... 1,834,000
Telehealth........................................... 19,000,000
Rural Opioid Overdose Reversal Grant................. 10,000,000
------------------------------------------------------------------------
Rural Outreach Programs.--The Committee directs HRSA to
target new funds to rural communities with high rates of
poverty, unemployment, and substance abuse.
Rural Hospital Flexibility Grants.--The Committee directs
HRSA to issue new funding announcements for Critical Access
Hospitals (CAHs) and give priority in grant awards to CAHs that
serve rural communities with high rates of poverty,
unemployment, and substance abuse.
Telehealth.--The Committee directs HRSA to give priority in
making grant awards to small hospitals serving communities with
high rates of poverty, unemployment, and substance abuse.
Training in Oral Health Care and Rural Health.--The
Committee encourages HRSA to work with States to develop and
facilitate public education programs that promote preventive
oral health treatments and habits via increased oral health
literacy in rural and underserved areas. The Committee believes
that prevention-centered programs represent a cost effective
way to address oral health access. The Committee also
encourages the Office of Rural Health Policy to support these
programs. Further, the Committee encourages HRSA to include
innovative public education programs as eligible for funding as
part of the State Oral Health Workforce Improvement Program.
Rural Opioid Overdose Reversal Grant
The Committee is concerned about the increasing number of
unintentional overdose deaths attributable to prescription and
nonprescription opioids. HRSA is urged to take steps to
encourage and support the use of funds for opioid safety
education and training, including initiatives that improve
access for licensed healthcare professionals, including
paramedics, to emergency devices used to rapidly reverse the
effects of opioid overdoses. Such initiatives should
incorporate robust evidence-based intervention training, and
facilitate linkage to treatment and recovery services.
FAMILY PLANNING
The Committee does not recommend funding for the Family
Planning program, which is $286,479,000 below the fiscal year
2016 enacted level and $300,000,000 below the fiscal year 2017
budget request. The Family Planning program administers Title X
of the Public Health Service Act.
PROGRAM MANAGEMENT
The Committee recommends $155,000,000 for the cost of
Federal staff and related activities to coordinate, direct, and
manage the programs of HRSA, which is $1,000,000 more than the
fiscal year 2016 enacted level and $2,061,000 below the fiscal
year 2017 budget request.
The Committee is disturbed to learn that despite its
directive in House Report (110-231) to establish a Chief Dental
Officer (CDO) position, HRSA has not maintained the
appointment. The Committee understands that since the beginning
of 2012 the position has been downgraded to Senior Dental
Advisor and moved several layers below HRSA leadership and
decision makers. This has occurred in spite of the
Administration's commitment in 2010 to establish the Oral
Health Initiative, which highlighted several HRSA initiatives
to improve access to oral health care, especially for needy
populations. The Committee directs HRSA to restore the position
of HRSA Chief Dental Officer with executive level authority and
resources to oversee and lead HRSA dental programs and
initiatives. The CDO is also expected to serve as the agency
representative on oral health issues to international,
national, State, and/or local government agencies,
universities, oral health stakeholder organizations, etc.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
The Committee estimates that $240,000,000 will be released
from the Vaccine Injury Compensation Trust Fund, which is
$3,000,000 more than the fiscal year 2016 enacted level and the
same as the fiscal year 2017 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 the 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 $8,350,000 in costs incurred by HRSA in the
operation of the program, which is $850,000 more than the
fiscal year 2016 enacted level and $850,000 less than the
fiscal year 2017 budget request.
Centers for Disease Control and Prevention
The Committee recommends a program level of $7,838,802,000
for the Centers for Disease Control and Prevention (CDC), which
is $605,399,000 more than the fiscal year 2016 enacted program
level and $799,598,000 more than the fiscal year 2017 budget
request. This level includes $6,930,502,000 in discretionary
appropriated dollars in conjunction with $908,300,000 in
transfers from the Prevention and Public Health (PPH) Fund. CDC
works with State, local and tribal health authorities and other
non governmental health-related organizations to understand,
control, and reduce public health problems.
In light of the recent crises with both Zika and Ebola, the
Committee has included $300,000,000 within the CDC to form a
new Infectious Diseases Rapid Response Reserve Fund. This
reserve, in which funds will be available until expended, will
provide an immediate source of funding, fully paid for with
annually appropriated dollars, that the Administration could
tap into to quickly respond to a future, imminent infectious
disease crisis that endangers American lives without waiting
for Congress to act on a supplemental funding bill. Funds would
be subject to all existing authorities and limitations.
The Committee recommendation increases support to State,
local, and tribal public health departments for disease areas
such as diabetes. The Committee recommendation also strengthens
heart and stroke prevention activities 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 and state laboratory
capacity. The Committee recommendation also supports flexible
funds for States to address local and tribal public health
issues through the Preventive Health and Health Services Block
Grant. Globally, the recommendation continues support for the
global polio eradication program.
On Zika, the Committee includes $390,000,000 across CDC to
support domestic and supplemental vector control activities;
international and territorial Zika response efforts, and
supports a block grant for States and local communities with
high potential for local Zika transmission to ensure local
officials have flexibility to address local needs.
The Committee expects that unless provided for differently
in the bill or report, CDC will follow the policy, funding
source, and levels described in the fiscal year 2017 budget
request.
The Committee expects CDC to provide public health and
preparedness goals with measures for each program in the fiscal
year 2018 budget request. The Committee appreciates the new
grant table provided in fiscal year 2017 budget request and
requests CDC note any year it changed a formula or plans to
change a formula for grants and provide the percent of funding
for grants with formula funding. The Committee requests a table
in the fiscal year 2018 budget request and future budget
requests with the percentage of funds used to support
intramural activity for each program.
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
burden on States and to reduce CDC's operational costs of its
independent data collection actions. The Committee requests an
update on these activities in the fiscal year 2018 budget
request.
The Committee remains concerned with duplication of effort
and overlapping of responsibilities between NIH and CDC and
requests an update in the fiscal year 2018 budget request on
how CDC programs coordinate with NIH Institutes and Centers
(ICs) to share scientific gaps related to activities supported
in NIH research portfolios.
IMMUNIZATION AND RESPIRATORY DISEASES
The Committee recommends $748,066,000 for Immunization and
Respiratory Diseases (IRD), which includes $410,766,000 in
discretionary appropriations, and $337,300,000 in transfers
from the PPH Fund. This level is $50,339,000 less than the
fiscal year 2016 enacted program level and equal to the fiscal
year 2017 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. The Committee encourages CDC to consider including
vaccines produced through recombinant DNA technology.
Within the total for IRD, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Section 317 Immunization Program..................... $560,508,000
National Immunization Survey..................... 12,864,000
Influenza Planning and Response...................... 187,558,000
------------------------------------------------------------------------
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES AND
TUBERCULOSIS PREVENTION
The Committee recommends $1,122,278,000 for HIV/AIDS, Viral
Hepatitis, Sexually Transmitted Diseases (STD), and
Tuberculosis (TB) prevention in discretionary appropriations,
which is the same as the fiscal year 2016 enacted level and
$5,000,000 less than the fiscal year 2017 budget request.
CDC 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.
The level does not provide support for the requested new pre-
exposure demonstration.
Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, the Committee recommends the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............ $788,712,000
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................................ 33,081,000
Viral Hepatitis...................................... 34,000,000
Sexually Transmitted Diseases........................ 157,310,000
Tuberculosis......................................... 142,256,000
------------------------------------------------------------------------
Hepatitis C (HCV).--The Committee understands the rates of
new HCV infection among American Indians (AI) and Alaska
Natives (AN) continue to rise, far surpassing other
communities. The Committee directs CDC to consider the
development of a grant program specifically for AI and AN
tribes to support prevention and screening efforts.
Furthermore, the Committee requests CDC work with the Indian
Health Service on a targeted action plan to promote HCV
prevention, increased screening, and increased access to
treatment.
HIV Prevention Activities.--The Committee requests an
update in the fiscal year 2018 budget request on steps CDC is
taking and plans to take to improve testing rates and reduce
late stage diagnosis. The update should include steps being
taken to ensure prevention program funds reach the most at risk
individuals to best ensure early detection with targeted
interventions.
Viral Hepatitis Screening.--The Committee continues to
support hepatitis screening activities and urges CDC to
prioritize education programs in medically underserved and
minority communities.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
The Committee recommends $677,522,000 for Emerging and
Zoonotic Infectious Diseases (EZID), which includes
$625,522,000 in discretionary appropriations and $52,000,000
made available from transfers from the PPH Fund. This level is
$97,637,000 more than the fiscal year 2016 enacted program
level and $48,037,000 more than the fiscal year 2017 budget
request program level.
The EZID programs support the prevention and control of
infectious diseases through surveillance, outbreak
investigation and response, research, and prevention. The
recommendation adds a new funding line dedicated to domestic
Zika response and supplemental vector control for States and
local communities to address vector-borne diseases. The request
does not provide the increase requested for refugee support.
Within the total for EZID, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Core Infectious Diseases............................. $490,950,000
Domestic Zika Response and Supplemental Vector 125,000,000
Control.........................................
Emerging Infectious Diseases..................... 125,000,000
Lab Safety and Quality........................... 8,000,000
Antibiotic Resistance Initiative................. 160,000,000
All Other Infectious Diseases.................... 29,840,000
Vector-borne Diseases............................ 26,410,000
Lyme Disease..................................... 10,700,000
Prion Disease.................................... 6,000,000
Food Safety.......................................... 52,000,000
National HealthCare Safety Network................... 21,000,000
Quarantine........................................... 31,572,000
Advanced Molecular Detection......................... 30,000,000
Epidemiology and Laboratory Capacity................. 40,000,000
Healthcare-Associated Infections..................... 12,000,000
------------------------------------------------------------------------
Fungal Diseases (FD).--The Committee notes the threat of FD
such as Cryptococcosis, Histoplasmosis, Aspergillosis,
Candidiasis, and Valley Fever. The Committee requests a report
in the fiscal year 2018 budget request on how CDC is continuing
to monitor and evaluate efforts for early diagnosis and
treatment for fungal infections in collaboration with other
centers and agencies. The Committee urges CDC to work closely
with NIH to identify research opportunities that can lead to
improved diagnostics, treatments, and vaccines. The Committee
expects CDC to conduct close coordination across all its fungal
disease activities to support advances and development of the
next generation of tools to address fungal diseases, and to be
vigilant in monitoring and supporting early diagnosis and
treatment.
Hand Hygiene.--The Committee reiterates its desire for CDC
to improve hand hygiene habits to help prevent the spread of
germs and infectious diseases. The Committee requests an update
in the fiscal year 2018 budget request on CDC's efforts to
incorporate the use of alcohol based hand rubs into hand
hygiene programs outside healthcare, such as schools and
restaurants, to reduce the risk of illness or infection.
CDC Laboratory Safety and Training.--The Committee requests
CDC continue to provide the quarterly reports with the same
information described in the fiscal year 2016 Consolidated
Appropriations Act Explanatory Statement on this topic.
Lyme Disease.--The Committee for years has encouraged CDC
to expand activity and coordination with other agencies to
develop more sensitive and accurate tools and tests for Lyme
disease. CDC is expected to share areas of research with NIH to
coordinate on research efforts. The Committee requests a time
line and implementation plan on activities that may lead to
commercialization of these efforts in the fiscal year 2018
budget request.
Tick-Borne Illnesses.--The Committee is concerned about the
rate of tick-borne illnesses across the country. The Committee
requests an update in the fiscal year 2018 budget request on
the prevalence of tick-borne illnesses, including information
on the geographic distribution with a particular focus on Lyme
disease and Rocky Mountain Spotted Fever. The Committee
encourages CDC to review, in conjunction with primary care
physicians, its website to ensure physician education programs
on Lyme disease include scientific resources and a process to
allow treating physicians to provide feedback on CDC provided
information.
Valley Fever.--The Committee continues to commend CDC and
NIH on the joint efforts to combat Valley Fever, specifically
by conducting a Randomized Controlled Trial (RCT) to identify
an effective treatment. The Committee understands establishing
and conducting a RCT is complex and recognizes the effort NIH
and CDC have committed to this project. The Committee requests
an update in the fiscal year 2018 budget request on these
efforts. Further, the Committee encourages development of early
diagnostic tests and supports efforts to increase awareness of
this disease among medical professionals and the public.
Vector Borne Disease Program (VBDP).--The Committee
continues to support the critical role CDC and its VBDP play to
prepare for and fight emerging tropical diseases, such as
Dengue, Chikungunya, and Zika. The groundwork laid in the CDC's
efforts on Dengue and Chikungunya will be critical to fighting
Zika.
Vector Control Guidelines to Reduce the Spread of Disease-
Carrying Insects.--The Committee requests CDC develop and
maintain an online guideline for use by States and local
communities with a full scope of vector control options, tools,
and other factors State and local jurisdictions may consider as
they develop plans to carry out vector control activities to
control Zika and other related diseases carried by insects. The
Committee expects the document to be available online within 60
days after enactment and updated at least annually.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
The Committee recommends $1,097,821,000 for Chronic Disease
Prevention and Health Promotion (CDPHP), which includes
$896,321,000 in discretionary appropriations and $201,500,000
made available from transfers from the PPH Fund. This level is
$79,275,000 less than the fiscal year 2016 enacted program
level and $19,324,000 less than the fiscal year 2017 budget
request program level. The CDPHP programs provide support for
State, tribal, and community programs on surveillance,
prevention research, evaluation, and health promotion.
Within the total provided, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Tobacco.............................................. $100,000,000
Nutrition, Physical Activity, and Obesity............ 49,920,000
High Obesity Rate Counties....................... 10,000,000
School Health........................................ 15,400,000
Health Promotion..................................... 14,525,000
Glaucoma......................................... 3,300,000
Visual Screening Education....................... 525,000
Alzheimer's Disease.............................. 4,000,000
Inflammatory Bowel Disease....................... 750,000
Interstitial Cystitis............................ 850,000
Excessive Alcohol Use............................ 3,000,000
Chronic Kidney Disease........................... 2,100,000
Prevention Research Centers.......................... 25,461,000
Heart Disease and Stroke............................. 175,000,000
Diabetes............................................. 185,000,000
National Diabetes Prevention Program................. 25,000,000
Cancer Prevention and Control........................ 352,515,000
Breast and Cervical Cancer....................... 210,000,000
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............................. 22,600,000
Johanna's Law.................................... 5,500,000
Ovarian Cancer................................... 7,500,000
Prostate Cancer.................................. 13,000,000
Oral Health.......................................... 18,000,000
Safe Motherhood/Infant Health........................ 46,000,000
Preterm Birth.................................... 2,000,000
Other Chronic Diseases............................... 25,000,000
Arthritis........................................ 11,000,000
Epilepsy......................................... 8,000,000
National Lupus Patient Registry.................. 6,000,000
Racial and Ethnic Approach to Community Health....... 30,000,000
Million Hearts....................................... 4,000,000
National Early Child Care Collaboratives............. 4,000,000
Hospitals Promoting Breastfeeding.................... 8,000,000
Good Health and Wellness in Indian Country........... 20,000,000
------------------------------------------------------------------------
Atopic Dermatitis (AD).--The Committee understands AD is a
severe and long-lasting form of eczema that is a potentially
debilitating condition. The Committee understands gaps in data
on AD exists that inhibit research. The Committee encourages
CDC, in collaboration with the National Center for Health
Statistics and NIH to coordinate on a report, to be included in
the fiscal year 2018 budget request, on their efforts to
identify the knowledge gaps related to AD and how they could
support efforts to obtain data to fill these gaps.
Alzheimer's Disease.--The Committee provides an increase to
support the Healthy Brain Initiative, of which the Committee
expects the increase will be dedicated to assisting States in
collecting cognitive decline and caregiving data through the
Behavioral Risk Factor Surveillance System in all 50 States,
the District of Columbia, and Puerto Rico. Additionally, the
Committee requests the fiscal year 2018 budget request include
a plan to implement the Healthy Brain Initiative's Public
Health Roadmap for State and National Partnerships.
Burden of Disease.--The Committee reiterates the desire for
CDPHP programs to expand the use of burden of disease as a
significant consideration in resource decisions. Specifically,
the request for applications should have applicants identify
the level of community burden reduction expected with funding
and funded applicants should track, monitor, and report
reductions over time where possible.
Cancer Survivorship.--The Committee continues to encourage
CDC, in coordination with NIH, to identify evidence-based
physical activity and wellness programs that can be used
throughout the health care and public health sector for cancer
survivors. The Committee requests a joint CDC and NIH update in
the fiscal year 2018 budget request on research and public
health programs related to this issue.
Comprehensive Cancer.--The Committee increased support for
Comprehensive Cancer and consolidates activity previously
supported in the ``Skin Cancer'' and ``Cancer Survivorship
Resource Center'' programs to provide CDC with more flexibility
to support these programs within a larger combined program.
Division of Diabetes Translation (DDT).--The Committee
expects the DDT to address the diabetes epidemic through
education to provide Americans with knowledge that leads to the
prevention of diabetes. The Committee reiterates its support
for the DDT to leverage Federal resources with public and
private organizations to prevent and reduce diabetes in
Americans. The Committee requests a report in the fiscal year
2018 budget request that describes the DDT's plan and on-going
actions to further use population-adjusted burden of disease as
the key criteria in awarding funds. The Committee urges a
significant focus of resources on efforts to expand State,
local, and tribal community diabetes control and prevention
activities. The Committee expects CDC will specifically
evaluate how to ensure programs support rural communities with
a high burden of disease that may have more limited access to
other prevention and outreach programs to control or prevent
diabetes. Additionally, the report shall describe how the DDT
translates research into better prevention and care with its
programs.
Division of Oral Health (DOH).--The Committee expects the
DOH to distribute new waterline safety guidelines to dentist
offices and clinics, to coordinate with NIH to conduct follow
up research where needed, and for CDC to work with professional
organizations to educate dentists and dental students of such
guidelines.
Diabetes.--The Committee has provided a significant
increase for Diabetes prevention and control activities. The
Committee expects the increase to go directly to communities
with the highest burden of disease to support scientifically
validated risk factor reduction measures through competitive
awards. The Committee requests a report in the fiscal year 2018
budget request on the amount of CDC diabetes support provided
to State, local, and tribal communities and the expected impact
on these communities.
Good Health and Wellness in Indian Country.--The Committee
appreciates the new five-year cooperative agreement to develop
a comprehensive approach to good health and wellness in Indian
Country. This population is disproportionately affected by
chronic disease compared to other racial and ethnic groups in
the United States. The Committee notes the program support is
in addition to and should not supplant existing funds provided
by other CDC activities. CDC is expected to build on these
existing programs within Indian Country to allow for a more
comprehensive public health infrastructure in tribal
communities and the ability to develop mechanisms to improve
good health and wellness in Indian Country.
Heart Disease and Stroke.--The Committee provides an
increase to support heart disease and stroke prevention at
State, local and tribal public health departments. The
Committee expects the increase to go directly to communities
with the highest burden of disease to support scientifically
validated risk factor reduction measures through competitive
awards. The Committee requests a report in the fiscal year 2018
budget request on how the heart disease and stroke funds
provided to communities are expected to impact those with the
highest disease burden.
Preterm Birth.--The Committee commends CDC for funding six
State-based perinatal collaboratives that focus on improving
birth outcomes and improving maternal health and safety using
known prevention strategies including reducing early elective
deliveries. The Committee encourages CDC to consider, through
support, coordination with other center programs, States, and
public-private partnerships, ways to identify, measure, and
evaluate the effectiveness of the program to increase the
number of States receiving assistance for perinatal
collaboratives.
Prostate Cancer.--The Committee encourages CDC and NIH to
examine how to develop a joint public-private partnership to
reduce the prevalence of prostate cancer in African-American
men. Specifically, CDC and NIH should consider how to develop
support via coordinated meritorious scientific competitive
research and public health outreach awards. The Committee
requests CDC and NIH provide a joint report on this potential
type of effort with a notional timeline and expected outcome
measures in the fiscal year 2018 budget request on these
efforts.
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 focus primarily on underage smoking.
Lung Cancer.--The Committee directs the CDC tobacco program
to ensure its activity includes a program to expand the
knowledge to high-risk populations on the value of early
detection of lung cancer through screening. The activity should
work in conjunction with local public health departments,
medical providers, insurers, and other public/private partners
to ensure appropriate education and awareness is targeted
through measurable means to high-risk communities. The
Committee requests an update in the fiscal year 2018 budget
request on the education and coordination activities CDC is
supporting with other Federal and non-Federal partners to
encourage screening in high-risk groups.
Inflammatory Bowel Disease (IBD).--The Committee continues
to support IBD epidemiology activity and requests an update in
the fiscal year 2018 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 Diabetes Prevention Program (NDPP).--The Committee
was disappointed that not all new fiscal year 2016 funds were
competitively awarded to new awards as requested in the fiscal
year 2017 Consolidated Appropriation Act Explanatory Statement.
The Committee continues to strongly support the successful NDPP
and directs all new funds provided in fiscal year 2016 and 2017
support an increase in the number of new competitively awarded
program providers. Specifically, the focus should be on rural
providers where the risk and burden of diabetes is greater, and
where the program has the potential for the biggest impact. The
Committee understands models exist for pairing the capacity of
existing program providers with program delivery areas that
lack sufficient resources to operate the program. The Committee
requests an update in the fiscal year 2018 budget request on
how these resources are being used for the provided purposes,
how observable weight measure is being maintained, and how
peer-reviewed science compares virtual providers to face-to-
face providers. The Committee requests CDC include long-term
public health measures and how this program coordinates with
other CDC and Department of Health and Human Services (HHS)
programs. The Committee also requests the total amount of
Federal, public and private sector funds leveraged to support
the NDDP annually in the fiscal year 2018 budget request and in
future budget requests.
Obesity.--The Committee continues support for the rural
extension and outreach services program to support grants for
rural counties with an obesity prevalence of over 40 percent.
The Committee expects support for childhood obesity
interventions based on scientific evidence 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. The Committee
understands the need to maximize impact of these funds, for
this reason and to assure coordination with other activities,
CDC should allocate maximum dollars to State programs.
Pulmonary Hypertension (PH).--The Committee encourages CDC
to continue to support education, outreach, and awareness to
promote early diagnosis of PH.
Special Interest Projects (SIPs).--The Committee requests
an update in the fiscal year 2018 budget request showing the
steps taken to competitively award SIPs. The Committee
continues to support CDC's 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 may be
duplicative with work ongoing in other Federal agencies, such
as the Federal Trade Commission (FTC) and NIH. The Committee
requests an update in the fiscal year 2018 budget request on
steps CDC is taking to reduce overlap and duplication in this
area.
BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES
The Committee recommends $135,310,000 for Birth Defects and
Developmental Disabilities (BDDD) program level in
discretionary appropriations, which is $300,000 less than the
fiscal year 2016 enacted level and the fiscal year 2017 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:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Child Health and Development......................... $65,800,000
Birth Defects.................................... 19,000,000
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.. 54,710,000
Disability & Health incl. Child Development...... 22,050,000
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........ 4,400,000
Hemophilia Activities............................ 3,400,000
Hemophilia Treatment Centers..................... 5,000,000
Thalassemia Blood Disorders...................... 2,000,000
------------------------------------------------------------------------
Duchenne Muscular Dystrophy (DMD).--The Committee continues
to support on-going activities to improve DMD newborn screening
outreach. The Committee encourages CDC to examine how its
centers, divisions, and public-private organizations can better
leverage Federal funds to increase education, knowledge, and
other outreach activities to foster screening. Additionally,
the Committee requests an update in the fiscal year 2018 budget
request on these efforts. It should include information on
steps CDC is taking or plans to take to disseminate information
on newborn screening and care for adults and newborns with
Duchenne and for other forms of muscular dystrophy.
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 systematically coordinate with NIH and the FXD Clinical
and Research Consortium. The Committee understands a recent
public-private partnership meeting resulted in a focus on
longitudinal data to characterize the natural history of
Fragile X and encourages CDC to actively coordinate with NIH to
support research through NIH's peer review process while CDC
focuses on public health translational aspects. The Committee
requests CDC and NIH provide a joint update in the fiscal year
2018 budget request on how the agencies support cross-agency
opportunities to accelerate high quality data driven science to
reduce the burden of both FXD and autism.
Surveillance.--The Committee expects CDC and NIH to jointly
expand their coordination and sharing of CDC's birth defects
surveillance and NIH's research portfolio to accelerate
understanding of birth defects. The Committee specifically
expects CDC and NIH to work closely on surveillance related to
potential Zika virus-related birth defects and future NIH
supported research. The NIH and CDC coordination should include
microcephaly surveillance, technical assistance, and research,
as appropriate. The Committee requests an update in the fiscal
year 2018 budget request on the Birth Defects Study to Evaluate
Pregnancy Exposures, which seeks to identify birth defects
causes and risk factors.
Thalassemia.--The Committee continues support for CDC's
Thalassemia activities. The Committee requests an update in the
fiscal year 2018 budget request on how the program supports
communications strategies, educational tools to enhance public
and provider awareness, and knowledge about Thalassemia
prevention and treatment practices.
PUBLIC HEALTH SCIENTIFIC SERVICES
The Committee recommends $485,397,000 for the Public Health
Scientific Services (PHSS) program level with discretionary
funds, which includes funds for the National Center for Health
Statistics. The level is $6,200,000 less than the fiscal year
2016 enacted program level and $15,234,000 less than the fiscal
year 2017 budget request program level.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Health Statistics.................................... $160,397,000
Surveillance, Epidemiology, and Informatics.......... 280,000,000
Laboratory Training and Oversight................ 5,000,000
Public Health Workforce.............................. 45,000,000
------------------------------------------------------------------------
Public Health Preparedness.--State and local public health
response capabilities are critical for effective all-hazards
response. In local jurisdictions, these capabilities are used
routinely for isolated events and local disease outbreaks, as
well as outbreaks of national significance, creating a
proficiency in local public health systems nationwide. State
and local public health departments closely coordinate public
health and healthcare system emergency preparedness and
response capabilities and routinely test response systems in
tandem. Continued erosion of State public health and healthcare
system response infrastructure, including redirection of
funding into disease specific response efforts at the Federal
level, threaten to significantly weaken response capacity at
the State and local level. Funding should continue to be
provided to develop and maintain State public health and
healthcare response infrastructure as an all-hazards,
capability driven approach. The Committee expects CDC to
continue robust support for the public health preparedness
program.
ENVIRONMENTAL HEALTH
The Committee recommends $160,800,000 for Environmental
Health (EH), which includes $143,300,000 in discretionary
appropriations and $17,500,000 made available from transfer
from the PPH Fund. This level is $21,503,000 less than the
fiscal year 2016 enacted level and the fiscal year 2017 budget
request program level. The EH 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:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Environmental Health Laboratory...................... $56,300,000
Newborn Screening Quality Assurance Program...... 8,500,000
Newborn Screening/Severe Combined 1,300,000
Immunodeficiency Diseases.......................
Environmental Health Activities...................... 24,000,000
Environmental Health Activities.................. 15,000,000
Safe Water....................................... 9,000,000
Amyotrophic Lateral Sclerosis (ALS) Registry..... 10,000,000
Environmental and Health Outcome Tracking Network.... 24,000,000
Asthma............................................... 29,000,000
Childhood Lead Poisoning............................. 17,500,000
------------------------------------------------------------------------
Algal Blooms.--The Committee supports the work that CDC is
doing to conduct surveillance for and report health concerns
related to harmful algal blooms and urges CDC to continue this
work and (1) to provide more outreach to State and local public
health officials to use these surveillance and reporting
systems and (2) to work with other agencies, including EPA,
NOAA, and USGS, to integrate disparate sets of data to allow
for a broader understanding of the spatial and temporal
dynamics of the environmental and health impacts of harmful
algal blooms.
Asthma.--The Committee encourages CDC to explore methods to
increase the number of States carrying out programmatic
activities. The Committee encourages CDC to use a population-
adjusted burden of disease criteria as a significant factor for
new competitive awards. The Committee requests a report in the
fiscal year 2018 budget request detailing the competitive
process.
Newborn Screening Quality Assurance Program.--The Committee
understands HHS recommendations are based on evaluations
conducted by the Advisory Committee on Heritable Disorders in
Newborns and Children with approved conditions compiled in a
``Recommended Uniform Screening Panel'' (RUSP). Most States
screen for the overwhelming majority of the disorders listed on
the RUSP but it can take several years for States to add new
conditions. The Committee requests CDC provide an update in the
fiscal year 2018 budget request on actions planned and on-going
to work with States on ways to ensure screening of infants for
diseases for which there is a preventable and/or effective
treatment. Further, the update should note what steps can be
taken to encourage States to adopt and implement new RUSP
conditions within one year of their addition.
Vitamin D.--The Committee is aware some epidemiological
studies connect the lack of vitamin D to increased risk of
death from cardiovascular disease, colon cancer, breast cancer,
and other diseases. In 2010, a report by the Institute of
Medicine (IOM) found that the recommended daily intakes of
vitamin D supplements did not provide any health benefit other
bone health. The Committee directs CDC to charter a National
Academies of Sciences comprehensive study on the link between
vitamin D and other health benefits of sun exposure; vitamin D
supplements' efficacy compared to non-burning sunshine; and the
issue of sunburns as the trigger for melanoma as opposed to
non-burning sunshine. The report shall include recommendations
for follow-on research where a lack of evidence is available
and public health recommendations, if based on sound high
quality peer-reviewed scientific evidence.
Climate Change.--The Committee does not provide support for
CDC's Climate Change program. The Committee provides funding
for programs that allow CDC to focus on more direct public
health activities.
INJURY PREVENTION AND CONTROL
The Committee recommends $261,059,000 for Injury Prevention
and Control (IPC) program level in discretionary funds, which
is $25,000,000 more than the fiscal year 2016 enacted program
level and $7,570,000 less than the fiscal year 2017 budget
request program level. The 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:
------------------------------------------------------------------------
Budget Activity FY 2017 Committee
------------------------------------------------------------------------
Intentional Injury................................... $97,730,000
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.................................. 44,430,000
National Violent Death Reporting System.............. 16,000,000
Unintentional Injury................................. 8,800,000
Traumatic Brain Injury........................... 6,750,000
Elderly Falls.................................... 2,050,000
Injury Prevention Activities......................... 28,950,000
Prescription Drug Overdose........................... 90,000,000
Rx Guidelines Distribution........................... 5,000,000
Illicit Opioid Use Risk Factors...................... 5,579,000
Injury Control Research Centers...................... 9,000,000
------------------------------------------------------------------------
Gun Research.--The Committee continues the general
provision to prevent any funds from being used to advocate or
promote gun control. The Committee does not include funding for
the proposed Gun Violence Prevention Research.
Injury Control Research Centers.--The Committee provides
support within the Injury Prevention Activities line to support
activities such as core operations, evaluation of injury
control interventions, and training activities within the
injury control research centers.
Prescription Drug Overdose (PDO) Prevention Activity.--The
Committee commends CDC for its leadership on combatting
prescription and opioid drug overdoses. The Committee provides
an increase and expects the Director to implement these
activities based on population-adjusted burden of disease
criteria, including mortality data (age adjusted rate), as
significant criteria when distributing funds for the State PDO
Prevention activities. The Committee assumes these funds will
be distributed via a competitive mechanism and not merely a
mathematical formula or standard allocation to each State.
Further, the Committee strongly encourages CDC to support local
prevention activity to determine the effectiveness of
naltrexone in treating heroin and prescription drug abuse and
reducing diversion of buprenorphine for illicit purposes.
Mandatory Funds.--The Committee does not provide support
for the requested mandatory funded initiatives.
National Vital Statistics System (NVSS).--The Committee
continues support for the NVSS which provides data on births,
deaths, and fetal deaths. The Committee is aware most States
now or will soon have operational electronic birth and death
registration systems, an essential tool in monitoring public
health and fighting waste, fraud, and abuse in Federal
entitlement programs. The Committee requests CDC ensure the
modernization of the CDC system to ensure interoperability with
state systems.
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.
Traumatic Brain Injury (TBI).--The Committee continues to
support CDC's TBI efforts and encourages the Director to
prioritize efforts on American children and youth education,
outreach, and similar public health activities.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
The Committee recommends $329,100,000 for the National
Institute for Occupational Safety and Health (NIOSH) program
level with discretionary appropriations, which is $10,021,000
less than the fiscal year 2016 enacted program level and
$43,479,000 more than the fiscal year 2017 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 NISOH, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
National Occupational Research Agenda................ $116,500,000
Agricultural, Forestry, and Fishing.............. 26,000,000
Education and Research Centers....................... 29,500,000
Personal Protective Technology....................... 20,000,000
Mining Research...................................... 62,000,000
National Mesothelioma Registry and Tissue Bank....... 1,100,000
Other Occupational Safety and Health Research........ 100,000,000
------------------------------------------------------------------------
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 2016 enacted funding level and the fiscal year 2017
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 $556,721,000 for Global Health
(GH) with discretionary appropriations, which is $129,600,000
more than the fiscal year 2016 enacted level and $114,600,000
more than the fiscal year 2017 budget request. Through its GH
activities, CDC coordinates, cooperates, participates with, and
provides consultation to other nations, Federal 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.
The Committee adds a new funding line dedicated to
international and territorial Zika response to address vector-
borne disease control to prevent the spread of Zika in the
United States and its territories. The Committee expects these
funds to supplement, not supplant, existing vector control
activities and to be part of a CDC-wide plan that works with
States and territories to prevent Zika from impacting
Americans.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Global AIDS Program.................................. $128,421,000
Global Immunization Program.......................... 224,000,000
Polio Eradication.................................. 174,000,000
Other Global/Measles............................... 50,000,000
Parasitic Diseases and Malaria....................... 24,500,000
Global Disease Detection and Emergency Response...... 45,000,000
Global Public Health Capacity Development............ 9,800,000
International and Territorial Zika Response.......... 125,000,000
------------------------------------------------------------------------
Global Health Strategy.--The Committee requests an update
on how CDC, the Food and Drug Administration, 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 a separate
detailed operating plan for all international activities funded
through all CDC programs be included in the fiscal year 2018
budget request and future budget requests.
Neglected Fungal Diseases (NFD).--The Committee encourages
CDC to continue to monitor and evaluate efforts for NFD in
collaboration with other centers and agencies. The Committee
encourages CDC to work closely with Office of Global AIDS
Coordinator (OGAC) on the early diagnosis and treatment
strategies for NFD. The Committee requests an update in the
fiscal year 2018 budget request on the activities it is
undertaking with OGAC to expand early diagnosis strategies for
NFD.
Polio Infrastructure.--The Committee notes the value of the
polio eradication infrastructure as a tool to strengthen global
immunization programs. The Committee understands the
infrastructure and international collaboration can serve as a
catalyst to support other future public health immunization
programs. The Committee requests a report in the fiscal year
2018 budget request describing the processes and policies in-
place to leverage the polio investments to expand global public
health immunization gains. The report should identify a list of
potential diseases and criteria CDC's partners can consider if
a follow-on eradication project is appropriate. It should
include the potential criteria, diseases, impact, cost,
timeline, and steps required to leverage the infrastructure for
another eradication--if feasible.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
The Committee recommends $1,485,800,000 for Public Health
Preparedness and Response (PHPR) in discretionary
appropriations, which is $80,800,000 more than the fiscal year
2016 enacted level and $83,634,000 more than the fiscal year
2017 budget request. CDC distributes grants to State, local,
tribal, and territorial public health agencies. The PHPR
supports capabilities and 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, support training,
strengthening epidemiology and surveillance, and upgrade
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:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
State and Local Preparedness and Response Capability. $714,000,000
Public Health Emergency Preparedness Cooperative 705,000,000
Agreement.......................................
Academic Centers for Public Health Preparedness.. 9,000,000
CDC Preparedness and Response........................ 161,800,000
BioSense......................................... 23,000,000
Select Agent..................................... 5,000,000
All Other CDC Preparedness and Response.......... 133,800,000
Strategic National Stockpile (SNS)................... 610,000,000
------------------------------------------------------------------------
Health Care Resources in an Emergency.--The Committee is
aware that CDC and the Assistant Secretary for Preparedness and
Response (ASPR) will issue new five-year guidance for the joint
Hospital Preparedness Program (HPP) and Public Health Emergency
Preparedness (PHEP) grants to States. The Committee expects the
guidance will further advance the cross-agency program
alignment with grant conditions that make meaningful progress
on secure communications, improved real-time resource reporting
(e.g. available bed types, types of facilities like dialysis,
emergency rooms, etc.) to strengthen the reporting of health
care resources and improve patient tracking. Further, CDC and
ASPR are expected to expand cross-agency coordination
activities to improve health care preparedness and response
capacity between the PEHP and HPP programs.
Public Health Emergency Preparedness (PHEP) Cooperative
Agreement Program.--The Committee has increased funding to
restore PHEP capacity lost based on the Secretary's decision to
transfer funds from this preparedness program in 2016. CDC
should work to ensure States have the tools to quickly detect,
monitor, and respond to health threats. The Committee requests
CDC explain in the fiscal year 2018 budget request how State
PHEP funding is supporting capacity building at the State,
tribal, and local levels. The CDC is expected to track PHEP
capacity goals via the PHEP index capabilities tool and work
with participants to agree on cooperative agreement objectives
for each State. The Committee requests an update in the fiscal
year 2018 budget request on how CDC is implementing the PHEP
index capacity measures.
SNS Replenishment of Medical Countermeasures.--The
Committee is concerned the budget request for the SNS is
inadequate for acquisition and replenishment of the vaccines
and other medical countermeasures with limited or no commercial
markets but necessary for emergency response. The Committee is
equally concerned with CDC's management of these public-private
partnerships relationships. The CDC should increase efforts to
work closely with their business partners on planning,
developing requirements, and execution of current contracts to
take into consideration business continuity. The Committee
recognizes the significant government investment in the
development and approval of these countermeasures and notes it
is critical for HHS to support appropriate acquisition,
replenishment and assure business continuity within the public-
private partnerships that develop and support a manufacturing
base for these countermeasures. The Committee recommendation
therefore includes an increase to the SNS.
BUILDINGS AND FACILITIES
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $10,000,000 for CDC buildings and
facilities in discretionary appropriations, which is equal to
the fiscal year 2016 enacted level and is $21,221,000 less than
the fiscal year 2017 budget request level. In addition, the
Committee continues the language from fiscal year 2016 to allow
CDC to retain unobligated funds in the Individual Learning
Accounts from departed employees to support the replacement of
the underground and surface coalmine safety and health research
capacity facility.
The Committee requests an update in the fiscal year 2018
budget request on the facility support for the NIOSH Taft and
Hamilton facilities that are becoming obsolete.
Underground Mine Safety.--The Committee appreciates CDC's
steps to re-establish the mine explosive research capacity. The
Committee directs CDC to move forward as quickly as feasible to
bring back on-line this capability needed to support mine
safety research. The Committee requests an updated plan and
timeline to expedite the construction schedule and an estimate
of the cost for construction, equipment and machinery in the
fiscal year 2018 budget request. The Committee does not expect
CDC 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 this project.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
The Committee recommends $713,570,000 for CDC-Wide
Activities and Program Support, which includes $413,570,000 in
discretionary funds and $300,000,000 made available from
transfers from the PPH Fund. This level is $440,000,000 more
than the fiscal year 2016 comparable enacted program level and
$600,000,000 more than the fiscal year 2017 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.
In light of the recent crises with both Zika and Ebola, the
Committee has included $300,000,000 within the CDC to form a
new Infectious Diseases Rapid Response Reserve Fund. This
reserve, in which funds will be available until expended, will
provide an immediate source of funding, fully paid for with
annually appropriated dollars, that the Administration could
tap into to quickly respond to a future, imminent infectious
disease crisis that endangers American lives without waiting
for Congress to act on a supplemental funding bill. Funds would
be subject to all existing authorities and limitations.
The Committee adds a new funding line of Zika block grants
specific for States to support counties with high potential for
local Zika transmission with flexible funds to support vector-
borne disease control and to respond to, prepare for, or
prevent the spread of Zika in the United States. The Committee
expects these funds to supplement, not supplant, existing
vector control activities. The Committee expects CDC to
coordinate with State, local, and tribal public health
officials to develop the criteria for this program. The
Committee expects criteria to include measurable objectives
related to the Federal, State, and local plans. The Committee
requests a report within 30 days after enactment on the
coordinated criteria and process CDC will use in the upcoming
year for awarding grants to States with counties that have the
highest potential for local transmission. The report should
include the projected funding level expected for each State,
counties within a State, and tribal areas that meet these
criteria. The Committee anticipates the composition of
recipients in this program to change over time. The Committee
expects the CDC PHHSBG program office to provide the oversight,
reporting, and program management of this new program within
the Public Health Leadership and Support funding line but not
from these new funds.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Preventive Health and Health Services Block Grant.... $160,000,000
Block Grant--Counties with High Potential for Local 140,000,000
Zika Transmission...................................
Infectious Disease Rapid Response Reserve Fund....... 300,000,000
Public Health Leadership and Support................. 113,570,000
------------------------------------------------------------------------
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 $160,000,000. The Committee expects CDC to provide these
flexible funds to State public health agencies. States should
work with local and tribal public health agencies to use these
resources to address its most critical public health needs
through measurable evidence-based activities.
Public Health Leadership and Support
The Committee expects the fiscal year 2018 budget 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. For each
office and function, the Committee expects the budget to
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 2018 budget request describing CDC's current
mechanisms and process to prevent advocacy violations. Further,
CDC should describe its on-going efforts to educate its staff
and grant recipients to prevent violations.
Burden of Disease Review.--The Committee appreciates CDCs
efforts to provide information online about the health profiles
for all 3,143 counties in the United States and willingness to
start engaging in how CDC can expand the use of burden of
disease as a more significant factor for funding allocations
and awards. The Committee requests a timeline and update in the
fiscal year 2018 budget request on actions to more broadly use
burden of disease (adjusted for population as appropriate) as a
significant program factor for funding allocations and awards
in CDC public health programs and activities.
Director's Discretionary Funds (DDF).--The Committee
requests, within 30 days after the end of each quarter, a
quarterly report on DDF obligations and each activity supported
with a description of the activity, and how it supports a high
priority. Further, the quarterly reports should be posted
online via the CDC website within 30 days after being released
to the Committee.
Service Contract Inventories.--The Consolidated
Appropriations Act, 2010, requires agencies to annually submit
to the Office of Management and Budget (OMB) an inventory of
service contracts by December 31 of each year. The Committee
requests CDC provide an update in the fiscal year 2018 budget
request summarizing the latest annual report submitted to OMB.
Standard of CDC Excellence.--The CDC should be an example
of excellence and should meet the highest standards in safety,
quality, and compliance. The Committee expects CDC to review
its policies and begin tangible steps to adopt commonly
accepted best practices and rules governing research and
laboratory practice programs. CDC is expected to ensure
appropriate regulatory requirements are uniformly applied and
to meet or exceed minimum requirements for any research or
laboratory facility. The Committee expects CDC to adhere to all
regulatory requirements in all CDC operations.
State Public Health Laboratories.--State public health
laboratories play an integral role in public health
surveillance activities including outbreak detection, disease
surveillance, case finding, and local identification of select
agents. This critical infrastructure serves the needs of the
local community while participating in and providing necessary
information to scalable laboratory networks and surveillance
systems. Advancements in laboratory technology have enhanced
the capabilities of State laboratories and broadened their role
in local protection of community health threats. While certain
rare, exceptionally low volume and cost prohibitive testing
capabilities may be developed and maintained through national
or regional laboratory networks, investments in State
laboratories must continue as a first line of defense for our
public health system. The Committee expects CDC to continue and
enhance public health funding for State public health
laboratory testing technology, training and infrastructure.
Sodium Reduction Activity grants.--The Committee notes CDC
has identified sodium, among three other nutrients, for an
updated Dietary Reference Intake (DRI). The Committee is
concerned CDC has put out a request for proposals for grants
targeting sodium reduction activities that may not be
consistent with completed DRI. Bill language is included
directing completion of a DRI on sodium before funds are spent
on population-wide sodium reduction activities.
Updates.--In addition the specific items of interest noted
above, the Committee requests general updates in the fiscal
year 2018 budget request for each of the listed topics, the
updates should describe both ongoing and planned efforts:
Cancer Survivorship;
Catheter Associated Urinary Tract Infections;
Chronic Obstructive Pulmonary Disease;
Chronic Pain;
Concussion Surveillance;
Cross-Border Disease Control;
Early Childcare Collaboratives;
Fragile X;
Harmonization of Lab Tests;
High Obesity Counties Program Dissemination of Results;
Immunization Information Systems;
Inflammatory Bowel Diseases;
Malaria and Parasitic Disease Program;
Mississippi Delta Health Collaborative;
Muscular Dystrophy Surveillance;
Musculoskeletal Health;
National Mesothelioma Patient Registry;
Physical Activity and Disability;
Prevalence of Hydrocephalus;
Primary Immunodeficiency;
Public Health Approach to Blood Disorders;
Sepsis;
Spina Bifida;
Tribal Epidemiology Centers;
Tuberculosis (TB) & TB Elimination;
Tuberous Sclerosis Complex; and
Vision Health Initiative.
National Institutes of Health
The Committee recommends $33,334,000,000 for the National
Institutes of Health (NIH), which is $1,250,000,000 above the
fiscal year 2016 enacted level, $2,250,000,000 above the fiscal
year 2017 budget request. This level includes $32,542,402,000
in discretionary appropriations and $791,598,000,000 in PHS Act
section 241 evaluation set-aside (TAP) transfers. Consistent
with the fiscal year 2016 appropriations, all of 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.
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 recommendation provides an increase of $100,000,000 for
the Precision Medicine Initiative (PMI); an increase of
$350,000,000 for Alzheimer's disease research; an increase of
$45,000,000 for the Brain Research through Application of
Innovative Neurotechnologies (BRAIN) Initiative; and increases
to every Institute and Center (IC) to support innovative
extramural basic research to advance fundamental knowledge and
speed the development of new therapies and diagnostics to
improve the health of all Americans.
The Committee strongly supports the goals of the Cancer
Moonshot initiative, to find cures for cancer and to reduce
cancer mortality in the United States. While death rates have
declined for all cancers combined, the disease continues to
have a devastating impact on too many families. In fiscal year
2016, NIH expected to spend $5,700,000,000 on cancer research.
The Committee continues the $195,000,000 used in fiscal year
2016 for this initiative. The Committee looks forward to the
Cancer Moonshot spending details once the taskforce completes
its work at the end of the calendar year.
The Committee expects the 3.9 percent increase of funds
over the fiscal year 2016 level to support a success rate of no
less than 20 percent with at least 11,175 new Research Project
Grants (RPGs). The Committee strongly urges NIH to restore
extramural support to at least 90 percent of all NIH funding.
Further, NIH shall continue its focus on emerging investigators
and first-time renewals of these young investigators with
actions to significantly reduce the average age of an NIH-
supported new investigator. NIH is expected to support a
consistent NIH-wide inflationary policy across all ICs that is
no less than the general increase provided to all ICs (2.5
percent) for non-competing grants. The Committee expects NIH to
support an increased number of Ruth L. Kirschstein National
Research Service Awards and other training grants in proportion
to at least the general IC level funding increase. NIH is also
expected to provide a stipend level increase to training
grantees that is consistent with any fiscal year 2017 Federal
employee pay raise.
The Committee appreciates the NIH-wide portfolio analysis
and strategic planning process. The Committee anticipates NIH
will use these tools to ensure grants are connected to the core
mission and priorities prior to grant award. Further, NIH is
directed to ensure funded projects adhere to the scope of the
original award.
The bill continues to provide specific funding levels for
the Clinical and Translational Science Awards (CTSA) program,
the Institutional Development Awards (IDeA) program, Cures
Acceleration Network, Common Fund (CF), and the follow-on to
the National Children's Study (NCS) with bill language.
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.
Breast Cancer.--The Committee understands a new Food and
Drug Administration approved technology is available for breast
cancer screening, called tomosynthesis (TM). The Committee
encourages NCI to continue their vital research to help provide
breast cancer patients and their physicians with a clear,
informed picture of how breast cancer imaging should be
considered for women's health. The Committee requests an update
describing planned and on-going research related to TM
technology and if any cohort studies are on-going and planned
on TM imaging.
Colorectal Cancer.--The Committee encourages support of
meritorious scientific research on colorectal cancer to better
understand the biology of young-onset colorectal cancer. The
Committee encourages additional research on the developmental
pathway of colorectal cancer among patients with inflammatory
bowel diseases.
Deadliest Cancers.--While overall cancer incidence and
death rates are declining, the Committee is concerned that
there are a group of cancers, defined in statute as
recalcitrant cancers, whose five-year survival rates remains
below 50 percent. Estimates are that half of cancer deaths are
caused by eight site-specific cancers that meet this
definition: pancreatic, liver, ovarian, myeloma, brain,
stomach, esophagus and lung. The Committee applauds the NCI for
launching the Molecular Analysis for Therapy Choice (MATCH), a
potentially ground-breaking trial that analyzes patients'
tumors to determine whether they contain genetic abnormalities
for which a targeted drug exists and assigns treatment based on
the abnormality. The goal for MATCH is for at least 25 percent
of the patients enrolled in the trial to have rare cancers.
Given the growing toll recalcitrant cancers take on society,
and the enormous potential MATCH offers for our Nation's
deadliest cancers, the Committee strongly urges NCI to increase
the set-aside goal and to broaden it to include recalcitrant
cancers.
Immunotherapy for Childhood Cancers.--The Committee
encourages NCI to continue to further explore new
interventions, such as immunotherapy, as a promising new
treatment strategy for children with cancer.
International Agency for Research on Cancer (IARC).--The
Committee recognizes that understanding the relationship among
chemical agents and other hazardous substances and cancer is an
important area of research. The Committee requests an update on
NIH support for the IARC on Cancer Monographs on the Evaluation
of Carcinogenic Risks to Humans.
Melanoma.--The Committee encourages consideration of a
coordinated effort to analyze bio specimens across clinical
trials. The Committee continues to encourage efforts to use
advances in genomic, proteomic and digital imaging technologies
for early detection research to understand genetic changes and
mechanisms that underlie clinical dormancy. The Committee
encourages NCI to consider convening a multisector,
multidisciplinary strategic planning committee to provide
recommendations and chart a collaborative path forward to
support evidence for melanoma screening. The Committee requests
an update on melanoma activities on-going and planned in the
fiscal year 2018 budget request.
NCI Designated Cancer Centers.--The Committee requests an
update in the fiscal year 2018 budget request on how NCI
supports or plans to support IDeA States to broaden NCI's
designated cancer center representation within these States.
NCI's PMI.--The Committee continues support for pediatric
oncology research, including clinical studies for children with
brain tumors, pediatric preclinical testing program, evaluating
new agents for treating pediatric malignancies, and the
pediatric Molecular Analysis for Therapy Choice (MATCH) study.
The Committee is pleased a goal of the NCI MATCH trial is for
at least 25 percent of the total patients enrolled in the trial
to have rare cancers, and that results of NCI's recent interim
analysis demonstrate the goal is exceeded. The Committee
encourages NCI to continue to prioritize rare cancers in the
MATCH trial. The Committee requests NCI provide an update on
its plans to utilize the PMI and MATCH to identify and test
more effective, less toxic treatments, and to improve the
targeting of treatments for children battling brain cancer in
the fiscal year 2018 budget request.
Ovarian Cancer.--The Committee requests serious
consideration be given to Ovarian Cancer in any ``Moonshot''
effort given the emerging genomics-driven immunotherapies
success. The Committee requests NCI provide an update in the
fiscal year 2018 budget request on the on-going and planned
research in this area.
Pancreatic Cancer.--In 2014, NCI announced the development
of the Scientific Framework for Pancreatic Ductal
Adenocarcinoma (PDAC), as called for by the Recalcitrant Cancer
Research Act. The Committee requests an update in the fiscal
year 2018 budget request on the actions taken to implement the
four recommendations to expanding pancreatic cancer research:
understanding the biological relationship between PDAC and
diabetes mellitus; evaluating longitudinal screening protocols
for biomarkers for early detection of PDAC and its precursors;
studying new therapeutic strategies in immunotherapy; and
developing new treatment approaches that interfere with RAS
oncogene-dependent signaling pathways.
Prostate Cancer.--The Committee is aware of NCI's ongoing
investment in prostate cancer research, but is concerned that
prostate cancer lacks treatments for men with advancing disease
as well as adequate diagnostic and imaging methodologies common
in other hormone-driven cancers with similar disease burden.
The Committee encourages NCI to coordinate with other Federal
agencies, including the Department of Defense, private research
foundations, and other stakeholders. Further, the Committee
encourages NIH and CDC to consider how to develop a joint
public/private partnership aimed at reducing the prevalence of
prostate cancer in African American men. The Committee requests
NIH and CDC provide a joint response on this type of effort in
the fiscal year 2018 budget request.
Radiation Oncology.--The Committee encourages support for
high quality meritorious radiation oncology research. The
Committee requests an update in the fiscal year 2018 budget
request on efforts to support radiation therapy's role in the
development and adoption of new combination therapies.
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 expects CDC and NIH to work together to complete the
COPD action plan on a timely basis and report on the
implementation of the recommendations of the plan in the fiscal
year 2018 budget request.
Heart Disease.--The Committee is aware of the enormous
burden heart disease inflicts on our Nation's population and
economy, particularly as the population ages. The Committee
requests an update in the fiscal year 2018 budget request on
the IC's strategic vision for heart research.
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.
Biomaterials.--The Committee understands biomaterials are
an important section of biomedical research. The Committee
encourages NIDCR to consider efforts to encourage an increased
focus on the development and innovation of dental materials.
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.
Gestational Diabetes.--The Committee continues to recognize
the importance of research related to gestational diabetes and
encourages continued support for highly meritorious research on
gestational diabetes.
Inflammatory Bowel Disease (IBD).--The Committee continues
to express support for the IBD genetics consortium. The
Committee also encourages continued support of meritorious
research on pediatric IBD.
Pediatric Kidney Disease.--The Committee continues to
encourage NIDDK to work collaboratively with other ICs,
including NICHD and NHLBI to encourage multi-disciplinary
research for children and young adults with kidney 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 Research through Advancing Innovative
Neurotechnologies (BRAIN) Initiative.--The Committee provides a
$45,000,000 increase for a total of $195,000,000 to NINDS,
NICHD, NEI, NIA, NIDCD, NIAAA, NIDA, NIMH, NIBIB, and NCCIH on
the same pro-rata basis as provided in the past. 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 2018 budget
request provides an appropriate level of funding to keep on
track toward the plan's milestones. Further, the Committee
encourages the distribution of a reasonable portion of BRAIN
research resources through co-funded projects in the IDeA
program.
Concussive and Subconcussive.--The Committee encourages
NINDS to work with the private sector to explore the use of
tools to monitor head impacts and help diagnose, treat and
prevent concussions in youth sports. In particular, the
Committee encourages NINDS to consider meritorious research
related to head impact sensor technology, including
biomechanical, which may assist diagnosis.
Hydrocephalus Research.--The Committee requests an update
on the scientific workshop on the current status of
hydrocephalus specific research. The Committee requests the
fiscal year 2018 budget request include a summary of the key
recommendations and other findings from the workshop.
Mucopolysaccharide (MPS).--The Committee encourages high
quality research on MPS to better understand and treat MPS and
related diseases. The Committee encourages basic research to
develop treatments for neurological, chronic inflammation,
cardiovascular and skeletal manifestations of MPS.
Stroke.--The Committee recognizes the burden strokes place
on our Nation and economy. The Committee encourages support of
highly meritorious stroke research. The Committee requests a
report in the fiscal year 2018 budget request on how NIH and
the IC are planning for enhanced research opportunities.
Traumatic Brain Injury (TBI).--The Committee encourages
research related to technologies using biomarkers to
distinguish trauma to the brain. The Committee requests an
update in the fiscal year 2018 budget request on TBI research.
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.
Antimicrobial Resistance.--The Committee continues to
support the research on mechanisms of drug resistance,
bacterial pathogenesis, and infection control; developing new
or repurposing existing antimicrobials; and exploring
approaches to prevention including bacterial vaccines and other
strategies. The Committee encourages NIH to coordinate with CDC
to determine how data in the CDC resistant pathogens database
can be leveraged to improve future research. The Committee
requests an update in the fiscal year 2018 budget request on
how NIAID is working with CDC and other Federal partners in
this field of research.
Autoimmune Research.--The Committee notes recent research
breakthroughs that are leading to the development of potential
treatment options for autoimmune conditions, including alopecia
areata, and encourages NIAID to support cross-cutting
autoimmune research projects. The Committee encourages NIAID to
work with NINDS and other ICs on these efforts. Further, the
Committee requests an update in the fiscal year 2018 budget
request on the latest state-of-the-science for autoimmune
neuropathies research into conditions like Guillain-Barre
syndrome (GBS) and chronic inflammatory demyelinating
polyneuropathy (CIDP), and the status of a cross-cutting
research plan for this portfolio.
National Strategy for Combating Antibiotic Resistant
Bacteria (CARB).--The Committee directs the Department to
continue to collaborate with the Department of Defense, United
States Department of Agriculture, Department of Veterans
Affairs, and the Food and Drug Administration, to develop and
maintain the National Database of Resistant Pathogens; broaden
and sustain efforts to track and store data on AbR genes and
the mobile genetic elements from AbR bacteria and metadata.
Geographic information systems describing where the AbR are
isolated is also essential to monitor emerging AbR and to
assess their threat to public health and develop mitigation
strategies. The Committee further directs consideration of best
evidence on the environmental locations for the influx of
antibiotic resistance into bacteria of medical importance, and
surveillance methodologies that ensure the greatest chance of
detecting the influx of new antibiotic resistance elements as
early as possible. The Committee requests a comprehensive
update in the fiscal year 2018 budget request on the progress
being made in areas described above and advancements being made
on the CARB national strategy initiative.
Tick-Borne Disease.--The Committee encourages NIH, in
coordination with CDC, to intensify research on tick-borne
diseases, including research that will increase understanding
of the full range of Lyme disease processes and the physiology
of borrelia burgdorferi and borrelia mayonii, including the
mechanisms of persistent infection and to intensify basic
research that can be used to focus on the development of more
sensitive and accurate diagnostic tests for Lyme and tick-borne
diseases.
Valley Fever.--The Committee continues to commend NIH and
CDC on the joint efforts to combat Valley Fever, specifically
by conducting a Randomized Controlled Trial (RCT) to identify
an effective treatment for Valley Fever. The Committee
understands establishing and conducting an RCT is complex and
recognizes the effort NIH and CDC have committed to this
project. The Committee encourages NIH to finalize the RCT so
patients in endemic areas can begin to enroll in the trial this
year. Further, the Committee encourages the development of a
vaccine.
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 has
provided $333,340,000 for the IDeA program, or a floor of 1
percent of the NIH budget. The Committee recognizes that the
NIH IDeA program funds almost half the States in the Nation,
yet had received less than one percent of the NIH budget until
last year. The Committee expects one percent to be the minimum
threshold for this program. Further, the Committee notes the
NIH Centers of Biomedical Research Excellence (COBRE) are
proven to successfully increase the number of new scientists at
institutions in States eligible for IDeA. NIH policy has
limited the number of COBRE institutions in IDeA States. The
Committee expects NIH and NIGMS Directors to jointly review
this policy toward developing a plan to expand the number of
competitively awarded COBREs. The Committee requests a summary
of the outcome of the review in the fiscal year 2018 budget
request. The Committee continues to expect the NIH Director to
ensure all CTSA grantees actively solicit interaction with IDeA
designated States. Further, the Committee requests all ICs co-
fund and report in the budget request how much each IC's funds
are supporting IDeA State grants to further improve the
distribution of innovation across the country.
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.
Rehabilitation Research.--The Committee recognizes the
significant challenges faced by patients with neurological
impairments who live in rural areas, where access to assistive
devices, medical advice, and community resources can be
limited. The Committee encourages the National Center for
Medical Rehabilitation Research to provide greater support for
research efforts that involve the combination of patient
navigators and assistive health technology, particularly in
underserved rural settings.
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
requests an update on the new challenge program to advance the
speed of basic research to cure retina disease in the fiscal
year 2018 budget request.
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.
Bisphenol A Toxicity.--The Committee is aware of the
ongoing debate on toxicity exposure from Bisphenol A (BPA)
amongst the National Toxicology Program (NTP), NIEHS, and Food
and Drug Administration (FDA). The program includes the 2008
Draft Assessment of Bisphenol A for Use in Food Contact
Applications, which reviewed the available data on the toxicity
of BPA, performed by FDA staff at the Agency's National Center
for Toxicological Research. The Committee requests NIEHS
coordinate with FDA to publish the results of relevant studies
as soon as the data analysis is completed. The Committee
requests NIH publish a jointly agreed upon FDA/NIEHS/NTP
timeline for publishing the most recent study results from the
interagency consortium in the fiscal year 2018 budget request.
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.--The Committee recommends an increase
of $350,000,000 within NIA to support a total of at least
$1,260,000,000 on Alzheimer's disease research. In recognition
that Alzheimer's disease poses a serious threat to the Nation's
long-term health and economic stability, the Committee expects
this increase to be directed to research on Alzheimer's. The
NIA should continue to address the research goals set forth in
the National Plan to Address Alzheimer's Disease, as well as
the recommendations from the Alzheimer's Disease Research
Summit in 2015. The Committee has been encouraged by recent
advances in the area of prevention, with respect to using drug
therapy to reverse cellular and genetic changes associated with
cognitive decline. The Committee understands that similarly
exciting research is also underway to prevent cognitive
impairment and Alzheimer's disease. A broad approach is
critical to future progress, and the NIA is encouraged to
continue exploring multiple avenues of prevention research-
including both pharmacological and non-pharmacological
approaches--and a broad range of potential therapeutic targets.
The Committee requests an update on the progress in the fiscal
year 2018 budget request that specifically notes how NIH is
using population cohort studies within the National Plan. The
Committee expects NIA to continue to support Alzheimer's
research with meritorious IDeA program researchers in a manner
that does not count against any NIH-COBRE policy limit. The
Committee is encouraged from the positive feedback of
stakeholders on the willingness of NIA and other ICs to work
with such groups to develop new mechanisms to supplement and
not supplant funding for Alzheimer's research using meritorious
research proposals submitted to but not funded by the NIA or
NIH to further leverage non-NIH funding. The Committees
encourages the further use of this mechanism across NIH.
Trisomy 21.--The committee encourages NIH to undertake a
multi-year study to examine the molecular, cellular, and
physiological mechanisms that predestine individuals born with
a third copy of human chromosome 21 to either live with--or be
protected from--a range of diseases that cause nearly 60
percent of U.S. deaths.
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.
Epidermolysis Bullosa (EB).--The Committee recognizes the
promising scientific gains made in pursuit of treatments for EB
and applauds the private partners working to advance research
towards practical treatments for EB. Further research in this
area holds great promise in terms of treatments for EB and for
other skin and connective-tissue disorders. The Committee
encourages NIH continue to support such research through
expert-led scientific conference awards through NIAMS and
NCATs. The Committee further encourages NIH to leverage Federal
funds with public-private partnerships in the areas of EB and
related disorders.
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.
Evidence Based Intervention.--The Committee encourages
consideration of research that may result in evidence-based
intervention on proven theory and tested methodologies to
reduce alcohol use and abuse in adolescent students in high
school.
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 continues to applaud the collaborative research
on addictions 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. The Committee requests
NIDA provide an update on the comprehensive study.
Marijuana Research.--The Committee is concerned that
marijuana public policies in the States are being changed
without the benefit of scientific research to help guide those
decisions. NIDA is encouraged to continue supporting a full
range of research on the effects of marijuana and its
components, including research focused on policy change and
implementation across the country. The Committee requests a
report in the fiscal year 2018 budget request on these efforts.
Opioid Drug Abuse.--The Committee is concerned about the
escalating epidemic of prescription opioid and heroin use,
addiction and overdose in the United States. The Committee
appreciates the important role that research can and should
play in the various Federal initiatives aimed at this crisis.
The Committee urges NIDA to continue supporting research on
medications to alleviate pain, including the development of
those with reduced abuse liability. In addition, the Committee
urges NIDA, as appropriate, to work with private companies on
innovative research and to provide an update in the fiscal year
2018 budget request on what is known on the transition from
opioid analgesics to heroin abuse and addiction within affected
populations.
Safe Prescribing.--The Committee notes education is a
critical component of any effort to curb drug use and
addiction, and it must target every segment of society,
including healthcare providers (doctors, nurses, dentists, and
pharmacists), patients, and families. The Committee encourages
NIDA to continue its work with Federal partners to further
engage the medical community, including physicians-in-training,
medical students and resident physicians in primary care
specialties (e.g. internal medicine, family practice, and
pediatrics), to help provide the tools and skills needed to
incorporate drug abuse screening and treatment into their
clinical practices. The Committee also encourages NIDA and CDC
to develop strategies for increasing participation in its
online continuing medical education courses on safe prescribing
for pain and managing patients who abuse prescription opioids.
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.
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 (RCMI).--The
Committee expects the RCMI program will receive no less than
$58,177,388, which is the fiscal year 2016 enacted 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 alternative medicine (CAM) practices and to
train individuals to apply the tools of exacting science to CAM
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
increased focus on rare disease research and orphan product
development; develop a centralized database on rare diseases
research; and stimulate rare disease 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.
Academic Partnerships to Support Clinical Development.--The
Committee understands the importance and partnerships between
NIH's intramural research program and academic based entities
to transition intramural research ideas into development
efforts. As such, the Committee encourages the center to
support such partnerships and provide a report on the center's
efforts in the fiscal year 2018 budget request.
Clinical and Translational Science Awards (CTSA).--The
Committee encourages NCATS to explore methods to further
integrate the CTSA program into more collaboration with other
ICs that can provide greater support for the CTSA hubs and
network.
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 systematically coordinate 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.
Within the total provided to the OD, the Committee expects
the Director to provide the OD scientific functions an increase
that is at least equal to the general increase provided to all
IC. The Committee expects the 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 (CF).
The Committee continues the bill language for specific
funds authorized by the Gabriella Miller Kids First Research
Act within the CF to support the third year of the 10-year
Pediatric Research Initiative. The Committee urges the Director
to use a portion of the $10,000,000 made available to the
Director's Discretionary Fund (DDF) to support additional
pediatric research. The Committee requests, within 30 days
after the end of each fiscal year quarter, a quarterly report
on DDF obligations for each activity supported. The report
should include a description of the program, which ICs are to
provide continuation costs, and how this research serves a high
priority for pediatric diseases. The quarterly reports shall be
posted on-line via the NIH web-site within 30 days after being
released to the Committee.
Common Fund (CF).--The Committee recommends $775,639,000
for the CF, including the $12,600,000 provided to support the
Gabriella Miller Kids First Research Act, and a $100,000,000
increase for PMI for a total of $230,000,000 in the CF for PMI.
NIH is expected to continue the longstanding CF policy for
projects to be short-term, high-impact awards, with no projects
receiving funding for more than 10 years. The Committee expects
NIH to support only biomedical research.
Capstone Awards.--The Committee continues to expect NIH to
pursue the establishment of the capstone awards. The program is
expected to promote partnerships between senior and junior
investigators, provide opportunities to acquire skills to
transition to a new role, and other purposes. The Committee
expects the Director of NIH to consult with the IC Directors,
patient advocacy groups, and industry leaders. The Committee
requests an update and timeline on the development, duration,
and amount for capstone awards in the fiscal year 2018 budget
request.
Operating Plan.--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 mechanism operating plans to the
Committee on Appropriations of the House of Representatives and
the Senate.
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 of 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 reduce duplication and increase
effectiveness and efficiency of research.
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 2018 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 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 encourages the Office to use a strategic focus of
resources allocated to AIDS towards the highest quality peer
reviewed project aimed at finding cures, creating a vaccine,
and developing better treatments for the disease.
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, 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
Adolescents and Young Adults.--The Committee encourages an
NIH-wide emphasis on understanding and addressing substance use
and substance use disorders among adolescents and young adults
as a specific population. The Committee encourages NIH to
identify and coordinate its efforts in this area and provide an
update in the fiscal year 2018 budget requests on actions to
further these desires.
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, funded by NIH, and the
private partners working to advance the growing body of
Angelman Syndrome research towards practical treatments. The
Committee encourages NIH to consider research on the roles of
the UBE3A gene in brain functions and explore innovative new
treatments. The Committee urges NIH to explore how public-
private partnerships can be leveraged to support translational
research in this area.
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.
Biomarkers.--Biomarkers are a defined characteristic that
is measured as an indicator of normal biological processes,
pathogenic processes, or responses to an exposure or
intervention, including therapeutic interventions. Biomarkers
play an important role in precision medicine by helping to
understand disease processes, the effectiveness of
interventions, and in targeting therapy to patients. The
Committee encourages NIDDK to accelerate the discovery and
validation of biomarkers to aid in designing and conducting
clinical trials to prevent, treat, and cure Type 1 diabetes.
The Committee also encourages NIDDK to work with NIAID to
develop biomarkers specifically related to immune interventions
for multiple autoimmune diseases, including Type I diabetes.
Children in NIH Research.--The Committee appreciates the
comments made by NIH in its fiscal year 2017 budget
justification to pursue a plan to collect and report the number
of human subjects included in NIH research by age. The
Committee requests an update in the fiscal year 2018 budget
request on progress and a timeline to further this effort.
Clinical Trials.--The recent GAO report (GAO-16-304)
provides recommendations to enhance stewardship of the clinical
trials across NIH with additional data. The Committee requests
an update in the fiscal year 2018 budget request on the steps
taken, planned, and timeline to complete the establishment of
the process to collect, analyze, and review the data needed to
enhance stewardship of NIH clinical trials as recommended in
the GAO report.
Coordination.--The Committee remains concerned regarding
the duplication of efforts and overlapping of responsibilities
and funding priorities between the NIH, CDC, and AHRQ. The
Committee encourages NIH, AHRQ, 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 2018 budget request on how each NIH
program coordinates with CDC and AHRQ.
Diabetes Complications.--Diabetes causes many damaging and
expensive complications. Cardiovascular disease death rates are
1.7 times higher among adults with diabetes than adults without
diabetes, and diabetes is the primary cause of kidney failure
in 44 percent of new cases. The Committee urges NIDDK and NHLBI
to devote additional resources for kidney disease and
cardiovascular events as they relate to .diabetes so that we
can prevent onset of these costly and burdensome complications
on patients and the U.S. economy.
Duchenne Muscular Dystrophy (DMD).--The Committee
encourages the ICs to consider strategies that could lead to
the development of combination therapies. The Committee
requests an update on current and planned research across NIH
for DMD and timeline for the next state-of-the-science in the
fiscal year 2018 budget request.
Enhanced Reporting on Research Spending.--The Committee
appreciates the initial steps taken by NIH to make public on an
annual basis, enhanced Research, Condition, and Disease
Categorization spending data with the number of Americans
affected by each category of disease according to CDC or other
Federally sourced data. The Committee requests an update on the
plan to maintain and provide data for the remaining categories,
where such data exists, in the fiscal year 2018 budget request.
Focal Segmental Glomerulosclerosis (FSGS).--The Committee
understands the APOL1 gene plays a role in the onset of FSGS
and subsequent end stage renal disease in African Americans.
The Committee encourages NIMHD to explore collaboration on high
quality peer reviewed research with NIDDK.
Fragile X Research.--The Committee encourages the ICs with
Fragile X and autism portfolios to explore ways to create
greater efficiency and synergy among these two research tracks
to accelerate translational research toward a better
understanding of both conditions and to shorten the time to
bring effective treatments for both conditions to market. The
Committee commends NIH for its previous work to create and
update the NIH Research Plan on Fragile X Syndrome and
Associated Disorders, last updated in 2012, and encourages
NICHD to reconvene this group before the end of fiscal year
2017 to update and publish a revised research plan.
Gut Microbiome.--The Committee encourages expanded research
on predictors and modifiable factors that can improve early
interventions and treatments, particularly among pediatric and
young adult populations.
Imaging.--The Committee notes the critical value of imaging
research to support the NIH research portfolio. The Committee
requests NIH provide an overview of imaging research throughout
NIH with a description of how gaps are identified, and of the
plans to address these gaps.
Kidney Cancer.--The Committee is concerned that the amount
of meritorious scientific research on kidney cancer is not
commensurate with the growing number of diagnoses, and
encourages NCI to support a Specialized Program of Research
Excellence in kidney cancer and other research programs for
subtypes of kidney cancer, such as papillary and chromophobe,
as well as diagnostic tests for early detection of the disease.
The Committee requests an update in the fiscal year 2018 budget
request on these efforts.
New Initiatives.--The Committee reiterates its requests for
NIH to expand the initiative table provided in the fiscal year
2017 budget request, in the fiscal year 2018 budget request,
and future budget requests to display the current year plus
five-year planned funding levels for each initiative already
listed and proposed in the current budget. The table should
identify the planned budget level provided; a list of
participating ICs; the linkage to the NIH-wide strategic plan;
and percentage of the funds focused on basic science, as a
minimum, for each initiative.
Minority Researchers.--The Committee requests an update in
the fiscal year 2018 budget request identifying the metrics,
impact of Building Infrastructure Leading to Diversity
initiative, and other programs designed to encourage minority
researchers.
Mitochondrial Disease.--The Committee commends NCI for its
work in establishing a Mitochondrial Model Organisms and
Cellular Systems Working Group and for its work to identify
needs, barriers and opportunities pertaining to mitochondrial
biology relevant to addressing mechanistic questions in cancer.
The Committee understands numerous ICs are involved in a
variety research efforts related to mitochondrial disease and
dysfunction. The Committee requests an update on the steps NIH
has taken, on-going, and planned in the fiscal year 2018 budget
request.
Muscular Dystrophy (MD).--The Committee understands the MD
Action Plan was updated in 2015. The Committee encourages NIH
consider meritorious research projects aligned to the updated
plan. The Committee requests an update in the fiscal year 2018
budget request on activities NIH is planning to facilitate
clinical trial and research infrastructure to improve
performance of clinical trial endpoints and validate biomarkers
of the disease. The Committee encourages NIH, in coordination
with FDA and other agencies, to consider a Duchenne follow-on
meeting to examine the current state-of-the-science of exon
skipping and targeted therapeutics.
National Children's Study (NSC) Follow-On.--The Committee
is encouraged by the progress to develop a research program to
succeed the NCS to improve children's health. NIH launched the
Environmental influences on Child Health Outcomes (ECHO)
program as a component of the NCS follow-on study with the
potential to coordinate multiple longitudinal studies. The
Committee expects NIH to ensure ECHO's plan collects data and
provides analysis for at least a 15-year period as envisioned
by the NCS. NIH should prioritize coordination and oversight of
the NCS follow-on research activity. The Committee requests an
update on steps NIH has taken to establish a Federal advisory
committee with outside pediatric experts and a variety of
stakeholders to coordinate efforts across NIH. The Committee
notes concern with ECHO's reliance on existing cohort studies
that may limit research findings on the impact of maternal
prenatal exposures on children's health. NIH is urged to ensure
ECHO grantees or other NCS follow-on activities collect data on
a wide variety of chemical, biological, and other related
maternal prenatal data to improve children's health outcomes.
The Committee requests a detailed report within 90 days after
enactment on the establishment of a Federal advisory committee,
the goals, objectives, milestones, projected funding estimates,
and program's progress.
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 encourages all the
funded ICs to continue to explore meritorious research. 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 understands NF1 may cause vision loss and
encourages NEI to explore research in NF1.
Partnerships to Find Private Support for Unfunded
Applications.--The Committee commends NIH for its leadership to
move forward with and expand the request for NIH to develop a
new mechanism for public-private organizations to directly fund
high quality unfunded applications from one IC to all ICs. The
program will not only benefit applicants by helping connect
them with potential funders, it allows the private funders to
take advantage of NIH's peer review system and reduce
researcher application drafting time. The Committee requests
that in fiscal year 2018 budget request, and future year budget
requests, NIH report the annual number of applications
supported and total annual dollar level of support provided
through this mechanism to expanded research.
Pediatric Rare Diseases.--The Committee is encouraged by
the work of the Rare Disease Clinical Research Network (RDCRN).
The Committee encourages NIH to have ICs consider how they can
work with RDCRN to create a pediatric rare disease center of
excellence model. Further, the Committee suggests NIH evaluate
how the National Pediatric Research Network Act and the
Gabriella Miller Kids First Research Act activity would benefit
from a single Program Management Office (PMO) to improve the
coordination of pediatric research efforts.
Precision Medicine Initiative (PMI) and Pediatrics.--The
Committee recommendation includes a $100,000,000 increase
within the CF for PMI for a total of $300,000,000 across NIH
for PMI. The Committee is aware that the Advisory Committee to
the Director (ACD) in its final report supported the inclusion
of children in the PMI cohort program and recommends that NIH
consider how to best incorporate necessary safeguards to ensure
appropriate enrollment, retention and protections for children.
The Committee encourages NIH to ensure the process of awarding
funds for the PMI cohort appropriately represents the pediatric
populations. Further, the Committee requests an update in the
fiscal year 2018 budget request on specific steps taken in the
PMI to ensure the research cohort includes children in
sufficient numbers and of appropriate diversity to make
meaningful studies possible.
Prioritization of Funding.--The Committee commends NIH for
including formal consideration of disease burden as a
``crucial'' factor for aligning its research priorities within
the new NIH-Wide Strategic Plan. The Committee expects NIH to
prioritize Federal funds for medical research on discovery over
outreach and education. NIH is expected to use the scientific
strategic plan to prioritize funding. The Committee requests a
report in the fiscal year 2018 budget request on how the NIH-
wide strategic plan was reviewed and used to allocate resources
for the fiscal year 2018 budget request and used during fiscal
year 2017 to better focus resources to diseases with the
significant opportunity to improve the current or future health
of the American population.
Red Team.--The Committee commends the NIH Advisory
Committee to the Director (ACD) for recognizing and chartering
a review due to the lapses in safety and compliance in the
sterile manufacturing components of the NIH pharmacy. The
investigation into the event led to an appreciation of broader
organizational deficiencies relating to priorities, quality,
compliance, and accountability. The public report identifies
issues related to a lack of a culture and practice of safety;
leadership issues related to clinical care quality, oversight,
and compliance; and specific issues with sterile processing.
The Committee agrees with the ACD that the implementation of
Red Team's recommendations should greatly reduce risks,
increase assurance of participant safety, and improve research
quality. In addition, the Committee supports the steps NIH has
started such as starting the process to replace the leadership
of the NIH Clinical Center (CC), establish a comprehensive
oversight/compliance office, and strengthen the board of the
CC. The Committee agrees NIH should issue a policy and begin
tangible steps to adopt commonly accepted best practices and
rules governing hospitals, clinical research, and laboratory
programs, ensure appropriate regulatory requirements are
uniformly applied, meeting and exceeding minimum requirements
for any research facility or laboratory. The intramural
research program (IRP), not limited to the CC, should seek
voluntary accreditation associated with quality and safety. The
NIH IRP should be an example of excellence and should meet the
highest standards in safety, quality, and compliance. The
Committee expects quarterly updates on the creation and use of
CC patient safety and quality measures, selection and
implementation of the voluntary adherence to regulatory
requirements. NIH should also provide plans and quarterly
progress on steps to improve leadership, culture of patient
safety, and research quality throughout the IRP and CC.
Finally, the Committee expects NIH to fund the costs of
implementing these recommendations from within existing IRP
resources and not from shifting extramural resources towards
these efforts.
Reproducibility of Scientific Methods.--The Committee
requests an update on the progress made and the plan for
additional activities in the fiscal year 2018 budget request.
Stimulating Peripheral Activity to Relieve Conditions
(SPARC).--The Committee notes bioelectronic medicine,
electrically stimulating specific neural circuits, could soon
offer a new treatment model for multiple medical conditions.
The Committee supports NIB efforts to better understand, model,
and decode the numerous neural circuits associated with the
peripheral nervous system, ultimately leading to the creation
of a Peripheral Nervous System Atlas. This could include the
development of tools to pinpoint promising intervention points
available for such therapy. The Committee encourages NIH to
continue ongoing work in the SPARC program, to include the
efforts to functional mapping of neural circuits.
Undiagnosed Disease Program (UDP).--The Committee is
pleased NIH has expanded access of the UDP and created a
database for all physicians and patients to share information.
The Committee requests an update in the fiscal year 2018 budget
request on the UDP with specific performance of Undiagnosed
Disease and the Match Maker Exchange.
Usher Syndrome.--The Committee continues to urge NIH to
prioritize Usher syndrome research at NEI and NIDCD. The
Committee requests an update in the fiscal year 2018 budget
request on steps NIH has taken to date and future plans to
accelerate treatment options and improve patient outcomes.
Women's Health Research.--The Committee appreciates the
efforts undertaken by NIH, specifically, the Office of Women's
Health, to ensure policies related to gender and sex in
clinical and pre-clinical research are in-place.The Committee
requests an update in the fiscal year 2018 budget request on
how the ICs are implementing the changes, the impact of these
new guidelines, the plans to improve public availability of
this data, and the status of implementing GAO recommendations
related to this issue.
Young Investigators.--The Committee expects NIH to report
on actions it has taken to lower the median age at which
investigators receive their first R01 awards annually in the
fiscal year 2018 budget request and future budget requests. 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 within 180 days of enactment. The
Committee further expects NIH to convene a working group
consisting of stakeholders from academia, young researchers,
industry leaders, and government officials to move forward on
this goal.
Updates.--In addition to the specific items of interest
above, the Committee requests general updates in the fiscal
year 2018 budget request for each of the listed disease,
condition, or topic to describe the latest efforts ongoing and
planned:
Administrative Burden Workgroup;
Alopecia Areata Research;
Amyloidosis;
Antibiotic Resistance;
Asthma;
Chronic Pain Conditions;
Chronic Kidney Disease;
Community Based Health Research;
Demographic Research;
Diabetes and Diabetes Care;
Dystonia;
Environmental Exposures;
Evaluation of the Basic Behavioral and Social Science
Opportunity Network;
Evidence Based Programs to Prevent Obesity;
Genomic Research and Alcohol Dependence;
Glomerular Diseases;
Grant Review;
Hyperimmune Globulin;
Kennedy's Disease;
Kidney Cancer;
Liver Cancer;
Liver Disease;
Lung Disease;
Hereditary Hemorrhagic Telangiectasia;
Hepatitis Research Related to Minorities;
Inflammatory Bowel Diseases;
Lung Cancer;
Lymphangioleiomyomatosis;
Microbicides research;
Muscular Dystrophy Action Plan;
Multiple Sclerosis Research;
Myotonic Dystrophy Research;
NIH Workforce Study;
NIDAMeD;
National Pediatric Research Network;
New Innovative Awards;
Pediatric Cancer Research Funding;
Pediatric Inflammatory Bowel Disease Safety Registry;
Peripheral Neuropathies;
Preterm Birth and Prevention of Preterm Birth;
Science, Technology, Education and Mathematics;
Sickle Cell Trait Research;
Spina Bifida;
Spinal Muscular Atrophy;
Study Sections Pediatric Expertise;
Trisomy;
Tuberous Sclerosis Complex;
Tuberculosis and;
Zika Therapeutic Treatment Research.
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 provides bill language to allow for the
demolition of buildings 18, 18T, and 32 that NIH has noted are
beyond service life and too expensive to maintain. NIH expects
the one-year authority to provide long-term maintenance and
building savings. The Committee requests an update in the
fiscal year 2018 budget request on the projected 10-year
savings of these three projects and does not expect this
authority to be used beyond these three specific projects.
Further, the Committee notes NIH has a significant backlog of
maintenance and repairs. The Committee requests NIH and HHS
develop a coordinated plan to address the backlog with the
Office of Management and Budget in the fiscal year 2018 budget
request.
Substance Abuse and Mental Health Services Administration
The Committee recommends $4,211,103,000 for the Substance
Abuse and Mental Health Services Administration (SAMHSA), which
is $431,167,000 more than the fiscal year 2016 enacted program
level and $480,955,000 more than the fiscal year 2017 budget
request 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 Public Health Service
Act section 241 evaluation set-aside in fiscal year 2017.
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 $1,147,667,000 for Mental Health
Services, which is $19,320,000 below the fiscal year 2016
enacted program level and $11,099,000 below the fiscal year
2017 budget request program level.
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee recommends
the following amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint.......................... $1,147,000
National Child Traumatic Stress Network.......... 46,887,000
Project Aware State Grants....................... 49,902,000
Mental Health First Aid.......................... 14,963,000
Healthy Transitions.............................. 19,951,000
Children and Family Programs..................... 7,229,000
Consumer and Family Network Grants............... 4,954,000
Mental Health System Transformation and Health 3,779,000
Reform..........................................
Project LAUNCH................................... 34,555,000
Primary and Behavioral Health Care Integration... 26,004,000
Suicide Prevention:
National Strategy for Suicide Prevention..... 4,000,000
Zero Suicide............................. 20,800,000
American Indian and Alaska Native Set- 5,200,000
Aside...............................
Suicide Lifeline............................. 7,198,000
Garrett Lee Smith--Youth Suicide Prevention:
State Grants............................. 35,427,000
Campus Grants............................ 6,488,000
American Indian and Alaska Native Suicide 2,931,000
Prevention..................................
Tribal Behavioral Health Grants.................. 16,000,000
Homeless Prevention Programs..................... 30,696,000
Minority AIDS.................................... 15,935,000
Criminal and Juvenile Justice Programs........... 4,269,000
Assisted Outpatient Treatment.................... 15,000,000
Science and Service:
Garrett Lee Smith--Suicide Prevention Resource 5,988,000
Center..........................................
Practice Improvement and Training................ 7,828,000
Consumer and Consumer Support Technical 1,918,000
Assistance Centers..............................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance............................
Disaster Response................................ 1,953,000
Homelessness..................................... 2,296,000
------------------------------------------------------------------------
Mental Health Block Grant
The Committee recommends a total of $532,571,000 for the
Mental Health Block Grant, which is the same as the fiscal year
2016 enacted program level and the fiscal year 2017 budget
request program level. 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 ten 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 $119,026,000 for the Children's
Mental Health program, which is the same as the fiscal year
2016 enacted level and the fiscal year 2017 budget request.
Funding for this program supports grants and technical
assistance for community-based services for children and
adolescents with serious emotional, behavioral, or mental
disorders. The program assists States and local jurisdictions
in developing integrated systems of community care.
The Committee remains deeply concerned about the safe,
appropriate and effective use of psychotropic medications in
children, particularly children in foster care settings. A 2012
GAO report found that an estimated 18 percent of foster
children are prescribed psychotropic medications, compared with
4.8 percent of privately insured children. Given that little is
known about the impact of these drugs on growth and
development, the Committee supports SAMHSA to explore treatment
approaches that rely more on psychosocial interventions that
can be used instead of, or in combination with, psychotropic
medications.
Projects for Assistance in Transition from Homelessness
The Committee recommends $64,635,000 for the Projects for
Assistance in Transition from Homelessness (PATH) program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 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 for Individuals with Mental Illness program, which is
the same as the fiscal year 2016 enacted level and the fiscal
year 2017 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 $2,189,402,000 for Substance Abuse
Treatment programs, which is $6,022,000 less than the fiscal
year 2016 enacted program level and $3,054,000 more than the
fiscal year 2017 budget request program level.
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and Regulatory $8,724,000
Activities......................................
Screening, Brief Intervention, Referral, and 28,000,000
Treatment.......................................
PHS Evaluation Funds......................... 2,000,000
Targeted Capacity Expansion--General............. 11,223,000
Medication-Assisted Treatment for 50,080,000
Prescription Drug and Opioid Addiction......
Pregnant and Postpartum Women.................... 15,931,000
Recovery Community Services Program.............. 2,434,000
Children and Families............................ 29,605,000
Treatment Systems for Homeless................... 36,386,000
Minority AIDS.................................... 58,859,000
Criminal Justice Activities...................... 78,000,000
Science and Service:
Addiction Technology Transfer Centers............ 8,081,000
------------------------------------------------------------------------
Targeted Capacity Expansion.--The Committee recommends
$61,303,000 for Targeted Capacity Expansion activities. Of this
amount, $50,080,000 is for services that address prescription
drug abuse and heroin use in high-risk communities. This
funding level will provide funding for 45 States. SAMHSA should
target States with the highest rates of admissions and that
have demonstrated a dramatic increase in admissions for the
treatment of opioid use disorders. The United States has seen a
500 percent increase in admissions for treatment for
prescription drug abuse since 2000. Moreover, according to a
recent study, in the past two years, 28 States saw an increase
in admissions for treatment for heroin dependence. 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
regimens that are less susceptible to diversion for illicit
purposes.
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 SAMHSA to expand
training and technical assistance to drug treatment court grant
recipients to ensure evidence-based practices are fully
implemented.
Drug Testing for Opioid Treatment Programs.--Drug testing
plays a key role in the delivery of safe and effective
substance abuse treatment programs. Providers utilize these
tests to identify the type of substance abuse, to determine a
proper treatment plan, to continue on-going evaluations, and to
prevent drug diversion. The Committee requests SAMHSA ensure
that all opioid treatment programs are implementing drug tests
at a frequency necessary to implement a safe and an effective
program.
Overdose Fatality Prevention.--The agreement reflects
strong concerns about the increasing number of unintentional
overdose deaths attributable to prescription and
nonprescription opioids. SAMHSA is urged to take steps to
encourage and support the use of Substance Abuse and Prevention
Block Grant funds for opioid safety education and training,
including initiatives that improve access for licensed
healthcare professionals, including paramedics, to emergency
devices used to rapidly reverse the effects of opioid
overdoses. Such initiatives should incorporate robust evidence
based intervention training, and facilitate linkage to
treatment and recovery services.
Viral Hepatitis Screening.--The Committee applauds SAMHSA
for encouraging grantees to screen for viral hepatitis
including the use of innovative strategies like rapid testing.
The Committee notes the disproportionate impact of viral
hepatitis among minority populations and the co-infection rate
among individuals with HIV/AIDS. The committee urges SAMHSA to
work with Minority AIDS grantees to incorporate hepatitis
screening into programmatic activities.
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends a program level of $1,858,079,000,
which is the same as the fiscal year 2016 enacted program level
and the fiscal year 2017 budget request program level. The
Substance Abuse Prevention and Treatment Block Grant provides
funds to States to support alcohol and drug abuse prevention,
treatment, and rehabilitation services. The Committee
recognizes the critical role the block grant plays in State
systems across the country.
SUBSTANCE ABUSE PREVENTION
The Committee recommends $711,148,000 for the Substance
Abuse Prevention programs, which is $499,929,000 more than the
fiscal year 2016 enacted level and $500,000,000 more than the
fiscal year 2017 budget request.
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework....................... $109,484,000
Strategic Prevention Framework Rx................ 0
PHS Evaluation Funds......................... 10,000,000
Grants to Prevent Prescription Drug and Opioid 5,000,000
Overdose Related Deaths.............................
PHS Evaluation Funds............................. 7,000,000
Minority AIDS........................................ 41,205,000
Federal Drug-Free Workplace.......................... 4,894,000
Sober Truth on Preventing Underage Drinking:
National Adult-Oriented Media Public Service 1,000,000
Campaign........................................
Community Based Coalition Enhancement Grants..... 5,000,000
Interagency Coordinating Committee to Prevent 1,000,000
Underage Drinking...............................
Tribal Behavioral Health Grants...................... 15,000,000
Science and Service:
Center for the Application of Prevention 7,493,000
Technologies....................................
Science and Service Program Coordination......... 4,072,000
------------------------------------------------------------------------
Strategic Prevention Framework State Incentive Grant and
Partnerships for Success.--The Committee intends that the
Strategic Prevention Framework State Incentive Grant and
Partnership for Success programs continue to focus exclusively
on: addressing State- and community-level indicators of
alcohol, tobacco, and drug use; targeting and implementing
appropriate universal prevention strategies, building
infrastructure and capacity, and preventing substance use and
abuse.
Grants to Prevent Prescription Drug and Opioid Overdose
Related Deaths.--The Committee recommends $12,000,000 for
discretionary grants to States to prevent prescription drug and
opioid overdose related deaths. This program will help States
equip and train first responders with the use of devices that
rapidly reverse the effects of opioids. SAMHSA is directed to
ensure applicants outline how proposed activities in the grant
would work with treatment and recovery communities in addition
to first responders. Furthermore, the agreement provides
$10,000,000 for the Strategic Prevention Framework Rx program
to increase awareness of opioid abuse and misuse in
communities. SAMHSA shall collaborate with CDC to implement the
most effective outreach strategy and to reduce duplication of
activities.
Oral Fluid Drug Screening Guidelines.--The Committee is
pleased with SAMHSA's recommendation of oral fluid as an
alternative specimen for drug testing, and commends the agency
for progress made to issue oral fluid guidelines for the
Federal Drug-Free Workplace testing program. The Committee
urges SAMHSA to implement the guidelines expeditiously in
partnership with key stakeholders and other agencies.
Comprehensive Opioid Response.--The Committee recommends
$500,000,000 for Comprehensive Opioid Response grants. SAMHSA,
in coordination with CDC, may award funds to eligible states,
units of local government, territories or Indian Tribes, which
may, in turn, sub-grant to non-governmental organizations as
appropriate. Funds may be used to plan for and implement an
integrated opioid abuse response initiative that incorporates
prevention and education, treatment, and recovery services.
Eligible activities are as follows: (1) Prevention and
education efforts concerning heroin and opioid use, treatment,
and recovery; (2) Education of physicians, residents, medical
students, and other medical providers who prescribe controlled
substances on the prescription drug monitoring program of the
State, on the CDC Guideline for Prescribing Opioids for Chronic
Pain, and on the treatment of addiction; (3) Expanding
prescription drug and opioid addiction treatment programs of
the State. This includes the expansion of abstinence-based and
medication assistance treatment programs that incorporate
training for treatment and recovery support providers;
behavioral health therapy for individuals who are in treatment
for prescription drug and opioid addiction; screening for and
clinically appropriate treatment of hepatitis C and HIV; and
screening, early intervention, and referral to treatment for
teenagers and young adults in primary care, middle schools,
high schools, universities, school-based health centers, and
other community-based health care settings; and (4) Developing,
implementing, and expanding programs to prevent overdose death
from prescription medications and opioids that incorporate a
referral to treatment services. Priority shall be given to
States with the highest burden of opioid-related overdoses.
SAMHSA is directed to brief the Committee no less than 30 days
before issuing a funding announcement regarding the criteria
for grant awards. In addition, SAMHSA is directed to brief the
Committee no less than 30 days before awarding a grant.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
The Committee recommends $162,886,000 for Health
Surveillance and Program Support, which is $43,420,000 below
the fiscal year 2016 enacted program level and $11,000,000
below the fiscal year 2017 budget request program level.
Within the total provided for Health Surveillance and
Program Support, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Health Surveillance.................................. $16,830,000
PHS Evaluation Funds............................. 30,428,000
Program Support...................................... 77,559,000
Public Awareness and Support......................... 13,482,000
Performance and Quality Information Systems.......... 12,918,000
Minority Fellowship Program.......................... 11,669,000
Behavioral Health Workforce Data..................... 0
PHS Evaluation Funds............................. 1,000,000
------------------------------------------------------------------------
Minority Fellowship Program.--The Committee understands
there is a workforce shortage among children's mental health
providers. The Committee is concerned that the National
Minority Fellowship Program unnecessarily excludes related
psychiatric subspecialists from programmatic eligibility. The
Committee requests SAMHSA review internal eligibility criterion
and provide an update in the fiscal year 2018 budget request.
Agency For Healthcare Research And Quality
HEALTHCARE RESEARCH AND QUALITY
The Committee recommends $280,240,000 in discretionary
funds for the Agency for Healthcare Research and Quality
(AHRQ), which is $53,760,000 less than the fiscal year 2016
enacted level and $189,452,000 less than the fiscal year 2017
budget request level. The recommendation does not include any
requested evaluation set-aside funds available under section
241 of the Public Health Service Act or Patient-Centered
Outcomes Research support. Within the total for AHRQ, the
agreement includes the following amounts:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Patient-Centered Health Research..................... $0
Prevention/Care Management........................... 7,400,000
Health Information Technology (IT)................... 15,740,000
Health IT to Improve Quality..................... 13,740,000
Patient Safety Research.............................. 64,600,000
Healthcare-Associated Infections (HAI) Prevention 36,000,000
Combating Antibiotic-Resistant Bacteria (non-add 10,000,000
within HAI).....................................
Section 933 Grants............................... 4,600,000
Patient Safety and Medical Errors................ 19,000,000
Patient Safety Organizations..................... 5,000,000
Crosscutting Activities Related to Quality, 58,500,000
Effectiveness and Efficiency Research...............
Health Services Contract/IAA Research............ 11,000,000
Investigator-Initiated Research Grants........... 47,500,000
Medical Expenditure Panel Survey..................... 65,000,000
Program Management................................... 69,000,000
------------------------------------------------------------------------
The agreement expects AHRQ to focus on its traditional
health services research mission, such as patient safety and
healthcare associated infections. The Committee expects AHRQ to
review its continuation portfolio including an evaluation of
available funds in determining the level of and allocation of
continuations. AHRQ should coordinate with other HHS Operating
Divisions (OpDivs) to determine how duplicative operations can
be realigned to OpDivs with overlapping activities.
Duplicative Activity.--The Committee notes that over time
other HHS agencies have expanded into AHRQ's mission area.
Therefore, AHRQ's mission and areas of research are duplicated
in other HHS agencies. For example, NIH estimates that in
fiscal year 2017 it will spend almost $1,500,000,000 on health
services research, about five times AHRQs total budget request.
CDC, like AHRQ, conducts Prevention Research and Care
Management activities. The Office of National Coordinator for
Health Information Technology (ONC) and CMS are both supporting
Health IT activity. The Committee directs the Secretary to work
with all other HHS OpDivs to determine where they have
activities that overlap with AHRQ in an effort to consolidate,
reduce duplication, and reduce overlap of mission areas across
the OpDivs. The review should include a plan to streamline all
OpDiv mission focus areas to improve the effectiveness,
consolidate operations, and reduce duplicative and related
overheard costs to taxpayers.
Investigator-Initiated Research.--The Committee provides
support for investigator-initiated research. Investigator-
initiated research should not be targeted to any specific area
of health services research and should be merit based from the
best unsolicited ideas from the research community within the
AHRQ patient safety and medical error mission.
Tick-borne Diseases.--The Committee encourages AHRQ to
determine when the last time a bibliography of peer-reviewed
tick-borne diseases literature was last completed and to work
with CDC and NIH to determine how best to develop a tool for
use by the scientific community, treating physicians, and the
public. The review should also evaluate the science related to
persistent infection with borrelia burgdorferi or other types
of borrelia.
Centers For Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
The Committee recommends $262,003,967,000 for the Federal
share of current law State Medicaid costs, which is
$18,458,557,000 more than fiscal year 2016 enacted level and
the same as the fiscal year 2017 budget request. This amount
does not include $115,582,502,000, which was provided as
advance funding for the first quarter of fiscal year 2016. In
addition, the Committee recommends an advance appropriation of
$125,219,452,000 for program costs in the first quarter of
fiscal year 2018. The Committee continues indefinite budget
authority bill language for unanticipated costs in fiscal year
2017. 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 $299,187,700,000 for the Payments
to the Health Care Trust Funds account, which supports Medicare
Part B and prescription drug benefits in fiscal year 2017. This
amount is $16,015,900,000 more than the fiscal year 2016
enacted level and equal to the fiscal year 2017 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 to
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 appropriations is
insufficient.
PROGRAM MANAGEMENT
The Committee makes available $3,093,690,000 in trust funds
for Federal Administration of the Medicare and Medicaid
programs, which is $576,054,000 less than the fiscal year 2016
enacted Program Management level and $1,015,859,000 less than
the fiscal year 2017 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
the Program Management account.
Program Operations
The Committee recommends $1,985,823,000 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 ensure access
to home health care by considering methods to waive the
requirement that home health plans be solely certified by a
physician. The Committee also requests CMS consider the entire
record of documentation and not require a subjective component
regarding an individual in determining whether home health
services meet the requirements for coverage. The Committee
requests CMS take authorized steps to address the backlog of
face-to-face appeals like allowing comparable documentation to
satisfy the face-to-face requirements, such as those recently
referred from the hospital setting, to be exempt from the face-
to-face requirement. The Committee requests an update in the
fiscal year 2018 budget request on these efforts.
Adult Immunization Quality Measures.--The Committee
recognizes the importance of quality measurement tools to
ensuring accountability and improvements in care delivery and
patient outcomes, including reducing racial and ethnic health
disparities. The Committee requests a report is the fiscal year
2018 budget request on steps the agency has taken to improve
outcome quality measures applicable to adult immunization under
the Medicare and Medicaid programs.
Cancer Hospitals.--The Committee notes concern that CMS
prevents certain cancer hospitals from increasing their bed
capacity and encourages CMS to re-evaluate this policy.
Clarify Third Party Payment of Qualified Health Plan
Premiums.--The Committee remains concerned about the CMS
interim final rule, Third Party Payment of Qualified Health
Plan Premiums, which facilitated marketplace insurance plans
prohibiting the established practice of health insurance
premium assistance by non-profit organizations. The Committee
encourages CMS to clarify that premium assistance should
continue to be accepted from qualified non-profit organizations
along with related State and Federal assistance programs.
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 2018 budget request outlining the
rationale for this determination, to include why CMS believes
it does not have the waiver authority.
Critical Access Hospitals (CAH).--The Committee continues
to note concerns about the proposal to eliminate CAH status
from facilities located less than 10 miles from another
hospital and reducing the reimbursement rate from 101 to 100
percent on the hospitals to properly provide care to local
residents. The Committee expects CMS to take steps to eliminate
negative impact of the proposed rate reduction on CAH ability
to fully operate if the reduction is implemented prior to
implementation.
CMS Test Environment for Testing Industry Solutions.--The
Committee requests an update in the fiscal year 2018 budget
request on the how it is using this initiative to test IT
solutions.
Durable Medical Equipment, Prosthetics, Orthotics and
Suppliers (DMEPOS).--The Committee encourages speedy
implementation of the DMEPOS bid surety bonds requirement to
take effect on January 1, 2017. The Committee requests an
update in the fiscal 2018 budget request on the expected impact
of this requirement in the 2017 competitions.
Evaluation and Management (E&M) Codes.--The Committee
requests CMS provide an update in the fiscal year 2018 budget
request on planned or on-going research related to E&M codes.
Fraud, Waste, and Abuse.--The Committee requests an update
in the fiscal year 2018 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'' measures typically
reported by CMS.
Genetic Testing.--To help eliminate the abuse of opioids,
the FDA recently implemented stricter black box advisories
requiring pharmacogenetics testing prior to prescribing many
opioid based pain medications. The Committee is concerned the
Medicare Administrative Contractors (MACs) changed their
coverage policy and are denying reimbursements for these
pharmacogenetics tests despite its requirement by the FDA. As a
result, providers cannot order these tests and patients are at
risk of serious adverse reactions. The Committee urges CMS to
review this coverage determination and allow patients to access
pharmacogenetics testing for opioid-based pain medications. The
Committee requests an update in the fiscal year 2018 budget
request on the justification for this new coverage decision
including the impact on patient safety, cost, and provider
compliance with FDA regulations.
Indian Health Care.--The Committee supports the CMS plan to
establish a Tribal Resources Center and requests a timeline in
the fiscal year 2018 budget request on the opening and expected
goals and objectives for fiscal years 2017 and 2018.
Medicare 1115 Waivers.--The Committee is concerned about
extended deliberations regarding the home and community-based
waiver application. For example, the Wisconsin Department of
Health Services in December 2014 submitted a waiver application
and a resolution still has not been provided. The Committee
encourages CMS to engage more fully the State and tribal
stakeholders in an effort to resolve the issue prior to the end
of the fiscal year. The Committee requests an update in the
fiscal year 2018 budget request on the process and the number
days it takes on average, along with the longest and shortest
time to make a determination on such a waiver. Further, it
should describe steps CMS is taking to reduce the final
decision timeframe.
Medicare Prosthetic Coverage.--The Committee is aware of
the draft Local Coverage Determination (LCD) Lower Limb
Prostheses. The Committee is aware of concerns raised that the
draft LCD could impose hardships or barriers to access to
prosthetic care for, seniors, veterans, and others requiring
artificial limbs. The Committee encourages CMS to consider the
intended and unintended consequences of the draft LCD and
further consult with clinicians, patient groups, and the
prosthetics field prior to moving forward with the draft
policy.
National Diabetes Prevention Program (NDPP).--The Committee
understands the CMS Office of the Actuary certified expansion
of the NDPP would reduce net Medicare spending and improve the
quality of care without limiting coverage or benefits. The
Committee requests CMS provide an update in the fiscal year
2018 budget request on the feasibility of establishing a
certification process for NDPP providers within CMS. Further,
the update should discuss the feasibility of establishing a new
provider class of practitioners for the NDPP to allow for the
lowest cost and effective delivery method.
Out of Network Emergency Care.--The Committee is concerned
the Center for Consumer Information and Insurance Oversight
(CCIIO) has not provided sufficient clarity on how to determine
the ``Usual, Customary & Reasonable'' (UCR) amount in its final
rule for patient protections (80 Fed. Reg. 72191). Therefore,
the Committee requests CCIIO publish guidance, which may come
in the form of Frequently Asked Questions, clarifying what
constitutes the UCR amount using a transparent and fair
standard, such as an independent unbiased charge database.
Quality Improvement.--The Committee is concerned about the
inconsistency of how health care practices and facilities focus
on quality improvement. The Committee requests the Secretary
conduct a cross-agency review of the programs, agencies, and
offices that are conducted in conjunction with public and
private organizations to evaluate the effectiveness of these
approaches to promote quality metrics that drive continuous
quality improvement within hospitals, health care facilities,
and health care systems. The review should include all CMS and
Innovation Center programs, as well as those conducted
throughout other HHS agencies. Further, the review should
examine how these efforts address pediatric neurodevelopmental
disabilities, including autism. The review should include
recommendations and a public report posted on an HHS website.
The Committee requests a time line and approach for the review
to be included in the fiscal year 2018 budget request.
Pediatric End-Stage Renal Disease.--The Committee
encourages CMS to examine the pediatric case-mix adjuster for
the End-Stage Renal Disease (ESRD) Prospective Payment System
(PPS). Specifically, the Committee requests CMS examine
Medicare claims and cost data along with data from CROWNWeb to
determine the cost of dialysis treatment for Medicare ESRD
pediatric patients compared to non-pediatrics Medicare patients
to ensure the appropriate reimbursement mix-adjustment formula
is being utilized in the PPS for pediatrics. The Committee
requests an update on this issue with the analysis in the
fiscal year 2018 budget request.
Pharmacy Benefit Managers (PBMs).--The Committee
understands CMS fails to conduct oversight on the updating of
the PBMs Maximum Allowable Cost (MAC) lists and that when not
updated correctly, errors in the PBM MAC lists can lead to
increased costs for the government, taxpayers, and most
importantly seniors. The Committee requests an update in the
fiscal year 2018 budget request on the process CMS uses to
oversee that the PBM MAC lists are updated as required.
Readmission Rates.--The Committee is supportive of CMS'
efforts to reduce readmission rates among high-risk seniors
living in communities challenged by poverty, poor health and
literacy, and health disparities or non-compliance with
treatment regimens. In particular, flexible, community-based
multi-payer arrangements have encouraged health and social
service providers to combine efforts in tailoring services to
these at-risk populations. The Committee encourages CMS to work
with community-based organizations to help identify best
practices.
Rural Health Clinics (RHC).--The Committee request CMS
provide a report within 120 days of enactment on State Medicaid
payment methodologies for facilities designated as RHC. The
report should identify any State, which uses a methodology that
includes a reconciliation process that may result in the
recoupment of funds from a RHC. For each State so identified,
the report shall: (1) describe the legal basis for recoupment
and the conditions governing it, including any Federal
requirements; (2) estimate the proportion of any potential
recoupment that would be owed by the State to the Federal
government; and (3) describe any options available under
Federal law to retroactively eliminate, reduce, or otherwise
mitigate the impact of such recoupment on RHC, including the
actions necessary to pursue such options.
Recovery Audit Contractors (RACs).--The Committee
understands that although the RACs significantly reduced the
number of audits recently, the number of audits is expected to
increase. The Committee agrees that true fraud, waste, and
abuse must be addressed; however, the existing audit process
continues to result in unintended consequences of reduced
patient access to care. A reasonable balance must be found to
eliminate true fraud and abuse while not slowing payment to
providers so significantly. The bill language redirects all
offsetting collections derived from the RACs to tackle this
challenge with additional resources 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 between OMHA, CMS, and CMS'
contractors to reduce unintended claims, speed appeals, and
reduce the number of claims elevated to OMHA. Further, the
Committee reiterates its request for CMS to publish in the
fiscal year 2018 budget request, and future budget requests, 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 Corridors.--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 CMS' decision to reverse the National Correct
Coding Initiative procedure edit regarding CPT codes 77295 and
77300 used in the provision of robotic radiosurgery
(retroactive to January 1, 2016). The Committee remains
concerned that the cuts CMS continues to make to robotic
stereotactic radiosurgery threatens its viability. The
Committee continues to urge CMS to make no further changes to
these services (G0339 and G0340) in the freestanding center
setting for three years as noted in House Report (114-195).
Skilled Nursing Facilities (SNF).--The Committee is
concerned with a proposed CMS regulation that would restrict or
prohibit pre-dispute arbitration agreements in skilled nursing
facilities. The Committee understands the Federal Arbitration
Act requires Congress to provide statutory language imparting
authority on an agency to regulate or prohibit arbitration. The
Committee is unaware of any such statutory authority and
discourages CMS from implementing any regulation to prohibit or
otherwise restrict the use of pre-dispute arbitration at
skilled nursing or long-term care facilities in compliance with
the Federal Arbitration Act.
Standard Plan Design and Plan Limitation.--The Committee is
concerned about recent proposals and considerations from CMS on
Federally Facilitated Exchanges, which could further
destabilize the individual market and limit beneficiary choice.
In the proposed 2017 notice of benefit and payment parameters,
CMS proposes to introduce standard plan designs and is
considering making these standard plan designs a requirement
for future years. Additionally, CMS appears to be considering
limiting the number of offerings from plans on the Exchanges
for future years. The Committee requests CMS provide
justification in the fiscal year 2018 budget request analyzing
the impact from the proposals on plan participation, premiums,
and formulary and network design for 2017 and the impact each
would have on consumers.
Therapeutic Foster Care (TFC) Services National Academy of
Sciences (NAS) Review.--The Committee is deeply concerned about
the lack of a uniform definition within the Medicaid program
for therapeutic foster care services. A uniformed TFC
definition can improve the ability for more consistent care and
treatment. The Committee directs CMS to charter a NAS review
within 90 days of enactment of this Act for the development of
an operational TFC definition for the Medicaid program.
Further, the review should examine advantages and challenges of
a uniform definition, and include a list of potential services
and interventions to treat mental illness and trauma that could
be considered within the scope of the uniform definition. The
Committee expects the report will be completed within 12 months
after enactment of this Act.
Federal Administration
The Committee recommends $710,533,000 to support Federal
Administrative activities related to the Medicare and Medicaid
programs, which is $22,000,000 less than the fiscal year 2016
enacted level and $25,317,000 less than the fiscal year 2017
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 explanatory statement accompanying the fiscal year 2016
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 recommends includes $681,000,000, to be
transferred from the Medicare trust funds, for the Health Care
Fraud and Abuse Control Account (HCFAC) activities. This
includes a base amount of $311,000,000 and an additional
$370,000,000 through a discretionary budget cap adjustment
authorized under section 251(b) of the Balanced Budget and
Emergency Deficit Control Act of 1985. The HCFAC funds support
activities conducted by CMS, the HHS Office of Inspector
General, and the Department of Justice. This level is equal to
the fiscal year 2016 enacted level and $44,000,000 less than
the fiscal year 2017 budget request. This funding is in
addition to other mandatory funding provided 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 Committee
continues to include bill language to ensure the Secretary
fully funds the Senior Medicare Patrol Program administered by
the Administration for Community Living from the level provided
in this account.
Part B Ambulance Providers.--The Committee supports
measures, including moratoriums, to curb and prevent waste,
fraud and abuse, but these must be measured against community
needs for emergency services.
Program Integrity Activities.--For several years now, the
Committee has requested CMS improve consistency, transparency,
and processing of appeals. The Committee has and continues to
request CMS use offsetting collections from the RAC program to
further educate health care providers on how to reduce errors
to reduce the backlog of appeals and resolve audits in a timely
manner. The Committee reiterates these requests and further
directs CMS to provide a quarterly report on how the overall
process of appeals, including all entities involved in the
appeals process are making the necessary changes to improve the
system. CMS should detail in the report all the actions the
agency has specifically taken to improve the process of audits
and appeals. The Committee also requests a description in the
fiscal year 2018 budget request on the adoption of a policy
similar to Social Security appeals that would require
Medicare's Administrative Law Judges (ALJs) to follow Medicare
payment policies. Further, the Committee requests the Secretary
consider ways to sample and consolidate similar claims for
administrative efficiency, expedite procedures for claims with
no material fact in dispute, rules to require ALJs to rule
according to Medicare policy if they do not violate the law,
the impact of sending claims back to the first level of appeal
when new evidence is introduced, and the impact of creating
Medicare Magistrates to streamline the appeal resolution
process.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
The Committee recommends $3,010,631,000 for the Child
Support Enforcement and Family Support programs, which is
$65,725,000 more than the fiscal year 2016 enacted level and
the same as the fiscal year 2017 budget request. The Committee
also recommends $1,400,000,000 in advance funding, as
requested, for the first quarter of fiscal year 2018 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 $3,490,304,000 for the Low Income
Home Energy Assistance Program, which is $100,000,000 above the
fiscal year 2016 enacted level and $490,000,000 more than the
fiscal year 2017 budget request. Within the amount provided,
the Committee recommends $3,490,304,000 exclusively for the
State formula grants. The Committee recommends an increase of
$100,000,000 for allocation under the formula authorized in
1984.
Within the amount available for formula grants, the
Committee recommends up to $2,988,000 for program integrity
initiatives. The funding will allow technical assistance on
both 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 $1,674,691,000 for Refugee and
Entrant Assistance programs, which is the same as the fiscal
year 2016 enacted level and $575,169,000 below the fiscal year
2017 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:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Transitional and Medical Services.................... $490,000,000
Victims of Trafficking............................... 18,755,000
Social Services...................................... 155,000,000
Preventive Health.................................... 4,600,000
Targeted Assistance.................................. 47,601,000
Unaccompanied Children............................... 948,000,000
Victims of Torture................................... 10,735,000
------------------------------------------------------------------------
Refugees and Unaccompanied Children
Healthcare and Education Costs Related to Illegal
Immigration.--The Committee is concerned with the significant
healthcare and education costs to State and local communities
resulting from illegal immigration. In addition, the Committee
is concerned about the response time from previous inquiries on
this matter; the Committee urges the Departments of Education
and Health and Human Services to provide timely and informative
assistance when requested. The Committee further directs the
Departments of Education and 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. The
report should cover the costs incurred over the course of
fiscal years 2014-2016 and include projected costs for fiscal
years 2017 through 2021. The report shall also include an
accounting of what Federal resources have been directed and
what Federal resources will be directed in each year to cover
these added expenses.
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT
The Committee recommends $2,801,000,000 for the
discretionary portion of the Child Care and Development Fund,
the Child Care and Development Block Grant, which is
$40,000,000 more than the fiscal year 2016 enacted level and
$160,672,000 below the fiscal year 2017 budget request. The
Child Care and Development Block Grant provides funds according
to a formula to States, territories, and tribes to provide
financial assistance to help low-income working families and
families engaged in training or education activities access
child care and to improve the quality of child care for all
children.
SOCIAL SERVICES BLOCK GRANT
The Committee recommends $1,700,000,000 for the Social
Services Block Grant, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. States
receive grants by formula. 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, abuse, or exploitation of
children and adults.
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.
Within the total, the Committee recommends the following:
------------------------------------------------------------------------
FY 2017
Budget Activity Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families:
Head Start........................................... $9,309,724,000
Preschool Development Grants......................... 250,000,000
Runaway/Homeless Youth............................... 101,980,000
Abuse of Runaway Youth Prevention.................... 17,141,000
State Child Abuse Prevention......................... 25,310,000
Discretionary Child Abuse Prevention................. 34,200,000
Community-based Child Abuse Prevention............... 39,764,000
Child Welfare Services............................... 268,735,000
Child Welfare Training............................... 17,984,000
Adoption Opportunities............................... 39,100,000
Adoption Incentives.................................. 37,943,000
Social Services/Income Maintenance Research.......... 6,512,000
Native American Programs............................. 53,100,000
Community Services:
Community Services Block Grant................... 715,000,000
Economic Development............................. 29,883,000
Rural Community Facilities....................... 7,500,000
Individual Development Account Initiative............ 18,950,000
Domestic Violence Hotline............................ 8,250,000
Family Violence/Battered Women's Shelters............ 151,000,000
Independent Living Training Vouchers................. 43,257,000
Disaster Human Services Case Management.............. 1,864,000
Program Direction.................................... 205,699,000
------------------------------------------------------------------------
Head Start
The Committee recommends $9,309,724,000 for the Head Start
program, which is $141,629,000 more than the fiscal year 2016
enacted level and $292,000,000 below the fiscal year 2017
budget request. Within the total for Head Start, the Committee
recommends a cost-of-living adjustment and includes $25,000,000
for the Designation Renewal System. Additionally, the Committee
recommends $645,000,000 for Early Head Start (EHS) grants
within the total for fiscal year 2017, which is $10,000,000
more than the fiscal year 2016 enacted level and the same as
the budget request.
The Committee supports efforts to strengthen and grow Head
Start and Early Head Start and to continue quality improvement
through increasing the number of teachers with bachelor's
degrees, reforming monitoring systems and implementing
recompetition. The Committee includes a $141,629,000 increase
for a cost-of-living adjustment to support and strengthen
workforce quality and stability and to assist Head Start
programs in meeting rising costs. Of that $141,629,000,
$10,000,000 is reserved for the Early Head Start expansion and
Early Head Start-Child Care Partnership grantees for a cost-of-
living adjustment. The Committee is pleased with the
efficiencies realized through announcing Birth through Five
grants, aligning Early Head Start and Head Start grants
together, and encourages ACF to expand this process where
possible.
Preschool Development Grants
The Committee recommends $250,000,000 for Preschool
Development Grants, which is the same as the fiscal year 2016
enacted level, and $100,000,000 below the fiscal year 2017
budget request. This program provides grants to states to build
state and local capacity to provide preschool for 4-year-olds
from low- and moderate-income families. Research confirms that
high-quality preschool improves school readiness and long-term
academic success of children by supporting their academic and
social-emotional skills. Support for this grant is an important
step to building a globally competitive 21st century workforce.
The Every Student Succeeds Act requires the Department of
Health and Human Services to work jointly with the Department
of Education in the administration of the program. Within 90
days of enactment, the Committee requests a report to be
submitted to the House of Representatives Committees on
Appropriations and Education and the Workforce outlining the
role of each Department in the administration of the program.
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 $53,100,000 for Native American
Programs, which is $3,100,000 more than the fiscal year 2016
enacted level and the same as the fiscal year 2017 budget
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 the Administration for Children and Families (ACF)
to give priority to grantees with rigorous immersion programs.
Community Services
The Committee recommends $771,333,000 for the Community
Services programs, which is $1,000,000 more than the fiscal
year 2016 enacted level and $78,383,000 more than the fiscal
year 2017 budget request.
Community Services Block Grant
The Committee is concerned funds are not reaching local
agencies and community residents promptly. The Committee urges
ACF to take all necessary action to ensure funds are made
available as soon as possible to States and annual allocation
amounts are made public as soon as can be accomplished. The
Committee further encourages ACF to engage with stakeholders on
the requirements, challenges, and implementation of new data
collection and Federal reporting initiatives. The Committee
requests an update on these efforts.
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 low-income individuals fill at least 75 percent of
the jobs created from CED funded projects. 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. Under CED grants, CDCs
provide financial assistance for economic development
activities designed to address the economic needs of low-income
individuals by creating employment and business development
opportunities. CDCs use CED funds with other sources of public
and private capital to finance commercial and industrial
facilities, small businesses, and mixed use projects. CDCs
leverage $9 in private capital to every $1 in Federal funds for
projects in communities with high poverty and unemployment
rates.
Rural Community Facilities
The Committee again rejects the proposed elimination of the
Rural Community Facilities program. The Committee recommends
$7,500,000 for the Rural Community Facilities program, which is
$1,000,000 more than the fiscal year 2016 enacted level, and
$7,500,000 more than the fiscal year 2017 budget request.
Grantees work with small communities on drinking water and
wastewater issues. Rural communities are often unincorporated
and therefore ineligible to qualify for financing for the
technical assistance, authorized under the Department of
Agriculture. In addition, some communities do not have central
systems that would make them eligible for technical assistance
provided through the Environmental Protection Agency.
Family Violence Prevention and Battered Women's Shelters
The Committee recommends $151,000,000 for the Family
Violence Prevention and Battered Women's Shelters programs,
which is $1,000,000 more than the fiscal year 2016 enacted
level and is the same as the fiscal year 2017 budget request.
The Family Violence Prevention and Services Act programs
provide funding to support the prevention of incidents of
family violence, domestic violence, and dating violence, and
provide the immediate shelter and supportive services for adult
and youth victims (and their dependents).
PROMOTING SAFE AND STABLE FAMILIES
The Committee recommends $325,000,000 in mandatory funds
for the Promoting Safe and Stable Families program, which is
the same as the fiscal year 2016 enacted level and the fiscal
year 2017 budget request. The Committee also recommends
$79,765,000 in discretionary funds for this program, which is
$20,000,000 more than the fiscal year 2016 enacted level and
the same as the fiscal year 2017 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.
The Committee recommends $20,000,000 to increase the
capacity of tribes to administer child welfare services, as
requested in the fiscal year 2017 budget request. American
Indian and Alaska Native children are disproportionately
represented at two times their population in state child
welfare systems nationally. Among individual state foster care
systems they are overrepresented at as much as ten times their
population rate. This funding will address this
disproportionality by investing in tribal child welfare systems
and provide culturally appropriate services to tribal families.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
The Committee recommends $5,764,000,000 for payments to
States for foster care and adoption assistance, which is
$466,000,000 more than the fiscal year 2016 enacted level and
the same as the fiscal year 2017 budget request. The Committee
also recommends an advance appropriation of $2,500,000,000 for
the first quarter of fiscal year 2018 to ensure timely
completion of first quarter grant awards.
Within the total, the Committee recommends $4,992,000,000
for the Foster Care program, which is $219,900,000 above the
fiscal year 2016 enacted level and the same as the fiscal year
2017 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 $2,780,000,000
for Adoption Assistance, which is $217,100,000 more than the
fiscal year 2016 enacted level and the same as the fiscal year
2017 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 $152,000,000 for
the Kinship Guardianship Assistance program, which is
$29,000,000 more than the fiscal year 2016 enacted level and
the same as the fiscal year 2017 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 2016 enacted level and the fiscal year
2017 budget request. This program assists foster children age
16 or older to 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 a total program level of
$2,003,975,000 for the Administration for Community Living
(ACL), which is $11,425,000 more than the fiscal year 2016
enacted program level and $17,019,000 below the fiscal year
2017 budget request program level. Of the funds provided,
$22,700,000 shall be transferred from the Prevention and Public
Health Fund and $52,115,000 shall be transferred from the
Federal Hospital Insurance and Federal Supplementary Medical
Insurance Trust Funds. The Committees recommends level funding
for the Senior Medicare Patrol Program, which is provided under
the Health Care Fraud and Control Abuse Account.
The Committee understands ACL has proposed to expand the
administrative capacity of grant programs by shifting funds
from grants to support new staff. The Committee recognizes this
additional capacity may enhance program oversight and
performance. However, the Committee's intent for appropriating
these funds is to expand program dollars available for grants,
not to expand ACL's administrative capacity. The Committee is
concerned about the programmatic impact a shift in funds will
have on grantees. The Committee directs ACL to maintain the
fiscal year 2015 funding for the grants for all programs, and
where there were increases provided in fiscal year 2016, the
Committee directs ACL to increase grants by the same amount.
The Committee requests additional detail in the fiscal year
2018 budget request under each program for any proposed
reduction in the amount for grants, including the amount of the
reduction for grants and the increase proposed for
administrative staff.
Home and Community-Based Supportive Services
The Committee recommends $353,049,000 for Home and
Community-Based Supportive Services, which is $5,325,000 more
than the fiscal year 2016 enacted level and $4,675,000 below
the fiscal year 2017 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 $19,963,000 for Preventive Health
Services, which is $115,000 more than the fiscal year 2016
enacted level and fiscal year 2017 budget request. This program
funds activities that help seniors remain healthy and avoid
chronic diseases.
Protection of Vulnerable Older Americans
The Committee recommends $20,823,000 for programs that
protect vulnerable older Americans, which is $165,000 more than
the fiscal year 2016 enacted level and fiscal year 2017 budget
request. These programs provide grants to States for protection
of vulnerable older Americans through the Long-Term Care
Ombudsman and Prevention of Elder Abuse and Neglect programs.
Family Caregiver Support Services
The Committee recommends $150,911,000 for the National
Caregiver Support program, which is $325,000 more than the
fiscal year 2016 enacted level and fiscal year 2017 budget
request. This program supports a multifaceted support system in
each State for family caregivers.
Native American Caregiver Support Services
The Committee recommends $7,556,000 for the Native American
Caregiver Support program, which is $25,000 more than the
fiscal year 2016 enacted level and fiscal year 2017 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 $454,091,000 for Congregate
Nutrition Services, which is $5,749,000 more than the fiscal
year 2016 enacted level and the same as the fiscal year 2017
budget request. The Committee further recommends $234,397,000
for Home-Delivered Meal Services, which is $8,055,000 more the
fiscal year 2016 enacted level and the same as the fiscal year
2017 budget request. These programs help older Americans remain
healthy and independent in their communities by providing meals
and related services in a variety of settings (including
congregate facilities such as senior centers) and via home-
delivery to older adults who are homebound due to illness,
disability, or geographic isolation.
Nutrition Services Incentives Program
The Committee recommends $160,069,000 for the Nutrition
Services Incentives Program, which is the same as the fiscal
year 2016 enacted level and the fiscal year 2017 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 $31,208,000 for Native American
Nutrition and Supportive Services, which is $50,000 above the
fiscal year 2016 enacted level and fiscal year 2017 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 2016
enacted level and the fiscal year 2017 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.
National Alzheimer's Call Center.--Within funding for the
Aging Network Support Activities, the Committee continues
funding for the National Alzheimer's Call Center, which is
available in all States, 24-hours a day, 7 days a week, year-
round to provide expert advice, crisis counseling, care
consultation and information referral services in at least 200
languages, for persons with Alzheimer's disease, their family
members and informal caregivers.
Alzheimer's Disease Programs
The Committee recommends $20,454,000 for Alzheimer's
Disease Programs, which is $954,000 more than the 2016 enacted
program level and fiscal year 2017 program level budget
request. These programs provide 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. The Committee
recommends $10,500,000 from the Prevention and Public Health
Fund for the Alzheimer's Disease Initiative--Specialized
Supportive Services. The Committee recommends $5,754,000 for
the Alzheimer's Disease Supportive Services Program. The
Committee recommends $4,200,000 from the Prevention and Public
Health Fund for the Alzheimer's Disease Outreach Campaign.
Lifespan Respite Care
The Committee recommends $4,000,000 for Lifespan Respite
Care, which is $640,000 more than the fiscal year 2016 enacted
level and $1,000,000 below the fiscal year 2017 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.
Elder Falls
The Committee recommends $5,000,000 for the Elder Falls
program, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 budget request. Fall prevention
grants support the promotion and dissemination of prevention
tools to be delivered in community settings.
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
2016 enacted level and the fiscal year 2017 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 Rights Support Activities
The Committee recommends $11,874,000 for Elder Rights
Support Activities, which is the same as the fiscal year 2016
enacted level and $2,000,000 below the fiscal year 2017 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.
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 2016 enacted level and $2,000,000 below the fiscal year
2017 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 the State Health
Insurance program, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. This
program provides accurate and understandable health insurance
information to Medicare beneficiaries and their families.
Paralysis Resource Center
The Committee does not recommend specific funding for the
Paralysis Resource Center. Other programs administered by ACL
can conduct the responsibilities of the Paralysis Resource
Center by providing information and referral services to people
living with paralysis.
Limb Loss Resource Center
The Committee does not recommend specific funding for the
Limb Loss Resource Center. Other programs administered by ACL
can conduct the responsibilities of the Limb Loss Resource
Center by providing information and referral services to people
dealing with limb loss.
Traumatic Brain Injury
The Committee recommends $9,321,000 for the Traumatic Brain
Injury program, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. The
program provides grants to States for the development of a
comprehensive, coordinated family and person-centered service
system at the state and community level for individuals who
sustain a traumatic brain injury.
Developmental Disabilities State Councils
The Committee recommends $73,215,000 for State Councils on
Developmental Disabilities, which is $215,000 more than the
fiscal year 2016 enacted level and fiscal year 2017 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 $38,949,000 for Developmental
Disabilities Protection and Advocacy, which is $215,000 more
than the fiscal year 2016 enacted level and fiscal year 2017
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.
Olmstead v. L.C. 527 U.S. 581 (1999).--The Committee notes
that the Developmental Disabilities Assistance and Bill of
Rights Act of 2000 does not require closure of long-term care
facilities for persons unable to care for themselves. The
Committee notes that the 1999 U.S. Supreme Court decision in
Olmstead v. L.C. does not mandate deinstitutionalization. ``We
emphasize that nothing in the Americans with Disabilities Act
or its implementing regulations condones termination of
institutional settings for persons unable to handle or benefit
from community settings . . . Nor is there any Federal
requirement that community-based treatment be imposed on
patients who do not desire it.'' Olmstead v. L.C. 119 S. Ct.
2176, 2187 (1999). The Committee asks for a report on the
current Olmstead enforcement activities within ACL.
Medicaid Licensed Intermediate Care Facilities.--There is a
nationwide trend towards deinstitutionalization of patients
with intellectual or developmental disabilities in favor of
community based settings. The Department is strongly urged to
continue to factor the needs and desire of patients, their
families, caregivers, and other stakeholders, as well as the
need to provide proper settings for care, into its enforcement
of the Developmental Disabilities Act. The Committee maintains
bill language requiring notification of affected individuals of
their legal rights in this regard.
Voting Access for Individuals with Disabilities
The Committee recommends $5,013,000 for the Voting Access
for Individuals with Disabilities program, which is $50,000
more than the fiscal year 2016 enacted level and fiscal year
2017 budget request. The Voting Access for Individuals with
Disabilities program authorized by the Help America Vote Act
provides formula grants to ensure full participation in the
electoral process for individuals with disabilities, including
registering to vote, casting a vote, and accessing polling
places.
Developmental Disabilities Projects of National Significance
The Committee recommends $10,000,000 for Developmental
Disabilities Projects of National Significance, which is the
same as the 2016 enacted level and the fiscal year 2017 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 $38,869,000 for University Centers
for Excellence in Developmental Disabilities (UCEDD), which is
$250,000 more than the fiscal year 2016 enacted level and
fiscal year 2017 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 $102,835,000 for the Independent
Living program, of which $22,993,000 is for the Independent
Living State Grants program and $79,842,000 is for the Centers
for Independent Living program. This funding level is
$1,652,000 above the fiscal year 2016 enacted level and fiscal
year 2017 budget request. Independent Living programs maximize
the leadership, empowerment, independence and productivity of
individuals with disabilities.
Muscular Dystrophy.--The Committee is aware that ACL is
included in the Muscular Dystrophy Coordinating Committee under
the Muscular Dystrophy CARE Act Amendments enacted in September
2014. The Committee supports programs and initiatives focused
on the transitions of persons with Duchenne into adulthood. The
Committee requests a report on ACL's plans to conduct
comprehensive studies focused on demonstrating 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 2016 enacted
level and the same as the fiscal year 2017 budget 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 $34,150,000 for Assistive
Technology, which is $150,000 more than the fiscal year 2016
enacted level and $2,150,000 more than the fiscal year 2017
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. Assistive Technology programs maximize
the ability of individuals with disabilities of all ages and
their family members, guardians, advocates, and authorized
representatives to obtain AT devices and AT services.
Program Administration
The Committee recommends $38,063,000 for Program
Administration, which is $2,000,000 below the fiscal year 2016
enacted level and $3,000,000 less than the fiscal year 2017
budget request. This funding supports Federal administrative
costs associated with administering ACL programs.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
The Committee recommends a program level total of
$423,037,000 for General Departmental Management, which is
$97,800,000 below the fiscal year 2016 enacted level and
$121,853,000 below the fiscal year 2017 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
2016 enacted level and $8,050,000 below the fiscal year 2017
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.
Abuse Deterrent Opioids.--A recent study indicates that
hospitalizations related to opioid abuse and dependence
significantly increased from 2002 to 2012, and associated
inpatient charges almost quadrupled over the same time period,
reaching almost $15 billion for hospitalizations related to
opioid abuse and dependence and more than $700 million for
those related to associated infection in 2012. Considering that
Medicaid was the most common primary payer for both types of
hospitalizations, the Committee supports actions that Centers
for Medicare and Medicaid Services can take to address this
challenge in Medicare and Medicaid. Among the strategies to
reduce abuse, misuse and diversion of these medications is the
availability of Abuse Deterrent Opioids (ADO) approved by the
U.S. Food and Drug Administration. The Committee directs HHS to
submit a report to the Committee on Appropriations regarding
beneficiary access to ADOs and actions that Congress and the
Administration can take to reduce barriers.
Administrative and Overhead Costs.--The Committee remains
concerned 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. Last year, the Committee directed 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. The Committee notes that this directive
was not complied with in the fiscal year 2017 budget submission
and reiterates its directive to include this information in
fiscal year 2018.
International Public Health Leadership.--The Committee
recognizes the importance of U.S. leadership in international
health policy discussions and directs the Secretary of the
Department of Health and Human Services to ensure that all such
policy recommendations are drafted only after a transparent and
inclusive public comment process has been established.
Furthermore, all policy recommendations should be derived from
sound science and well established data and should also include
a thorough cost and benefit analysis. Policy recommendations
must also take into account the perspectives of all relevant
U.S. agencies and must be consistent with U.S. international
trade obligations.
Mental Health Inpatient Care.--The Committee understands
the critical need for access to mental health services,
especially for those suffering from serious mental illness. The
Committee believes additional information is needed to
determine the best-suited form of assistance that States
require to address geographic disparities in access to mental
health treatment. Therefore, the Committee directs the
Secretary of Health and Human Services to research access to
mental health services, especially access to inpatient service
for those suffering from serious mental illness, and to
research options for assisting State, local, and tribal
governments in ensuring equitable access to mental health
services. The Secretary should include options that address
regions with low numbers of inpatient beds. The Committee
directs the Secretary to provide a report within 120 days of
enactment of this Act.
Tribal Advisory Committee.--The Committee appreciates the
Secretary's Tribal Advisory Committee as a tool to facilitate
intergovernmental interaction with the tribal governments. The
Committee requests the Secretary use this and the HHS Tribal
Consultation process to examine ways to better integrate,
prioritize, and streamline grants, contracts, and other funding
mechanisms for tribes that support programs such as public
health, mental health, and dental care, among others. The
review should examine how funds can be better coordinated or
provided directly to tribes in a manner that supports the
tribal, Federal, and State objectives where all three have an
interest. Further, the Committee expects the Secretary to use
the review to consider improved methods to prioritize and
coordinate funds made available to tribes to meet the
objectives of the tribally led health assessments. Finally, the
Committee requests the Secretary explore alternative approaches
to better maximize the health prevention activities that
examine the various HHS-wide programs, mechanisms, and
flexibilities in consultation with the Tribal Advisory
Committee process.
Quick Health Data Online System.--The Committee directs the
Secretary to continue the operation of the Quick Health Data
Online System. The ongoing and upgraded version of the data
query system should include all variables previously available,
and access data from relevant datasets beyond HHS. User-
friendly data queries should have the capacity to seek
information by sex and by race/ethnicity simultaneously, at the
State and county levels.
Office of the Assistant Secretary for Health
Breastfeeding and Medications.--Nearly 4 million women in
the United States give birth each year, and 3 million
breastfeed their infants. Almost all of those women will take a
medication during this time. However, not much is known about
the effects of those medications on the woman or baby. The
Committee asks the Secretary to create a task force consisting
of all HHS agencies--including NIH, FDA and CDC, among others,
public stakeholders including healthcare professionals,
consumers, and industry representatives to meet several times
throughout the year and report to Congress on the following:
existing Federal research and programs related to medications
during pregnancy and lactation--both public and private; a list
of disease states in which pregnant and lactating women may
take prescription medications; appropriate research endpoints
for clinical trials in pregnancy; and recommendations for
future steps in ensuring the safety and efficacy of drugs in
pregnancy and lactation, among other appropriate topics.
Embryo Adoption Awareness Campaign.--The Committee
recommends $1,000,000 for the Embryo Adoption Awareness
Campaign, the same as the fiscal year 2016 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 to help other
couples build their families. 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 $53,900,000 for specific program
activities to address the high-priority HIV prevention and
treatment needs of minority communities, the same as the fiscal
year 2016 level and the fiscal year 2017 budget request. These
funds are provided to promote an effective, culturally
competent and linguistically appropriate public health response
to the HIV/AIDS epidemic.
Pulmonary Hypertension (PH).--The Committee is concerned
that most PH patients are not diagnosed for many years until
the condition has reached a catastrophic stage, which leads to
significant disability, greatly increased mortality, and the
need for costly and dramatic medical interventions, such as
heart-lung transplantation. Considering the availability of
effective therapies for early-stage PH, HHS is encouraged to
work across agencies and with the patient and professional
community to prepare recommendations to improve early diagnosis
and treatment of PH.
Sexual Risk Avoidance.--The Committee provides $20,000,000
in budget authority for sexual risk avoidance programs, which
is $10,000,000 above the fiscal year 2016 level and $20,000,000
above the fiscal year 2017 budget request.
In implementing these funds, it is the intent of the
Committee that HHS provide substantive and practical technical
assistance to grantees so they place meaningful emphasis on
Sexual Risk Avoidance (SRA) in all educational messaging to
teens. The Committee notes that such technical assistance
should be provided in the following venues: during National and
regional conferences, webinars and one-on-one conversations
with funded projects. The Committee further intends that SRA-
credentialed experts consult with grantees and HHS staff with
oversight of these programs on methodologies and best practices
in SRA for teens. The Committee also encourages all operating
divisions at HHS that implement or inform youth programs to
consistently implement a public health model that stresses risk
avoidance or works to return individuals to a lifestyle without
risk, particularly as it relates to sexual risk.
Tick-Borne Diseases.--The Committee directs the Secretary
to create a Tick-Borne Diseases Advisory Committee (TBDAC) to
enhance interagency coordination and communication and minimize
overlap regarding efforts to address tick-borne diseases;
identify opportunities to coordinate efforts with other Federal
agencies and private organizations addressing such diseases;
ensure interagency coordination and communication with
constituency groups; ensure that a broad spectrum of scientific
viewpoints is represented in public health policy decisions and
that information disseminated to the public and physicians is
balanced; and advise relevant Federal agencies on priorities
related to the Lyme and tick-borne diseases. The Secretary
should appoint voting members to the Committee who should
represent a diversity of scientific perspectives, and
specifically should consist of members of the scientific
community, representatives of tick-borne voluntary
organizations, health care providers, individuals who have been
diagnosed with a tick-borne disease or their family members,
and representatives of State and local health departments and/
or their organizations. The TBDAC should submit a report to the
Committee on Appropriations by September 30, 2017.
Unique Patient Health Identifier.--The Committee is aware
that one of the most significant challenges inhibiting the safe
and secure electronic exchange of health information is the
lack of a consistent patient data matching strategy. With the
passage of the HITECH Act, a clear mandate was placed on the
Nation's healthcare community to adopt electronic health
records and health exchange capability. Although the Committee
continues to carry a prohibition against HHS using funds to
promulgate or adopt any final standard providing for the
assignment of a unique health identifier for an individual
until such activity is authorized, the Committee notes that
this limitation does not prohibit HHS from examining the issues
around patient matching. Accordingly, the Committee encourages
the Secretary, acting through the Office of the National
Coordinator for Health Information Technology and CMS, to
provide technical assistance to private-sector led initiatives
to develop a coordinated national strategy that will promote
patient safety by accurately identifying patients to their
health information.
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
2016 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.
The agreement continues to provide $2,000,000 for Lupus
activities at OMH. The Committee continues to support the OMH
National Health Education Lupus Program and its efforts to
develop a clinical trial education action plan for lupus and
implementation of the action plan. The action plan will focus
on developing public-private and community partnerships,
evaluate current minority clinical trial education and
participation programs, and development of a research plan for
creating new clinical trial education models in lupus to inform
the development of the broader actionable lupus clinical trial
education plan.
The Committee has historically supported OMH cooperative
agreements with historically black medical schools. As trusted
community partners, these institutions have an extensive
history of making contributions to end health disparities. The
Committee requests a report on the cooperative agreements with
a focus on how these grants enable constructive programmatic
activity that benefits the communities and geographic locations
of the schools.
The Committee recognizes advancements in the treatment and
management of hepatitis and encourages OMH to purse community
collaborations that promote awareness and outreach to improve
testing, diagnosis, and treatment.
Office of Women's Health
The Committee includes $32,140,000 for the Office of
Women's Health, the same as the fiscal year 2016 enacted level
and the fiscal year 2017 budget request.
Faith Based Center
The Committee includes $1,299,000 for the Faith Based
Center, the same as fiscal year 2016 enacted level and $83,000
below the fiscal year 2017 budget request.
OFFICE OF MEDICARE HEARINGS AND APPEALS
The Committee provides $107,381,000 for the Office of
Medicare Hearings and Appeals (OMHA), which is the same as the
fiscal year 2016 enacted level and $12,619,000 below the fiscal
year 2017 budget request. This Office supports hearings at the
administrative law judge level, the third level of Medicare
claims appeals. The Committee has included language allowing
for an additional $2,000,000 to be transferred from the Office
for Civil Rights to OMHA upon certain conditions.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY
The Committee provides $65,367,000 for the Office of the
National Coordinator for Health Information Technology (ONC),
which is $5,000,000 above the fiscal year 2016 enacted level
and $16,633,000 below the fiscal year 2017 budget request. The
budget proposed to fund this entire office from the evaluation
tap.
Prescription Drug Monitoring.--The Committee understands
that the spread of the prescription drug epidemic throughout
the Nation has made the creation, implementation, and use of
State Prescription Drug Monitoring Programs (PDMPs) and their
ability to operate in concert with Electronic Health Records
(EHR) and electronic prescribing (e-prescribing) systems more
important than ever. In furthering this goal, the Committee
encourages ONC to continue its support for pilot programs to
find usability challenges among PDMP, EHR, and e-prescribing
systems; develop and award challenge awards to private entities
for health information technology innovation; and offer
targeted technical assistance to help medical professionals use
PDMP, EHR, and e-prescribing systems. The Committee further
encourages ONC to collaborate and coordinate its efforts toward
creation, implementation, and use of PDMPs with partner
agencies such as the Substance Abuse and Mental Health Services
Administration within HHS and the Bureau of Justice Assistance
within the Department of Justice.
Immunization Information Systems.--The threat of the
disease outbreaks and the ongoing work to target outreach to
under immunized communities underscores the importance of
maintaining robust immunization information systems (IIS).
However, despite widespread availability of state and
jurisdictional IIS' and their frequent use by pediatric
providers, only 32 percent of adults 18 and over have
immunization records in an IIS. The Committee encourages ONC to
continue pilots to explore ways to increase the usage of IIS by
adults.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $85,000,000 for the Office of
Inspector General (OIG), which is $10,000,000 more than the
fiscal year 2016 enacted level and equal to the fiscal year
2017 budget request. In addition, within the Health Care Fraud
and Abuse Control (HCFAC) program discretionary appropriations
for fiscal year 2017, 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 $152,200,000 in fiscal year 2017.
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 Affordable Care Act and describe
the activity in the fiscal year 2017 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 agreement again
requests that within 90 days of enactment the OIG provide a
revised top-25 unimplemented recommendations report under the
same terms and condition 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 Department of 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 2016 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.
Protected Health Information.--The Committee is concerned
about the breadth and consequences of the February 25, 2016
HIPAA guidance regarding access to protected health information
(PHI) issued by the Office for Civil Rights in the form of
Frequently Asked Questions. In particular, OCR's issuance of
the guidance without notice and formal, comment rulemaking
newly regulates that covered entities and business associates
must use one of three restrictive methods to calculate the
reasonable, cost-based fee that they may charge an individual
for providing PHI, one of which is an arbitrary ``flat fee''
option of $6.50. The guidance also expressly mandates that
covered entities and business associates must apply this
restrictive calculation scheme not only to an individual's
requests for personal access to his or her own PHI or an
individual's request to direct records to third parties for
patient-care and research, but also for commercial uses
unrelated to patient care and research. This mandate could
result in a significant shift of costs onto patient care for
the production of such commercial requests.
The Committee urges that OCR delay the enforcement of the
guidance and eliminate, or at the very least modify, the three
methods to calculate the reasonable, cost-based fee that may be
charged the individual; and clarify that the reasonable, cost-
based fee applies only to patient access and patient requests
directing transmittal of PHI to third parties for patient care
and research.
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 $630,408,000 for fiscal year 2017,
which is $44,220,000 above the fiscal year 2016 enacted level
and the same as the fiscal year 2017 budget request.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
The Committee provides $1,631,258,000 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. This amount is
$98,300,000 more than the fiscal year 2016 level and
$200,141,000 more than the fiscal year 2017 budget request.
Office of the Assistant Secretary for Preparedness and Response
The Committee provides $1,494,928,000 for activities
administered by the Office of the Assistant Secretary for
Preparedness and Response (ASPR). This amount is $98,300,000
more than the fiscal year 2016 enacted level and $253,150,000
more than the fiscal year 2017 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.
Burn Patient Management in Mass Casualty Event.--The
Committee directs ASPR to provide a report in the fiscal year
2018 budget request on the current and on-going efforts to
improve the logistics of burn patient triage and transfer in
the event of a mass casualty event. The Committee understands
the ability to maximize efficiency and effectiveness of triage
and that subsequent care would be critical to the management of
an overwhelming surge in burn patient volume and intensity.
Specifically, the report should note the on-going and planned
research from across HHS related to treatment and systems
capability like the development of a network platform for
reporting immediate and surge burn bed availability to match
patient acuity or critical providers into the network.
Regional Treatment Centers.--The Committee is aware that
HHS has created a regional treatment network for future
infectious disease outbreaks through a tier system using Ebola
funds. The Committee requests a report on the Department's
plans, including funding and timetables, for each tier
outlining capabilities for infrastructure, training, and other
key parameters such as waste management. HHS should make a
public version of the report available on the HHS website.
Biomedical Advanced Research and Development Authority
The Committee provides $520,000,000 for the Office of
Biomedical Advanced Research and Development Authority (BARDA),
which is $8,300,000 more than fiscal year 2016 enacted level
and the fiscal year 2017 budget request. In addition, the
Committee provides $600,000,000 for Project BioShield, which is
$90,000,000 more than the fiscal year 2016 enacted level and
$250,000,000 more than the fiscal year 2017 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
partnerships to develop MCMs is required to successfully
prepare and defend the Nation against these threats. The
Committee supports the goal of market development where there
is little or no 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 from year to year, especially
when the country is facing such tight budget constraints while
threats persist.
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.
Biomedical Advanced Research and Development Authority 90-
Day Review.--The Committee recognizes BARDA as a critical link
in the Public Health Emergency Medical Countermeasures
Enterprise (PHEMCE) to enhance the capability of the United
States government to develop MCMs for natural and intentional
threats to public health. The process relies on inherent
Federal capabilities and critical capabilities with private
sector partners that are the linchpin to develop needed MCMs,
including vaccines, therapeutics, diagnostics, and non-
pharmaceutical countermeasures, against a broad array of public
health threats, whether natural or intentional in origin. The
Committee requests ASPR conduct a comprehensive 90-day review
to assess whether: 1) The current structure meets the
appropriate capabilities to ensure preparedness; 2) The
structure of the capability response platform, such as the
Centers for Innovation in Advanced Development and
Manufacturing, are appropriate for future advanced
technological platforms needs; 3) The current mix of
technological capabilities are in place to address potential
gaps in the medical countermeasure enterprise and to ensure
rapid deployment of medical countermeasures; and 4) BARDA has
the correct measures and indicators in place to assure it
leverages the resources of PHEMCE, private sector, and other
Federal agencies and can report these indicators on a regular
basis to the Secretary and other Federal leaders to provide
them with an accurate risk assessment of the ability to respond
and known limitations. The report shall include recommendations
for policy changes, capability adjustments, and other
appropriate actions. The report should be provided to the
Committees on Appropriations and appropriate authorizing
committees, with a public version to be published on the HHS
website within 15 days of being submitted to Congress.
Antibiotic Resistance.--BARDA is directed to work closely
with CDC and NIAID on the government-wide antibiotic resistance
activity. The Committee requests an update in the fiscal year
2018 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 for this effort.
General Provisions
PREVENTION AND PUBLIC HEALTH FUND
The Committee continues a provision that directs the
transfer of the Prevention and Public Health (PPH) Fund. In
fiscal year 2017, the level appropriated for the fund is
$931,000,000 after accounting for sequestration. The agreement
includes bill language in section 221 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:
------------------------------------------------------------------------
Agency Budget Activity FY 2017 Committee
------------------------------------------------------------------------
ACL............................. Alzheimer's Disease $14,700,000
Prevention
Education and
Outreach.
ACL............................. Chronic Disease 8,000,000
Self-Management.
CDC............................. Breast Feeding 8,000,000
Grants (Hospitals
Promoting
Breastfeeding).
CDC............................. Diabetes........... 80,000,000
CDC............................. Epidemiology and 40,000,000
Laboratory
Capacity Grants.
CDC............................. Healthcare 12,000,000
Associated
Infections.
CDC............................. Heart Disease and 75,500,000
Stroke Prevention
Program.
CDC............................. Million Hearts 4,000,000
Program.
CDC............................. Preventive Health 160,000,000
and Health
Services Block
Grants.
CDC............................. Racial and Ethnic 30,000,000
Approaches to
Community Health.
CDC............................. Section 317 337,300,000
Immunization
Grants.
CDC............................. Lead Poisoning 17,500,000
Prevention.
CDC............................. Early Care 4,000,000
Collaboratives.
CDC............................. Block Grant-- 140,000,000
Counties with High
Potential for
Local Zika
Transmission.
------------------------------------------------------------------------
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
salary of an individual through an HHS grant or other
extramural mechanism to not more than the rate of Executive
Level II.
Sec. 203. 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. 204. The Committee modifies a provision regarding the
enacted level for the PHS evaluation set-aside, reducing it to
2.4 percent.
(TRANSFER OF FUNDS)
Sec. 205. 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. Notification must be
provided to the Committees on Appropriations at the program,
project, and activity level in advance of any such transfer.
Sec. 206. The Committee continues the 60 day flexibility
for National Health Service Corps contract terminations.
Sec. 207. 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. 208. 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. 209. The Committee continues a provision related to
the Medicare Advantage program.
Sec. 210. The Committee continues a provision prohibiting
funds from being used to advocate or promote gun control.
Sec. 211. 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. 212. The Committee continues a provision authorizing
certain international health activities.
(TRANSFER OF FUNDS)
Sec. 213. 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. 214. The Committee continues a provision that makes
NIH funds for human immunodeficiency virus research available
to the Office of AIDS Research.
Sec. 215. 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. 216. 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. 217. The Committee continues 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. 218. The Committee continues a provision relating to
payments for research organisms.
Sec. 219. The Committee continues the Biomedical Advanced
Research and Development Authority ten year contract authority.
Sec. 220. The Committee continues a provision relating to
publicly accessible information regarding uses of funds under
section 4002 of Public Law 111-148.
(TRANSFER OF FUNDS)
Sec. 221. The Committee continues language directing the
spending of the Prevention and Public Health fund.
Sec. 222. The Committee continues language requiring HHS to
include certain information concerning the number of full-time
Federal employees and contractors working on the Affordable
Care Act in the fiscal year 2017 budget request.
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 certain Congressional
notification requirements.
Sec. 225. The Committee continues a provision prohibiting
CMS Program Management account from being used to support risk
corridor payments.
(RESCISSION)
Sec. 226. The Committee includes a new provision rescinding
amounts in the Nonrecurring Expenses Fund.
Sec. 227. The Committee includes a new provision
prohibiting funds from being used for patient-centered outcomes
research.
Sec. 228. The Committee includes a new provision
prohibiting funds from being used for Title X family planning
activities.
Sec. 229. The Committee includes a new provision to prevent
funding of the Navigator program.
Sec. 230. 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.
(TRANSFER OF FUNDS)
Sec. 231. The Committee includes a new provision creating
an Infectious Disease Rapid Response Reserve Fund and specifies
the purposes and circumstances under which such fund may be
accessed.
TITLE III--DEPARTMENT OF EDUCATION
Education for the Disadvantaged
The Committee recommends $15,986,790,000 for the Education
for the Disadvantaged programs, which is $30,000,000 below the
fiscal year 2016 enacted level and $57,000,000 below the fiscal
year 2017 budget request. Of the total amount available,
$4,897,006,000 is appropriated for fiscal year 2017 for
obligation on or after July 1, 2017 and $11,041,177,000 is
appropriated for fiscal year 2017 for obligation on or after
October 1, 2017. This appropriation account includes
compensatory education programs authorized under title I and
subpart 2 of part B of title II 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 2017, the Committee recommends
$15,359,802,000 for Title I grants to Local Educational
Agencies (LEAs, or school districts), which is $450,000,000
above the fiscal year 2016 enacted level and the same as the
fiscal year 2017 budget request. Title I grants provide
supplemental education funding for activities that offer extra
academic support to help students from low-income families and
in high-poverty schools to meet State academic standards.
Of the amounts provided for Title I programs,
$6,909,401,000 is available for Basic Grants to LEAs, which is
$450,000,000 above the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. Basic grants are awarded to
school districts with at least 10 low-income children who make
up more than two percent of the school-age population.
Within the amount for Title I Basic Grants, up to
$3,984,000 is made available to the Secretary of Education on
October 1, 2016, 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 2016
enacted level and the fiscal year 2017 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 $3,544,050,000 for Title I
Targeted Grants, which is the same as the fiscal year 2016
enacted level and $225,000,000 below the fiscal year 2017
budget request. Targeted Grants provide higher payments to
school districts with high numbers or percentages of low-income
students.
The Committee recommends $3,544,050,000 for Title I
Education Finance Incentive Grants (EFIGs), which is the same
as the fiscal year 2016 enacted level and $225,000,000 below
the fiscal year 2017 budget request. EFIGs provide payments to
States and school districts that incorporate ``equity'' and
``effort'' factors to improve the equity of State funding
systems.
Title I State Plan.--The Every Student Succeeds Act (ESSA)
shifted control over many decisions regarding public K-12
education from the Federal to the State and local level.
Despite this clear direction from Congress, the Department is
overstepping its bounds in the implementation of the law. For
example, the Congressional Research Service issued a report
stating that a new Department regulation regarding ``supplement
not supplant'' policy exceeds the underlying statute. The
Committee is concerned that the Department may also improperly
intervene in the implementation of other areas of the law, such
as the review of Title I State plans. The Committee notes that
there are specific criteria in ESSA for denying approval of
State plans and that the Department should not take this
process as an opportunity to exert undue control over States
and school districts.
School Improvement Grants
The Committee recommends no funding for School Improvement
Grants, which is $450,000,000 below the fiscal year 2016
enacted level and the same as the fiscal year 2017 budget
request. The ESSA eliminated the authorization for this program
and replaced it with a set-aside within Title I for school
improvement activities.
Comprehensive Literacy Development Grants
The Committee recommends $160,000,000 for Comprehensive
Literacy Development Grants, which is $30,000,000 below the
fiscal year 2016 enacted level and the fiscal year 2017 budget
request. This program makes competitive grants to States to
subgrant to school districts and/or early childhood education
programs to improve literacy instruction for disadvantaged
children.
Innovative Approaches to Literacy
The Committee recommends no funding for Innovative
Approaches to Literacy, which is $27,000,000 below the 2016
enacted level and the fiscal year 2017 budget request. This
program was funded in the Fund for the Improvement of Education
(FIE) in fiscal year 2016. This program provides competitive
grants to support school libraries. The Committee has chosen to
focus resources on core formula-based education programs
instead of narrowly-focused competitive grants such as this
one.
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 2016 enacted level and the fiscal year 2017 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 2016 enacted level and the fiscal year
2017 budget request. This formula grant program supports
educational services for children and youth under age 21 in
state-run institutions, attending community day programs, and
in correctional facilities. A portion of these funds is
provided for projects that support the successful re-entry of
youth offenders into postsecondary and vocational programs.
Special Programs for Migrant Students
The Committee recommends $44,623,000 for the Special
Programs for Migrant Students, which is the same as the fiscal
year 2016 enacted level and the fiscal year 2017 budget
request. These programs make 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.
IMPACT AID
The Committee recommends $1,328,603,000 for Federal Impact
Aid programs, which is $23,000,000 above the fiscal year 2016
enacted level and the fiscal year 2017 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.
Basic Support Payments
The Committee recommends $1,191,233,000 for Basic Support
Payments to LEAs, which is $23,000,000 above the fiscal year
2016 enacted level and the fiscal year 2017 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 2016 enacted level and the fiscal year 2017 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 2016 enacted
level and $66,813,000 below the fiscal year 2017 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 2016 enacted
level and the fiscal year 2017 budget request. This program
provides competitive grants for building and renovating school
facilities to school districts 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 2016
enacted level and $66,813,000 above the fiscal year 2017 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 $4,799,912,000 for School
Improvement Programs, which is $366,283,000 above the fiscal
year 2016 enacted level and $241,503,000 above the fiscal year
2017 budget request. The School Improvement account includes
programs authorized under Titles I, 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.
Supporting Effective Instruction State Grants
The Committee recommends $1,949,830,000 for Supporting
Effective Instruction State Grants, which is $400,000,000 below
the fiscal year 2016 enacted level and $300,170,000 below the
fiscal year 2017 budget request. These grants provide States
and school districts with a flexible source of funding to
strengthen the skills and knowledge of teachers, principals,
and administrators to enable them to improve student
achievement.
Mathematics and Science Partnerships
The Committee recommends no funding for Mathematics and
Science Partnerships, which is $152,717,000 below the fiscal
year 2016 enacted level and the same as the fiscal year 2017
budget request. The ESSA eliminated the authorization for this
program.
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 2016 enacted level and the fiscal year 2017 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 $1,166,673,000 for 21st Century
Community Learning Centers, which is the same as the fiscal
year 2016 enacted level and $166,673,000 above the fiscal year
2017 budget request. This program awards formula grants to
States, which in turn distribute funds on a competitive basis
to local school districts, nonprofit organizations, and other
public entities. Funds may be used to provide activities that
compliment and reinforce the regular school-day program for
participating students.
State Assessments
The Committee recommends $300,000,000 for State
Assessments, which is $78,000,000 below the fiscal year 2016
enacted level and $103,000,000 below the fiscal year 2017
budget request. Funds are available to develop and implement
academic standards and assessments. The program includes a set-
aside for audits to identify and eliminate low-quality or
duplicative assessments.
Education for Homeless Children and Youth
The Committee recommends $70,000,000 for the Education for
Homeless Children and Youth program, which is the same as the
fiscal year 2016 enacted level and $15,000,000 below the fiscal
year 2017 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.
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 2016 enacted level
and the fiscal year 2017 budget request. Title IV-A authorizes
technical assistance and training services for school districts
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 the same as the fiscal year
2016 level and the fiscal year 2017 budget request. Funds are
used to provide competitive awards for supplemental education
services to the Native Hawaiian population. The Committee does
not include bill language allowing these funds to be used for
construction.
Alaska Native Education Equity
The Committee recommends $32,453,000 for the Alaska Native
Education Equity program, which is the same as the fiscal year
2016 level and the fiscal year 2017 budget request. Funds are
used to provide competitive awards for supplemental education
services to the Alaska Native population. The Committee does
not include bill language allowing these funds to be used for
construction.
Rural Education
The Committee recommends $175,840,000 for Rural Education
programs, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 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 $48,445,000 for Comprehensive
Centers, which is $3,000,000 below the fiscal year 2016 enacted
level and $7,000,000 below the fiscal year 2017 budget request.
This grant program currently supports 22 comprehensive centers,
including 15 regional centers that provide training, technical
assistance, and professional development to build State
capacity to provide high-quality education to all students. The
remaining seven centers specialize in particular content areas.
The Committee includes bill language directing the Secretary to
ensure that the Bureau of Indian Education (BIE) has access to
services provided under this section.
Student Support and Academic Enrichment State Grants
The Committee recommends $1,000,000,000 for Student Support
and Academic Enrichment (SSAE) State Grants, which is
$500,000,000 above the fiscal year 2017 budget request. The
ESSA eliminated several narrowly-focused competitive grant
programs and replaced them with this new formula grant program.
States and school districts have flexibility to focus these
resources on locally-determined priorities to provide students
with access to a well-rounded education, including rigorous
coursework, and to improve school conditions and the use of
technology. The Committee does not include bill language
proposed in the budget request to allow States to make
subgrants to school districts on a competitive basis.
STEM and Computer Science Education.--The Committee notes
that funds available under this program may be used by States
and school districts to provide or strengthen instruction in
STEM fields, including computer science.
Non-Cognitive Factors.--The Committee notes that programs
designed to support non-cognitive factors such as critical
thinking skills, social skills, work ethic, problem solving,
and community responsibility are an eligible use of funds under
SSAE grants supporting a well-rounded education.
Needs Assessments.--In conducting a needs assessment for
SSAE grants pursuant to section 4106(d), the Committee
encourages States to work with school districts in identifying
already available and appropriate local data and metrics, which
may include incidence and prevalence of the issues and
behaviors that are appropriate to be addressed by the program,
such as drug use and bullying.
School Counselors.--The Committee recognizes that school-
employed counseling professionals play a critical role in
addressing barriers to learning and promoting academic success.
These professionals guide students through academic, social,
emotional and behavioral challenges, as well as the college
admission process and career development, preparing them for
fulfilling lives as responsible members of their communities.
School counseling programs help students make individual
choices geared to their unique abilities, interests and goals.
The most recent data from the National Center for Education
Statistics shows that the current school counselor-to-student
ratio is now 1:491, the highest it has been since 1999 even
though this kind of guidance is in demand now more than ever.
The Committee notes that supporting school counselors is an
allowable use of SSAE funds and encourages States and school
districts to support school counseling programs.
Physical Education.--The Committee believes that physical
education is a foundation for healthy, active lifestyles and an
important part of a well-rounded public education. The
Department is encouraged to provide guidance to States and
school districts on all available funding for physical
education under ESSA.
INDIAN EDUCATION
The Committee recommends $174,939,000 for Indian Education,
which is $31,000,000 above the fiscal year 2016 enacted level
and the same as the fiscal year 2017 budget request. This
account supports programs authorized by part A of title VI 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 2016
enacted level and the fiscal year 2017 budget request. This
program provides assistance through formula grants to school
districts and schools supported or operated by the Bureau of
Indian Education. The purpose of this program is to improve
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 $67,993,000 for Special Programs
for Indian Children, which $30,000,000 above the fiscal year
2016 enacted level and the same as the fiscal year 2017 budget
request. These programs make competitive awards to improve the
quality of education for American 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 $53,452,000 for
Native Youth Community Projects, $30,562,000 above the fiscal
year 2016 enacted level and the same as the fiscal year 2017
budget request. This program makes competitive awards to
support culturally-relevant coordinated strategies to improve
the college- and career-readiness of Native American youth.
National Activities
The Committee recommends $6,565,000 for National
Activities, which is $1,000,000 above the fiscal year 2016
enacted level and the same as the fiscal year 2017 budget
request. Funds under this authority support (1) research,
evaluation and data collection to provide information about the
educational status of Indian students and the effectiveness of
Indian education programs; (2) grants to support Native
language immersion schools and programs; and (3) grants to
tribes for education administrative planning, development, and
coordination.
State-Tribal Education Partnership.--The Committee
recommends continued funding for the State-Tribal Education
Partnership (STEP) program. This program makes grants to tribes
to build capacity to assume certain State responsibilities for
the administration of ESEA programs. Indian educators have long
called for tribal-State-Federal partnerships to involve Indian
tribes in educating their students and to improve American
Indian education outcomes. STEP programs have, and will
continue to, assist State and tribal governments to continue
delivering the highest quality education for Indian students.
Language Immersion Program.--Within the total for National
Activities, the Committee includes $1,200,000 for a Native
American and Alaska Native Language Immersion Program, the same
as the fiscal year 2017 budget request. This program, which was
authorized in ESSA, will make grants to maintain and promote
the use of Native languages, support Native language education
and development, and provide professional development to
teachers.
INNOVATION AND IMPROVEMENT
The Committee recommends $632,938,000 for Innovation and
Improvement programs, which is $548,288,000 below the fiscal
year 2016 enacted level and $778,618,000 below the fiscal year
2017 budget request. This appropriation account includes
programs authorized under portions of Titles II and IV of the
ESEA.
Education Innovation and Research
The Committee recommends no funding for the Education
Innovation and Research program. This amount is $120,000,000
below the fiscal year 2016 enacted level and $180,000,000 below
the fiscal year 2017 budget request. This program makes
competitive grants to support the replication and scaling-up of
evidence-based education innovations. Given budget constraints,
the Committee has chosen instead to focus resources on core
formula grant programs.
Teacher and School Leader Incentive Grants
The Committee recommends $200,000,000 for the Teacher and
School Leader Incentive Grants program, which is $30,000,000
below the fiscal year 2016 enacted level and $50,000,000 below
the fiscal year 2017 budget request. This program provides
grants to States, school districts, and partnerships to
develop, implement, improve, or expand human capital management
systems or performance-based compensation systems in schools.
American History and Civics Academies
The Committee recommends $1,815,000 for American History
and Civics Academies, the same as the fiscal year 2016 enacted
level and the fiscal year 2017 budget request. This program was
funded in FIE in fiscal year 2016. This program makes
competitive grants to institutions of higher education (IHEs),
nonprofit organizations, museums, libraries, and research
centers to improve the quality of American history and civics
education by providing intensive workshops for teachers and
students.
American History and Civics National Activities
The Committee recommends $6,500,000 for American History
and Civics National Activities. This program was authorized in
ESSA and was not funded in fiscal year 2016 or included in the
fiscal year 2017 budget request. The Committee recognizes the
importance of improving the quality of instruction in American
history, civics, and geography, particularly for schools in
underserved rural and urban communities. In recognition of the
fact that no one size fits all in effective education, and that
a variety of approaches are required to meet the range of
student and community needs, these competitive grants will
support multiple grantees in making available a menu of
innovative, effective approaches to teaching American history,
civics and government, and geography. These validated
approaches will be available to schools and school districts
for their consideration and voluntary use, based on the
approach that best meets the needs of the students and
community.
Supporting Effective Educator Development
The Committee recommends $53,710,000 for the Supporting
Effective Educator Development (SEED) grant program,
$46,120,000 below the fiscal year 2016 level and $46,290,000
below the fiscal year 2017 budget request. This program was
funded as a set-aside of the State Grants for Improving Teacher
Quality program in fiscal year 2016 and was established as a
standalone program in ESSA. SEED provides competitive grants to
IHEs, national nonprofit organizations, BIE, and partnerships
to support alternative certification and other professional
development and enrichment activities for teachers, principals,
and other school leaders. Funds are included to support fully
continuation costs for grants made in prior years.
School Leader Recruitment and Support
The Committee recommends no funding for School Leader
Recruitment and Support, which is $16,368,000 below the fiscal
year 2016 enacted level and $30,000,000 below the fiscal year
2017 budget request. This program provides competitive grants
to improve the recruitment, preparation, and retention of
principals and other school leaders. The Committee includes
funding for similar activities within other programs, such as
Supporting Effective Instruction State Grants and SEED.
Science, Technology, Engineering, and Math (STEM) Master
Teacher Corps
The Committee recommends no funding for STEM Master Teacher
Corps. The fiscal year 2017 budget request includes $10,000,000
for this new program that would support State efforts to
identify and retain STEM teachers. The Committee has included
funding elsewhere in this bill to support teacher preparation
and retention.
Teach to Lead
The Committee recommends no funding for Teach to Lead. The
fiscal year 2017 budget request includes $10,000,000 for this
new program, which would award one grant to conduct a national
competition for teacher-led projects to improve student
outcomes. The Committee has chosen to focus resources on
programs that give States and school districts the flexibility
to make improvements that best suit local needs.
Charter Schools Grants
The Committee recommends $333,172,000 for Charter Schools
Grants, which is the same as the fiscal year 2016 enacted level
and $16,828,000 below the fiscal year 2017 budget request.
In exchange for a commitment to increase student
achievement, charter schools are exempt from many statutory and
regulatory requirements. The Charter Schools Grants program
awards grants to State educational agencies (SEAs) or, if a
State's SEA chooses not to participate, to charter school
developers to support the development and initial
implementation of public charter schools. State Facilities
Incentive Grants and Credit Enhancement for Charter School
Facilities awards help charter schools obtain adequate school
facilities. These programs work in tandem to support the
development and operation of charter schools.
The Committee recommends an allocation of funds within this
program that aligns with ESSA. In particular, the
recommendation increases funds for grants to States and to
charter school developers in States that do not receive a State
grant, and reduces funds for grants to Charter Management
Organizations for replication and expansion of charter school
models.
Magnet Schools Assistance
The Committee recommends no funding for the Magnet Schools
Assistance program, which is $96,647,000 below the fiscal year
2016 enacted level and $115,000,000 below the fiscal year 2017
budget request. This program makes competitive grants to
support the establishment and operation of magnet schools that
are a part of a court-ordered or Federally-approved voluntary
desegregation plan.
Stronger Together
The Committee recommends no funding for Stronger Together
grants. The fiscal year 2017 budget request includes
$120,000,000 for this new, unauthorized program that would make
competitive grants to support voluntary community efforts to
increase socioeconomic diversity in schools.
Next Generation High Schools
The Committee recommends no funding for the Next Generation
High Schools program. The fiscal year 2017 budget request
includes $80,000,000 for this new activity, which would make
grants to school districts for whole school redesign of the
high school experience. The Committee has chosen to focus
resources on core formula grants instead of new programs.
Computer Science for All Development Grants
The Committee recommends no funding for Computer Science
for All Development Grants. The fiscal year 2017 budget request
includes $100,000,000 for this new, unauthorized program that
would make competitive grants to States to improve access to
and the quality of computer science instruction.
The Committee recognizes the importance of funding K-12
computer science education to enhance American competitiveness.
Only about one quarter of all the K-12 schools in the United
States offer high-quality computer science instruction that
includes programming and coding. Supporting education in the
science, technology, engineering, and mathematics (STEM)
fields, particularly computer science, will help to ensure that
our nation continues to lead in innovation. However, while the
Committee believes that computer science instruction helps to
prepare and inspire students to pursue further education and
careers in technology, it does not believe that a new,
competitive Federal grant program is the best way to support
this goal. The Committee notes that funds are available
elsewhere in the bill, including in the Student Support and
Academic Enrichment State Grants program, for States and school
districts to support computer science education.
Ready to Learn Programming
The Committee recommends $25,741,000 for Ready to Learn
Programming, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 budget request. This program
supports the development and distribution of educational video
programming for preschool and elementary school children and
their parents, caregivers, and teachers.
Advanced Placement Program
The Committee recommends no funding for the Advanced
Placement program, which is $28,483,000 below the fiscal year
2016 enacted level and the same as the fiscal year 2017 budget
request. The ESSA eliminated the authorization for this
program.
Preschool Development Grants
The Committee recommends no funding within the Department
of Education for Preschool Development Grants (PDGs), which is
$250,000,000 below the fiscal year 2016 enacted level and the
same as the fiscal year 2017 budget request. This program was
funded in FIE in fiscal year 2016. The Committee recommends
that this program be funded in the Department of Health and
Human Services (HHS), consistent with ESSA and as requested in
the fiscal year 2017 budget. The Committee encourages the
Department of Education to transition PDGs to HHS in an
efficient and timely manner.
Arts in Education
The Committee recommends no funding for Arts in Education,
$27,000,000 below the fiscal year 2016 level and the fiscal
year 2017 budget request. This program provides competitive
grants to support professional development and the development
of instructional materials and programming that integrate the
arts into the curricula. States and school districts may use
funds from the SSAE grants to support arts education.
Non-Cognitive Skills Initiative
The Committee recommends no funding for the Non-Cognitive
Skills Initiative, which is $3,000,000 below the fiscal year
2016 enacted level and the same as the fiscal year 2017 budget
request. The authorization for this program was eliminated in
ESSA.
Javits Gifted and Talented Education
The Committee recommends $12,000,000 for the Javits Gifted
and Talented Education Program, which is the same as the fiscal
year 2016 enacted level and the fiscal year 2017 budget
request. This program was funded in FIE in fiscal year 2016.
This program makes grants and contracts to States, school
districts, and other organizations to support a coordinated
program of research, demonstration projects, innovative
strategies, and other activities to help schools identify
gifted and talented students and meet their special educational
needs.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
The Committee recommends $73,254,000 for Safe Schools and
Citizenship Education programs, which is $171,561,000 below the
fiscal year 2016 enacted level and $154,746,000 below the
fiscal year 2017 budget request. This appropriation account
includes programs authorized under parts of Title IV of the
ESEA.
Promise Neighborhoods
The Committee recommends $63,254,000 for Promise
Neighborhoods, which is $10,000,000 below the fiscal year 2016
enacted level and $64,746,000 below the fiscal year 2017 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.
School Safety National Activities
The Committee recommends no funding for School Safety
National Activities, which is $75,000,000 below the fiscal year
2016 enacted level and $90,000,000 below the fiscal year 2017
budget request. This program includes a variety of competitive
grants that aim to increase students' safety and well-being.
The Committee instead includes robust funding for SSAE State
Grants to expand flexible funding to all States and school
districts that can be used for the same activities and
purposes.
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 2016 enacted level and the same as the fiscal year
2017 budget request. The ESSA eliminated the authorization for
this program.
Carol M. White Physical Education Program
The Committee recommends no funding for the Carol M. White
Physical Education program, which is $47,000,000 below the
fiscal year 2016 enacted level and the same as the fiscal year
2017 budget request. The ESSA eliminated the authorization for
this program.
Full-Service Community Schools
The Committee recommends $10,000,000 for Full-Service
Community Schools, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. This
program was funded in FIE in fiscal year 2016. This program
makes competitive grants to support school-based comprehensive
services for students, families, and communities.
ENGLISH LANGUAGE ACQUISITION
The Committee recommends $737,400,000 for the English
Language Acquisition program, which is the same as the fiscal
year 2016 enacted level and $63,000,000 below the fiscal year
2017 budget request. Of this amount provided for the 2017-2018
academic year, funds are appropriated for obligation on or
after July 1, 2017 and available through September 30, 2018.
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. The bill continues language to calculate all State
awards based on a three-year average of data from the American
Community Survey.
The Committee recommends no funds for the pilot program on
multigenerational approaches that was proposed in the fiscal
year 2017 budget request.
SPECIAL EDUCATION
The Committee recommends $13,406,517,000 for programs
authorized under the Individuals with Disabilities Education
Act (IDEA) for children with disabilities. This is $429,659,000
above the fiscal year 2016 enacted level and $339,659,000 above
the fiscal year 2017 budget request. Of the total amount
available, $3,956,259,000 is available for obligation on July
1, 2017, and $9,283,383,000 is available for obligation on
October 1, 2017. These grants help States and localities pay
for a free appropriate education for 6.7 million students with
disabilities aged 3 through 21 years.
Grants to States
The Committee recommends $12,412,848,000 for Part B Grants
to States, which is $500,000,000 above the fiscal year 2016
enacted level and the fiscal year 2017 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 continues to include 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 continues to
include 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 $368,238,000 for Preschool Grants,
which is the same as the fiscal year 2016 enacted level and
$35,000,000 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.
The Committee does not include bill language proposed in
the fiscal year 2017 budget request to reserve funds for
coordination and early intervention services for children who
are otherwise ineligible for IDEA-funded services.
Grants for Infants and Families
The Committee recommends $458,556,000 for Grants for
Infants and Families, which is the same as the fiscal year 2016
enacted level and $45,000,000 below the fiscal year 2017 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.
The Committee does not include bill language proposed in
the fiscal year 2017 budget request to reserve funds for
demonstration projects for children who are otherwise
ineligible for IDEA-funded services.
IDEA National Activities
The Committee recommends $166,875,000 for the IDEA National
Activities program, which is $70,341,000 below the fiscal year
2016 enacted level and $80,341,000 below the fiscal year 2017
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
$18,414,000 for State Personnel Development, which is
$23,216,000 below the fiscal year 2016 enacted level and the
fiscal year 2017 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. Funds are included to fully support
continuation costs for grants made in prior years.
Technical Assistance and Dissemination.--The Committee
recommends $43,088,000 for Technical Assistance and
Dissemination, which is $11,340,000 below the fiscal year 2016
enacted level and $21,340,000 below the fiscal year 2017 budget
request. This program provides funding for technical
assistance, demonstration projects, and information
dissemination. These funds support efforts by State and local
educational agencies, IHEs, and other entities to build State
and local capacity to make systemic changes and improve results
for children with disabilities. Funds are included to fully
support continuation costs for grants made in prior years.
Personnel Preparation.--The Committee recommends
$61,692,000 for Personnel Preparation, which is $22,008,000
below the fiscal year 2016 enacted level and the fiscal year
2017 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. Funds are included to fully support continuation
costs for grants made in prior years.
Parent Information Centers.--The Committee recommends
$27,411,000 for Parent Information Centers, which is the same
as the fiscal year 2016 enacted level and the fiscal year 2017
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.
Educational Technology, Media, and Materials.--The
Committee recommends $16,270,000 for Educational Technology,
Media, and Materials, which is $13,777,000 below the fiscal
year 2016 enacted level and the fiscal year 2017 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. Funds are included to fully support
continuation costs for grants made in prior years.
The Committee recognizes the ongoing progress made with the
tools and services provided under the Educational Technology,
Media and Materials Program that has allowed more than 380,000
students with disabilities free access to more than 325,000
books in multiple digitally accessible formats. The Committee
strongly encourages continued effort to expand this program's
reach to K-12 students in underserved areas.
REHABILITATION SERVICES
The Committee recommends $3,534,027,000 for Rehabilitation
Services, which is $4,422,000 above the fiscal year 2016
enacted level and $7,362,000 below the fiscal year 2017 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 $3,398,554,000 for Vocational
Rehabilitation (VR) State Grants, which is $6,784,000 above the
fiscal year 2016 enacted level and the same as the fiscal year
2017 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 bill 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 2016 enacted
level and the fiscal year 2017 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 $27,826,000 for the Training
program, which is $2,362,000 below the fiscal year 2016 enacted
level and the fiscal year 2017 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. Funds are
included to fully support continuation costs for grants made in
prior years.
Demonstration and Training Programs
The Committee recommends $5,796,000 for Demonstration and
Training Programs, which is the same as the fiscal year 2016
enacted level the fiscal year 2017 budget request. These
programs authorize competitive grants 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 2016 enacted level and the fiscal year 2017 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
2016 enacted level and $3,000,000 below the fiscal year 2017
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 Services for Older Individuals Who Are Blind
The Committee recommends $33,317,000 for Independent Living
Services for Older Individuals Who Are Blind, which is the same
as the fiscal year 2016 enacted level and $2,000,000 below the
fiscal year 2017 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 the
same as the fiscal year 2016 enacted level and the fiscal year
2017 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.
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
The Committee recommends $216,722,000 for Special
Institutions for Persons with Disabilities, which is the same
as the fiscal year 2016 enacted level and the fiscal year 2017
budget request.
AMERICAN PRINTING HOUSE FOR THE BLIND
The Committee recommends $25,431,000 for the American
Printing House for the Blind, which is the same as the fiscal
year 2016 enacted level and the fiscal year 2017 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.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
The Committee recommends $70,016,000 for the National
Technical Institute for the Deaf, which is the same as the
fiscal year 2016 enacted level and the fiscal year 2017 budget
request. Congress established the National Technical Institute
for the Deaf 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 the same as the fiscal year 2016 enacted
level and the fiscal year 2017 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 $1,720,686,000 for Career,
Technical, and Adult Education programs, which is the same as
the fiscal year 2016 enacted level and $88,000,000 below the
fiscal year 2017 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 2016 enacted level and $75,000,000 below the fiscal
year 2017 budget request. Funds are made available for
obligation on October 1, 2017.
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 American
Technical Training Fund. The fiscal year 2017 budget request
includes $75,000,000 for this new activity.
National Programs
The Committee recommends $7,421,000 for National Programs,
which is the same as the fiscal year 2016 enacted level and
$2,000,000 below the fiscal year 2017 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 $581,955,000 for Adult Basic and
Literacy Education State Grants, which is the same as the
fiscal year 2016 enacted level and the fiscal year 2017 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.
Adult Education National Leadership Activities
The Committee recommends $13,712,000 for National
Leadership Activities, which is the same as the fiscal year
2016 enacted level and $11,000,000 below the fiscal year 2017
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 $22,888,210,000 for Student
Financial Assistance programs, which is $1,310,000,000 below
the fiscal year 2016 enacted level and the fiscal year 2017
budget request.
Pell Grants
The Committee recommends $21,165,352,000 for the Pell Grant
program, which is $1,310,000,000 below the fiscal year 2016
enacted level and the fiscal year 2017 budget request. These
funds will support Pell grants to students for the 2017-2018
academic year.
The Pell Grant program costs have come in below estimates
for the past few years, resulting in a surplus of funding for
the program. Because of this, 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 $1,075, this will result in a $5,935 maximum Pell
Grant in the 2017-2018 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.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $733,130,000 for this program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 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 71 percent of dependent recipients
have annual family incomes under $30,000 and nearly 76 percent
of independent SEOG recipients have annual family incomes under
$20,000. Institutions must contribute a 25 percent match toward
their SEOG allocation.
Federal Work-Study
The Committee recommends $989,728,000 for the Federal Work-
Study program, which is the same as the fiscal year 2016
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 3,300 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 2016
enacted level. The Work Colleges program is authorized under
section 448 of the HEA and supports institutions that require
all resident students to participate in a work-learning
program.
STUDENT AID ADMINISTRATION
The Committee recommends $1,551,854,000 for Student Aid
Administration (SAA), which is the same as the fiscal year 2016
enacted level and $80,136,000 below the fiscal year 2017 budget
request. Programs administered under this account include Pell
Grants, campus-based programs, Teacher Education Assistance for
College and Higher Education grants, and Federal student loan
programs.
Salaries and Expenses.--Within the total provided for
Student Aid Administration, the Committee recommends
$696,643,000 for salaries and expenses, which is the same as
the 2016 enacted level and $35,709,000 below the fiscal year
2017 budget request.
Loan Servicing Activities.--Within the total provided for
SAA, the Committee recommends $855,211,000 for Loan Servicing
Activities, which is the same as the 2016 enacted level and
$44,427,000 below the fiscal year 2017 budget request.
Loan Origination.--The Committee is concerned that the
Department has unnecessarily restricted consumer choice by only
permitting student and parent loan borrowers to select from
among the four Title IV Additional Servicers when choosing a
servicer for their consolidation loans. The Committee directs
the Department to permit borrowers to choose from among all 10
Federal student loan servicers. The Committee directs the
Department to brief the Committees on Appropriations of the
House of Representatives and the Senate within 30 days of
enactment of this Act on how it plans to carry out this
directive.
Third Party Servicers.--The Committee is concerned that the
Department has not provided adequate information to student
loan counseling and default management providers impacted by
new third-party servicer requirements. Last year, the
Department released a Dear Colleague Letter (GEN-15-01)
expanding the definition of `third-party servicer' and the
reporting requirements for those institutions and providers
that manage parts of the financial aid system and provide
specialized support services to students. To date, the
Department has not issued any guidance, such as an audit guide,
that would explain who is a third-party servicer and what is
expected of them. The Committee directs the Department to
develop and submit to the Committee a plan for how it intends
to implement the third-party servicer requirements, including
who is a third-party service provider, how the regulations will
seek to minimize compliance costs, and how the regulations will
refrain from creating unnecessary barriers to helping student
and parent borrowers.
Nonprofit Organizations.--With respect to the upcoming
procurement for servicing of student loans owned by the
Department, the Committee directs the Department to develop and
submit to the Committees on Appropriations of the House of
Representatives and the Senate a plan under which it will give
credit for subcontracting with small businesses, including
State-based nonprofit organizations with expertise in assisting
borrowers in the repayment of their student loans, that provide
value-added services but do not meet the formal definition of a
``small business'' because they are State or nonprofit
entities.
Student Loan Debt.--Total U.S. student loan debt continues
to increase, surpassing $1.2 trillion in 2015. The Committee
recognizes that rising student debt is a growing burden for
students, borrowers, and the economy overall. The Committee
encourages the Department to explore creative solutions to help
reduce the burden student debt will impose on the U.S. economy.
Physician Assistant Education Access.--The Committee
encourages the Secretary of Education to investigate the impact
that lower Federal Direct Unsubsidized Stafford Loan borrowing
limits for physician assistant students compared to other
health professions have on access to physician assistant
education, overall student loan debt upon graduation, and
impact on physician assistant employment in underserved and
rural communities.
HIGHER EDUCATION
The Committee recommends $1,976,666,000 for Higher
Education programs, which is $5,519,000 below the fiscal year
2016 enacted level and $212,534,000 below the fiscal year 2017
budget request.
Strengthening Institutions
The Committee recommends $86,534,000 for the Part A,
Strengthening Institutions program, which is the same as the
fiscal year 2016 enacted level and the fiscal year 2017 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 $107,795,000 for the Hispanic-
Serving Institutions program, which is the same as the fiscal
year 2016 enacted level and the fiscal year 2017 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 $9,671,000 for the Promoting
Postbaccalaureate Opportunities for Hispanic Americans program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. This program provides expanded
postbaccalaureate educational opportunities for the academic
attainment of Hispanic and low-income students. In addition, it
expands academic offerings and enhances program quality at IHEs
educating the majority of Hispanic college students.
Strengthening Historically Black Colleges and Universities
The Committee recommends $244,694,000 for Strengthening
Historically Black Colleges and Universities (HBCUs), which is
the same as the fiscal year 2016 enacted level and the fiscal
year 2017 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.
Strengthening Historically Black Graduate Institutions
The Committee recommends $63,281,000 for the Strengthening
Historically Black Graduate Institutions program, which is the
same as the fiscal year 2016 enacted level and the fiscal year
2017 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
postbaccalaureate and professional degrees.
Strengthening Predominantly Black Institutions
The Committee recommends $9,942,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is the
same as the fiscal year 2016 enacted level and the fiscal year
2017 budget request. This program provides grants to PBIs to
increase their capacity to serve the academic needs of
students.
Strengthening Asian American and Native American
Pacific-Islander-Serving Institutions
The Committee recommends $3,348,000 for the Asian American
Pacific Islander program, which is the same as the fiscal year
2016 enacted level and the fiscal year 2017 budget request.
This program provides grants to undergraduate institutions that
have an undergraduate student enrollment of at least 10 percent
Asian American or Native American Pacific Islander.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions
The Committee recommends $13,802,000 for the Strengthening
Alaska Native and Native Hawaiian-Serving Institutions program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request, to provide competitive grants
to improve capacity to serve Alaska Native and Native Hawaiian
students.
Native American-Serving NonTribal Institutions
The Committee recommends $3,348,000 for the Native
American-Serving NonTribal Institutions program, which is the
same as the fiscal year 2016 enacted level and the fiscal year
2017 budget request. This program makes grants to IHEs at which
enrollment is at least 10 percent Native American students and
that are not Tribally Controlled Colleges or Universities.
Strengthening Tribally Controlled Colleges and Universities
The Committee recommends $27,599,000 for the Strengthening
Tribally Controlled Colleges and Universities (TCCUs) program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. This program makes grants to
TCCUs to increase their capacity to serve the academic needs of
students.
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 (IEFLS) program, which is the same as
the fiscal year 2016 enacted level and the fiscal year 2017
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 IEFLS, which is the same as the fiscal
year 2016 enacted level and $4,893,000 above the fiscal year
2017 budget request. Funding for these programs support group
projects, faculty research, special bilateral research, and
doctoral dissertation research conducted abroad.
HBCU and Minority-Serving Institutions Innovation for
Completion Fund
The Committee does not recommend funding for this program.
The fiscal year 2017 budget request includes $30,000,000 for
this new activity. The Committee continues to support HBCUs and
Minority-Serving Institutions through Aid for Institutional
Development, and supports efforts to improve college access and
completion at these and other institutions through increased
funding for TRIO programs.
Fund for the Improvement of Postsecondary Education
The Committee recommends no funding for the Fund for the
Improvement of Postsecondary Education (FIPSE), which is the
same as the fiscal year 2016 enacted level and $100,000,000
below the fiscal year 2017 budget request. The budget request
proposes to allocate all FIPSE funds for the First in the World
program, which makes competitive grants for the replication and
scaling-up of innovations in access to and completion of
postsecondary education programs. Instead, the Committee
continues to make significant investments in increasing college
access and completion throughout the country through TRIO
programs.
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 2016 level and the fiscal year 2017
budget request. This program supports grants to create model
transition programs into higher education for students with
intellectual disabilities.
Minority Science and Engineering Improvement
The Committee recommends $9,648,000 for the Minority
Science and Engineering Improvement Program, which is the same
as the fiscal year 2016 enacted level and the fiscal year 2017
budget request. This 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 $8,286,000 for this program, which
is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 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 $960,000,000 for TRIO programs,
which is $60,000,000 above the fiscal year 2016 enacted level
and the fiscal year 2017 budget request. The TRIO programs
provide a variety of outreach and support services to encourage
low-income, often first-generation college students to enter
and complete college. Discretionary grants of up to four or
five years are awarded competitively to IHEs and other
nonprofit organizations. At least two-thirds of the eligible
participants in TRIO must be low-income, first-generation
college students.
The Committee does not include funding for the TRIO
demonstration project proposed in the budget request.
The Committee is disappointed with the Department's
decision to sharply limit the ability of current TRIO grantees
to partake of the increased funding provided in the fiscal year
2016 omnibus. In limiting additional funding only to grantees
who agreed to spend the funds for a few narrow purposes
dictated by the Department, the Department disregarded
Congress' direction to allocate funds to all current grantees.
As a result, grantees who could have taken the opportunity to
use additional funds to conduct more college tours, provide
salary increases for program staff, or make other program
enhancements were not able to do so. The Department is directed
to allocate fiscal year 2017 TRIO funding such that all current
grantees receive an increase in their grant award. The
Committee expects the Department to adhere to this direction
and not impose additional requirements as a condition for
grantees to receive these funds. Additionally, the Department
is also directed to increase the number of new grants provided
for those programs that will conduct a new competition this
year.
Additionally, the Committee directs the Department to
announce the grant competitions and award the grants for this
program in a timely manner, as well as provide sufficient time
for grantees to prepare their applications.
Gaining Early Awareness and Readiness for Undergraduate
Programs
The Committee recommends $344,754,000 for Gaining Early
Awareness and Readiness for Undergraduate Programs (GEAR UP),
which is $22,000,000 above the fiscal year 2016 enacted level
and the fiscal year 2017 budget request. GEAR UP provides
grants to States and partnerships of low-income middle and high
schools, IHEs, and community organizations to target entire
grades of students and give them the skills, encouragement, and
scholarships to successfully pursue postsecondary education.
The Committee continues bill language allowing the
Department to maintain the 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.
The Committee directs the Department to conduct a new grant
competition for this program in fiscal year 2017.
Graduate Assistance in Areas of National Need
The Committee recommends no funding for the Graduate
Assistance in Areas of National Need program, which is
$29,293,000 below the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. The program awards grants to
IHEs 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. This program duplicates the efforts of other Federally
funded programs that support fellowships in these disciplines
within the Department and other agencies.
Teacher and Principal Pathways
The Committee recommends no funding for Teacher and
Principal Pathways. The budget request includes $125,000,000
for this new activity, which would fund competitive grants to
IHEs and nonprofit organizations to create or expand pathways
into the teaching profession or into school leadership. There
are other funding streams within the Department that support
teacher preparation and training.
Teacher Quality Partnership Grants
The Committee recommends no funding for Teacher Quality
Partnerships, which is $43,092,000 below the fiscal year 2016
enacted level and the same as the fiscal year 2017 budget
request.
Child Care Access Means Parents in School
The Committee recommends no funding for the Child Care
Access Means Parents in School program, which is $15,134,000
below the fiscal year 2016 enacted level and the fiscal year
2017 budget request. This program makes competitive grants to
colleges and universities to support or establish a campus-
based childcare program primarily serving the needs of low-
income students enrolled at the institution. Given budget
constraints, the Committee chose to reduce investment in
narrowly focused grant programs such as this one.
HOWARD UNIVERSITY
The Committee recommends $221,821,000 for Howard
University, which is the same as the fiscal year 2016 enacted
level and the fiscal year 2017 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 2016 enacted level and the fiscal year
2017 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 2016 enacted level and $22,000 below the fiscal
year 2017 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 $20,484,000 for the HBCU Capital
Financing program, which is the same as the fiscal year 2016
enacted level and $15,000 below the fiscal year 2017 budget
request. Funds are available through September 30, 2017. This
program is authorized under part D of Title III of the HEA 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 $20,150,000 for loan
subsidy costs that will be sufficient to guarantee up to
$282,213,000 in new loans in fiscal year 2017. Funds will also
be used to continue technical assistance services to help HBCUs
improve their financial stability and access to capital
markets.
INSTITUTE OF EDUCATION SCIENCES
The Committee recommends $536,049,000 for the Institute of
Education Sciences, which is $81,966,000 below the fiscal year
2016 enacted level and $157,769,000 below the fiscal year 2017
budget request. This account supports education research,
statistics, dissemination, evaluation, and assessment
activities.
Research, Development, and Dissemination
The Committee recommends $154,473,000 for Research,
Development, and Dissemination, which is $40,527,000 below the
fiscal year 2016 enacted level and $54,800,000 below the fiscal
year 2017 budget request. This budget account 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. Funds are included
to fully support continuation costs for grants made in prior
years.
Statistics
The Committee recommends $103,060,000 for the activities of
the National Center for Education Statistics (NCES), which is
$8,940,000 below the fiscal year 2016 enacted level and
$22,300,000 below the fiscal year 2017 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 $54,423,000 for Regional
Educational Laboratories, which is the same as the fiscal year
2016 enacted level and the fiscal year 2017 budget request.
This program support a network of ten laboratories that promote
the use and development of knowledge and evidence to increase
student learning and further school improvement efforts. Funds
are included to fully support continuation costs for grants
made in prior years.
Research in Special Education
The Committee recommends $49,300,000 for Research in
Special Education, which is $4,700,000 below the fiscal year
2016 enacted level and the fiscal year 2017 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 $10,818,000 for Special Education
Studies and Evaluations, which is the same as the fiscal year
2016 enacted level and $2,182,000 below the fiscal year 2017
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. Funds are included to fully support
continuation costs for grants made in prior years.
Statewide Data Systems
The Committee recommends $27,230,000 for Statewide Data
Systems, which is $7,309,000 below the fiscal year 2016 enacted
level and $53,787,000 below the fiscal year 2017 budget
request. Competitive grants under this authority are made to
SEAs to help them manage, analyze, disaggregate and use student
data consistent with the ESEA.
Assessment
The Committee recommends $136,745,000 for Assessment, which
is $20,490,000 below the fiscal year 2016 enacted level and
$20,000,000 below the fiscal year 2017 budget request. This
amount includes $7,745,000 for the National Assessment
Governing Board (NAGB), which is $490,000 below the fiscal year
2016 enacted level and the same as the fiscal year 2017 budget
request.
The National Assessment of Educational Progress (NAEP) 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 NAEP is
operated by contractors through competitive awards made by the
NCES. The NAGB formulates the policy guidelines for the
program.
DEPARTMENTAL MANAGEMENT
The Committee recommends $591,256,000 for Departmental
Management, which is $7,000,000 below the fiscal year 2016
enacted level and $83,220,000 below the fiscal year 2017 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 Inspector General.
Program Administration
The Committee recommends $432,000,000 for Program
Administration, which is the same as the fiscal year 2016
enacted level and $42,827,000 below the fiscal year 2017 budget
request. These funds support the staff and other costs of
administering programs and activities at the Department. Items
include personnel compensation, 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. Within the total, the Committee includes $1,000,000
for building modernization.
Free Speech Zones.--The Committee is concerned about the
proliferation of colleges and universities that are limiting
protests, speeches, distribution of literature, petitions, and
other expressive activities to ``free speech zones''. The
Committee notes that the outdoor areas of campuses of public
IHEs are traditional public forums. The Committee therefore
believes that public IHEs may maintain and enforce reasonable
time, place, and manner restrictions in service of a
significant institutional interest only when such restrictions
employ clear, published, content- and viewpoint-neutral
criteria and provide for ample alternative means of expression.
Any such restrictions must allow for members of the university
community to spontaneously and contemporaneously distribute
literature and assemble.
Campus Religious Organizations and Nondiscrimination
Policies on Campus.--Many colleges and universities have
nondiscrimination policies that prohibit student groups from
discriminating on the basis of gender, sexual orientation, or
race, among other factors. Often these policies also prohibit
discrimination in who organizations may consider for leadership
positions. However, many IHEs are misusing these
nondiscrimination policies in a way that has a chilling effect
on religious organizations. Specifically, some institutions are
barring religious student groups that require candidates for
leadership positions to adhere to the same faith as the
organization. This is clearly not an example of the type of
behavior that these policies are intended to stop. Many
institutions make exceptions to their nondiscrimination
policies for fraternities and sororities, which are exclusive
to men and women respectively, and they can make an exception
for religious organizations as well if they choose. The
Department is encouraged to offer guidance to academic
institutions that they should allow religious organizations to
choose leadership based on faith.
Educational Materials on Human Trafficking.--The Committee
encourages the Department to develop educational materials
regarding all forms of human trafficking, including sex and
labor trafficking, to ensure that educators are aware of how to
identify and treat all types of trafficking, and to undertake a
study to examine the appropriate role of educators and the
education system in preventing, identifying, and supporting
child trafficking victims.
Illegal Immigration.--The Department is directed to
expeditiously provide a report of its official findings
regarding the significant healthcare and education costs to
State and local communities resulting from illegal immigration.
The Committee is concerned about the lack of response from last
year's inquiry regarding this specific matter and urges the
Office of the Secretary to provide timely and informative
assistance upon request. The Committee directs the Department
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 directs the
Department, in conjunction with the Office of Refugee
Resettlement, to report to the House Appropriations Committees
on Labor, Health and Human Services, the Committee on Commerce,
Justice, Science and the Committee on Homeland Security within
90 days of passage of this Act on the costs borne by local,
State, and Federal governments for providing health and
education services to people in the United States without a
legal immigration status in fiscal years 2014-2016, and a
projected cost for fiscal years 2017 through 2021. The report
shall also include an accounting of what Federal resources have
been directed, and what Federal resources will be directed, in
each year to cover these added expenses.
Funding Review.--The Committee is concerned about any use
of Federal funds to support activities that are in conflict
with Congress's support for the security of Israel. As such,
the Committee encourages the Department of Education to take
measures to ensure that none of the funds provided within this
bill be used to facilitate or support any activities or
policies, written or oral, that prohibit interaction with
particular academic persons or institutions from a particular
country due to an association that the person or institution
has with that country.
OFFICE FOR CIVIL RIGHTS
The Committee recommends $100,000,000 for the Office for
Civil Rights, which is $7,000,000 below the fiscal year 2016
enacted level and $37,708,000 below the fiscal year 2017 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,
18,200 LEAs, and nearly 7,200 IHEs, including proprietary
schools. They also extend to 80 State rehabilitation agencies,
libraries, museums, and other institutions receiving Federal
funds.
The Committee is deeply concerned segregation in public
elementary and secondary schools and its well documented
adverse impact on children. For example, a recent report from
the Government Accountability Office indicates that a high
percentage of Black and Hispanic students are racially and
economically concentrated in public elementary and secondary
schools. Specifically, 65 percent of all high poverty schools
are populated by at least 75 percent of students of color.
Therefore, the Committee requests that the Secretary of
Education, in coordination with the Office of Civil Rights, not
later than 6 months after the date of enactment of this Act,
submit to Congress a report detailing recommendations on how to
address the adverse impacts of segregation, including
designating school monitors under title VI of the Civil, Rights
Act of 1964, to ensure that every student has the opportunity
for an equal education.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $59,256,000 for the Office of
Inspector General, which is the same as the fiscal year 2016
enacted level and $2,685,000 below the fiscal year 2017 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 to include a provision
that permits Palau to continue participating in Department of
Education and other programs pending formal ratification of a
new compact agreement.
Sec. 306. The Committee amends a provision allowing ESEA
funds consolidated for evaluation purposes to be available from
July 1, 2017 through September 30, 2018.
Sec. 307. The Committee includes a provision allowing
certain institutions to continue to use endowment income for
student scholarships.
Sec. 308. The Committee continues to include a provision
extending the authorization of the National Advisory Committee
on Institutional Quality and Integrity.
Sec. 309. The Committee continues to include a provision
extending the authority to provide account maintenance fees to
guaranty agencies for Federal student loans.
Sec. 310. The Committee includes a provision that prohibits
the Department from moving forward with regulations that would
define ``gainful employment'' and ``credit hour'', dictate how
States must authorize or license IHEs within the State, and
regulate teacher preparation programs.
Sec. 311. The bill includes language prohibiting funds from
being used to implement on a retrospective basis the Dear
Colleague Letter dated July 10, 2015 (GEN 15-14) regarding the
imposition of collection costs by guaranty agencies upon
certain defaulted borrowers.
Sec. 312. The Committee includes a provision renaming
various offices in the Department, as proposed in the budget
request.
Sec. 313. The Committee includes language prohibiting funds
from being used to withhold Federal financial assistance to
public education institutions subject to the May 13, 2016 Dear
Colleague Letter published by the Departments of Education and
Justice until an appropriate court determines violations have
occurred.
TITLE IV--RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
The Committee recommends $8,597,000 for the Committee for
Purchase From People Who Are Blind or Severely Disabled, which
is $2,406,000 more than the fiscal year 2016 enacted level and
$2,015,000 below the fiscal year 2017 budget request. 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 continues bill
language requiring AbilityOne to enter into contracts with
central nonprofit agencies. This will enable AbilityOne to
increase auditing, oversight and reporting functions in
accordance with standard Federal procurement policies.
Committee For Purchase From People Who Are Blind or
Severely Disabled--Requested Reports.--The Committee for
Purchase From People Who Are Blind or Severely Disabled shall
submit in an electronic format quarterly reports, due at the
end of each calendar month after the end of the fiscal year
quarter, to the Committees on Oversight and Government Reform
and Education and the Workforce of the House of
Representatives, Committees on Homeland Security and
Governmental Affairs and Health, Education, Labor, and Pensions
of the Senate, and Committees on Appropriations of the House of
Representatives and the Senate. The first report (Report 1)
will include information on CNA Fees. The report shall include
the following:
1. Each fee charged pursuant to section 51--3.5 of
title 41, Code of Federal Regulations
2. Each organization charged a fee pursuant to
section 51--3.5 of title 41, Code of Federal
Regulations
3. For each fee charged, for each Government order,
please include the following information:
a. name of the nonprofit agency,
b. description of product or service ordered,
c. ordering government agency,
d. order price (total),
e. contract award ID associated with any
order, where applicable,
f. a subtotal row for fees and amounts under
3.d., and
g. cumulative totals for the fiscal year.
The second report (Report 2) will include information on
CNA Expenditures. Each CNA designated pursuant to section
8503(c) of title 41, United States Code shall submit, in an
electronic format, a report on expenditures, due at the end of
each calendar month after the end of the fiscal year quarter,
to the Committees on Oversight and Government Reform and
Education and the Workforce of the House of Representatives,
Committees on Homeland Security and Governmental Affairs and
Health, Education, Labor, and Pensions of the Senate, and
Committees on Appropriations of the House of Representatives
and the Senate. The report shall include the total amount
obligated by the CNA in the previous quarter for each of the
following:
1. Employee salaries (total), including executive
salaries,
2. Employee benefits, including executive benefits,
3. Executive salaries,
4. Executive benefits,
5. Total travel expenses,
6. Executive travel,
7. Lobbying,
8. Advertising and promotion,
9. CNA reserve level,
10. Funds spent to support the efforts of the
Committee For Purchase From People Who Are Blind or
Severely Disabled, including a description of the
activities, services, and products supplied to the
Committee For Purchase From People Who Are Blind or
Severely Disabled, and
11. Cumulative totals for the fiscal year and the
total amount for all spending under items 1-10.
Office of Inspector General.--The Committee recommends no
less than $1,000,000 for the Office of Inspector General.
ADMINISTRATIVE PROVISION
Sec. 401. The Committee continues bill language requesting
quarterly reports.
Corporation for National and Community Service
OPERATING EXPENSES
The Committee recommends $787,929,000 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 funding level is the same as the fiscal year 2016 enacted
level and $6,679,000 below the fiscal year 2017 budget request.
Volunteers in Service to America (VISTA)
The Committee recommends $92,364,000 for VISTA, the same as
the fiscal year 2016 enacted level and $3,516,000 below the
fiscal year 2017 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
2016 enacted level and the fiscal year 2017 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:
------------------------------------------------------------------------
National Senior Volunteer Corps FY 2017 Committee
------------------------------------------------------------------------
Foster Grandparents Program.......................... $107,702,000
Senior Companion Program............................. 45,512,000
Retired Senior Volunteer Program..................... 48,903,000
------------------------------------------------------------------------
AmeriCorps State and National Grants
The Committee recommends $386,010,000 for AmeriCorps State
and National Grants, which is the same as the fiscal year 2016
enacted level and the fiscal year 2017 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.
The Committee is very concerned about the lack of oversight
within the Corporation that allowed an AmeriCorps subgrantee to
participate in activities prohibited by the Serve America Act
for years. The Committee appreciates the Corporation's prompt
efforts to refer the issue to the Office of Inspector General,
suspend the subgrantee's activities, and review other current
AmeriCorps grantees to identify whether any other prohibited
activities occurred. However, further reforms and improvements
are necessary to prevent such violations from happening among
AmeriCorps and other grantees in the future. The Committee is
encouraged by the Corporation's decision to hire a Chief Risk
Officer and expects that the Corporation will provide
sufficient resources and authority to this office to enable it
to make a meaningful contribution to improving grant oversight.
Additionally, the Committee looks forward to reviewing the
findings and recommendations of the forthcoming GAO study of
the Corporation's grant oversight practices and expects that
the Corporation will take these recommendations seriously and
incorporate them as appropriate into the agency's improvement
plan. Within 90 days of enactment, the Corporation is directed
to brief the Committees on Appropriations of the House of
Representatives and the Senate on the steps it will take to
improve its risk-based oversight of grantees.
Innovation, Assistance, and Other Activities
The Committee recommends $57,400,000 for this program,
which is the same as the fiscal year 2016 enacted level and
$201,000 below the fiscal year 2017 budget request. Within this
total, $50,000,000 is included for the Social Innovation Fund
and $3,800,000 is included for the Volunteer Generation Fund.
Evaluation
The Committee recommends $4,000,000 for this program, which
is the same as the fiscal year 2016 enacted level and
$2,000,000 below the fiscal year 2017 budget request. These
funds support research on program effectiveness.
National Civilian Community Corps
The Committee recommends $30,000,000 for this program,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. This program supports
residential, team-based service opportunities for individuals
aged 18-24.
State Commission Administrative Grants
The Committee recommends $16,038,000 for this program,
which is the same as the fiscal year 2016 enacted level and
$962,000 below the fiscal year 2017 budget request. Funds are
used for formula grants to support State oversight of service
programs.
Payment to the National Service Trust
The Committee recommends $205,792,000 for payments to the
National Service Trust, $14,208,000 below the fiscal year 2016
enacted level and $1,050,000 below the fiscal year 2017 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 $81,737,000 for Salaries and
Expenses, the same as the fiscal year 2016 enacted level and
$7,593,000 below the fiscal year 2017 budget request. The
Committee expects the Corporation to provide sufficient
resources to the newly-created Office of the Chief Risk Officer
to strengthen the Corporation's oversight of its grant
portfolio.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $6,300,000 for the Office of
Inspector General, $1,050,000 above the fiscal year 2016
enacted level and $200,000 above the fiscal year 2017 budget
request.
ADMINISTRATIVE PROVISIONS
Sec. 402. The Committee continues bill language that
combines separate matching requirements for AmeriCorps grants.
Sec. 403. The Committee continues bill language related to
National Service Trust minimum share requirements.
Sec. 404. The Committee continues bill language related to
donations.
Sec. 405. The Committee continues bill language related to
veterans.
Sec. 406. 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 2019. This appropriation
will fund content development, community services, and other
local station and system needs for the Corporation for Public
Broadcasting. In addition, the Committee recommends $10,000,000
for the public broadcasting interconnection system, which is
$30,000,000 below the fiscal year 2016 enacted level and
$40,000,000 below the fiscal year 2017 budget request.
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 $46,488,000 for the Federal
Mediation and Conciliation Service, which is $2,260,000 less
than the fiscal year 2016 enacted level and $4,250,000 less
than the fiscal year 2017 budget request.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
The Committee recommends $17,184,000 for the Federal Mine
Safety and Health Review Commission, which is $99,000 more than
the fiscal year 2016 enacted level and the same as the fiscal
year 2017 budget request.
Institute for Museum and Library Services
OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION
The Committee recommends $230,000,000 for the Institute of
Museum and Library Services (IMLS), which is the same as the
fiscal year 2016 enacted level and the fiscal year 2017 budget
request. Within the total for IMLS, the Committee recommends
the following amounts:
----------------------------------------------------------------------------------------------------------------
This Bill compared to--
-------------------------------------
Budget Activity This Bill FY 2017 Budget
FY 2016 Request
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
Grants to States................................... $155,863,000 74,000 1,015,000
Native American Library Services................... 4,063,000 0 202,000
National Leadership: Libraries..................... 13,092,000 0 -628,000
Laura Bush 21st Century Librarian.................. 10,000,000 0 -0
Museum Services Act:
Museums for America................................ 21,149,000 0 -949,000
21st Century Museum Professionals.................. 0 0 0
Conservation Project Support....................... 0 0 0
Native American/Hawaiian Museum Services........... 972,000 0 48,000
National Leadership: Museums....................... 7,741,000 0 -1,379,000
African American History and Culture Act:
Museum Grants for African American History and 1,407,000 -74,000 0
Culture...........................................
Museum and Library Services Act General Provisions:
Research, Analysis and Data Collection............. 1,713,000 0 -207,000
Program Administration................................. 14,000,000 0 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 same as the fiscal year 2016
enacted level and the fiscal year 2017 budget request. These
funds provide administrative and management support for all
programs administered by IMLS. Funds are included for office
relocation and renovation. The Committee also includes
$1,713,000 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 $12,000,000 for the Medicare
Payment Advisory Commission, which is $75,000 more than the
fiscal year 2016 enacted level and $234,000 less than the
fiscal year 2017 budget request.
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
The Committee provides $7,000,000 for the Medicaid & CHIP
Payment and Access Commission, which is $765,000 less than the
fiscal year 2016 enacted level and $1,700,000 below the fiscal
year 2017 budget request.
Medicaid and CHIP Payment and Access Commission (MACPAC).--
The Committee appreciates that MACPAC has provided
recommendations to Congress on issues intended to improve
Medicaid and the Children's Health Insurance Program (CHIP).
However, in a period of program growth and change, the
Committee notes that many of MACPAC's recommendations could
increase program costs, but do not include recommendations for
offsetting such costs. As such, the Committee requests that
future recommendations that would increase costs for Medicaid
or CHIP be accompanied by specific recommendations for
legislative changes that are estimated to produce changes in
health-care related budget authority, outlays, or revenues to
offset the increased costs.
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
2016 enacted level and $218,000 below the fiscal year 2017
budget request.
Olmstead v. L.C. 527 U.S. 581 (1999).--The Committee notes
that the Developmental Disabilities Assistance and Bill of
Rights Act of 2000 does not require closure of long-term care
facilities for persons unable to care for themselves. The
Committee notes that the 1999 U.S. Supreme Court decision in
Olmstead v. L.C. does not mandate deinstitutionalization. ``We
emphasize that nothing in the Americans with Disabilities Act
or its implementing regulations condones termination of
institutional settings for persons unable to handle or benefit
from community settings . . Nor is there any federal
requirement that community-based treatment be imposed on
patients who do not desire it.'' Olmstead v. L.C. 119 S. Ct.
2176, 2187 (1999). The Committee asks for a report on the
current Olmstead enforcement activities within the National
Council on Disability.
National Labor Relations Board
SALARIES AND EXPENSES
The Committee recommends $215,000,000 for the National
Labor Relations Board, which is $59,224,000 less than the
fiscal year 2016 enacted level and $59,695,000 less than the
fiscal year 2017 budget request.
ADMINISTRATIVE PROVISIONS
Sec. 407. The Committee continues a provision relating to
electronic voting for purposes of collective bargaining.
Sec. 408. The Committee includes a new provision relating
to regulation of representation-case procedures.
Sec. 409. The Committee includes a new provision relating
to jurisdiction over Indian tribes.
Sec. 410. The Committee includes a new provision relating
to joint-employer standards.
Sec. 411. The Committee includes a new provision relating
to bargaining unit standards.
National Mediation Board
SALARIES AND EXPENSES
The Committee recommends $13,300,000 for the National
Mediation Board, which is $70,000 more than the fiscal year
2016 enacted level and the same as the fiscal year 2017 budget
request.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
The Committee recommends $12,975,000 for the Occupational
Safety and Health Review Commission, which is $336,000 more
than the fiscal year 2016 enacted level and $436,000 less than
the fiscal year 2017 budget request.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
The Committee recommends $25,000,000 for dual benefits,
which is $4,000,000 less than the fiscal year 2016 enacted
level and the same as the fiscal year 2017 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
2016 enacted level and the same as the fiscal year 2017 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 2016 enacted level and $11,274,000 below the
fiscal year 2017 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 Railroad Retirement and Survivors' Improvement Act of
2001.
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 2016 enacted level and
$2,062,000 below the fiscal year 2017 budget request.
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
The Committee recommends $11,400,000 for mandatory payments
necessary to compensate the Old Age and Survivors Insurance
(OASI) Trust Fund and the Disability Insurance (DI) Trust Fund,
which is the same as the fiscal year 2016 enacted level and the
fiscal year 2017 budget request. This appropriation provides
reimbursement to the Social Security trust funds for non-trust
fund activities.
SUPPLEMENTAL SECURITY INCOME PROGRAM
The Committee recommends $43,162,469,000 for the
Supplemental Security Income (SSI) program, which is
$3,143,264,000 below the fiscal year 2016 enacted level and
$662,399,000 below the fiscal year 2017 budget request. The
Committee recommends $15,000,000,000 in advance funding for the
first quarter of fiscal year 2018, as requested.
Research and Demonstration
Within the appropriation for SSI, the Committee recommends
$58,000,000 for the research and demonstration activities,
which is $43,000,000 less than the fiscal year 2016 enacted
level and the same as the fiscal year 2017 budget request.
Administration
Within the appropriation for SSI, the Committee recommends
$4,573,733,000, which is $75,000,000 below the fiscal year 2016
enacted level and $660,399,000 below the fiscal year 2017
budget request level for payment to the Social Security trust
funds for SSI's share of the base administrative expenses of
the Social Security Administration (SSA).
LIMITATION ON ADMINISTRATIVE EXPENSES
The Committee recommends $10,348,945,000 for the Limitation
on Administrative Expenses (LAE) account to be funded from the
Social Security and Medicare trust funds, which is $250,000,000
less than the fiscal year 2016 enacted level and $772,055,000
below the fiscal year 2017 budget request. The fiscal year 2016
Consolidated Appropriations Act included $150,000,000 for
renovations of SSA headquarters at the Altmeyer building. These
one-time expenses are not included for fiscal year 2017. In
fiscal year 2016, SSA plans to use $100,000,000 from their
administrative expenses funding for program integrity
activities despite having targeted program integrity funds
available for the same purpose. Funds for program integrity
activities, which have other specific funding, are not included
in the funding level for administrative expenses in fiscal year
2017. The LAE funds support SSA operational costs to administer
the Old Age and Survivors Insurance (OASI), Disability
Insurance (DI), and Supplemental Security Income programs, and
to support the Centers for Medicare and Medicaid Services in
administering their programs.
Update to the Social Security Statement.--The Social
Security benefit calculation is based on an individual's
earnings history. Beginning in 1978, SSA has both covered and
non covered earnings data. The Committee directs SSA to include
both covered and non covered earnings information in the Social
Security Statement, in order to allow Americans to confirm the
accuracy of agency records from 1978 and later.
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 of
Representatives Committee on Appropriations Subcommittee on
Labor, Health and Human Services, and Education, and Related
Agencies and the Committee on 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
include in the fiscal year 2018 budget request the amount of
funding for the following categories for fiscal years 2016-
2018:
Personnel costs by General Schedule grade,
Administrative Law Judge personnel costs, Senior
Executive Service personnel costs, reemployed annuitant
personnel costs, including the number of Full-Time
Equivalent for each General Schedule grade,
Administrative Law Judge, and Senior Executive Service
Personnel costs by region, including the
number of General Schedule grade, Administrative Law
Judge, and Senior Executive Service Full-Time
Equivalent for each 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 administrative expenses and program
operation expenses for the following programs:
OASI
DI
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--separated from other
SSA administered program costs
Office of Disability Adjudication and Review (ODAR).--The
Committee is aware that some locations average twice the
processing time of others and that it can take up to two years
to process. This degree of differential processing times is a
concern to the Committee. The Social Security Administration is
directed to include in the fiscal year 2018 budget request
steps taken to reduce the processing times at offices that
average over 600 days.
Information Technology.--The Social Security Administration
is requested to submit to the Committee an information
technology (IT) modernization plan in the fiscal year 2018
budget request. The plan shall include: a complete list of any
new systems and significant improvements of existing systems
proposed for development; the projected cost of each
development project each year to completion including the total
estimated cost of development; the estimated annual operations
and maintenance costs for each system once development is
complete; and a timeline and estimated maintenance cost savings
of any legacy systems that will no longer be necessary and are
proposed to be eliminated. The plan should also include an
assessment of SSA's IT management controls, including how the
systems integrate into SSA's enterprise architecture; an
analysis of SSA's project management capabilities; and a review
of SSA's IT investment and human capital management practices.
The requested plan shall address IT funding provided in this
Act and any other spending authority planned for or proposed to
be used for such purposes.
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 2018 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.
Administrative Law Judge Hiring.--SSA's National Hearing
Centers (NHCs) provide the SSA with invaluable flexibility and
support to address the hearings backlog. Understanding the
value of this flexibility and support, the Committee directs
SSA to ensure that its upcoming Administrative Law Judge (ALJ)
hiring allocates no less than 25 percent of those newly hired
ALJs to NHCs.
Administrative Law Judge Data Publication.--The Committee
expects SSA to publish the same performance and decisional
statistics for Administrative Appeals Judge (when holding
hearings under SSA's ``CARES'' plan) as it does for
Administrative Law Judges in its public use data files.
Disability Fraud Rate Baseline.--The SSA has committed
significant resources to fighting fraud in the Disability
Insurance program. To understand if these efforts are
effective, the Committee directs the SSA Commissioner to work
with the Office of Inspector General to establish a disability
fraud rate baseline no later than September 30, 2017.
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 2016 enacted level
and $200,000 below the fiscal year 2017 budget request. The
Committee requests the Social Security Advisory Board include
additional information regarding the work of the Social
Security Advisory Board and Federal administrative expenses in
the fiscal year 2018 budget request.
User Fees
In addition to the other amounts provided, the Committee
recommends $124,000,000 for administrative activities funded
from user fees. Of this amount, $123,000,000 is derived from
fees collected from States that request SSA to administer State
SSI supplementary payments.
Continuing Disability Reviews and Redeterminations
The Committee recommends $1,426,000,000 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 $105,500,000 for the Office of
Inspector General, of which the bill provides authority to
expend $75,713,000 from the OASI and DI trust funds. This
funding level is the same as the fiscal year 2016 enacted level
and $5,287,000 below the fiscal year 2017 budget request.
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 purposes 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 appropriations 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
the 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
the use of funds to implement a Social Security totalization
agreement with Mexico.
Sec. 520. The Committee continues a provision related to
needle exchange.
Sec. 521. The Committee continues a provision prohibiting
the use of funds for the downloading or exchanging of
pornography.
Sec. 522. 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. 523. The Committee continues a provision relating to
reporting requirements for conference expenditures.
Sec. 524. The Committee continues a provision relating to
disclosure of U.S. taxpayer funding for programs used in
advertising.
Sec. 525. 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. 526. 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. 527. The Committee rescinds $15,000,000 provided under
section 3403 [Independent Payment Advisory Board] of Public Law
111-148.
(RESCISSION)
Sec. 528. The Committee rescinds $7,000,000,000 provided
under section 3021(a) [Center for Medicare and Medicaid
Innovation] of Public Law 111-148.
(RESCISSION)
Sec. 529. The Committee rescinds $150,000,000 provided
under section 6301(e) [Patient-Centered Outcomes Research Trust
Fund] of Public Law 111-148.
(RESCISSION)
Sec. 530. The Committee modifies a provision relating to
the Children's Health Insurance Program.
(RESCISSION)
Sec. 531. The Committee modifies a provision relating to
the Child Enrollment Contingency Fund.
(RESCISSION)
Sec. 532. The Committee continues a provision relating to
Children's Health Insurance Performance Bonus Payments.
Sec. 533. 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.
SPENDING REDUCTION ACCOUNT
Sec. 534. 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 Labor
Dislocated Workers National Reserve........ $200,000,000
Department of Health and Human Services
Nonrecurring Expenses Fund................. Unobligated Balances
Independent Payment Advisory Board......... 15,000,000
Center for Medicaid & Medicaid Innovation.. 7,000,000,000
Patient-Centered Outcomes Research Trust 150,000,000
Fund......................................
Child Enrollment Contingency Fund.......... 570,000,000
Children's Health Insurance Program........ 541,900,000
Performance Bonus Payments................. 195,640,000
------------------------------------------------------------------------
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
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 that 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.
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 ``Administration for Children
and Families--Refugee and Entrant Assistance'' permitting
transfers pursuant to a general provision to increase an
appropriation under this heading by ten percent.
Language is included under ``Administration for Community
Living, Aging and Disability Services Programs'' for transfer
to the Secretary of Agriculture to carry out 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
committee report accompanying this Act.
A new general provision is included to create an Infectious
Disease Rapid Response Reserve Fund and specify the purposes
and circumstances under which such fund may be accessed.
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 appropriation 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 italics, 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.]
* * * * * * *
----------
HIGHER EDUCATION ACT OF 1965
* * * * * * *
TITLE I--GENERAL PROVISIONS
* * * * * * *
PART B--ADDITIONAL GENERAL PROVISIONS
* * * * * * *
SEC. 114. NATIONAL ADVISORY COMMITTEE ON INSTITUTIONAL QUALITY AND
INTEGRITY.
(a) Establishment.--There is established in the Department a
National Advisory Committee on Institutional Quality and
Integrity (in this section referred to as the ``Committee'') to
assess the process of accreditation and the institutional
eligibility and certification of institutions of higher
education (as defined in section 102) under title IV.
(b) Membership.--
(1) In general.--The Committee shall have 18 members,
of which--
(A) six members shall be appointed by the
Secretary;
(B) six members shall be appointed by the
Speaker of the House of Representatives, three
of whom shall be appointed on the
recommendation of the majority leader of the
House of Representatives, and three of whom
shall be appointed on the recommendation of the
minority leader of the House of
Representatives; and
(C) six members shall be appointed by the
President pro tempore of the Senate, three of
whom shall be appointed on the recommendation
of the majority leader of the Senate, and three
of whom shall be appointed on the
recommendation of the minority leader of the
Senate.
(2) Qualifications.--Individuals shall be appointed
as members of the Committee--
(A) on the basis of the individuals'
experience, integrity, impartiality, and good
judgment;
(B) from among individuals who are
representatives of, or knowledgeable
concerning, education and training beyond
secondary education, representing all sectors
and types of institutions of higher education
(as defined in section 102); and
(C) on the basis of the individuals'
technical qualifications, professional
standing, and demonstrated knowledge in the
fields of accreditation and administration in
higher education.
(3) Terms of members.--Except as provided in
paragraph (5), the term of office of each member of the
Committee shall be for six years, except that any
member appointed to fill a vacancy occurring prior to
the expiration of the term for which the member's
predecessor was appointed shall be appointed for the
remainder of such term.
(4) Vacancy.--A vacancy on the Committee shall be
filled in the same manner as the original appointment
was made not later than 90 days after the vacancy
occurs. If a vacancy occurs in a position to be filled
by the Secretary, the Secretary shall publish a Federal
Register notice soliciting nominations for the position
not later than 30 days after being notified of the
vacancy.
(5) Initial terms.--The terms of office for the
initial members of the Committee shall be--
(A) three years for members appointed under
paragraph (1)(A);
(B) four years for members appointed under
paragraph (1)(B); and
(C) six years for members appointed under
paragraph (1)(C).
(6) Chairperson.--The members of the Committee shall
select a chairperson from among the members.
(c) Functions.--The Committee shall--
(1) advise the Secretary with respect to
establishment and enforcement of the standards of
accrediting agencies or associations under subpart 2 of
part H of title IV;
(2) advise the Secretary with respect to the
recognition of a specific accrediting agency or
association;
(3) advise the Secretary with respect to the
preparation and publication of the list of nationally
recognized accrediting agencies and associations;
(4) advise the Secretary with respect to the
eligibility and certification process for institutions
of higher education under title IV, together with
recommendations for improvements in such process;
(5) advise the Secretary with respect to the
relationship between--
(A) accreditation of institutions of higher
education and the certification and eligibility
of such institutions; and
(B) State licensing responsibilities with
respect to such institutions; and
(6) carry out such other advisory functions relating
to accreditation and institutional eligibility as the
Secretary may prescribe by regulation.
(d) Meeting Procedures.--
(1) Schedule.--
(A) Biannual meetings.--The Committee shall
meet not less often than twice each year, at
the call of the Chairperson.
(B) Publication of date.--The Committee shall
submit the date and location of each meeting in
advance to the Secretary, and the Secretary
shall publish such information in the Federal
Register not later than 30 days before the
meeting.
(2) Agenda.--
(A) Establishment.--The agenda for a meeting
of the Committee shall be established by the
Chairperson and shall be submitted to the
members of the Committee upon notification of
the meeting.
(B) Opportunity for public comment.--The
agenda shall include, at a minimum, opportunity
for public comment during the Committee's
deliberations.
(3) Secretary's designee.--The Secretary shall
designate an employee of the Department to serve as the
Secretary's designee to the Committee, and the
Chairperson shall invite the Secretary's designee to
attend all meetings of the Committee.
(4) Federal advisory committee act.--The Federal
Advisory Committee Act (5 U.S.C. App.) shall apply to
the Committee, except that section 14 of such Act shall
not apply.
(e) Report and Notice.--
(1) Notice.--The Secretary shall annually publish in
the Federal Register--
(A) a list containing, for each member of the
Committee--
(i) the member's name;
(ii) the date of the expiration of
the member's term of office; and
(iii) the name of the individual
described in subsection (b)(1) who
appointed the member; and
(B) a solicitation of nominations for each
expiring term of office on the Committee of a
member appointed by the Secretary.
(2) Report.--Not later than the last day of each
fiscal year, the Committee shall make available an
annual report to the Secretary, the authorizing
committees, and the public. The annual report shall
contain--
(A) a detailed summary of the agenda and
activities of, and the findings and
recommendations made by, the Committee during
the fiscal year preceding the fiscal year in
which the report is made;
(B) a list of the date and location of each
meeting during the fiscal year preceding the
fiscal year in which the report is made;
(C) a list of the members of the Committee;
and
(D) a list of the functions of the Committee,
including any additional functions established
by the Secretary through regulation.
(f) Termination.--The Committee shall terminate on September
30, [2016] 2017.
* * * * * * *
TITLE IV--STUDENT ASSISTANCE
* * * * * * *
PART D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM
* * * * * * *
SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES.
(a) Administrative Expenses.--
(1) Mandatory funds for fiscal year 2006.--For fiscal
year 2006, there shall be available to the Secretary,
from funds not otherwise appropriated, funds to be
obligated for--
(A) administrative costs under this part and
part B, including the costs of the direct
student loan programs under this part; and
(B) account maintenance fees payable to
guaranty agencies under part B and calculated
in accordance with subsections (b) and (c),
not to exceed (from such funds not otherwise
appropriated) $820,000,000 in fiscal year 2006.
(3) Authorization for administrative costs beginning
in fiscal years 2007 through 2014.--For each of the
fiscal years 2007 through 2014, there are authorized to
be appropriated such sums as may be necessary for
administrative costs under this part and part B,
including the costs of the direct student loan programs
under this part.
(4) Continuing mandatory funds for account
maintenance fees.--For each of the fiscal years 2007
through [2016] 2017, there shall be available to the
Secretary, from funds not otherwise appropriated, funds
to be obligated for account maintenance fees payable to
guaranty agencies under part B and calculated in
accordance with subsection (b).
(5) Account maintenance fees.--Account maintenance
fees under paragraph (3) shall be paid quarterly and
deposited in the Agency Operating Fund established
under section 422B.
(6) Technical assistance to institutions of higher
education.--
(A) Provision of assistance.--The Secretary
shall provide institutions of higher education
participating, or seeking to participate, in
the loan programs under this part with
technical assistance in establishing and
administering such programs.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $50,000,000 for
fiscal year 2010.
(C) Definition.--In this paragraph, the term
``assistance'' means the provision of technical
support, training, materials, technical
assistance, and financial assistance.
(7) Additional payments.--
(A) Provision of assistance.--The Secretary
shall provide payments to loan servicers for
retaining jobs at locations in the United
States where such servicers were operating
under part B on January 1, 2010.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $25,000,000 for
each of the fiscal years 2010 and 2011.
(8) Carryover.--The Secretary may carry over funds
made available under this section to a subsequent
fiscal year.
(b) Calculation Basis.--Account maintenance fees payable to
guaranty agencies under subsection (a)(4) shall be calculated
on the basis of 0.06 percent of the original principal amount
of outstanding loans on which insurance was issued under part
B.
(c) Budget Justification.--No funds may be expended under
this section unless the Secretary includes in the Department of
Education's annual budget justification to Congress a detailed
description of the specific activities for which the funds made
available by this section have been used in the prior and
current years (if applicable), the activities and costs planned
for the budget year, and the projection of activities and costs
for each remaining year for which administrative expenses under
this section are made available.
* * * * * * *
----------
PATIENT PROTECTION AND AFFORDABLE CARE ACT
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Patient
Protection and Affordable Care Act''.
(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. 1562. Conforming amendments.
Sec. 1563. Sense of the Senate promoting fiscal responsibility.
* * * * * * *
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)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).
* * * * * * *
----------
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.
* * * * * * *
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 that allotments to outlying areas
are not required to be made through the Pacific Region
Educational Laboratory as provided by section 127 of the
Workforce Innovation and Opportunity Act (WIOA).
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 that the Department of Labor may
take no action to limit the number or proportion of eligible
applicants receiving related assistance services in the migrant
and seasonal farmworkers programs.
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, 2018.
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 ``Federal Unemployment Benefits
and Allowances'' providing that funding may be available beyond
the current year in accordance with section 245(c) of the Trade
Act of 1974.
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 on behalf of States for
the use of the National Directory of New Hires.
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 cost
allocation principles prescribed under the Office of Management
and Budget ``Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.''
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 ``Special Benefits'' 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 ``Special Benefits'' providing
that funds shall be transferred to the appropriation from
entities required under 5 U.S.C. 8147(c) as determined by the
Department of Labor.
Language is included under ``Special Benefits'' providing
that funds transferred from entities under 5 U.S.C. 8147(c),
specified amounts may be used by the Department of Labor for
maintenance and 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 ``Special Benefits'' providing
that the Secretary may prescribe regulations requiring
identification for the filing 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 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 funds made available for State
assistance grants may be used for the purchase and maintenance
of equipment required by the Coal Mine Dust rule.
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
appropriated funds to provide for costs associated with mine
rescue and survival operations in the event of a major
disaster.
Language is included under ``Departmental Management--
Salaries and Expenses'' providing that the Bureau of
International Labor Affairs may operating 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 ``Departmental Management--
Salaries and Expenses'' providing that funds available to the
Women's Bureau may be used for grants authorized by the Women
in Apprenticeship and Nontraditional Occupations Act.
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 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 funds made available to assist
homeless veterans may be awarded through September 30, 2017.
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 the salaries and
bonuses at a rate in excess of Executive Level II.
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 visa 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 the
salaries and bonuses at a rate in excess of Executive Level II
except under specific exclusions.
Language is included under ``General Provisions'' providing
that the Department of Labor may transfer funds from the
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
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 implementing the
``Definition of the Term ``Fiduciary''; Conflict of Interest-
Retirement Investment Advice'' regulation.
Language is included under ``General Provisions''
prohibiting the Department of Labor from implementing the
``Defining and Delimiting the Exemptions for Executive,
Administrative, Professional, Outside Sales and Computer
Employees'' regulation.
Language is included under ``General Provisions'' providing
flexibility of crossing for H-2B nonimmigrant workers.
Language is included under ``General Provisions'' providing
requirements for the determination of prevailing wages in the
H-2B nonimmigrant workers program.
Language is included under ``General Provisions''
rescinding advance appropriations for the Dislocated Workers
National Reserve.
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 ``Centers for Disease Control
and Prevention--Public Health Preparedness and Response''
permitting CDC to operate and maintain an aircraft.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute of Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Centers for Disease Control
and Prevention--Buildings and Facilities'' providing funds from
former employees with existing Individual Learning Accounts
unobligated 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 ``Substance Abuse and Mental
Health Services Administration--Mental Health'' requiring
states to spend 10 percent of the Mental Health Block Grant for
programs for individuals with early serious mental illness.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' exempting the
Mental Health Block Grant from the evaluation set-aside in
section 241 of the Public Health Service Act.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance permitting funds
to be used for the national communications system for victims
of severe forms of trafficking.
Language is included under Administration for Community
Living 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 public notice
has been provided within 90 of instituting action to the named
person or their legal guardian.
Language is included under Administration for Community
Living waiving the public notice requirement for individuals
without a guardian, who are not competent to consent, who are
wards of the State or subject to public guardianship.
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 salary of an individual through an
HHS grant or other extramural mechanism to not more than the
rate of Executive Level II.
Section 203 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 204 reduces the section 241 of the Public Health
Service Act evaluation set-aside to 2.4 percent.
Section 205 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.
Notification must be provided to the Committees on
Appropriations at the program, project, and activity level in
advance of any transfer.
Section 206 continues the 60-day flexibility for National
Health Service Corps contract terminations.
Section 207 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 208 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 209 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 210 prohibits funds from being used to advocate or
promote gun control.
Section 211 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 212 relates to certain international health
activities.
Section 213 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 214 makes NIH funds available for human
immunodeficiency virus research available to the Office of AIDS
Research.
Section 215 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 216 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 217 transfers one percent of the funding made
available for National Institutes of Health National Research
Service Awards to the Health Resources and Services
Administration and Agency for Healthcare Research and Quality.
Section 218 allows NIH to retain payments for certain
research organisms.
Section 219 continues the Biomedical Advanced Research and
Development Authority ten year contract authority.
Section 220 requires HHS to provide details on its public
web site related to how the Prevention and Public Health Funds
are used.
Section 221 directs the spending of the Prevention and
Public Health fund.
Section 222 requires HHS to include certain information
concerning the number of full-time federal employees and
contractors working on the ACA in the fiscal year 2018 budget
request.
Section 223 includes specific report requirements for CMS's
marketplaces activities in the fiscal year 2017 budget request.
Section 224 continues certain Congressional notification
requirements.
Section 225 prohibits CMS Program Account from being used
to support risk corridor payments.
Section 226 rescinds the Nonrecurring Expenses Fund.
Section 227 prohibits funds from being used for patient-
centered outcomes research.
Section 228 prohibits funds from being used for Title X
family planning activities.
Section 229 prevents funding of the Navigator program.
Section 230 requires HHS to submit an analysis of the
impact of section 2713 of the Public Health Service Act on
discretionary programs.
Section 231 creates an Infectious Disease Rapid Response
Reserve Fund and specifies the purposes and circumstances under
which such fund may be accessed.
TITLE III--DEPARTMENT OF EDUCATION
Language is included under ``General Provisions'' allowing
Elementary and Secondary Education Act funds consolidated for
evaluation purposes to be available from July 1, 2017 through
September 30, 2018.
Language is included under ``General Provisions'' allowing
certain institutions to continue to use endowment income for
student scholarships.
Language is included under ``General Provisions'' extending
the authorization of the National Advisory Committee on
Institutional Quality and Integrity.
Language is included under ``General Provisions'' extending
the authority to provide account maintenance fees to guaranty
agencies for Federal student loans.
Language is included under ``General Provisions''
prohibiting the Department from moving forward with regulations
that would define ``gainful employment'' and ``credit hour'',
dictate how States must authorize or license institutions of
higher education within the State, and regulate teacher
preparation programs.
Language is included under ``General Provisions''
prohibiting funds from being used to withhold Federal financial
assistance to public educational institutions subject to the
Dear Colleague Letter published by the Departments of Education
and Justice on May 13, 2016 unless an alleged violation is
determined to have occurred by the appropriate courts.
TITLE IV--RELATED AGENCIES
Language is included under ``Federal Mediation and
Conciliation Service--Salaries and Expenses'' providing that
fees charged for special training and other services and be
retained and used for authorized purposes, that fees for
arbitration services may only be used for training agency
personnel, and that the Director may accept gifts and services
in aid of any projects under the Director's jurisdiction.
Language is included under ``National Labor Relations
Board--Salaries and Expenses'' prohibiting the use of funds for
organizing or assisting in the organization of agricultural
workers or for investigations, hearings, directives, or orders
related to bargaining units of agricultural workers including
employees involved in the maintenance and operations of
ditches, canals, reservoirs and waterways for agricultural
purposes.
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 exertion of
jurisdiction related to Indian tribes.
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 application
of a new bargaining unit standard.
Language is included under ``The Committee for Purchase
from People Who are Blind or Severely Disabled'' requiring that
written agreements, with certain oversight provisions, be in
place in order for authorized fees to be charged by certified
nonprofit agencies.
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 prohibits the use of funds for the downloading
or exchanging of pornography.
Section 522 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 523 relates to reporting requirements for
conference expenditures.
Section 524 requires a statement regarding funding by U.S.
taxpayers in certain advertisements.
Section 525 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 526 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 527 rescinds $15,000,000 provided under section
3403 [Independent Payment Advisory Board] of Public Law 111-
148.
Section 528 rescinds $7,000,000,000 provided under section
3021(a) [Center for Medicare and Medicaid Innovation] of Public
Law 111-148.
Section 529 rescinds $150,000,000 provided under section
6301(e) [Patient-Centered Outcomes Research Trust Fund] of
Public Law 111-148.
Section 530 rescinds various funds from the Children's
Health Insurance program.
Section 531 rescinds various funds from the Child
Enrollment Contingency Fund.
Section 532 rescinds various funds from the Children's
Health Insurance Performance Bonus Payment.
Section 533 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 in Last Year of Appropriations
Authorization Level Authorization in this Bill
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA:
Reintegration of Ex- FY 2010............ $20,000,000........ $15,000,000 $88,078,000
Offenders (transition
activities authorized by
Second Chance Act, 2007).
VETERANS' EMPLOYMENT AND
TRAINING SERVICE:
Homeless Veterans Program... FY 2015............ 50,000,000......... 38,109,000 50,000,000
Homeless Women Veterans and FY 2016............ 50,000,000......... 38,109,000 50,000,000
Homeless Veterans with
Children Reintegration
Grant Program.
Referral and Counseling FY 2016............ 50,000,000......... 38,109,000 50,000,000
Services to Veterans at
Risk of Homelessness.
DEPARTMENT OF HEALTH AND HUMAN
SERVICES HRSA:
School-Based Health Centers. FY 2013............ 50,000,000......... 47,450,000 - - -
National Health Service FY 2012............ Such Sums.......... - - - - - -
Corps.
Nursing Education Loan FY 2007............ Such Sums.......... 31,055,000 83,135,000
Repayment.
Faculty Loan Repayment...... FY 2014............ 5,000,000.......... 1,187,000 1,190,000
Scholarships for FY 2014............ Such Sums.......... 44,857,000 45,970,000
Disadvantaged Students.
National Center for FY 2014............ 7,500,000.......... 4,651,000 4,663,000
Workforce Analysis.
Primary Care Training and FY 2014............ Such Sums.......... 36,831,000 38,924,000
Enhancement.
Oral Health Training FY 2012............ 25,000,000......... 31,928,000 35,873,000
Programs.
Area Health Education FY 2014............ 125,000,000........ 30,250,000 30,250,000
Centers.
Education & Training-- ................... ................... 33,237,000 38,737,000
Geriatrics
(Workforce Development). FY 2014............ 10,800,000.........
(Career Incentive FY 2013............ 10,000,000.........
Awards).
Mental & Behavioral Health FY 2013............ 35,000,000......... 7,896,000 9,916,000
Education.
Nursing Workforce FY 2014............ Such Sums.......... 37,913,000 39,913,000
Development (Nurse
Education, Practice,
Retention, and Quality
Grants).
(Nurse Faculty Loan Program) FY 2014............ Such Sums.......... 24,500,000 26,500,000
Sickle Cell................. FY 2009............ 10,000,000......... 4,455,000 4,455,000
Healthy Start............... FY 2013............ Formula............ 100,746,000 103,500,000
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........ 205,544,000 205,079,000
Coordinated Services and FY 2013............ 87,273,000......... 75,088,000 75,088,000
Access to 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 FY 2013............ 42,178,000......... 33,275,000 33,611,000
Centers--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 65,500,000
Rural Hospital Flexibility FY 2012............ Such Sums.......... 41,040,000 45,609,000
Grants.
State Offices of Rural FY 2002............ Such Sums.......... 4,000,000 10,511,000
Health.
Telehealth.................. FY 2006............ Such Sums.......... 6,814,000 19,000,000
CDC:
Sexually Transmitted FY 1998............ Such Sums.......... 113,671,000 157,310,000
Diseases Grants.
National Cancer FY 2003............ Such Sums.......... N/A 49,440,000
Registries.
National Center for FY 2003............ Such Sums.......... 125,899,000 160,397,000
Health Statistics.
WISEWOMEN............... FY 2003............ Such Sums.......... 12,419,000 21,120,000
Asthma (Environmental).. FY 2005............ Such Sums.......... 32,422,000 29,000,000
Folic Acid.............. FY 2005............ Such Sums.......... 2,188,000 3,150,000
Injury Prevention and FY 2005............ Such Sums.......... 138,237,000 261,059,000
Control.
Oral Health Promotion... FY 2005............ Such Sums.......... 11,204,000 18,000,000
Safe Motherhood/Infant FY 2005............ Such Sums.......... 44,738,000 46,000,000
Health Promotion.
Birth Defects, FY 2007............ Such Sums.......... 122,242,000 135,310,000
Developmental
Disability, Disability
and Health.
Developmental FY 2011............ 21,000,000......... 21,380,000 23,100,000
Disabilities
Surveillance and
Research Program
(Autism).
Breast and Cervical FY 2012............ 275,000,000........ 204,779,000 210,000,000
Cancer.
Johanna's Law........... FY 2012............ 18,000,000......... 4,972,000 5,500,000
Epidemiology Laboratory FY 2013............ 190,000,000........ 32,424,000 40,000,000
Capacity Grants.
National TB Strategy FY 2013............ 243,101,000........ 132,997,000 142,256,000
Grants.
Public Health Workforce FY 2013............ 39,500,000......... 64,000,000 45,000,000
and Career Development.
National Diabetes FY 2014............ Such Sums.......... 10,000,000 25,000,000
Prevention Program.
Section 317 Immunization FY 2014............ Such Sums.......... 610,847,000 565,508,000
Young Women's Breast FY 2014............ 9,000,000.......... 4,951,000 4,960,000
Health Awareness.
Congenital Heart Disease FY 2015............ Such Sums.......... 4,000,000 4,000,000
Programs.
Lead Poisoning FY 2005............ Such Sums.......... 36,474,000 17,500,000
Prevention.
Preventive Health and FY 1998............ Such Sums.......... 194,092,000 160,000,000
Health Services Block
Grant.
NIH:
All 27 Institutes and FY 2009............ Such Sums.......... 30,317,024,000 32,542,402,000
Centers.
SAMHSA:
Treatment Systems for FY 2003............ 50,000,000......... 16,700,000 36,386,000
Homeless Individuals.
Residential Treatment FY 2003............ Such Sums.......... 0 15,931,000
Programs for Pregnant
and Postpartum Women.
Priority Substance Abuse FY 2003............ 300,000,000........ 322,994,000 331,323,000
Treatment Needs of
Regional and National
Significance.
Substance Abuse FY 2003............ 40,000,000......... 20,000,000 29,605,000
Treatment Services for
Children and
Adolescents.
Priority Substance Abuse FY 2003............ 300,000,000........ 138,399,000 211,148,000
Prevention Needs of
Regional and National
Significance.
Priority Mental Health FY 2003............ 300,000,000........ 94,289,000 395,289,000
Needs of Regional and
National Significance.
Youth Interagency FY 2007............ 5,000,000.......... 3,960,000 5,988,000
Research, Training, and
Technical Assistance
Centers.
Suicide Prevention for FY 2007............ 35,000,000......... 22,779,000 41,915,000
Children and Youth.
Primary and Behavioral FY 2014............ 50,000,000......... 50,000,000 26,004,000
Health Care Integration.
Grants for Jail Division FY 2003............ 10,000,000......... 6,043,000 4,269,000
Programs.
PATH Grants to States... FY 2003............ 75,000,000......... 46,855,000 64,635,000
Community Mental Health FY 2003............ 100,000,000........ 96,694,000 119,026,000
Services for Children
with Serious Emotional
Disturbances.
Grants for Persons who FY 2003............ 50,000,000......... 20,000,000 46,887,000
Experienced Violence
Related Stress.
Community Mental Health FY 2003............ 450,000,000........ 433,000,000 532,571,000
Services Block Grants.
Substance Abuse FY 2003............ 2,000,000,000...... 1,785,000,000 1,858,079,000
Prevention and
Treatment Block Grant.
Protection and Advocacy FY 2003............ 19,500,000......... 32,500,000 36,146,000
for Individuals with
Mental Illness Act.
AHRQ:
Research on Health FY 2005............ Such Sums.......... 260,695,000 280,240,000
Costs, Quality, and
Outcomes.
ACF:
Low Income Home Energy FY 2007............ 5,100,000,000...... 2,161,170,000 3,490,304,000
Assistance Program.
Children and Families
Services Programs
Adoption Awareness FY 2005............ Such Sums.......... 12,453,000 39,100,000
Programs.
Native American Programs FY 2002............ Such Sums.......... 45,826,000 53,100,000
Community Services Block FY 2003............ Such Sums.......... 645,762,000 715,000,000
Grant.
Community Economic FY 2003............ Formula............ 27,082,000 29,883,000
Development Program.
Assets for Independence. FY 2003............ 25,000,000......... 24,827,000 18,950,000
Head Start.............. FY 2012............ Such Sums.......... 7,968,544,000 9,309,724,000
Runaway and Homeless FY 2013............ Such Sums.......... 107,852,000 119,121,000
Youth Programs.
CAPTA programs.......... FY 2015............ Such Sums.......... 143,981,000 138,374,000
Family Violence Programs FY 2015............ 178,500,000........ 139,500,000 159,250,000
Disaster Human Services N/A................ N/A................ N/A 1,864,000
Case Management.
Refugee and Entrant
Assistance
Transitional and Medical FY 2002............ Such Sums.......... 227,243,000 490,000,000
Services.
Social Services......... FY 2002............ Such Sums.......... 158,600,000 155,000,000
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 FY 2002............ Such Sums.......... 11,483,000 4,800,000
Demonstration.
Lifespan Respite Care... FY 2011............ 94,810,000......... 2,495,000 3,360,000
State Health Insurance FY 1996............ 10,000,000......... N/A 52,115,000
Assistance Program.
Developmental FY 2007............ Such Sums.......... 155,115,000 160,353,000
Disabilities.
Voting Access for People FY 2005............ 17,410,000......... 13,879,000 4,963,000
with Disabilities.
Elder Justice/Adult FY 2014............ 129,000,000........ 0 8,000,000
Protective Services.
Assistive Technology.... FY 2010............ Such Sums.......... 25,000,000 34,000,000
OS:
Office of Women's Health FY 2014............ Such Sums.......... 33,958,000 32,140,000
Office of Minority FY 2016............ Such Sums.......... 56,670,000 56,670,000
Health.
DEPARTMENT OF EDUCATION
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 FY 2009............ Such Sums.......... 617,175,000 409,956,000
Sciences.
RELATED AGENCIES
Institute of Museum and FY 2009............ Such Sums.......... 274,840,000 230,000,000
Library Services.
National Council on FY 2003............ Such Sums.......... 3,144,000 3,250,000
Disability.
----------------------------------------------------------------------------------------------------------------
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 Budget
authority Outlays authority Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary............................................... $163,081 $169,053 $163,081 \1\$169,073
Mandatory................................................... 775,573 775,186 775,573 \1\775,186
----------------------------------------------------------------------------------------------------------------
\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:
2017................................................... \1\$844,780
2018................................................... 63,022
2019................................................... 16,670
2020................................................... 4,888
2021 and future years.................................. 29,612
------------------------------------------------------------------------
\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....................................... $443,271
Fiscal year 2017 outlays resulting therefrom............... \1\423,606
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.
MINORITY VIEWS OF REP. NITA LOWEY AND REP. ROSA DELAURO
We would like to acknowledge the efforts of Chairman Rogers
and Chairman Cole to hold a full committee markup of the Labor,
Health and Human Services, and Education bill. This bill, which
includes some of the nation's most important domestic programs,
has not made it to the full committee nearly enough in recent
years. We believe the Committee should debate these critical
issues in public every year, which is why we appreciate
Chairman Cole's efforts to hold markups during both years of
his subcommittee chairmanship.
However, Republicans on the Committee disappointingly
approved a bill this year that cuts labor, health, and
education programs by $569 million compared to the FY 2016
level.
Less than a year ago, the Labor-HHS-Education bill received
only a fraction--about one-half--of its proportionate share of
additional funds made available by the Bipartisan Budget Act,
which increased discretionary spending in fiscal years 2016 and
2017. The Labor-HHS-Education bill should have received about
$5.2 billion more than its fiscal year 2016 allocation. This
year's cut would do even more damage.
The cuts in this bill, with which we strongly disagree,
will harm women, seniors, students, workers, and families.
Specifically:
The bill hurts women's health by completely
eliminating funding for Title X Family Planning and the
Teen Pregnancy Prevention program.
The bill hurts seniors by cutting the operating
budget for the Centers for Medicare and Medicaid
Services (CMS) by $881 million and cutting the
operating budget for the Social Security Administration
(SSA) by $264 million. Millions of seniors and low
income families rely on benefits provided by Medicare,
Medicaid, and Social Security--but this bill slashes
more than $1.1 billion dollars from the agencies that
manage those vital services.
The bill hurts students by cutting $1.3 billion from
the Pell Grant program at a time when our economy is
burdened with over $1.2 trillion in student debt. It
also cuts or eliminates more than two dozen education
programs.
The bill hurts unemployed workers by cutting $300
million from job training funds reserved for dislocated
workers, and by completely eliminating Apprenticeship
Grants, which were funded at $90 million last year.
The bill is also weighed down by ideological riders. It
blocks funding for the Affordable Care Act (ACA), which would
cause more than 20 million Americans to lose their health
coverage.
The bill continues an outrageous rider that has blocked the
Centers for Disease Control and Prevention (CDC) from
supporting gun violence prevention research for the past twenty
years. This rider continues to have tragic consequences, as the
CDC has been unable to research effective strategies to reduce
the nation's crisis of gun deaths--which exceed 30,000 every
year.
Even Congressman Dickey--the original author of this
rider--has spoken out in favor of removing his own prohibition,
noting, ``We must learn what we can do to save lives.''
In addition, the bill leaves students and workers more
vulnerable to exploitation. It blocks the Department of
Education from protecting students from high-debt for-profit
college programs that provide limited employment opportunities;
it blocks the Department of Labor from ensuring that financial
advisers act in the best interests of their clients; it also
blocks a needed update of overtime pay provisions that would
enable 4.2 million workers to receive the overtime pay they've
earned. And it blocks the National Labor Relations Board from
enforcing its own rules facilitating union elections.
The Majority once again tries 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 Pell
Grants, literacy education, research in Special Education,
family planning services, teen pregnancy prevention, tobacco
prevention, healthcare research, job training, worker
protection, and community service programs. We also sought to
boost funding for NIH research, as well early learning programs
such as the Child Care and Development Block Grant, Head Start,
and Preschool Grants.
We proposed amendments to restore funding to the operating
budgets at CMS and SSA, because our retired seniors and workers
with disabilities deserve programs that are managed
effectively.
In addition, we introduced amendments to respond to public
health emergencies occurring across the country. We offered an
amendment to provide $1.9 billion in emergency funding to
prepare for, and respond to, the Zika virus, which has infected
649 pregnant women in the United States (as of July 7); we
offered an amendment to increase the Infectious Disease Rapid
Response Reserve Fund to $5 billion; and we offered an
amendment to boost funding for CDC's Childhood Lead Poisoning
Prevention and Safe Water programs by $80 million, which would
help address the crisis of lead poisoning in youth across the
country. All of these programs would have been designated as
emergencies.
We also introduced amendments to strike offensive riders
from the bill and to support gun violence prevention research
at the CDC.
In sum, our amendments would have resolved many of the
bill's defects. Unfortunately, the Majority blocked all of
these important amendments.
Therefore, without our proposed improvements, the bill is
too fundamentally flawed due to its insufficient 302(b)
allocation and the inclusion of unnecessary and ideological
riders to merit our support.
Moreover, the much-needed funding to restore investments in
the Labor-HHS-Education bill will not materialize unless, and
until, we undo sequestration. That is why 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 any long-term budget discussions.
The Majority has made it clear that it is willing to
violate the budget caps for defense spending--as it already
shifted $15.7 billion in Overseas Contingency Operations
funding to the base defense bill. We simply ask for similar
considerations for critical investments in non-defense
programs, such as the education and health programs in this
bill.
While the Labor-HHS-Education bill has a great many
shortcomings due to its inadequate allocation, we strongly
support some of its investments--though many of these increases
fall short of the funds needed to make long-lasting progress.
For example:
National Institutes of Health (NIH). The
bill includes $33.3 billion for the NIH, an increase of
$1.25 billion above the FY 2016 Omnibus. These
additional funds would enable the NIH to move forward
with the Precision Medicine Initiative, the BRAIN
Initiative, Alzheimer's research, and basic science
research across NIH's Institutes and Centers.
Unfortunately, the bill does not fund the President's
Cancer Moonshot.
Special Education State Grants. The bill
includes $12.4 billion for IDEA Part B State Grants, an
increase of $500 million above the FY 2016 level. These
additional funds would assist States in covering the
excess costs of providing special education and
services to children with disabilities. Unfortunately,
the bill also reduces funding by 30 percent for
critical special education national activities that
provide much-needed support for technology, materials,
and personnel recruitment and development.
Comprehensive Opioid Response Grants. The
bill includes $500 million for grants to states,
territories, and tribes, which would help to respond to
the opioid crisis that is causing devastating death and
destruction across the country.
Infectious Disease Rapid Response Reserve
Fund. The bill includes $300 million for a new
infectious disease rapid response reserve fund, which
is similar to legislation that Ms. DeLauro authored to
fund the Public Health Emergency Fund. While the
creation of this no-year fund is a step in the right
direction, much more funding is needed to respond to
future public health emergencies and the funding should
be designated as emergency spending.
Head Start. The bill includes $9.3 billion
for Head Start, an increase of $142 million above the
FY 2016 level. However, due to recent improvements to
the Head Start program, the funding provided would not
be sufficient to continue to serve the same number of
children--in fact, Head Start would lose 125,000 slots
at this funding level.
Harmful Budget Cuts in the Majority's Bill (by Department)
The Labor-HHS-Education bill is often called the People's
Bill for a reason. It is about providing Americans with
opportunities to get ahead. The programs we fund level the
playing field for low-income children to learn; help Americans
learn the skills to find a job in a tough economy; and equip
our nation to deal with public health emergencies. That is why
we are so disappointed that the Majority continues to target
this bill for funding cuts.
DEPARTMENT OF EDUCATION
The Department of Education alone takes a net cut of $1
billion--and that is after accounting for an increase of $500
million for special education State grants and $1 billion for
the newly authorized Student Support and Academic Enrichment
Block Grant. The bill slashes funding for more than a dozen
programs, including Special Education Personnel Development,
Teacher Quality State Grants, Office for Civil Rights,
Institute for Education Sciences Research, and it terminates
nine other fully authorized programs and activities.
DEPARTMENT OF EDUCATION--PROGRAM ELIMINATIONS
1 Graduate Assistance in Areas of National Need
2 Child Care Access Means Parents in School
3 Education Innovation and Research (13)
4 School Leader Recruitment and Support
5 Magnet School Assistance Program
6 Arts in Education
7 Innovative Approaches to Literacy
8 Safe and Drug-free Schools and Communities National
Activities (including ``Now is the Time'')
9 Teacher Quality Partnership
We are also concerned that the bill eliminates a key
funding source for 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. While universal literacy is the mark
of a civilized society, the bill even eliminates Innovative
Approaches to Literacy and cuts funding for Comprehensive
Literacy Development (Striving Readers), the largest reading
program for low-income children from birth through grade 12.
The Pell Grant program, which has allowed millions of low-
and middle-income students to gain access to college and the
middle class, loses $1.3 billion.
Instead of cutting the Pell Grant program, we offered an
amendment to restore the Year-Round Pell Grant benefit, which
would allow full-time students to earn a third semester of Pell
Grants in an academic year--enabling them to finish faster by
taking additional courses year-round.
In addition, we offered amendments to restore funding for
Pell Grants as well as to restore funding for education
programs that were eliminated or reduced. We also offered an
amendment to boost funding for early childhood programs,
including Preschool Development Grants (which were formerly
funded through the Department of Education). We are
disappointed 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, the rest of the department is
roughly flat funded.
The bill eliminates funding for Title X Family Planning at
a time when the program's services are needed most--especially
considering the public health threat of the Zika virus. The
bill also eliminates the Teen Pregnancy Prevention program, an
action we find baffling given the program's proven track
record. Between 2010 and 2014, the last years for which we have
data, the U.S. teen birthrate declined by 29 percent. The
elimination of the Teen Pregnancy Prevention program would put
that success at risk.
The bill cuts CMS Program Management by $881 million below
the FY 2016 level and $1 billion below the President's request,
despite an influx of 6.5 million Medicare enrollees over the
past five years. Such a massive funding cut would break our
promise to seniors by undermining the effective operation of
the Medicare program.
Moreover, the bill cuts CDC's Tobacco Prevention activities
by $110 million, including complete elimination of the ``Tips
from Former Smokers'' campaign, an incredibly successful
program which has helped 400,000 smokers quit for good since
2012, saving 16,000 lives every year.
And while we support the additional funding for Head Start,
it is still $292 million below the President's request. At the
funding level in this bill, the number of children enrolled in
Head Start would decline by approximately 125,000, which is
simply unacceptable.
Similarly, the bill provides only a minimal increase of $40
million for the Child Care and Development Block Grant (CCDBG),
which is $161 million below the President's request. This
increase is not enough for States to implement the quality
improvements and reforms that were enacted in bipartisan child
care legislation while continuing to serve the same number of
children.
We sought to improve the bill by offering amendments to
restore funding for Family Planning, Teen Pregnancy Prevention,
CMS's operating budget, and CDC's Tobacco Prevention program.
And we tried to increase funding for Head Start, CCDBG, and
Preschool Development Grants.
We introduced amendments to provide the President's request
of $1.9 billion to respond to the Zika virus; to increase the
Infectious Disease Rapid Response Reserve Fund to $5 billion;
and to increase funding for the CDC's Childhood Lead Poisoning
Prevention and Safe Water programs, which would help address
the crisis of lead poisoning in youth across the country. Each
of these three amendments would have designated the funds as
emergency spending.
We also offered an amendment to increase funding for NIH
research, to match last year's increase of $2 billion over the
previous year.
Again, our colleagues across the aisle did not support
these efforts.
DEPARTMENT OF LABOR
The Department of Labor is cut by $538 million below last
year's level, once a rescission of $200 million to Dislocated
Worker job training funds is taken into account. The bill not
only fails to boost investments in job training, it actually
makes huge cuts to job training programs--including a net cut
of approximately $300 million to job training for dislocated
workers and the complete elimination of Apprenticeship Grants,
a cut of $90 million. These cuts are incredibly harmful because
job training and apprenticeship programs offer an opportunity
to connect job seekers with the business community--
particularly at a time when the unemployment rates for African-
American and Latino workers continue to exceed the national
unemployment rate.
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 workplaces with the worst records
of injuries on the job.
Finally, all funds for grants through the Bureau of
International Labor Affairs 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, apprenticeship grants, worker protection
agencies, and grants to eradicate child labor. 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 $13 million below the
FY 2016 level, with the cut coming from the National Service
Trust.
The National Labor Relations Board is cut by about $60
million, 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 once again note that
federal courts have upheld the NLRB's rulemaking authority.
And lastly, the bill cuts the Social Security
Administration's (SSA) operating expenses by $264 million below
the FY 2016 level, which is $1.2 billion below the President's
FY 2017 request for SSA. This shortfall could lead to field
office closures, 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.
Ideological Policy Riders in the Majority's Bill
As discussed above, the bill is also marred by the
inclusion of dozens of unnecessary and ideological riders. Some
of the most egregious riders are highlighted below.
THE AFFORDABLE CARE ACT
Unfortunately, we also see yet another attempt to block
funding for the Affordable Care Act, which would cause more
than 20 million Americans to lose their health insurance
coverage.
The evidence is now in--the ACA is working. It has
successfully expanded health coverage to millions of hard-
working American families and reduced the uninsured rate to the
lowest point on record. We should be supporting the ACA, not
undermining it.
The Majority voted to keep this poison pill.
OTHER HARMFUL POLICY RIDERS
The bill rescinds $7 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 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 cost the Medicare
program a total of $34 billion in unrealized savings over the
next decade, weakening the Medicare program for future
beneficiaries.
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
implementing a new threshold to ensure that workers receive
overtime pay they have earned. It continues the Majority's
assault on workers by stopping the National Labor Relations
Board from enforcing its own rulings that facilitate union
elections, the responsibilities of joint employers, and the
size of bargaining units.
The bill also prohibits funding for research into patient-
centered outcomes and blocks a Department of Education rule
that would protect students from high-debt for-profit college
programs that provide limited employment opportunities.
This type of legislation does not belong in appropriations
bills, so we offered several amendments to strike these
extraneous provisions. The Majority, once again, rejected the
amendments.
ANTI-WOMAN IDEOLOGY
This bill is an affront to women and families. In addition
to eliminating funding for the Family Planning program, it
would block any federal funds for family planning services,
which would have a devastating impact on women--especially
women in rural communities and low-income women.
To make matters worse, the bill also eliminates the Teen
Pregnancy Prevention program, which has helped to achieve great
success in reducing teenage pregnancy and abortion, including a
29 percent decline in teen pregnancy rates between 2010 and
2014, the most recent years for which data are available.
The bill includes the entire text of the Health Care
Conscience Rights Act, an authorizing bill that allows
employers to block access to preventive health services if the
employers have so-called ``religious or moral'' objections.
Once again, the Majority is unnecessarily meddling in a woman's
right to make her own health care decisions. This policy rider
would allow employers to create obstacles for women seeking
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.
And finally, the Majority passed an amendment to block
funding in any bill for in-vitro fertilization treatment--
including treatment for wounded veterans--unless the embryos
are preserved in perpetuity. First, the scope of the policy
goes well beyond the jurisdiction of the Labor-HHS-Education
bill. And second, parents should control their own embryos--the
government has no business in this decision. Parents should be
able to decide whether they want to freeze their embryos, allow
them to be adopted, or allow them to be donated for research.
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
health care decisions; we offered amendments to restore funding
to programs that were eliminated; and we strongly opposed the
ideological rider that would limit in vitro fertilization
services for our wounded veterans. Quite frankly, we are
appalled that our colleagues opposed our efforts.
Conclusion
This bill stands in stark contrast to the bipartisan Labor-
HHS-Education bill passed by our colleagues in the Senate.
While the Senate version is not the bill we would have written,
it reflects Republican and Democratic compromise on critical
issues.
Instead, this bill is another example of the Majority's
continued attempt to enact their extreme and divisive
ideological preferences, 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.
We hope our colleagues on the other side of the aisle will
work with Democrats during the conference process to fix the
many inadequacies in this bill. At that point, we look forward
to working with Chairman Rogers and Chairman Cole to move
forward.
Nita M. Lowey.
Rosa L. DeLauro.
ADDITIONAL VIEWS
Federal agencies tasked with stemming the spread of Zika
within the U.S. and effected areas have requested $1.9 billion
in emergency funding to adequately respond to the virus and
prevent the severe birth defects that it causes. If Congress
does not act now and get ahead of the spread of Zika, we could
be facing a national emergency similar to what is tragically
playing out in other parts of the world. Expecting parents or
those who will be starting families should not have to face the
risk of severe birth defects this virus causes on a massive
scale, and know Congress could have done more to stop it. I
support robust funding for Zika and have voted for an amendment
to provide $1.9 billion for Zika efforts previously and I
intended to vote in support of the amendment during the markup.
Jaime Herrera Beutler.
[all]