[House Report 115-244]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 115-244
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2018
_______
July 24, 2017.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Cole, from the Committee on Appropriations,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 3358]
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, 2018,
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
11
Pension Benefit Guaranty Corporation............... 15
11
Wage and Hour Division............................. 16
12
Office of Labor-Management Standards............... 17
12
Office of Federal Contract Compliance Programs..... 17
12
Office of Workers' Compensation Programs........... 17
13
Occupational Safety and Health Administration...... 21
14
Mine Safety and Health Administration.............. 24
15
Bureau of Labor Statistics......................... 26
16
Office of Disability Employment Policy............. 26
17
Departmental Management............................ 27
17
General Provisions................................. 31
19
Title II--Department of Health and Human Services:
Health Resources and Services Administration....... 42
20
Centers for Disease Control and Prevention......... 46
33
National Institutes of Health...................... 52
49
Substance Abuse and Mental Health Services
Administration................................. 60
74
Centers for Medicare and Medicaid Services......... 64
82
Administration for Children and Families........... 68
88
Administration on Aging............................
93
Office of Secretary................................ 79
99
Office of Inspector General........................ 82
103
Public Health and Social Services Emergency Fund... 83
104
General Provisions................................. 85
105
Title III--Department of Education:
Education for the Disadvantaged.................... 101
108
Impact Aid......................................... 102
110
School Improvement Programs........................ 103
111
Indian Education................................... 104
113
Innovation and Improvement......................... 105
115
Safe Schools and Citizenship Education............. 105
117
English Language Acquisition....................... 105
117
Special Education.................................. 106
118
Rehabilitation Services and Disability Research.... 109
120
Special Institutions for Persons with Disabilities. 110
122
Career, Technical and Adult Education.............. 110
123
Student Financial Assistance....................... 111
124
Student Aid Administration......................... 111
125
Higher Education................................... 111
125
Howard University.................................. 112
129
College Housing and Academic Facilities Loans...... 113
130
Historically Black College and University Capital
Financing...................................... 113
130
Institute of Education Sciences.................... 114
130
Departmental Management............................ 114
132
Office for Civil Rights............................ 115
134
Office of the Inspector General.................... 115
134
General Provisions................................. 115
134
Title IV--Related Agencies:
Committee for the Purchase from People Who Are
Blind or Severely Disabled..................... 118
135
Corporation for National and Community Service..... 119
136
Federal Mediation and Conciliation Service......... 124
139
Federal Mine Safety and Health Review Commission... 125
139
Institute of Museum and Library Services........... 125
139
Medicaid and CHIP Payment and Access Commission.... 126
140
Medicare Payment Advisory Commission............... 126
140
National Council on Disability..................... 126
140
National Labor Relations Board..................... 126
141
National Mediation Board........................... 130
141
Occupational Safety and Health Review Commission... 130
141
Railroad Retirement Board.......................... 130
141
Social Security Administration..................... 132
142
Title V--General Provisions:
House of Representatives Reporting Requirements....
147
Minority Views.....................................
260
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2018, the
budget request for fiscal year 2018, and the Committee
recommendation for fiscal year 2018 in the accompanying bill.
2018 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2018 Committee compared to--
Budget Activity -------------------------------------------------------------------------------
2017 Enacted 2018 Budget 2018 Committee 2017 Enacted 2018 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $12,088,155 $10,641,329 $10,767,464 (1,320,691) 126,135
Department of Health and Human 78,118,630 63,029,369 77,576,400 (542,230) 14,547,031
Services.......................
Department of Education......... 68,239,195 62,889,423 65,823,945 (2,415,250) 2,934,522
Related Agencies................ 14,885,326 13,682,005 14,715,337 (169,989) 1,033,332
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2018, the Committee recommends a total of
$157,938,000,000 in current year discretionary funding,
including offsets and adjustments. The fiscal year 2018
recommendation is a decrease of $5,047,000,000 below the fiscal
year 2017 enacted 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, the
Committee continues to build on the investment made last year
in biomedical research by increasing funding for the National
Institutes of Health (NIH) by $1,100,000,000. This increase
builds on the prior $2,000,000,000 increase included in the
Consolidated Appropriations Act, 2017 and continues funding
from the 21st Century Cures Act. Within the total increase, the
Committee provides an increase of $80,000,000 to the Precision
Medicine Initiative, which holds the promise of designing
personalized, targeted cures and treatment. The Committee also
includes an increase of $400,000,000 to help find a cure for
Alzheimer's disease and an increase of $76,000,000 for the
BRAIN initiative to help better understand how the brain
functions and learns.
The Committee has also placed a high priority on combatting
opioid addiction by including an additional $500,000,000 for
grants to States, as outlined in the 21st Century Cures Act.
The Committee also continues support for programs addressing
opioid addiction as authorized in the Comprehensive Addiction
and Recovery Act.
To protect public health and the Nation in the event of a
bioterrorism or other pandemic crisis, the Committee
recommendation also includes increases to the Bioshield and the
Biomedical Research and Advanced Development Authority (BARDA)
programs as well as a $178,000,000 increase for detecting and
preventing a pandemic flu outbreak. The recommendation also
increases the Strategic National Stockpile by $25,000,000 and
includes language allowing the Secretary of Health and Human
Services greater flexibility to respond to an imminent public
health threat within the public health and social services
emergency fund.
In the area of education, the Committee has included an
increase of $200,000,000 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 provides a total of $500,000,000 for the new Student
Support Services program created in the Every Student Succeeds
Act. 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,
computer science or physical education needs as local demands
may dictate. The recommendation also includes an increase of
$28,000,000 for charter schools.
The Committee includes robust increases for the TRIO,
$60,000,000, and GEAR UP, $10,246,000, programs to ensure that
students from disadvantaged backgrounds have access to a
college program. The bill also provides sufficient funding to
maintain the maximum Pell grant award at $5,920 in the 2018-
2019 academic year.
The Head Start program is increased by $21,905,000 and the
Child Care and Development Block Grant is increased by
$4,000,000 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.
These increases are offset by eliminating funding for
programs that do not have a clear or effective Federal role, or
that have large unobligated balances that are not needed in
this fiscal year.
The Committee believes that public service is a public
trust that requires Federal employees to place ethical
principles above private gain. Federal employees are reminded
that they shall not advance a personal agenda or give
preferential treatment to any outside organization or
individual within the government programs that they administer.
Information that is received by the employee, including
information from other employees, offices, or Congress should
be handled in a professional and confidential manner in
accordance with Code of Federal Regulations regarding the basic
obligation of public service (5 CFR 2635.101).
The Committee directs each of the agencies funded by this
Act to continue to report any funds derived by the agency from
non-Federal sources, including user charges and fines, that are
authorized by law, to be retained and used by the agency or
credited as an offset in annual budget submissions.
Paper Reduction Efforts.--The Committee urges each agency
funded by this Act to work with the Office of Management and
Budget (OMB) to reduce printing and reproduction costs and
directs each agency to inform the Committee on what steps have
been taken to achieve this goal, including identifying how much
money each agency expects to save by implementing these
measures.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
The Committee recommends $3,042,720,000 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
$295,979,000 less than the fiscal year 2017 enacted level, and
$988,954,000 more than the fiscal year 2018 budget request.
Workforce Training.--The Committee continues to be
concerned by the skills gap. According to Bureau of Labor
Statistics data, employers are currently reporting over six
million open positions. Employers are unable to fill many of
these positions due to a lack of applicants with the required
skills. The Committee believes this is an enormous missed
economic opportunity. In the November 2016 Top Management and
Performance Challenges Facing the U.S. Department of Labor, the
Department of Labor Office of Inspector General (DOL-OIG)
states that the Department has been challenged to assure that
participants in its job training programs receive industry-
recognized credentials and that participants obtain employment
in the occupations they have been trained for. The Committee
urges the Department to consider ways that job-training
programs can be better targeted and improved within existing
authorities in order to train participants for in-demand jobs
and reduce the skills gap.
Governors' Reserve Fund.--The Committee recommendation
maintains the Governors' Reserve Fund at the level authorized
by WIOA. The Committee supports efforts by the Department of
Labor to work with States to ensure that funds are used for
authorized purposes in a timely manner and to minimize the
accumulation of balances.
Apprenticeship.--The Committee provides $35,000,000 for the
Office of Apprenticeship Services. The Committee urges the
Employment and Training Administration (ETA) to continue to
expand apprenticeship options through outreach and increased
employer engagement in registered apprenticeships. The bill
provides no new funding for the Apprenticeship Grants program.
The Committee encourages ETA to work with the authorizing
committees of jurisdiction to enact an appropriate
apprenticeship program authorization.
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 service members, and veterans.
Pay for Performance.--The Pay-for-Performance authority
provided in WIOA is a promising, innovative approach that
leverages data, evaluation, and evidence-based performance to
improve workforce development outcomes. The Committee urges the
Department to consider how this authority can be used to
improve training and employment programs across the workforce
development system.
Formal Partnerships and Job-Placement Services.--The United
States is experiencing a shortfall of workers with education
and training beyond a high school education. At the same time,
industry surveys show that a lack of qualified workers is a top
concern for many employers. The Committee urges the Secretary
of Labor to research and develop strategies for creating formal
partnerships and job-placement services with industry employers
and the Adult Employment and Training Activities and Dislocated
Worker Employment and Training Activities programs authorized
by WIOA.
Evaluation.--The Committee supports rigorous evaluation of
the Department's programs, particularly the workforce training
programs authorized by WIOA. The Committee provides $8,040,000
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 the
Department to use the findings to improve program delivery and
results. The Committee urges the Department to follow through
on evaluation findings with evidence-based Congressional
justifications.
Program Integrity.--The Committee continues to be concerned
by the improper payment rate in the Unemployment Insurance (UI)
program and urges the Department to use its authority and
program integrity resources to help address this issue.
Information Technology (IT) Consortia.--The Committee
remains 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 all consortia projects and to implement
appropriate policies and procedures for assessing and funding
projects by State consortia. In addition, the Committee directs
the Department to include in the fiscal year 2019 Congressional
Justification any necessary recommendations for language or
direction that would be helpful to ensure the long-term
viability of the consortia projects and ensure that funds being
used for IT modernization projects are achieving the intended
results.
Adult Employment and Training Activities.--For Adult
Employment and Training Activities, the Committee recommends
$776,736,000, which is $38,820,000 less than the fiscal year
2017 enacted level and $286,366,000 more than the fiscal year
2018 budget request.
Youth Employment and Training Activities.--For Youth
Employment and Training Activities, the Committee recommends
$831,842,000, which is $41,574,000 less than the fiscal year
2017 enacted level and $308,175,000 more than the fiscal year
2018 budget request.
Dislocated Worker Employment and Training Activities.--For
Dislocated Worker Employment and Training Activities, the
Committee recommends $1,145,530,000 which is $96,189,000 less
than the fiscal year 2017 enacted level and $413,045,000 more
than the fiscal year 2018 budget request.
Of the total provided for Dislocated Worker Employment and
Training Activities, $1,015,530,000 is designated for State
grants that provide core and intensive services, training, and
supportive services for dislocated workers. In addition, States
use these funds for rapid response assistance to help workers
affected by mass layoffs and plant closures.
The remaining $130,000,000 is available for the Dislocated
Workers National Reserve (DWNR). The DWNR supports national
emergency grants, technical assistance and demonstration
projects as authorized by WIOA. The Committee recommendation
eliminates advance appropriations for the DWNR by providing
$130,000,000 in current year funds and rescinding the advance
provided in fiscal year 2017. No advance is provided for fiscal
year 2019. The Committee recommendation includes up to
$66,000,000 to assist dislocated workers in the Appalachian
region as requested in the fiscal year 2018 budget request. The
Committee appreciates the Department's efforts to address
severe dislocations of workers in the coal industry.
Native Americans.--For the Indian and Native American
programs, the Committee recommends $50,000,000, which is the
same as the fiscal year 2017 enacted level and $95,000 more
than the fiscal year 2018 budget request.
Migrant and Seasonal Farmworkers.--For the National
Farmworker Jobs program, the Committee recommends $72,000,000,
which is $9,896,000 less than the fiscal year 2017 enacted
level. The fiscal year 2018 budget request proposed no funding
for this program.
The Committee encourages the Department to consider ways
that the Migrant and Seasonal Farmworkers program can be used
to help address shortages of workers in the agricultural
sector.
YouthBuild.--For the YouthBuild program, the Committee
recommends $84,534,000, which is the same as the fiscal year
2017 enacted level and $161,000 more than the fiscal year 2018
budget request.
Technical Assistance.--The Committee recommends no direct
funding for technical assistance, which is $2,500,000 less than
the fiscal year 2017 and $5,226,000 less than the fiscal year
2018 budget request. WIOA provides the authority to use DWNR
funds for technical assistance and the Committee maintains a
provision allowing the set-aside of up to 10 percent of such
funds for technical assistance activities.
Reintegration of Ex-Offenders.--The Committee recommends
$82,078,000 for ex-offender retraining and reintegration
activities, which is $6,000,000 less than the fiscal year 2017
enacted level and $4,167,000 more than the fiscal year 2018
budget request.
Workforce Data Quality Initiative.--The Committee
recommends no funding for the Workforce Data Quality
Initiative, which is $6,000,000 less than the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request.
JOB CORPS
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $1,688,155,000 for Job Corps,
which is $16,000,000 less than the fiscal year 2017 enacted
level and $239,711,000 more than the fiscal year 2018 budget
request.
Operations.--For Job Corps Operations, the Committee
recommends $1,572,886,000, which is $14,439,000 less than the
fiscal year 2017 enacted level and $231,568,000 more than the
fiscal year 2018 budget request.
Construction, Rehabilitation, and Acquisition.--The
Committee recommends $83,000,000 for construction,
rehabilitation, and acquisition activities of Job Corps
centers, which is $1,500,000 less than the fiscal year 2017
enacted level and $8,143,000 more than the fiscal year 2018
budget request.
Administration.--The Committee recommends $32,269,000 for
the administrative expenses of the Job Corps program, which is
$61,000 less than the fiscal year 2017 enacted level and the
same as the fiscal year 2018 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.
On March 31, 2017, the DOL-OIG issued a report entitled
Review of Job Corps Center Safety and Security (Report Number
26-17-001-03-370). The DOL-OIG found that campuses audited had
significant physical security weaknesses and that center
management continued to underreport or misclassify incidents of
student misconduct to Job Corps. The Consolidated
Appropriations Act, 2017 and the fiscal year 2018 Committee
recommendation includes additional funds for Job Corps
construction. The Committee directs the Department to use these
funds to address physical security weaknesses at Job Corps
centers. The Committee directs the Department to review and
make any necessary changes to the collection and processing of
misconduct reports.
The Committee continues to be concerned about the safety
and security of students in the Job Corps program. The
Committee supports the Department's efforts to improve safety
and urges ETA to continue to review and implement policies that
will enhance safety and security on Job Corps campuses
throughout the country.
The Committee is concerned that a backlog in the
procurement of Job Corps operations contracts has resulted in a
number of unnecessary and costly bridge contracts in recent
years. The Committee recognizes that fewer bridge contracts
were reported in the most recent quarter and appreciates the
efforts the Department has undertaken to reduce the backlog and
need for such bridge contracts in the future.
The Committee is aware of challenges with respect to the
recruitment of women participants in the Job Corps program. The
Department is directed to submit a report to the Committees on
Appropriations of the House of Representatives and the Senate
within 180 days of enactment of this Act providing detail on
current outreach and recruitment activities, barriers to
women's participation in the program, and ways that Job Corps
recruitment policies can better target women. As part of the
report, the Committee encourages ETA to work with HHS early
childhood education programs to assess current partnerships and
develop recommendations to improve or expand upon successful
partnership models at Job Corps campuses to facilitate the
participation of women with children.
The Committee encourages the Department to consider
establishing a working group of Job Corps administrators,
industry leaders and other relevant parties to identify ways in
which the program can be better targeted to support the goals
of training young Americans for in-demand jobs that benefit
their communities, the economy, and help reduce poverty.
The Committee continues to support the policy of closing a
limited number of chronically underperforming Job Corps centers
and 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 of the costs and anticipated
savings that will result from the closure.
Section 106(b) authorizes the Secretary to transfer up to
0.5 percent of discretionary ETA appropriations to carry out
program integrity activities within those programs, the
Committee directs the Department to notify the Committees on
Appropriations of the House of Representatives and the Senate
at least 15 days in advance of any such transfer with respect
to funds appropriated to Job Corps.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
The Committee recommends transferring the Community Service
Employment for Older Americans program to the Administration
for Community Living at the Department of Health and Human
Services.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
The Committee recommends $790,000,000 for Federal
Unemployment Benefits and Allowances, which is $59,000,000 less
than the fiscal year 2017 enacted level and the same as the
fiscal year 2018 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, 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 $2,830,903,000 for State
Unemployment Insurance and Employment Service Operations. The
total includes $2,760,903,000 from the Employment Security
Administration Account from the Unemployment Trust Fund and
$70,000,000 from the General Fund of the Treasury. These funds
are used to support the administration of Federal and State
unemployment compensation laws.
Unemployment Insurance Compensation.--For Unemployment
Insurance (UI) Compensation, the Committee recommends
$2,665,775,000, which is $21,825,000 less than the fiscal year
2017 enacted level and $30,000,000 more than the fiscal year
2018 budget request. The total includes $2,665,775,000 for
State Operations and $13,000,000 for National Activities.
The recommendation for State UI Operations includes
$160,000,000 to conduct in-person reemployment and eligibility
assessments (REA), which is $45,000,000 more than the fiscal
year 2017 enacted level and $30,000,000 more than the fiscal
year 2018 budget request. The Committee supports the REA
program as a means to reduce waste, fraud, abuse, to conduct
eligibility assessments, and to refer beneficiaries to
appropriate training options.
As in previous years, the recommendation provides
contingency funding for increased workloads that States may
face in the administration of UI. During fiscal year 2018, for
every 100,000 increase in the total average weekly insured
unemployment above 2,246,000, an additional $28,600,000 shall
be made available from the Unemployment Trust Fund.
Employment Service.--The Committee recommends $19,818,000
for Employment Service National Activities, which is the same
as the fiscal year 2017 enacted level and $38,000 more than the
fiscal year 2018 budget request.
Foreign Labor Certification.--The Committee recommends
$62,310,000 for the Foreign Labor Certification (FLC) program,
which is the same as the fiscal year 2017 enacted level and
$118,000 more than the fiscal year 2018 budget request. The
recommendation includes $48,028,000 for Federal administration
activities and $14,282,000 for grants to States.
The FLC program administers temporary foreign worker
programs including the H-2A and the H-2B temporary visa
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 previous delays in the
processing of labor certifications 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 2018.
The Committee is aware that there continues to be concern
regarding the methodology for calculating H-2A wage rates
prescribed in the Final Rule published by the Department of
Labor on February 12, 2010. The Committee encourages the
Department to review the wage methodology prescribed in the
Final Rule and determine whether an alternate methodology could
reduce disparate impacts on local areas.
One-Stop Career Centers/Labor Market Information.--The
Committee recommends $70,000,000 for One-Stop Career Centers
and Labor Market Information, which is $2,347,000 more than the
fiscal year 2017 enacted level and $2,476,000 more than the
fiscal year 2018 budget request. The Committee expects the
Department to use additional funds to ensure claimants have
access to timely information on job openings and other
appropriate labor market information.
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 $156,348,000 for Program
Administration, which is $2,308,000 less than the fiscal year
2017 enacted level and $2,083,000 more than the fiscal year
2018 budget request. The recommendation includes $106,461,000
from the General Fund of the Treasury and $49,887,000 from the
Employment Security Administration Account in the Unemployment
Trust Fund.
Employee Benefits Security Administration
SALARIES AND EXPENSES
The Committee recommends $175,600,000 for the Employee
Benefits Security Administration (EBSA). This recommendation is
$5,400,000 less than the fiscal year 2017 enacted level and
$8,326,000 less than the fiscal year 2018 budget request. The
EBSA assures the security of retirement, health and other
workplace-related benefits of working Americans.
The Committee understands there is concern regarding the
amount of time it takes to complete audits of Association
Health Plans and urges the Department to review its audit
policies to determine if there are ways to reduce the burdens
on plan administrators and complete audits in a timely manner.
Pension Benefit Guaranty Corporation
The Committee includes an obligation limitation for
administrative expenses of $424,417,000 for the Pension Benefit
Guaranty Corporation (PBGC). The limitation is $95,089,000 less
than the fiscal year 2017 enacted level and $98,500,000 less
than the fiscal year 2018 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. Congress established the PBGC to insure the
defined-benefit pension plans of working Americans.
The Committee recommendation does not include $98,500,000
for expenses related to the relocation of headquarters space,
which was provided in the Consolidated Appropriations Act,
2017. The Committee expects the fiscal year 2019 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 a report to the
Committees on Appropriations of the House of Representatives
and the Senate within 180 days of enactment of this Act that
includes an evidence-based review and assessment of the Smaller
Asset Manager Pilot Program. The report should include
performance comparisons of pilot participants and non-pilot
PBGC asset managers, after fees, relative to their portfolio
benchmarks, and should identify best practices and lessons
learned that could be applied at PBGC and other Federal pension
and retirement benefit systems.
The Committee directs PBGC to submit reports required by
the Employee Retirement Income Security Act of 1974 and the
Pension Protection Act of 2006.
Wage and Hour Division
SALARIES AND EXPENSES
The Committee recommends $217,500,000 for the Wage and Hour
Division (WHD), which is $10,000,000 less than the fiscal year
2017 enacted level and $12,568,000 less than the fiscal year
2018 budget request.
The WHD enforces Federal minimum wage, overtime pay,
recordkeeping, and child labor requirements of the Fair Labor
Standards Act. WHD also has enforcement and other
administrative responsibilities related to the Migrant and
Seasonal Agricultural Worker Protection Act, the Employee
Polygraph Protection Act, the Family and Medical Leave Act, the
Davis Bacon Act and the Service Contract Act.
The Committee continues to be concerned that the
Establishing a Minimum Wage for Contractors regulation
published by the Department of Labor in the Federal Register on
October 7, 2014 (79 Fed. Reg. 60634 et seq.) disproportionately
affects entities operating seasonal recreational services and
equipment rental to the general public on Federal property or
lands.
Office of Labor-Management Standards
SALARIES AND EXPENSES
The Committee recommends $41,129,000 for the Office of
Labor-Management Standards (OLMS), which is $2,942,000 more
than the fiscal year 2017 enacted level and $5,505,000 less
than the fiscal year 2018 budget request. The recommendation
does not include funding for the proposed Electronic Labor
Organization Reporting System (e.LORS) modernization project.
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 $94,500,000 for the Office of
Federal Contract Compliance Programs (OFCCP), which is
$9,976,000 less than the fiscal year 2017 enacted level and
$6,500,000 more than the fiscal year 2018 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.
In September 2016, GAO issued a report entitled, ``Equal
Employment Opportunity: Strengthening Oversight Could Improve
Federal Contractor Nondiscrimination Compliance'' (GAO-16-750).
In the report GAO found, among other things, that OFCCP does
not have reasonable assurance that the methods used for
selecting contractors for compliance reviews effectively target
contractors that pose the greatest risk of non-compliance, that
compliance assistance activities have declined by 30 percent
since 2012 ``as the agency refocused its activities on
enforcement,'' and that ``many contractors told GAO they do not
feel comfortable contacting OFCCP for assistance and hire third
party support to help comply with federal nondiscrimination and
affirmative action requirements.''
The Committee has raised concerns with these issues in
recent years and appreciates that the Department agreed with
the six recommendations GAO made in its report. The Committee
directs OFCCP to submit a report to the Committees on
Appropriations of the House of Representatives and the Senate
within 160 days of enactment of this Act on its efforts and the
status of implementing each of the GAO recommendations.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
The Committee recommends $116,550,000 for the Office of
Workers' Compensation Programs (OWCP), which is $1,051,000 less
than the fiscal year 2017 enacted level and $1,268,000 more
than the fiscal year 2018 budget request. The recommendation
includes $114,377,000 in General Funds from the Treasury and
the authority to expend $2,173,000 from the Special Fund
established by the Longshore and Harbor Workers' Compensation
Act.
The OWCP administers the Federal Employees' Compensation
Act, the Longshore and Harbor Workers' Compensation Act, the
Energy Employees Occupational Illness Compensation Program Act,
and the Black Lung Benefits Act. These programs provide
eligible injured and disabled workers and their survivors with
compensation, medical benefits, and services including
rehabilitation, supervision of medical care, and technical and
advisory counseling.
The Committee supports the efforts of OWCP to reduce fraud
and abuse related to the prescription of compound
pharmaceuticals and opioids.
The Committee remains concerned about backlogs of claims in
OWCP programs. The Committee directs OWCP to implement policies
and consider other ways in which processing times can be
brought more closely into alignment with agency goals.
SPECIAL BENEFITS
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $220,000,000 for Special Benefits,
which is the same as the fiscal year 2017 enacted level and the
fiscal year 2018 budget request. These funds provide mandatory
benefits under the Federal Employees' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
The Committee recommends $54,319,000 for Special Benefits
for Disabled Coal Miners. This amount is in addition to the
$16,000,000 appropriated in fiscal year 2017 as an advance for
the first quarter of fiscal year 2018. The total program level
recommendation is $70,319,000, which is $10,000,000 less than
the fiscal year 2017 enacted level and the same as the fiscal
year 2018 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 $15,000,000 as an
advance appropriation for the first quarter of fiscal year
2019. 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
the same as the fiscal year 2017 enacted level and the fiscal
year 2018 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.
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 $414,806,000
for the Black Lung Disability Trust Fund, which is $42,121,000
more than the fiscal year 2017 enacted level and the same as
the fiscal year 2018 budget request.
The Black Lung Disability Trust Fund pays black lung
compensation, medical and survivor benefits, and administrative
expenses when no mine operator can be assigned liability for
such benefits, or when mine employment ceased prior to 1970.
The Black Lung Disability Trust Fund is financed by an excise
tax on coal, reimbursements from responsible mine operators,
and short-term advances from the Treasury. The Emergency
Economic Stabilization Act of 2008 authorized a restructuring
of the Black Lung Disability Trust Fund debt and required that
annual operating surpluses be used to pay down the debt until
all remaining obligations are retired.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
The Committee recommends $531,470,000 for the Occupational
Safety and Health Administration (OSHA). This recommendation is
$21,317,000 less than the fiscal year 2017 enacted level and
$11,787,000 less than the fiscal year 2018 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 workplace and protect workers from
injury, illness, and death. The Committee supports the efforts
of OSHA to adopt an approach that more effectively balances
enforcement with education, training, and compliance
assistance. Unfortunately, overreliance on enforcement in
recent years has fostered a toxic environment between the
agency and employers that is undermining the agency's goals for
workplace safety and is at odds with Federal policies that
support economic growth and job creation.
Safety and Health Standards.--The Committee recommends
$18,000,000 for Safety and Health Standards.
Federal Enforcement.--The Committee recommends $194,250,000
for Federal Enforcement.
Whistleblower Programs.--The Committee recommends
$17,500,000 for Whistleblower Programs.
State Programs.--The Committee recommends $100,850,000 for
State Programs.
Technical Support.--The Committee recommends $24,469,000
for Technical Support.
Compliance Assistance.--The Committee recommends
$131,851,000 for Federal and State compliance assistance
programs. The total includes $72,351,000 for Federal Assistance
and $59,500,000 for State Consultation Grants.
Training Grants.--No funding is provided for Training
Grants.
Voluntary Protection Program/Safety and Health Achievement
Recognition Program.--The Committee supports the Voluntary
Protection Program and the Safety and Health Achievement
Recognition Program 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.
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.
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.
National/Regional/Local Emphasis Programs.--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 2018.
Mine Safety and Health Administration
SALARIES AND EXPENSES
The Committee recommends $359,975,000 for the Mine Safety
and Health Administration (MSHA), which is $13,841,000 less
than the fiscal year 2017 enacted level and $15,197,000 less
than the fiscal year 2018 budget request.
MSHA enforces the Federal Mine Safety and Health Act in
underground and surface coalmines 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 supports the efforts of MSHA to reemphasize
compliance assistance programs that help mine operators to
improve safety and comply with regulations without the threat
of punitive enforcement.
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 continues to receive reports of
inspectors exceeding necessary and appropriate levels of
oversight to the point of significantly impeding mining
operations. The Committee questions whether this strategy
materially improves safety and if the costs outweigh the
benefits of such additional oversight. The Committee continues
to support the efforts MSHA has undertaken to realign its
resources and capacity to match where mining activity is
currently occurring. MSHA has made progress in recent years but
must accelerate the process, including reductions in force if
necessary, in order to ensure sufficient industry oversight
that meets and does not exceed statutory and regulatory
requirements.
The Committee continues to support advances MSHA has made
in mine rescue technology and communications. The Committee
directs MSHA to assess its current mine rescue deployment
capability and strategy and discuss ongoing operational and
resource needs in the fiscal year 2019 Congressional
Justification.
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
2017 enacted level and $1,158,000 more than the fiscal year
2018 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 public. Its principal
surveys include the Consumer Price Index and the monthly
unemployment series.
Employment and Unemployment Statistics.--The Committee
recommends $203,878,000 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
$211,444,000 for Prices and Cost of Living.
Compensation and Working Conditions.--The Committee
recommends $82,880,000 for Compensation and Working Conditions.
Productivity and Technology.--The Committee recommends
$10,798,000 for Productivity and Technology.
Executive Direction and Staff Services.--The Committee
recommends $35,000,000 for Executive Direction and Staff
Services.
Office of Disability Employment Policy
SALARIES AND EXPENSES
The Committee recommends $36,800,000 for the Office of
Disability Employment Policy (ODEP), which is $1,403,000 less
than the fiscal year 2017 enacted level and $9,597,000 more
than the fiscal year 2018 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 $272,847,000 for Departmental
Management, which is $61,997,000 less than the fiscal year 2017
enacted level and $12,989,000 more than the fiscal year 2017
budget request. The recommendation includes $272,539,000 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.
Program Direction and Support.--The Committee recommends
$30,250,000 for Program Direction and Support.
Departmental Program Evaluation.--The Committee recommends
$8,040,000 for Departmental Program Evaluation.
Legal Services.--The Committee recommends $122,445,000 for
Legal Services.
International Labor Affairs.--The Committee recommends
$26,500,000 for International Labor Affairs (ILAB). The
recommendation provides no funding for ILAB grants as requested
in the fiscal year 2018 budget request and returns ILAB to its
original mission of research, advocacy, and technical
assistance.
Administration and Management.--The Committee recommends
$23,496,000 for Administration and Management.
Adjudication.--The Committee recommends $33,561,000 for
Adjudication.
Women's Bureau.--The Committee recommends $11,466,000 for
the Women's Bureau.
Civil Rights Activities.--The Committee recommends
$6,867,000 for Civil Rights Activities.
Chief Financial Officer.--The Committee recommends
$9,914,000 for the Chief Financial Officer.
The Committee directs the Department to submit its annual
Operating Plan to the Committees on Appropriations of the House
of Representatives and the Senate within the 45-day statutory
deadline.
VETERANS EMPLOYMENT AND TRAINING
The Committee recommends $284,051,000 for the Veterans
Employment and Training (VETS) program, which is $5,010,000
more than the fiscal year 2017 enacted level and $4,456,000
more than the fiscal year 2018 budget request. The
recommendation includes $47,537,000 from the General Fund of
the Treasury and $236,514,000 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 includes funding for the initiation of the
HIRE Vets Medallion Program authorized by the Honoring
Investments in Recruiting and Employing American Military
Veterans Act of 2017.
State Grants.--The Committee recommends $175,000,000 for
State Grants.
Transition Assistance Program.--The Committee recommends
$16,073,000 for the Transition Assistance Program.
Homeless Veterans' Reintegration Program.--The Committee
recommends $47,537,000 for the Homeless Veterans' Reintegration
Program.
Federal Administration.--The Committee recommends
$42,027,000 for Federal Administration.
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 $20,769,000 for Information
Technology (IT) Modernization, which is $1,991,000 more than
the fiscal year 2017 enacted level and $8,953,000 less than the
fiscal year 2018 budget request.
The Committee directs the Department to establish a multi-
year IT modernization plan consistent with the Department's
capacity to oversee effectively projects, within available
appropriations, and to propose the plan and required funding in
the fiscal year 2019 Congressional Justification.
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 the all IT
modernization projects are executed effectively, according to
Departmental requirements, on time, and within budget.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $89,147,000 for the Department of
Labor Office of Inspector General (DOL-OIG), which is
$1,426,000 more than the fiscal year 2017 enacted level and
$3,011,000 more than the fiscal year 2018 budget request. The
recommendation includes $83,487,000 from the General Fund of
the Treasury and $5,660,000 from the Employment Security
Administration Account in the Unemployment Trust Fund.
The DOL-OIG conducts audits of Department programs and
operations in order to determine that they comply with the
applicable laws and regulations, that they use resources
effectively, and that they are achieving their intended
results.
The Committee supports the DOL-OIG efforts to reduce
improper payments in the UI program, and to reduce fraud and
abuse in the Workers' Compensation programs related to the
prescription of compound pharmaceuticals and opioids.
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 continues 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 and program
integrity activities.
(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 continues a provision relating to
the Fair Labor Standards Act and certain insurance personnel
conducting post-disaster activity.
(RESCISSION)
Sec. 110. The Committee continues a provision rescinding
advance appropriations in the Dislocated Workers' National
Reserve account.
Sec. 111. The Committee continues a provision relating to
flexibility of H-2B nonimmigrant crossings.
Sec. 112. The Committee continues a provision relating to
wage determinations in the H-2B program.
Sec. 113. The Committee continues a provision relating to
the administration of the H-2B program.
Sec. 114. The Committee includes a new provision relating
to the definition of the term ``fiduciary.''
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
The Committee recommends $5,815,727,000 for health
resources and services programs, which is $397,620,000 below
the fiscal year 2017 enacted level and $276,893,000 above the
fiscal year 2018 budget request. The Health Resources and
Services Administration (HRSA) supports programs that provide
health services to disadvantaged, medically underserved, and
special populations; decrease infant mortality rates; assist in
the education of health professionals; and provide technical
assistance regarding the utilization of health resources and
facilities.
PRIMARY HEALTH CARE
Health Centers
The Committee recommends $1,491,422,000 for the Health
Centers program, which is $900,000 above the fiscal year 2017
enacted level and $2,835,000 above the fiscal year 2018 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 2017 enacted level and $190,000
above the fiscal year 2018 budget request. The program provides
medical malpractice liability protection to Federally supported
health centers.
The Committee requests HRSA include an update in the fiscal
year 2019 Congressional justification on the agency's efforts
to implement the recommendations described in GAO Report (GAO-
12-546) Health Center Program: Improved Oversight Needed to
Ensure Grantee Compliance with Requirements.
In addition, the Committee allocates not less than
$15,000,000 for the establishment of a Health Center Audit,
Compliance, and Oversight Office within the Bureau of Primary
Health Care. The Committee expects the office to perform
periodic audits and compliance reviews of all health center
access points, with a goal of conducting a compliance or audit
review for every access point location every five years. The
office shall oversee Federally Qualified Health Centers, Health
Center Program Look-Alikes, and Health Centers receiving a
grant under section 330 of the Public Health Service Act. The
office should provide uniform guidance to health center project
officers, monitor project officer adherence to program
guidance, and periodically assess whether program guidance is
meeting program objectives. The office will also conduct
independent compliance reviews, ensuring all health center
access points have policies, procedures, and training to comply
with applicable Federal laws. The office shall submit quarterly
reports to the Committees on Appropriations of the House of
Representatives and the Senate containing the results of all
audits and compliance reviews of health center access points
and oversight of health center project officers. The Committees
directs HRSA to provide a briefing within 45 days of enactment
of this Act on efforts to establish this office.
Tuberculosis.--The Committee supports the coordination
between health centers and State and local Tuberculosis (TB)
control programs to help ensure appropriate identification,
treatment, and prevention of TB among target populations. The
Committee encourages HRSA to continue to implement the
recommendations of the Tuberculosis Action Plan and recommends
that the agency include an update of its progress in the fiscal
year 2019 Congressional Justification.
Free Clinics Medical Malpractice
The Committee recommends $100,000 for carrying out
responsibilities under the Federal Tort Claims Act. This amount
is $900,000 below the fiscal year 2017 enacted level and the
same as the fiscal year 2018 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 $748,236,000 for the Health
Professions programs, which is $90,459,000 below the fiscal
year 2017 enacted level and $365,605,000 above the fiscal year
2018 budget request. The Health Professions programs support
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.
Within the total for Health Professions, the Committee
recommends the following amounts:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Health Professions Training for Diversity
Centers of Excellence............................ $9,711,000
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........................ 36,673,000
Interdisciplinary, Community-based Linkages
Area Health Education Centers.................... 30,250,000
Geriatric Programs............................... 34,737,000
Mental and Behavioral Health..................... 9,916,000
Behavioral Health Workforce Education and 25,000,000
Training........................................
NURSE Corps Scholarship and Loan Repayment........... 83,135,000
Nursing Workforce Development........................ 128,067,000
------------------------------------------------------------------------
Training for Diversity
Centers of Excellence.--The Committee directs HRSA to
provide continuation grants for activities authorized under
section 736 of the Public Health Service Act.
Primary Care Training and Enhancement
Interprofessional Education.--The Committee is aware of the
growing recognition that interprofessional clinical health
programs represent the state of the art in health care. The
Committee believes interprofessional clinical care teams that
include physicians and physician assistants and other
disciplines (such as nurses, oral health practitioners,
behavioral health professionals, and allied health providers)
can achieve better care, better population health, and lower
costs. Further, the Committee shares HRSA's belief 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, be
prepared effectively to work side-by-side. In carrying out the
various workforce programs authorized by Title VII and VIII of
the Public Health Service Act, including the Primary Care
Training and Enhancement Program, the Committee supports
efforts by the Bureau of Health Workforce to include
interprofessional education as a component in funding
announcements, particularly with respect to programs that
address student and faculty learning as well as clinical site
readiness.
Integration of Primary Care and Oral Health Practice.--The
Committee is aware that a number of medications (prescription
drugs, over the counter drugs, and vitamins and minerals) can
affect oral health. Many medications used to treat chronic
diseases have adverse effects on oral health that patients and/
or providers might not be aware of. The most common side effect
is dry mouth, which can be brought on by more than 400
different prescription medications. Dry mouth raises the risk
of tooth decay and gum disease. The Committee encourages HRSA
to address the impact of medication on oral health as part of
its ongoing efforts to promote oral health and primary care
integration across the patient lifespan, additional focus would
feature diabetic patients as a population of interest for
primary care integration.
Rare Diseases.--The Committee encourages HRSA to examine
programs to increase primary care physician's preparedness in
the diagnosis of rare diseases.
Oral Health Training
The Committee recommends $36,673,000 for Oral Health
Training programs, which is the same as the fiscal year 2017
enacted level and $36,673,000 above the fiscal year 2018 budget
request. 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.
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. The
Committee directs HRSA to provide continuation funding for pre-
doctoral and postdoctoral training grants initially awarded in
fiscal year 2015.
Within the funds provided, the Committee provides not less
than $1,675,000 for the Dental Faculty Loan Repayment program
authorized by section 748 of the Public Health Service Act. The
Committee directs HRSA to provide continuation funding for
grants initially awarded in fiscal years 2016 and 2017.
Area Health Education Centers
The Committee strongly supports Area Health Education
Centers (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 encouraged to work with these programs.
The Committee is pleased with the national work of the AHEC
program, which has worked to educate primary care health
providers on emerging public health needs. The Committee
encourages HRSA to engage additional Federal partners, external
stakeholders, including current and former grantees of the
program, to determine how the AHEC network can be used to
continually educate primary care health professionals,
especially concerning infectious diseases.
Mental and Behavioral Health
The Committee recommendation includes $8,916,000 for the
interprofessional Graduate Psychology Education (GPE) Program
to increase the number of health service 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 GPE program is dedicated to the education and
training of doctoral-level psychologists to provide supervised
behavioral, mental health services to underserved populations,
including older adults, children, the chronically ill, and
veterans. HRSA should build on recent efforts to expand
training to increase mental, behavioral health services for
returning service members, veterans, and their families, with
an emphasis on veterans reintegrating into rural civilian
communities.
Behavioral Health Workforce Education and Training
The Committee recommends $25,000,000 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.
Nursing Workforce Development
The Committee recognizes the need for a highly educated
nursing workforce to reflect the diversity of the populations
it serves. The recruitment of culturally and economically
diverse individuals positively impacts the classroom and
professional practice environments. Exposure to other
viewpoints and perspectives serves to advance collaboration
that will translate into improved care delivery. The Title VIII
Nursing Workforce Development Programs directly bolster this
effort by supporting students from diverse and underrepresented
backgrounds in the nursing profession through recruitment and
retention efforts. For example, in Academic Year 2014-2015, the
Title VIII Nursing Workforce Diversity (NWD) Grants program
supported 13,225 students and aspiring students, partnering
with over 900 clinical training sites. Of these sites, 42
percent were located in medically-underserved areas. Title VIII
programs like NWD offer a two-fold benefit: not only are the
direct recipients provided financial assistance, but they also
connect these clinicians with communities that vary in
socioeconomic, racial/ethnic, and geographic backgrounds some
that experience higher rates of health disparities. The
Committee requests HRSA include in the fiscal year 2019
Congressional Justification information on the impact of Title
VIII programs on workforce diversity.
The Committee is aware of provider shortages and recognizes
that training postgraduate Nurse Practitioners in Federally
Qualified Health Centers could address aspects of the primary
care provider shortage. The Committee supports efforts to train
Nurse Practitioners on a model of care consistent with both
Institute of Medicine principles and the needs of vulnerable
populations. The Committee believes a focus of the program
should be training in the integration of primary care and
behavioral health, since mental health issues and opioid and
other illegal drug addiction remain healthcare priorities.
Children's Hospitals Graduate Medical Education
The Committee recommends $300,000,000 for the Children's
Hospitals Graduate Medical Education Payment program, which is
the same as the fiscal year 2017 enacted level and $5,000,000
more than the fiscal year 2018 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 $18,000,000 for the National
Practitioner Data Bank, which is $814,000 below the fiscal year
2017 enacted level and the same as the fiscal year 2018 budget
request. The Committee recommendation and the fiscal year 2018
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 data
bank operations.
MATERNAL AND CHILD HEALTH
Maternal and Child Health Block Grant
The Committee recommends $641,700,000 for the Maternal and
Child Health (MCH) Block Grant, which is the same as the fiscal
year 2017 enacted level and $25,287,000 below the fiscal year
2018 budget request. States use the 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.
Maternal Depression.--The Committee recognizes that over
400,000 women in the United States suffer from postpartum
depression each year. Postpartum depression can affect mother-
infant bonding and have longer-term effects on the development
of children. The Committee supports efforts by HRSA to address
the needs of mothers and children related to maternal
depression.
Neonatal Abstinence Syndrome Effects on Maternal and Child
Health.--The Committee is alarmed by the prevalence of Neonatal
Abstinence Syndrome (NAS) and the resulting health and
developmental impacts on children. The Committee requests an
update in the fiscal year 2019 Congressional Justification on
efforts undertaken by HRSA to address NAS.
Prenatal Screening Working Group.--Patient education
materials related to non-invasive prenatal screening (NIPS)
often lag behind fast-moving NIPS technological advancements
and fail to reflect the most current clinical guidance. To
ensure patients and providers are educated about evidence-based
practices and their applications, as well as the underlying
conditions for which a patient may require further diagnostic
testing based on screening results, the Committee asks the
Maternal and Child Health Bureau within 120 days of enactment
of this Act to convene a meeting of Federal and public
stakeholders representing health care professionals, industry,
and patient voices to discuss the purposes and definitions of
NIPS, the status of research regarding the effectiveness of
various practices regarding NIPS, other factors that should be
considered in implementing NIPS, provider best practices and
guidance, and patient and industry needs related to information
dissemination and standards for screenings. The goal of such a
meeting is for stakeholders to establish consensus about next
steps for provider and patient education. Within 120 days after
the meeting, recommended consensus driven activities will be
reported from HRSA, along with a plan and timeline for
implementation of next steps. The Committee expects a report
outlining consensus recommendations for education of women
regarding NIPS, and possible methods/timeline for implementing
an education initiative related to prenatal screening. In
addition, the working group should recommend to the Secretary a
process by which materials related to specific conditions are
created, disseminated, and updated on a routine basis.
The Committee continues bill language identifying specific
amounts for Special Projects of Regional and National
Significance (SPRANS). The Committee provides the following
within SPRANS:
------------------------------------------------------------------------
FY 2018
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 to continue 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. The Committee expects
the Chief Dental Officer to play a key role in the design,
monitoring, oversight, and implementation of these projects.
Thalassemia.--HRSA has a long history of supporting
thalassemia services. The thalassemia program has been
instrumental in aiding patients with this inherited blood
disorder, especially as treatments and best practices have
evolved over time. The Committee encourages HRSA to
reconstitute this program in order to ensure the continued
improvement of care and treatment options for patients with
this complex and debilitating blood disorder.
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 2018
Budget Activity Committee
------------------------------------------------------------------------
Sickle Cell Anemia 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
------------------------------------------------------------------------
Birthplace and Seamless Systems for Transfer of Care.--The
Committee continues to note the rising rates for out of
hospital births in the United States, 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. The Committee encourages HRSA to work with its
partners, including 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. The goal of this effort should be to achieve
optimal mother-baby outcomes in all settings and with all
providers. The Committee requests HRSA include information on
this effort in the fiscal year 2019 Congressional
Justification.
Breastfeeding Support and Safe Sleep Promotion.--The
Committee is aware that 49 jurisdictions have selected the
Title V National Performance Measure 4 on Breastfeeding and
encourages HRSA to ensure incorporation and coordination of
breastfeeding support within and among the Title V Maternal and
Child Health Block Grant, the Healthy Start program, and the
Maternal, Infant and Early Childhood Home Visiting Program. The
Committee further encourages the integration of breastfeeding
support and safe sleep promotion activities within these
programs.
Vision.--One out of four children in the United States have
some form of low vision and at least four million
schoolchildren start the school year not being able to see
clearly. Most of these cases of poor vision are due to
refractive error, a condition that is easily corrected. The
Committee supports efforts at HRSA to assist programs that
identify and provide prescription eyeglasses to children from
low-income families.
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 2017 enacted level and $47,099,000 above the fiscal
year 2018 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.
The Committee provides not less than $31,317,485 for the
Leadership Education in Neurodevelopmental and Related
Disabilities (LEND) program to maintain the program's capacity
to train professionals to screen, diagnose, and provide
evidence-based interventions to individuals with autism
spectrum disorder and other developmental disabilities as
authorized by the Autism CARES Act. This funding will also
enable the LEND network to assist in ongoing developmental
monitoring, especially for children exposed to lead and other
environmental toxins and for infants exposed to the Zika virus
with its resulting complications. LEND programs provide a
strong community link to services and support these newest
members of the disability community and their families. In
addition, the funding will allow these programs to develop
innovative strategies to integrate and enhance existing
investments, including translating research findings on
interventions, development of guidelines, tools, and systems
management approaches for training settings and promotion of
life-course considerations, from developmental screening in
early childhood, to transition to adulthood issues.
Heritable Disorders
The Committee provides $13,883,000 for the Heritable
Disorders program, which is the same as the fiscal year 2017
enacted level and $13,883,000 above the fiscal year 2018 budget
request. Newborn Screening is a complex public health system
that relies on coordinated actions by stakeholders, including
clinicians, hospitals, parents, labs, and public health
professionals. HRSA's Heritable Disorders Program supports a
number of activities that strengthen this system to ensure
infants born in every State receive rapid identification, early
intervention, and potentially life-saving treatment.
Pediatric Hospice Care.--The Committee recognizes the
importance of pediatric hospice care. The Committee understands
the unique conditions surrounding pediatric hospice care and
grief support for families including the need to support family
members, the recognition that child death can have more intense
and longer grieving periods, and the need for development of
best practices for counseling, support, medication, and other
factors impacting the end of life experience for children.
Recommended Uniform Screening Panel.--The Committee
encourages HRSA to expand the Heritable Disorders program to
support States with the implementation, education, and
awareness of newborn screening for new conditions recently
added to the Recommended Uniform Screening Panel, including
Pompe, Mucopolysaccharidosis I, and X-linked
adrenoleukodystrophy. The program will also disseminate
National, regional and State education and training resources
for parents, families and providers.
Severe Combined Immune Deficiency.--Within the amount for
Heritable Disorders, the Committee provides $2,000,000 to
continue efforts to support wider implementation, education,
and awareness of Newborn Screening for Severe Combined Immune
Deficiency (SCID). The Committee supports HRSA's efforts to
address SCID and encourages the agency to continue the program
in its current form.
Healthy Start
The Committee recommends $103,500,000 for the Healthy Start
program, which is the same as the fiscal year 2017 enacted
level and $24,803,000 below the fiscal year 2018 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.
Within the total for Healthy Start, the Committee directs
not less than $1,000,000 for screening and treatment for
maternal depression as authorized in section 10005 of the 21st
Century Cures Act (P.L. 114-255).
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.
RYAN WHITE HIV/AIDS PROGRAM
Ryan White HIV/AIDS Program
The Committee provides $2,318,781,000 for the Ryan White
HIV/AIDS program, which is the same as the fiscal year 2017
enacted level and $58,773,000 above the fiscal year 2018 budget
request.
The Ryan White HIV/AIDS program funds 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 the Ryan White HIV/AIDS program, the
Committee provides the following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Emergency Assistance................................. $655,876,000
Comprehensive Care Programs.......................... 1,315,005,000
AIDS Drug Assistance Program......................... 900,313,000
Early Intervention Program........................... 201,079,000
Children, Youth, Women, and Families................. 75,088,000
AIDS Dental Services................................. 13,122,000
Education and Training Centers....................... 33,611,000
Special Projects of National Significance............ 25,000,000
------------------------------------------------------------------------
HEALTH CARE SYSTEMS
The Committee recommends $100,518,000 for Health Care
Systems, which is $3,675,000 below the fiscal year 2017 enacted
level and $1,167,000 above the fiscal year 2018 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 program; and
operating a national toll-free poison control hotline.
Within the total for Health Care Systems, the Committee
provides the following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Organ Transplantation................................ $23,549,000
National Cord Blood Inventory........................ 12,266,000
C.W. Bill Young Cell Transplantation Program......... 22,109,000
Office of Pharmacy Affairs........................... 10,238,000
Poison Control Centers............................... 18,846,000
National Hansen's Disease Program.................... 11,653,000
Hansen's Payment to Hawaii........................... 1,857,000
------------------------------------------------------------------------
Organ Transplantation
Organ Donation Rates.--The Committee remains aware of the
insufficient supply of donated organs to meet Nationwide need
and of the existing variations among local communities in
donation rates and procurement practices. The Committee directs
HRSA to develop a comprehensive report with recommendations and
initiatives that can be pursued to ensure that local
communities adopt best practices to increase the supply of
donated organs. The recommendations shall place special
emphasis on assisting localities with low donation and
procurement rates. HRSA shall provide this report within 120
days of enactment of this Act.
Organ Distribution Proposal.--The Committee understands
that the Organ Procurement and Transplantation Network (OPTN)
developed the ``Redesigning Liver Distribution'' proposal and
released the proposal for public comment in 2016. The Committee
recognizes that OPTN expects to release for public comment an
amended proposal in 2017. The Committee urges HRSA to ensure
that any proposals see a robust and transparent public debate
on the merits of the proposal. Furthermore, the Committee
believes that an extended process will allow the transplant
community and its stakeholders to assess fully the use of
appropriate supply and demand metrics and the protection of
programs serving rural and underserved communities. The
Committee encourages HRSA to ensure that liver redistribution
proposals go through a transparent process and receive support
from the transplant community prior to final action.
Costs of Liver Distribution Proposals.--The Committee is
aware that OPTN is preparing a revised proposal for redesigning
the distribution of livers for transplant in the United States.
The Committee encourages the proposal to include the scope of
financial costs associated with the proposal, including
estimates of the direct and indirect costs imposed on the
Federal government, State governments, local governments, and
public and private health insurers.
Positions at Organ Procurement and Transplantation
Network.--The Committee appreciates the valuable role played by
individuals in leadership positions and other voting positions
at OPTN. The Committee expects HRSA to ensure OPTN policymaking
committees and subcommittees are selected in a manner that
provides equal representation with unbiased selection.
National Cord Blood Inventory
The Committee recommends $12,266,000 for the National Cord
Blood Inventory, which is the same as the fiscal year 2017
enacted level and $1,021,000 more than the fiscal year 2018
budget request. The National Cord Blood Inventory program
builds a genetically and ethnically diverse inventory of high-
quality umbilical cord blood for transplantation.
C.W. Bill Young Cell Transplantation Program
The Committee recommends $22,109,000 for the C.W. Bill
Young Cell Transplantation program, which is the same as the
fiscal year 2017 enacted level and $42,000 more than the fiscal
year 2018 budget request.
The Committee continues to support cell transplantation
through the use of cord blood, bone marrow, and peripheral
blood stem cells. The Committee appreciates HRSA's efforts to
increase the diversity of the volunteer registry and the
program's research efforts to improve the availability,
efficiency, safety, and cost of transplants and the
effectiveness of program operations.
Office of Pharmacy Affairs
The Committee provides $10,238,000 for the Office of
Pharmacy Affairs (OPA), which is the same as the fiscal year
2017 enacted level and $19,000 above the fiscal year 2018
budget request. 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 the 340B Drug Pricing program
was designed to help safety net providers maintain, improve,
and expand patient access to healthcare services generally.
Since its enactment in 1992, the 340B program has lowered the
cost of outpatient drugs to Government funded health clinics,
as well as nonprofit and public hospitals that serve a
disproportionate share of low-income patients or rural
communities.
The Committee is aware that the 340B statute requires HRSA
to make 340B ceiling prices available to covered entities
through a secure website and continues to be concerned that OPA
has failed to meet 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
2019 budget request.
Poison Control Centers
The Committee recommends $18,846,000 for Poison Control
Centers, which is the same as the fiscal year 2017 enacted
level and $36,000 above the fiscal year 2018 budget request.
The Committee recognizes the critical role of this proven
National public health program and the value of its services to
all citizens. In 2015, poison control centers managed 2.8
million calls, which is an average of approximately 8,000 calls
per day. Of these calls, 47 percent related to exposures to
children age five and under, and 22 percent came from health
care facilities. Of the approximate 2.2 million poisonings
reported in 2015, 67 percent were managed at the site of
exposure, avoiding unnecessary visits to emergency departments.
RURAL HEALTH
The Committee recommends $156,060,000 for Rural Health
programs, which is the same as the fiscal year 2017 enacted
level and $81,665,000 more than the fiscal year 2018 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.
The Committee requests an update in the fiscal year 2019
Congressional Justification information on the best practices
and strategies to attract healthcare practitioners to rural
clinics and hospitals in areas with healthcare professional
shortages.
Within the total for Rural Health activities, the Committee
provides the following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Rural Outreach Programs.............................. $65,500,000
Rural Health Research................................ 9,351,000
Rural Hospital Flexibility Grants.................... 43,609,000
State Offices of Rural Health........................ 10,000,000
Black Lung Clinics................................... 7,266,000
Radiation Exposure Screening and Education........... 1,834,000
Telehealth........................................... 18,500,000
------------------------------------------------------------------------
Radiation Safety.--The Committee supports efforts to ensure
information regarding exposure to radiation is up-to-date on
all available options to protect surgical/interventional health
care personnel and patients from radiation exposure.
Telehealth.--The Committee recognizes the growing
importance of telehealth in delivering high-quality healthcare
to medically underserved communities in both rural and urban
areas. The Committee encourages the Secretary to establish a
Telehealth Center of Excellence to test the efficacy of
telehealth services in both urban and rural geographic
locations.
FAMILY PLANNING
The Committee does not recommend funding for the Family
Planning program, which is $286,479,000 below the fiscal year
2017 enacted level and fiscal year 2018 budget request. The
Family Planning program administers Title X of the Public
Health Service Act.
PROGRAM MANAGEMENT
The Committee recommends $151,993,000 for the cost of
Federal staff and related activities to coordinate, direct, and
manage the programs of HRSA, which is $2,007,000 below the
fiscal year 2017 enacted level and the same as the fiscal year
2018 budget request.
Chief Dental Officer.--The Committee is pleased that HRSA
has restored the position of Chief Dental Officer (CDO) and
looks forward to learning how the agency has ensured that the
CDO is functioning with executive level authority with
resources to oversee and lead HRSA oral health programs and
initiatives. The Committee would like an update in the fiscal
year 2019 Congressional Justification on how the CDO is serving
as the agency representative on oral health issues to
international, National, State, and/or local government
agencies, universities, and oral health stakeholder
organizations.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
The Committee estimates that $268,000,000 will be released
from the Vaccine Injury Compensation Trust Fund, which is
$28,000,000 more than the fiscal year 2017 enacted level and
the same as the fiscal year 2018 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. The Vaccine
Injury Compensation Trust Fund receives revenues raised by this
tax. Trust funds made available will support the liability
costs of vaccines administered after September 30, 1988.
The Committee recommends $8,250,000 for administration of
the program, which is $500,000 more than the fiscal year 2017
enacted level and $950,000 less than the fiscal year 2018
budget request.
Centers for Disease Control and Prevention
The Committee recommends a program level of $7,056,811,000
for the Centers for Disease Control and Prevention (CDC), which
is $198,350,000 below the fiscal year 2017 enacted level and
$1,026,210,000 above the fiscal year 2018 budget request. This
level includes $6,010,153,000 in discretionary budget
authority, $55,358,000 in mandatory funds under the terms of
the Energy Employees Occupational Illness Compensation Program
Act (EEOICPA), $840,600,000 in transfers from the Prevention
and Public Health (PPH) Fund, and $150,700,000 in PHS Act
section 241 evaluation set-aside transfers. CDC works with
State, local, and Tribal health authorities and other non-
governmental health-related organizations to understand,
control, and reduce public health problems.
IMMUNIZATION AND RESPIRATORY DISEASES
The Committee recommends $744,350,000 for Immunization and
Respiratory Diseases (IRD), which includes $470,700,000 in
discretionary budget authority, and $273,650,000 in transfers
from the PPH Fund. This level is $50,000,000 below the fiscal
year 2017 enacted level and $43,522,000 above the fiscal year
2018 budget request level.
Immunization grants are awarded to States and local
agencies for planning, developing, and conducting childhood,
adolescent, and adult immunization programs, including
enhancement of the vaccine delivery infrastructure. CDC
directly maintains a stockpile of vaccines, supports
consolidated purchase of vaccines for State and local health
agencies, and conducts surveillance, investigations, and
research into the safety and efficacy of new and presently-used
vaccines.
Within the total for IRD, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Section 317 Immunization Program..................... $556,792,000
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 $1,117,278,000 for HIV/AIDS, Viral
Hepatitis, Sexually Transmitted Diseases (STD), and
Tuberculosis (TB) Prevention, which is the same as the fiscal
year 2017 enacted level and $183,278,000 above the fiscal year
2018 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.
Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, the Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity 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
Organizations...................................
School Health-HIV................................ 33,081,000
Viral Hepatitis...................................... 34,000,000
Sexually Transmitted Infections...................... 152,310,000
Tuberculosis......................................... 142,256,000
------------------------------------------------------------------------
Hepatitis B.--The Committee is concerned that even though
the hepatitis B vaccine is more than 90 percent effective,
there are over 50,000 new hepatitis B virus (HBV) infections
each year and more than 10 deaths each day due to this disease
in the U.S. As a result of the opioid epidemic, infection with
HBV has spiked in many parts of the nation with, for example,
acute HBV infections increasing 114 percent from 2006 to 2013
in three states that have suffered from widespread opioid
overuse (Kentucky, Tennessee, and West Virginia). The Committee
notes that the link between HBV infection and primary liver
cancer is well-established, with up to 60 percent of global
liver cancer cases caused by HBV. Many of these liver cancer
cases are preventable with early detection of, treatment of,
and vaccination for HBV. An innovative public health effort to
reduce HBV-related disease burden would move the U.S. into a
global leadership position likely to benefit U.S. relations
with countries in Asia, Africa, and other global regions where
HBV infection and its severe complications are endemic.
Latent TB Infection.--The Committee notes with concern that
there are up to 13 million individuals in the U.S. with latent
TB infection. The diagnosis and treatment of individuals with
latent TB infection at highest risk of progression to active TB
would prevent future cases of this airborne infectious disease.
The Committee acknowledges that only by addressing latent TB
infection can the U.S. achieve TB elimination. The Committee
recognizes the vital role of CDC's Division of TB Elimination
to address TB and urges support to ensure that State and local
TB programs have adequate resources to effectively identify and
treat latent TB infection cases.
Liver Health.--The Committee commends CDC for its efforts
to increase national awareness of viral hepatitis B and C, and
requests that CDC support liver health and wellness activities
in an effort to reduce morbidity and mortality for persons
infected with viral hepatitis who develop liver disease,
cirrhosis, liver failure, and liver cancer.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
The Committee recommends $551,522,000 for Emerging and
Zoonotic Infectious Diseases (EZID), which includes
$499,522,000 in discretionary appropriations and $52,000,000 in
transfers from the PPH Fund. This level is $33,400,000 below
the fiscal year 2017 enacted level and $37,522,000 above the
fiscal year 2018 budget request. The EZID programs support the
prevention and control of infectious diseases through
surveillance, outbreak investigation and response, research,
and prevention.
Within the total for EZID, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Core Infectious Diseases............................. $362,950,000
Emerging Infectious Diseases..................... 125,000,000
Lab Safety and Quality........................... 8,000,000
Antibiotic Resistance Initiative................. 163,000,000
All Other Infectious Diseases.................... 23,840,000
Vector-borne Diseases............................ 26,410,000
Lyme Disease..................................... 10,700,000
Prion Disease.................................... 6,000,000
Chronic Fatigue Syndrome......................... 0
Food Safety.......................................... 54,000,000
National Health Care 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
------------------------------------------------------------------------
Combating Antibiotic-Resistant Bacteria.--The Committee
recognizes the importance of addressing antibiotic-resistant
bacteria through a ``One Health'' approach, simultaneously
combating antibiotic resistance in human, animal, and
environmental settings. The Committee encourages CDC to develop
a national capacity to identify and catalog microbial genome
sequences, paying attention to antibiotic-resistant microbes.
CDC is encouraged to continue to pursue research opportunities
in the area of antimicrobial stewardship in diverse healthcare
settings and encourage regional collaborations to study the
most effective strategies to improve antibiotic prescribing and
stewardship.
Lyme Disease Activities.--Lyme disease can be found in at
least 80 countries around the globe and is endemic in many
regions. In the U.S., Lyme disease is the most common disease
transmitted from animals to humans. CDC estimated in 2013 that
only 10 percent of Lyme disease cases were being reported
annually. The Committee encourages CDC to expand activities
related to developing sensitive and more accurate diagnostic
tools and tests for Lyme disease and evaluating the development
of a national reporting system.
Sepsis.--The Committee encourages CDC to 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. The Committee
requests an update in the fiscal year 2019 Congressional
Justification on activities to improve public awareness of
sepsis.
Tick-Borne Disease Resources and Guide.--The Committee
encourages CDC to ensure transparency on its website of its
physician education programs regarding Lyme disease, including
scientific resources and schedules; to solicit input from the
treating physician community at large regarding such education
programs; and to include the broad spectrum of scientific
viewpoints. The Committee also encourages CDC to provide a
written rationale for the selection of Lyme and tick-borne
disease treatment guidelines it displays on its website and to
intensify surveillance of Borrelia infections in non-endemic/
non-high incidence areas.
Vector-Borne Diseases.--Vector-borne diseases, such as Lyme
disease, West Nile Virus, and Zika, have high human
consequences and are a growing threat to public health. The
impacts of these diseases and the effectiveness of programs for
surveillance, prevention, and control should be better gauged
and understood. Therefore, the Committee directs CDC to include
goals and performance indicators for each high-priority vector-
borne disease in its annual Congressional Justification.
Additionally, within 90 days of enactment, the Committee
directs CDC to submit a report to the Committees on
Appropriations of the House of Representatives and the Senate,
that: (1) Compares funding for high priority vector-borne
diseases to the burden of disease as defined by Disability
Adjusted Life Years (DALYs), and (2) Includes estimates for the
burden of each high-priority vector-borne disease on the U.S.
economy, including direct medical costs, indirect medical
costs, nonmedical costs, and productivity losses.
Vector Control Guidelines.--The Committee requests that CDC
maintain an online guide 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 encourages CDC to update the guidelines annually.
Zika.--The Committee continues to support CDC's
preparedness and response efforts to control outbreaks of Zika
virus infection. The Committee strongly encourages CDC to
invest in innovative vector control technologies to enhance
current vector-borne disease control efforts, including those
discussed by the World Health Organization's Vector Control
Advisory Group, which outlines new and existing vector control
tools for use in response to Zika virus outbreaks. The
Committee also notes CDC's report of research from Brazil
showing that some infants exposed to Zika who were born without
microcephaly nevertheless did develop it later or developed
other neurological problems. Therefore, the Committee expects
CDC to continue to work closely with the vector control unit in
Puerto Rico and to address not only basic surveillance and
research but also the use of new approaches to limit the spread
of infected Aedes Aegypti mosquitoes through innovative vector
control technologies which can be effective in environments and
locations not amenable to traditional pesticides.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
The Committee recommends $1,041,646,000 for Chronic Disease
Prevention and Health Promotion (CDPHP), which includes
$703,696,000 in discretionary appropriations and $337,950,000
in transfers from the PPH Fund. This level is $73,950,000 below
the fiscal year 2017 enacted level and $89,396,000 above the
fiscal year 2018 budget request level. The CDPHP programs
provide support for State, Tribal, and community programs on
surveillance, prevention research, evaluation, and health
promotion.
The Committee recommendation for CDPHP maintains most of
the existing program line items as they were funded in fiscal
year 2017 and does not provide funding for the America's Health
Block Grant proposed in the budget request. Chronic diseases,
such as Alzheimer's disease, diabetes, heart disease, and
stroke, are the leading causes of death and disability in the
U.S. and account for 86 cents of every dollar spent on health
care. Many of these conditions are largely preventable through
improved nutrition and physical activity. Recent large-scale
pilots have shown that as much as $2,650 per year per senior
can be saved by investing in public health programs like the
National Diabetes Prevention Program and similar studies have
shown hospitalizations can be reduced and save as much as $945
per year per adult by scaling programs that control arthritis
pain through evidence-based physical activity programs. A
robust investment in in the prevention and control of chronic
diseases is essential to curb health spending and improve
health and quality of life for millions of Americans, who are
at risk of, living with, or have survived a chronic condition.
Within the total provided, the Committee recommends the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Tobacco.............................................. $155,000,000
Nutrition, Physical Activity, and Obesity............ 49,920,000
High Obesity Rate Counties ...................... 10,000,000
School Health........................................ 15,400,000
Health Promotion..................................... 14,025,000
Glaucoma......................................... 3,300,000
Visual Screening Education....................... 525,000
Alzheimer's Disease.............................. 3,500,000
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............................. 136,037,000
Diabetes............................................. 144,129,000
National Diabetes Prevention Program ................ 25,000,000
Cancer Prevention and Control........................ 356,674,000
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 ............................... 43,294,00
Comprehensive Cancer ............................ 19,675,000
Johanna's Law ................................... 5,500,000
Ovarian Cancer .................................. 8,000,000
Prostate Cancer ................................. 13,205,000
Skin Cancer ..................................... 2,125,000
Cancer Survivorship Resource Center ............. 475,000
Oral Health.......................................... 18,500,000
Safe Motherhood/Infant Health........................ 44,000,000
Preterm Birth ................................... 2,000,000
Other Chronic Diseases............................... 25,500,000
Arthritis........................................ 11,000,000
Epilepsy......................................... 8,500,000
National Lupus Patient Registry ................. 6,000,000
Racial and Ethnic Approaches to Community Health..... 0
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........... 16,000,000
------------------------------------------------------------------------
Chronic Obstructive Pulmonary Disease.--The Committee
understands that chronic obstructive pulmonary disease (COPD)
is the third leading cause of death in the U.S., leading to the
death of over 145,000 Americans each year. The Committee
commends CDC for working with the National Heart, Lung, and
Blood Institute on the development of the National Action Plan
for COPD. The Committee expects CDC to implement the public
health recommendations identified in the plan.
Chronic Pain.--According to the Institute of Medicine, 100
million Americans are burdened with chronic pain, which costs
the U.S. economy more than $560 billion annually in direct
healthcare costs and lost productivity. Longitudinal
comparisons of pain data to identify trends, subpopulations at
risk, and the health consequences of pain in terms of
morbidity, mortality, and disability are critical in order to
address this issue. The Committee directs CDC to collect
epidemiological data to clarify the incidence and prevalence of
various pain syndromes differentiated by patient age,
comorbidities, socio-economic status, race, and gender. The
Committee directs CDC to collect resource utilization data of
medical and social services; on direct healthcare costs of pain
treatment, both traditional and alternative; on the
effectiveness of evidence-based treatment approaches; and on
indirect costs (i.e., missed work, public and private
disability, reductions in productivity). Finally, the Committee
directs CDC to report these pain statistics to Congress and
publish annually.
Epilepsy.--Close to three million individuals in the U.S.
have epilepsy and, while new cases are most common among young
children, the onset of epilepsy can occur at any age. The
Committee encourages CDC to support telehealth and educational
training programs for rural and under-served areas that reach
school nurses, childcare personnel, first responders, and care
providers for seniors, to recognize and respond appropriately
to seizures caused by epilepsy or result from trauma and other
acute chronic illness.
Good Health and Wellness in Indian Country.--The Committee
recommendation includes $16,000,000 for awards to Tribes and
Tribal Organizations to comprehensively address the leading
causes of death and associated risk factors while incorporating
culturally-driven wellness practices under the Good Health and
Wellness in Indian Country program. The Committee also directs
CDC to provide funding at not less than the fiscal year 2017
level within CDPHP for the Comprehensive Approach to Good
Health and Wellness in Indian Country cooperative agreement.
Heart Disease and Stroke Prevention.--Largely preventable,
cardiovascular disease, including heart disease and stroke,
continues to inflict the highest burden on our Nation's health
and economy. Yet, effective evidence-based prevention
initiatives are not fully implemented and death rates are
starting to rise. The Committee increases support for CDC's
heart disease and stroke prevention activities within State,
local, and Tribal public health departments, and for enhanced
surveillance and research to target high-burden populations and
guide public health strategies.
Heart Valve Disease.--The Committee understands that heart
valve disease can be debilitating and if not treated properly
can result in heart failure, sudden cardiac arrest, and death.
The Committee urges CDC to include information on valve disease
on its website and to help bring public awareness to this
disease. The Committee encourages CDC to engage with patient
and research organizations to explore collaborative ways to
integrate information about the warning signs, symptoms, and
risk factors of valve disease into CDC's existing programs.
Inflammatory Bowel Disease.--The Committee commends CDC for
its commitment to the study of Inflammatory Bowel Disease (IBD)
epidemiology and is concerned by the results of the recent
Morbidity and Mortality Weekly Report study ``Prevalence of
Inflammatory Bowel Disease Among Adults Aged 18 Years'', which
demonstrates that IBD affects 3.3 million Americans, twice as
many as originally thought. The Committee is particularly
concerned that IBD is increasingly recognized in minority and
underserved communities, yet there are gaps in our knowledge
about IBD in these populations. The Committee expects CDC to
include a focus on these groups in its existing IBD
epidemiology study.
Johanna's Law.--The Committee strongly encourages CDC to
take steps to integrate components of the Inside Knowledge
Campaign and Know: BRCA, to the extent possible, to ensure
coordination of public health messages related to ovarian
cancer, leveraging of resources, and maximizing economies of
scale.
Million Hearts 2022.--The Committee continues to support
Million Hearts 2022 to capitalize on the solid foundation, best
practices, evidence, shared tools, and progress made on this
public-private initiative to prevent heart attacks and strokes.
Funding will allow for mobilization of communities and the
healthcare sector to implement evidence-based interventions to
prevent heart disease and stroke in areas with the highest
burden by implementing the ABCS: Aspirin when appropriate,
Blood pressure control, Cholesterol management, and Smoking
cessation; supporting innovative strategies to increase
physical activity; using cardiac rehabilitation; and developing
innovative, scalable approaches to improve cardiovascular
health.
National Early Child Care Collaboratives Program.--The
Committee recognizes the importance of the early years and
particularly early child care and education settings in
promoting healthy habits. The Committee is aware that the
National Early Child Care Collaboratives (NECCC) program has
produced statistically significant improvements in adoption of
best practices for healthy eating, physical activity, reduced
screen time, and breastfeeding support. The Committee
encourages CDC to build on the success of the NECCC program to
provide training and technical assistance to early care and
education providers to improve healthy eating and physical
practices, including testing approaches to strengthen family
engagement. Funds support technical assistance to integrate
healthy eating and physical activity into State and local
systems initiatives. The Committee encourages the NECCC to
service a mix of rural, suburban, and urban areas, including
areas with high childhood obesity rates.
National Lupus Patient Registry.--The Committee continues
to support research efforts under the National Lupus Patient
Registry program and acknowledges that there has been
significant progress to understand better the epidemiology of
lupus. However, the Committee recognizes that challenges still
remain and encourages CDC to focus on studies related to the
natural history and pathogenesis of pediatric lupus to
understand better the lifetime burden of disease in children
and young adults. The Committee also encourages the continuing
development of lupus self-management programs by current lupus
registry cohorts and national voluntary health organizations
for adults with lupus to improve quality of life and health
outcomes.
Oral Health.--The Committee has provided additional funding
for the Division of Oral Health to continue distributing new
waterline safety guidelines to dentist offices and clinics, to
conduct follow up research where needed, and to work with
professional organizations to educate dentists and dental
students of such guidelines.
Outreach to and Study of Obese Populations with Limited
English Ability.--The Committee is concerned about specific
obese populations that are overrepresented and medically
underserved. The Committee encourages CDC to conduct additional
outreach to and study of these specific populations. CDC is
additionally encouraged to work with Hispanic-Serving
Institutions and Historically Black Colleges and Universities
in this effort.
Ovarian Cancer.--The Committee continues to support the
Ovarian Cancer Control Initiative to advance ovarian cancer
prevention, early detection, risk assessment, and access to
care. The Committee commends the CDC for its work to evaluate
existing risk assessment tools, which can be used to help
identify patients with a genetic predisposition to ovarian and
other cancers, and identify which of these existing tools are
valid, reliable, and the most user-friendly for providers and
patients. The Committee requests that the Secretary of HHS
present the findings of this review and provide recommendations
with respect to how CDC can support the deployment of the tools
found to have the greatest value and utility in the fiscal year
2019 Congressional Justification.
Psoriasis and Psoriatic Arthritis.--The Committee
recognizes the growing body of evidence linking psoriatic
disease, which impacts more than eight million Americans, to
other comorbidities such as cardiovascular disease, mental
health and substance abuse challenges, kidney disease, and
other conditions. The Committee also recognizes the low rate of
diagnosis of psoriatic arthritis and the high percentage of
patients with psoriatic disease who do not treat or who
undertreat their disease. The Committee directs the CDC to
develop an action plan not later than 180 days after the
enactment of this Act as to how it can leverage existing
programs and resources, including the Prevention Research
Centers and projects supported by the CDC's Arthritis program,
to build upon the agency's Public Health Agenda for Psoriasis
and Psoriatic Arthritis to address diagnosis, treatment and
public health self-management needs of this patient population.
Pulmonary Hypertension Program.--The Committee is concerned
that most Pulmonary Hypertension (PH) patients are not
diagnosed 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, CDC
is encouraged to support education, awareness, and epidemiology
activities that promote early and accurate diagnosis of PH.
Safe Motherhood and Infant Health.--The Committee continues
to support activities within this line related to maternal and
infant health, such as State-Based Perinatal Collaboratives and
the Pregnancy Risk Assessment Monitoring System, at the fiscal
year 2017 enacted level. The Committee recommendation does not
include funding for the teen pregnancy prevention cooperative
agreement.
Type 1 Diabetes and Diabetic Ketoacidosis.--The Committee
is concerned about the increase in type 1 diabetes and the risk
of diabetic ketoacidosis, and encourages the CDC to work with
the States to educate parents, providers, and schools on this
risk.
BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES
The Committee recommends $137,560,000 for Birth Defects and
Developmental Disabilities (NCBDDD), which is the same as the
fiscal year 2017 enacted level and $37,560,000 above the fiscal
year 2018 budget request. This program supports the prevention
of and 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:
------------------------------------------------------------------------
Budget Activity FY 2018 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.. 56,660,000
Disability & Health incl. Child Development...... 24,000,000
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...................................... 15,100,000
Public Health Approach to Blood Disorders........ 4,400,000
Hemophilia Activities............................ 3,500,000
Hemophilia Treatment Centers..................... 5,100,000
Thalassemia Blood Disorders...................... 2,100,000
------------------------------------------------------------------------
Blood Safety Monitoring.--Patients who receive regular
blood transfusions are at increased risk for transmission of
blood-borne infectious diseases. Facing an increase in
infectious diseases that have a known or potential risk of
transmission via blood transfusion, patients with thalassemia,
anemia, and other diseases that impact blood production often
face a lack of information about transmission modes and rates
of infectious diseases, including new or emerging viruses like
the Zika virus. Given the increased threat to patients who are
reliant on blood transfusions, and the increased prevalence of
blood-borne viruses like babesia, the Committee urges CDC to
provide specific information to assist blood centers in
responding to emerging infectious diseases that may be
transmitted by blood transfusion.
Congenital Heart Disease.--The Committee commends NCBDDD
for its leadership in addressing Congenital Heart Disease (CHD)
and adult CHD surveillance efforts and requests a report in the
fiscal year 2019 Congressional Justification on CDC
surveillance and research efforts regarding CHD across the
lifespan, age-specific prevalence, and factors associated with
those patients who may have dropped out of appropriate
specialty care.
Duchenne Muscular Dystrophy.--The Committee expects NCBDDD
to continue its work to update, evaluate, and disseminate the
revised Duchenne care standards; to expand surveillance of
Duchenne via the MD STARnet, to develop a Duchenne newborn
screening program; and to support refinement of an
International Classification of Disease (ICD 10) code for
Duchenne and Becker Muscular Dystrophy.
Fragile X and Associated Disorders.--The Committee commends
CDC's efforts to identify and define the population impacted by
Fragile X (FX) and all conditions associated with the gene
mutation with the goal of understanding the public health
impact of these conditions. The Committee acknowledges the
significant progress made by the NCBDDD Fragile X Clinical and
Research Consortium in growing its FORWARD Database and Patient
Registry, and is pleased that a new grant was awarded in 2015
to continue and expand upon this important work. The Committee
also notes with approval the public-private partnership meeting
to set the Public Health Research Agenda and the resulting
focus on longitudinal data to characterize the natural history
of Fragile X, to in turn better inform the development of
outcome measures and biomarkers for new drug treatments under
development. The Committee believes even more robust natural
history data will lead to improved outcome measures and urges
increased focus on this effort. Given the connections among
Fragile X, the FX protein, and autism, the prospect of targeted
treatments for both conditions, the overlapping public health
impacts and current budgetary constraints, the Committee urges
the NCBDDD to explore cross-divisional funding opportunities to
accelerate data-driven public health research to reduce the
public health burdens of both FX and autism.
Hereditary Hemorrhagic Telangiectasia Pilot.--The Committee
recommends $100,000 within the Hemophilia Treatment Centers
line to support the second year of a two-year pilot program
that enables up to three existing Federally-funded Hemophilia
Treatment Centers across the country to serve as specialty
centers for the evaluation and management of Hereditary
Hemorrhagic Telangiectasia.
National Spina Bifida Program.--The Committee recognizes
that Spina Bifida is the most common permanently disabling
birth defect in the U.S. While Spina Bifida and related neural
tube defects are largely preventable through education and
adequate daily folic acid consumption, there are an estimated
166,000 individuals living with all forms of this complex birth
defect. The Committee commends the work of the National Spina
Bifida Program (NSBP) and its support of the Spina Bifida
Clinical Care Monitoring and Tracking Program, which provides
input into research priorities for the National Spina Bifida
Patient Registry. Further, the Committee commends the NSBP for
serving as a model for programs assisting other individuals
living with similar complex conditions and encourages the CDC
to continue to work with a National patient advocacy
organization that disseminates information to clinicians,
parents, and families living with Spina Bifida.
Preterm Birth Perinatal Collaboratives.--Preterm birth
affects more than 500,000 babies each year in the U.S. and is
the leading cause of neonatal mortality. 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 such as reducing
early elective deliveries.
Tuberous Sclerosis Complex.--The Committee encourages CDC
to take into consideration tuberous sclerosis complex (TSC) as
a possible cause of autism, epilepsy, and cardiac rhabdomyomas
in its surveillance network.
PUBLIC HEALTH SCIENTIFIC SERVICES
The Committee recommends $479,397,000 program level for
Public Health Scientific Services (PHSS), which includes funds
for the National Center for Health Statistics. The total
program level includes $328,697,000 in discretionary budget
authority and $150,700,000 from PHS Act section 241 evaluation
set-aside transfers. The Committee recommendation is
$10,000,000 below the fiscal year 2017 enacted level and
$19,397,000 above the fiscal year 2018 budget request.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Health Statistics.................................... $155,397,000
Surveillance, Epidemiology, and Informatics.......... 279,000,000
Laboratory Training and Oversight................ 5,000,000
Public Health Workforce.............................. 45,000,000
------------------------------------------------------------------------
Hydrocephalus.--The Committee encourages CDC to collect
information on the incidence rates and prevalence of
hydrocephalus, including available information on children and
adults, and to identify any changes over time with respect to
the incidence and prevalence of hydrocephalus.
ENVIRONMENTAL HEALTH
The Committee recommends $159,750,000 for Environmental
Health (EH), which includes $142,750,000 in discretionary
appropriations and $17,000,000 in transfers from the PPH Fund.
This level is $56,000,000 below the fiscal year 2017 enacted
level and $2,750,000 above the fiscal year 2018 budget request.
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:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Environmental Health Laboratory...................... $56,150,000
Newborn Screening Quality Assurance Program...... 8,400,000
Newborn Screening /Severe Combined 1,250,000
Immunodeficiency Diseases.......................
Environmental Health Activities...................... 32,600,000
Environmental Health Activities.................. 14,000,000
Safe Water....................................... 8,600,000
Amyotrophic Lateral Sclerosis (ALS) Registry..... 10,000,000
Climate Change................................... 0
Environmental and Health Outcome Tracking Network.... 25,000,000
Asthma............................................... 29,000,000
Childhood Lead Poisoning............................. 17,000,000
------------------------------------------------------------------------
Harmful Algal Blooms.--The Committee supports the work that
CDC is doing to conduct surveillance for and report health
concerns related to harmful algal blooms. The Committee urges
CDC to continue this work and (1) provide more outreach to
State and local public health officials to use these
surveillance and reporting systems, and (2) 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.
Lead Poisoning Prevention.--The Committee commends CDC for
funding nearly 60 childhood lead poisoning prevention programs
to develop, implement, and evaluate lead poisoning prevention
activities. The Committee encourages CDC to require that States
receiving funding for lead prevention report all blood tests in
a standardized format through the National Notifiable Diseases
Surveillance System.
National Asthma Control Program.--The Committee continues
to support the work of the National Asthma Control Program,
recognizing that asthma is one of the most common and costly
health conditions in the U.S. Twenty-five million Americans
have asthma, including six million children. The Committee
understands that better coordination of public health and
health systems interventions are necessary to reduce the burden
caused by asthma, and encourages CDC to continue its
collaboration with payers and health systems.
Newborn Screening Quality Assurance Program.--The Committee
is aware that State laboratories need specialized support to
begin screening for additional newborn conditions and
recognizes CDC's expertise in working with laboratories to
implement accurate newborn screening tests. The Committee
continues to support State laboratories through the Newborn
Screening Quality Assurance Program as they implement screening
for new disorders. This program will also support evaluation of
testing methods for new conditions, expansion of CDC's quality
assurance materials, and critical infrastructure and
development of tests for rare conditions.
INJURY PREVENTION AND CONTROL
The Committee recommends $286,059,000 for Injury Prevention
and Control, which is the same as the fiscal year 2017 enacted
level and $69,894,000 above the fiscal year 2018 budget
request. 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 2018 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........................... 112,000,000
Illicit Opioid Use Risk Factors...................... 13,579,000
Injury Control Research Centers...................... 9,000,000
------------------------------------------------------------------------
Childhood Lead Poisoning Prevention.--The Committee
encourages CDC to collaborate with the Department of Education
to improve awareness of educational intervention strategies for
children with elevated blood lead levels. The CDC and the
Department of Education are expected to implement
prioritization initiatives and provide technical assistance
that informs educators, parents, and State and local education
agencies about the severity and symptoms of lead poisoning and
intervention strategies for children with elevated blood lead
levels. The Committee requests an update on the CDC's strategy
and its outcomes on this topic in the fiscal year 2019
Congressional Justification.
Gun Research.--The Committee continues a general provision
to prevent funds from being used to advocate for or promote gun
control.
Rape Prevention.--The Committee directs CDC to allocate at
least 75 percent of funds appropriated to the Rape Prevention
and Education program to State and territory health departments
through formula grants that support State and local rape
prevention activities.
Using Data to Prevent Opioid-Related Overdosing.--The
Committee continues to be very concerned about the high rate of
opioid abuse and overdosing and understands that with data,
forecasting of overdosing risk by geographic region can be
provided. The Committee encourages CDC to begin using data to
provide such forecasts that public health officials can use to
intervene and prevent overdoses.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
The Committee recommends $325,200,000 for the National
Institute for Occupational Safety and Health (NIOSH), which is
$10,000,000 below the fiscal year 2017 enacted level and
$125,200,000 above the fiscal year 2018 budget request. NIOSH
conducts applied research, develops criteria for occupational
safety and health standards, and provides technical services to
government, labor, and industry, including training for the
prevention of work-related diseases and injuries. This
appropriation supports surveillance, health hazard evaluations,
intramural and extramural research, instrument and methods
development, dissemination, and training grants.
Within the total for NIOSH, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
National Occupational Research Agenda................ $116,000,000
Agricultural, Forestry, and Fishing.............. 25,500,000
Education and Research Centers....................... 29,000,000
Personal Protective Technology....................... 20,000,000
Mining Research...................................... 59,500,000
National Mesothelioma Registry and Tissue Bank....... 1,100,000
Other Occupational Safety and Health Research........ 99,600,000
------------------------------------------------------------------------
Total Worker Health.--The agreement provides funding in the
Other Occupational Safety and Health Research line to continue
to support the Total Worker Health program at no less than the
fiscal year 2017 level.
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM
The Committee recommends $55,358,000 in mandatory funding
for CDC to administer the Energy Employees Occupational Illness
Compensation Program (EEOICPA), which is the same as the fiscal
year 2017 enacted level and the fiscal year 2018 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 $435,121,000 for Global Health
(GH), which is the same as the fiscal year 2017 enacted level
and $85,121,000 above the fiscal year 2018 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.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2018
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...... 48,400,000
Global Public Health Capacity Development............ 9,800,000
------------------------------------------------------------------------
Global Health Security and Global Health Research.--The
Committee supports CDC's work to protect American and global
health security through the Center for Global Health, the
National Center for Emerging and Zoonotic Infectious Diseases,
and other programs that detect, prevent, and respond to
infectious disease and other health threats. As emerging
infectious diseases like Ebola and Zika represent perpetual
challenges for our health system, the Committee supports
continued and enhanced work in health research, innovation,
capacity building for disease research, detection, and
surveillance, and robust monitoring and evaluation systems at
home and abroad.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
The Committee recommends $1,450,000,000 for Public Health
Preparedness and Response (PHPR), which is $45,000,000 above
the fiscal year 2017 enacted level and $184,000,000 above the
fiscal year 2018 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
upgrades for 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 2018
Budget Activity Committee
------------------------------------------------------------------------
State and Local Preparedness and Response Capability. $688,200,000
Public Health Emergency Preparedness Cooperative 680,000,000
Agreement.......................................
Academic Centers for Public Health Preparedness.. 8,200,000
CDC Preparedness and Response........................ 161,800,000
BioSense......................................... 23,000,000
All Other CDC Preparedness and Response.......... 138,800,000
Strategic National Stockpile (SNS)................... 600,000,000
------------------------------------------------------------------------
Procurement of Medical Countermeasures.--The Committee
continues to have concerns over the consistency in acquisition
and replenishment of vaccines and medical countermeasures
(MCMs) that are procured for emergency response under Federal
contracts. Because these MCMs, in many cases, have few or no
commercial market applications, procurement requires special
planning, development, and contract execution so that private
industry will continue to invest in their development. The
Committee strongly encourages CDC to take steps to ensure that
the procurement process for MCMs is efficient, consistent, and
aligned with the mission of the Strategic National Stockpile.
BUILDINGS AND FACILITIES
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $10,000,000 for CDC buildings and
facilities, which is the same as the fiscal year 2017 enacted
level and $10,000,000 below the fiscal year 2018 budget
request. In addition, the Committee continues the language from
fiscal year 2017 to allow CDC to retain unobligated funds in
the Individual Learning Accounts from departed employees to
support the replacement of the underground and surface coal
mine safety and health research facility.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
The Committee recommends $263,570,000 for CDC-Wide
Activities and Program Support, which includes $103,570,000 in
discretionary funds and $160,000,000 in transfers from the PPH
Fund. This level is $10,000,000 below the fiscal year 2017
enacted level and $158,570,000 above the fiscal year 2018
budget request. This activity supports several crosscutting
areas within CDC. Included is CDC's leadership and management
function, which funds the CDC Office of the Director.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Preventive Health and Health Services Block Grant.... $160,000,000
Public Health Leadership and Support................. 103,570,000
------------------------------------------------------------------------
Cross-Border Disease Control.--The Committee requests that
CDC provide a report in the fiscal year 2019 Congressional
Justification on how CDC coordinates its various programs with
State and local public health departments and international
partners to measure, track, control, and manage cross-border
infectious disease in high-volume port cities.
Vector-Borne Disease Centers of Excellence.--The Committee
encourages CDC to fund an additional university-based vector-
borne disease center of excellence in the West. The Committee
notes that CDC only awarded centers east of the Rocky
Mountains, despite the fact that the West is home to densely
populated areas and is at high risk of importation of vectors
and vector-borne diseases due to high volumes of travel and
trade.
Preventive Health and Health Services Block Grant
The Committee does not concur with the Administration's
proposed elimination of the Preventive Health and Health
Services Block Grant and funds this program at the fiscal year
2017 enacted level of $160,000,000. The Committee expects CDC
to provide these flexible funds to State public health agencies
to work with local and Tribal public health agencies to address
the most critical public health needs.
National Institutes of Health
The Committee recommends $35,184,000,000 for the National
Institutes of Health (NIH), which is $1,100,000,000 above the
fiscal year 2017 enacted level and $8,580,443,000 above the
fiscal year 2018 budget request. This level includes
$34,359,557,000 in discretionary appropriations and
$824,443,000,000 in PHS Act section 241 evaluation set-aside
transfers. Within the total discretionary appropriations, the
Committee recommendation includes $496,000,000 in budget
authority authorized in the 21st Century Cures Act.
The mission of NIH is to seek fundamental knowledge about
the nature and behavior of living systems and the application
of that knowledge to enhance health, lengthen life, and reduce
illness and disability. NIH conducts and supports research to
understand the basic biology of human health and disease; apply
this understanding towards designing new approaches for
preventing, diagnosing, and treating disease and disability;
and ensure that these approaches are widely available.
The recommendation provides an increase of $400,000,000 for
Alzheimer's disease research; an increase of $30,000,000 for
combating antibiotic-resistant bacteria; an increase of
$80,000,000 for the ``All of Us'' research program (formerly
called the Precision Medicine Initiative); an increase of
$76,000,000 for the Brain Research through Application of
Innovative Neurotechnologies (BRAIN) Initiative; an increase of
$8,000,000 for regenerative medicine; and increases to every
Institute and Center (IC) to support innovative research to
advance fundamental knowledge and speed the development of new
therapies and diagnostics to improve the health of all
Americans. The Committee also continues to support the Cancer
Moonshot Initiative with a total of $300,000,000 in fiscal year
2018.
The Committee expects the 3.2 percent increase of funds
over the fiscal year 2017 enacted level to support an increase
in the number of new and competing Research Project Grants
(RPGs), with a focus on early-stage investigators and
investigators seeking first-time renewals. The Committee
encourages NIH to restore extramural support to at least 90
percent of all NIH funding and to continue to focus on basic
research. The Committee expects NIH to support an increased
number of Ruth L. Kirschstein National Research Service Awards
and to provide a stipend level increase to training grantees
that is consistent with any fiscal year 2018 Federal employee
pay raise. The Committee continues to provide in bill language
specific funding levels for Clinical and Translational Science
Awards, Institutional Development Awards (IDeA), the Cures
Acceleration Network, the Common Fund (CF), and the follow-on
to the National Children's Study.
While the Committee appreciates the Secretary's efforts to
find efficiencies in NIH research spending, the
Administration's proposal to drastically reduce and cap
reimbursement of facilities and administrative (F&A) costs to
research institutions is misguided and would have a devastating
impact on biomedical research across the country. To ensure
that NIH can continue supporting both direct and F&A costs as
is their current practice, the bill includes a new general
provision directing NIH to continue reimbursing institutions
for F&A costs according to the rules and procedures described
in 45 CFR 75 (with the exception of existing waivers for
training grants). This provision also prohibits funds in this
Act from being used to implement any further caps on F&A cost
reimbursements.
The Committee recognizes that there are opportunities to
reduce the administrative burden on research institutions
through legislative, regulatory, and administrative means, so
that NIH can support more researchers who can in turn spend
more time on science and less time on paperwork. The National
Academies of Sciences, Engineering, and Medicine 2016
publication ``Optimizing the Nation's Investment in Academic
Research: A New Regulatory Framework for the 21st Century'' put
forth several recommendations for reducing burden on
institutions and investigators. The Committee directs NIH to
identify the most appropriate and potentially impactful
recommendations and submit a plan to the Committees on
Appropriations of the House of Representatives and the Senate
within 90 days of enactment of this Act outlining concrete
steps to achieving these goals. NIH should consult with
academic and independent research institutions, investigators
who receive NIH grants, the HHS Office of Cost Allocation, the
Office of Management and Budget, and other relevant
stakeholders in developing this plan.
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 translate rapidly basic research findings
into clinical practice.
Cancer Moonshot.--The Committee recommendation directs NIH
to transfer $300,000,000 from the NIH Innovation Account to NCI
to support the Cancer Moonshot initiative. These funds were
authorized in the 21st Century Cures Act.
Gastric Cancer.--The Committee continues to be concerned
about the deadly outcomes of gastric cancer, particularly among
young adults. The five-year survival rate for stomach cancer is
30 percent. The Committee encourages NCI to consider developing
a scientific framework, as specified by the Recalcitrant Cancer
Research Act of 2012, for advancing stomach cancer research.
Heavy Ion Cancer Therapy and Research.--The Committee
supports NIH's continued exploration of advanced therapeutic
cancer research, specifically heavy ion irradiation technology.
Heavy ion technology will introduce a novel treatment option to
cancer patients that is currently not available in the U.S. The
Committee notes that the U.S. stands to be a world leader in
this advanced research. The Committee encourages NIH to explore
further the development of a state of the art heavy ion
research facility in the U.S. Furthermore, the Committee
encourages NIH to work with the Departments of Defense and
Energy, and other applicable Federal agencies to equip the
first U.S. heavy ion research center. The Committee urges NIH
to capitalize on the expertise and potential of recently
awarded heavy ion facility planning grant recipients in order
to foster a multidisciplinary approach and advance heavy ion
research that would produce novel, cutting edge treatments for
cancer patients.
Hepatitis B.--The Committee notes that liver cancer is the
second deadliest cancer in the U.S., with a five-year survival
rate less than 18 percent. According to the CDC, unlike other
cancers, the rates of liver cancer deaths and incidence are
rising. To increase the five-year survivability of liver
cancer, the Committee urges that NCI issue targeted calls for
proposals and create an ad hoc special emphasis panel to review
liver cancer applications. The Committee also notes that the
link between hepatitis B infection and primary liver cancer is
well-established with up to 60 percent of global liver cancer
cases caused by the hepatitis B virus (HBV) and, therefore,
urges close collaboration with NIAID and NIDDK on issues
related to HBV research.
Immunotherapy for Childhood Cancers.--Recent NIH studies
demonstrate that a new cancer immunotherapy method to
specifically attack tumor cells that have mutations unique to a
patient's cancer could be effective against a wide range of
cancers. The Committee encourages NCI to continue to explore
further new interventions, such as immunotherapy, as a
promising new treatment strategy for children with cancer.
Glyphosate.--The Committee directs NIH to provide an update
within 60 days of enactment of this Act on research related to
whether glyphosate causes cancer in humans.
Lung Cancer.--The Committee encourages NCI to continue to
prioritize support for meritorious research for lung cancer
generally and specifically related to early detection of lung
cancer and continued advances in treating lung cancer with
personalized medicine, immunotherapy, and other innovative
treatments. The Committee requests an update in the fiscal year
2019 budget request on these efforts.
Melanoma.--Given the significant advances in melanoma
research, in biology, molecular profiling, targeted therapies,
immunology, vaccines, and other areas, and with added
Congressional support to achieve Cancer Moonshot goals in five
years, the Committee requests that NCI update the Committee on
advances in melanoma research in the fiscal year 2019
Congressional Justification.
Pancreatic Cancer Research.--In 2016, pancreatic cancer
rose to become the third leading cause of cancer-related death
in the U.S., claiming the lives of nearly 42,000 Americans.
Despite progress in combating other forms of cancer, pancreatic
cancer remains the only major cancer with a five-year survival
rate in the single digits, at nine percent, in large part
because there are no reliable early detection methods or
effective treatment options. To help turn the tide against this
deadly cancer, Congress in 2012 passed the Recalcitrant Cancer
Research Act (P.L. 112-239), calling for the development of a
scientific framework for certain recalcitrant cancers. The
Committee requests an update on pancreatic cancer research in
the fiscal year 2019 Congressional Justification.
Pediatric Oncology Research.--The Committee encourages NCI
to continue its important investments in pediatric oncology
research, including clinical studies for children with brain
tumors, the important pediatric preclinical testing program
evaluating new agents for treating pediatric malignancies, and
development of the novel pediatric Molecular Analysis for
Therapy Choice (MATCH) study. The Committee requests an update
in the fiscal year 2019 Congressional Justification on the
progress of these important programs.
Precision Oncology.--The Committee recognizes the potential
for significant advancements in cancer treatments from the NCI
MATCH trial. It remains the central pillar of precision
medicine research focused on oncology for cancers that are
unresponsive to standard interventions. The Committee urges NCI
to continue to expand precision oncology trials. NCI should
also continue to focus on launching the important pediatric-
MATCH trial as pediatric oncology mechanisms are very different
from mutations seen in adults. NCI shall provide an update on
these activities in the fiscal year 2019 Congressional
Justification.
Regional Clinical Trial Networks.--The Committee encourages
NCI to coordinate with other ICs to leverage existing platforms
and consider new approaches in conjunction with communities to
identify clinical research and fosters enhanced participation
in clinical trials by community members. The Committee
encourages that the resulting model include robust
collaboration with industry partners, the identification of
best practices, and methods to efficiently implement clinical
studies in the regional networks.
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.
Lung Disease.--Lung disease is the third leading cause of
death in the U.S., with a rising morbidity and mortality burden
among all Americans, including older Americans. The Committee
urges the institute to collaborate with the National Institute
on Aging to study the impact of the lungs' vulnerability to
systemic disease and aging.
Lymphangioleiomyomatosis (LAM).--The Committee remains very
interested in efforts to find a cure for LAM, a progressive and
often fatal lung disease in women. The Committee supports both
intramural and extramural research on LAM and urges NHLBI to
use all available mechanisms as appropriate, including
Translational Program Project Grants, to stimulate a broad
range of clinical and basic research. The Committee commends
NIH for supporting multicenter LAM trials and encourages
additional support of such trials.
Pulmonary Hypertension.--The Committee applauds NHLBI for
identifying the study of underlying mechanisms of disease of
Pulmonary Hypertension as one of its areas of focus within its
recent strategic vision plan for research. The Committee
encourages NHLBI to continue its focus in this area,
particularly on idiopathic pulmonary arterial hypertension, so
that additional gains can be made that benefit patient outcomes
and further improve survivability for affected individuals.
Sickle Cell Disease Research.--The Committee understands
the burden sickle cell disease places on more than 100,000
Americans. Additionally, Federal research spending on sickle
cell disease has historically been eclipsed by other medical
conditions that affect fewer Americans. The Committee
encourages NHLBI to consider an increased focus on innovation
in treatment of sickle cell disease and continue support for
highly meritorious research on sickle cell disease.
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.
Biomaterials.--The Committee is pleased that NIDCR is
exploring approaches to prevent dental caries with probiotic
therapy, and in the development of biomaterials. The Committee
encourages NIDCR to increase its investment in the development
of new and improved biomaterials for use in clinical settings
to enhance the prevention and treatment of caries.
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.
Glomerular Diseases.--The Committee encourages continued
support for the Cure Glomerulonephropathy (CureGN) initiative,
which has enrolled over 1,500 clinical research subjects
working towards furthering the understanding of rare forms of
kidney diseases.
Inflammatory Bowel Disease.--The Committee is pleased by
NIDDK's support of research into inflammatory bowel disease
(IBD) and urges the Institute to provide support for research
on the environmental triggers and epigenetics of IBD as well as
interventions for the rising prevalence of IBD to both
pediatric and adult patients.
Interstitial Cystitis.--The Committee is pleased with the
evolving research on interstitial cystitis and encourages NIDDK
to work with stakeholders on a comprehensive state of the
science conference to examine mechanisms for scientific
opportunity.
Multidisciplinary Approach to the Study of Chronic Pelvic
Pain.--The Committee is pleased with the progress of the
Multidisciplinary Approach to the Study of Chronic Pelvic Pain
Research Network and encourages collaborations with
stakeholders to ensure proper dissemination of information.
Pediatric Kidney Disease.--The Committee is encouraged by
the current multicenter pediatric kidney disease research
funded by NIDDK. While important strides have been made,
further research is critical to the validation of new
prognostic indicators, novel diagnostic biomarkers, and
therapeutics necessary to better understand and treat kidney
disease as children mature from newborns and ultimately
transition to adulthood. The Committee urges the NIDDK to work
collaboratively with other NIH institutes, including the NICHD,
NHLBI, and NIMHD, to advance further multidisciplinary research
for children and young adults with kidney disease and its
complex co-morbidities. The Committee requests that NIDDK
report back in the fiscal year 2019 Congressional Justification
on the steps taken to advance this type of collaborative
research.
Study of Overrepresented and Medically Underserved
Populations with Diabetes.--The Committee is concerned about
specific diabetic populations that are more likely to be
overrepresented and medically underserved. The Committee
encourages NIDDK to support research on these specific
populations. The Committee also encourages NIDDK to work with
Hispanic-Serving Institutions and Historically Black Colleges
and Universities in this effort.
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.
BRAIN Initiative.--The Committee recommendation includes
bill language transferring $43,000,000 from the NIH Innovation
Account to NINDS to support the BRAIN Initiative. These funds
were authorized in the 21st Century Cures Act.
Brain Aneurysm Research.--The Committee is concerned that
an estimated one out of every 50 individuals in the U.S. has a
brain aneurysm and an estimated 30,000 Americans suffer a brain
aneurysm rupture each year, with little to no warning. Ruptured
brain aneurysms are fatal in about 40 percent of cases. The
Committee requests a report from NINDS regarding its annual
funding level for brain aneurysm research funding over the past
five years, including the types of grants supported.
Duchenne Muscular Dystrophy.--The Committee is aware of
stakeholder efforts to achieve validated and qualified
biomarkers for Duchenne Muscular Dystrophy. The Committee
supports these activities and urges NINDS to work with other
Institutes and with the Food and Drug Administration to provide
the necessary guidance and to assemble a workshop of all
stakeholders to advance this work. The Committee is also
concerned about a lack of access to Federally-funded data, such
as imaging and biomarker data, which could support
qualification of an MRI imaging biomarker and directs NIH to
ensure all Federally-funded Duchenne investigators are in full
compliance with the data sharing requirements included in the
21st Century Cures Act. The Committee also remains optimistic
about the potential for additional Duchenne treatments using
exon skipping splicing and encourages NIH to work with other
Federal agencies to convene a workshop on exon skipping in
Duchenne and other neuromuscular diseases.
Dystonia.--The Committee encourages NINDS to continue to
expand the dystonia research portfolio. NINDS is encouraged to
work with stakeholders in support of a comprehensive state of
the science conference to examine evolving mechanisms for
scientific opportunities in dystonia research.
Headache Disorders.--The Committee encourages NIH to
prioritize fundamental, translational, and clinical research on
headache disorders over the next decade. The World Health
Organization has found that migraines are the third most
prevalent global disorder and the seventh leading cause of
global disability.
Hydrocephalus Research.--The Committee encourages NIH,
under the direction of NINDS, to conduct a scientific workshop
on hydrocephalus research. The Committee requests that a key
agenda item of the workshop be a discussion of future needs for
hydrocephalus research, and that NIH report back to the
Committee in the fiscal year 2019 Congressional Justification
on this and other findings and recommendations of the workshop.
Myotonic Dystrophy.--The Committee recognized there are
significant gaps in our scientific understanding of the causes
of myotonic dystrophy and there are still no FDA approved
treatments for this inherited genetic disorder that can cause
multiple organ systems to fail or severely disrupt their
function that affects approximately 100,000 Americans. The
Committee encourages the NIH to fund efforts to recruit young
researchers to this field and stimulate more high quality
research proposals to advance this critical scientific field.
Myotonic dystrophy research holds significant promise for major
advances across many neurodegenerative diseases, particularly
other triplet repeat expansion diseases.
Peripheral Neuropathies.--The Committee is pleased at the
progress of ongoing research into Guillain-Barre syndrome
(GBS), chronic inflammatory demyelinating polyneuropathy, and
related conditions, and notes the important connection between
Zika and GBS. The Committee encourages NINDS to continue work
to advance emerging research in an organized and meaningful
way.
Stroke.--The Committee is concerned that stroke continues
to inflict a massive burden on our Nation's long-term health
and economic stability and encourages NIH to expand its
investment commensurate with the impact on public health, the
economy, and innovative scientific opportunities. NINDS shall
continue to implement top priorities identified in the 2012
planning initiative for stroke prevention, treatment and
recovery research, particularly augmentation of the Stroke
Clinical Trials Network, including early stroke recovery. The
Committee lauds the Institute for its leadership in convening a
workshop on ``Translational Stroke Research: Vision and
Opportunities'' and directs NINDS to accelerate implementation
of key recommendations and other findings.
Traumatic Brain Injury.--The Committee understands
regenerative medicine research and the use of adult stem cells
may play an important role in the treatment of Traumatic Brain
Injury (TBI). The Committee strongly encourages NINDS to work
with the National Institute of Aging to support a robust and
coordinated portfolio of TBI research with a focus on how to
leverage regenerative medicine research and the use of adult
stem cells in the treatment of TBI. The Committee requests an
update in the fiscal year 2019 Congressional Justification on
efforts in these specific areas of 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.
Antimicrobial Resistance.--The Committee recommendation
includes an increase of $30,000,000 within NIAID for combating
antimicrobial resistance. The Committee continues to support
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 2019 Congressional
Justification on how NIAID is working with CDC and other
Federal partners in this field of research.
Autoimmune Neuropathies.--The Committee is pleased that
NIAID and NINDS are working on a state of the science of
autoimmune neuropathies research into conditions like Guillain-
Barre syndrome and chronic inflammatory demyelinating
polyneuropathy, and encourages them to work with stakeholders
on the importance of the patient perspective.
Hepatitis B.--The Committee notes that infection with
hepatitis B virus (HBV) is a serious public health threat and
is associated with approximately 887,000 deaths each year
worldwide, making it a leading cause of death in the world. In
the U.S., one in 20 Americans has been infected with HBV and up
to 2.2 million are chronically infected. Left undiagnosed and
untreated, one in four of those with chronic HBV infection will
die prematurely from cirrhosis, liver failure, and/or liver
cancer. With hepatitis C now curable and study of the entire
HBV lifecycle now possible, NIAID is urged to intensify its
current efforts to find a cure for HBV. To meet this goal, the
Committee urges NIAID to issue targeted calls for HBV research
proposals in fiscal year 2018, focused on therapeutic
development and the many critical research opportunities
identified by the scientific community.
Malaria.--The Committee urges NIH to continue its efforts
to understand the biology of the malaria parasite, and to
continue its role in developing tools needed for effective and
sustainable malaria prevention, treatment, and control,
including vaccines.
Microbicides.--The Committee recognizes that with NIH and
United States Agency for International Development (USAID)
leadership, research has shown the potential for antiretroviral
(ARV) drugs to prevent HIV infection in women. The Committee
encourages NIAID to continue coordination with USAID, the State
Department, and others to advance ARV-based microbicide
development efforts with the goal of enabling regulatory
approval of the first safe and effective microbicide for women
and supporting an active ARV-based microbicide pipeline to
produce additional solutions to prevent HIV and to help end the
epidemic.
Neglected Tropical Diseases.--One-sixth of the world's
population suffers from one or more neglected tropical diseases
(NTDs). In the U.S., we have seen Chikungunya, Dengue, and
Chagas disease emerge. Research conducted by NIH is a key
component to ensuring there are tools to treat, control, and
eventually eradicate many neglected diseases. The Committee
urges NIH to continue its investment in malaria and NTD
research, including work in late-stage and translational
research for NTDs, and to work with other agencies to foster
research and ensure that basic discoveries are translated into
solutions.
Tick-Borne Diseases.--The Committee encourages NIH to
intensify research on Lyme and 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 such as persisters and potential treatment
protocols for identified mechanisms of persistence. The
Committee also encourages NIH to intensify research efforts
focused on the development of more sensitive and accurate
diagnostic tests for Lyme and tick-borne diseases, including
next generation polymerase chain reaction and new testing
methodologies such as proteomics and metabolomics.
Translational Vaccinology.--The Committee notes a very
promising area in the field of vaccine and immunology is
translational vaccinology, in which researchers are able to
translate the science of vaccine design and development into
the assessment of current and novel, experimental vaccines
through pre-clinical and clinical trials. The Committee
strongly encourages NIAID to support a robust portfolio of
extramural, highly meritorious translational vaccine research
that focus on an interdisciplinary approach to this research.
The Committee requests NIAID provide an update in the fiscal
year 2019 Congressional Justification on expansion
opportunities for interdisciplinary translational vaccinology
research.
Tuberculosis.--According to the World Health Organization
(WHO), Tuberculosis (TB) is the leading global infectious
disease killer, accounting for the deaths of 1.8 million people
annually and the continued spread of drug resistant TB is a
serious global health problem. There is an urgent need to
develop faster point-of-care diagnostics; shorter, safer, and
more tolerable treatments; and effective vaccines for all
populations, including for drug resistant TB. The Committee
urges the Institute to prioritize the development of new TB
diagnostic, treatment, and prevention tools.
Zika-Related Conditions.--The Committee encourages NIAID
along with other Institutes and Centers to establish cross-
cutting research activities to combat Zika-related conditions,
including Guillain-Barre Syndrome.
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.
Institutional Development Awards.--The Committee has
provided $373,641,000 for the IDeA program, $40,000,000 above
the fiscal year 2017 enacted level. IDeA supports high-quality
research and investigators throughout the country in States in
which the success rate for NIH grants has been historically
low.
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.
National Breastfeeding Research Consortium.--The Committee
is aware of the substantial amount of research showing that
breastfeeding can contribute significantly to health and the
prevention of childhood obesity and chronic conditions. The
Committee supports the Surgeon General's Call to Action to
Support Breastfeeding and its recommendations for the
development of a national consortium on breastfeeding research.
The Committee urges NICHD to convene the national consortium on
breastfeeding research called for by the Surgeon General.
Preterm Birth Research.--The Committee applauds NICHD's
work with leading global health organizations to develop a
research agenda aimed at reducing preterm birth. Public and
privately funded research that spans the range of discovery,
development, and delivery science is needed to identify the
causes of premature birth. The Committee urges NICHD to enhance
investments in biomedical and clinical research related to the
prevention of preterm birth and the care and treatment of
preterm infants.
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. Proper rehabilitation, with the help of patient
``navigators,'' is critical to improving patients' quality of
life and preventing further, and more costly, health problems.
Therefore, the Committee urges the NIH, acting through the
trans-NIH Rehabilitation Coordinating Committee that is chaired
by the National Center for Medical Rehabilitation Research at
NICHD, to provide greater support for research efforts that
involve the combination of patient navigators and assistive
health technology, particularly in underserved rural settings.
Research on the Long-Term and Developmental Health Effects
of Zika.--The Committee recognizes the unique nature of NICHD
research into how the Zika virus infection affects pregnancy
and the long-term and developmental health effects on children
exposed to the Zika virus. The Committee urges NICHD to
prioritize investment into long-term and developmental health
effects of the Zika virus as the fight against the virus
continues.
Task Force on Research in Pregnant Women and Lactating
Women.--The Committee looks forward to an update on the work of
the Task Force on Research in Pregnant Women and Lactating
Women, and continues to encourage and support the important
work of the Task Force to ensure that consumers and health care
professionals have up-to-date and accurate information on the
safety and efficacy of drugs that women are taking while
pregnant or breastfeeding.
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.
3-D Retina Organoid Challenge.--The Committee directs NIH
to provide an update on the 3-D Retina Organoid Challenge
authorized in the Consolidated Appropriations Act, 2016.
Blepharospasm.--The Committee encourages NEI to expand
research on blepharospasm, a form of dystonia.
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.
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.
Alzheimer's Disease.--In recognition that Alzheimer's
disease poses a serious threat to the nation's long-term health
and economic stability, the Committee recommends an increase of
$400,000,000 within NIA to support a total of at least
$1,791,000,000 on Alzheimer's disease research. 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. Additionally, the Committee encourages NIA to continue
support for additional Alzheimer's Disease Centers in States
with high patient incidences of Alzheimer's disease. Preference
shall be given to centers demonstrating collaborative work
among basic scientists and clinical scientists to expedite new
treatment protocols, particularly among underrepresented areas.
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.
Alopecia Areata Research.--The Committee recognizes NIAMS
for leadership on recent research breakthroughs that could
potentially lead to effective treatments for alopecia areata
and related conditions, and encourages NIAMS to continue to
support research in this area.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
(NIDCD)
Mission.--NIDCD funds and conducts research in human
communication. Included in its program areas are research and
research training in the normal and disordered mechanisms of
hearing, balance, smell, taste, voice, speech and language. The
Institute addresses special biomedical and behavioral problems
associated with people who have communication impairments or
disorders. In addition, NIDCD is actively involved in health
promotion and disease prevention, and supports efforts to
create devices that substitute for lost and impaired sensory
and communication functions.
Spasmodic Dysphonia.--The Committee encourages NIDCD to
expand research on spasmodic dysphonia, a form of dystonia.
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.
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.
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.
Barriers to Research.--The Committee is concerned that
restrictions associated with Schedule 1 of the Controlled
Substance Act effectively limit the amount and type of research
that can be conducted on certain schedule 1 drugs, especially
marijuana or its component chemicals and certain synthetic
drugs. At a time when we need as much information as possible
about these drugs, we should be lowering regulatory and other
barriers to conducting this research. The Committee directs
NIDA to provide a short report on the barriers to research that
result from the classification of drugs and compounds as
Schedule 1 substances.
Drug Treatment in the Justice System.--The Committee
understands that providing evidence-based treatment for
substance use disorders offers a valuable opportunity to
interrupt the substance use/criminal justice system cycle for
people struggling with substance use disorders. Untreated
substance use disorder renders prior criminal offenders
particularly vulnerable to recidivism and continued health
problems, preventing them from being able to find stable
employment, jeopardizing public health and safety, and taxing
justice and health system resources. When combined with
therapy, medication assisted treatment (MAT) has consistently
been shown to be more effective in treating substance use
disorder than abstinence. The Committee applauds NIDA's focus
on adult and juvenile justice populations in its research
around substance use disorder treatment. The Committee supports
this important work and asks for a progress report on those
efforts, including information on the use and success of MAT in
the juvenile justice system.
Marijuana Research.--The Committee is concerned that States
are changing public policies related to marijuana 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.
Neonatal Abstinence Syndrome.--The Committee recognizes the
importance of research on prevention, identification, and
treatment of prenatal opioid exposure and Neonatal Abstinence
Syndrome. The Committee encourages NIDA to ensure that the
review process includes appropriate focus on geographic
locations where the problem is particularly acute. The
Committee encourages NIH, based on appropriate scientific
review, to support meritorious research opportunities in
Appalachia and at institutions that have unique opportunities
to study innovative care models.
Opioid Misuse and Addiction.--The Committee continues to be
extremely concerned about the epidemic of prescription opioids,
heroin, and synthetic opioid use, addiction, and overdose in
the U.S. Approximately 144 people die each day in this country
from opioid overdose, making it one of the most common causes
of non-disease-related deaths for adolescents and young adults.
This crisis has been exacerbated by the availability of
fentanyl and its analogs into many communities. 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 (1) continue funding research on
medication development to alleviate pain, especially the
development of medications with reduced abuse liability; (2) as
appropriate, work with private companies to fund innovative
research into such medications; and (3) report on what is knows
regarding the transition from opioid analgesics to heroin and
synthetic opioid abuse and addiction within affected
populations.
Raising Awareness and Engaging the Medical Community in
Drug Abuse and Addiction Prevention and Treatment.--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. Medical professionals
must be in the forefront of efforts to curb the opioid crisis.
The Committee continues to be pleased with the NIDAMeD
initiative, targeting physicians-in-training, including medical
students and resident physicians in primary care specialties
(e.g., internal medicine, family practice, and pediatrics).
NIDA should continue its efforts in this space, providing
physicians and other medical professionals with the tools and
skills needed to incorporate drug abuse screening and treatment
into their clinical practices.
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.
BRAIN Initiative.--The Committee recommendation includes
bill language transferring $43,000,000 from the NIH Innovation
Account to NIMH to support the BRAIN Initiative. These funds
were authorized in the 21st Century Cures Act.
Adolescent and Young Adult Brain Development.--The
Committee recognizes and supports the NIH Adolescent Brain and
Cognitive Development (ABCD) Study. The Committee recognizes
that an individual's brain continues to develop into his or her
mid-twenties. However, little is known about the dramatic brain
development that takes place during adolescence and how the
various experiences people are exposed to during this time
interact with each other and their biology to affect brain
development and, ultimately, social, behavioral, health, and
other outcomes. The ABCD study addresses this knowledge gap.
Improving the Treatment of Mental Illness.--The Committee
shares the concern of the NIMH National Advisory Mental Health
Council that over the past decade the NIMH research portfolio
has increasingly become focused on basic neuroscience research
at the expense of research focused on finding ways to ease the
burden of those currently suffering from devastating mental
conditions. Therefore, the Committee urges NIMH to diversify
its research portfolio to better balance basic neuroscience and
applied research to increase the development of more effective
treatments for people suffering from mental conditions now.
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.
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.
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.
Focal Segmental Glomerulosclerosis (FSGS) Research.--The
Committee encourages NIMHD to continue research collaboration
with NIDDK to address the connection between the APOL1 gene and
the onset of FSGS.
Health Disparities and Pediatric Kidney Disease.--The
Committee recognizes that health disparities play a significant
role in kidney disease in children, from the incidence and
progression of kidney disease in children, to the long-term
health outcomes, such as access to kidney transplant, access to
living donors and disparate transplant survival. Children of
minority populations are disproportionately impacted by kidney
disease, and NIMHD's work in this area is critical to defining
the basis for these health disparities and developing
mechanisms to address them. The Committee requests that NIMHD
catalog the research being conducted in this area and report
back on the research currently underway and research gaps in
this area of study in the fiscal year 2019 Congressional
Justification.
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE (NCCAM)
Mission.--NCCAM 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.
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.
Clinical and Translational Science Awards.--The Committee
remains deeply concerned over the broad utilization of
resources it specifically allocated for the Clinical and
Translational Science Awards (CTSA) hubs and has provided NCATS
with direct instructions regarding the number of awards. As
investment in the CTSA program continues, NCATS is directed to
ensure the level of support for CTSA institutions is maintained
to appropriately reflect the additional resources provided by
the Committee. Further, NCATS is directed to maintain the
number of CTSA hubs at no fewer than 64 institutions.
Hereditary Angioedema.--The Committee applauds the Office
of Rare Diseases Research for their efforts to facilitate
research into Hereditary Angioedema (HAE) and encourages
continued collaboration with other Institutes and Centers (ICs)
to advance our scientific understanding and spur the further
development of innovative treatment options for patients.
Pediatric Rare Diseases.--The Committee is encouraged by
the work of the Rare Diseases Clinical Research Network (RDCRN)
across a range of rare diseases. The burden of pediatric rare
diseases is especially difficult for families navigating
multiple research opportunities and clinical service needs. The
Committee encourages NCATS to work with RDCRN members to create
a pediatric rare disease center of excellence model.
JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)
Mission.--FIC was established to improve the health of the
people of the U.S. 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.
Recent disease outbreaks such as Ebola, Zika, and Dengue
have shown the importance of the Center's essential role in
global infectious disease health research training and health
system strengthening to help developing countries to eventually
advance their own research and health solutions and tools. FIC
has developed important partnerships in countries, including
countries unfriendly to the U.S., to not only fight malaria,
neglected tropical diseases, and other infectious diseases, but
also to have the capabilities to help the U.S. detect and treat
infectious diseases that are not endemic to the U.S. before
they travel to the U.S., thus protecting Americans here at
home. The Committee urges FIC to continue this important work
building relationships with scientists abroad to foster a
stronger and more effective science workforce and health
capacity on the ground, helping to detect infectious diseases
and building the capacity to confront those diseases while
improving the image of the U.S. though health diplomacy in
their countries.
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.
OFFICE OF THE DIRECTOR (OD)
Mission.--The OD provides leadership to the NIH research
enterprise and coordinates and directs initiatives that
crosscut 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.
Common Fund.--The Committee recommends $695,580,000 for the
Commond Fund (CF), including $12,600,000 provided to support
the Gabriella Miller Kids First Research Act for the fourth
year of the ten-year Pediatric Research Initiative. 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 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 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 the NIH
website within 30 days after being released to the Committee on
Appropriations of the House of Representatives and the Senate.
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 Research
Infrastructure Programs.
The Committee directs the Director of DPCPSI to develop a
trans-NIH strategic approach to improve coordination and
facilitation of trans-NIH research with measurable objectives.
The Director should also take specific steps with the ICs to
strengthen to reduce duplication and increase effectiveness and
efficiency of research.
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 projected 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
Addressing Hispanic Research Issues.--The Committee is
encouraged by NIH's efforts seeking to address health disparity
research issues impacting the U.S. Hispanic population across
various ICs. The Committee recognizes that the longitudinal
Study of Latino Health research program being conducted by
NHLBI, as well as the collaborative research efforts at NIMHD,
are providing important progress in measuring more precisely
the risk factors and outcomes and determining effective
interventions among U.S. Hispanics. The Committee urges NIH to
fill out key gaps in its translational research portfolio to
include children and youth and reproductive-age young women, as
well as older populations, in high-density areas to allow for
broader research cohorts.
Adolescents and Medication-Assisted Treatment.--The
Committee applauds the ongoing coordinated efforts at NIH to
understand and address substance use and substance use
disorders among adolescents and young adults as a specific
population. As part of those efforts, the Committee also
encourages NIH to examine the effectiveness of medication
assisted treatment in adolescents struggling with substance use
disorder, and identify any barriers to treatment as well as
potential unintended consequences.
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 2019 Congressional Justification on
these actions.
Amyloidosis.--The Committee recommends that NIH continue to
expand its research efforts into amyloidosis, a group of rare
diseases characterized by abnormally folded protein deposits in
tissues. Amyloidosis is often fatal and there is no known cure.
Current methods of treatment are risky and unsuitable for many
patients. The Committee directs NIH to keep the Committee
informed on the steps taken to increase the understanding of
the causes of amyloidosis and the measures taken to improve the
diagnosis and treatment of this devastating group of diseases.
Angelman Syndrome.--The Committee recognizes the promising
scientific gains made in the pursuit of treatments for Angelman
Syndrome. The Committee applauds the significant contributions
of the Angelman Syndrome Natural History Study, funded by NIH,
and the private partners working diligently to advance the
growing body of Angelman Syndrome research towards practical
treatments. Because Angelman Syndrome is a single-gene
disorder, specifically caused by a deleted UBE3A gene, the
Committee believes that with recent advances in medical
therapeutics and technology, the disorder is curable today.
Further research in this area holds great promise for both
Angelman Syndrome and forms of autism also linked to
misexpression of the UBE3A gene. With two innovative new
treatments poised for clinical trials, the Committee urges NIH
to dedicate available resources to Angelman Syndrome research,
and specifically to advance research in the roles of the UBE3A
gene in brain functions. In this challenging budget
environment, the Committee also believes public-private
partnerships should be further encouraged as translational
research progresses in the areas of Angelman Syndrome, autism,
and UBE3A related disorders.
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 encourages NIH to 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.
Bilateral Renal Agenesis.--The Committee requests NIH
conduct a state of the science report on bilateral renal
agenesis research, possible treatments, and related dialysis
for preemies and newborns, and provide an update in the fiscal
year 2019 Congressional Justification.
Cerebral Cavernous Angioma Research.--The Committee urges
NIH to expand and strengthen NINDS programs regarding research
and related activities for cavernous angioma by including
basic, clinical, and translational research as well as
promoting training programs for medical and allied health
clinicians and scientists, increasing outreach and awareness,
and sharing clinical and other surveillance information. The
Committee also encourages NIH and FDA to work with patient
advocacy organizations to research and promote effective
treatments. The Committee is aware of patient advocacy groups
asking NIH to conduct clinical trials. The Committee urges NIH
to continue to work with these organizations on this request.
Children in NIH Research.--The inclusion of children in
clinical research is essential to ensure that children benefit
from important scientific advances. The Committee appreciates
provisions of the 21st Century Cures Act that will now require
NIH to track systematically enrollment data to determine if
children are actually being enrolled appropriately in clinical
research. The Committee recognizes that without better data
collection, the Committee is unable to fully exercise its
oversight role and researchers are unable to determine whether
children as a whole, or particular pediatric subpopulations,
are underrepresented in Federally-funded biomedical research.
The Committee directs NIH to implement these new requirements
expeditiously.
Chimpanzee Sanctuary Support.--The Committee commends NIH
for their decision to relocate all Federally-owned chimpanzees
to the federal sanctuary system. The Committee supports NIH's
careful consideration for their welfare, including their health
and social grouping. The Committee is pleased to see that NIH
intends to continue transferring chimpanzees to the federal
sanctuary system in fiscal year 2017 and strongly encourages
further progress towards finding both cost-effective and humane
care for all Federally-owned and -supported chimpanzees in
their retirement. The Committee is aware of the suggestion that
a change in transportation methods or a system expansion could
facilitate earlier completion of the retirement effort.
Therefore, the Committee directs NIH to develop a plan that
addresses impediments in the rate of transportation of
chimpanzees to the sanctuary system and explores the need for
expansion, taking into account age and health of chimpanzees as
well any expansion and facility costs. This plan should also
include details on how NIH plans to meet the goal of retiring
all the NIH-owned chimpanzees to the Federal sanctuary system
as rapidly as possible, but no later than within five years.
The NIH shall report back to the Committee with this plan
within 120 days of enactment of this act.
Chronic Fatigue Syndrome.--The Committee is pleased that
NIH has begun to expedite research into Myalgic
Encephalomyelitis/Chronic Fatigue Syndrome, including its
intramural study and the request for applications (RFAs) for
the collaborative research centers. However, the Committee is
concerned that the level of funding is still very low
considering the burden of disease and the current plan to
expand research will take too long to produce Food and Drug
Administration approved treatments and diagnostic tests. The
Committee urges NIH to collaborate with disease experts and the
patient community to identify additional opportunities to
expedite progress on this understudied disease. Specifically,
the Committee recommends that NIH significantly increase
research funding to be commensurate with disease burden and use
that funding to further accelerate the research field through a
set of intramural and extramural investments such as (a) RFAs
for biomarkers and treatment trials, (b) additional funding for
investigator initiated studies and early stage investigator
awards, (c) an initiative to reach consensus on the case
definition, and (d) mechanisms to incentivize researchers to
enter the field.
Coordination with the Department of Energy (DOE) and
National Laboratories to Implement 21st Century Cures Act.--NIH
is encouraged enter into collaborative research programs, as
appropriate, with DOE, the National Laboratories, and others
determined to be appropriate, to utilize the broader scientific
and technological capabilities of DOE and the National
Laboratories relevant to the successful implementation of the
21st Century Cures Act (P.L. 114-255).
Dietary Reference Intake for Carbohydrates.--The Committee
notes keen public interest in various dietary guidance
proposals and food labeling initiatives regarding consumption
of carbohydrates. Yet, the last Dietary Reference Intake (DRI)
review conducted regarding carbohydrates was completed in 2002.
The Committee encourages NIH to consider arranging for a DRI
review for carbohydrates.
Fragile X.--The Committee commends NIH for the NICHD-led
effort that has resulted in significant progress in mapping the
molecular, physiological, biological and genetic connections
among Fragile X (FX), the FX protein, and autism. Increased
focus on basic science is needed to identify additional
targetable mechanisms of the disease. The Committee
acknowledges that recently concluded drug trials were unable to
demonstrate and measure positive clinical outcomes when
compared to a placebo. The Committee urges the Director to
support expanded natural history studies to supplement the
CDC's efforts, and to focus on validating outcome measures and
biomarkers that bridge the mouse model and humans with the
disease across the full spectrum of CGG repeat expansion in
males and females. The Committee endorses the creation of a
Clinical Trial Network that builds upon the already established
consortium of FX clinics to accelerate the development of
specialized outcome measures. This will ensure that, as
additional targetable mechanisms of the disease are identified,
clinical trials can promptly follow. Given the inextricable
connection between the FX protein and autism, the Committee
urges the Director and his counterparts at each institute 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 the NIH for its previous work to create and
update the NIH Research Plan on Fragile X Syndrome and
Associated Disorders.
Gut Microbiome.--The Committee commends the Office of the
Director's partnership with NIDDK on the Human Microbiome
project and urges expanded investigation into the manipulation
of the microbiome to improve scientific understanding of
functional gastrointestinal disorders, including Irritable
Bowel Syndrome.
National Children's Study (NSC) Follow-On.--The Committee
continues to recognize the importance of investigating the
effects of environmental exposures on child health and
development. The National Children's Study (NCS)/Environmental
Influences on Child Health Outcomes (ECHO) Project has the
potential to increase greatly understanding of this critical
determinate of health across the lifespan. The Committee is
pleased that NIH has established an External Scientific Board
for NCS/ECHO that reports directly to the NIH Director, and
encourages greater communication about to the program's
progress toward goals, milestones, and projected funding
estimates with both external stakeholders and Congress. The
Committee directs NIH to provide an update in the fiscal year
2019 Congressional Justification including a summary of
progress made to date, an analysis of the composition of the
funded cohort studies, and the short- and long-term goals of
the study.
Neurofibromatosis.--The Committee supports efforts to
increase funding and resources for Neurofibromatosis (NF)
research and treatment at multiple NIH Institutes, including
NCI, NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. Children
and adults with NF are at significant risk for the development
of many forms of cancer; the Committee encourages NCI to
increase its NF research portfolio in fundamental basic
science, translational research and clinical trials focused on
NF. The Committee also encourages the NCI to support NF
centers, NF clinical trials consortia, NF preclinical mouse
models consortia and NF-associated tumor sequencing efforts.
Because NF causes brain and nerve tumors and is associated with
cognitive and behavioral problems, the Committee urges NINDS to
continue to aggressively fund fundamental basic science
research on NF relevant to nerve damage and repair. Based on
emerging findings from numerous researchers worldwide
demonstrating that children with NF are at significant risk for
autism, learning disabilities, motor delays, and attention
deficits, the Committee encourages NINDS, NIMH and NICHD to
expand their investments in laboratory-based and clinical
investigations in these areas. Since NF2 accounts for
approximately 5 percent of genetic forms of deafness, the
Committee encourages NIDCD to expand its investment in NF2
basic and clinical research. Since NF1 can cause vision loss
due to optic gliomas, the Committee encourages NEI to expand
its investment in NF1 basic and clinical research. The
Committee requests an update on efforts to address these
research efforts in the FY19 Congressional Justification.
Neurogenic Bladder and Kidney Disease.--The Committee
encourages NIA, NIDDK, NICHD, and NINDS to study the causes and
care of the neurogenic bladder and kidney disease in order to
improve the quality of life of children and adults with Spina
Bifida; to support research to address issues related to the
treatment and management of Spina Bifida and associated
secondary conditions, such as hydrocephalus; and to invest in
understanding the myriad co-morbid conditions experienced by
individuals with Spina Bifida, including those associated with
both paralysis and developmental delay.
Pediatric Precision Medicine.--The Committee is encouraged
by the enormous potential of precision medicine for all
populations, including children, since much of adult health is
rooted in the earliest years. The Committee is aware that, at
an All of Us Research Program stakeholder briefing, NIH
announced plans to develop a working group to address inclusion
of the pediatric population and has also indicated plans to
host a pediatric stakeholder convening. The Committee requests
an update within 30 days of enactment of this Act on the status
and timeline for the working group to release recommendations
regarding pediatric enrollment in the All of Us Research
Program and the expected timeline for beginning enrollment of
children in the program. The Committee expects NIH to ensure
that the research cohort includes a sufficient number of
children to make meaningful studies possible.
Pregnancy-Related Research.--Each year, approximately four
million women give birth in the U.S. Pregnancy research is
essential to learning more about the health and development of
both mother and baby, yet this research lags behind disease or
organ-specific research. The U.S. is ranked 47th globally for
its maternal mortality rate, and unlike any other
industrialized country, its rates are on the rise. As maternal
mortality and maternal morbidity increases, health care costs
rise, and pregnancy presents a greater need for improved
research and clinical guidance, the need to understand how to
manage pregnancy better to prevent poor outcomes and to have
evidence-based guidelines for management of high-risk
pregnancies is imperative. The Committee requests that NIH
conduct a state of the science report on pregnancy research and
provide an update in the fiscal year 2019 Congressional
Justification. The Committee requests the following additional
information from the NIH as it relates to research in
pregnancy, for each of the last three years: the number of
clinical research awards, including all Institutes and Centers,
addressing questions related to pregnancy; within NICHD, what
is the proportion of the total NICHD budget spent on clinical
research involving pregnancy; and how might NIH better address
questions related to pregnancy across the ICs.
Teacher Stress.--The Committee is aware that high levels of
stress are adversely affecting the health of teachers.
Elementary school teachers who have greater stress and show
more symptoms of depression create classroom environments that
are less conducive to learning. Stress is contributing to the
high turnover rate among teachers. The Committee encourages NIH
to support research on reducing teacher stress and promoting
wellbeing by implementing and analyzing evidence-based stress
management programs that will help reduce the stress of
teachers.
Trisomy 21.--The Committee continues to recognize that the
presence of a third copy of human chromosome 21, which causes
Down syndrome, predisposes individuals to significant immune
system dysregulation. This dysregulation is associated with the
occurrence of Alzheimer's disease as individuals with Down
syndrome age and the high incidence of autoimmune disease as
well as protections against most solid tumor cancers and
cardiovascular disease. These findings present a rich research
opportunity and, based on the NIH's recently released report on
the Feasibility of a Multi-Year Study on Trisomy 21 in Humans,
the Committee encourages NIH to pursue a multi-year, trans-NIH
research initiative examining immune system dysregulation and
trisomy 21, with the aim of yielding scientific learnings that
could significantly improve the health of individuals with Down
syndrome as well as millions of typical individuals.
Undiagnosed Illnesses.--The Committee urges the Undiagnosed
Disease Network (UDN) to continue efforts to enhance access to
patients, caregivers, and other stakeholders as well as make
information obtained through the UDN available to Federal
agencies and health-related agencies.
Usher Syndrome.--The Committee continues to urge the NIH to
prioritize Usher syndrome research at NEI and NIDCD. The
Committee requests an update in the fiscal year 2019
Congressional Justification. The update should include efforts
to stimulate the field and to accelerate viable human treatment
options for those with Usher syndrome.
Valley Fever.--The Committee commends NIH and CDC on
launching a Randomized Control Trial (RCT) to identify an
effective treatment for Valley Fever. The Committee requests an
update on the status of the RCT, and continues to support
efforts to develop early diagnostic tests, increase awareness
of this disease among medical professionals and the public, and
develop a vaccine.
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 2019 Congressional Justification. In addition, the
NIH shall provide an update on the concrete steps it is taking
to lower the median age at which individuals receive their
first R01 award within 60 days of enactment of this Act.
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 U.S.
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 2019
Congressional Justification.
Substance Abuse and Mental Health Services Administration
The Committee recommends $3,458,934,000 for the Substance
Abuse and Mental Health Services Administration (SAMHSA), which
is $306,086,000 below the fiscal year 2017 enacted program
level and $68,101,000 above than the fiscal year 2018 budget
request program level.
The Committee includes bill language directing 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 2018.
The Committee does not include the requested bill language
allowing the Assistant Secretary for Mental Health and
Substance Use to transfer three percent or less of funds
between any of the SAMHSA accounts.
American Indians and Alaska Natives continue to face
significant behavioral health problems, and have significantly
limited access to behavioral health services. The Committee is
aware that State authorities must have meaningful and timely
Tribal consultation as they undertake their block grant
planning process. The Committee strongly encourages SAMHSA to
ensure States engage meaningfully with their Tribal
populations. The Committee would also support information from
States on how block grant funds have been used to support
Indian Tribes and/or Tribal organizations within their borders
and to what extent States have consulted with Tribes on the
disbursement of block grant funds.
The Committee directs SAMHSA, where statute allows, when
issuing new funding opportunity announcements, to include as
eligible applicants, States, political subdivisions of States
such as local government or communities, Indian Tribes or
tribal organizations, health facilities, or programs operated
by or in accordance with a contract or grant with the Indian
Health Service, or other public or nonprofit private entities.
It is important to the Committee that all of these entities
have the opportunity to compete for funding. While States play
a critical role, in many cases Tribal governments, nonprofit
organizations, or local communities are better positioned to
target resources to those most in need. The Committee
encourages SAMHSA to provide outreach and technical assistance
to these entities to ensure they are able to compete for new
grant announcements.
MENTAL HEALTH
The Committee provides $949,707,000 for Mental Health,
which is $231,330,000 below the fiscal year 2017 enacted
program level and $37,360,000 above the fiscal year 2018 budget
request program level.
The Committee requests an update in the fiscal year 2019
Congressional Justification information on the costs to law
enforcement, first responders, judicial systems, and health
systems that accrue due to recidivist clients, including
potential options for more cost-effective solutions to
providing care for such clients.
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2018 Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint.......................... $1,147,000
Mental Health First Aid.......................... 14,963,000
National Child Traumatic Stress Network.......... 48,887,000
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................................... 23,605,000
Primary and Behavioral Health Care Integration... 49,877,000
Suicide Prevention:
National Strategy for Suicide Prevention......... 11,000,000
Zero Suicide................................. 9,000,000
American Indian and Alaska Native Set- 2,000,000
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.................. 15,000,000
Homeless Prevention Programs..................... 30,696,000
Minority AIDS.................................... 4,206,000
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..........................................
Consumer and Consumer Support Technical 1,918,000
Assistance Centers..............................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance............................
Minority Fellowship Program...................... 8,059,000
Disaster Response................................ 1,953,000
Homelessness..................................... 2,296,000
------------------------------------------------------------------------
Mental Health First Aid.--The Committee is pleased with the
progress of the Mental Health First Aid program including
training more than 740,000 Americans to recognize the signs and
symptoms of common mental disorders. In continuing competitive
funding opportunities, SAMHSA is directed to include as
eligible grantees local law enforcement agencies, fire
departments, and emergency medical units with a special
emphasis on training for crisis de-escalation techniques.
SAMHSA is also encouraged to allow training for veterans, armed
services personnel and their family members. Any qualified
community mental health education program should be considered
as eligible for funding under the Mental Health First Aid
program.
Mental Health Block Grant
The Committee recommends a total of $421,039,000 for the
Mental Health Block Grant, which is $141,532,000 below the
fiscal year 2017 enacted program level and $5,500,000 above the
fiscal year 2018 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
2017 enacted level and $226,000 above the fiscal year 2018
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.
Pediatric Psychiatric Beds.--The Committee understands
there is a shortage of psychiatric beds, particularly pediatric
psychiatric beds, which help treat children with mental health
and substance abuse issues. The Committee recommends SAMHSA
review the best practices of pediatric psychiatric programs and
provide an update in the fiscal year 2019 Congressional
Justification on this topic.
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 2017 enacted level and
$123,000 above the fiscal year 2018 budget request. The PATH
program supports grants to States and territories for
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 2017 enacted level and $69,000
above the fiscal year 2018 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 $2,211,506,000 for Substance Abuse
Treatment programs, which is $1,000,000 less than the fiscal
year 2017 enacted program level and $15,071,000 more than the
fiscal year 2018 budget request program level.
State Targeted Response to the Opioid Crisis.--The
Committee includes $500,000,000 for the second year of
continuation funding as authorized under section 1003 of the
21st Century Cures Act. Consistent with the authorization, the
Committee recommends States be given flexibility within the
existing grant to direct resources in accordance with local
needs. SAMHSA should permit States to allocate funds for
prevention, training, treatment, recovery, and other public
health related activities at levels based on the conditions of
each State.
The Committee is aware of the significant challenge
presented by opioid abuse, and believes that addressing the
opioid crisis requires that states coordinate efforts among
myriad agencies and organizations. Regional collaborations
involving hospital systems, institutions of higher education,
local government, and the judiciary can drive best practices
and have shown success in identifying solutions for opioid
abuse. Therefore, the Committee encourages SAMHSA to utilize
such regional collaborative stakeholder teams.
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and Regulatory $8,724,000
Activities......................................
Screening, Brief Intervention and Referral to 30,000,000
Treatment.......................................
PHS Evaluation Funds......................... 2,000,000
Targeted Capacity Expansion-General.............. 67,192,000
Medication-Assisted Treatment for 56,000,000
Prescription Drug and Opioid Addiction......
Pregnant and Postpartum Women.................... 19,931,000
Recovery Community Services Program.............. 2,434,000
Children and Families............................ 29,605,000
Treatment Systems for Homeless................... 36,386,000
Minority AIDS.................................... 65,570,000
Criminal Justice Activities...................... 78,000,000
Building Communities of Recovery................. 3,000,000
Science and Service:
Addiction Technology Transfer Centers............ 9,046,000
Minority Fellowship Program...................... 3,539,000
------------------------------------------------------------------------
Screening, Brief Intervention and Referral to Treatment
The Committee provides $30,000,000 for Screening, Brief
Intervention and Referral to Treatment, which is the same as
the fiscal year 2017 enacted program level, and $16,804,000
below the fiscal year 2018 budget request program level. Within
this amount, the Committee provides $1,000,000 for grants to
pediatric health care providers in accordance section 9016 of
the 21st Century Cures Act (P.L. 114-255). Grants should focus
on screening for underage drinking, opioid use, and other drug
use. The Committee understands that substance use disorders,
including opioid use, typically begin in adolescence, and that
preventing underage drinking and other early substance use is a
cost-effective strategy in preventing costly problems later in
life.
Targeted Capacity Expansion
The Committee recommends $67,192,000 for Targeted Capacity
Expansion activities. Of this amount, $56,000,000 is for
services that address prescription drug abuse and heroin use in
high-risk communities. 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 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.
Pregnant and Postpartum Women
The Committee provides $19,931,000 for Pregnant and
Postpartum Women, which is the same as the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request. Addiction to opioids has risen dramatically over the
past few years. Especially important are pregnant women at risk
for opioid dependence and opioid exposure during pregnancy, and
infants born with neonatal abstinence syndrome. The Government
Accountability Office conducted a review of programs and stated
in a 2015 report ``the program gap most frequently cited was
the lack of available treatment programs for pregnant women.''
Substance abuse treatment that supports the family as a unit
has proven effective for maintaining maternal sobriety and
child well-being. There is a need for increased availability of
outpatient treatment options that are responsive to women's
complex responsibilities, often as the primary or sole
caregivers for their families. Reauthorized as part of the
Comprehensive Addiction and Recovery Act (P.L. 114-198), the
Pregnant and Postpartum Women program supports residential
treatment programs for pregnant and postpartum women with
substance use disorders, including opioids. These programs
provide substance use disorder treatment to women in
residential facilities, and allow women to bring their minor
children. Congress authorized the program to use funds for
pilot programs to address service delivery gaps for pregnant
and postpartum women, including services in non-residential
settings, and to encourage new approaches and models of service
delivery across the continuum of care.
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 Courts.--The Committee continues to direct SAMHSA to
ensure that all funding appropriated for Drug Treatment Courts
is allocated to serve people diagnosed with a substance use
disorder as their primary condition. The Committee directs
SAMHSA 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.
Minority AIDS
Viral Hepatitis Screening.--The Committee commends 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 encourages
SAMHSA to continue its work with grantees to incorporate
hepatitis screening into programmatic activities and requests a
report on the implementation of hepatitis screening activities
in the fiscal year 2019 Congressional Justification.
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends a program level of $1,858,079,000
for the Substance Abuse Prevention and Treatment Block Grant,
which is the same as the fiscal year 2017 enacted program level
and $3,382,000 above the fiscal year 2018 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.
Handheld Analyzers.--The Committee understands the role
played by handheld drug analyzers, particularly for police
officers and other first responders. These instruments can
identify various drugs and assist first responders in treatment
referral. They also keep officers safe by minimizing the
exposure to toxic drugs, while reducing the overall cost and
backlog of cases at crime labs. The Committee encourages SAMHSA
to work with the relevant stakeholders to clarify the policy of
block grant funds and handheld analyzers.
Peer Recovery Support Services.--The Committee values the
role of peer recovery support services to individuals and
families impacted by substance use disorder treatment. The
Committee requests information in the fiscal year 2019
Congressional Justification on the amount of funds from the
Substance Abuse Prevention and Treatment Block Grant used for
peer recovery support services.
Pregnant Women.--The Committee remains concerned about the
lack of treatment options for pregnant women and women with
dependent children. States are required to allocate a portion
of their block grant funds to support treatment for this
population. The Committee requests information in the fiscal
year 2019 Congressional Justification on the amount of funds
from the Substance Abuse Prevention and Treatment Block Grant
used for pregnant women and women with dependent children,
including information on how States are implementing these
requirements, funding level by State, and information on
availability of treatment, and barriers to treatment.
SUBSTANCE ABUSE PREVENTION
The Committee recommends $165,373,000 for the Substance
Abuse Prevention programs, which is $57,846,000 below the
fiscal year 2017 enacted level and $15,670,000 above the fiscal
year 2018 budget request.
Within the total provided for Programs of Regional and
National Significance, the Committee provides the following
amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework....................... $74,000,000
Strategic Prevention Framework Rx................ 10,000,000
Grants to Prevent Prescription Drug and Opioid 12,000,000
Overdose Related Deaths.............................
First Responder Training............................. 12,000,000
Rural Focus...................................... 6,000,000
Minority AIDS........................................ 28,843,000
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
Minority Fellowship Program...................... 71,000
------------------------------------------------------------------------
Federal Drug Free Workplace.--The Committee is concerned
that the Secretary of Health and Human Services has yet to
release technical guidelines for the use of hair testing as a
Federally accepted drug testing method, in accordance with
section 5402 of the Fixing America's Surface Transportation Act
(P.L.114-94). The Committee believes these guidelines pose
tremendous safety implications due to hair testing's many
advantages over currently recognized testing methods, including
providing employers with a longer detection window than the
standard urinalysis, as well as being easier to collect and
harder to adulterate. Therefore, the Committee strongly
encourages the Secretary to expeditiously produce the technical
guidelines for the use of hair testing as a Federally accepted
drug testing method. The Committee requests an update on this
effort in the fiscal year 2019 Congressional Justification.
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 must facilitate linkage to
treatment and recovery services.
Strategic Prevention Framework.--The Committee directs
SAMHSA to provide continuation grants for Strategic Prevention
Framework activities in fiscal year 2018.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
The Committee provides $132,348,000 for Health Surveillance
and Program Support, which is $15,910,000 below the fiscal year
2017 enacted program level and the same as the fiscal year 2018
budget request program level.
The Committee provides the following amounts for Health
Surveillance and Program Support:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Health Surveillance.................................. $33,842,000
PHS Evaluation Funds............................. 22,428,000
Program Support...................................... 73,043,000
Public Awareness and Support......................... 11,572,000
Performance and Quality Information Systems.......... 12,893,000
Agency-Wide Initiatives..............................
PHS Evaluation Funds............................. 998,000
------------------------------------------------------------------------
National Survey on Drug Use and Health.--The Committee
provides level funding for the National Survey on Drug Use and
Health.
Agency for Healthcare Research and Quality
HEALTHCARE RESEARCH AND QUALITY
The Committee recommends $300,000,000 in discretionary
funds for the Agency for Healthcare Research and Quality
(AHRQ), which is $24,000,000 below the fiscal year 2017 enacted
level and $300,000,000 above the fiscal year 2018 budget
request. Within the total for AHRQ, the agreement includes the
following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Patient-Centered Health Research..................... $0
Prevention/Care Management........................... 11,649,000
Health Information Technology (IT)............... 16,500,000
Health IT to Improve Quality..................... 14,500,000
Patient Safety Research.............................. 70,276,000
Healthcare-Associated Infections (HAI) Prevention 36,000,000
Combating Antibiotic-Resistant Bacteria (non-add 10,000,000
within HAI).....................................
Section 933 Grants............................... 10,000,000
Patient Safety and Medical Errors................ 19,000,000
Patient Safety Organizations..................... 5,276,000
Crosscutting Activities Related to Quality, 68,731,000
Effectiveness and Efficiency Research...............
Health Services Contract/IAA Research............ 12,000,000
Investigator-Initiated Research Grants........... 25,731,000
Medical Expenditure Panel Survey..................... 66,000,000
Program Management................................... 66,844,000
------------------------------------------------------------------------
The Committee notes that the findings from research
conducted and supported by AHRQ provide evidence to improve the
quality, safety, accessibility, and affordability of health
care. It is in the Nation's interest to ensure this work is
being supported and managed effectively and efficiently, and in
a way that avoids unnecessary duplication with other Federal
agencies and/or the private sector. The Committee directs AHRQ
to enter into an agreement with the National Academy of Public
Administration to conduct a study and make recommendations for
how the Federal government should best manage this important
research, including the optimal organizational location and
means of avoiding unnecessary overlap with other stakeholders.
DRI for Sodium.--The Committee notes that the systematic
review for updating the DRI for sodium for healthy populations
is already underway. The Committee is concerned that the key
questions being asked in the AHRQ systematic review ignore the
impact of sodium intake on healthy populations within the
normal (as defined by medical literature) versus low sodium
ranges. This question must be answered in order for the DRI
committee to be able to determine optimal sodium intakes for
healthy populations, including whether the impact to health at
normal vs. low intakes is linear or non-linear. The Committee
requests that AHRQ answer this question and report back to the
Committee before finalizing the systematic review and sending
it to the DRI committee.
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. The Committee is
aware that enhanced utilization of independent academic medical
centers (non-university-owned centers that retain significant
graduate medical education positions) could lead to innovative
and pragmatic solutions that improve clinical practices.
Patient-Reported Outcomes in Children.--Patient-reported
outcomes play a major role in assessing the type and quality of
care being received by patients. While patient-reported outcome
measures are being advanced as an important component of
clinical decision-making, there is little evidence to guide
pediatric providers with respect to implementation and
application of these measures, particularly as children move
from early childhood through adolescence and to adulthood. The
Committee requests that AHRQ report back on the state of
patient reported outcomes in children with kidney disease and
how the agency intends to advance the scientific application of
these measures toward improving health outcomes in kidney
patients as they mature from newborns to young adults in the
fiscal year 2019 Congressional Justification.
Bibliography of Peer-Reviewed Tick-Borne Diseases
Literature.--The Committee encourages AHRQ to assemble a
bibliography of peer-reviewed tick-borne diseases literature,
appropriately organized for use by the scientific community,
treating physicians, and the public. The bibliography should
include literature relating to possible mechanisms of
persistent infection with Borrelia burgdorferi or other types
of Borrelia.
Centers for Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
The Committee recommends $284,798,384,000 for the Federal
share of Medicaid costs, which is $22,794,417,000 above the
fiscal year 2017 enacted level and the same as the fiscal year
2018 budget request. This amount does not include
$125,219,452,000, which was provided as advance funding for the
first quarter of fiscal year 2018. In addition, the Committee
recommends an advance appropriation of $134,847,759,000 for
program costs in the first quarter of fiscal year 2019.
The Committee continues bill language providing indefinite
budget authority for unanticipated costs in fiscal year 2018.
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 $323,497,300,000 for the Payments
to the Health Care Trust Funds account. This amount is
$24,309,600,000 above the fiscal year 2017 enacted level and
equal to the fiscal year 2018 budget request.
This 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 appropriation is insufficient.
PROGRAM MANAGEMENT
The Committee makes available $3,451,141,000 in trust funds
for Federal administration of the Medicare and Medicaid
programs, which is $218,603,000 below the fiscal year 2017
enacted level and $136,855,000 below the fiscal year 2018
budget request.
Program Operations
The Committee recommends $2,341,274,000 for Program
Operations to support activities used to administer the
Medicare program, fund beneficiary outreach and education,
maintain information technology (IT) infrastructure needed to
support various claims processing systems, and continue
programmatic improvements.
Adult Immunization Quality Measures.--The Committee is
aware that the Centers for Medicare & Medicaid Servies (CMS) is
working to close gaps in quality measures to improve care
delivery and patient outcomes, including reducing racial and
ethnic health disparities. Adult immunization quality measures
are one area where more work is needed, as noted in a 2014
National Quality Forum (NQF) report entitled Priority Setting
for Healthcare Performance Measurement: Addressing Performance
Measure Gaps for Adult Immunization. The Committee recommends
CMS work with relevant partners, such as NQF, to address the
current gaps in adult immunization quality measures and ensure
the quality measures reflect current immunization practice
standards as well as the Advisory Committee on Immunization
Practice recommendations for adult immunization. The Committee
requests a report from CMS no later than 12 months following
enactment of this Act on the steps the agency has taken to
improve quality measures applicable to adult immunization under
Medicare and Medicaid, including an action plan to enable
widespread adoption across healthcare settings.
Agents Used for Cosmetic Purposes or Hair Growth.--The
Committee recognizes that recently passed legislation
eliminated Federal Medicaid matching funds for prescription
drugs used for cosmetic purposes or hair growth unless they are
determined to be medically necessary. The Committee encourages
CMS to include autoimmune conditions that cause hair loss, such
as alopecia areata and thyroid disease, within these medically
necessary coverage criteria.
Ambulatory Surgical Centers.--CMS is directed to submit a
report to the Committees on Appropriations of the House of
Representatives and Senate, and the authorizing committees of
jurisdiction, on any increased cost to the Medicare program and
its beneficiaries due to the migration of procedures from
ambulatory surgical centers (ASCs) to higher cost settings. The
report will evaluate volume changes over the past ten years to
identify procedures that are migrating from ASCs to higher cost
settings and make specific recommendations that CMS can
implement to reverse this trend.
Chronic Obstructive Pulmonary Disease.--Chronic Obstructive
Pulmonary Disease (COPD) is the third leading cause of death
and fourth most costly condition with respect to hospital
readmissions. Respiratory therapists are educated and trained
in all aspects of pulmonary medicine and play a critical role
in the treatment of COPD patients. The Committee encourages CMS
to conduct an analysis of the most recent claims data of
services provided to Medicare beneficiaries with COPD in the
emergency department, inpatient and physician office settings,
and long-term care facilities to determine the role of
respiratory therapists in improved health outcomes, reduced
readmissions, and potential cost savings. The Committee
requests an update on this effort in the fiscal year 2019
Congressional Justification.
Colorectal Cancer Screening.--The Committee recognizes the
inequity in beneficiary cost sharing for screening
colonoscopies. The Committee urges CMS to align its
interpretation of the colorectal cancer screening cost-sharing
requirements for Medicare beneficiaries with the policy of
colorectal cancer cost-sharing requirements for other Federally
funded health programs. The Committee encourages CMS to conduct
an analysis of recent scientific literature on the efficacy of
colorectal cancer screening. The Committee requests an update
on this topic in the fiscal year 2019 Congressional
Justification.
Critical Access Hospitals.--The Committee continues to note
concerns about the proposal to eliminate Critical Access
Hospitals (CAH) status from facilities located less than 10
miles from another hospital and reducing the reimbursement rate
from 101 to 100 percent. Changes to the reimbursement for CAH
can affect their ability to provide proper care to local
residents. The Committee supports efforts by CMS to address
concerns from CAH.
Diabetic Retinal Exams.--According to the CDC, diabetes-
related blindness costs the nation about $500 million annually.
The Committee recognizes that as more Medicare beneficiaries
are diagnosed with diabetes, diabetic retinopathy remains a
concern. Experts recommend that all individuals diagnosed with
diabetes should be examined for eye health yet failure to
receive annual diabetic retinal exams (DREs) is prevalent due
to a variety of reasons. The Committee urges CMS to update its
policy to make DREs more accessible to diabetic patients in
primary care settings.
Electrodiagnostic (EDX) Patient Care.--The Committee thanks
CMS for providing additional guidance on actions taken in
response to the recommendations in the 2014 OIG Report:
Questionable Billing for Medicare Electrodiagnostic Tests. The
Committee notes that utilization of the codes for EDX testing
continue to increase and that identified efforts to curb
rampant fraud and abuse are exclusively focused on physicians
with high utilization rates, and do not capture the full scope
of the problem. The Committee remains interested in
comprehensive solutions from CMS that advance quality care and
cost savings by ensuring patients do not receive inadequate or
unnecessary EDX tests.
Evaluation and Management Codes.--Over 90 percent of the
care provided by infectious disease (ID) physicians is
considered evaluation and management (E&M). These face-to-face
encounters continue to be undervalued by current payment
systems that much more generously reward procedures. This has
created a significant compensation disparity between ID
physicians and specialists who provide more procedure-based
care, as well as primary care physicians who provide similar or
identical E&M services but who have received payment increases
simply because their specialty enrollment designations as
``primary care physicians.'' The Committee requests CMS, as
part of its ongoing effort to improve valuation and payment
accuracy, research the necessary documentation that would more
precisely describe the cognitive work in the office visits of
ID physicians. The Committee requests an update on this topic
in the fiscal year 2019 Congressional Justification.
Home Health Care.--The Committee is aware that the current
requirement that home health plans be certified solely by a
physician has resulted in problems with access to home health
care. The Committee acknowledges CMS' efforts to limit the
requirements placed on the certifying physician. The Committee
requests an update in the fiscal year 2019 Congressional
Justification on the face-to-face encounter performed by an
allowed non-physician practitioner (working in collaboration
with/under the supervision of the certifying physician or the
acute/post-acute-care physician).
Hospital Rating System.--The Committee is concerned with
the implementation of CMS's Hospital Star Rating System. While
the Committee supports the goals of transparency for patients,
it is concerned with how CMS measures factors in determining
these ratings. The Committee requests CMS provide details on
the methodology used to determine the ratings in the fiscal
year 2019 budget request. The Committee encourages CMS to
solicit feedback from the stakeholder community regarding the
methodology and factors used to determine ratings.
Long Term Care Hospitals.--The Committee recognizes the
challenges faced by Long Term Care Hospitals (LTCHs). The
Committee encourages continued discussion and analysis on
payment methodologies that permit flexibility for LTCHs to meet
the needs of their patients and community.
Medication Diversion.--The Committee understands the
important role of medication-assisted treatment for
beneficiaries with opioid use disorder. At the same time, there
are reports from several authorities of rising rates of
diversion of these Food and Drug Administration-approved
medications. The Committee directs CMS to evaluate diversion
data from the Drug Enforcement Administration and State sources
to determine the scope of this problem and to include in the
fiscal year 2019 Congressional Justification options to reduce
diversion.
National Health Expenditures.--The Committee requests CMS
include information in its fiscal year 2019 Congressional
Justification explaining the methodology for including data in
the National Health Expenditure (NHE) database. In addition,
the Committee requests an analysis of how CMS-published data
compares to other comparable information on health
expenditures, such as industry surveys.
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.
Patient Matching.--The Committee recognizes that a lack of
a patient matching system for Medicare beneficiaries results in
duplicate procedures and poses a significant patient safety
risk. The Committee is aware that a number of patient matching
systems are currently being used in the commercial sector, but
one has yet to be adopted in Medicare. The Committee requests a
report not less than 12 months after the date of enactment of
this Act on the impact on care improvement, reduction in costs,
estimated saved lives or reduction in errors, and improvements
in patient safety if hospitals were required to use a patient
matching system as a requirement for participation in the
Medicare program.
Readmission Rates.--The Committee continues to support CMS
efforts to reduce readmission rates among high-risk seniors
living in communities challenged by poverty, poor health
literacy, 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 continues to encourage CMS to
work with community-based organizations to help identify best
practices and transition them to Medicare's value-based
purchasing initiatives.
Recovery Audit Contractors.--The Committee values the role
played by Recovery Audit Contractors (RACs) in the
identification and prevention of improper Medicare payments.
However, some audit processes have resulted in prolonged delays
in payment to providers. The Committee encourages efforts by
CMS to provide oversight to ensure RACs are operating
consistent with CMS issued guidance.
Risk Corridors.--The Committee continues bill language
prohibiting use of the Program Management appropriation from
being available for risk corridor payments.
Rural Health Clinics.--The Committee encourages CMS to
engage States and other stakeholders on outstanding issues of
payment recoupment, as it relates to CMS-designated Rural
Health Clinics. The Committee also requests an update in the
fiscal year 2019 Congressional Justification on the study
requested in House Report 114-699 under this heading.
Therapeutic Foster Care Services.--The Committee remains
concerned about the lack of a uniform definition within the
Medicaid program for therapeutic foster care (TFC) services. A
uniform definition would improve the ability for more
consistent care and treatment. The Committee requests an update
in the fiscal year 2019 Congressional Justification on the
study requested in House Report 114-699 under this heading.
Transparency in Hospital Reimbursement.--The Committee
requests CMS provide information in the fiscal year 2019
Congressional Justification identifying all pass-through
payments reimbursed from the Hospital Insurance Trust Fund. The
Committee expects CMS to address pass-through payments for
hospital-based nursing programs, as well as the oversight
function CMS performs to ensure such programs are fully
accredited.
Federal Administration
The Committee recommends $712,533,000 for Federal
Administration activities related to the Medicare and Medicaid
programs, which is $20,000,000 below the fiscal year 2017
enacted level and $10,000,000 below the fiscal year 2018 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.
Health Insurance Exchange Transparency.--The Committee
continues to include bill language requiring CMS to provide
cost information for the following categories: Federal Payroll
and Other Administrative Costs; Exchange related Information
Technology (IT); Non IT Program Costs, including Health Plan
Bid Review, Management and Oversight; Payment and Financial
Management; Eligibility and Enrollment; Consumer Information
and Outreach, including the Call Center, Navigator Grants, and
Consumer Education and Outreach; Exchange Quality Review; Small
Business Health Options Program and Employer Activities; and
Other Marketplace Activities. Cost information should be
provided for each fiscal year since the enactment of the
Patient Protection and Affordable Care Act (Public Law 111-
148). CMS is also required to include the estimated costs for
fiscal year 2019.
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT
The Committee provides $745,000,000 to the Health Care
Fraud and Abuse Control Account (HCFAC). This includes a base
amount of $311,000,000 and an additional $434,000,000 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 $20,000,000 above the fiscal year 2017
enacted level and $6,000,000 below the fiscal year 2018 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 funds the Senior Medicare Patrol Program
administered by the Administration for Community Living from
funds provided to this account.
The Committee expects all recipients of funds from the
Health Care Fraud and Abuse Control Account, the Centers for
Medicare & Medicaid Services, the Department of Health and
Human Services Office of Inspector General, and the Department
of Justice, to use funds for efforts to address fraud and abuse
as described in section 1128C of the Social Security Act.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
The Committee recommends $2,995,400,000 for the Child
Support Enforcement and Family Support programs, which is
$15,231,000 below the fiscal year 2017 enacted level and the
same as the fiscal year 2018 budget request. The Committee also
recommends $1,400,000,000 in advance funding, as requested, for
the first quarter of fiscal year 2019 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 $3,390,304,000 for the Low Income
Home Energy Assistance Program, which is the same as the fiscal
year 2017 enacted level and $3,390,304,000 above the fiscal
year 2018 budget request. Within the amount available for
formula grants, the Committee recommends up to $2,988,000 for
technical assistance, training, and monitoring of program
activities.
REFUGEE AND ENTRANT ASSISTANCE
The Committee recommends $1,022,811,000 for Refugee and
Entrant Assistance programs, which is $651,880,000 below the
fiscal year 2017 enacted level and $433,944,000 below the
fiscal year 2018 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.
The Committee recognizes the responsibilities of the
Federal government for the care of unaccompanied children while
in Federal custody. The Committee supports policies that are in
the best interest of the child while in the custody of the U.S.
Department of Homeland Security and when subsequently
transferred to the Department of Health and Human Service's
Office of Refugee Resettlement (ORR). The Committee expects ORR
to coordinate closely with U.S. Immigration and Customs
Enforcement (ICE) on the transfer to ICE of unaccompanied
children who turn 18 while in ORR custody.
Within the total, the Committee recommends the following:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Transitional and Medical Services.................... $320,000,000
Victims of Trafficking............................... 18,755,000
Refugee Support Services............................. 175,321,000
Unaccompanied Children............................... 498,000,000
Victims of Torture................................... 10,735,000
------------------------------------------------------------------------
Healthcare Costs Related to Illegal Immigration.--The
Committee requests an update to the report submitted to
Congress by the Department of Health and Human Services
pursuant to this heading as it appeared in the explanatory
statement accompanying division H of the Consolidated
Appropriations Act, 2016 (P.L. 114-113).
National Human Trafficking Training and Assistance
Center.--The Committee directs the Administration for Children
and Families to increase funding for the National Human
Trafficking Hotline.
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT
The Committee recommends $2,860,000,000 for the
discretionary portion of the Child Care and Development Fund,
the Child Care and Development Block Grant, which is $4,000,000
above the fiscal year 2017 enacted level and $99,000,000 above
the fiscal year 2018 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 2017
enacted level and $1,700,000,000 above the fiscal year 2018
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 Committee recommends $11,181,500,000 for Children and
Families Services programs, which is $112,868,000 below the
fiscal year 2017 enacted level and $977,207,000 above the
fiscal year 2018 budget request. The Children and Families
Services programs fund activities serving children, youth,
families, the developmentally disabled, Native Americans,
victims of child abuse and neglect and domestic violence, and
other vulnerable populations.
The Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2018
Budget Activity Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families:
Head Start........................................... $9,275,000,000
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................. 33,000,000
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............................. 52,050,000
Community Services:
Community Services Block Grant................... 600,000,000
Community Economic Development................... 10,000,000
Rural Community Facilities....................... 7,500,000
Domestic Violence Hotline............................ 8,750,000
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.................................... 194,610,000
------------------------------------------------------------------------
Head Start
The Committee recommends $9,275,000,000 for the Head Start
program, which is $21,905,000 above the fiscal year 2017
enacted level and $106,905,000 above the fiscal year 2018
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. Within the total for Head
Start, the Committee recommends $640,000,000 for Early Head
Start-Child Care Partnership grants, which is the same as the
fiscal year 2017 enacted level and $5,000,000 above the fiscal
year 2018 budget request.
The Committee is concerned about closures and
consolidations of Head Start centers that have resulted from a
number of re-competitions across the country in recent years.
The Committee strongly encourages HHS to consider the
consequences of Head Start program closures, reductions, and
consolidations have on the ability of children and families to
access Head Start services, particularly in rural areas.
Transportation barriers can lead to increased absenteeism and
missed work for families. In the event of a Head Start center
closure, reduction, or consolidation, the Committee encourages
the Office of Head Start to work with the local grantees to
consider the impact on children, and encourage grantees to
provide transportation for children who are displaced to a new
Head Start center that is more than 15 miles from the center in
which they were enrolled during the previous school year.
Preschool Development Grants
The Committee recommends $250,000,000 for Preschool
Development Grants, which is the same as the fiscal year 2017
enacted level and $250,000,000 above the fiscal year 2018
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.
Child Abuse Discretionary Activities
Infant-Toddler Court Teams.--The Committee continues
funding to for a National resource center to preserve,
disseminate, and amplify the work of the Quality Improvement
Center (QIC) for Research-based Infant-Toddler Court Teams by
providing training and technical assistance in support of such
court teams' efforts across the country. This funding should
help to build upon and continue the work of sites established
through the QIC initiative, which have brought 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 $52,050,000 for Native American
Programs, which is the same as the fiscal year 2017 enacted
level and $2,145,000 above the fiscal year 2018 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 Generation
Indigenous, which focuses on improving Native American language
instruction across the educational continuum. The Committee
provides not less than $4,000,000 for language immersion
programs as 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 of2006. The Committee
strongly encourages the Administration for Children and
Families (ACF) to give priority to grantees with rigorous
immersion programs.
Community Services Programs
Community Services Block Grant.--The Committee recommends
$600,000,000 for the Community Services Block Grant, which is
$115,000,000 below the fiscal year 2017 enacted level and
$600,000,000 more than the fiscal year 2018 budget request.
Community Economic Development.--The Committee provides
$10,000,000 for Community Economic Development grants, which is
$9,883,000 below the fiscal year 2017 enacted level and
$10,000,000 above the fiscal year 2018 budget request.
Community Economic Development is a Federal grant program
funding Community Development Corporations that address the
economic needs of individuals and families with low income
through the creation of sustainable business development and
employment opportunities. CED awards funds to private, non-
profit organizations that are community development
corporations, including faith-based organizations, and Tribal
and Alaskan Native organizations. The Committee directs the
Administration for Children and Families to issue a funding
opportunity announcement prioritizing applications from rural
areas with high rates of poverty, unemployment, and substance
abuse.
Rural Community Facilities.--The Committee recommends
$7,500,000 for the Rural Community Facilities program, which is
the same as the fiscal year 2017 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.
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 the same as the fiscal year 2017 enacted level and the
fiscal year 2018 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 2017 enacted level and $20,000,000
below the fiscal year 2018 budget request. The Committee also
recommends $59,765,000 in discretionary funds for this program,
which is the same as the fiscal year 2017 enacted level and the
fiscal year 2018 budget request. This program enables each
State to operate a coordinated program of family preservation
services, community-based family support services, time-limited
reunification services, and adoption promotion and support
services. States receive funds based on their share of children
in all States receiving food stamp benefits.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
The Committee recommends $6,225,000,000 for payments to
States for foster care and adoption assistance, which is
$461,000,000 more than the fiscal year 2017 enacted level and
the same as the fiscal year 2018 budget request. The Committee
also recommends an advance appropriation of $2,700,000,000 for
the first quarter of fiscal year 2018 to ensure timely
completion of first quarter grant awards.
Within the total, the Committee recommends $5,537,000,000
for the Foster Care program, which is $545,000,000 above the
fiscal year 2017 enacted level and the same as the fiscal year
2018 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 $2,867,000,000
for Adoption Assistance, which is $87,000,000 more than the
fiscal year 2017 enacted level and the same as the fiscal year
2018 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 $181,000,000 for
the Kinship Guardianship Assistance program, which is
$29,000,000 more than the fiscal year 2017 enacted level and
the same as the fiscal year 2018 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 2017 enacted level and the fiscal year
2018 budget request. This program assists foster children age
16 or older make successful transitions to independence. Funds
support a variety of services, including educational
assistance, career exploration, vocational training, job
placement, life skills training, home management, health
services, substance abuse prevention, preventive health
activities, and room and board. Each State receives funds based
on the number of children on whose behalf the State receives
Federal Foster Care Payments.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
The Committee recommends a total program level of
$2,237,224,000 for the Administration for Community Living
(ACL), which is $243,409,000 above the fiscal year 2017 enacted
program level and $385,774,000 above the fiscal year 2018
budget request. The Committee recommends funding for the Senior
Medicare Patrol Program, and provides this funding under the
Health Care Fraud and Control Abuse Account.
Home and Community-Based Supportive Services
The Committee recommends $350,224,000 for Home and
Community-Based Supportive Services, which is the same as the
fiscal year 2017 enacted level and $3,161,000 above the fiscal
year 2018 budget request. This program provides formula grants
to States and territories to fund a wide range of social
services that enable seniors to remain independent in their
homes for as long as possible.
Preventive Health Services
The Committee recommends $19,848,000 for Preventive Health
Services, which is the same as the fiscal year 2017 enacted
level and $38,000 above the fiscal year 2018 budget request.
This program funds activities that help seniors remain healthy
and avoid chronic diseases.
Protection of Vulnerable Older Americans
The Committee recommends $20,658,000 for activities to
protect vulnerable older Americans, which is the same as the
fiscal year 2017 enacted level and $39,000 above the fiscal
year 2018 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 $150,586,000 for the National
Caregiver Support program, which is the same as the fiscal year
2017 enacted level and $286,000 above the fiscal year 2018
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 the same as the fiscal year
2017 enacted level and $39,000 above the fiscal year 2018
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 a total of $837,753,000 for senior
nutrition. The Committee recommends $450,342,000 for Congregate
Nutrition Services, which is the same as the fiscal year 2017
enacted level and $2,852,000 above the fiscal year 2018 budget
request. The Committee recommends $227,342,000 for Home-
Delivered Meal Services, which is the same as the fiscal year
2017 enacted level and $1,430,000 above the fiscal year 2018
budget request. The Committee recommends $160,069,000 for the
Nutrition Services Incentives program, which is the same as the
fiscal year 2017 enacted level and $304,000 above the fiscal
year 2018 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.
Native American Nutrition and Supportive Services
The Committee recommends $31,208,000 for Native American
Nutrition and Supportive Services, which is the same as the
fiscal year 2017 enacted level and $109,000 above the fiscal
year 2018 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 2017
enacted level and $19,000 above the fiscal year 2018 budget
request. This program supports activities that expand public
understanding of aging and the aging process.
Holocaust Survivor's Assistance.--Within funding for the
Aging Network Support Activities, the Committee provides not
less than $3,000,000 for Holocaust Survivor's Assistance. This
program provides supportive services for aging Holocaust
survivors living in the United States.
Alzheimer's Disease Services
The Committee recommends $19,500,000 for the Alzheimer's
Disease Services programs, which is the same as the 2016
enacted program level and $10,000 above the fiscal year 2018
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 accepts the Administration's proposal to
consolidate funding for Alzheimer's disease programs into one
more flexible program authorized under Title IV of the Older
Americans Act.
Lifespan Respite Care
The Committee recommends $3,360,000 for Lifespan Respite
Care, which is the same as the fiscal year 2017 enacted level
and $6,000 above the fiscal year 2018 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 2017 enacted
level and the fiscal year 2018 budget request. Fall prevention
grants support the promotion and dissemination of prevention
tools delivered in community settings.
Chronic Disease Self-Management Program
The Committee recommends $5,000,000 for Chronic Disease
Self-Management program, which is $3,000 below the fiscal year
2017 enacted level and the same as the fiscal year 2018 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 $2,000,000 below the fiscal year
2017 enacted level and $23,000 above the fiscal year 2018
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 2017 enacted level and $12,000 above the fiscal year 2018
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.
Senior Community Service Employment Program
The Committee transfers the Senior Community Service
Employment Program (SCSEP) from the Department of Labor to the
Administration for Community Living. The Committee recommends
$300,000,000 for the administrative and operational costs of
SCSEP, which is $100,000,000 below the fiscal year 2017 enacted
level and $300,000,000 above the fiscal year 2018 budget
request. This program supports low-income seniors in community
service positions.
State Health Insurance Program
Due to funding constraints, the Committee recommends no
funding for the State Health Insurance program, which is
$47,115,000 below the fiscal year 2017 enacted level and the
same as the fiscal year 2018 budget request. Other Federal
programs provide similar services.
Paralysis Resource Center
The Committee recommends $6,700,000 for the Paralysis
Resource Center, which is the same as the fiscal year 2017
enacted level and $6,700,000 above the fiscal year 2018 budget
request. The Paralysis Resource Center offers activities and
services aimed at increasing independent living for people with
paralysis and related mobility impairments, and supporting
integration into the physical and cultural communities in which
they live.
Limb Loss Resource Center
The Committee recommends $2,500,000 for the Limb Loss
Resource Center, which is the same as the fiscal year 2017
enacted level and $2,500,000 above the fiscal year 2018 budget
request. The Limb Loss Resource Center supports a variety of
programs and services for those living with limb loss,
including a national peer support program, educational events,
training for consumers and healthcare professionals, and
information and referral services.
Traumatic Brain Injury
The Committee recommends $9,321,000 for the Traumatic Brain
Injury program, which is the same as the fiscal year 2017
enacted level and $6,159,000 above 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 $73,000,000 for State Councils on
Developmental Disabilities, which is the same as the fiscal
year 2017 enacted level and $73,000,000 above the fiscal year
2018 budget request. The State Councils work to develop,
improve and expand the system of services and supports for
people with developmental disabilities.
Partnerships for Innovation, Inclusion, and Independence
The Committee does not consolidate the State Councils on
Developmental Disabilities, State Independent Living Councils,
and State Advisory Boards on Traumatic Brain Injury. The
Committee recognizes the unique role played by each program and
believes consolidation into one program will not serve the
needs of people living with a disability.
Developmental Disabilities Protection and Advocacy
The Committee recommends $38,734,000 for Developmental
Disabilities Protection and Advocacy, which is the same as the
2017 enacted level and $74,000 above the fiscal year 2018
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.
The Committee recognizes that the Americans with
Disabilities Act (ADA) encourages states to administer services
for people with intellectual/developmental disabilities (I/DD)
``in the most integrated setting appropriate to the needs of
qualified individuals with disabilities.'' As a result of
enactment of the ADA and the Supreme Court decision in Olmstead
v. L.C. (1999), there has been a National trend towards
deinstitutionalization, whereby individuals have been
encouraged to move out of State-run and other Federally-funded,
certified facilities and into residential settings in their
respective communities. However, the Committee is aware that
many family members and legal guardians of individuals residing
in these facilities have been pressured to move their loved
ones into the community against their wishes. The Committee is
concerned about the adequacy of community-based housing and the
lack of specialized care and support services available in
them, the pace of transfer, higher rates of abuse and mortality
in community settings, and the adequacy of opportunities for
residents to express views and preferences throughout the
process.
The Committee fully supports the ADA's goal of enabling
people with I/DD to receive services ``in the most integrated
setting appropriate to the[ir] needs.'' However, the Committee
also notes that Olmstead held that the ADA does not condone or
require removing individuals from institutional settings when
they are unable to handle or benefit from a community-based
setting and that the ADA does not require the imposition of
community-based treatment on patients who do not desire it.
Congress endorsed the same principle in the Developmental
Disabilities (DD) Act of 2000. The Committee strongly urges the
DD Act programs (state developmental disabilities councils,
protection and advocacy systems and university centers for
excellence in developmental disabilities) to continually
consult with parents and guardians of those individuals within
these facilities. The Committee urges the Administration on
Community Living to monitor this matter and to include an
update on the efforts to ensure compliance with bill language
requiring notification in the fiscal year 2019 Congressional
Justification.
The Committee strongly urges the Department to ensure that
DD Act programs properly account for the needs and desires of
patients, their families, and caregivers, and the importance of
affording patients the proper setting for their care, into
their enforcement of the ADA.
Voting Access for Individuals with Disabilities
The Committee recommends $4,963,000 for Voting Access for
Individuals with Disabilities program, which is the same as the
fiscal year 2017 enacted level and $9,000 above the fiscal year
2018 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 $7,600,000 for Developmental
Disabilities Projects of National Significance, which is
$2,400,000 below the fiscal year 2017 enacted level and the
same as the fiscal year 2018 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 $38,619,000 for University Centers
for Excellence in Developmental Disabilities, which is the same
as the fiscal year 2017 enacted level and $73,000 above the
fiscal year 2018 budget request.
Independent Living
The Committee recommends $101,183,000 for the Independent
Living program, of which $22,878,000 is for the Independent
Living State Grants program and $78,305,000 is for the Centers
for Independent Living program. This funding level is the same
as the fiscal year 2017 enacted level and $23,027,000 above the
fiscal year 2018 budget request. Independent Living programs
maximize the leadership, empowerment, independence and
productivity of individuals with disabilities.
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 2017 enacted
level and $8,843,000 above the fiscal year 2018 budget request.
The National Institute on Disability, Independent Living, and
Rehabilitation Research 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 $34,000,000 for Assistive
Technology, which is the same as the fiscal year 2017 enacted
level and $2,061,000 above the fiscal year 2018 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. The Committee intends for this funding
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 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 $37,987,000 for Program
Administration, which is $2,076,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 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
$350,346,000 for General Departmental Management, which is
$175,111,000 below the fiscal year 2017 enacted level and
$11,620,000 below the fiscal year 2018 budget request. Of the
funds provided, $57,465,000 shall be derived from evaluation
set-aside funds available under section 241 of the Public
Health Service Act, which is $7,363,000 below the fiscal year
2017 enacted level and the same as the fiscal year 2018 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.
Office of the Assistant Secretary for Health
Breastfeeding.--The Committee recognizes the importance of
breast milk in improving health outcomes for babies and mothers
and requests HHS to report to the Committee on the impact of
recommended breastfeeding rates on health outcomes and
healthcare costs. The report should examine the impact of
clinically recommended breastfeeding rates on associated
Medicaid expenditures, urgent care costs, and direct and
indirect medical costs, including workplace productivity and
employee retention. The Committee also directs the Secretary to
ensure that pregnant women have access to guidance on
nutritional advice based on the latest scientific research on
the health and cost benefits of human milk.
Chronic Fatigue Syndrome (CFS).--The Committee supports the
CFS Advisory Committee and encourages HHS agencies to partner
with the medical community and other stakeholders to ensure
access to clinical care and expert medical providers and Food
and Drug Administration approved treatments to better address
the needs of over one million Americans suffering from CFS.
Embryo Adoption Awareness Campaign.--The Committee
recommends $1,000,000 for the Embryo Adoption Awareness
Campaign, the same as the fiscal year 2017 enacted level and
the budget request. 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.
Evidence-Based Programming.--The Committee is concerned
about the uneven capacity of HHS operating divisions to apply
and to build evidence that will improve program effectiveness.
The Committee believes that ASPE can play a central role in
improving evaluation and evidence-based policymaking across the
Department by helping all HHS components develop capacity to
meet the standards set forth in the Administration on Children
and Families' Evaluation Policy. The Committee encourages ASPE
to help operating divisions adopt cost-effective approaches to
building evidence through use of innovative grant designs that
support partnerships between service delivery projects and
researchers; by leveraging emerging opportunities to use linked
data to measure performance and conduct comprehensive, rigorous
evaluations at a reasonable cost; and by partnering with
philanthropic organizations that focus on improving the use of
rigorous research to inform policy.
Global Health.--The Committee requests an update on how the
CDC, Food and Drug Administration (FDA), Biomedical Advanced
Research and Development Authority (BARDA), and NIH--including
the National Center for Advancing Translational Science--
jointly coordinate global health research activities with
specific measurable metrics used to track progress and
collaboration toward shared health goals.
Indian Hospital Facilities.--The Committee continues to be
concerned by the poor quality of facilities operated by HHS in
Indian country. The Committee is aware that funding from the
Nonrecurring Expenses Fund has been planned for facility
upgrades in these hospitals, and strongly supports this effort.
The Committee directs the Secretary to prioritize obligations
for these facilities and expects obligation of such funds as
quickly as possible in order to continue progress on improving
these structures. The Committee requests an update within 45
days of enactment of this Act on all obligations from the
Nonrecurring Expenses Fund.
Opioid Response.--The Committee believes that the Federal
response to the opioid epidemic will be most effective if
resources made available through the Comprehensive Addiction
and Recovery Act and related programs are directed to
strategies that are backed by strong evidence or to innovative
and promising approaches that will be rigorously evaluated to
learn their impact. In implementing new and existing programs
that address the opioid epidemic, HHS is urged to utilize
evidence-based policymaking principles, tools, and program
designs such as those disseminated by the Evidence-Based
Policymaking Collaborative. The Committee encourages HHS to
collaborate with outside researchers and philanthropic
organizations that focus on improving the use of rigorous
research to inform policy.
Pulmonary Hypertension (PH).--The Committee remains
concerned that most PH patients are not diagnosed for many
years until the condition has reached a catastrophic stage,
which leads to greatly increased mortality and the need for
costly and dramatic medical interventions. There are many
effective therapies for early-stage PH and HHS is encouraged to
work collaboratively 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 $5,000,00 above the fiscal year 2017 level and the fiscal
year 2018 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
implement consistently 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.
Vector-Borne Disease Research.--A number of agencies across
the Federal government are engaged in various facets of vector-
borne disease research and control. In an effort to foster
greater coordination, collaboration and transparency across
agency lines, the Committee encourages the Secretary to
establish a coordinating office to facilitate and expedite the
government's response to vector-borne disease threats,
including combating the spread of disease through innovative
vector control technologies.
Office of Minority Health
The Committee provides $45,250,000 for the Office of
Minority Health (OMH), which is $11,420,000 below the fiscal
year 2017 enacted level and $11,312,000 below the budget
request. The OMH works with U.S. Public Health Service agencies
and other agencies of the Department to address the health
status and quality of life for racial and ethnic minority
populations in the United States. OMH develops and implements
new policies; partners with States, Tribes, and communities
through cooperative agreements; supports research,
demonstration, and evaluation projects; and disseminates
information.
Hepatitis.--The Committee continues to be concerned about
the HIV/AIDS epidemic in the African American and Hispanic
communities, and is aware of the concurrent high co-infection
rate for hepatitis C. The Committee commends OMH for their
advancements in the treatment and management of hepatitis. The
Committee asks that the agency provide the Committee with a
report that outlines the progress in continuing encouragement
of community partnerships that promote awareness and outreach
to improve testing, diagnosis, and treatment no later than 60
days after enactment of this Act.
Lupus.--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. The action plan
will focus on fostering public-private and community
partnerships, evaluating current minority clinical trial
education and participation programs, and creating a research
plan for new clinical trial education models in lupus. The
Committee is encouraged by the research conducted by the OMH
National Health Education Lupus Program and encourages OMH to
optimize that research and utilize other resources in
development to further support populations at highest risk;
more specifically Hispanics, Native Americans, Asians and
African Americans. The Committee recommends collaborating with
the lupus community to expand the development of linguistically
and culturally appropriate tools, resources and materials for
these adults and children with lupus, their caregivers and
health care providers.
Office of Women's Health
The Committee includes $25,712,000 for the Office of
Women's Health, which is $6,428,000 below the fiscal year 2017
enacted level and the 2018 budget request.
Faith Based Center
The Committee includes $1,299,000 for the Faith Based
Center, the same as fiscal year 2017 enacted level and the
fiscal year 2018 budget request.
OFFICE OF MEDICARE HEARINGS AND APPEALS
The Committee provides $112,381,000 for the Office of
Medicare Hearings and Appeals, which is $5,000,000 above the
fiscal year 2017 enacted level and $4,796,000 below the fiscal
year 2018 budget request. This Office supports hearings at the
administrative law judge level, the third level of Medicare
claims appeals.
Medicare Appeals Backlog.--The Committee is concerned with
the size of the Medicare Appeals Backlog. The Committee
supports the Office of Medicare Hearings and Appeals to take
administrative actions that will reduce the number of cases
awaiting a hearing with an Administrative Law Judge.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
The Committee provides $38,381,000 for the Office of the
National Coordinator for Health Information Technology (ONC),
which is $21,986,000 below the fiscal year 2017 enacted level
and the same as the fiscal year 2018 budget request. ONC is the
principal Federal entity charged with coordination of
Nationwide efforts to implement and use the most advanced
health information technology and the electronic exchange of
health information.
Patient Data Matching.--The Committee is aware that a
challenge inhibiting the safe and secure electronic exchange of
health information is the lack of a consistent approach to
matching patient data. The Committee encourages ONC to engage
with stakeholders on private-sector led initiatives to develop
a coordinated strategy that will promote patient safety by
accurately identifying patients to their health information.
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 record
(EHR) and electronic prescribing (e-prescribing) systems more
important than ever. 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 with partner agencies such as the
Centers for Disease Control and Prevention and the Bureau of
Justice Assistance in the Department of Justice.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $80,000,000 for the Office of
Inspector General (OIG), which is the same as the fiscal year
2017 enacted level and $11,915,000 above the fiscal year 2018
budget request. In addition, within the Health Care Fraud and
Abuse Control (HCFAC) program discretionary appropriations for
fiscal year 2018, the Committee provides the OIG with
$82,132,000. Mandatory appropriations for this office also are
contained in the HCFAC program and the Health Insurance
Portability and Accountability Act of 1996.
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.
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 2017 enacted
level and $6,268,000 above the 2018 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.
The Committee is concerned about reports of continued
discrimination against persons with disabilities in organ
transplant programs. Despite the Americans with Disabilities
Act (ADA) and Section 504 of the Rehabilitation Act prohibiting
discrimination on the basis of disability in organ
transplantation, a number of States have found it necessary to
enact laws to address continued barriers to receiving this
lifesaving care. These barriers are reported to include medical
professionals and transplant centers refusing to approve organ
transplants for people with disabilities who may need help in
order to follow complicated post-transplant treatment plans, or
deciding that people with disabilities should be given a lower
priority on waiting lists to receive an organ transplant. In
coordination with HRSA, the Committee urges the Office for
Civil Rights (OCR) to develop and issue guidance that clarifies
the obligations of ADA- and Section 504-covered entities
participating in the transplant process to provide equal access
to their programs to individuals with disabilities. In
developing such guidance, the Committee encourages OCR to
consider prohibiting such covered entities from, among other
things, denying medical services related to organ
transplantation, refusing to refer an individual to a
transplant center or other related specialist for the purpose
of evaluation or receipt of an organ transplant, and refusing
to place an individual on an organ transplant waiting list, or
placement of the individual at a lower-priority position on the
list than the position at which he or she would have been
placed if not for his or her disability.
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 $618,689,000 for fiscal year 2018,
which is $11,719,000 below the fiscal year 2017 enacted level
and the same as the fiscal year 2018 budget request.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
The Committee provides $1,739,258,000 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
$221,300,000 above the fiscal year 2017 enacted level and
$76,642,000 above the 2018 budget request.
The Committee does not include the authority requested in
the budget to create a Federal Emergency Response Fund.
However, the Committee recognizes the benefit of allowing some
flexibility to allow HHS to move more quickly in the event of a
public health emergency. To address this issue, the Committee
provides enhanced transfer authority to make it easier for HHS
to direct resources where they are needed in the case of a
public health emergency, such as an influenza pandemic.
National Ebola Training and Education Center.--The
Committee supports the continued efforts of the National Ebola
Training and Education Center (NETEC). Supplemental funds to
support NETEC were provided in P.L. 113-235.
Office of the Assistant Secretary for Preparedness and Response
The Committee provides $1,424,928,000 for activities
administered by the Office of the Assistant Secretary for
Preparedness and Response (ASPR). This amount is $28,300,000
above the fiscal year 2017 enacted level and $55,883,000 above
the fiscal year 2018 budget request. ASPR is responsible for
coordinating national policies and plans for medical and public
health preparedness and for administering a variety of public
health preparedness programs, including the National Disaster
Medical System, the Hospital Preparedness Cooperative Agreement
Grants Program, Project BioShield, and the Office of Biomedical
Advanced Research and Development Authority.
Biomedical Advanced Research and Development Authority (BARDA)
The Committee provides $520,000,000 for BARDA, which is
$8,300,000 above fiscal year 2017 enacted level and the fiscal
year 2018 budget request. In addition, the Committee provides
$530,000,000 for Project BioShield, which is $20,000,000 above
the fiscal year 2017 enacted level and the fiscal year 2018
budget request. The funds support acquisitions of medical
countermeasures (MCMs) 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 are 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.
Pathogen Reduction Technology.--The Committee commends
BARDA for taking the critical steps of supporting FDA-approved
pathogen reduction technology in U.S. blood centers to ensure
the safety of blood products being provided to patients and
specifically for patients at risk for exposure to emerging
pathogens. The Committee urges BARDA to continue funding the
development of pathogen reduction technology.
The Committee recommends $250,000,000 for the ASPR's
pandemic influenza program, which is $178,000,000 above the
fiscal year 2017 enacted level and $43,137,000 above the fiscal
year 2018 budget request. This funding supports research and
development of next-generation influenza MCMs, preparedness
testing and evaluation, and stockpiling.
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 2018, the level appropriated for the fund is
$840,600,000 after accounting for sequestration. The agreement
includes bill language in section 225 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:
------------------------------------------------------------------------
FY 2018
Agency Budget Activity Agreement
------------------------------------------------------------------------
CDC............................. Breast Feeding $8,000,000
Grants (Hospitals
Promoting
Breastfeeding).
CDC............................. Diabetes........... 72,000,000
CDC............................. Epidemiology and 40,000,000
Laboratory
Capacity Grants.
CDC............................. Healthcare 12,000,000
Associated
Infections.
CDC............................. Heart Disease and 107,950,000
Stroke Prevention
Program.
CDC............................. Good Health and 16,000,000
Wellness in Indian
Country.
CDC............................. Million Hearts 4,000,000
Program.
CDC............................. Preventive Health 160,000,000
and Health
Services Block
Grant.
CDC............................. Tobacco............ 126,000,000
CDC............................. Section 317 273,650,000
Immunization
Grants.
CDC............................. Lead Poisoning 17,000,000
Prevention.
CDC............................. Early Care 4,000,000
Collaboratives.
------------------------------------------------------------------------
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 the Biomedical Advanced
Research and Development Authority ten year contract authority.
Sec. 219. The Committee continues a provision relating to
publicly accessible information regarding uses of funds under
section 4002 of Public Law 111-148.
Sec. 220. The Committee continues language requiring HHS to
include certain information concerning the number of full-time
Federal employees and contractors working on the Affordable
Care Act in the fiscal year 2018 budget request.
Sec. 221. The Committee continues specific report
requirements for CMS's marketplaces activities in the fiscal
year 2018 budget request.
Sec. 222. The Committee continues certain Congressional
notification requirements.
Sec. 223. The Committee continues a provision prohibiting
CMS Program Management account from being used to support risk
corridor payments.
Sec. 224. The Committee continues a provision requiring HHS
to submit an analysis of the impact of section 2713 of the PHS
Act on discretionary programs.
Sec. 225. The Committee continues language directing the
spending of the Prevention and Public Health fund.
Sec. 226. The Committee includes a new provision
prohibiting funds from being used for Title X family planning
activities.
Sec. 227. The Committee continues a provision relating to
breast cancer screening.
Sec. 228. The Committee includes a new provision relating
to indirect cost negotiated rates.
Sec. 229. The Committee includes a new provision
prohibiting funds from being used for the Navigators program.
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
The Committee recommends $15,953,790,000 for the Education
for the Disadvantaged programs, which is $190,000,000 below the
fiscal year 2017 enacted level and $393,768,000 below the
fiscal year 2018 budget request. Of the total amount available,
$5,035,990,000 is appropriated for fiscal year 2018 for
obligation on or after July 1, 2018 and $10,841,177,000 is
appropriated for fiscal year 2018 for obligation on or after
October 1, 2018. 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 2018, the Committee recommends
$15,459,802,000 for Title I grants to Local Educational
Agencies (LEAs, or school districts), which is the same as the
fiscal year 2017 enacted level and $421,656,000 below the
fiscal year 2018 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,
$6,459,401,000 is available for Basic Grants to LEAs, which is
the same as the fiscal year 2017 enacted level and $28,344,000
above the fiscal year 2018 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
$5,000,000 is made available to the Secretary of Education on
October 1, 2017, 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 2017
enacted level and the fiscal year 2018 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 $3,819,050,000 for Title I
Targeted Grants, which is the same as the fiscal year 2017
enacted level and $275,000,000 above the fiscal year 2018
budget request. Targeted Grants provide higher payments to
school districts with high numbers or percentages of low-income
students.
The Committee recommends $3,819,050,000 for Title I
Education Finance Incentive Grants (EFIGs), which is the same
as the fiscal year 2017 enacted level and $275,000,000 above
the fiscal year 2018 budget request. EFIGs provide payments to
States and school districts that incorporate ``equity'' and
``effort'' factors to improve the equity of State funding
systems.
The Committee is aware of the budget request proposal to
include up to $1,000,000,000 for grants to local educational
agencies to implement weighted per-pupil funding systems,
including open enrollment systems that allow students to enroll
in a public school selected by their parents. However, the
Committee notes that such a program has not been authorized.
Accordingly, the Committee has not provided funding for such a
program within this bill. Funding for this approach will be
considered should it be authorized in law.
Comprehensive Literacy Development Grants
The Committee recommends no funding for Comprehensive
Literacy Development Grants, which is $190,000,000 below the
fiscal year 2017 enacted level and the same as the fiscal year
2018 budget request. The Committee notes that the current
cohort of grantees will complete projects in fiscal year 2017,
so program termination will not impact funding for any existing
grantees.
Innovative Approaches to Literacy
The Committee recommends $27,000,000 for Innovative
Approaches to Literacy, the same as the 2017 enacted level and
$27,000,000 above the fiscal year 2018 budget request. This
program provides competitive grants to support school
libraries.
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 2017 enacted level and $712,000 above the fiscal year 2018
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 2017 enacted level and $91,000 above
the fiscal year 2018 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 2017 enacted level and $85,000 above the fiscal year 2018
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 $1,333,603,000 for Federal Impact
Aid programs, which is $5,000,000 above the fiscal year 2017
enacted level and $97,168,000 above the fiscal year 2018 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 $1,194,233,000 for Basic Support
Payments to LEAs, which is $5,000,000 above the fiscal year
2017 enacted level and $28,221,000 above the fiscal year 2018
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 2017 enacted level and $92,000 above the fiscal year 2018
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 2017 enacted
level and $9,000 above the fiscal year 2018 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 2017 enacted
level and $33,000 above the fiscal year 2018 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 2017
enacted level and $66,813,000 above the fiscal year 2018 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 $2,261,064,000 for School
Improvement Programs, which is $2,147,503,000 below the fiscal
year 2017 enacted level and $1,563,833,000 above the fiscal
year 2018 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 no funding for Supporting
Effective Instruction State Grants, which is $2,055,830,000
below the fiscal year 2017 enacted level and the same as the
fiscal year 2018 budget request. This program duplicates
activities that may be supported with other funds, has not
demonstrated success in contributing to improved teacher
quality and makes formula-based allocations to school districts
that often are too small to have a meaningful impact on student
outcomes.
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 2017 enacted level and $32,000 above the fiscal
year 2018 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 $1,000,000,000 for 21st Century
Community Learning Centers, which is $191,673,000 below the
fiscal year 2017 enacted level and $1,000,000,000 above the
fiscal year 2018 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 complement and reinforce the regular
school-day program for participating students and may also fund
local activities that are included as part of an expanded
learning time program. The Committee notes that $1,000,000,000
is the level authorized for this program by the ESSA.
State Assessments
The Committee recommends $369,100,000 for State
Assessments, which is the same as the fiscal year 2017 enacted
level and $8,181,000 below the fiscal year 2018 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 $77,000,000 for the Education for
Homeless Children and Youth program, which is the same as the
fiscal year 2017 enacted level and $7,133,000 above the fiscal
year 2018 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 2017 enacted level
and $12,000 above the fiscal year 2018 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
2017 level and $33,397,000 above the fiscal year 2018 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
2017 level and $32,453,000 above the fiscal year 2018 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 2017 enacted
level and $334,000 above the fiscal year 2018 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 $50,000,000 for Comprehensive
Centers, which is the same as the fiscal year 2017 enacted
level and $1,347,000 above the fiscal year 2018 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 $500,000,000 for Student Support
and Academic Enrichment (SSAE) State Grants, which is
$100,000,000 above the fiscal year 2017 enacted level and
$500,000,000 above the fiscal year 2018 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.
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. The Committee
recognizes the importance of funding Pre K-12 computer science
education to address national security, and ensure American
competitiveness. Supporting education in the science,
technology, engineering, arts, and mathematics fields,
particularly computer science, is critical to ensure that our
nation continues to lead in innovation. As computer science is
a basic skill in the 21st century global economy, the Committee
encourages the Department to support Pre K-12 computer science
education to schools across the country.
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.
INDIAN EDUCATION
The Committee recommends $164,939,000 for Indian Education,
which is the same as the fiscal year 2017 enacted level and
$21,274,000 above the fiscal year 2018 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 2017
enacted level and $191,000 above the fiscal year 2018 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 $57,993,000 for Special Programs
for Indian Children, which the same as the fiscal year 2017
enacted level and $20,072,000 above the fiscal year 2018 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.
National Activities
The Committee recommends $6,565,000 for National
Activities, which is the same as the fiscal year 2017 enacted
level and $1,011,000 above the fiscal year 2018 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 continues funding for a Native
American and Alaska Native Language Immersion Program, the same
as the fiscal year 2018 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 $747,904,000 for Innovation and
Improvement programs, which is $139,671,000 below the fiscal
year 2017 enacted level and $460,122,000 below the fiscal year
2018 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 $100,000,000
below the fiscal year 2017 enacted level and $370,000,000 below
the fiscal year 2018 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.
The Committee is aware of the budget request proposal to
include up to $250,000,000 for grants to local educational
agencies to implement a program of awarding scholarships to
students from low-income families to attend a private school
selected by their parents. However, the Committee notes that
such a program has not been authorized. Accordingly, the
Committee has not provided funding for such a program within
this bill. Funding for this approach will be considered should
a program be authorized.
Teacher and School Leader Incentive Grants
The Committee recommends $200,000,000 for the Teacher and
School Leader Incentive Grants program, which is the same as
the fiscal year 2017 enacted level and $437,000 above the
fiscal year 2018 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 no funding for American History
and Civics Academies, $1,815,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request. This program reaches only a very limited number of
teachers and students since an academy may select no more than
300 teachers or students for participation.
American History and Civics National Activities
The Committee recommends $1,700,000 for American History
and Civics National Activities, the same as the fiscal year
2017 enacted level and $1,700,000 above the fiscal year 2018
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 $42,000,000 for the Supporting
Effective Educator Development (SEED) grant program,
$23,000,000 below the fiscal year 2017 level and the same as
the fiscal year 2018 budget request. SEED provides competitive
grants to Institutions of Higher Education (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 $14,500,000 below the fiscal
year 2017 level and the same as the budget request. This
program supports a small number of grantees and has minimal
national impact. While school leadership is important, other
Federal funds are available to support improved leadership in
high-need schools.
Charter Schools Grants
The Committee recommends $370,000,000 for Charter Schools
Grants, which is $27,828,000 above the fiscal year 2017 enacted
level and $130,000,000 below the fiscal year 2018 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.
Magnet Schools Assistance
The Committee recommends $96,463,000 for the Magnet Schools
Assistance program, which is $1,184,000 below the fiscal year
2017 enacted level and the same as the fiscal year 2018 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.
Ready to Learn Programming
The Committee recommends $25,741,000 for Ready to Learn
Programming, which is the same as the fiscal year 2017 enacted
level and $25,741,000 above the fiscal year 2018 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.
Arts in Education
The Committee recommends no funding for Arts in Education,
$27,000,000 below the fiscal year 2017 level and the same as
the fiscal year 2018 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.
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 2017 enacted level and $12,000,000 above the fiscal year
2018 budget request. This program has limited impact, and the
Department can support research on gifted and talented
education through other Institute of Education Science
programs.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
The Committee recommends $138,000,000 for Safe Schools and
Citizenship Education programs, which is $13,254,000 below the
fiscal year 2017 enacted level and $3,143,000 above the fiscal
year 2018 budget request. This appropriation account includes
programs authorized under parts of Title IV of the ESEA.
Promise Neighborhoods
The Committee recommends $60,000,000 for Promise
Neighborhoods, which is $13,254,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 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 $68,000,000 for School Safety
National Activities, which is the same as the fiscal year 2017
enacted level and $6,857,000 below the fiscal year 2018 budget
request. This program includes a variety of competitive grants
that aim to increase students' safety and well-being.
Full-Service Community Schools
The Committee recommends $10,000,000 for Full-Service
Community Schools, which is the same as the fiscal year 2017
level and $10,000,000 above the fiscal year 2018 budget
request. 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 2017 enacted level and $1,402,000 above the fiscal year
2018 budget request. Of this amount provided for the 2018-2019
academic year, funds are appropriated for obligation on or
after July 1, 2018 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 is interested in information on the
effectiveness of English Learner (EL) programs in delivering
adequate services and accommodations to qualified students and
requests the Department to include information on outcomes in
English language acquisition and proficiency levels in math and
reading nationwide, disaggregated, to the extent possible, by
the major race and ethnicity categories in the Decennial
Census, in the fiscal year 2019 Congressional Justification.
SPECIAL EDUCATION
The Committee recommends $13,251,691,000 for programs
authorized under the Individuals with Disabilities Education
Act (IDEA) for children with disabilities. This is $187,333,000
above the fiscal year 2017 enacted level and $309,565,000 above
the fiscal year 2018 budget request. Of the total amount
available, $1,864,818,000 is available for obligation on July
1, 2018, and $11,164,824,000 is available for obligation on
October 1, 2018. 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 $12,202,848,000 for Part B Grants
to States, which is $200,000,000 above the fiscal year 2017
enacted level and $312,646,000 above the fiscal year 2018
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 2017 enacted level and
$700,000 above the fiscal year 2018 budget request. These funds
provide additional assistance to States to help them make free,
appropriate public education available to children with
disabilities ages three through five.
Grants for Infants and Families
The Committee recommends $458,556,000 for Grants for
Infants and Families, which is the same as the fiscal year 2017
enacted level and $872,000 above the fiscal year 2018 budget
request. These funds provide additional assistance to States to
help them make free, appropriate public education available to
children with disabilities from birth through age two.
IDEA National Activities
The Committee recommends $222,049,000 for the IDEA National
Activities program, which is $12,667,000 below the fiscal year
2017 enacted level and $4,653,000 below the fiscal year 2018
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
$38,630,000 for State Personnel Development, which is the same
as the fiscal year 2017 enacted level and $2,921,000 below the
fiscal year 2018 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 $44,261,000 for Technical Assistance and
Dissemination, which is $12,667,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 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
$83,700,000 for Personnel Preparation, which is the same as the
fiscal year 2017 enacted level and $159,000 above the fiscal
year 2018 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 2017 enacted level and $52,000 above the
fiscal year 2018 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 $28,047,000 for Educational Technology,
Media, and Materials, which is the same as the fiscal year 2017
enacted level and $1,943,000 below the fiscal year 2018 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. The Committee recognizes the ongoing
progress made with the tools and services provided under this
program that have allowed more than 440,000 students with
disabilities free access to more than 515,000 books in
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 $3,562,582,000 for Rehabilitation
Services, which is $26,993,000 above the fiscal year 2017
enacted level and $426,000 below the fiscal year 2018 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 $3,452,931,000 for Vocational
Rehabilitation (VR) State Grants, which is $54,377,000 above
the fiscal year 2017 enacted level and the same as the fiscal
year 2018 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.
Client Assistance State Grants
The Committee recommends $13,000,000 for Client Assistance
State Grants, which is the same as the fiscal year 2017 enacted
level and $25,000 above the fiscal year 2018 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 $29,388,000 for the Training
program, which is the same as the fiscal year 2017 enacted
level and $743,000 below the fiscal year 2018 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 2017
enacted level and $11,000 above the fiscal year 2018 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 2017 enacted level and $34,000 above the fiscal year 2018
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 no funding for Supported
Employment State Grants, which is $27,548,000 below the fiscal
year 2017 enacted level and the same as the fiscal year 2018
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. Because supported employment
is now an integral part of the vocational rehabilitation State
grants program, there is no longer a need for a separate
funding stream to ensure the provision of these services. This
elimination will therefore reduce unnecessary administrative
burden. The Committee expects State vocational rehabilitation
agencies to continue to provide supported employment services
in fiscal year 2018 to approximately the same number of
individuals as they did previously.
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 2017 enacted level and $63,000 above the
fiscal year 2018 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 $10,500,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults, which is
$164,000 above the fiscal year 2017 enacted level and $184,000
above the fiscal year 2018 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 $224,447,000 for Special
Institutions for Persons with Disabilities, which is $7,725,000
above as the fiscal year 2017 enacted level and $8,137,000
above the fiscal year 2018 budget request.
AMERICAN PRINTING HOUSE FOR THE BLIND
The Committee recommends $26,431,000 for the American
Printing House for the Blind, which is $1,000,000 above the
fiscal year 2017 enacted level and $1,048,000 above the fiscal
year 2018 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 2017 enacted level and $133,000 above the fiscal
year 2018 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 $128,000,000 for Gallaudet
University, which is $6,725,000 above the fiscal year 2017
enacted level and $6,956,000 above the fiscal year 2018 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 2017 enacted level and $244,245,000 above the
fiscal year 2018 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 2017 enacted level and $168,099,000 above the
fiscal year 2018 budget request. Funds are made available for
obligation on October 1, 2018.
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.
Maker Education.--The Committee recogmzes the need for
increased maker education in career and technical education in
addition to K-12 curriculum in response to the increasing
reliance on tools such as 3D printers, laser cutters, desktop
machines, and programs for digital design becoming more
affordable. Maker education exposes students to hands on
project based learning approaches that build critical skills
needed to increase economic growth and encourages students to
imagine, create, innovate, and collaborate through the process
of manufacturing, testing and demonstrating their ideas. The
Committee encourages the expansion of maker-spaces in schools,
which are community spaces that provide access to tools,
technology and knowledge for learners and entrepreneurs and
result in the prototyping or creation of physical goods, and
support the development of educational opportunities for
personal growth, workforce training, and early stage business
ventures.
National Programs
The Committee recommends $7,421,000 for National Programs,
which is the same as the fiscal year 2017 enacted level and
$19,986,000 below the fiscal year 2018 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 2017 enacted level and $96,106,000 above the fiscal
year 2018 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
2017 enacted level and $26,000 above the fiscal year 2018
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 $24,198,210,000 for Student
Financial Assistance programs, which is the same as the fiscal
year 2017 enacted level and $1,265,584,000 above the fiscal
year 2018 budget request.
Pell Grants
The Committee recommends $22,475,352,000 for the Pell Grant
program, which is the same as the fiscal year 2017 enacted
level and $42,726,000 above the fiscal year 2018 budget
request. These funds will support Pell grants to students for
the 2018-2019 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 surplus, 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. Combined with mandatory
funding streams, the maximum Pell Grant in 2018-2019 will be
maintained at $5,920.
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 2017 enacted level and
$733,130,000 above the fiscal year 2018 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 2017
enacted level and $489,728,000 above the fiscal year 2018
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 2017
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 $1,697,711,000 for the Student Aid
Administration (SAA), which is $120,857,000 above the fiscal
year 2017 enacted level and the same as the fiscal year 2018
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
$680,711,000 for salaries and expenses, which $15,932,000 below
the fiscal year 2017 enacted level and the same as the fiscal
year 2018 budget request.
Loan Servicing Activities.--Within the total provided for
SAA, the Committee recommends $1,017,000,000 for Loan Servicing
Activities, which is $136,789,000 above the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request.
HIGHER EDUCATION
The Committee recommends $2,038,126,000 for Higher
Education programs, which is $17,313,000 below the fiscal year
2017 enacted level and $492,821,000 above the fiscal year 2018
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 2017 enacted level and 86,534,000 above the fiscal
year 2018 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 2017 enacted level and $205,000 above the fiscal year 2018
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 2017 enacted level and
$18,000 above the fiscal year 2018 budget request. This program
provides expanded post baccalaureate educational opportunities
for the academic attainment of Hispanic and low-income
students. In addition, it expands academic offerings and
enhances program quality at 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 2017 enacted level and $465,000
above the fiscal year 2018 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 2017 enacted level and $120,000 above
the fiscal year 2018 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. Institutions
may use funds to build endowments, provide scholarships and
fellowships, and to assist students with the enrollment and
completion of post baccalaureate and professional degrees.
Strengthening Predominantly Black Institutions
The Committee recommends $9,942,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is the
same as the fiscal year 2017 enacted level and $19,000 above
the fiscal year 2018 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
2017 enacted level and $6,000 above the fiscal year 2018 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 2017 enacted level and
$26,000 above the fiscal year 2018 budget request, to provide
competitive grants to improve capacity to serve Alaska Native
and Native Hawaiian students.
Native American Serving Non-Tribal Institutions
The Committee recommends $3,348,000 for the Native American
Serving Non-Tribal Institutions program, which is the same as
the fiscal year 2017 enacted level and $6,000 above the fiscal
year 2018 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 2017 enacted level and
$52,000 above the fiscal year 2018 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 program, which is the same as the
fiscal year 2017 enacted level and $65,103,000 above the fiscal
year 2018 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 no funding for
the Overseas Programs, which is $7,061,000 below the fiscal
year 2017 enacted level and the same as the fiscal year 2018
budget request. Funding for these programs support group
projects, faculty research, special bilateral research, and
doctoral dissertation research conducted abroad. The U.S.
Department of State funds similar programs that can continue to
support these activities.
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 2017 level and $22,000 above the
fiscal year 2018 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 2017 enacted level and $18,000 above the
fiscal year 2018 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 2017 enacted level and $16,000
above the fiscal year 2018 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 $1,010,000,000 for TRIO programs,
which is $60,000,000 above the fiscal year 2017 enacted level
and $201,711,000 above the fiscal year 2018 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 intends that funds be allocated in the same
ratio as they were allocated during fiscal year 2017.
Gaining Early Awareness and Readiness for Undergraduate Programs
The Committee recommends $350,000,000 for Gaining Early
Awareness and Readiness for Undergraduate Programs (GEAR UP),
which is $10,246,000 above the fiscal year 2017 enacted level
and $131,000,000 above the fiscal year 2018 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 pursue
successfully postsecondary education.
In addition to making continuation awards to existing
grantees, the Committee directs the Department to conduct a new
grant competition for this program in fiscal year 2018. The
Department is strongly encouraged to publish the notice
inviting applications as soon as possible.
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.
Graduate Assistance in Areas of National Need
The Committee recommends $5,775,000 for the Graduate
Assistance in Areas of National Need program, which is
$22,272,000 below the fiscal year 2017 enacted level and the
same as the fiscal year 2018 budget request. This program
duplicates the efforts of other Federally-funded programs that
support fellowships in these disciplines within the Department
and other agencies. The Committee recommendation will enable
the Department to fund fully the continuation costs of current
awards. This program operates at a high per student cost,
$50,000 per student, and as a result, the program supports only
a limited number of graduate students.
Teacher Quality Partnership Grants
The Committee recommends no funding for Teacher Quality
Partnerships, which is $43,092,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request. The Department has determined that the authority for
this program is overly restrictive and does not provide States,
school districts and institutions of higher education the
flexibilities needed to make meaningful design changes to
teacher preparation, recruitment and induction to meet their
needs. Other Federal and State programs may provide funding for
these activities. Existing authority will enable grantees to
close out existing projects and draw down grant funds already
awarded in prior years.
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 2017 enacted level and the same as the
fiscal year 2018 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 2017 enacted
level and $422,000 above the fiscal year 2018 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 2017 enacted level and $52,000 above
the fiscal year 2018 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 $434,000 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 $1,000
below the fiscal year 2017 enacted level and the same as the
fiscal year 2018 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 $20,445,000 for the HBCU Capital
Financing program, which $39,000 below the fiscal year 2017
enacted level and the same as the fiscal year 2018 budget
request. Funds are available through September 30, 2018. 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 $333,000 for the administrative
expenses to carry out the program and $20,112,000 for loan
subsidy costs that will be sufficient to guarantee up to
$313,513,000 in new loans in fiscal year 2018. 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 $605,267,000 for the Institute of
Education Sciences, which is the same as the fiscal year 2017
enacted level and $11,572,000 below the fiscal year 2018 budget
request. This account supports education research, statistics,
dissemination, evaluation, and assessment activities.
The Committee recognizes the lack of publicly available
research indicating the specific educational needs of students
with elevated blood lead levels. The Committee encourages the
Department to collaborate with the CDC to improve awareness of
educational intervention strategies for children with elevated
blood lead levels. The Department and the CDC are expected to
implement prioritization initiatives and provide technical
assistance that informs educators, parents, and State and local
education agencies about the severity and symptoms of lead
poisoning and intervention strategies for children with
elevated blood lead levels. The Committee requests an update on
the Department's strategy and its outcomes on this topic.
Research, Development, and Dissemination
The Committee recommends $187,500,000 for Research,
Development, and Dissemination, which is the same as the fiscal
year 2017 enacted level and $7,129,000 below the fiscal year
2018 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.
Statistics
The Committee recommends $109,500,000 for the activities of
the National Center for Education Statistics (NCES), which is
the same as fiscal year 2017 enacted level and $2,287,000 below
the fiscal year 2018 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
2017 enacted level and $103,000 above the fiscal year 2018
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 support fully
continuation costs for grants made in prior years.
Research in Special Education
The Committee recommends $54,000,000 for Research in
Special Education, which is the same as the fiscal year 2017
enacted level and $103,000 above the fiscal year 2018 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
2017 enacted level and $21,000 above the fiscal year 2018
budget request. This program awards competitive grants,
contracts and cooperative agreements to assess the
implementation of the IDEA and the effectiveness of State and
local efforts to provide special education and early
intervention programs and services to infants, toddlers, and
children with disabilities.
Statewide Data Systems
The Committee recommends $32,281,000 for Statewide Data
Systems, which is the same as the fiscal year 2017 enacted
level and $2,192,000 below the fiscal year 2018 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 $156,745,000 for Assessment, which
is the same as the fiscal year 2017 enacted level and $191,000
below the fiscal year 2018 budget request. This amount includes
$7,745,000 for the National Assessment Governing Board (NAGB),
which is the same as the fiscal year 2017 enacted level and
$474,000 below the fiscal year 2018 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 $598,756,000 for Departmental
Management, which is $1,000,000 below the fiscal year 2017
enacted level and $7,184,000 below the fiscal year 2018 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 $431,000,000 for Program
Administration, which is $1,000,000 below the fiscal year 2017
enacted level and $7,000,000 below the fiscal year 2018 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.
Absenteeism.--The Committee notes the need to support
evidence-based strategies to address chronic absenteeism, and
the need to expand the reach of attendance-focused activities
that have been found to be more likely to decrease the
percentage of students who miss twenty or more days of school
each year. Students who are chronically absent, on average,
score lower than students with better attendance on the
National Assessment for Educational Progress, regardless of
race or socioeconomic status. Students who are chronically
absent in preschool, kindergarten, and 1st grade are much less
likely to read at grade level by the 3rd grade. Additional
studies demonstrate the connection between chronic absenteeism,
low academic achievement and high dropout rates and suggest
that attendance may predict a student's academic progress as
effectively as test scores. The Committee notes that chronic
absenteeism programs that use school, family, and community
partnership practices can significantly decrease chronic
absenteeism.
Education Costs Related to Illegal Immigration.--The
Committee requests an update to the report submitted to
Congress by the Department of Education on this topic as it
appeared in the explanatory statement accompanying division H
of the Consolidated Appropriations Act, 2016 (P.L. 114-113).
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.
Physician Assistant (PA) Education Access.--The Committee
encourages the Secretary of Education to investigate the impact
that lower Federal Direct Unsubsidized Stafford Loan borrowing
limits for PA students has on access to physician assistant
education, overall student loan debt upon graduation, and
impact on PA graduate employment in underserved and rural
communities.
Puerto Rico.--The Committee understands that Puerto Rico is
facing additional technical assistance needs as it works to
restructure its education system, and encourages the Department
to work closely with Puerto Rico to identify and address those
needs.
Science, Technology, Engineering, and Math (STEM).--The
Committee recognizes the benefits and advantages of a diverse
workforce and encourages the Department of Education to
increase diversity in the STEM workforce and pipeline by
working to assist small and disadvantaged businesses, minority
serving institutions, and underserved communities in developing
greater diversity. The Committee supports robust investments in
STEM training for teachers, internship opportunities in STEM
industries such as biotechnology, and creating clear education
pathways in STEM between K-12, community colleges, and four-
year institutions.
The Committee encourages the Secretary of Education to
study the feasibility of creating a database for schools, which
would document employees of educational institutions who have
been convicted of sexual assault and make such information
available to the public.
Youth Deradicalization.--As defense, security, law
enforcement and diplomatic efforts work together to combat
extremism and terror at home and abroad, the effectiveness of
our counter-terrorism policy and prevention efforts also need
to continuously evolve. Domestically, the public education
system may be a key point for intervention within the United
States, but there is a gap in research or guidance from Federal
agencies on the most effective methods, practices, programs,
curriculum, modules, methodologies and holistic approaches to
combating radicalization and extremist ideology influence on
youth and students. In order to inform instruction, teachers,
administrators and communities, such research could help assess
and implement preventative measures to combat the growing
impact of extremist and radical organizations on youth, school
climate, safety and quality. The Committee believes the
National Academy of Education may be well suited to conduct
exploratory research to identify the best practices and most
effective intervention models to combat the influence of
extremist organizations and radicalization of youth in schools.
OFFICE FOR CIVIL RIGHTS
The Committee recommends $108,500,000 for the Office for
Civil Rights, which is the same as the fiscal year 2017 enacted
level and $1,703,000 below the fiscal year 2018 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.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $59,256,000 for the Office of
Inspector General, which is the same as the fiscal year 2017
enacted level and $1,887,000 below the fiscal year 2018 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, 2018 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 modifies a provision to rescind
$3,270,844,000 from the Pell Grant program surplus.
TITLE IV--RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
The Committee recommends $8,000,000 for the Committee for
Purchase From People Who Are Blind or Severely Disabled
(referred to as the AbilityOne Commission), which is the same
as the fiscal year 2017 enacted level and $1,883,000 above the
fiscal year 2018 budget request. The Committee believes
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
ensure the AbilityOne Commission maintains its oversight
capacity, the Committee continues bill language requiring the
AbilityOne Commission to establish written agreements with any
central nonprofit agencies (CNA). The written agreements ensure
the AbilityOne Commission can conduct appropriate audit,
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 fees charged by a CNA. 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), and
e. contract award ID associated with any
order, where applicable.
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, and
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.
Office of Inspector General.--The Committee recommends not
less than $1,250,000 for the Office of Inspector General.
Corporation for National and Community Service
OPERATING EXPENSES
The Committee recommends $1,030,358,000 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 2017 enacted
level and $895,366,000 above the fiscal year 2018 budget
request.
Volunteers in Service to America (VISTA)
The Committee recommends $92,364,000 for VISTA, which is
the same as the fiscal year 2017 enacted level and $87,454,000
above the fiscal year 2018 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, which is the same as the
fiscal year 2017 enacted level and $201,766,000 above the
fiscal year 2018 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 2018 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 2017
enacted level and $383,669,000 above the fiscal year 2018
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.
Innovation, Assistance, and Other Activities
The Committee recommends $5,000,000 for this program, which
is the same as the fiscal year 2017 enacted level and
$5,000,000 above the fiscal year 2018 budget request.
Evaluation
The Committee recommends $4,000,000 for this program, which
is the same as the fiscal year 2017 enacted level and
$4,000,000 above the fiscal year 2018 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 2017 enacted level and
$5,913,000 above the fiscal year 2018 budget request. This
program supports residential, team-based service opportunities
for individuals aged 18-24.
State Commission Administrative Grants
The Committee recommends $16,538,000 for this program,
which is the same as the fiscal year 2017 enacted level and
$16,538,000 above the fiscal year 2018 budget request. Funds
are used for formula grants to support State oversight of
service programs.
Payment to the National Service Trust
The Committee recommends $206,842,000 for payments to the
National Service Trust, which is the same as the fiscal year
2017 enacted level and $206,842,000 above the fiscal year 2018
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, which is the same as the fiscal year 2017 enacted
level and $17,998,000 below the fiscal year 2018 budget
request.
OFFICE OF INSPECTOR GENERAL
The Committee recommends $5,750,000 for the Office of
Inspector General, which is the same as the fiscal year 2017
enacted level and $2,182,000 above the fiscal year 2018 budget
request.
ADMINISTRATIVE PROVISIONS
Sec. 401. The Committee continues bill language that
combines separate matching requirements for AmeriCorps grants.
Sec. 402. The Committee continues bill language related to
National Service Trust minimum share requirements.
Sec. 403. The Committee continues bill language related to
donations.
Sec. 404. The Committee continues bill language related to
veterans.
Sec. 405. The Committee continues bill language related to
criminal history background checks.
Corporation for Public Broadcasting
The Committee recommends $445,000,000 for the Corporation
for Public Broadcasting for fiscal year 2020. This
appropriation will fund content development, community
services, and other local station and system needs for the
Corporation for Public Broadcasting (CPB). The Committee does
not provide funding for the public broadcasting interconnection
system. The Committee recommendation is $50,000,000 below the
fiscal year 2017 enacted level and $445,000,000 more than the
fiscal year 2018 budget request.
The Committee values the contributions of public television
and radio stations in serving the needs of their local
communities. National organizations should continue to invest
in high quality, national, diverse programming to be made
available to locally-owned and operated stations. In fulfilling
the mission of the Public Broadcasting Act, CPB should
encourage Federally funded content distributed through National
organizations to focus on rural America, civic discourse and
engagement, and life-long learning. This content should reflect
America's increasing diversity, including age, ethnicity, race,
gender, socio-economic background, geography, and points of
view. Local television and radio stations, in the interest of
best serving their communities, should continue to have
discretion on what content to broadcast from the National
organizations.
National Minority Consortia.--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 $46,650,000 for the Federal
Mediation and Conciliation Service, which is the same as the
fiscal year 2017 enacted level and $2,005,000 less than the
fiscal year 2018 budget request.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
The Committee recommends $17,134,000 for the Federal Mine
Safety and Health Review Commission, which is $50,000 less than
the fiscal year 2017 enacted level and $81,000 more than the
fiscal year 2018 budget request.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION
The Committee recommends $231,000,000 for the Institute of
Museum and Library Services (IMLS), which is the same as the
fiscal year 2017 enacted level and $208,000,000 above the
fiscal year 2018 budget request. Within the total for IMLS, the
Committee recommends the following amounts:
------------------------------------------------------------------------
Budget Activity This Bill
------------------------------------------------------------------------
Library Services Technology Act:
Grants to States................................. $156,103,000
Native American Library Services................. 4,063,000
National Leadership: Libraries................... 13,406,000
Laura Bush 21st Century Librarian................ 10,000,000
Museum Services Act:
Museums for America.............................. 21,149,000
21st Century Museum Professionals................ 0
Conservation Project Support..................... 0
Native American/Hawaiian Museum Services......... 972,000
National Leadership: Museums..................... 8,113,000
African American History and Culture Act:
Museum Grants for African American History and 1,481,000
Culture.........................................
Museum and Library Services Act General Provisions:
Research, Analysis and Data Collection........... 1,713,000
Program Administration............................... 14,000,000
------------------------------------------------------------------------
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 2017
enacted level. These funds provide administrative and
management support for all programs administered by IMLS. 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 $12,175,000 for the Medicare
Payment Advisory Commission, which is $250,000 more than the
fiscal year 2017 enacted level and $120,000 less than the
fiscal year 2018 budget request.
The Medicare Payment Advisory Commission (MedPAC) is an
independent agency tasked with advising the U.S. Congress on
issues affecting the Medicare program. In addition to advising
the Congress on payments to private health plans participating
in Medicare and providers in Medicare's traditional fee-for-
service program, MedPAC is also responsible for providing
analysis on access to care, quality of care, and other issues
affecting Medicare.
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
The Committee provides $7,500,000 for the Medicaid & CHIP
Payment and Access Commission, which is $265,000 less than the
fiscal year 2017 enacted level and $1,200,000 below the fiscal
year 2018 budget request.
The Committee supports the unique role played by the
Medicaid and CHIP Payment and Access Commission (MACPAC) in
providing nonpartisan policy and data analysis on a wide array
of issues affecting Medicaid and the State Children's Health
Insurance Program. In addition to the analysis, MACPAC is also
responsible for making recommendations to ensure the programs
continue to serve low-income and other vulnerable populations,
including an examination of the budget consequences. The
Committee encourages MACPAC to include in their policy
recommendations additional specific recommended policy changes
to the program that can results in savings to accompany any
policy changes that may entail additional costs. Recognizing
the wide array of State practices and States' unique
partnership role in running the Medicaid program, the Committee
also encourages MACAPAC to consider how it may serve as a
resource in highlighting State innovations in delivery system
reforms, cost-containment strategies, care coordination best
practices, and other efforts to run an efficient and effective
State Medicaid program.
National Council on Disability
SALARIES AND EXPENSES
The Committee recommends $3,200,000 for the National
Council on Disability, which is $50,000 below the fiscal year
2017 enacted level and $11,000 below the fiscal year 2018
budget request.
National Labor Relations Board
SALARIES AND EXPENSES
The Committee recommends $249,000,000 for the National
Labor Relations Board, which is $25,224,000 less than the
fiscal year 2017 enacted level and $9,000,000 less than the
fiscal year 2018 budget request.
ADMINISTRATIVE PROVISIONS
Sec. 406. The Committee continues a provision relating to
electronic voting for purposes of collective bargaining.
Sec. 407. The Committee includes a new provision relating
to jurisdiction over Indian tribes.
Sec. 408. The Committee includes a new provision relating
to joint-employer standards.
Sec. 409. The Committee includes a new provision relating
to collective bargaining units.
National Mediation Board
SALARIES AND EXPENSES
The Committee recommends $13,500,000 for the National
Mediation Board, which is $300,000 above the fiscal year 2017
enacted level and $295,000 below the fiscal year 2018 budget
request.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
The Committee recommends $12,875,000 for the Occupational
Safety and Health Review Commission, which is $350,000 below
the fiscal year 2017 enacted level and $260,000 above the
fiscal year 2018 budget request.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
The Committee recommends $22,000,000 for dual benefits,
which is $3,000,000 below the fiscal year 2017 enacted level
and the same as the fiscal year 2018 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
$1,000,000 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 same as the fiscal year
2017 enacted level and the fiscal year 2018 budget request.
LIMITATION ON ADMINISTRATION
The Committee recommends a consolidated limitation of
$113,500,000 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 2017 enacted level and $2,275,000 above the
fiscal year 2018 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 $10,000,000
from the Railroad Retirement and Railroad Unemployment
Insurance Trust Funds for the Office of Inspector General,
which is equal to the fiscal year 2017 enacted level and
$1,563,000 above the fiscal year 2018 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 2017 enacted level and the
fiscal year 2018 budget request. This appropriation provides
reimbursement to the Social Security trust funds for non-trust
fund activities.
SUPPLEMENTAL SECURITY INCOME PROGRAM
The Committee recommends $38,591,635,000 for the
Supplemental Security Income (SSI) program, which is
$5,026,528,000 below the fiscal year 2017 enacted level and
$35,109,000 above the fiscal year 2018 budget request. The
Committee recommends $19,500,000,000 in advance funding for the
first quarter of fiscal year 2019, as requested.
Research and Demonstration
Within the appropriation for SSI, the Committee recommends
$101,000,000 for research and demonstration activities, which
is $43,000,000 more than the fiscal year 2017 enacted level and
the same as the fiscal year 2018 budget request.
The Committee does not include bill language extending the
period of availability for research and demonstrations. The
Committee requests, as part of the fiscal year 2019
Congressional Justification, for each research or demonstration
project the total cost obligated to date.
Administration
Within the appropriation for SSI, the Committee recommends
$5,095,635,000, which is $66,208,000 above the fiscal year 2017
enacted level and $35,109,000 above the fiscal year 2018 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 $10,538,945,000 for the Limitation
on Administrative Expenses (LAE) account to be funded from the
Social Security and Medicare trust funds, which is the same as
the fiscal year 2017 enacted level and $64,055,000 below the
fiscal year 2018 budget request. The LAE funds support SSA
operational costs to administer the Old Age and Survivors
Insurance (OASI), Disability Insurance (DI), and Supplemental
Security Income programs, and to support the Centers for
Medicare and Medicaid Services in administering their programs.
Pilot Program Metrics.--Pilot programs are valuable
opportunities to evaluate the effects of programmatic changes,
but require a well thought out design that includes appropriate
measures to evaluate the pilot's effectiveness. For instance,
the Social Security Advisory Board found, despite beginning the
Single Decision Maker pilot in 1999, the Social Security
Administration (SSA) is unable to determine if it was effective
due to a lack of quality data. The Committee is concerned with
the SSA's consistent struggle to capture useful metrics to
evaluate the performance of its pilot programs and expects
that, prior to undertaking any new pilots, the SSA will ensure
that it has developed a research design that includes adequate
metrics to determine the pilot's effectiveness. For any new
pilot launched in the prior fiscal year, or proposed in the
current or budget year, the Committee directs the SSA to
include in the fiscal year 2019 Congressional Justification a
description of the pilot and what measures SSA will use to
determine its effectiveness.
Information Technology.--The Committee continues to request
the plan referenced under this heading in House Report 114-699.
Reducing Social Security Number Use.--Social Security
numbers (SSNs) are valuable targets for identity theft because
of their regular use by both the Federal government and the
private sector as a unique identifier. Despite this, the Social
Security Administration (SSA) still mails full SSNs on
approximately 233 million notices or forms of correspondence
each year. While the SSA has committed to removing SSNs from
its mailings whenever possible, it has not provided a timeframe
to do so. The Committee appreciates the SSA's stated commitment
to reducing the use of SSNs on mailed documents and requires
additional information to monitor progress. The Committee
directs the SSA to provide a report within 60 days of enactment
of this Act to the House of Representatives Committee on
Appropriations Subcommittee on Labor, Health and Human
Services, and Education, and Related Agencies and to the
Committee on Ways and Means Subcommittee on Social Security,
that includes the title and identification number of each
document used by the SSA containing a full SSN, the most recent
date this document was updated, and either a justification for
why the use of a full SSN is necessary for inclusion on that
document or the projected date on which the full SSN will be
removed from the document.
Report on Medical Listings.--SSA employs medical listings
to make disability determinations, many of which have not been
updated. The Committee continues direction for 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 for all medical listings.
Report on LAE Expenditures.--The Committee continues to
request the report referenced under this heading in House
Report 114-699 as part of the fiscal year 2019 Congressional
Justification.
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 2017 enacted level
and the fiscal year 2018 budget request.
The Committee requests the Social Security Advisory Board
include additional information regarding the work of the Social
Security Advisory Board in developing recommendations to
improve SSA's quality of service to the public in the fiscal
year 2019 Congressional Justification. The Committee does not
include bill language providing the Social Security Advisory
Board reception and representation authority.
User Fees
In addition to the other amounts provided, the Committee
recommends $119,000,000 for administrative activities funded
from user fees. Of this amount, $118,000,000 is derived from
fees collected from States that request SSA to administer State
SSI supplementary payments.
Continuing Disability Reviews and Redeterminations
The Committee recommends $1,735,000,000 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 $75,500,000 from the OASI and DI trust funds. This
funding level is the same as the fiscal year 2017 enacted level
and the fiscal year 2018 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 a provision relating to
performance partnership pilots.
Sec. 526. 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. 527. 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.
Sec. 528. The Committee includes a new provision
prohibiting use of funds for research on fetal tissue obtained
from an induced abortion.
Sec. 529. The Committee includes a new provision
restricting funding to certain health care entities.
(RESCISSION)
Sec. 530. The Committee rescinds $560,000,000 from the
nonrecurring expenses fund.
(RESCISSION)
Sec. 531. The Committee rescinds $15,000,000 provided under
section 3403 [Independent Payment Advisory Board] of Public Law
111-148.
Sec. 532. The Committee modifies a provision relating to
the Child Enrollment Contingency Fund.
(RESCISSION)
Sec. 533. The Committee rescinds $323,000,000 in unused
funds provided under section 1101(g) [Pre-Existing Condition
Insurance Program] of Public Law 111-148.
(RESCISSION)
Sec. 534. The Committee rescinds $88,613,000 in unused
funds provided under section 2105(a)(3) [Children's Health
Insurance Program Performance Bonus Payment] of the Social
Security Act.
(RESCISSION)
Sec. 535. The Committee rescinds $3,945,905,000 in unused
funds provided under section 301(b)(3) [Children's Health
Insurance Program allotments] of Public Law 114-10.
Sec. 536. The Committee includes a new provision relating
to conscience protection with respect to health care entities
that refuse to participate in abortions.
Sec. 537. The Committee includes a new provision relating
to minimum wage on Federal lands.
SPENDING REDUCTION ACCOUNT
Sec. 538. 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....................... 560,000,000
Independent Payment Advisory Board............... 15,000,000
Preexisting Condition Insurance Program.......... 323,000,000
Children's Health Insurance Program.............. 3,945,905,000
Performance Bonus Payments....................... 88,046,000
Department of Education
Pell Grants...................................... 3,270,844,000
------------------------------------------------------------------------
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
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,
Salaries 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 that authorizes the
transfer of funds from the ``Employment and Training
Administration'' for technical assistance services to grantees
to ``Program Administration.''
A general provision is included that provides for the
transfer of up to 0.75 percent of funds from each appropriation
to carry out evaluations of any of the programs or activities
from ``Training and Employment Services'', `` Job Corps'',
``Community Service Employment for Older Americans,'' ``State
Unemployment Insurance and Employment Service Operations'',
``Employee Benefits Security Administration'', ``Office of
Workers' Compensation Programs'', ``Wage and Hour Division'',
``Office of Federal Contract Compliance Programs'', ``Office of
Labor-Management Standards'', ``Occupational Safety and Health
Administration'', ``Mine Safety and Health Administration'',
Office of Disability Employment Policy, ``Bureau of
International Affairs'' and Women's Bureau'' within the
Departmental Management, Salaries and Expenses'' account, and
``Veterans Employment and Training'' for use by the Office of
the Chief Evaluation Officer.
TITLE II
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 carryout section 311 of the
Older Americans Act of 1965.
Language is included under ``Public Health and Social
Services Emergency Fund'' to provide enhanced transfer
authority to this account to address public health emergencies.
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.
TITLE III
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
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
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 italic, existing law in which no change is
proposed is shown in roman):
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, [2017] 2018.
* * * * * * *
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.
(2)
(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 [2017] 2018, 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.
* * * * * * *
----------
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS
* * * * * * *
Part B--Miscellaneous Provisions
* * * * * * *
SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINATION AGAINST PROVIDERS OF
HEALTH SERVICES THAT ARE NOT INVOLVED IN ABORTION.
(a) In General.--Notwithstanding any other law, the Federal
Government, and any State or local government that receives
Federal financial assistance, may not penalize, retaliate
against, or otherwise discriminate against a health care
provider on the basis that the provider does not--
(1) perform, refer for, pay for, or otherwise
participate in abortion;
(2) provide or sponsor abortion coverage; or
(3) facilitate or make arrangements for any of the
activities specified in this subsection.
(b) Rule of Construction.--Nothing in this section shall be
construed--
(1) to prevent any health care provider from
voluntarily electing to participate in abortions or
abortion referrals;
(2) to prevent any health care provider from
voluntarily electing to provide or sponsor abortion
coverage or health benefits coverage that includes
abortion;
(3) to prevent an accrediting agency, the Federal
Government, or a State or local government from
establishing standards of medical competency applicable
only to those who have knowingly, voluntarily, and
specifically elected to perform abortions, or from
enforcing contractual obligations applicable only to
those who, as part of such contract, knowingly,
voluntarily, and specifically elect to provide
abortions;
(4) to affect, or be affected by, section 1867 of the
Social Security Act (42 U.S.C. 1395dd, commonly
referred to as the ``Emergency Medical Treatment and
Active Labor Act''); or
(5) to supersede any law enacted by any State for the
purpose of regulating insurance, except as specified in
subsection (a).
(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 245 of this 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.
(d) Definitions.--For purposes of this section:
(1) Federal financial assistance.--The term ``Federal
financial assistance'' means Federal 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) Health care provider.--The term ``health care
provider'' means--
(A) an individual physician, nurse, or other
health care professional;
(B) a hospital, health system, or other
health care facility or organization (including
a party to a proposed merger or other
collaborative arrangement relating to health
services, and an entity resulting therefrom);
(C) a provider-sponsored organization, an
accountable care organization, or a health
maintenance organization;
(D) a social services provider that provides
or authorizes referrals for health care
services;
(E) a program of training in the health
professions or an applicant to or participant
in such a program;
(F) an issuer of health insurance coverage;
or
(G) a group health plan or student health
plan, or a sponsor or administrator thereof.
(3) State or local government that receives federal
financial assistance.--The term ``State or local
government that receives Federal financial assistance''
includes every agency and other governmental unit and
subdivision of a State or local government, if such
State or local government, or any agency or
governmental unit or subdivision thereof, receives
Federal financial assistance.
SEC. 245B. 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.--For purposes of this section:
(1) Qualified party.--The term ``qualified party''
means--
(A) the Attorney General of the United
States; or
(B) any person or entity adversely affected
by the designated violation.
(2) Designated violation.--The term ``designated
violation'' means an actual or threatened violation
of--
(A) section 245 or 245A of this Act; or
(B) any of subsections (b) through (e) of
section 401 of the Health Programs Extension
Act of 1973 regarding an objection to abortion.
(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, and any agency or
other governmental unit or subdivision of a State or of
such a local government.
(e) Nature of Relief.--In an action under this section, 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 technical assistance projects
may provide assistance to new entrants in the workforce and
incumbent workers.
Language is included under ``Employment and Training
Administration'' providing that the Secretary of Labor may
reserve not more than 10 of funds to provide technical
assistance activities related to the transition to WIOA.
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, 2019.
Language is included under ``Job Corps'' providing that no
funds from any other appropriation may be used for meal
services at Job Corps.
Language in 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 the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the Unemployment Insurance Integrity Center of Excellence.
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, 2019, 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 balances of reimbursements unobligated on September 30,
2017 shall remain available until expended.
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 certain amounts made
available to the Women's Bureau shall 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 the HIRE Vets Medallion Award Fund
shall be available to the Secretary for expenses of the HIRE
Vets Medallion Award Program.
Language is included under ``Veterans Employment and
Training'' providing that funds made available to assist
homeless veterans may be awarded through September 30, 2018.
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''
authorizing the transfer of up to one percent of discretionary
funds between programs, projects, or activities as long as the
transfer does not increase any program, project, or activity by
more than three percent and no new program, project, or
activity is created by such transfer.
Language is included under ``General Provisions''
prohibiting the use funds for procurement of goods or services
rendered by forced or indentured child labor.
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 and that the Department may transfer
certain amounts to Program Administration to conduct program
integrity activities.
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'' regarding
the application of certain Fair Labor Standards Act
requirements pertaining to the evaluation of claims following a
major disaster.
Language is included under ``General Provisions''
rescinding advance appropriations for the Dislocated Workers
National Reserve.
Language is included under ``General Provisions'' providing
flexibility of crossing for H-2B nonimmigrant workers in the
seafood industry.
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''
prohibiting the use of any funds to enforce certain
administrative requirements under the H-2B nonimmigrant workers
program.
Language is included under ``General Provisions'' providing
that the regulation regarding the definition of the term
fiduciary has no effect.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Language is included under ``Health Resources and Services
Administration--Health Workforce'' overriding the proportional
funding requirements in the Public Health Service Act for
sections 736, 747, 751, and 762.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing that fees
collected for the disclosure of information under the
information reporting requirement program authorized by section
1921 of the Social Security Act shall be sufficient to recover
the full costs of the operation program and shall remain
available until expended to carry out that Act.
Language is included under ``Center for Disease Control and
Prevention--Public Health Preparedness and Response''
permitting CDC to operate and maintain an aircraft.
Language is included under ``Center for Disease Control and
Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Center for Disease Control and
Prevention--Buildings and Facilities'' providing 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 ``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 ``Substance Abuse and Mental
Health Services Administration Substance Abuse Treatment''
exempting the Substance Abuse Prevention and Treatment Block
Grant from the evaluation set-aside in section 241 of the
Public Health Service Act.
Language is included under ``Centers for Medicare and
Medicaid Services--Program Management'' prohibiting the
collection of fees from qualified health plans offered through
an Exchange established under Public Law 111-148.
Language is included under ``Centers for Medicare and
Medicaid Services--Health Care Fraud and Abuse Control
Account'' providing funds to support the cost of the Senior
Medicare Patrol program.
Language is included under ``Administration for Children
and Families Refugee and Entrant Assistance'' permitting a 10
percent transfer.
Language is included under Administration for Community
Living establishing an assistive technology alternative
financing program.
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.
Language is included under ``Public Health and Social
Services Emergency Fund'' to provide enhanced transfer
authority to this account to address public health emergencies.
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 PHS 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 continues the Biomedical Advanced Research and
Development Authority ten year contract authority.
Section 219 requires HHS to provide details on its public
website related to how the Prevention and Public Health Funds
are used.
Section 220 requires HHS to include certain information
concerning the number of full-time federal employees and
contractors working on the ACA in the fiscal year 2019 budget
request.
Section 221 includes specific report requirements for CMS's
marketplaces activities in the fiscal year 2019 budget request.
Section 222 continues certain Congressional notification
requirements.
Section 223 prohibits CMS Program Account from being used
to support risk corridor payments.
Section 224 requires HHS to submit an analysis of the
impact of section 2713 of the PHS Act on discretionary
programs.
Section 225 directs the spending of the Prevention and
Public Health fund.
Section 226 prohibits funds from being used for Title X
family planning activities.
Section 227 continues a provision relating to breast cancer
screening.
Section 228 requires the NIH to continue to use existing
indirect cost negotiated rates.
Section 229 prevents funding of the Navigator program.
TITLE III--DEPARTMENT OF EDUCATION
Language is included under ``General Provisions'' allowing
ESEA funds consolidated for evaluation purposes to be available
from July 1, 2018 through September 30, 2019.
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.
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 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 certain 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 appropriations 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 directs certain reporting requirements for
conference expenditures.
Section 524 requires disclosure of U.S. taxpayer funding
for programs used in advertising.
Section 525 authorizes performance partnership pilots.
Section 526 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 527 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 528 prohibits funds for research on fetal tissue
obtained from an induced abortion.
Section 529 restricts funding to certain health care
entities.
Section 532 delays obligations in the Child Enrollment
Contingency Fund.
Section 537 prohibits application of certain minimum wage
requirements on Federal lands.
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:
----------------------------------------------------------------------------------------------------------------
Appropriations
Last Year of in Last Year Appropriations
Agency Program Authorization Authorization Level of in this Bill
Authorization
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA:
Reintegration of Ex-Offenders FY 2010.............. $20,000,000.......... $15,000,000 $82,078,000
(transition activities
authorized by Second Chance
Act, 2007).
VETERANS' EMPLOYMENT AND TRAINING
SERVICE:
Homeless Veterans Program..... FY 2015.............. 50,000,000........... 38,109,000 47,537,000
DEPARTMENT OF HEALTH AND HUMAN
SERVICES:
HRSA:
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 36,673,000
Programs.
Area Health Education FY 2014.............. 125,000,000.......... 30,250,000 30,250,000
Centers.
Education & Training--
Geriatrics.
(Workforce FY 2014.............. 10,800,000........... 33,237,000 34,737,000
Development).
(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
Development.
(Nurse Education, FY 2014.............. Such Sums............ 37,913,000 128,067,000
Practice, Retention,
and Quality Grants).
(Nurse Faculty Loan FY 2014.............. Such Sums............ 24,500,000 ..............
Program).
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.......... 205,544,000 201,079,000
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 FY 2013.............. 25,000,000........... 25,000,000 25,000,000
National Significance--
Part F.
Education and Training FY 2013.............. 42,178,000........... 33,275,000 33,611,000
Centers--Part F.
Dental Reimbursement--Part FY 2013.............. 15,802,000........... 12,991,000 13,122,000
F.
Organ Transplantation..... FY 1993.............. Such Sums............ 2,767,000 23,549,000
Rural Health Outreach FY 2012.............. 45,000,000........... 55,553,000 65,500,000
Grants.
Rural Hospital Flexibility FY 2012.............. Such Sums............ 41,040,000 43,609,000
Grants.
State Offices of Rural FY 2002.............. Such Sums............ 4,000,000 10,000,000
Health.
Telehealth................ FY 2006.............. Such Sums............ 6,814,000 18,500,000
CDC:
Sexually Transmitted FY 1998.............. Such Sums............ 113,671,000 152,310,000
Diseases Grants.
National Cancer Registries FY 2003.............. Such Sums............ N/A 49,440,000
National Center for Health FY 2003.............. Such Sums............ 125,899,000 155,397,000
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............ 138,237,000 286,059,000
Control.
Oral Health Promotion..... FY 2005.............. Such Sums............ 11,204,000 18,500,000
Safe Motherhood/Infant FY 2005.............. Such Sums............ 44,738,000 44,000,000
Health Promotion.
Birth Defects, FY 2007.............. Such Sums............ 122,242,000 137,560,000
Developmental Disability,
Disability and Health.
Developmental Disabilities FY 2011.............. 21,000,000........... 21,380,000 23,100,000
Surveillance and Research
Program (Autism).
Breast and Cervical Cancer FY 2012.............. 275,000,000.......... 204,779,000 210,000,000
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............ 610,847,000 556,792,000
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.
SAMHSA:
Treatment Systems for FY 2003.............. 50,000,000........... 16,700,000 36,386,000
Homeless Individuals.
AHRQ:
Research on Health Costs, FY 2005.............. Such Sums............ 324,000,000 300,000,000
Quality, and Outcomes.
ACF:
Low Income Home Energy FY 2007.............. 5,100,000,000........ 2,161,170,000 3,390,304,000
Assistance Program.
Children and Families
Services Programs
Adoption Awareness FY 2005.............. Such Sums............ 12,453,000 39,100,000
Programs.
Adoption and Legal FY 2016.............. Such Sums............ 37,943,000 37,943,000
Guardianship
Incentive Payments.
Native American FY 2002.............. Such Sums............ 45,826,000 52,050,000
Programs.
Community Services FY 2003.............. Such Sums............ 645,762,000 600,000,000
Block Grant.
Head Start............ FY 2012.............. Such Sums............ 7,968,544,000 9,275,000,000
Runaway and Homeless FY 2013.............. Such Sums............ 107,852,000 119,121,000
Youth Programs.
CAPTA programs........ FY 2015.............. Such Sums............ 143,981,000 137,174,000
Family Violence FY 2015.............. 178,500,000.......... 139,500,000 159,750,000
Programs.
Disaster Human N/A.................. N/A.................. N/A 1,864,000
Services Case
Management.
Refugee and Entrant Assistance
Transitional and Medical FY 2002.............. Such Sums............ 227,243,000 320,000,000
Services.
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 19,500,000
Demonstration.
Lifespan Respite Care..... FY 2011.............. 94,810,000........... 2,495,000 3,360,000
Developmental Disabilities FY 2007.............. Such Sums............ 155,115,000 162,916,000
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 11,874,000
Protective Services.
Assistive Technology...... FY 2010.............. Such Sums............ 25,000,000 34,000,000
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............ 617,175,000 459,903,000
Sciences.
RELATED AGENCIES:
Corporation for Public FY 1996.............. 425,000,000.......... 275,000,000 445,000,000
Broadcasting.
Institute of Museum and FY 2009.............. Such Sums............ 274,840,000 231,000,000
Library Services.
National Council on Disability FY 2003.............. Such Sums............ 3,144,000 3,200,000
----------------------------------------------------------------------------------------------------------------
PROGRAM DUPLICATION
Pursuant to section 3(j)(2) of H. Res. 5 (115th 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............................................... $157,938 $170,231 $157,938 \1\$168,476
Mandatory................................................... 778,472 778,222 778,472 \1\778,222
----------------------------------------------------------------------------------------------------------------
\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:
2018....................................... \1\$847,411
2019....................................... 71,432
2020....................................... 18,776
2021....................................... 2,909
2022 and future years...................... 628
------------------------------------------------------------------------
\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........................... $428,675
Fiscal year 2018 outlays resulting therefrom... \1\425,239
------------------------------------------------------------------------
\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
Frelinghuysen and Chairman Cole to hold a full committee markup
of the Labor-HHS-Education bill for the third consecutive year.
This bill, which includes some of the nation's most important
domestic programs, needs to be debated by the committee in
public every year.
We are disappointed, however, that Republicans introduced
and approved a bill that would cut labor, health, and education
programs by $5 billion compared to the fiscal year 2017 enacted
level. We are concerned that such a severe cut would harm
students, seniors, women, families, and workers. To make
matters worse, the Labor-HHS-Education bill's allocation is
already $30 billion below the fiscal year 2010 level, after
adjusting for inflation.
The biggest economic challenge of our time is that too many
people are in jobs that do not pay them a living wage. Too
often, workers lack the skills and experience to access better
jobs and earn family-sustaining wages.
It used to be that workers with high school degrees were
able to secure good paying jobs, in manufacturing and
elsewhere, that allowed them and their families to prosper. But
those jobs, and the high wages that used to go with them, have
been in decline over the past 40years.
We need to enact policies that ensure everyone can benefit
from a growing economy, and that everyone has the skills and
training to get a good job with high wages. We need a country
that works for the middle class and the vulnerable, not just
the wealthy and those with the most lobbyists.
That's why the Labor-HHS-Education bill is so important.
The programs in this bill provide opportunities for hardworking
Americans to improve their economic security and for our
economy to grow. This committee must commit to investing in
education and job training to fulfill this country's potential.
We must put at the center of our effort the 70 percent of
Americans for whom a four-year college degree is not their
preferred pathway. We must recognize and support their
aspirations for their families and communities.
If people are to achieve better lives for their families,
we must build a pipeline of skilled workers. That means we need
to have a public workforce development system that adapts to
businesses' changing needs. In many cases, work-based learning
and apprenticeship programs are the best options to equip
workers with the skills to get a good job with high wages.
The federal government has a rich history of helping
Americans learn and grow through workforce development and
connecting businesses with a skilled workforce, and we need to
reinvest in that system. We will describe below how this
Republican Labor-HHS-Education bill is a repudiation of the
American tradition of the federal government improving schools,
making college more affordable, training workers for better
paying jobs, and providing health services for women.
Of course, there are a few bright spots in this bill. We
strongly support increases for NIH research, emergency
preparedness, Special Education, and TRIO and GEAR UP. But even
those increases show the fundamental insufficiency of the
subcommittee's allocation: the NIH increase is about half the
size of the increase for each of the past two years, and
Special Education funding continues to fall short. When
adjusting for inflation, the increase for Special Education
State Grants is an effective cut, taking us further away from
living up to our commitment to fully fund IDEA.
Overall, the modest increases in this bill are far
outweighed by harmful cuts to programs that ought to be
increased.
LABOR-HHS-EDUCATION CUTS
[Dollars in millions]
------------------------------------------------------------------------
FY 2018 House comp
FY 2017 FY 2018 to FY 2017 Enacted
Enacted House ---------------------
dollar percent
------------------------------------------------------------------------
Elementary & Secondary 23,822 21,337 -2,485 -10%
Education..................
Pell Grants (discretionary). 22,475 22,475 0 0%
Pell Grant Rescission -1,310 -3,271 -1,961 150%
(non-add)..............
Health Service and Resources 6,206 5,824 -382 -6%
Admin......................
Centers for Disease Control/ 7,165 7,001 -163 -2%
Prevention.................
Substance Abuse and Mental 3,765 3,459 -306 -8%
Health.....................
Agency for Healthcare 324 300 -24 -7%
Research/Quality...........
CMS Program Management...... 3,975 3,451 -524 -13%
Administration for Children 19,275 18,514 -761 -4%
and Families...............
Administration for Community 1,994 1,937 -57 -3%
Living.....................
HHS GDM and other HHS 812 620 -192 -24%
agencies...................
Job Training (including Job 5,202 4,887 -314 -6%
Corps).....................
Senior Community Service 400 300 -100 -25%
Employment.................
UI & Employment Service 3,524 2,831 -693 -20%
Operations.................
Worker Protection Agencies.. 1,595 1,537 -59 -4%
International Labor Affairs. 86 27 -60 -69%
------------------------------------------------------------------------
EDUCATION--A KEY TO THE MIDDLE CLASS
The Department of Education is cut by $2.2 billion below
the fiscal year 2017 enacted level, before accounting for the
rescission of $3.3 billion from the Pell Grant program.
We are deeply disappointed that the bill fails to make
additional investments in Title I, which reaches 25 million
students in more than 80 percent of our school districts, and
imposes harmful cuts to the 21st Century Community Learning
Centers program, which would deny 192,000 kids enrichment
opportunities in before- and after-school and summer school
programs. To restore these harmful cuts, we offered an
amendment to return the program's funding to the fiscal year
2017 level. Unfortunately, it was defeated.
Despite the mountain of evidence that early childhood
interventions work to reduce inequality and narrow achievement
gaps, the bill provides level funding for Preschool Development
Grants and nominal increases for Head Start and Child Care,
meaning we will continue to fall behind in providing children
and families with high-quality early education opportunities
and care.
We proposed amendments to boost funding for these programs
as well as the Child Care Access Means Parents in School
program to help meet the needs of students with kids.
Unfortunately, the amendments were defeated.
This bill is fundamentally anti-teacher. It eliminates the
Supporting Effective Instruction grants, which reduce class
sizes and give teachers evidence-based professional
development. Approximately 8,000 teachers across the country
would lose their jobs. States represented by Members of this
committee would lose a total of $1.7 billion if the majority's
proposal was enacted.
We proposed an amendment to restore funding for this
program and a number of other teacher programs proposed to be
cut or eliminated in the bill because we know that strong
leaders are the most important school-based factor in our kids'
academic success. While we attracted one member from across the
aisle to join us, the amendment was ultimately defeated.
The bill eliminates nearly a dozen education programs,
including the largest reading program for low-income children
and youth, Special Olympics, and funding to expand access to
the arts in our most under-resourced communities.It imposes
harmful cuts to proven education programs like Promise
Neighborhoods. Cutting funding for the Special Olympics will
not make a difference in reducing the Federal debt, but it will
rob a segment of our population a chance at an enriching
experience.
We proposed amendments to reverse damaging cuts to these
and other programs, in order to provide our children with tools
for success. Unfortunately, while we had one member of the
majority join us, all other Republicans opposed this amendment
to restore funds.
The bill threatens the very future of the Pell Grant
program by slashing $3.3 billion and doing nothing to make
college more affordable. It sets Pell on a dangerous path at a
time when 44 million student borrowers have more than $1.3
trillion in student debt.
We tried to improve the bill by offering an amendment to
increase the maximum Pell Grant award by $135 to keep up with
inflation. Our Republican colleagues rejected our effort to
help make college more affordable by voting against the
amendment.
In addition, we offered an amendment to require the
Secretary of Education to implement the Borrower Defense to
Repayment regulation to safeguard students and taxpayer dollars
from unscrupulous institutions that commit fraud and mislead
students. The majority opposed, and the amendment failed. We
also offered an amendment affirming that all students deserve
to learn in an environment free from sexual violence. With the
support of only one member from across the aisle, the amendment
was defeated.
HEALTH SERVICES
Setting aside the much-needed increase for research at the
National Institutes of Health, the rest of the Department of
Health and Human Services would be cut by more than $2 billion
under this bill.
The bill cuts access to Mental Health and Substance Abuse
Prevention services by more than $300 million below the fiscal
year 2017 level, which is particularly distressing due to the
ongoing opioid crisis. We speak often about the opioid crisis,
but when the opportunity arises to take strong action, we fail
to fund these priorities in a meaningful way.
Democrats proposed amendments to restore funding for mental
health and substance abuse prevention, in addition to nurse
training, tobacco prevention, immunizations, research in health
care settings, and a slate of programs that disproportionately
serve minority communities. We also proposed an amendment to
provide $5 billion in emergency funding to the Public Health
Emergency Fund.
Unfortunately, all of our efforts to improve health care
services, train a health workforce, and fund a rapid emergency
response were rejected.
SENIORS
The bill cuts and eliminates programs designed to protect
one of our most vulnerable populations: seniors. The State
Health Insurance Assistance Program provides seniors with help
in navigating the complex Medicare program; the Senior
Community Service Employment Program provides unemployed low-
income older adults with paid work experiences; and Elder
Rights Support Activities helps protect our elderly through the
prevention and detection of abuse.
We proposed an amendment to restore the harmful cuts
proposed to these critical programs, but it was rejected.
WOMEN'S HEALTH SERVICES
This bill's approach to women's health pushes a dangerous
and harmful ideological agenda. It eliminates funding for Title
X Family Planning and the Teen Pregnancy Prevention program--a
combined cut of about $400 million to reproductive health
services for women--and includes new ideological riders that
would block funding for Planned Parenthood and effectively
block life-saving research using cells from fetal tissue.
We proposed amendments to restore funding for Title X
Family Planning and the Teen Pregnancy Prevention program. In
addition, we offered amendments to strike several ideological
riders that would be harmful to women's health, including the
riders that would block funding for Planned Parenthood and
fetal tissue research. To our disappointment, the majority
rejected restoring funds for reproductive health and retained
each of the ideological riders that do not belong in this bill.
THE UNEMPLOYED
The largest proportional department-level cut in the bill
is the Department of Labor by $1.2 billion, or 10.1 percent,
below the fiscal year 2017 level, before accounting for the
rescission of $200 million from the Dislocated Worker National
Reserve. That is baffling given the President's campaign
promises to American workers.
This bill hurts workers by eliminating the Employment
Service, which helped nearly six million unemployed workers,
including veterans, find jobs in 2015. This funding goes to our
One-Stops to help people looking for jobs get relevant skills.
Cutting this funding is a betrayal of job seekers in our
economy.
The bill also eliminates grants expanding the highly-
effective Registered Apprenticeship model that connects job
seekers with good paying jobs employers are desperate to fill.
The bill includes cuts to programs that make our country more
competitive, like Job Corps, slashes job training for
dislocated workers, and eliminates a tool that helps us
evaluate if workforce and education programs are effective. Why
would we eliminate programs that have for so long been about
economic opportunity and a ladder to the middle class?
We proposed amendments to restore funding for job training
programs and apprenticeships, as well as Job Corps and the
Employment Service. We also fought to restore funding to
crucial enforcement agencies and the Bureau of International
Labor Affairs. Once again, the majority opposed our efforts and
the amendments failed.
PARTISAN POLICY RIDERS
In addition to riders that would limit a woman's access to
health care, this bill also attempts to block all funding for
the Affordable Care Act. It continues to prohibit funding for
gun violence prevention, which has had a chilling effect on gun
violence research. And it prohibits the Department of Labor
from ensuring that financial advisers act in the best interests
of their clients.
We proposed amendments to eliminate each of these
ideological riders; unfortunately, the majority rejected each
amendment.
CONCLUSION
This bill stands in stark contrast to the bipartisan Labor-
HHS-Education bill included in the fiscal year 2017 Omnibus.
The funding in this bill fails to meet our country's needs and
breaks our promises to students, seniors, women, families and
our workforce. It does not reflect our values of putting the
middle class and the vulnerable first; instead, it benefits
those with the most money and the most lobbyists.
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 Frelinghuysen and Chairman Cole to
move forward on a bill we can all support.
Nita M. Lowey.
Rosa DeLauro.