[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]